Homelessness Solutions Program Maryland Department of Housing and Community Development Capstone Project

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…Research Proposal Option: Proposal to Conduct an Evaluation(Evaluation Template)Proposed Outcomes Evaluation of the Maryland Department of Housing and CommunityDevelopments Homelessness Solutions ProgramHM893January 26, 2024Note: You are provided recommended page lengths per section to guide your writing efforts. Your entire paper should be a maximum of 30 pages (including Title Page, Abstract, References, and Appendices)Abstract (150 to 250 words maximum): The abstract should contain the following information: What is the public health problem addressed? What is the program/policy you plan to evaluate? Who is the target population? What is/are the main evaluation question(s)? What is the evaluation design? What are the expected implications of the evaluation? What data will be collected and used to conduct the evaluation? Where and when will the evaluation be conducted?Note: The abstract should be on a separate page after the title page and before Section 1.The proposed evaluation seeks to address the homelessness issue in Maryland. Point-in-time data showed that over 6,300 people in the state were homeless in 2020. While homelessness rates in the state have declined over the past decade, special populations such as veterans, chronically ill patients, and unaccompanied youth continue to be overrepresented among the homeless population. This evaluation seeks to evaluate the effectiveness of the Maryland Homelessness Solution Program (HSP) in reducing homelessness among Marylanders. The target population is individuals and households experiencing or at risk of homelessness in the State of Maryland. The evaluation will be conducted between January 2024 and December 2025 at 10 homeless shelters spread across Baltimore City, Baltimore, MD-BOS, Anne Arundel and Montgomery Counties. The following questions guide the evaluation: Compared to non-participants, are HSP participants more able to secure and maintain stable housing? How does the financial well-being of HSP participants compare with non-participants? Is the program accessible and relevant to the diverse needs of homeless people? Are program participants satisfied with the services offered? The evaluation will follow a case study with control group design. It will use survey and interview data collected from 300 randomly selected participants (150 HSP participants and 150 non-participants) at baseline, at program end, and at six months follow-up. Descriptive statistics will be used to analyze the program's effectiveness in reducing homelessness and to assess participants' satisfaction with available services. The evaluation findings will inform public health policy by providing insights on designing effective homelessness prevention interventions.Section 1: Background/Rationale for Proposed Evaluation: This section should address the following elements (2-3 double spaced pages):1. What public health problem and/or issue does the program/policy address?2. Why is this problem or issue important?3. What does existing data demonstrate about the magnitude and potential health impacts of this problem or issue?4. What population(s) is affected by this public health problem/ issue?5. What has previous evaluation literature found regarding this problem? Use peer-reviewed references to summarize the findings from evaluations of similar programs or policies. Address the following elements:a. Describe your search methods, inclusion criteria, and studies that you reviewedb. Describe the overall evaluation findings, including the strengths and weaknesses of this work6. What are the gaps or limitations in the evaluation literature? How does your proposed evaluation address these issues?The proposed evaluation focuses on homelessness. The 2009 Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act defines homelessness as a situation where a family or individual lacks an adequate, regular, and fixed nighttime residence (Substance Abuse and Mental Health Services Administration, SAMHSA, 2023). This definition of homelessness includes persons living in transitional housing, emergency shelters, abandoned buildings, the streets, and other places not meant for habitation. Individuals who stand to lose their nighttime residence within 14 days or are fleeing domestic violence and lack the resources to obtain alternative housing are also considered homeless under the HEARTH Act of 2009 (SAMHSA, 2023).Data from the National Alliance to End Homelessness shows that the number of homeless people in the United States (US) has risen by approximately 6 percent since 2017 (SAMHSA, 2023). Contrary to expectations, the COVID-19 pandemic that peaked in 2020 had no significant effect on the US homelessness rate (National Alliance to End Homelessness, 2023). According to a report by the Maryland Interagency Council on Homelessness (2022), this is due to the increase in economic assistance programs and attempts to de-congregate shelters in line with social distancing requirements that took place at the time. Nonetheless, a point-in-time count conducted in 2022 showed that over 582,000 (9 in every 5,000) people were homeless across the United States (National Alliance to End Homelessness, 2023). Individual adults made up 72 percent of this population, while 28 percent lived in the streets and other unfit environments with their children (National Alliance to End Homelessness, 2023).In Maryland, point-in-time count data from 2020 showed that slightly over 6,300 people were homeless statewide, with Baltimore City accounting for the highest rates of homelessness at 35 percent (Maryland