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In 2014, RAND developed a new version of the survey used by the U.S. Department of Defense (DoD) to estimate the prevalence of sexual assault and sexual harassment. More than 115,000 active-component members completed that survey in the summer of 2014. Subsequently, the Sexual Assault Prevention and Response Office in the Office of the Secretary of Defense asked RAND whether a short version of the sexual harassment measure in the new survey could be developed for use in the Organizational Climate Surveys fielded by the Defense Equal Opportunity Management Institute. Whereas the sexual harassment instrument in the survey RAND developed required up to 52 questions to establish whether a service member experienced sexual harassment as defined in DoD regulations, in this short report the authors document a five-question measure that reliably predicts scores on the longer instrument. The five-item sexual harassment survey seems to be appropriate for use in military organizational climate surveys. The current report documents the suggested scoring of the short form instrument and demonstrates the close association between the short and full instruments when used to assess sexual harassment at either the individual or organizational level.

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Although rates of homelessness have remained fairly steady in the United States over the past decade, the number of people experiencing homelessness in California has continued to grow. California now has an estimated 151,000 people experiencing homelessness, more than any state in the nation. Permanent supportive housing (PSH) has been recently adopted by health plans, hospitals, and large health systems as a way to address one of the key social determinants of health: stable housing. This report represents a second examination of a PSH program operated by a large not-for-profit Medicaid and Medicare managed care plan in Southern California. This PSH program combines a long-term housing subsidy with intensive case management services for adult plan members experiencing homelessness who have one or more chronic physical or behavioral health conditions and represent high utilizers of inpatient health care. In this report, the authors provide an overview of implementation to date, including information about referrals and enrollment into the program, housing placements, and participant characteristics. The authors also assess the short-term impact of the program by examining health care service utilization and associated costs in the six months prior to and six months following enrollment in PSH in comparison with an observational control group of adult plan members who did not receive PSH. The authors also examine the PSH program costs during this period.

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Many individuals on probation in Los Angeles County face challenges with housing and employment, placing them at risk for further involvement with the criminal justice system. To address the needs of this population, Los Angeles County piloted a program called Breaking Barriers to provide adults on probation with a time-limited rental housing subsidy and housing retention services coupled with case management and employment supports. The primary goals of the Breaking Barriers pilot program were to (1) reduce recidivism, (2) improve participants' housing stability, and (3) improve employment incomes sufficiently for individuals to take over their own rental payments by the end of the program period. This report presents feedback from formative and summative evaluations that were conducted to help provide early findings from this innovative housing-employment initiative. Among the findings, for example, the program successfully housed more than 80 percent of participants, despite the challenges regarding the lack of affordable housing. Researchers also found that most participants did not achieve great gains in employment and associated income during the two-year program period. Each day of housing was associated with a 25-cent increase in the participants' contribution to rent. However, participants who had been in the program for two years were contributing on average only 19 percent of the total rental amount. For participants who received the full Breaking Barriers intervention (i.e., housing, case management, and employment services), the felony reconviction rate was 13 percent, which is lower than the rate among individuals with prior felonies in California (greater than 20 percent).

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Homelessness, which refers to the lack of a fixed, regular, and adequate nighttime residence, is a pervasive public health issue. This report presents results from an implementation and outcome study of an ongoing permanent supportive housing (PSH) program—including service utilization and associated costs review—operated by a large not-for-profit Medicaid and Medicare managed care plan serving more than 1 million members in the Inland Empire area of Southern California. This PSH program combines a long-term housing subsidy with intensive case management services for adult plan members experiencing homelessness who have one or more chronic physical or behavioral health conditions and represent high utilizers of inpatient health care. The aim of this report was to determine whether programmatic costs incurred by the health plan supporting the PSH program were partially or fully offset by decreased costs attributable to health care utilization within the health system. The evaluation used a quasi-experimental research design with an observational control group. The authors differentiated the program's effect during the transitional period—that is, after program enrollment and prior to housing placement—from its effect during the period after members were housed. In addition, the authors present participant flow through the key program milestones (e.g., referral, enrollment, housing placement, program exit) and describe health care utilization and associated costs for members who exited the program. Finally, they report the PSH programmatic expenditures relative to the changes in health care costs to provide an overall picture of the intervention's benefits and costs to the health plan.