Outcome Evaluation of the Shelter-A-Family Program

Kimberly Jacob Arriola, PhD, MPHAssociate Professor

November 20, 20133rd Annual Georgia Supportive Housing Association Conference

SAF Program Staff Joyce Sloan, LCSW-Program Director Naomi Haynes, MSW-Program Manager Ja’Nai Johnson, MSW-Coordinator Nefertari I, BSW-Case Manager Ronterius Sanders, MS-Case Manager Stacie Fitzgerald, LCSW-Counseling Manager Pamela Crosling, MS-Substance Abuse Counselor Shondella Andre, BA-GED Instructor

Today’s Agenda Overview of the program Purpose of the outcome evaluation Evaluation methods

CMHS TRAC NOMs Staff-administered supplemental evaluation

interview Findings & limitations Conclusions

Program Description SAF is a community-based, supportive housing program

for families with children who have experienced: long-term homelessness where the head of household suffers with disabilities of:*mental illness*substance abuse and/or*HIV/AIDS

Provides site-based supportive servicesto 43 families in HUD-fundedapartment units in NW Atlanta

Program Goals To help formerly homeless individuals:

Reduce and eliminate substance dependency and useAchieve mental and emotional stabilityMove toward greater self-reliance

To promote child safety and development To prevent future homelessness amongchildren traumatized by:

HomelessnessAbuse & neglectParent’s substance abuse and MH challenges

Eligibility Must be experiencing long-term homelessness, as

defined by HUD Very low income Verifiable disability, as defined by HUD, of mental

illness, substance abuse, or HIV or AIDS Must be a family with child(ren) under the age of 18

Single female headed households Single male headed household Two parent, married household

Supportive Services Intensive case management Home –based counseling sessions On-site substance abuse individual & group treatment Life skills training Mental health support groups for adults and youth Provide access to resources, including health, asset development,

and linkages to community activities & groups On-site GED instruction, educational and employment supports,

job search assistance Assertive Community Treatment (ACT) Team meetings Monthly community meetings

Program Modification SAF I

Established in 2005 June 1, 2009 received

additional funding from SAMHSA to provide site-based supportive services

Adopted Housing First Model.

23 families in current analyses

SAF II Effective February 1, 2013 20 families that were

consolidated into existing SAF program

Initially resided at Delowe Village Families First Project

G.R.O.W. Program

Outcome Evaluation To explore change in clients based on:

Housing stability Physical and mental health and sense of well-

being Dependence on illegal and harmful substances Academic, vocational, life and social skills, and

income Perceived family & community support

Outcome Evaluation Constructs CMHS TRAC NOMs

Demographic data Functioning Stability in housing Education and

employment Crime and criminal

justice Social connectedness

Evaluation Interview Medical status and

health insurance Drug/alcohol use Psychiatric status Health and well-being Child well-being

Outcome Evaluation Constructs CMHS TRAC NOMs

Demographic data Functioning Stability in housing Education and

employment Crime and criminal

justice Social connectedness

Evaluation Interview Medical status and

health insurance Drug/alcohol use Psychiatric status Health and well-being Child well-being

CMHS TRAC NOMs Instrument Baseline Assessment conducted within 7 days

of program enrollment Reassessment interview conducted every 6

months (+/- 30 calendar days) Administered by staff

CMHS TRAC NOMs Data (as of 8/1/13)

Assessment Number of AssessmentsBaseline 556 month assessment 3112 month assessment 2918 month assessment 2424 month assessment 1930 month assessment 1436 month assessment 11Clinical Discharge 17

Supplemental Evaluation Interview

Largely based on the Addiction Severity Index (McGahan, Griffith, Parente, & McLellan, 1986)

Key domains Medical status and health insurance; Drug/alcohol use; Psychiatric status; Health and well-being Child well-being

Administered by staff after TRAC NOMs

Supplemental Evaluation Interview(as of 8/1/13)

Assessment Interviews ConductedBaseline 446 month follow-up 2612 month follow-up 2018 month follow-up 1224 month follow-up 930 month follow-up 5

Client Demographics (based on service utilization data)

Client Characteristics SAF (N=86)Client n (%)

SAF II (N=58)Client n (%)

Gender           Female 49 (57) 38 (66)Marital Status    Single 26 (30) 16 (28)Unknown 55 (64) 42 (72)

Age    0-17 years 38 (44) 35 (61)18-36 years 25 (29) 14 (24)37+ years 20 (23) 9 (15)

Race/Ethnicity    Black  75 (87) 55 (95)

Results: Housing Stability TRAC NOMs “In the past 30 days,

where have you been living most of the time?” Owned or rented house,

apartment, trailer, room

Results: Physical Health TRAC NOMs “How would you rate

your overall health right now?” Excellent or very good

Results: Functioning TRAC NOMs 8 separate items

Response options ranged from 1 (SD) to 5 (SA)

Percent who strongly agree

Results: Emotional Health Supplemental

Evaluation Interview “How many days in the

last 30 days have you experience these psychological or emotional problems?” E.g., serious depression,

hallucinations, serious anxiety or tension

Results: Substance Use

Random drug screens 170 screens

performed on 31 clients

Based on service utilization data

  SAF I SAF IINumber of clients screened

21 10

Number of screens

121 49

Positive 9 15 Negative 61 27 Inconclusive 51 7Percent positive 7% 31%

Results: Academic, Vocation, Social Skills TRAC NOMs “Are you currently

enrolled in school or a job training program?” Not enrolled or

Enrolled full or part time

Results: Social Connectedness TRAC NOMs 4 items E.g., “I am happy with

the friendships I have” Response options

ranged from 1 (SD) to 5 (SA)

Percent who strongly agree

Limitations Study design Small numbers of participants Effect sizes

Consolidation of 2 programs Child well-being data

Limited number of children in which there are 2 or data points that are clearly linked to a particular child

Conclusions Clients are largely achieving stable housing Indicators of adult well-being show improvement over time Lower rates of drug use were found among SAF I clients

(7%) than among SAF II clients (31%) Enrollment in an academic, vocational, or job skills program

has remained somewhat flat over time Participants reported greater satisfaction with their

friendships at 36 months, but other measures of social connectedness did not yield clear patterns.

Thank You! Kimberly Jacob Arriola

RSPH of Emory University

1518 Clifton Road, NE

Room 520

Atlanta, GA 30322

kjacoba@emory.edu

404-727-2600