HomePath

Project

Overview

Project Overview

HomePath is a combined Housing First and shared-medical-appointments intervention. It aims to increase housing stability, improve treatment outcomes, and reduce returns to shelters, emergency rooms, and justice systems for people who have experienced homelessness and are struggling with opioid addiction.

Housing First is a person-centered approach to reducing chronic homelessness that works by first providing permanent supportive housing, regardless of substance dependency or other issues. There are no treatment or sobriety conditions for being placed in or staying in housing. Once housed, people can decide whether and when to make use of the supportive services and treatment plans that are available to them.

Shared medical appointments combine medical treatment, behavioral health treatment, and social work help. Usually, a group of about 10 to 15 patients and three to five health care and social service providers meet weekly. Each patient has time to discuss his or her treatment and progress toward personal goals. Everyone in the group can ask questions and share concerns and experiences with each other. A shared medical appointment can address many needs at once. Patients can get prescription refills, information about transportation or other services, support for recovery, and connections to housing and supportive services that use a Housing First approach.

With funding from Arnold Ventures, MDRC is conducting an 18-month feasibility study to determine whether to conduct a full-scale rigorous evaluation of HomePath. If the feasibility study shows promise, the full-scale evaluation would begin in 2020.

STATUS: Current

Basics

Issue: Health

Focus Area: Health, Housing/Community Initiatives

Population: Populations with Barriers to Employment

Focus Population: People with Substance Use Disorders

Intervention: Coordinated Care/Care Management

Agenda, Scope, <br> & Goals

Agenda, Scope, and Goals

The recent opioid epidemic has led to a sharp increase in the unsheltered homeless population across the country, and the housing field has not found a consistently effective approach to treating substance use disorder among its most vulnerable residents.

The goal of the HomePath study is to build evidence on a treatment model that incorporates Housing First and shared medical appointments. Ultimately, the study aims to evaluate whether HomePath can increase housing stability and treatment retention for substance use disorder and reduce the use of shelter, hospital, and criminal justice systems for individuals who have experienced homelessness and have opioid use disorder.

STATUS: Current

Basics

Issue: Health

Focus Area: Health, Housing/Community Initiatives

Population: Populations with Barriers to Employment

Focus Population: People with Substance Use Disorders

Intervention: Coordinated Care/Care Management

Design, Sites, & <br> Data Sources

Design, Sites, and Data Sources

MDRC is conducting the HomePath feasibility study in Chicago, Illinois; Philadelphia, Pennsylvania; and Richmond, Virginia. The study will gauge whether it would be possible to conduct a rigorous, full-scale evaluation of Housing First with shared medical appointments. To do so, MDRC will assess:

Whether it would be viable to recruit enough sample members to have the statistical power necessary for a rigorous full-scale evaluation
Whether the treatment contrast (that is, differences in services received) between the program and control groups is large enough to warrant further testing for program effects
Whether reliable outcome data can be collected using administrative data sources

In Philadelphia and Richmond, the study will examine only the implementation of the program. In Chicago, MDRC will adopt a mixed-methods approach to assess feasibility by pilot testing a natural experiment using the city’s coordinated entry system for permanent supportive housing. MDRC will also collect implementation data on patients who are referred directly to the clinic for opioid addiction treatment. MDRC is using data from a baseline survey, administrative data, participation data, and qualitative data across the three cities for the feasibility study.

In spring 2020, MDRC will make a recommendation to Arnold Ventures about whether to conduct a full-scale evaluation of the HomePath intervention.

STATUS: Current

Basics

Issue: Health

Focus Area: Health, Housing/Community Initiatives

Population: Populations with Barriers to Employment

Focus Population: People with Substance Use Disorders

Intervention: Coordinated Care/Care Management

Funders & <br />Partners

Funders

Arnold Ventures

Partners

The Cloudburst Group

Valley Homeless Healthcare Program

MDRC Staff

Richard Hendra
Director, MDRC Center for Data Insights
Hendra directs the Center for Data Insights, which uses rigorous data science methods to improve programs that serve populations in need.
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Edith Yang
Senior Associate, Economic Mobility, Housing, and Communities
Yang joined MDRC in 2008 and her work spans the areas of employment, housing and homelessness, financial inclusion, community development, and postsecondary education. Her work encompasses project development, project management, data science methods, impact and process analyses, and benefit-cost analysis.
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Frieda Molina
Director, Economic Mobility, Housing, and Communities
Molina has over 20 years of experience providing technical and operational assistance to workforce development service providers, and has worked at MDRC for 17 years on numerous workforce development evaluations.
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Alexandra Bernardi
Research Associate, Economic Mobility, Housing, and Communities
Since joining MDRC in 2008, Bernardi has worked on site development, research operations, and implementation data collection and analysis.
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