Interagency Council on Homelessness, 2022). Generally, the statewide annual count showed that Maryland had approximately 28,288 homeless people in 2020 (Maryland Interagency Council on Homelessness, 2022). Unfortunately, homelessness disproportionately affects special populations, including persons with disability, mentally ill individuals, veterans, unaccompanied in-parenting youth, and victims of domestic violence (Maryland Interagency Council on Homelessness, 2022). Twenty-one percent of homeless people in the state, as per the 2020 point-in-time count, were chronically homeless individuals who had been homeless for over a year and struggled with a physical disability, substance use disorder, or severe mental illness (Maryland Interagency Council on Homelessness, 2022). Homeless veterans made up 7.5 percent of the homeless population, while individuals experiencing domestic violence and unaccompanied homeless youth made up 5 percent and 4 percent of the homeless population, respectively (Maryland Interagency Council on Homelessness, 2022).Policymakers across the US need to institute ways of addressing homelessness because it increases the risk of mortality and reduces the average life expectancy of affected populations (Maryland Interagency Council on Homelessness, 2022). Studies have shown that homeless people report higher rates of injury-related death and violence than the general population (Maryland Interagency Council on Homelessness, 2022). Data from the Office of the Chief Medical Examiner (as cited in Maryland Interagency Council on Homelessness, 2022) shows that approximately 243 homeless people died in Maryland in 2020. This translates to a death rate of 3,835 per 100,000 people for homeless populations, which is three times the death rate of the general Maryland population (Maryland Interagency Council on Homelessness, 2022).On average, homelessness reduces an individual's life expectancy by 30 years relative to the average person (Maryland Interagency Council on Homelessness, 2022). Unfortunately, homelessness is also associated with a higher risk of drug overdose and other complications related to the use of substances (Maryland Interagency Council on Homelessness, 2022). For instance, 65 percent of deaths reported among homeless individuals in 2020 were due to drug overdose and other related complications, with opioid overdoses accounting for 88 percent of these deaths (Maryland Interagency Council on Homelessness, 2022).A significant amount of lierature exists on the topic of homelessness. Many studies have sought to evaluate the effectiveness of various interventions in preventing or reducing homelessness. To identify possible studies for review, the evaluator conducted a literature search on three databases, Cochrane, PubMed, and Science Direct, for studies on homelessness prevention, case management, income assistance, and permanent supportive housing programs. The inclusion criteria included randomized controlled trials (RCTs) or systematic reviews conducted in high-income countries and published in peer-reviewed journals before 2020. Only studies that used housing stability as the outcome of interest were considered.Generally, the studies found homelessness prevention programs and interventions effective in preventing and reducing homelessness. Dwyer et al. (2023) found that unconditional cash transfers, coupled with coaching supports and workshops on plan-making, goal-setting, and self-affirmation, improved housing stability for homeless people within three months better than cash transfers alone. Similarly, Philips and Sullivan (2022) found that financial assistance coupled with case management for homeless people increased housing stability and reduced evictions more than monetary assistance programs. The primary weakness of these evaluations is that they focus on a single intervention, income interventions, and disregard supportive housing programs, which are also quite common. In their systematic review, Aubry et al. (2020) address this weakness by studying the effect of both housing support and income assistance interventions. The study found that compared to usual care, housing support programs increase long-term housing stability at a rate of 1.13. At the same time, income assistance coupled with case management improved the number of days a homeless individual is housed by eight days relative to usual care (Aubry et al., 2020).While these evaluations provide invaluable insights into the effectiveness of homeless assistance interventions, they have a limited scope, focusing on one or two interventions. The proposed assessment seeks to evaluate the HSP, which incorporates a range of diverse interventions targeted at homeless people. Moreover, the reviewed studies do not focus specifically on Maryland, and it would be interesting to check whether the findings of studies conducted in other environments could be replicated in the state of Maryland.Section 2: Program or Policy Description: This section provides detailed information about the program/policy that you are evaluating. This section should include the following elements: (4-8 double spaced pages):1. Program or Policy Purpose (Goals and Objectives)a. What are the goals and objectives of the program/policy that you are evaluating? What are the goals and objectives of your evaluation? Goals are broad statements of what you want to achieve with the proposed evaluation. Objectives are specific steps that establish how the goal will be achieved. Objectives should be specific, measurable, achievable, relevant, and time-based (i.e., SMART). Both goals and objectives should be aligned with the main evaluation question(s).Example of Goal and SMART ObjectiveGoal 1: Increase health…