0930-0381 PATH _ 2020 Triennial Report

Attachment 4: 2020 Triennial Process Evaluation Report of the Projects for
Assistance in Transition from Homelessness Program (PATH)
(Data from 2016, 2017, and 2018)

2020 Triennial PATH Evaluation Report

2020 Triennial Process Evaluation
Report of the Projects for
Assistance in Transition from
Homelessness Program (PATH)
(Data from 2016, 2017, and 2018)
\

Substance Abuse and Mental Health Services Administration
Center for Mental Health Services

2020 Triennial PATH Evaluation Report

Substance Abuse and Mental Health Services Administration
Miriam Delphin-Rittmon, Ph.D.
Assistant Secretary for Mental Health and Substance Use

Center for Behavioral Health Statistics and Quality
CAPT Michael King, Ph.D., M.S.W
Acting Director

Center for Mental Health Services
Anita Everett, M.D., DFAPA
Director

2020 Triennial PATH Evaluation Report

Table of Contents
Executive Summary.......................................................................................................4
Introduction ...................................................................................................................5
Data Sources..................................................................................................................8
Evaluation Goals and Provider Background .................................................................8
PATH Evaluation Findings and Achievements ..........................................................13
Conclusion and Recommendations .............................................................................27

2020 Triennial PATH Evaluation Report

Executive Summary

The Projects for Assistance in Transition from Homelessness (PATH) program was created as part
of the Stewart B. McKinney Homeless Assistance Amendments Act of 1990 (P.L. 101.645). The
Program is administered by the Division of State and Community Systems Development of the
Center for Mental Health Services (CMHS) within the Substance Abuse and Mental Health
Services Administration (SAMHSA). The PATH program was created to reduce or eliminate
homelessness for individuals with serious mental illness (SMI), co-occurring disorders, or are at
imminent risk of becoming homeless. In 2016, 2017 and 2018, funds were provided to all 50 states,
the District of Columbia, Puerto Rico, and four U.S. territories. Program funds support services
such as street outreach, case management and services not otherwise supported by mainstream
mental health programs. All grantees are required to provide a match of at least $1 for every $3 in
federal funding. Through the PATH program, grantees offer funding to provider organizations with
over half (53%) of grantees providing funds to community mental health centers followed by social
service agencies (14%), shelters or housing agencies (9%), health care for the homeless agencies
(2%), substance use treatment agencies and consumer-run mental health agencies each accounted
for 1% and other types of agencies accounted for 20% of provider organizations. In 2018, a total of
466 PATH providers received grant funds.
Data in this report were collected from two sources: a triennial report covering activities in 2016,
2017, and 2018, as well as a state PATH contact (SPC) web-based survey administered in August
2020. The SPC survey collected detailed information on program administration and oversight,
provision of technical assistance (TA) and training, involvement/collaboration with the Continuums
of Care program and perceptions of the appropriateness of the PATH program. This report presents
findings for each of the federally mandated evaluation questions for the PATH program based on
quantitative data collected from PATH grantees.
The first evaluation question focuses on whether services funded with PATH monies are
appropriate. There are two factors in assessing this question: the degree to which the services
delivered conform to the program guidelines and the SPC’s assessment of the appropriateness of
the PATH program design. Data from PATH grantee annual reports suggest that over the three
years, PATH programs offered appropriate services, such as outreach services, case management,
allowable housing services, staff training, community mental health services, screening and
diagnostic treatment services, alcohol and drug treatment services and supportive and supervisory
services in residential settings. Data from the two sources indicate that an average of 57% of those
reached with serious mental illness (SMI) were enrolled in services and an average of 58% of those
reached received community mental health services. Through the SPC survey, 90% of respondents
reported that the program focused on the appropriate client population. Seventy-three percent
(73%) believe that the program had a positive effect on moving clients into permanent housing.
The second evaluation question focuses on whether services funded through PATH were well
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2020 Triennial PATH Evaluation Report
administered by the grantee. This question was evaluated through the examination of three factors:
level of oversight of PATH providers, opportunities to improved skills, and collaboration with
community services. PATH grantees use different mechanisms to monitor grant performance. The
most common mechanism to monitor performance was through the HUD Homeless Management
Information System (88%) followed by site visits and review of financial documents or billing
(85% of grantees for each category). Additional methods of monitoring included: meetings and
teleconferences (69%), evaluation of performance goals (67%) and audits (50%). When an issue
was identified, the two most commonly used strategies were the provision of technical assistance
(TA) (84%) and training (75%) while over half (64%) of the grantees used corrective action plans
to handle concerns with providers. In addition, more than half (57%) of PATH providers reported
providing TA/training on evidence-based practices (EBP). Regarding collaborating with
community services, the majority (94%) of PATH grantees reported they participated in the
Continuums of Care (CoC) program.
Finally, this report examines whether the outcome and process goals for the PATH program have
been achieved. Although not every target was met for each year, data suggest that the PATH
program has achieved some success in the program’s Government Performance and Results Act
(GPRA) measures. According to the annual reports for each year, over 140,000 homeless
individuals were reached each year (in 2016, an estimated 170,000 individuals were reached). Each
annual report reported that over 65,000 of those reached were enrolled in the program. The
majority of individuals enrolled by PATH programs, for each of the three years, were male
(approximately 60% each year) with an average of 48% each year being between 31-50 years old
(over 90% were between 18-61 years old). Slightly more than half of participants were White
(58%) and veterans constituted 7-8% of individuals enrolled in PATH programs. Across all years,
approximately 47% of persons enrolled in PATH had co-occurring mental and substance abuse
disorders.
In addition to summarizing the results of the PATH program, this report also represents the first
deliverable for SAMHSA as manager and evaluator of the PATH initiative. Evaluations in previous
years have been completed in partnership with outside contractors with SAMHSA staff providing
consultation and guidance. This shift in governance is not only a more efficient use of federal
funds, but it also allows SAMHSA to be closer to the data to enable greater understanding of what
is working and what is not. Based on this evaluation, SAMHSA is engaging in efforts to shorten the
report and survey burden on grantees while adding a qualitative component to allow for greater
understanding of the ‘why’ behind the number. In addition, SAMHSA recommends including indepth interviews or other opportunities for evaluators to hear directly from grantees. Understanding
challenges and best practices in overcoming these challenges are critical components to developing
recommendations for future programs.

