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Evaluation of Permanent Supportive Housing for Justice-Involved Frequent Utilizers

Last registered on June 10, 2019

Pre-Trial

Trial Information

General Information

Title
Evaluation of Permanent Supportive Housing for Justice-Involved Frequent Utilizers
RCT ID
AEARCTR-0004275
Initial registration date
June 04, 2019

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
June 10, 2019, 10:07 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Primary Investigator

Affiliation
University of Notre Dame

Other Primary Investigator(s)

Additional Trial Information

Status
On going
Start date
2019-01-23
End date
2021-03-01
Secondary IDs
Abstract
This proposed project will examine the effect of receiving permanent supportive housing services on housing, health, labor market, and criminal justice outcomes for individuals who repeatedly interact with the criminal justice system. The Frequent Users Systems Engagement (FUSE) Initiative, a new program in Franklin County, OH (Columbus), offers permanent supportive housing (PSH) to individuals with a history of many jail stays. “Frequent utilizers” of the criminal justice system are often affected by one or more adverse conditions that make it difficult to attain stability and increase the likelihood of recidivism. The County, in partnership with implementing partners and the Wilson Sheehan Lab for Economic Opportunities (LEO) at the University of Notre Dame, is conducting a randomized controlled trial to quantify the impact of receiving supportive housing. The initial, pilot phase of the study will include 84 eligible individuals in the County. The study will track several key outcomes, including housing stability and homelessness, emergency care use, the cost of healthcare services, public benefit usage, and recidivism. This pilot would provide the basis for a larger scale evaluation as the program expands.
External Link(s)

Registration Citation

Citation
Phillips, David. 2019. "Evaluation of Permanent Supportive Housing for Justice-Involved Frequent Utilizers." AEA RCT Registry. June 10. https://doi.org/10.1257/rct.4275-1.0
Former Citation
Phillips, David. 2019. "Evaluation of Permanent Supportive Housing for Justice-Involved Frequent Utilizers." AEA RCT Registry. June 10. https://www.socialscienceregistry.org/trials/4275/history/47867
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
The Frequent Users Systems Engagement (FUSE) initiative is a new program in Franklin County, OH that offers permanent supportive housing to individuals with a history of many jail stays. Housing is non-time limited and driven by tenant choice. Services provided include: housing case management, including emergency housing assistance and rental assistance; behavioral healthcare, which may include psychiatry, treatment and counseling, and physical health care coordination; employment services; benefit counseling; and transportation assistance.
Intervention Start Date
2019-01-23
Intervention End Date
2021-03-01

Primary Outcomes

Primary Outcomes (end points)
One-year recidivism (re-arrest)
Primary Outcomes (explanation)
Our primary outcome will be based on administrative records of arrests in Franklin County. It will be a dummy variable equal to 1 if the individual was re-arrested within one year of release from jail, and equal to 0 if the individual has not been arrested in that time frame.

Secondary Outcomes

Secondary Outcomes (end points)
Secondary outcomes will include other criminal justice outcomes, including type of offense for re-arrests and number of jail stays since study enrollment. Additionally, we hope to measure housing stability and shelter use. Use of emergency vs. preventative health care and public benefits usage are outcomes we hope to explore as well in the future.
Secondary Outcomes (explanation)
Type of offense for re-arrest will be a categorical variable based on the type of arrest for each re-arrest after study enrollment. Number of jail stays will be measured as the number of times an individual has returned to jail since study enrollment. Nights in jail will be measured as the cumulative number of days an individual has spent in jail since study enrollment.
Housing stability will be constructed as a dummy variable equal to one if the individual has an address and their name on a lease at one year post-study enrollment. Number of moves, an additional component of housing stability, will be constructed as a count of address changes in the time period following study enrollment. Shelter use will be measured as both a count of times entered shelter and a cumulative number of nights spent in shelter.
Emergency care use will be measured as a count of hospitalizations since study enrollment. Use of preventative care will be measured as a count of visits with a primary care provider since study enrollment.
Public benefits use will be measured as a dummy variables for enrollment in the following programs: SNAP, TANF, and Medicaid.

