The Search for Clarity: An Impact Assessment of Permanent Supportive Housing in Dallas, Texas, and Comparative Case Studies of Housing First in Five Cities

Abstract

Homelessness is one of the most visible social problems. Effective policies and programs require an understanding of the complexity of homelessness, including its intersection with other policy areas like health and criminal justice. In recent years, the federal government has embraced the Housing First approach to address chronic homelessness. This resulted in widespread adoption of Housing First, and subsequent programmatic variation, by homeless service providers across the nation. This study consists of two parts: an impact assessment of permanent supportive housing in Dallas, Texas, and comparative case studies of Housing First programs in five cities. The impact assessment uses administrative data from four sources: the Metro Dallas Homeless Alliance Beacon Health, Inc., the Texas Department of State Health Services, and Dallas County. Results show housing placement and tenure are associated with decreased acute healthcare and jail use by homeless individuals. The findings from this study may be informative to local policymakers as they discuss potential solutions to the homeless problem in Dallas. The comparative case studies explore the variation in the implementation of Housing First programs in five select cities: Dallas, Austin, Houston, Salt Lake City, and Los Angeles. Data collection entailed interviews with homeless service providers, documentation review, and site-visits. Findings highlight the dynamic environment in which Housing First programs operate and the challenges faced in service delivery. Furthermore, the findings underscore the importance of contextual factors, which affect how Housing First is implemented.