Evaluation of VA's Supported Housing Program for Homeless Veterans

描述(由申请人提供)： 三十多年来，退伍军人中的无家可归者一直是一个全国性的问题。去年，退伍军人事务部部长埃里克·新关承诺将无家可归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现象的五年计划。住房和城市发展-退伍军人事务支持住房(HUD-VASH)计划是为无家可归的退伍军人提供的最重要的退伍军人计划之一，需要评估、研究和改进。HUD-VASH是美国最大的退伍军人支持住房计划，并正在继续扩大。HUD-VASH方案目前为长期无家可归的精神或身体残疾成年人提供了20,000多张住房代金券，用于租赁援助以及支持性病例管理服务；今年又批准了10,000多张住房代金券。这项拟议的研究的目的是调查HUD-VASH计划在当地和全国的实际运作情况，目的是改善资源分配并根据退伍军人的需求定制退伍军人无家可归者服务。有三个具体目标。第一个目标是评估弗吉尼亚州康涅狄格州医疗系统HUD-VASH的创新群体密集型同行支持(GIPS)病例管理模式。此研究站点的性能和客户结果将使用退伍军人管理局管理程序数据在同一时间与其他对照HUD-VASH站点进行比较。据推测，该模式将成为HUD-VASH和全国其他支持住房计划的病例管理的一种具有成本效益的替代模式。第二个目标是对HUD-VASH临床医生进行一次全国调查，了解他们的病例管理做法和对在计划中使用小组的态度。调查结果将有助于为当前的病例管理做法建立基线，并确定可能有兴趣参与更大规模的GIPS模式演示的地点。第三个目标是在全国范围内评估住房安置和计划参与HUD-VASH。与住房安置的速度和计划参与HUD-VASH的持续时间相关的因素将被审查。将使用对退伍军人管理局最新行政方案数据的分析，结果将在方案开发中提供信息。这项申请是为了支持蔡崇信博士进行拟议的研究，并帮助他作为一名专注于退伍军人管理局无家可归者服务的独立调查员发展自己的职业生涯。蔡博士将主要在罗伯特·罗森海克医学博士的指导下工作，罗森海克是一位国际知名的精神卫生服务研究员，他评估了退伍军人事务部的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。蔡博士将由第二导师詹姆斯·麦奎尔(James McGuire)博士和第三位导师林海群(音)支持，前者是退伍军人管理局无家可归者服务的国家行政主管，后者是一名生物统计学家和纵向数据分析专家。此外，还聘请了MSW的文斯·凯恩顾问，为传播工作提供行政支持和指导。通过这个职业发展奖，蔡博士将能够评估当地和全国主要的退伍军人支持计划。通过课程作业和指导，蔡博士将获得研究方法和政策方面的培训。他将在项目评估方面发展专业知识，最终目标是在研究的基础上改善无家可归者的服务。在奖项结束时，蔡博士将成为退伍军人事务部的一名资深研究员，并将参与独立资金的竞争。

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.