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Service-enriched housing

Health Factors: Housing & Transit
Decision Makers: Community Development Professionals Community Members Local Government Public Health Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 10-19% of WI's population
Impact on Disparities: Likely to decrease disparities

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Description

Service-enriched housing is permanent, basic rental housing in which social services are available onsite or by referral through a supportive services program or service coordinator (Sturtevant 2015). Housing and services can be provided by nonprofit, private, or government organizations; housing options can be unsubsidized, government assisted, mixed income or a combination. Programs often support low income families, seniors, people with disabilities, or veterans (Castle 2014, Sturtevant 2015, Brown 2013b). Some service-enriched housing programs also assist families or individuals experiencing homelessness; programs that support households experiencing  homelessness are often referred to as permanent supportive housing.

Expected Beneficial Outcomes

Reduced homelessness
Increased housing stability
Reduced hospital utilization
Improved health outcomes
Improved mental health

Evidence of Effectiveness

There is some evidence that service-enriched housing reduces homelessness, increases housing stability (Rog 2014, Fitzpatrick-Lewis 2011, Sturtevant 2015, Montgomery 2013, Burt 2007), and decreases the use of urgent care and related health care costs for participating individuals and families (Castle 2014, Rog 2014, Fitzpatrick-Lewis 2011, Bamberger 2015). Programs are particularly effective among individuals experiencing homessless; additional evidence is needed to confirm effects among other families and individuals (Rog 2014, Fitzpatrick-Lewis 2011, Montgomery 2013).

Participation in service-enriched housing programs can reduce anxiety (Urban-Popkin 2010) and programs with strong case management can stabilize physical and mental health conditions for formerly homeless individuals with HIV (Fitzpatrick-Lewis 2011). Service-enriched housing programs may improve the health of seniors by reducing preventable risk factors (Castle 2008) and provide support to allow seniors to age-in-place (Castle 2014). In one study, service-enriched housing was also associated with increased maintenance of sobriety (Collard 2008).

There is a demonstrated need for service-enriched housing among the elderly (Castle 2014, Golant 2010), veterans (Sturtevant 2015), and individuals with chronic mental illness and substance abuse problems (Rog 2014, Fitzpatrick-Lewis 2011, Culhane 2002). Tailoring service-enriched housing to meet the specific needs of older veterans, female veterans with children, or young veterans, can increase effects on housing stability and mental health or substance disorders, and ease the transition from military service to civilian workplaces (Sturtevant 2015).

Service-enriched housing appears to be a cost effective mechanism to achieve stable housing for vulnerable families and individuals (Urban-Popkin 2010, Cohen 2004). Decreased emergency care utilization and hospitalizations may offset program costs (Castle 2014, Fitzpatrick-Lewis 2011, Brown 2013b, Bamberger 2015, Montgomery 2013). 

Implementation

United States

Service-enriched housing programs for low income or homeless families and individuals are in place throughout the United States. Programs may be implemented across a region, as by the LINC Housing Corporation in California and the Colorado Coalition for the Homeless, or in individual communities as in Bridgeport, CT via the PT Barnum Partnership (PT Partners) (LINC Cares-Resident services, CCH-Housing, FCCF-PT Partners). Beyond Shelter and Mercy Housing are two additional examples of service-enriched housing programs in local communities (Beyond Shelter, Mercy Housing). Programs can also be implemented by faith-based non-profits as in Washington DC’s Jubilee Housing (Jubilee Housing).

There are many veteran-specific service-enriched housing programs. The US Department of Housing and Urban Development (US HUD) and the US Department of Veteran Affairs (VA) support the HUD-VA Supported Housing (HUD-VASH) program, a service-enriched housing program for homeless veterans with psychiatric or substance abuse disorders (Rosenheck 2003). The Mayors Challenge to End Veteran Homelessness, a further partnership between the VA and US HUD, uses permanent supportive housing with added mental health services along with concepts from rapid re-housing and Housing First to serve homeless veterans (RWJF-Veteran homelessness 2014).

Implementation Resources

Housing Hope - Housing Hope. Housing and services. Accessed on August 12, 2016
US HUD-ALCP - US Department of Housing and Urban Development (US HUD). Assisted Living Conversion Program (ALCP): Grant program to convert private, non-profit housing developments to service-enriched housing or assisted living facilities for elderly residents aging in place. Accessed on February 23, 2017

Citations - Description

Brown 2013b - Brown RT, Thomas ML, Cutler DF, Hinderlie M. Meeting the housing and care needs of older homeless adults: A permanent supportive housing program targeting homeless elders. Seniors Housing & Care Journal. 2013; 21(1), 126–135. Accessed on August 12, 2016
Castle 2014* - Castle N, Resnick N. Service-Enriched Housing: The Staying at Home Program. Journal of Applied Gerontology. 2014; 1–21. Accessed on August 12, 2016
Sturtevant 2015 - Sturtevant L, Brennan M, Viveiros J, Handelman E. Housing and services needs of our changing veteran population. Washington, DC: National Housing Conference and Center for Housing Policy; 2015. Accessed on August 12, 2016