Experimental Design

Experimental Design
This study pilots a randomized controlled trial of permanent supportive housing services for the target population. Franklin County has identified 165 individuals who are eligible to participate based on their incarceration history, however, CSH has 45 housing units available. Leveraging this excess demand provides an ethical basis for random assignment. Individuals in the treatment group will receive permanent supportive housing services provided by CSH Ohio and ISBH. Individuals in the treatment group will not receive housing services from these organizations, but may seek services from other programs in the County for which they are eligible. The effect of providing permanent supportive housing on outcomes of interest will be calculated by comparing outcomes between the treatment and control groups.
Experimental Design Details
The study pilots a randomized controlled trial of permanent supportive housing services for the target population. Franklin County, CSH Ohio, and ISBH have developed a new permanent supportive housing initiative that targets currently incarcerated individuals with a high number of previous jail stays. Because the FUSE Initiative is new, implementing partners have collaborated with researchers at the University of Notre Dame to build randomization into program recruitment and enrollment. The study launched in January 2019.
Franklin County has identified 165 eligible individuals based on number of jail stays and nights spent in jail. CSH Ohio has 45 PSH units available and hopes to receive funding from the County to increase the number of available units over the next year. CSH Ohio aims to place three individuals per month into housing. This would require enrolling six individuals per month into the study, with three randomized into the treatment group and three into the control group. In total, at the end of March 2020, we will enroll 84 individuals into the pilot study, 42 of whom will be randomized into the treatment group and placed in housing (assuming six placements per month for twelve months), and 42 of whom will be randomized into the control group. Comparing outcomes between the treatment and control groups will allow us to measure the causal impact of permanent supportive housing on outcomes of interest.
Randomization Method
Randomization occurs on the spot at the time of consent to participate in research. Each time an eligible individual appears in jail or in shelter in Franklin County, they are flagged and consented into research by jail or shelter staff. Individuals who consent then complete an intake survey and are finally referred to CSH, who performs on-the-spot randomization.
Randomization takes place using a survey programmed by LEO on the SurveyCTO online platform. CSH enters several identifying fields about the individual, and the survey assigns each entry a random number between zero and one, with numbers higher than 0.5 categorized as treatment. CSH must “submit” the survey to see the randomization result, precluding the possibility that an individual may be randomized multiple times before their results are viewed by the research team.
Randomization Unit
Randomization will occur at the individual level.
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
0
Sample size: planned number of observations
84
Sample size (or number of clusters) by treatment arms
42 treatment, 42 control
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
A previous evaluation Returning Home Ohio re-entry program (Fontaine et al, 2012) provides a useful benchmark for a power analysis. That study examined felony offenders entering supportive housing. The matched comparison group was re-arrested within 1 year 37% of the time. Consider a study with a similar baseline arrest rate, a take-up rate of 90%, power of 0.8, and a test level of 0.05. A pilot sample of 84 participants could detect effects down to 33 percentage points for 1-year re-arrest rates. However, a scaled-up study including 1,000 participants could detect effects of 10 percentage points, which is the effect size claimed in the non-experimental Returning Home Ohio study. Of course, power in the full study would depend on high take-up. Regarding the risk of partial compliance, CSH predicts it is very improbable that an individual offered housing will not take it up. The housing assistance is very generous and is not tied to use of supportive services. In any case, we will have access to HMIS data on use of both the study intervention and other permanent supportive housing interventions via HMIS. Therefore, the pilot will allow us to construct a reasonable estimate of take-up that will be important for power calculations in a scaled-up study.
IRB

Institutional Review Boards (IRBs)

IRB Name
University of Notre Dame Institutional Review Board
IRB Approval Date
2019-01-22
IRB Approval Number
18-12-5040

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials