Does Rapid ReHousing Work? Well, it depends.

Seems there is no shortage of conversation and commentary about how rapid rehousing does not work, these days. NPR did a story on it. The Family Options Study findings from HUD paint a not-so-pretty picture. The Urban Institute released research that was a bit more favourable but also raised some flags too. Aside from those, people on the inside in various states have started to see certain trends related to Rapid ReHousing, calling into question what they initially touted as success.

 

All of this on some level is warranted. And on some level it drives me nuts. Let me explain.

 

From community to community to community there are different interpretations of what exactly Rapid ReHousing is, and as a result we can be calling something Rapid ReHousing when it really is not. There are no national or international standards. There is no consistent mechanism for evaluating whether one community is doing a Rapid ReHousing intervention, or another community is providing casual housing help with rental assistance.

It is my firm belief that Rapid ReHousing is a particular type of housing intervention. It is supposed to be time limited case management assistance – usually 4-6 months – with co-occurring financial assistance as it is warranted. It is intended for an individual or family with moderate acuity. That means they have a number of medium-level issues in their life or one or two big issues. When connected to community supports and mainstream services (critical to Rapid ReHousing) they stabilize in housing. Rapid ReHousing does not solve poverty. It does not take issues away. It houses and stabilizes.

Recently we released data regarding the SPDAT and various housing interventions. Collected and analyzed independent of OrgCode, it showed 92% of households where the SPDAT was used and moved into Rapid ReHousing were still housed – and this covers a five year period. Less than 69% of people that moved into Rapid ReHousing where the SPDAT was not used stay housed. Was the housing retention rate solely a result of the impact of the SPDAT? No. OrgCode also trained every single provider in each of the 12 test communities on how to deliver Rapid ReHousing in what we believe to be the proper way of doing the intervention. We provided policy and procedures to follow. We connected and did follow-up training. We shadowed staff in all 12 communities while in the field with individuals and families to coach and measure fidelity to practice. There was very limited variation in how the supports were provided. It seems that made a difference.

What do we believe to be the essential elements for Rapid ReHousing to be successful?

  • Moderate acuity households for the intervention.
  • Home visits and supports in vivo.
  • Choice in where the household wants to live relative to the amount of money they have (no choosing an apartment that they are unlikely to afford on their own when the subsidy ends).
  • Connection to mainstream and community supports from day one in housing.
  • Strong focus on employment whenever practical and possible from early on in housing.
  • Objective-based interactions in each engagement.
  • All goal-setting is related back to housing stability.
  • Structured, sequential and documented planning.
  • Crisis planning and risk assessment with each household after housed.
  • Honest and realistic budgeting with an eye to when the subsidy ends.
  • Rigorously following the five essential and sequential elements to housing stability.
  • Following the same philosophy as Housing First, for which you can watch an easy to understand video here.

 

We are doing ourselves no favours debating whether Rapid ReHousing works or does not work when it is not clear whether or not we are actually talking about the same thing. This is the fundamental apples to apples argument to be made if we are going to discuss whether or not it actually works – or does not. So  before we buy into the hype of Rapid ReHousing working or not working, ask yourself what exactly was the service that was being provided. (And as an aside, you might review the methods used to evaluate Rapid ReHousing – there is a reason why the Family Options Study took so long to see the light of day.)

Iain De Jong

About Iain De Jong

2 Responses to “Does Rapid ReHousing Work? Well, it depends.”

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  1. Rose Phillips says:

    Are you saying that the survey methodology or statistics were needlessly complex, or that it had a near-fatal flaw that almost got it vetoed for release? Are you referring specifically to the fact that not all four interventions were available at each site, or that a slot in a given intervention had to be available for a family to be assigned to that intervention?

    Interestingly, some of the locations in the study have been touted as having RRH best practices, and/or are included in the 14-CoC compilation of HMIS data used by NAEH in many training materials–e.g. Alameda County, CA and Salt Lake County, UT. It wouldn’t be surprising if these communities have improved their RRH programs since then. And perhaps some communities had better RRH performances, even if the sample sizes were too small to detect statistically significant differences. Also, it’s unfortunate that the Family Options Study couldn’t detect differences in either housing stability (except for one measure on independent tenancy) or adult well-being, and no consistent differences in child well-being. The whole reason we seek to end homeless episodes quickly, and to target those who are literally homeless, is to minimize the trauma associated with literal homelessness–and significant differences in the housing stability outcome could have shed more light on whether RRH affects the other outcomes.

    While the Family Options Study may be the most pessimistic study to date, it does provide a note of assurance to local communities. If they take a chance on RRH, their families probably aren’t going to be any *worse* off, and they’ll save money while they’re fine-tuning the program. Presumably not every community can get intensive technical assistance from OrgCode Consulting or other agencies, and not every community has supportive political leadership. But that’s no reason to give up on the idea–the most positive findings show what is achievable if CoCs give it their all.

  2. Judson Bliss says:

    It appears to me that the point of the study, based on its methodology, was to look at the importance of housing stability on families/children. This methodology focused on assessing for these effects. Obviously, they found that housing stability helps folks. With that finding, we’re all on the same page.

    What they did not effectively differentiate, as pointed out by Iain and Rose, is on the “treatment” (see Cronbach 1982 description of UTOS). The assessments they used focused primarily on behavioral health (of the children), financial, and family needs (see below). These assessments did not include a housing triage instrument such as the VI-SPDAT. Therefore, we need to make sure with this study, as with all studies, that we consider its limitations. Metaphorically, every lens has a particular focal length and field of view, so we need to be careful how we use them within those limitations.

    Rock on, Iain…

    UC: “Nearly all families assigned to UC were recruited from shelters that assessed family needs related to housing, self-sufficiency, employment, health, mental health, substance abuse, and child-specific needs.”

    CBRR: “assessment, considering a standard set of criteria such as family income, debt, size, and local housing costs. For another 19 percent of families, the initial subsidy was set at the discretion of the program, based on what the program staff determined was needed to get the family into housing, and
    then the ongoing subsidy was adjusted based on a formula.”

    PBTH: “Program staff reported that the assessments covered a broad range of topics, exploring family needs related to housing; self-sufficiency; employment; physical health, mental health, and substance abuse; child-specific needs; parenting; and family life skills. A few programs included other assessment domains such as domestic violence, trauma, debt burden, and cultural needs, but these domains were not widespread areas of assessment.”

    I could not find a similar assessment description for SUB.