Home Again: Only a Home Ends Homelessness
Home Again presents progress at Massachusetts State House briefing


Worcester based housing first project improves health outcomes and reduces chronic homelessness


At a state house briefing sponsored by Representatives James O’Day and Byron Rushing, representatives from The Health Foundation of Central Massachusetts highlighted the significant impacts of the Worcester-based Home Again project to reduce adult chronic homelessness and improve health outcomes. The briefing provided an overview of Home Again (funded by The Health Foundation of Central MA) and Home & Healthy for Good (administered by Massachusetts Housing and Shelter Alliance), two of the Commonwealth’s leading “housing first” projects.


"This is a terrific start towards revamping the way in which we address the issue of homelessness. I feel certain that the success will lead to better outcomes for those who have been chronically homeless," said Representative James O'Day.


With the housing first approach, adults who are chronically homeless have access to permanent housing, case management and support services necessary for them to function at their highest capacity and remain housed.  Home Again was designed through a collaborative effort of several of the Worcester region's largest providers of emergency shelter, mental health and other support services. In Worcester, approximately 125 individuals, about 20 percent of the city's homeless, had been identified as chronically homeless. To date, the Home Again project has successfully housed 49 of these individuals.


“What we intuitively thought: ‘Only a home ends homelessness’ has been scientifically documented,” said Dr. Jan Yost, President and CEO of The Health Foundation.“The participants have maintained their housing and their health status has improved.”


State Representative Rushing, who co-chaired the Massachusetts Commission to End Homelessness, said, “This was an important presentation at the State House about Home Again’s work. Reports of successes like these show that, even in this tough economy, we are on the right track toward ending homelessness in our state.”


Home & Healthy for Good (HHG), the Housing First initiative overseen by MHSA, has placed more than 425 chronically homeless people into homes of their own across the Commonwealth. According to the March 2010 HHG report, which is submitted to the Department of Housing and Community Development and the State Legislature, tenant retention stands at 84 percent. The annual costs per person decreased from $33,479 before housing to $24,079 after housing placement, resulting in an annual savings of $9,400 per person. A recent analysis by the state Office of Medicaid showed that on average, Medicaid costs per HHG participant dropped by 67 percent after participants moved into housing.


A 21-month outcome evaluation of the Home Again project, conducted by a team from the Boston University School of Public Health, assessed both the Home Again participants and a random group of control subjects who received more traditional support services.


Among the key findings:

Home Again participants were 2.5 times as likely to achieve and maintain housing over six months. (97% v. 38%).

Home Again clients’ use of hospital emergency room services decreased by an average of 1.46 visits per three months during the evaluation period. By contrast, the control group reported an increase of 0.62  visits per three months.

The mental health of participants in both groups improved from baseline to the 6-month follow-up, but the mental health of the clients in Home Again improved more. 

Home Again participants were nearly twice as likely as participants receiving standard services to have good social support (34% vs. 19%). In general, people with good social support are more likely to have good physical and mental health, and are better equipped to reduce unhealthy substance use, than people with poor social support. 

“This was a rigorously conducted randomized trial with excellent six month follow-up rates, and the outcomes we assessed were in the anticipated and positive direction, indicating that the Home Again program was successful in achieving its goals—particularly in terms of enabling clients to achieve and maintain housing,” said lead researcher Dr. Emily Rothman, associate professor at the Boston University School of Public Health. 

One participant in the Home Again program, Ray, who is a part of the program with his wife, talks about the real life impact of the housing first model, saying: “When you have nothing, you have nothing to lose.  Since we have a home, we’re not the same people any more…our attitude has changed and we don’t want to go back to that culture.”

Home Again is a partnership of Community Healthlink (Administering and Fiscal Agent); the Central Massachusetts Housing Alliance; Dismas House; Henry Lee Willis Community Center; Jeremiah's Inn; and SMOC/People In Peril Shelter. Those interested in learning more about Home Again should visit the website at homeagainincentralma.org.