Veterans' Assignment to Single-Site Versus Scattered-Site Permanent Supportive Housing

• Published in: American journal of orthopsychiatry 2020-01, Vol.90 (1), p.37-47
• Main Authors: Montgomery, Ann Elizabeth, Szymkowiak, Dorota, Cusack, Meagan C, Austin, Erika L, Vazzano, Jesse K, Kertesz, Stefan G, Gabrielian, Sonya
• Format: Article
• Language: English
• Subjects: Adult; Disabled Persons - statistics & numerical data; Female; Government Programs; Health problems; Health Status; Homeless; Homeless people; Housing; Human; Humans; Ill-Housed Persons - statistics & numerical data; Illnesses; Inpatient; Male; Medicine; Mental Disorders; Mental Health; Mental health services; Middle Aged; Military Veterans; Needs; Outpatient; Patient History; Physical disabilities; Physical Disorders; Program Development; Public housing; Public Housing - statistics & numerical data; Substance abuse; Substance Use Disorder; Test Construction; United States; United States Department of Veterans Affairs - statistics & numerical data; Urban development; Veterans; Veterans - statistics & numerical data; Vulnerability
• ISSN: 0002-9432; 1939-0025; 1939-0025
• DOI: 10.1037/ort0000380

To address homelessness among Veterans, a growing proportion of permanent supportive housing units supported by the U.S. Departments of Housing and Urban Development and Veterans Affairs Supportive Housing (HUD-VASH) program are allocated to programs where multiple Veterans with a history of homelessness live in a particular building, referred to as single-site housing. This mixed-methods study-including administrative data from Veterans who moved into HUD-VASH housing and qualitative data from focus groups with services providers at 10 single-site programs-describes the characteristics and needs of Veterans who moved into single-site HUD-VASH programs, the rationale for developing single-site HUD-VASH programs, and the services provided in single-site programs that are responsive to Veterans' needs. Based on quantitative analyses, Veterans who were older and had chronic medical and mental health conditions and sought related care were at increased odds of receiving single-site housing. Qualitatively, we found that HUD-VASH programs developed single-site programs for two reasons: to ensure that the most vulnerable Veterans remained housed through the provision of supportive services and to increase housing options for hard-to-house Veterans, including those who require more support because of medical, mental health, or substance use disorders; physical disabilities; or lack of ability to live independently for other reasons. Due to the high needs of Veterans served by single-site programs, development of these programs should consider both space and staffing needs. Future research should assess the relationship between assignment to housing type and health and housing outcomes for participants as well as service enhancements to address Veterans' needs. Public Policy Relevance Statement Permanent supportive housing is a preferred policy response for addressing homelessness among high-need individuals. One variant of permanent supportive housing-the use of single-site buildings to house multiple formerly homeless individuals-is understudied. Results indicate that these programs serve particularly high-need individuals, with implications for both program and policy responses.