Padwa Howard, Smith Bikki Tran, Harris Taylor, Ijadi-Maghsoodi Roya, Cooper Madelyn, Loya Carissa, Kuhn Randall, Henwood Benjamin F, Gelberg Lillian
Department of Addiction Psychiatry, University of California, 10911 Weyburn Avenue, Suite 200, Los Angeles, 90024, CA, USA.
Department of Biomedical & Health Sciences, University of Vermont, 302 Rowell Building, 106 Carrigan Drive, Burlington, 05405, VT, USA.
Health Soc Care Community. 2024 Jul 2;2024. doi: 10.1155/2024/8254034.
Permanent supportive housing (PSH) is an evidence-based solution to chronic homelessness. There are two common PSH models: place-based (PB) programs where clients live in one building with services provided onsite and scattered-site (SS) programs, which use community apartments coupled with mobile case management and support. Understanding the relative strengths and weaknesses of PB and SS is important for PSH planning and service delivery. This paper explores homeless service provider perspectives on these two models after the onset of the COVID-19 pandemic.
Service providers ( = 37) from across 5 PSH agencies in Los Angeles that provided either PB or SS services during the pandemic participated in focus groups. Discussions were recorded, transcribed, and analyzed using template analysis, grounded theory, and inductive techniques.
Providers identified four major differences between PB and SS services: (1) challenges in finding placements; (2) managing relationships with landlords/property managers; (3) frequency of contact; and (4) community integration. Advantages of PB included ease of finding units, ease of managing relationships with landlords/property managers, greater ability to serve clients efficiently, more frequent client contact, and more community among residents. SS was seen to provide tenants with more opportunities to grow, live in healthier environments, and develop independence. During the pandemic, finding units for SS clients became more difficult, while differences between PB and SS related to frequency of contact and community integration became more attenuated.
PB can be advantageous for clients with higher levels of acuity, whereas SS could be more appropriate for clients who are more stable and independent. PB programs are seen to have practical and logistical advantages, but some providers prefer SS services. Clients and providers should be matched to PSH configurations that best match their needs and preferences, and providers should be aware that public health emergencies may impact PB and SS settings differently.
永久性支持性住房（PSH）是解决长期无家可归问题的一种基于证据的方案。有两种常见的PSH模式：基于地点（PB）的项目，即客户居住在一栋楼里，现场提供服务；以及分散地点（SS）的项目，该项目使用社区公寓并结合移动个案管理与支持。了解PB和SS的相对优势与劣势对于PSH的规划和服务提供至关重要。本文探讨了新冠疫情爆发后无家可归服务提供者对这两种模式的看法。
来自洛杉矶5家PSH机构的服务提供者（n = 37）参与了焦点小组讨论，这些机构在疫情期间提供PB或SS服务。讨论内容被记录、转录，并使用模板分析、扎根理论和归纳技术进行分析。
提供者确定了PB和SS服务之间的四个主要差异：（1）寻找安置点的挑战；（2）与房东/物业经理管理关系；（3）联系频率；（4）社区融合。PB的优势包括易于找到房源、易于与房东/物业经理管理关系、更有能力高效服务客户、更频繁地与客户接触以及居民之间有更多社区氛围。SS被认为为租户提供了更多成长机会、居住在更健康的环境中以及培养独立性的机会。在疫情期间，为SS客户寻找房源变得更加困难，而PB和SS在联系频率和社区融合方面的差异变得更加不明显。
PB对于 acuity 较高的客户可能具有优势，而SS可能更适合更稳定和独立的客户。PB项目具有实际和后勤方面的优势，但一些提供者更喜欢SS服务。客户和提供者应与最符合其需求和偏好的PSH配置相匹配，并且提供者应意识到公共卫生紧急情况可能对PB和SS环境产生不同的影响。
