Impact of Housing and Services Inteventions for Homeless Families

Impact of Housing and Services Interventions for Homeless Families

Consent Form

Impact of Housing and Services Inteventions for Homeless Families

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Impact of Housing and Services Interventions for Homeless Families

Participation Agreement


[NAME of Community] is part of a study about the kinds of housing and services that help families who are homeless. The US Department of Housing and Urban Development (or HUD) is sponsoring the study which is authorized by Senate Report 109-109 for The FY2006 Transportation, Treasury, Judiciary, HUD, and Related Agencies Appropriations bill. Abt Associates, an independent research company, is helping HUD with the study.


I invite you to participate in this study to help HUD and [Name of Community] learn more about the kind of assistance that is most helpful for families.


Participating in this study is voluntary—you do not have to participate. If you decide to participate, I will ask you a number of questions about your housing, your work experience, people who are part of your family, and about your health. The interview will take about 40 minutes. Some of the questions I will ask you will help us to determine if you are eligible for some kinds of housing programs. At the end of the interview, you may be selected to receive one of the kinds of housing that you are eligible for. A computer lottery will determine which type of housing each person will receive, I don’t know what you will get, but some of the families who decide to participate will get a housing voucher or subsidy that helps to pay the rent and others will receive other types of help with rent. About a quarter of families will get temporary housing in a transitional housing program with social services to help them get their own housing later. About a quarter will not get any special offer. However, they can continue to use other services and assistance that aren’t part of the special programs. If you don’t get a special offer, you can stay here and continue to look for housing on your own. Of course, you don’t have to take any offer that you don’t want. It is also possible that the housing program that we offer you will not accept you. You can help to minimize that possibility by answering all the questions honestly, so that the computer only looks for housing for which you are eligible.


If you decide not to participate in this study, you will be able to look for other assistance in [Name of Community]. If you decide not to join, you won’t be able to receive one of the special programs that are part of the study, but it will not affect your eligibility for other housing or services that may be available in [Name of Community].


What do I need to do to participate in this study?

To join the study, you will need to sign this Participation Agreement. It explains more about the study and what is required of participants.


What happens once I agree to participate?

Once you have agreed to participate I will ask you to complete the interview and will ask you questions. The interview session will take about 40 minutes. The interviewer will ask you questions about your experiences with housing and work, your health, and who is part of your family. You will be given $35 as a way of thanking you for the time needed to complete the interview.


After you complete this interview, your name will be placed into one of the four program groups that you are eligible for, through a process called random assignment, which is like a lottery. A special computer program will be used to determine randomly each person’s group assignment. Every person who agrees to join the study has the same chance of receiving the participating housing programs for which they are eligible. These programs include a housing subsidy; a housing subsidy with social services; transitional housing with a temporary subsidy and social services, or no special services. If you are assigned to the fourth group, you will continue to be eligible to apply for any other assistance or housing available in the community, just as you are now.


If I sign the participation agreement, what else am I agreeing to do?

If you agree to participate in this study, you also will be asked to answer questions for other surveys in the future. We will contact you again about every six months or so for the next couple of years to ask about your experiences. The surveys are voluntary and you can refuse to answer any question. Agreeing to participate also means that you give the program staff and researchers permission to get other types of information about you from other government programs while the study is going on. That means that everyone in the study, no matter which group they are assigned to, gives permission to the researchers to collect information about you and your family such as:

.

  • The dates of your participation in housing or services programs

  • Data about earnings from jobs from unemployment insurance wage records or other earnings data

  • Data about receipt of public assistance

  • Child welfare records

  • Information about new addresses from any of these sources


Who will see the information I provide?

Any and all information you provide is confidential and will be protected under the Privacy Acti. Only the interviewer and authorized project staff and researchers evaluating the new program will see your survey responses. No one at the shelter or at the housing program to which you may be assigned will see your information (although they will be told that you met the criteria for eligibility for their program.) Any information that the researchers collect about you from other programs will also be kept confidential. Your name will never be used in any report. Reports for this study will only show summaries, no names or individual identifying information will ever be used in any research report.


Are there any costs to me to participate in this new program?

No, there are no financial costs to you for participating in this new program. Any services you receive from the new program will be provided to you at no cost.


Questions About Participation

If you have questions regarding this new program please contact the Abt Associates Inc. Project Director, Ms. Michelle Wood at (301) 634-1777. You may also contact Ms. Anne Fletcher at the U.S. Department of Housing and Urban Development at (202) 402-4347.


Consent by Participant

By signing this participation agreement, I confirm that I have read and understand the information presented in it. The information in this form has also been explained to me. I have had the opportunity to ask questions. I understand that my participation is voluntary, and I can ask to be withdrawn from the study at any time. I understand that I will be given a signed copy of this consent form to keep. I voluntarily agree to take part in this study of programs for homeless families.



_______________________________________________

Participant’s Name – PLEASE PRINT



_______________________________________________ ____________________

Participant’s Signature Date


_______________________________________________ (____)_____-_________

Street, City, State, Zip Code Telephone



Participant Study ID#1 _________________


1 This ID will be generated at the time of random assignment and is not the participant’s SSN. The site liaison will note the ID on the consent form after random assignment is completed. This will be the ID used to link between consent form and the random assignment record.


Privacy Act Statement: HUD’s authoritative and principle purpose, conditions of uses, and impacts, if any, for not participating in the survey are referenced within the participant agreement.


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