Research

2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001 | 1998

In addition to grant programs relevant to homelessness, the Department of Health and Human Services also works to advance research in this field. The Department funds the development of a range of research projects to aid providers and policymakers in better understanding and addressing the issues facing people experiencing homelessness.

2016

  • Final Report – Street Outreach Program Data Collection Study
    This first-of-its-kind study focused on 873 youth ages 14 to 21 in 11 cities. Respondents included street youth receiving services from ACF’s Street Outreach Program grantees and street youth who were not currently using services from SOP grantees. Study findings include that: nearly half of respondents became homeless for the first time because they were asked to leave home by a parent or caregiver; more than half have tried to stay at a shelter but found it full; the average youth had spent nearly two years living on the street; and nearly 30 percent identified as lesbian, gay, or bisexual, and nearly 7 percent identified as transgender.

  • Are Homeless Families Connected to the Social Safety Net?
    This analysis of HUD's Family Options Study data shows that families in a shelter and 20 months later are generally connected to public benefits at similar rates to other families in deep poverty. This non-experimental analysis finds that homeless families receive TANF, publicly funded health insurance (including Medicaid, CHIP, and state-funded insurance), and SNAP at equal or greater rates than other families in their communities who are also living in deep poverty.

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2015

  • State Strategies for Coordinating Medicaid Services and Housing for Adults with Behavioral Health Conditions
    This Issue Brief describes the strategies used by four states--Louisiana, Massachusetts, Tennessee, and Illinois--to improve the link between Medicaid and housing services for adult Medicaid beneficiaries with behavioral health conditions. This brief does not assess the success of these strategies, but instead focuses on the mechanisms the states are using to improve care coordination for individuals with both behavioral health and housing needs. Federal and state policymakers and other stakeholders can use this information in developing their own initiatives.

  • Improving the Coordination of Services for Adults with Mental Health and Substance Use Disorders: Profiles for Four State Medicaid Initiatives
    In 2013, ASPE contracted with Mathematica Policy Research to conduct case studies of the financing arrangements and delivery models that states are using to improve the coordination of care for Medicaid beneficiaries with mental health and substance use disorders in four states: Illinois, Louisiana, Massachusetts, and Tennessee. This report profiles and describes the key elements of the strategy used in each state, including the financing mechanisms, state-level and local-level partnerships, use of data and information systems, and efforts to improve coordination with housing. Moreover, the case studies sought to describe the "on-the-ground" operation of the care coordination models from the perspectives of providers, consumers, and other stakeholders. Although these case studies do not evaluate the effectiveness or outcomes of the strategies used in these states, policymakers, managed care organizations, providers, and other stakeholders may wish to consider the components of these strategies in their own efforts to improve care coordination.

  • State Strategies for Improving Provider Collaboration and Care Coordination for Medicaid Beneficiaries with Behavioral Health Conditions
    This Issue Brief highlights the efforts of four states--Illinois, Louisiana, Massachusetts, and Tennessee--to facilitate provider-level coordination for Medicaid beneficiaries with behavioral health disorders. It describes the financing strategies and specific mechanisms that states are using to improve care coordination. It summarizes some of the key ingredients of these efforts as reported by providers, consumers, agency representatives, and managed care companies in the four states. This information may be useful to federal and state policymakers and other stakeholders as they develop their own initiatives.

  • "Homeless Caseload is Associated with Behavioral Health and Case Management Staffing in Health Centers"   [Journal Article authored by an analysts at ASPE and SAMHSA)]
    This paper examines organizational characteristics and staffing patterns in FQHCs with large homeless caseloads.  Regardless of whether each health center received targeted Health Care for the Homeless funding, health centers with high homeless caseloads were more likely to have high behavioral health and enabling services staffing—indicating that health centers tailor their staffing mix to the needs of their patients.  The study also found that rural health centers had lower levels of behavioral health and enabling services staffing, highlighting the need to monitor disparities, link health centers with technical assistance on partnering with community-based behavioral health providers, and emphasize co-locating behavioral health services through grant oversight mechanisms.  

