Permanent Supportive Housing (PSH) is an evidence-based intervention that combines affordable housing with wrap-around support services in order to end homelessness for individuals who experience barriers to housing stability, such as serious mental illness, substance use problems, and chronic health conditions. Since the model’s inception, the number of PSH beds in the U.S. has increased substantially, up 52% just over the past ten years. Currently, the U.S. Department of Housing and Urban Development estimates that close to 320,000 PSH beds exist within the federal housing inventory. However, demand for PSH still outstrips supply, and one of the overarching questions for policymakers is how to “right-size” homeless services to individual need and maximize the use of limited resources.

While some service recipients will require the intensity of support services and housing assistance that PSH offers for a lifetime, others may not need this level of support after some time and want to transition from the PSH program into mainstream housing completely separate from supportive services. In fact, a previous study of PSH programs estimated that 5 to 25 percent of PSH residents would be able to successfully move on from these programs and live independent from services.

In recognition of this gap in the homeless service system, several recent pilot programs (commonly called Moving On initiatives) are assisting willing and able PSH residents with the transition from program-based apartments into mainstream independent units using a combination of transitional supports and affordable housing subsidies. Moving On initiatives address the PSH “supply bottleneck” by allowing homeless individuals and families with greater needs to access intensive services, while providing opportunities for those who can move on with the opportunity to achieve fully integrated, independent living in the community in the least restrictive setting possible. However, best practices for the Moving On model have yet to be developed and little is known about the outcomes of those leaving PSH through these initiatives over time.

Dr. Emmy Tiderington (Assistant Professor of Social Work at Rutgers, the State University of New Jersey), in collaboration with Dr. Dan Herman (Professor of Social Work at Hunter College), is conducting a three-year study funded by the Oak Foundation of the implementation and outcomes of New York City’s Moving On Initiative (MOI). The New York City MOI is one of the largest in the country, assisting 125 PSH recipients across five supportive housing agencies and a range of subpopulations (e.g. adults, families, and youth who have aged out of foster care) as they move from PSH into independent apartments using Housing Choice Vouchers and various transitional supports.

The aims of this mixed methods study are to: 1) Capture MOI recipient outcomes regarding quality of life, health and recovery, community integration, service utilization, and housing stability, at one year and two years post-leaving PSH; 2) Describe MOI program implementation processes and experiences within and across the five different Moving On provider agencies; and 3) Identify the individual-, program-, and system-level barriers to and facilitators of MOI recipients’ successful transition from PSH programs to independent living in the community. Findings from this study will be used to inform the development of best practices for MOI implementation and broader scale-ups of MOI across the country.

Dr. Emmy Tiderington

Blog Post Author: Emmy Tiderington, PhD, LMSW Assistant Professor, School of Social Work and Associate Faculty, Institute for Health, Health Care Policy and Aging Research at Rutgers, The State University of New Jersey

Dr. Tiderington’s research focuses on the implementation and effectiveness of supportive housing and other forms of homeless services as a means for ending homelessness and improving outcomes for service recipients. She is a licensed social worker with extensive direct practice experience working in supportive housing and case management services for adults with serious mental illness. In addition to leading the Moving On study, her research has explored the mechanisms and processes by which homeless adults achieve recovery from substance abuse and serious mental illness. She has also examined the individual, organizational, and macro-systemic barriers to “street-level” policy implementation of person-centered care, harm reduction, and the management of risk and recovery in supportive housing services.

Like this post?
Check out this one written by Dr. Kimberly Bender from the University of Denver.

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