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. 2021 Feb 1;4(2):e2037047.
doi: 10.1001/jamanetworkopen.2020.37047.

Association of Temporary Financial Assistance With Housing Stability Among US Veterans in the Supportive Services for Veteran Families Program

Richard E Nelson  1   2   3 , Thomas H Byrne  3   4   5 , Ying Suo  1   2 , James Cook  1   2 , Warren Pettey  1   2 , Adi V Gundlapalli  1   2 , Tom Greene  2   6 , Lillian Gelberg  7   8 , Stefan G Kertesz  3   9   10 , Jack Tsai  3   11 , Ann Elizabeth Montgomery  3   9   12
Affiliations

Association of Temporary Financial Assistance With Housing Stability Among US Veterans in the Supportive Services for Veteran Families Program

Richard E Nelson et al. JAMA Netw Open. .

Abstract

Importance: Temporary financial assistance (TFA) for housing-related expenses is a key component of interventions to prevent homelessness or to quickly house those who have become homeless. Through the US Department of Veterans Affairs (VA) Supportive Services for Veteran Families (SSVF) program, the department provides TFA to veterans in need of housing assistance.

Objective: To assess the association between TFA and housing stability among US veterans enrolled in the SSVF program.

Design, setting, and participants: This retrospective cohort study analyzed data on veterans who were enrolled in the SSVF program at 1 of 203 partner organizations in 49 US states and territories. Some veterans had repeat SSVF episodes, but only the first episodes were included in this analysis. An episode was defined as the period between entry into and exit from the program occurring between October 1, 2015, and September 30, 2018.

Exposures: Receipt of TFA.

Main outcomes and measures: The main outcome was stable housing, defined as permanent, independent residence with payment by the program client or housing subsidy after exit from the SSVF program. Covariates included demographic characteristics, monthly income and source, public benefits, health insurance, use of other VA programs for homelessness, comorbidities, and geographic location. Multivariable mixed-effects logistic regression, inverse probability of treatment weighting, and instrumental variable approaches were used.

Results: The overall cohort consisted of 41 969 veterans enrolled in the SSVF program, of whom 29 184 (mean [SD] age, 50.4 [12.9] years; 25 396 men [87.0%]) received TFA and 12 785 (mean [SD] age, 50.0 [13.3] years; 11 229 men [87.8%]) did not receive TFA. The mean (SD) duration of SSVF episodes was 90.5 (57.7) days. A total of 69.5% of SSVF episodes involved receipt of TFA, and the mean (SD) amount of TFA was $6070 ($7272). Stable housing was obtained in 81.4% of the episodes. Compared with those who did not receive TFA, veterans who received TFA were significantly more likely to have stable housing outcomes (risk difference, 0.253; 95% CI, 0.240-0.265). An association between the amount of TFA received and stable housing was also found, with risk differences ranging from 0.168 (95% CI, 0.149-0.188) for those who received $0 to $2000 in TFA to 0.226 (95% CI, 0.203-0.249) for those who received more than $2000 to $4000 in TFA.

Conclusions and relevance: This study found that receipt of TFA through the SSVF program was associated with increased rates of stable housing. These results may inform national policy debates regarding the optimal solutions to prevent and reduce housing instability.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Nelson reported receiving grants from the VA Health Services Research and Development Service during the conduct of the study. Mr Cook reported receiving grants from the VA Health Services Research and Development Service during the conduct of the study. Mr Pettey reported receiving grants from the VA Health Services Research and Development Service during the conduct of the study. Dr Greene reported receiving grants from Boehringer Ingelheim, AstraZeneca, CSG-CSL, Invokana, and Vertex and personal fees from Durect and Pfizer outside the submitted work. Dr Kertesz reported being an employee of the VA; receiving income from UpToDate Inc; owning stock in health technology companies Thermo Fisher and Zimmer Biomet (not exceeding 5% of his assets); and previously holding stock in CVS Caremark. No other disclosures were reported.

Figures

Figure.
Figure.. US Locations of the Supportive Services for Veteran Families Program Grantees Included in the Study From Fiscal Year 2016 to Fiscal Year 2018
See this image and copyright information in PMC

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