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Evaluating the Impact of Rapid Rehousing on Single Adults
Last registered on February 28, 2019

Pre-Trial

Trial Information
General Information
Title
Evaluating the Impact of Rapid Rehousing on Single Adults
RCT ID
AEARCTR-0002533
Initial registration date
March 22, 2018
Last updated
February 28, 2019 3:46 PM EST
Location(s)

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Primary Investigator
Affiliation
University of Notre Dame
Other Primary Investigator(s)
PI Affiliation
University of Notre Dame
Additional Trial Information
Status
In development
Start date
2018-07-10
End date
2024-10-31
Secondary IDs
Abstract
This study evaluates the effectiveness of a new rapid rehousing program in Santa Clara County on single adults. The goal of the study is to determine whether an intervention of this type is effective at decreasing shelter entry, emergency room visits, and arrests and/or increasing earnings and stable housing. The key components of intervention include a short-term housing subsidy and individual case management. The program is being run by a community service provider in agreement with Santa Clara County's Office of Supportive Housing. We will use County administrative records to track outcomes for at least two years post random assignment. Demographic data obtained from HMIS records will be used to investigate how treatment effects vary across subgroups.
External Link(s)
Registration Citation
Citation
Phillips, David and James Sullivan. 2019. "Evaluating the Impact of Rapid Rehousing on Single Adults." AEA RCT Registry. February 28. https://doi.org/10.1257/rct.2533-2.0.
Former Citation
Phillips, David and James Sullivan. 2019. "Evaluating the Impact of Rapid Rehousing on Single Adults." AEA RCT Registry. February 28. https://www.socialscienceregistry.org/trials/2533/history/42226.
Experimental Details
Interventions
Intervention(s)
HomeFirst, a long-time provider of housing services in Santa Clara County, will implement Rapid Rehousing services while under contract with the County. HomeFirst employs three RRH case managers, each with a capacity to serve 20 clients at any given time, giving the program a static capacity of 60 clients. RRH provides enrolled clients with a progressive rental assistance subsidy that is meant to ease homeless persons’ transition back into housing. The value and duration of the subsidy depends on the income of each client. In addition to the rental assistance, participants receive case management services that include assistance in finding an apartment. RRH participants are typically housed within 60 days of enrollment. RRH services last, on average, 9 months with a typical maximum of two years. The presence of the study will not change any existing aspects of implementing the intervention. The evaluation will primarily affect how clients are enrolled and how data is collected during intake.
Intervention Start Date
2018-07-10
Intervention End Date
2023-07-10
Primary Outcomes
Primary Outcomes (end points)
Housing
-HMIS: use of rapid re-housing, shelters, transitional housing, homelessness prevention, PSH, other project-based affordable housing,
Health
-Emergency: emergency dept. visits
-Inpatient: admissions, days, identifying visits for preventable causes
-Outpatient: primary care visits, other visits
-Mental health: same as physical health
-Substance abuse: visits to rehab
Criminal justice
-Police: arrests
-Criminal Courts: case filings, verdicts, sentences (ideally all levels of courts)
-Jail: time served in jail; time served on probation/parole
-State Prison: same as jail
Public benefits
-SNAP: total benefit amount
-TANF: total benefit amount
-SSDI/SSI: total benefit amount
Employment
-Unemployment insurance: quarterly employment and earnings
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
Eligibility for Referral
The study will maintain the program’s existing eligibility, namely clients must (1) be homeless, (2) be a single adult, and (3) score within the RRH range on the VI-SPDAT.
1) The criterion of being “homeless” is met if the client falls within the definition of HUD category 1 homelessness or HUD category 4 homelessness.
a. HUD category 1 homelessness includes: Individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning: (i) Has a primary nighttime residence that is a public or private place not meant for human habitation; (ii) Is living in a publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal, state and local government programs); or (iii) Is exiting an institution where (s)he has resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution.
b. HUD category 4 homelessness includes: Any individual or family who: (i) Is fleeing, or is attempting to flee, domestic violence; (ii) Has no other residence; and (iii) Lacks the resources or support networks to obtain other permanent housing
2) The criterion of being a single adult is met if the client lives in a household without children.
3) The criterion of being within the RRH range is met if a client scores between 4-7 on their most recent VI-SPDAT.
Program Referral
The existing enrollment process consists of the County’s Office of Supportive Housing (OSH) identifying potentially eligible clients within the existing HMIS registry and referring them to housing providers like HomeFirst. Historically, OSH has imposed the same eligibility criteria as listed above when referring single adults to RRH programs. However, OSH prioritized individuals in the RRH range, referring first those who scored a 7, then those who scored a 6, and so on and so forth. Furthermore, they prioritized within VI-SPDAT score, referring first those with the highest “risk score” within the pool of those who scored a 7. Moreover, as an ultimate tiebreaker, OSH referred those with the most days homeless among clients with otherwise equal scores.
