Five Year Study Offers Insights into Ending Veteran Homelessness

A longitudinal study of nearly 3,000 homeless and at-risk Veterans reveals factors that contribute to lasting housing stability and overcoming challenges most likely to lead Veterans to become homeless again. The analysis provides insights to help policymakers strengthen collaborations funded by VA’s $2.7 billion annual budget for homeless Veteran initiatives, such as HUD-VASH subsidy vouchers, Supportive Services for Veteran Families (SSVF), and Grant Per Diem (GPD) transitional housing programs.

The study of 2,839 Veteran families also offers insights into actions VA and its partners can take to improve the likelihood that the 40,401 homeless Veterans VA Secretary Denis McDonough announced his department had “permanently housed” last year do not become homeless again, said Dr. Paul R. Lawrence, a former VA Under Secretary for the Veteran Benefits Administration and Veteran advocate.

Prior studies, such as a 2008 review by the Department of Psychiatry at the Yale University School of Medicine, found as many as half of Veterans placed in permanent housing return to homelessness.

Veterans at Greatest Risk of Returning to Homelessness

The analysis found that Veterans with prior felony arrests, charges or convictions are twice as likely to return to homelessness after being placed in permanent housing. Veterans with disabilities are 50% more likely to return to homelessness after being permanently housed. 

Which Veterans Most Likely to Succeed?

Veterans who have consistent income at the time they are placed in permanent housing are twice as likely as others to remain permanently housed.

Five Year Longitudinal Analysis

The five-year study was conducted by analyzing data on clients served by Purpose Built Families Foundation’s Operation Sacred Trust program from 2017 to 2022. Purpose Built Families Foundation (PBFF) is a nonprofit delivering preventative and reparative services to end Veteran homelessness and prevent suicide. The foundation has achieved multi-year CARF Accreditation for its homelessness prevention, rapid rehousing and community housing programs. The agency’s Operation Sacred Trust collaboration is funded by VA Supportive Services for Veteran Families grants.

Ending Veteran Homelessness

Since 2011, Operation Sacred Trust (OST) has been one of the nation’s largest initiatives targeting Veteran homelessness, delivering comprehensive services to 1,000 homeless and at-risk Veteran families each year in the Greater Miami-Fort Lauderdale metropolitan area. South Florida represents the state’s largest concentration of homeless Veterans. The Annual Point-in-Time Count conducted by local volunteers and homeless program professionals on a single night in January conducted between 2011 and 2020 indicates a 54% decrease in Veteran homelessness and a 68% decrease in the number of unsheltered homeless Veterans across the Greater Miami-Fort Lauderdale area.

Connecting the Dots

Two years ago, as PBFF began focusing on analytics highlighting the connection between stable income and permanent housing stability, the foundation hired Dr. Lawrence to mentor the agency’s Veteran Benefits team. Dr. Lawrence was later elected to the nonprofit’s Board of Directors.

Over that period, the program has helped homeless veterans served by OST collectively receive more than $3 million in new annual benefits. “That’s a significant contribution to enduring housing stability and the local economy,” Dr. Lawrence said while emphasizing the successes are just the very beginning of what’s possible.

Improving Nationwide Outcomes

Dr. Lawrence said the study delivers insights that can improve outcomes nationwide.

RAND Corporation reports nearly 60% of U.S. veterans are eligible for VA benefits, yet fewer than half of those eligible veterans use VA benefits. “With passage of the PACT Act, those numbers are increasing,” Dr. Lawrence said.

“The study confirms that homeless initiatives that improve veterans’ rapid access to care and the benefits they’ve earned are most likely to have an enduring impact,” Dr. Lawrence said.

A Replicable Model for Ending Veteran Homelessness and Preventing Suicide

Dr. Lawrence said the study validates the Operation Sacred Trust model as a unique approach other service providers can replicate to improve the impact of VA’s annual investment ending Veteran homelessness and preventing suicide.