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2014

  • Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices From the Field (Assistant Secretary for Planning and Evaluation)
    This report describes existing practices in the field of communities currently serving homeless and formerly homeless individuals as Medicaid beneficiaries.
  • Building Partnerships to Address Family Homelessness
    Around the country, Head Start and Early Head Start programs are building partnerships in their communities in order to make their services more accessible for children experiencing homelessness. This resource paper highlights the work being done by local Head Start and Early Head Start programs to connect with public housing associations, emergency shelter providers, local education agencies, and other community service providers. It also provides recommendations and resources to facilitate collaborations in other communities.
  • Promising Practices for Children Experiencing Homelessness: A Look at Two States
    This resource paper highlights work to create interventions that are specifically targeted at increasing access to high-quality early care and learning programs for children experiencing homelessness. It provides an overview of the effects of homelessness on young children, reviews federal initiatives that have expanded access to early care and learning for this population, looks at how two states - Massachusetts and Oregon - have implemented innovative policies to improve early childhood outcomes for this group, and presents recommendations for how other states can develop their own interventions.
  • Identifying and Serving LGBTQ Youth: Case Studies of Runaway and Homeless Youth Program Grantees
    To better understand provider experiences serving lesbian, gay, bisexual, transgender and Questioning (LGBTQ) runaway and homeless youth, this study reports on case studies of four local agencies receiving grants from the Administration for Children and Family’s Runaway and Homeless Youth (RHY) Program. The purpose of the study was to learn about programs’ strategies for identifying and serving LGBTQ RHY, the challenges programs face in understanding and addressing the needs of this population, and potential areas for future research.
  • Promoting Protective Factors for In-Risk Families and Youth: A Brief for Researchers  (Administration for Children and Families)
    This report explores the factors that make children and young people more able to cope with the trauma they face. It focuses on five populations that are often victimized the most: infants, children, and adolescents who are victims of child abuse and neglect; runaway and homeless youth; youth in or transitioning out of foster care; children and youth exposed to domestic violence; and pregnant and parenting teens.

  • Housing for Youth Aging Out of Foster Care
    (U.S. Department of Housing and Urban Development, with HHS’ Assistant Secretary for Planning and Evaluation)
    This research project focused on the housing needs of the over 25,000 youth who “age out” of the foster care system each year. It explores and documents the range of housing options available to these youth, includes an in-depth review of communities using the Family Unification Program (FUP) vouchers, identifies opportunities to mitigate the risk of homelessness for youth as they transition from the foster care system, and suggests areas for future research.

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2013

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2012

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2011

  • Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Literature Synthesis and Environmental Scan
    This report reflects existing published and unpublished literature on permanent supportive housing (PSH) for people who are chronically homeless. It has a particular focus on the role that Medicaid currently plays in covering the costs of the supportive services that help people keep their housing and improve their health and quality of life. In addition to written material, this document incorporates the knowledge of housing and service configurations and ways that providers have been able to cover the cost of supportive services, garnered over our many years in the field.
  • Human Services and Housing Supports to Address Family Homelessness: Promising Practices in the Field (Assistant Secretary for Planning and Evaluation)
    This ASPE Research Brief explores local programs for linking human services and housing supports to prevent and end family homelessness. The Research Brief is based on interviews with stakeholders in 14 communities nationwide, highlighting key practices that facilitated the implementation and ongoing sustainability of the programs. The Research Brief was prepared by Abt Associates under contract with the Office of the Assistant Secretary for Planning and Evaluation.

