Assessing an Initiative to Facilitate Long-Term Financial and Housing Stability in Vulnerable Veterans

NIH RePORTER · VA · I01 · · view on reporter.nih.gov ↗

Abstract

Background and Significance: Through the Shallow Subsidy component of the Supportive Services for Veteran Families (SSVF) program, Veterans and their families living in high cost-of-living locations in the US who are experiencing homelessness or at risk of becoming homeless can receive up to 2 years of rental subsidies and job training through non-profit organizations in the community. The goal of the program is for Veterans to achieve long-term financial self-sufficiency through employment and housing stability. The impact on Veteran housing, healthcare cost, and health outcomes as well as Veteran satisfaction with this program is not known. Poverty has a devastating effect on Veterans’ health and well-being. In addition, homelessness can be costly both to the healthcare system and society as a whole. Solving the problem of long-term Veteran financial and housing instability is one of the most important initiatives the VA is currently pursuing. Innovation: Our study – evaluating a program implemented in 15 different communities in the US – will be the largest to examine the impact of long-term financial support for individuals facing housing instability in the US. In addition, we will use both structured and unstructured data and detailed, Veteran-level data on services and financial assistance received by Veterans enrolled in this program. Finally, we will join VA clinical data with tax filings data available through the US Department of the Treasury to estimate the impact of Shallow Subsidies on income and employment outcomes. Specific aims: Aim 1: Identify barriers and facilitators to implementation and use of the Shallow Subsidy program using semi-structured interviews with VA operations partners, SSVF grantee employees, VA homeless services providers, and Veterans using the Shallow Subsidy program. Aim 2: Describe and identify predictors of the amount of financial support for Veterans enrolled in the Shallow Subsidy program for FY2020- FY2023 using HMIS, VA administrative, and publically-available community-level data. Aim 3: Perform an outcome and economic assessment of the Shallow Subsidy program. 3a: Measure the impact of this program on housing, income, employment, health, and healthcare cost outcomes through retrospective cohort analyses for FY2020-FY2023. 3b: Conduct economic evaluations of the Shallow Subsidy program compared to standard SSVF and usual care using input parameters from the published literature and from Aims 2 and 3a. Methodology: In Aim 1, we will conduct interviews with national VA stakeholders, SSVF grantee employees, VA homeless service providers, and Veterans who have enrolled in the SSVF program. In Aim 2 we will construct multi-level regression models to identify both individual- and community-level predictors of Shallow Subsidy use and expenditures. In Aim 3a, we will fit outcome models relating Shallow Subsidy program initiation to the subsequent mortality, exit from homelessness, income, employment, and cost...

Key facts

NIH application ID
10739722
Project number
5I01HX003387-03
Recipient
VA SALT LAKE CITY HEALTHCARE SYSTEM
Principal Investigator
Richard E. Nelson
Activity code
I01
Funding institute
VA
Fiscal year
2024
Award amount
Award type
5
Project period
2021-10-01 → 2025-09-30