“When a Veteran walks into an Operation Sacred Trust Veterans Service Center, they get rapid support pursuing VA benefits, legal aid, help navigating health care challenges with VA and private providers, care management, financial assistance, and skills training to strengthen connections with friends, family and social support networks. That investment in comprehensive, wrap-around care under one roof is a formula that works,” Dr. Lawrence said.

Merging Compassion with Analytics

PBFF Founder and CEO Seth Eisenberg agrees.

Eisenberg said the agency’s model is built on a constant review of analytics combined with compassionate, trauma-informed, client-centered care individualized to meet the needs of each Veteran. Eisenberg stressed that homeless and at-risk Veterans are at heightened risk for suicide, a consideration that has long influenced OST’s commitment to 24/7/365 accessibility and responsiveness.

Serving Veterans After Incarceration

“Data helped us better understand the challenges for homeless Veterans reentering our community after incarceration and act on that information,” Eisenberg said. 

As an example of how the agency learns from that data, Eisenberg pointed to a recent Veteran who reached Operation Sacred Trust two days after being released from a ten-year prison sentence.

“We’d seen even prior to the study’s conclusion that formerly incarcerated Veterans were at far greater risk of recidivism,” Eisenberg said. “In response, we made adjustments in staffing and focus to have the best chance of delivering rapid assistance with enduring value to this particularly significant Veteran population.”

Recently, Air Force Veteran Lloyd Christopher was a beneficiary.

“Simultaneously, our team helped Christopher pursue benefits for which we anticipated he’d be eligible, strengthen interpersonal connections, involve our resilience, legal and health navigation teams, and identify housing options. Within 60 days, he’d been awarded almost $90,000 in benefits, was pursuing new career opportunities, and living in a new apartment,” Eisenberg said. “Analytics helped us know what we needed to strengthen, act on that information, and deliver supports to give this Veteran and others the best chance of lasting success – all under one roof,” he added.

Housing Programs Can Save Taxpayer Dollars

The five year analysis builds on a 2020 Miami study by the University of South Florida, Behavioral Science Research Institute and Carrfour Supportive Housing considering the overall costs for housing the homeless versus the public cost of homelessness. The study was supported by Florida Housing Finance Corporation and set out to explore whether providing affordable housing combined with intensive on-site services to “our most at-risk neighbors saves the community money by decreasing use of emergency room visits, jail stays, shelter stays and usage of other expensive systems of care.”

“While we knew that housing this population was the right thing to do, we were not sure whether the cost of housing would be cost effective,” said Carrfour President Stephanie Berman-Eisenberg. Berman-Eisenberg co-founded the Operation Sacred Trust collaboration with her husband, Seth Eisenberg, in 2011 to uniquely focus on ending Veteran homelessness and preventing suicide.

The study found that supportive housing successfully “reduced the usage of other costly systems of care and ultimately saved the community money.”

“Supportive housing not only significantly improves the quality of life for those served, but also saves taxpayer’s
dollars. We now know that providing an array of targeted on-site supportive services and stable, sustainable, affordable housing is not just better for those who have lived on the streets of our communities — it’s better for all of us,” Berman-Eisenberg said.

What Does it Cost to End Veteran Homelessness?

Eisenberg said delivering comprehensive care to homeless and at-risk Veterans costs between $1,500 and $2,000 each month. Those costs have increased in the Greater Miami area since the COVID pandemic as housing prices have soared, affordable housing is increasingly scarce, and inflation has made many basic necessities more expensive, he said.

Most recently, Eisenberg said the average monthly cost per Veteran family served by the agency is $1,500, with 38% going towards temporary financial assistance, 57% for direct services such as help pursuing veteran benefits, health care navigation, legal aid, and care management, and 5% for administrative costs. The program aims to help each Veteran achieve housing stability in no more than 90 days, with many moving into permanent housing within days or weeks, he said.

Help for Homeless and At-Risk Veterans

VA-funded programs are available to Veterans throughout the United States. More information is available from the VA website. For more information on VA-funded SSVF programs for Florida veterans, visit VeteranHousingHelp.com.