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2010

  • Homeless Children Roundtable, Conference  (Assistant Secretary for Planning and Evaluation)
    The purpose of the Roundtable (May 2010) was to understand the impact of homelessness on children, identify the resources currently available to address the needs of homeless children, and discuss opportunities for coordination. While other meetings have focused on the adults in homeless families, the Roundtable focused specifically on the children in families that are experiencing homelessness. A diverse group of policy experts, researchers, practitioners, and federal agency staff were invited.
    • Homeless Children: Discussion Synthesis  (Assistant Secretary for Planning and Evaluation)
      This document synthesizes the discussion from the Roundtable on Homeless Children. The background paper from this meeting is also available and provides an update on the research, policy, laws, and funding for programs and services for children who are homeless in the United States.
    • Homeless Children: Update on Research, Policy, Programs, and Opportunities (Assistant Secretary for Planning and Evaluation)
      Despite the knowledge that homeless children face poor outcomes, research has largely focused on the parent(s) in a homeless family, perhaps because these children are still part of a family unit. The children themselves, however, have different and separate needs from their parent(s). Given the impact of the current recession, it is critical to understand the impact of homelessness on our youngest population, and to ensure that resources are mobilized to guarantee that these children's needs are met quickly and thoroughly. This paper provides an update on the research, policy, laws, and funding for programs and services for children who are homeless in the United States. Education, health, and mental health for homeless children are examined.
  • Findings from a Study of the SSI/SSDI Outreach, Access, and Recovery (SOAR)  Initiative  (Assistant Secretary for Planning and Evaluation)
    The Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs provide critical income support for those who meet eligibility requirements. The SSI/SSDI Outreach, Access, and Recovery (SOAR) initiative aims to improve access to SSI/SSDI benefits for individuals who are homeless through a multi-pronged strategy designed to mitigate the challenges this population faces when navigating the SSI/SSDI application process. To determine how and the extent to which SOAR is achieving its goals, ASPE conducted an evaluation of SOAR. The goals of the evaluation were to (1) provide a comprehensive description of SOAR processes, (2) examine the outputs and some of the short- and long-term outcomes that may be associated with these processes, (3) assess the factors that appear to be associated with successful implementation of the initiative, and (4) describe ways in which the initiative might be improved at either the state or federal level. This report summarizes the findings from the evaluation.

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2009

  • Homelessness Data in HHS Mainstream Programs (Assistant Secretary for Planning and Evaluation)
    This study explores the extent to which states collect data on housing status and homelessness from applicants for the two largest HHS mainstream programs that may serve individuals or families experiencing homelessness:  Medicaid and Temporary Assistance for Needy Families (TANF). Interviews were conducted with TANF and Medicaid directors in all 50 states and the District of Columbia to learn about state practices related to the collection of housing status and homelessness data from program applicants. The study also includes a review of data-collection practices in nine other HHS mainstream programs. The Assistant Secretary for Planning and Evaluation (ASPE) and the Health Resources and Services Administration (HRSA) jointly funded this project. The study yielded three publications:
  • Study of HHS Programs Serving Human Trafficking Victims
    This project developed information on how HHS programs are currently addressing the needs of victims of human trafficking, including domestic victims (i.e., citizens and legal permanent residents), with a priority focus on domestic youth. The project provides in-depth and timely information to help HHS design and implement effective programs and services that help trafficking victims overcome the trauma and injuries they have suffered, to regain their dignity, and become self-sufficient. Components to the study include a comprehensive review of relevant literature, studies or data (published or unpublished) related to providing services to victims of human trafficking (including domestic victims); nine site visits to geographic areas (e.g., counties) containing at least one HHS- or federally-funded program currently assisting victims of human trafficking; at least three brief reports highlighting interesting, innovative, and/or effective experiences, knowledge, or information resulting from one or more of the site visits; and a final report providing a synthesis of all information obtained under the study.
  • The Mental Health of Vulnerable Youth and their Transition to Adulthood: Examining the Role of the Child Welfare, Juvenile Justice, and Runaway/Homeless Systems
    This project focused on the mental health of vulnerable youth who have been in contact with service systems, including child welfare, juvenile justice, and run-away and homeless programs. Data for this project come from the National Longitudinal Study of Adolescent Health (Add Health). The Add Health is a nationally representative study that was designed to examine the causes of health-related behaviors of adolescents and their outcomes in young adulthood. The analytic sample for this current study was limited to participants who completed an interview at Waves 1 and 3 and who have a valid population weight for these Waves.

