Using the housing first model (HFM) fidelity index to evaluate the current supportive housing system in Indiana

The Housing First Model (HFM) was designed as an alternative to traditional abstinence-based housing for individuals experiencing chronic homelessness. The model is now considered to be the preferred approach to ending homelessness due to the results of previous studies that have demonstrated its efficacy related to a number of health and social outcomes. However, there is concern that many Housing First programs have not implemented the model correctly due to a lack of replication guidelines during its initial dissemination. Demonstrating correct implementation of the model is becoming even more important, as the U.S. Department of Housing and Urban Development is beginning to consider Housing First practice in its funding decisions. The HFM Fidelity Index was developed to measure the extent of implementation of the model for research and evaluation purposes. The index uses a structured phone interview approach to gather information from program staff, which is used to determine the extent of implementation of elements determined to be critical to Housing First practice. Previous testing of the instrument among a random sample of federally funded permanent supportive housing programs demonstrated its reliability and validity. In January of 2014, evaluators in Indiana partnered with the local homeless Continuum of Care to utilize the instrument for the purpose of assessing the extent of Housing First practices within the state. Seventeen programs out of 39 responded to the invitation to participate in the evaluation and completed interviews. In this presentation, we will discuss the use of the phone fidelity approach for evaluation (rather than research) purposes. Initial results from these interviews bring to light concerns about the "phone fidelity" approach and indicate that further testing of the instrument for evaluation purposes is necessary.