Evaluation of VA's Supported Housing Program for Homeless Veterans

描述（由申请人提供）： 30多年来，退伍军人无家可归一直是一个全国性的问题。去年，退伍军人事务部长埃里克·辛塞基承诺将无家可归问题作为他的五大优先事项之一，并宣布了一项结束退伍军人无家可归问题的五年计划。无家可归的退伍军人，住房和城市发展退伍军人事务支持性住房（HUD-VASH）计划是最重要的VA计划之一，需要评估，研究和改进。HUD-VASH是全国最大的退伍军人支持住房计划，并将继续扩大。住房和城市发展方案-住房、住房、住房和卫生方案目前为长期无家可归的有精神或身体残疾的成年人提供了20 000多张住房券，用于租赁援助沿着支助性个案管理服务;今年又批准了10 000多张住房券。 拟议研究的目标是调查当地和全国的HUD-VASH计划的实际操作，以改善资源分配和定制退伍军人无家可归者服务退伍军人的需求为目标。有三个具体目标。第一个目的是评估一个创新的小组密集型同行支持（GIPS）模式的情况下管理的HUD-VASH在弗吉尼亚州康涅狄格州医疗保健系统。使用VA管理程序数据，将该研究中心的性能和客户结局与同期其他对照HUD-VASH中心进行比较。据推测，这一模式将是一个具有成本效益的替代模式的个案管理住房和城市发展-瓦什和其他支持住房方案在全国各地。第二个目标是对HUD-VASH临床医生进行一项全国性调查，了解他们对该计划中使用群体的病例管理实践和态度。调查结果将有助于为当前的病例管理实践建立一个基线，并确定可能有兴趣参与更大规模的GIPS模型演示的地点。第三个目标是在全国范围内评估住房和城市发展方案中的住房安置和方案参与情况。与住房安置的速度和方案参与HUD-VASH的持续时间相关的因素将进行检查。将使用最近VA管理程序数据的分析，其结果将在程序开发中提供信息。 这个应用程序是为了支持杰克蔡博士，在进行拟议的研究，并帮助他发展职业生涯作为一个独立的调查员，重点是退伍军人事务部无家可归的服务。蔡博士将主要在医学博士罗伯特·罗森赫克的指导下工作，一位国际知名的心理健康服务研究人员，他评估了弗吉尼亚州数百个无家可归者项目，并在该国建立了首批40个HUD- VASH项目。蔡博士将得到二级导师詹姆斯·麦奎尔博士的支持，他是弗吉尼亚州无家可归者服务的国家行政领导人，第三位导师，林海群，医学博士，哲学博士、他是生物统计学家和纵向数据分析专家。另外还聘请了一名顾问，即社会福利部的Vince Kane，负责提供行政支助和传播指导。 通过这个职业发展奖，蔡博士将能够评估主要的退伍军人管理局支持住房计划无家可归的退伍军人在当地和全国。通过课程和指导，蔡博士将获得研究方法和政策方面的培训。他将发展在项目评估的专业知识，最终目标是根据研究改善无家可归者的服务。在该奖项结束时，蔡博士将是一个既定的研究人员在退伍军人事务部，并在一个位置，以竞争独立的资金。

DESCRIPTION (provided by applicant): Homelessness among veterans has remained a national problem for over three decades. Last year, Secretary of Veterans Affairs Eric Shinseki has pledged homelessness as one of his top 5 priorities and has announced a 5-year plan to end homelessness among veterans. One of the most important VA programs for homeless veterans, the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program is in need of evaluation, research, and improvement. HUD-VASH is the largest supported housing program for veterans in the nation and is continuing to expand. The HUD-VASH program currently provides over 20,000 housing vouchers for rental assistance along with supportive case management services for adults with mental or physical disabilities who are chronically homeless; over 10,000 more housing vouchers have been approved this year. The objective of the proposed research is to investigate the real-world operation of the HUD-VASH program locally and nationally, with the goal of improving resource allocation and tailoring VA homeless services to veteran needs. There are three specific aims. The first aim is to evaluate an innovative group- intensive peer-support (GIPS) model of case management for HUD-VASH at the VA Connecticut Healthcare System. Performance and client outcomes at this study site will be compared to other control HUD-VASH sites during the same time using VA administrative program data. It is hypothesized that this model will be a cost- effective alternative model of case management for HUD-VASH and other supported housing programs across the country. The second aim is to conduct a national survey of HUD-VASH clinicians about their case management practices and attitudes about using groups in the program. The results of the survey will help establish a baseline for current case management practices and identify sites that may be interested in participating in a larger demonstration of the GIPS model. The third aim is to assess housing placement and program participation in HUD-VASH nationally. Factors related to the rapidity of housing placement and duration of program participation in HUD-VASH will be examined. Analysis of recent VA administrative program data will be used and the results will be informative in program development. This application is to support Jack Tsai, Ph.D., in conducting the proposed research and to help him develop a career as an independent investigator with a focus on VA homeless services. Dr. Tsai will work primarily under the mentorship of Robert Rosenheck, M.D., an internationally renowned mental health services researcher who has evaluated hundreds of homeless programs in the VA and established the first 40 HUD- VASH programs in the country. Dr. Tsai will be supported by a secondary mentor, James McGuire, Ph.D., who is a national administrative leader of VA homeless services, and a third mentor, Haiqun Lin, M.D., Ph.D., who is a biostatistician and an expert on longitudinal data analyses. An additional consultant, Vince Kane, MSW, has been recruited to provide administrative support and guidance on dissemination. Through this career development award, Dr. Tsai will be able to evaluate the main VA supported housing program for homeless veterans locally and nationally. Through coursework and mentorship, Dr. Tsai will gain training on research methodology and policy. He will develop expertise in program evaluation with the ultimate goal of improving homeless services based on research. At the end of the award, Dr. Tsai will be an established researcher in the VA and be in a position to compete for independent funding.