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2008

  • Characteristics and Dynamics of Homeless Families with Children (Assistant Secretary for Planning and Evaluation)
    This report investigates the availability of data with which to construct a typology of homeless families with the goal of identifying key knowledge gaps regarding homeless families and to consider whether these gaps may most efficiently be filled through secondary analysis of existing data, adding questions or a module to planned surveys that include low-income populations, or whether additional primary data collection would be needed. Ultimately, it is intended that an improved understanding of the characteristics of homeless families with children will guide the development of appropriate service responses to such families and provide an empirical foundation for the design of homelessness prevention and intervention approaches. The project consisted of three phases: assessing the availability of already existing data that could be mined through secondary data analysis; proposing a set of questions to modify existing and ongoing surveys that would allow for the key research questions related to homeless families to be answered, and conceptualizing various primary data collections that would specifically collect the kind of data required to develop a typology of homeless families.
  • Evaluation of the Collaborative Initiative to Help End Chronic Homelessness (Assistant Secretary for Planning and Evaluation)
    A cornerstone effort of the Administration goal to end chronic homelessness was the development of the Collaborative Initiative to Help End Chronic Homelessness (CICH), an innovative demonstration project coordinated by the U.S. Interagency Council on Homelessness, jointly funded by the Departments of Housing and Urban Development, Health and Human Services (HHS: SAMHSA and HRSA), and Veterans Affairs.
    • Summary of CICH Interim Reports
      The summary reviews the background of the study, the methods, client outcomes, and system outcomes.
    • Preliminary Client Outcomes Report, February 2007 
      This report presents data on screening, enrollment, client characteristics across sites, service use over time, and outcomes during the first 12 months of CICH participation. Data are also presented on a comparison group that received some lesser combination of housing and services than the CICH clients.
    • An Evaluation of an Initiative to Improve Coordination and Service Delivery of Homeless Service Networks, February 2007 
      This report examines the service system of the CICH during the first 24 months of the program including the types of housing and service models that were available for the target population and the nature of the interaction between agencies in the CICH.
    • Is System Integration Associated with Client Outcomes?, June 2007
      This report merges network data reflecting collaboration, trust and use of evidence-based practices at the time clients enrolled in the CICH with 12-month client outcome data to examine the association of interagency relationships at the start of the program and client outcome during the first year of program participation.
  • Computer Retrieval of Information on Scientific Projects  (National Institutes of Health)
    The National Institutes of Health (NIH) supports a wide range of studies involving homeless populations because of associations between homelessness and many adverse health conditions. Research projects funded via an NIH grant are traditionally published in scientific journals. To access a full list of research relevant to homelessness currently being supported by NIH and other Public Health Agencies, follow the link to search Computer Retrieval of Information on Scientific Projects (CRISP). CRISP is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other research institutions. The database, maintained by the Office of Extramural Research at the National Institutes of Health, includes projects funded by the National Institutes of Health, Substance Abuse and Mental Health Services Administration, Health Resources and Services Administration, Food and Drug Administration, Centers for Disease Control and Prevention, Agency for Health Care Research and Quality, and Office of Assistant Secretary of Health.
  • Toward Understanding Homelessness: The 2007 National Symposium on Homelessness Research  (Department of Health and Human Services and Department of Housing and Urban Development)
    The National Symposium on Homelessness Research, co-funded by the Department of Health and Human Services (both Assistant Secretary for Planning and Evaluation and Substance Abuse Mental Health Services Administration) and the Department of Housing and Urban Development in FY 2005, sponsored the development of twelve research papers in an effort to capture the current state of the research related to homelessness. The Symposium event itself, which was held over two days in March of 2007, brought together 200 researchers, policy makers, government officials, service providers, and consumers from across the country to discuss the research papers and directions for future research related to homelessness. This Symposium was a follow-on event to the first National Symposium on Homelessness Research, which took place in 1998 and was also sponsored by Department of Health and Human Services and the Department of Housing and Urban Development. This volume presents the twelve papers developed and presented at the 2007 Symposium.

