IHI ID 02 Sustaining an end to homelessness over time

Beth Sandor; Lindsey Giblin

doi:10.1136/ihisciabs.2

Abstract

Background Sustainably ending homelessness requires multi-stakeholder teams to constantly solve for population level outcomes over time. Previously, no measurement framework existed for knowing if a community had reached an end to homelessness, and more importantly, if those gains were continually maintained.

Objectives In 2015, we began to use a sustaining threshold to measure if the communities that had reached functional zero for veteran homelessness had sustained their progress over time by continually developing new solutions to the ever-changing complex problem of homelessness.

Methods Built for Zero communities that have reached functional zero submit seven monthly data points related to the number of actively homeless veterans entering and exiting their systems. We compare this monthly data to the community’s original functional zero threshold to measure sustainability over time.

Results To date, eight communities have ended and sustained a measurable end to veteran homelessness. All continue to experience fluctuation in the number of veterans experiencing homelessness, after they reach functional zero. Four communities have sustained consistently, especially those with higher thresholds relative to their system size and capacity. Communities that have sustained for three months or more are more likely to have sustained long term.

Conclusions Sustaining an end to homelessness requires communities to continually track and respond to the dynamics of homelessness across a geographically defined area, even after they have ‘ended’ homelessness. Given the impact of social determinants on health outcomes, understanding how to maintain an end to homelessness has implications for population-level outcomes across housing and health sectors.