HUD's Shelter Plus Care (S+C) program was designed to help the most vulnerable and hard-to-serve segment of the homeless population -- disabled persons with severe mental illness, AIDS, or chronic substance abuse problems -- leave the streets for permanent, supportive housing. The recently published National Evaluation of the Shelter Plus Care Program reports that S+C effectively serves its intended clients, though not as initially planned.

S+C provides grants to public agencies for projects that offer participants a variety of housing choices coupled with supportive services to fashion residential environments that range from highly supportive to independent living. The report examines how communities use S+C to provide disabled homeless people with stable housing where they can address their problems, increase their skills, earn income, and gain more influence over the decisions that affect their lives.

Perhaps the most important discovery made by the evaluators was that the program's statutory intent -- to assist disabled persons to leave the street and move straight into permanent housing -- proved impractical. Most clients who had been homeless needed to complete a transitional program using intensive case management, life skills training, and treatment before moving into the more permanent and independent S+C regimes. The evaluation also found that:

• S+C reached its target clients. During the first 2 years, 34 percent of S+C clients had severe mental illnesses, 33 percent were chronic substance abusers, 8 percent had AIDS, and 25 percent had multiple disabilities.

• More than one-half of participants reported improvement in their physical and mental health, their ability to care for themselves, and mending frayed social and familial ties. These improvements usually occurred within 3 months. For participants with multiple disabilities, however, substantial improvements appeared only after 2 years. This progress was reflected in fewer encounters with emergency room services, inpatient hospital care, substance abuse treatment centers, and jails.

• The average income of participants rose and employment increased by 10 percent. Case managers estimate that one-third of the participants may eventually be capable of gainful employment.

• The administrative costs of securing, coordinating, and tracking the delivery of supportive services proved to be much higher than initially anticipated. Grantees called for greater administrative and programmatic flexibility in using S+C.