Community Housing Network Implements Critical Time Intervention into Its Rapid Rehousing Services

Evidence-based practice helps prevent recurrent homelessness by ensuring access to resources, supports needed for long-term housing stability

When a person transitions from homelessness to stable housing, they often face immense challenges. Securing a place to live is just the first step on the path towards long-term stability, which requires more than just a roof over one’s head.

After leaving a hospital, a shelter or transitional housing, sleeping in a car or abandoned building, being incarcerated, or fleeing an abusive environment, consistent support is crucial during this time when individuals are particularly vulnerable as they navigate their housing journey.

It’s with that in mind that Community Housing Network (CHN) has recently incorporated the Critical Time Intervention (CTI) model into its Rapid Rehousing (RRH) program.

People surviving in places not meant for human habitation, and people who cannot exit homelessness on their own, are eligible for and have had access to RRH programs for the last 15 years. The cost-effective intervention that began in 2008 provides short- to medium-term rental assistance and services to help individuals and families obtain housing quickly, increase self-sufficiency, and stay housed permanently.

CHN helped 361 individuals last year through its RRH program, of which 164 (or 45 percent) were children.

Staff leadership in CHN’s Short-Term Programs Department attended training sessions late last year to learn more about CTI, a time-limited evidence-based practice that facilitates housing stability, community integration, and continuity of care. CTI has proven to be successful in supporting the return to housing for people with serious mental illness, people experiencing homelessness, veterans, and many other groups.

Understanding CTI

CTI was first tested in a randomized trial with unhoused men in a large men’s shelter in New York City in the early 1990s. CTI significantly reduced the risk of recurrent homelessness following placement into housing, according to the Center for the Advancement of Critical Time Intervention (CACTI). Over the 18-month follow-up period, those assigned to CTI had only one third the number of homeless nights as the comparison group.

A decade later, a second randomized trial tested the model with unhoused men and women after discharge from inpatient treatment. Once again, a large protective effect of CTI was found on both homelessness and rehospitalization, supporting the model’s effectiveness and demonstrating its applicability to hospital settings. In both studies, the impact of CTI persisted for nine months after the intervention ended.

Since then, CTI has been adapted for RRH to deliver shorter-term (six months) targeted services designed to increase economic resources and connect individuals and families to community supports that will help them retain housing after the financial assistance and case management period end. This strategy, developed by CACTI and the National Alliance to End Homelessness (NAEH) , has been strongly endorsed by the U.S. Interagency Council on Homelessness.

CTI-RRH is composed of three distinct phases guided by the following core values – strengths based, individualized, culturally sensitive, transparent, and trauma informed. Each phase – transition to the community, try-out, and transfer of care – is approximately two months long following a housing search and placement through an RRH program. The amount of contact between case managers and program participants should decrease as program participants move through the phases, promoting a gradual transition to community resources and support.

Some program participants may not be stably housed or successfully linked to needed support by the end of the six-month period. CHN will have explicit procedures in place that authorize extended or enhanced assistance. Some might need monthly visits from a case worker to ensure they’re getting the support they need. Some struggle a lot once off the streets and will need weekly – maybe even daily – support from service providers.

CTI-RRH does not create additional housing, income, treatment or other resources on its own but seeks to maximize access to and the impact of existing resources, according to CACTI. Since communities differ significantly on the availability of such resources, the model’s form and impact may vary in different communities.

CHN expects to focus on factors that directly influence housing stability, including housing stability planning, financial empowerment, physical and mental wellness, community resources and support, and daily living skills.

“At CHN, we added a new tool to our process to highlight the strengths our program participants have to navigate their housing crisis in addition to figuring out where the barriers exist so our staff can help empower and support them,” said Taylor Eberhart, Director of Short-Term Programs, who began training her team and rolling out best practices last month.

Why CTI-RRH?

At the end of January last year, 653,104 people – or about 20 of every 10,000 people – were counted as homeless on a single night, according to the 2023 Annual Homeless Assessment Report by the U.S. Department of Housing and Urban Development (HUD). This figure is the highest since HUD began reporting on the issue to Congress in 2007, and a 12 percent increase from 2022.

The rise in homelessness since 2017 is, in large part, because of the country’s massive shortage of affordable housing. Federal government officials have said that sweeping federal aid during the pandemic kept people from getting evicted and becoming homeless, but that aid started running out two years ago then inflation spiked to its highest level in a generation, and median rent hit a record high. Research shows there is a strong connection between the increase in rent prices and homelessness.

Other reasons for homelessness include difficulty finding employment and housing with a criminal record after leaving institutions such as prison. Advocates say there’s also a need for more addiction and mental health treatment, though it’s most effective once someone is safely housed. Yet the programs to help people stay housed are underfunded, scattered across different agencies, and are challenging for people reentering the community to access.

That’s why CTI-RRH is so important. Without adequate support, individuals and families may struggle to maintain their housing. While CTI-RRH is not designed to resolve poverty, and in many cases program participants’ housing will remain precarious, most are expected not to return to homelessness.

If service providers, like CHN, can catch people at that critical moment before they fall into homelessness, society will be one step closer to ending the homelessness crisis.