title: Barriers to care and service needs among chronically homeless persons in a housing first program.
abstract: OBJECTIVE
  In 2010, more than 600,000 people in the United States experienced homelessness. Efficient and cost-effective housing methods that reduce homelessness need to be implemented. Housing Ready programs are the standard method that often has set requirements including earned income and sobriety, among others. These programs enable a subset of the homeless to become housed. However, chronically homeless persons, who use the most resources, are often not successful at enrollment or maintaining enrollment. Housing First (H1) is a method focusing on chronically homeless persons. Housing First places a client in housing and provides services after stabilization. This article assessed differences between chronically homeless persons in a H1 program and chronically homeless persons who are not in H1.
  
  
  METHODS
  A case-control study imbedded within a homeless service program collected sociodemographic and service variables, including access and barriers to care.
  
  
  RESULTS
  Although the sample was 100% native English speaking, 22% of homeless persons reported that their providers do not speak their same language. All (100%) of participants had a disabling condition under HUD guidelines, but only 17.78% of homeless controls reported having a disabling condition. There were no differences on housing status based on income, gender, race, or age. The lack of differences between these groups indicates that a H1 program can be a clear derivation from the more common Housing Ready programs that have specific requirements for participation.
  
  
  CONCLUSIONS
  Provider communication may negatively impact an individual's ability to transition from homelessness. Furthermore, chronically homeless persons not in intensive case management are less likely to understand the eligibility requirements for housing and, therefore, self-disqualify because of this lack of knowledge. Intentional communication and education for chronically homeless persons are 2 examples where case managers could improve the ability of the chronically homeless to obtain housing.
authors.affiliation: Departmentof Medicine, University of South Carolina, Columbia, SC 29203, USA. parkerrd@mailbox.sc.edu
authors.forename: R David
authors.initials: RD
authors.lastname: Parker
authors.forename: Helmut A
authors.initials: HA
authors.lastname: Albrecht
mesh_terms: D016022:Case-Control Studies; D016001:Confidence Intervals; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016730:Program Development; D015397:Program Evaluation; D012042:Registries; D012111:Residence Characteristics; D013223:Statistics as Topic; D013997:Time Factors