PATH Evaluation December 7, 2004

1. Howard H. Goldman Professor of Psychiatry University of Maryland School of Medicine, Baltimore Westat Consultant PATH Evaluation December 7, 2004 Pamela J. Fischer Director of Evaluation Homeless Programs Branch SAMHSA Lisa C. Patton Project Director Westat

2. Projects that Assist in Transitions from Homelessness (PATH): Federal monies directed toward people who are homeless and have serious mental illness Congressionally-mandated evaluation: Conducted every 3 years

3. PATH role in MH Transformation • New Freedom Commission report • Call for an end to chronic homelessness • Participation of national leadership in this effort • States/communities develop means to end chronic homelessness

4. PATH role in MH Transformation • PATH focus is to help people with most serious mental illnesses to obtain • Housing • Additional support beyond mental health • Income support

5. PATH role in MH Transformation • 13+ years: PATH as transformational agent in MH system • State MH systems • PATH funds are used most often for State-selected, community-based activities including outreach/case management • Voluntary performance goals • Use exemplary practices • Transition PATH participants to mainstream services

6. Evaluations Conducted by Westat Past and Current Major findings of past evaluation PATH is a flexible funding stream Hallmark of PATH is its flexibility

7. PATH flexibility Problem or strength?

8. 2004/05 Evaluation • Initial activities • Reviews of PATH Annual Reports and State plans • Phone interviews with State PATH contacts

9. Phone Interview Qualitative Trends • Changes in the homeless population • Increase in number of homeless families • Increase in number of females served (now closer to 50% in some states) • Increase in number of people presenting with major affective disorders • Homeless providers typically not skilled in assisting family units

10. Phone Interview Qualitative Trends (cont.) • “New” competencies may be needed for homeless providers • Assisting family units (still needed) • Substance abuse (recent improvements) • Cultural competence (recent improvements) • One state reported that the 4% administrative fee goes to an organization to provide training and extensive TA to PATH providers. For example, developed supportive housing plan and guidebook featuring best housing practices for their communities

11. Phone Interview Qualitative Conclusions • Increased collaboration needed among CMS, HUD, and PATH, e.g. CMS funding HMIS as of Oct 04 • Integration of PATH information system with HMIS

12. Phone Interview Qualitative Conclusions (cont.) • PATH funding lends credibility • Leverage for increased visibility in communities/states • Increased support and involvement in homeless coalitions and policy academy followup

13. PATH is a major financing mechanism, providing communities with flexibility to serve people who are homeless and experience a mental illness It is critical to align the reporting requirements with program reality ensure that the information collected is useful to providers and programs

14. Next Steps: 2004/05 PATH Evaluation • Site Visits (9 states) • Diverse sample: geography, urban/rural, amount of funding, commitment of State PATH contact, history of innovation in the field, use of technology, current PATH outcomes • Interviews to be conducted with PATH consumers, frontline staff, and administrative staff

15. Comments/Questions?