'Housing First' Increased Psychiatric Care Office Visits And Prescriptions While Reducing Emergency Visits.

Housing First is an approach to ending homelessness that recognizes permanent housing as a platform for stability and engagement in health services. As part of a randomized controlled trial to test the effects of permanent supportive housing with the Housing First approach in Denver, Colorado, we analyzed the intervention's impact on health care use, Medicaid enrollment, and mortality among people experiencing chronic homelessness who had frequent arrests and jail stays. Two years after assignment to the Housing First intervention, participants had an average of eight more office-based visits for psychiatric diagnoses, three more prescription medications, and six fewer emergency department visits than the control group. Although enrollment in Medicaid increased over the course of the study for both the intervention group and the control group, the intervention group was 5 percentage points less likely to be enrolled in Medicaid. Supportive housing had no significant impact on mortality. When considering pathways to scale up supportive housing, policy makers should recognize the potential of Housing First to facilitate the use of office-based psychiatric care and medications in a population with many health care needs.

The Impact of Family Unification Housing Vouchers on Child Welfare Outcomes.

This study addresses whether providing housing vouchers through the Family Unification Program (FUP) to families involved in the child welfare system reduces child maltreatment and the need for child welfare services. The study uses child welfare administrative data on 326 children in Portland, Oregon, and 502 children in San Diego, California from the point at which their families were referred to the program through 18 months post-referral. Using a quasi-experimental waitlist comparison design, probit regressions show little impact of FUP on preventing child removal from home, but some positive impact on reunification among children already placed out of home. Hazard estimations show receipt of FUP speeds up child welfare case closure. Impacts on new reports of abuse and neglect are mixed, but point toward reduced reports. Low rates of removal among intact comparison families and high rates of reunification for children in out-of-home care suggest poor targeting of housing resources. Housing vouchers are being given to families not bearing the risks the program is intended to address. The presence of some positive findings suggests that housing vouchers might help reduce child welfare involvement if better targeting were practiced by child welfare agencies.