SAF Program Staff

Outcome Evaluation of the Shelter-A-Family ProgramKimberly Jacob Arriola, PhD, MPHAssociate ProfessorNovember 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

Overview of the program Purpose of the outcome evaluation Evaluation methods CMHS TRAC NOMs Staff-administered supplemental evaluation interview Findings & limitations Conclusions Today’s Agenda

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 services to 43 families in HUD-funded apartment units in NW Atlanta

Program Goals • To help formerly homeless individuals: • Reduce and eliminate substance dependency and use • Achieve mental and emotional stability • Move toward greater self-reliance • To promote child safety and development • To prevent future homelessness among children traumatized by: • Homelessness • Abuse & neglect • Parent’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

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)

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)

Client Demographics (based on service utilization data)

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

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.

Kimberly Jacob Arriola RSPH of Emory University 1518 Clifton Road, NE Room 520 Atlanta, GA 30322 kjacoba@emory.edu 404-727-2600 Thank You!

SAF Program Staff