Citations - Evidence

Bamberger 2015* - Bamberger JD, Dobbins SK. A research note: Long-term cost effectiveness of placing homeless seniors in permanent supportive housing. Cityscape. 2015;17(2):269–277. Accessed on August 12, 2016
Brown 2013b - Brown RT, Thomas ML, Cutler DF, Hinderlie M. Meeting the housing and care needs of older homeless adults: A permanent supportive housing program targeting homeless elders. Seniors Housing & Care Journal. 2013; 21(1), 126–135. Accessed on August 12, 2016
Burt 2007* - Burt MR, Pearson C, Montgomery AE. Community-wide strategies for preventing homelessness: Recent evidence. Journal of Primary Prevention. 2007;28(3-4):213-28. Accessed on August 12, 2016
Castle 2008* - Castle NG. Service enriched housing and the senior living enhancement program. Journal of Housing for the Elderly. 2008;22(3):263-78. Accessed on August 12, 2016
Castle 2014* - Castle N, Resnick N. Service-Enriched Housing: The Staying at Home Program. Journal of Applied Gerontology. 2014; 1–21. Accessed on August 12, 2016
Cohen 2004* - Cohen CS, Mulroy E, Tull T, White C, Crowley S. Housing plus services: Supporting vulnerable families in permanent housing. Child Welfare. 2004;83(5):509-28. Accessed on August 12, 2016
Collard 2008 - Collard CS, Larkin R. Supportive housing: Implications for its efficacy as intervention with special needs low-income African Americans. Journal of Public Management & Social Policy. 2008;14(2):69-83. Accessed on August 12, 2016
Culhane 2002 - Culhane DP, Metraux S, Hadley T. Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing public service reductions associated with placement of homeless. 2002;13(1):107-163. Accessed on August 5, 2016
Fitzpatrick-Lewis 2011 - Fitzpatrick-Lewis D, Ganann R, Krishnaratne S, et al. Effectiveness of interventions to improve the health and housing status of homeless people: A rapid systematic review. BMC Public Health. 2011;11:638. Accessed on August 4, 2016
Golant 2010* - Golant SM, Parsons P, Boling PA. Assessing the quality of care found in affordable clustered housing-care arrangements: Key to informing public policy. Cityscape: A Journal of Policy Development and Research. 2010;12(2):5-28. Accessed on August 12, 2016
Montgomery 2013* - Montgomery AE, Hill LL, Kane V, Culhane DP. Housing chronically homeless veterans: Evaluating the efficacy of a Housing First approach to HUD-VASH. Journal of Community Psychology. 2013;41(4):505-514. Accessed on August 4, 2016
Rog 2014 - Rog DJ, Marshall T, Dougherty RH, George P, Daniels AS, Delphin-Rittmon ME. Recovery Housing: Assessing the Evidence. Psychiatric Services. 2014;65(3):295-300. Accessed on August 2, 2016
Sturtevant 2015 - Sturtevant L, Brennan M, Viveiros J, Handelman E. Housing and services needs of our changing veteran population. Washington, DC: National Housing Conference and Center for Housing Policy; 2015. Accessed on August 12, 2016
Urban-Popkin 2010 - Popkin SJ, Theodos B, Getsinger L, Parilla J. Supporting vulnerable public housing families: An evaluation of the Chicago Family Case Management Demonstration. Washington, DC: Urban Institute; 2010: Brief No. 1. Accessed on August 12, 2016

Citations - Implementation

Beyond Shelter - PATH Beyond Shelter. Combating chronic poverty, welfare dependency & homelessness. Accessed on August 12, 2016
CCH-Housing - Colorado Coalition for the Homeless (CCH). Housing: Affordable housing and support services for low income or homeless families and individuals. Accessed on August 12, 2016
FCCF-PT Partners - Partners in Progress. Fairfield County Community Foundation’s (FCCF) PT Barnum Partnership (PT Partners), a public housing project with a broad range of supportive services. Accessed on August 12, 2016
Jubilee Housing - Jubilee Housing. Affordable housing and family services in Washington DC. Accessed on August 12, 2016
LINC Cares-Resident services - Limited Income Communities (LINC) Housing Corporation. LINC Cares: Resident services. Accessed on April 22, 2016
Mercy Housing - Mercy Housing. Live in hope. Accessed on August 12, 2016
Rosenheck 2003* - Rosenheck R, Kasprow W, Frisman L, Liu-Mares W. Cost-effectiveness of supported housing for homeless persons with mental illness. Archives of General Psychiatry. 2003;60(9):940-951. Accessed on August 2, 2016
RWJF-Veteran homelessness 2014 - Robert Wood Johnson Foundation (RWJF). RWJF Culture of Health blog: Ending veterans' homelessness by next year, including information about the Mayors Challenge and additional programs to end veteran homelessness. 2014. Accessed on August 4, 2016

Page Last Updated

August 12, 2016

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