The study examines the issue of the effectiveness and cost effectiveness of homelessness prevention and support programs operating in Western Australia.

A feature of the research is the close collaboration between the research team and community service agencies.

The 'effectiveness' of a homelessness prevention or support program is given by the difference in outcomes achieved by those who receive services from a homelessness prevention or support program over and above what would have been achieved had those same clients not received support.

The 'cost-effectiveness' of the program is the differential outcome of the program relative to the cost of providing the service.

One of the key issues that the study is examining in this context is that homelessness programs may achieve savings elsewhere as a result of the program being in place.

Savings occur when homelessness prevention and assistance programs lower outlays in non-homelessness-related areas. Homelessness programs may improve the health, financial security, employment and accommodation outcomes of clients. This, in turn, may result in decreased utilisation of homelessness prevention and support services in the future, reduced utilisation of hospital and justice services, lower income support payments and higher tax payments.

This study attempts to measure the outcomes and costs of homelessness prevention and support services operating in Perth, the South-West and the Southern regions of Western Australia. In so doing it represents the first major attempt at a comprehensive economic evaluation of homelessness prevention and support services in Australia. Working closely with agencies providing support to those who are homeless and at risk of homelessness, the study will gather primary research evidence on client outcomes and costs using a retrospective-prospective methodology. In this approach, data is captured on the position and history of the client as they enter a service. For case-managed clients, progress through the support period and beyond is assessed at three months, and at 12-months and on exit from support. A separate analysis is being undertaken with respect to community day centres.

The project also encompasses a case-study component.

 In addition to gathering and analysing primary research data, the study will also utilise existing administrative data sources to examine client outcomes and levels of service utilisation. The study will attempt to estimate the differences that services make to the lives of those who receive support taking into account their needs, background and forms of support.

The range of potential outcomes include changes in status (labour force changes, income etc), changes in resource use, changes in the capability of the client to resolve or manage their need, changes in self-assessed satisfaction with the quality of life and changes in the utilisation of other services. Moreover, the presence of complexity makes the assessment of outcomes particularly difficult and the use of simple single outcome measures (much used in the cost-effectiveness field) close to meaningless. We should not underestimate how difficult it is for service providers to gain the trust of clients who present with co-morbidity, a history of trauma as a result of sexual abuse, family violence, war injuries or street violence.

Real advances may be being made by services but not show up in any quantitative measure for a long period of time. Indeed, it may be possible that long-term beneficial impacts will only accrue over a number of occasions of support. Studies that focus on measuring outcomes over a discrete period of time cannot fully capture the impact of services of client outcomes.

It is important to this project and to the agencies participating in it that an assessment of outcomes takes these complications of measurement into account.

The project will provide community service agencies and Federal and State Governments with evidence on the whole-of-government budgetary costs of providing, and not providing homelessness prevention, support and transition programs. It will also provide evidence on the outcomes achieved by homeless people and those at risk of becoming homeless in the intervention and no intervention cases.

Quantitative Analyses

The study involves a quantitative survey and a qualitative case study analysis. For the purposes of the research project, clients are divided into three categories. A separate type of client survey is completed for each client type.

1.  Main Client Survey: Longer-term case managed clients. Clients with an expected continuous support period lasting more than 2-3 weeks. The Main Client Survey contains three timed waves (entry, 3 months and 12 months) plus an exit wave.

2.  Short Form Client Survey: Short-term clients. Clients with an expected continuous support period lasting for less than 3 weeks. The Short Form Client Survey contains three timed waves (entry/exit, 3 months and 12 months).

3.   Community Centres Client Survey: Clients of SAAP-funded Day Centres. A one-off survey.

The study also places considerable importance on the use of a qualitative design framework, involving interviews with both project participants and program administrators to enrich our understanding of outcomes achieved by clients. A particular focus in the qualitative component of the research is on the pathways into and out of homelessness as well as within homelessness.