Community-Wide Strategies for Preventing Homelessness: Recent Evidence

Ana Stefancic; Sam Tsemberis


J Prim Prev. 2007;28(3):265-279. 

In This Article


Housing Status

Pathways housed its first consumer in early June of 2000 and the Consortium housed its first consumer the following month. Twenty months later, by February 2002, Pathways had placed a total of 62 clients in independent scatter-site housing, at an average rate of approximately 3.1 clients per month. Five of these clients were discharged from the program (four moved out of state), leaving 57 still housed at the end of 20 months. During this same time period, the Consortium had housed 52 clients, at an average rate of approximately 2.6 clients per month. Six of these clients were discharged from housing, leaving 46 consumers still housed at the end of 20 months. Altogether, the Housing First agencies had 103 participants in permanent housing at this time.

In contrast to the participants enrolled in Housing First, few participants in the control group were living in permanent housing by the end of the 20-month period. Twelve were placed into supportive housing by the Department of Mental Health (DMH) and one was placed by the Veteran's Administration (VA). Two consumers reconnected with their children and were transferred to the county's Homeless Families System. They were placed into emergency housing units operated by a non-profit agency contracted by the county. Only one client was living independently, and another moved in with a family member. Five clients remained in shelters and three ended up in a variety of institutional settings. One client was deemed ineligible for DMH placement due to a developmental disability and four moved out of the county. The whereabouts of the remaining 21 participants who dropped out of the shelter system were unknown. Additionally, members of the control group continued to cycle in and out of the system over the course of the study period. For control group members with available shelter histories during the 20 months, the average number of returns to the shelter was 3.6 and the average length of those returns was 13.3 nights.

Housing Retention

Figure 1 presents housing retention rates by Housing First condition for each month for a period of 47-months. Two years after program inception, approximately 84% of the consumers who had been housed by the Housing First agencies were still in housing, with Pathways at 88.5% and the Consortium at 79%. After 47 months, approximately 68% of consumers housed by Housing First were still maintaining housing, with Pathways at 78.3% and the Consortium at 57%.

Figure 1.

Housing First: rates of housing retention

Selection: Engaged vs. Housed

Figure 2 presents the number of participants in housing within each Housing First agency for each month and the total number of participants that the agency had outreached/engaged. Two years after program inception, Pathways had 54 participants in housing out of the 78 participants that they had outreached/engaged. At this same time-point, the Consortium had 54 participants in housing out of the 164 that they had outreached/engaged. By the end of 47 months, Pathways had 58 participants in housing out of the 89 participants engaged and the Consortium had 48 participants in housing out of the 204 that they had outreached/engaged.

Figure 2.

Housing First: engaged/outreached versus housed


As Table 2 indicates, the per diem costs for Pathways and the Consortium, based on 2002 budgets, was $55.92, or $20,410 per client per year. Shelter reimbursement rates, meanwhile, ranged from a $66.49 to $119.26 per diem, or $24,269 to $43,530 per client per year. The Housing First costs included: staff salaries, operation costs, and funding for rents and property management.


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