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2007

  • Promising Strategies to End Youth Homelessness  (Administration for Children and Families)
    Provides an overview of youth homelessness, as well as a set of preventive strategies that show promise in the effort to end homelessness. This report was created by the Administration for Children and Families, in consultation with the U.S. Interagency Council on Homelessness.
  • Strategic Action Plan on Homelessness  (Department of Health and Human Services)
    Report details Departmental strategies to prevent homelessness; ensures the provision of services to eligible individuals and families; empower states and community partners to improve their response to homelessness, and track Departmental progress in reaching these goals.
  • Condensed Version of the Medicaid Primer on How to Use Medicaid to Assist Persons Who are Homeless to Access Medical, Behavioral Health and Support Services (Centers for Medicare and Medicaid Services)
    Primer to help to connect people who are homeless with critical Medicaid benefits

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2006

  • An Evaluation of the Respite Pilot Initiative (Health Resources and Services Administration)
    In May 2000, Health Resources Services Administration (HRSA) funded ten Health Care for the Homeless grantees, for up to five years, to enhance their medical respite services for homeless persons. HRSA also supported a prospective evaluation to document the differing models of respite care delivery being used and assess the effect of those respite services on the health of homeless persons. 
  • The DASIS Report: Homeless Admissions to Substance Abuse Treatment: 2004 (Substance Abuse and Mental Health Services Administration)
    A short report based on the Substance Abuse and Mental Health Services Administration's (SAMHSA) Drug and Alcohol Services Information System, the primary source of national data on substance abuse treatment. According to SAMHSA's Treatment Episode Data Set (TEDS), more than 175,300 admissions to substance abuse treatment in 2004 were homeless at time of admission. The admissions who were homeless comprised 13% of all admissions for which living arrangements were recorded; an increase from 10% TEDS admissions reported to be homeless in 2000.

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2005

  • Evaluability Assessment of Discharge Planning and the Prevention of Homelessness: Final Report  (Assistant Secretary for Planning and Evaluation)
    The purpose of this study was to conduct an evaluability assessment of discharge planning in institutional and custodial settings, with a specific focus on whether discharge planning is a strategy that can prevent homelessness. 
  • Using Medicaid to Support Working Age Adults with Serious Mental Illness in the Community: A Handbook (Assistant Secretary for Planning and Evaluation)
    The purpose of this primer is to describe the Medicaid program in the delivery of services to adults with serious mental illnesses; specifically, the primer explains how existing Medicaid options and waivers are used by states to finance a broad range of community services and supports for adults with serious mental illnesses, and to demonstrate what aspects of state-of-the-art community services and supports for this population are funded by Medicaid.  
  • Stepping Stones to Recovery: A Case Manager's Manual for Assisting Adults Who Are Homeless, with Social Security Disability and Supplemental Security Income Applications (Substance Abuse and Mental Health Services Administration)
    Individuals who are homeless and have mental illnesses often face overwhelming challenges in obtaining disability benefits through the Social Security Administration.  A complex application system, confusion over eligibility criteria, and lack of a fixed address can all create seemingly insurmountable hurdles. This manual was designed to assist case managers and other professionals in obtaining critical services for their clients.

  • The Implementation of Maternity Group Home Programs: Serving Pregnant and Parenting Teens in a Residential Setting
    Given the considerable interest in maternity group homes and the roles they can play in assisting pregnant and parenting teens’ transition to independence, it is important to fill some of the gaps in the existing research. For this reason, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services is interested in learning more about maternity group home programs and in assessing the feasibility of conducting a rigorous evaluation to measure the effectiveness of such programs. To this end, ASPE contracted with Mathematica Policy Research, Inc. to conduct a study of how these programs operate and to explore options for studying them further. This report aims to document the implementation of maternity group home programs.

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2004

  • Improving Medicaid Access for People Experiencing Chronic Homelessness: State Examples (Centers for Medicare & Medicaid Services)
    This technical assistance report is designed to highlight several state initiatives that increase Medicaid access for people who are chronically homeless.
  • The DASIS Report: Characteristics of Homeless Female Admissions to Substance Abuse Treatment: 2002 (Substance Abuse and Mental Health Services Administration)
    A short report based on the Substance Abuse and Mental Health Services Administration’s Drug and Alcohol Services Information System, the primary source of national data on substance abuse treatment. The data in this report is from the Treatment Episode Data Set 2002 Supplemental Data Set on living arrangements of people admitted for substance abuse treatment.

