Permanent supportive housing for those with severe and persistent disabilities: A comparison of three program types

Background: The goal of permanent supportive housing (PSH) is to house the most severely disabled. However, there are scant evidence-based PSH programs. In Ohio, three models are provided with varying levels of individual and on-site assistance. The purpose of this study is twofold: understand the demographic profile of clients by program type and determine which program has the most successful outcomes.

Methods: The sample included 460 clients in 20 scattered site PSH in Cincinnati, Ohio in 2006. Persons were followed annually until 2009 using HMIS data. The mean age was 41.7(SD 10.5) years, 62.2% were male, and 72.7% were Black. Multinomial logistic regression models were used to examine differences between three PSH subsidy programs (long-term, on-site shelter plus care (SPC); shorter-term PSH; and other non-HUD/CoC funded).

Results: Forty-two percent were in the long-term SPC program and 34% in the short-term program. Persons in SPC had more mental health problems, lived in an emergency shelter or place not habitable before entering, and reported substance abuse issues compared to the other programs(p<.05). SPC clients were more likely (OR=2.8p=.008) to remain in the program as compared to those in the other non-HUD/CoC funded PSH. Those who left SPC were less likely (OR=.294;p=.001) to leave under favorable circumstances (e.g. complete program).

Implications: The long-term SPC subsidy appears to capture clients most in need while being able to maintain enrollment. Housing advocates seeking to end homelessness should consider reducing the emphasis on short-term, less structured PSH subsidies that may not promote a resolution of homelessness.