Healthy Community Collaborative

the goal

Homelessness is a significant social issue that affects individuals and families across the United States. As per the Department of Housing and Urban Development (HUD) 2022 Point in Time Count, there were 582,682 people experiencing homelessness in the United States, with 24,432 people experiencing homelessness in Texas. 

Homelessness not only causes housing insecurity but also has severe consequences on the overall health of individuals. Many individuals experiencing homelessness also suffer from chronic health conditions, mental health disorders, and substance use disorders. Trauma is also a common experience among individuals who are homeless, and children experiencing homelessness are at risk of developing emotional and behavioral problems. The need for solutions to address homelessness is critical, and this is where Healthy Community Collaboratives (HCCs) come in. 

The Texas state government recognized the need for community-wide collaboration to address the issue of homelessness and authorized the creation of Community Collaboratives through Senate Bill 58 of the 83rd Texas Legislature. The Healthy Community Collaborative programs, which began in FY2015, are designed to help people experiencing homelessness who have a serious mental illness or a co-occurring substance use disorder. The HCC approach aims to reduce barriers to treatment by forging a collaborative effort among different sectors to provide housing and coordinate recovery-oriented mental health and substance use care. This approach is based on the housing first model, which prioritizes providing housing to individuals experiencing homelessness before addressing other needs. 

While Texas contributed significantly to the national estimates of people experiencing homelessness, it has lower rates of homelessness than the national average of 18 people per 10,000 (8 for every 10,000 people in Texas). According to the same research set, Texas has had one of the most significant decreases in homelessness in the country in recent years. From 2007-2022, the number of people experiencing homelessness in Texas decreased by 38.6%, and from 2020-2022, it decreased by 10.3%. 

As third-party evaluators, we play an essential role in assessing the effectiveness of the state homelessness program and helping to make improvements that will better serve those experiencing homelessness. We are dedicated to providing accurate and comprehensive evaluations that can guide decision-making and ultimately improve outcomes for individuals and communities across Texas. 

the approach

The Texas Department of Health and Human Services (HHSC) has implemented a collaborative approach to address homelessness through the Healthy Community Collaboratives (HCC) in five metro areas and two rural areas. The HCC brings together individuals, agencies, organizations, and community members to systematically tackle issues that cannot easily be confronted by one group alone. 

The HCC Sites address their unique community needs in different ways, but each area has developed a coordinated assessment process to provide housing and engage individuals to participate in mental health or co-occurring treatment services. The collaborative approach of the HCCs has shown promise in reducing barriers to treatment and addressing the complex needs of individuals experiencing homelessness with mental and substance use disorders. 

“Our philosophy has really been walking with people and being really intensively involved. So setting up the appointments with them, going with them, transporting them….Walking alongside someone through this whole process…..this journey to restore what they’ve missed out on – what’s been taken away through homelessness.” Case Manager at HCC site

the evaluation

The Texas Institute for Excellence in Mental Health (TIEMH) is conducting a comprehensive evaluation of the HCCs to measure their effectiveness. Using qualitative and quantitative methods, TIEMH researchers assess individual outcome measures such as housing, mental health treatment, substance use treatment, medical services, and services to support employment and employment readiness. They are also developing descriptions of each project site and emerging practices for dissemination in other communities. 

The TIEMH researchers also conduct ongoing data reviews for accuracy, quality, validation, and consistency and provide feedback for quality improvement every quarter. The evaluation conducted by TIEMH will provide valuable insights into the effectiveness of the HCC approach in addressing homelessness in Texas and inform future efforts to reduce homelessness and support recovery-oriented care.