  • Maternity Group Homes Classification and Literature Review
    This document provides an overview of past research and develops a preliminary classification framework for maternity group homes. The report classifies maternity group homes according to population served, degree of structure and supervision provided, and level of support services offered. The report also reviews research related to maternity group homes by categorizing existing studies into four groups: those that describe the characteristics of maternity group homes, but do not report data on outcomes; those that collect some data, but without any context for comparison; those that compare outcomes of different groups or at different points in time; and those that look at implementation of maternity group homes. Included in the review of research are resident characteristics, experiences during residence, outcomes after leaving maternity group homes, limitations of existing studies, and recommendations for future research.

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2003

  • Blueprint for Change: Ending Chronic Homelessness for Persons with Serious Mental Illnesses and Co-Occurring Substance Use Disorders  (Substance Abuse and Mental Health Services Administration)
    This report was developed to disseminate state-of-the-art information about ending homelessness for people who have mental or addictive disorders. The Blueprint offers practical advice for how to plan, organize, and sustain a comprehensive, integrated system of care designed to end homelessness.
  • Achieving the Promise: Transforming Mental Health Care in America  (President's New Freedom Commission on Mental Health)
    In 2002, the President announced the creation of the New Freedom Commission on Mental Health and charged the Commission to study the mental health service delivery system, and to make recommendations that would enable adults with serious mental illnesses and children with serious emotional disturbance to live, work, learn, and participate fully in their communities. Achieving the Promise is the final report of the New Freedom Commission.
  • Adapting Your Practice: Treatment and Recommendations for Homeless Patients with HIV/AIDS Pocket Guidebook  (Health Resources and Services Administration)
    This condensed pocket guidebook on adapting clinical guidelines for homeless clients with HIV/AIDS was a project of the HIV/AIDS Bureau Homelessness and Housing Workgroup in revising the original manual, Adapting Your Practice: Treatment and Recommendations for Homeless Patients with HIV/AIDS (2003), developed by the Health Care for the Homeless Clinicians’ Network. 
  • Adapting Your Practice: Treatment and Recommendations for Homeless Patients with HIV/AIDS (Health Resources and Services Administration)
    A clinical guidebook written by clinicians with extensive experience caring for individuals who are homeless and who routinely adapt their medical practice to foster better outcomes for these patients. 
  • Core Performance Indicators for Homeless-Serving Programs Administered by the U.S. Department of Health and Human Services (Assistant Secretary for Planning and Evaluation)
    This report explores the feasibility of developing a core set of performance measures across four Health and Human Services (HHS) programs that focus on service delivery to homeless persons. The report also explores the extent to which mainstream service-delivery programs supported by HHS, i.e., those not specifically targeted to homelessness, could generate performance measures on the extent to which homeless persons are served and to what effect. 
  • Ending Chronic Homelessness: Strategies for Action  (Department of Health and Human Services)
    This document was developed in 2003 by the Health and Human Services Secretary’s Work Group on Ending Chronic Homelessness to outline a series of goal and strategies that would align the Department’s effort towards the goal of ending chronic homelessness.

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2002

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2001

  • Housing is Health Care: A Guide to Implementing the HIV/AIDS Bureau (HAB) Ryan White CARE Act Housing Policy (Health Resources and Services Administration)
    The main purpose of the Guidebook is to provide guidance on funding of housing-related costs under the Ryan White CARE Act.  The Guide focuses on implementation of HAB Policy 99-02, as issued in 1999 by the Health Resources and Services Administration, HIV/AIDS Bureau, which administers the Ryan White CARE Act. The publication was funded by the Department of Health and Human Services, Health Resources and Services Administration, HIV/AIDS Bureau, with John Snow, Inc. and AIDS Housing of Washington.

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1998

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