Because this study seeks to identify for whom RRH is most effective, the research team requests that the enrollment process be changed in two important ways.
1) Instead of referring one client with the highest VI-SPDAT score as a new slot becomes available, OSH will refer a list of clients across the eligible VI-SPDAT range, referring an equal number of clients who scored a 7, 6, 5, and 4 (prioritized within each score as OSH sees fit).
2) When the list of clients is depleted and program slots begin to turnover, referrals will cycle through 7’s, 6’s, 5’s, and 4’s, maintain an approximately equal number of clients from each score range in the program at all times.
These changes allow for homeless individuals with scores across the entire RRH range to receive services. Ultimately, this new referral process will allow the research team to not only analyze the impact of RRH, but also examine for which VI-SPDAT score RRH was most effective.
Intake and Randomization
Given HomeFirst’s static capacity of 60 clients, the first list of referrals should contain at least 170 homeless individuals (42-43 from each eligible score) with the goal of enrolling 15 from each score into the intervention group and approximately 15 from each score into the comparison group.
When HomeFirst receives this list of referrals from OSH, potential clients should be divided into equal group for case managers to contact. When attempting to contact clients, case managers need to make three reasonable attempts (according to OSH standard of reasonable attempt) to connect with a potential client before removing them from the list. Each case manager should have a variety of clients (i.e. each case manager should be in charge of contacting, enrolling, and ultimately serving approximately five 7’s, five, 6’s, five 5’s, and five 4’s). PROVIDER IS FREE TO CONTACT CLIENTS IN WHATEVER IS MOST EFFECTIVE. If case managers were charged with serving only one score group it would be difficult to parse out the effect of the program on a particular score group from the effect of a particular case manager. The goal of this study is to evaluate the impact of the program on individuals across the score range, not the impact of a case manager on a score group.
When the service provider contacts a potential participant, they will proceed through the intake process on an Android tablet loaded with the SurveyCTO app to accomplish four goals
1) Confirm Eligibility: determine if the client is still eligible by documenting major life changes since the time of the VI-SPDAT scoring date. This step is included to confirm that the client is still homeless and still a part of a household without children, SPECIFICALLY NO CUSTODIAL RIGHTS and, therefore, still eligible. If the client is ineligible, they will not be consented or randomized.
2) Consent: explain the nature of the study and consent the client on the tablet. Explain that if a client consents they are not guaranteed a program slot. If clients do not consent to be in the study, they will be referred to other programs and informed that they can call back if they change their mind. Because the funds are being used for participants in the study, clients who do not consent will not be offered RRH slots dedicated to this study. If a client does not consent, no additional information will be collected.
3) Record information: prior to proceed with the take questions, the case worker will enter the client’s HMIS ID and verify the client’s social security number, name and spelling), and date of birth in HMIS on another window on the tablet. The VI-SPDAT will not be re-administered, though a short intake form will be completed by all study participants to collect baseline information such as:
a. Housing status at entry
b. Zip Code of last permanent address
c. Length of stay on prior living situation
d. Night before measure of homelessness
e. Date homelessness started
f. In the last three years, how many times have you been homeless?
g. Income from any source
h. Non-cash benefit sources
i. Health insurance coverage
j. Primary language
4) Randomization: if clients consent to participate in the study, proceed to randomization page of tablet and inform the client on whether they are in the control group and will have access to usual care or in the treatment group and will receive RRH through this study. If the client is in the treatment group the case manager will proceed forward with the program intake form.
5) REFERRAL/ENROLMENT
This process must be completed every time a new slot becomes available. Clients in the control group will be eligible for any other usual service provided through the County outside of this study. When new program slots within the study become available, the control group will not be contacted again. Individuals can only be randomized once. At the close of the study, all study participants will be eligible for any program they would normally be eligible for in absence of the study.
Experimental Design Details
Not available
Randomization Method
Randomization done by computer behind the scenes during intake.
Randomization Unit
Individual
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
Projected 720 individuals
Sample size: planned number of observations
Projected 720 individuals
Sample size (or number of clusters) by treatment arms
360 Treatment, 360 Control
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Evaluating the Impact of Rapid Rehousing on Single Adults
IRB Approval Date
2017-05-19
IRB Approval Number
1704-3851
Analysis Plan

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