Identifying Viable Strategies to Address the Homeless Problem in Maryland

Identifying Solutions to Homelessness in Maryland

Like many other states, homelessness in Maryland is a serious issue today. Despite ongoing efforts by the federal and state governments, Maryland has continued to experience an increase in homelessness in recent years, especially among families and individuals who are suffering the combination of poverty and a dearth of affordable housing (Decker et al., 2022). While some of this trend is attributable on the ongoing Covid-19 pandemic and its negative effect on the national economy, a wide array of chronic issues comprises the complex problem of homelessness in Maryland (The Maryland Interagency Council on Homelessness. 2022). Moreover, some people choose to remain homeless for a constellation of personal reasons despite the adversity of the condition, including most especially substance abuse and mental illness. Consequently, identifying viable strategies to improve the effectiveness of homeless interventions represents a timely and important enterprise. To this end, the purpose of this paper is to provide a description concerning homelessness in Maryland and why it is important to address this target population. In addition, an overview of the program proposed for evaluation is followed by a discussion concerning the evaluation questions most salient in addressing this problem. Further, an assessment concerning how the proposed evaluation will expand on existing work and a discussion concerning other evaluations of this program and their findings are followed by a description of the potential contributions the proposed evaluation can make to public health. Finally, a summary of the research and the key findings are provided in the conclusion.

1. What is the target health issue or topic (Homelessness), and why is it important to address? Who is the target population(s)?

The target population of interest in the proposed evaluation consists of homeless individuals in Maryland. Although precise figures are not available, state and federal officials estimate the number of homeless in Maryland at more than 50,000 people. A growing body of research indicates that a number of factors contribute to homelessness, but there is an inextricable relationship between homelessness and public health threats which makes this issue important to address. In this regard, one authority emphasizes that, “People typically experience homelessness because they can’t afford housing — which is often perpetuated by things like poor health. The connection between poverty, housing and health is close and direct” (Homelessness in Maryland, 2023, para. 5).

Because many state-level interventions for homelessness rely solely on taxpayer money for funding, it is essential to evaluate this programming to determine if there are gaps in coverage and other opportunities for improvement. For instance, according to Adams and Neville (2020), “Integral to health professional practice is the development and delivery of initiatives aimed at improving the health and wellbeing of individuals and communities. Given that many of these initiatives are publicly funded, an [evaluation] should be included for these initiatives” (p. 1). Therefore, evaluating health programs such as those that are designed to address the problem of homelessness is an essential element in achieving optimal outcomes as discussed further below.

2. What is the health program or policy that you will propose to evaluate?

The health program proposed for evaluation is the Maryland Department of Housing and Community Development’s Homelessness Solutions Program (HSP). Although the HSP does not articulate a specific mission or vision, the organization reports that, “The [HSP] serves as a statewide response to address the issue of homelessness in Maryland, providing technical support and funding to Continuums of Care and Local Homeless Coalitions which coordinate funding and resources for service providers across the state” (Homeless Solutions Program, 2023, para. 1).

In sum, the HSP was developed and implemented in 2017 in response to the growing public health threat of homelessness. In this regard, the state’s annual report on homelessness notes that in 2014, “Maryland agencies came together to create a statewide Homelessness Solutions Program (HSP) to provide a coordinated crisis response for addressing homelessness and begin to align homelessness programs across the state to national and federal best practices” (2022, p. 17). As discussed further in section 4, the HSP has been successful in some areas of its operation, but the problem of homelessness in Maryland continues to worsen for reasons that defy easy explanation. Consequently, the proposed evaluation will seek answers to several relevant questions as noted below.

3. What evaluation questions are you interested in addressing.

Although the following evaluation questions may be changed and/or new ones added as the research progresses, this group of proforma questions provides an indication of the main issues of interest for the proposed evaluation:

· Are program outcomes being tracked and measured effectively?

· Is the program effectively addressing the root causes of homelessness?

· Are program participants able to secure and maintain stable housing?

· Is the program cost-effective compared to alternative solutions?

· Is the program adequately funded to meet the needs of its target population?

· Is there adequate and ongoing support and resources for program participants after they secure permanent housing?

· Are the partnerships with other organizations and service providers being effectively used to optimize their impact?

· Is the program culturally sensitive and competent as well as being accessible to an increasingly diverse population?

· Are program participants consistently satisfied with the services and support they receive?

· Is the program adaptable and responsive to changes in the needs of the target population and community?

4. How will your proposed evaluation expand on existing work? What other evaluations of the health program or policy have been conducted? What were the findings? How do you envision your proposed evaluation contributing to public health?

An evaluation conducted by the Maryland Interagency Council on Homelessness (MICH) found that the HSP has largely been a good steward of its $10.3 annual budget from the state and federal governments. Of these funds, about $1 million was set aside specifically to fund programs targeting unaccompanied homeless minors pursuant to the Ending Youth Homelessness Act of 2018. The evaluation by the MICH found that the HSP “help[ed] to increase the efficiency of the funding process for the crisis response to homelessness, giving local communities more control and flexibility over spending decisions” (p. 17). The MICH evaluation also determined that the HSP was successful in aligning local homeless services with the federal government’s best practices, including low barrier shelters, coordinated entry systems and Housing First programming. In addition, the HSP was also effective in ensuring that partner organizations were in compliance with applicable state regulations (Annual Report on Homelessness, 2022).

Conspicuously absent from the MICH evaluation, though, is the harsh reality that since its implementation, the homeless problem in Maryland has just gotten worse. When something is made a priority, it is be definition supposed to get better. As noted above, there were some extenuating factors involved in this calculus, but the expenditure of millions of dollars in taxpayer money has not translated into any improvements in the homeless situation in Maryland. Therefore, formulating informed and timely answers to the above-listed evaluation questions will serve to identify potential opportunities to improve the administration of the HSP and its partner organizations in addressing the chronic problem of homelessness in Maryland today and in the future.