HOMELESSNESS: Programs and the People They Serve SUMMARY REPORT Findings of the National Survey of Homeless Assistance Providers and Clients DECEMBER 1999 HOMELESSNESS: Programs and the People They Serve SUMMARY REPORT Findings of the National Survey of Homeless Assistance Providers and Clients AUGUST 1999 Martha R. Burt Laudan Y. Aron Toby Douglas Jesse Valente Edgar Lee Britta Iwen The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the study’s federal funders or to the Urban Institute, its trustees, or its funders. Contents PREFACE . xiii ACKNOWLEDGMENTS . xv HIGHLIGHTS . xvii 1 Introduction and Design Overview . 1 Introduction . 2 Overview of the Study Design . 2 Data Collection Approaches . 3 Basic Analytic Categories . 5 Defining Homelessness Status . 5 Specifying Time Frames . 6 Defining Family and Single Status . 6 Defining Alcohol/Drug/Mental Health (ADM) Status . 6 Describing Urban/Rural Location . 7 Statistical Significance of Findings . 7 Confidence Intervals . 7 Statistical Significance of Comparisons . 7 Risk of False Positives . 7 Limitations of NSHAPC Findings . 7 The Study Is Descriptive . 7 The People in the Study Come from Homeless Assistance Programs . 8 NSHAPC Was Designed to Collect Data on Clients Who Use Homeless Assistance Services . 8 All Client Information Comes from the Clients Themselves . 8 What the Study Does Not Do . 8 The Structure of This Report . 9 Additional Information May Be Found in the Technical Report . 9 vi Contents 2 An Overview of Homeless Clients . 11 Introduction . 13 Demographic Characteristics of Homeless Clients . 13 Sex . 14 Race/Ethnicity . 15 Age . 15 Marital Status . 16 Education . 17 Veteran Status . 18 The Children of Homeless Clients . 18 Service Needs, Stresses, and Vulnerabilities . 20 Service Needs as Seen by Clients . 20 Food Consumption and Hunger . 21 Victimization While Homeless . 22 Physical Health Status and Insurance . 22 Alcohol, Drug, and Mental Health Problems . 23 History of Incarceration . 25 Adverse Childhood Experiences . 25 Where Homeless Clients Were Living . 26 Characteristics of Clients Using Different Housing and Other Services . 27 Income, Employment, and Other Income Sources . 28 Income . 28 Paid Employment . 29 Receipt of Government Benefits . 29 History of Homelessness . 30 Clients Who Change Locations after Becoming Homeless . 32 Comparisons of Clients from Central Cities, Suburbs, and Rural Areas . 33 Comparisons with 1987 Urban Institute Findings . 35 Comparing Currently with Formerly Homeless Clients 3 and Other Service Users . 39 Introduction . 41 Basic Demographic Characteristics . 41 Sex . 41 Race/Ethnicity . 41 Age . 43 Education . 43 Marital and Household Status . 43 Veteran Status . 44 Service Needs, Stresses, and Vulnerabilities . 44 Service Needs as Seen by Clients . 44 Food Consumption and Hunger . 44 Contents vii Physical Health Status and Insurance . 45 Alcohol, Drug, and Mental Health Problems . 49 Incarceration . 50 Adverse Childhood Experiences . 50 Income Levels, Sources, and Employment . 52 History of Homelessness . 55 Use of Homeless Assistance Programs . 56 Lifetime Service Use . 56 Urban/Rural Location . 57 4 Homeless Assistance Programs . 59 Introduction . 60 Service Locations and Program Types . 60 Service Level and Program Size . 61 Total Number of Expected Service Contacts . 62 Variability in Program Size . 63 Operating Agencies . 64 Funding Sources . 66 Population Focus . 66 Household Type . 66 Special Population or Special Need . 67 Occupancy Levels of Shelter/Housing Programs . 69 Location of Homeless Assistance Programs . 69 Availability of Services within NSHAPC’s 76 Sampling Areas . 71 Distribution of Program Contacts within Sampling Areas . 72 Distribution of Services within Sampling Areas by Program Type . 73 Distribution within Sampling Areas of Contacts with Different Types of Shelter/Housing Programs . 76 5 Postscript . 79 APPENDIX A: NSHAPC’s PRIMARY SAMPLING AREAS . 81 APPENDIX B: NSHAPC PROGRAM DEFINITIONS . 85 REFERENCES . 87 Figures and Tables Figure 1.1 Sampling Areas for NSHAPC . 3 Table 2.1 Demographic Characteristics of Homeless Clients, by Family Status . 14 Figure 2.1 Sex of Homeless Clients and the U.S. Adult Population . 15 Figure 2.2 Homeless Clients in Families . 15 Figure 2.3 Race/Ethnicity of Homeless Clients and U.S. Adults . 16 Figure 2.4 Age Distribution of Homeless Clients in Families, Single Homeless Clients, and U.S. Adults . 16 Figure 2.5 Marital Status of Homeless Clients in Families, Single Homeless Clients, and All U.S. Adults . ..