1. Introduction
The Projects for Assistance in Transition from Homelessness (PATH) program was created as part
of the Stewart B. McKinney Homeless Assistance Amendments Act of 1990 (P.L. 101.645). The
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2020 Triennial PATH Evaluation Report
Program is administered by the Division of State and Community Systems Development of the
Center for Mental Health Services (CMHS) within the Substance Abuse and Mental Health
Services Administration (SAMHSA). The goal of the PATH program is to reduce or eliminate
homelessness or the imminent risk of homelessness for individuals with serious mental illness
(SMI) or co-occurring disorders.
PATH grants are authorized under Section 521 of the Public Health Service Act (42 U.S.C. §
290cc-21), as amended, and Section 9004 of the 21st Century Cures Act (P.L. 114-255). Funding is
allocated based on a formula detailed in Section 524 of the original authorizing legislation
(Sections 521–535). PATH operates as a formula grant program and provides funds to its grantees
within the 50 states, the District of Columbia, Puerto Rico, and four U.S. territories (the U.S. Virgin
Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands).
Program funds support services such as outreach, case management and services that are not
supported by mainstream mental health programs. The PATH grantees in turn provide funding to
provider organizations, which are referred to as PATH providers within this evaluation report. This
evaluation report includes PATH Annual Report data for the fiscal years 2016 through 2018 as well
as the results of a web survey conducted in August 2020.
PATH state and provider contacts submit data through the PATH Data Exchange (PDX). PDX is an
online tool used to record and update information about PATH programs and services. To comply
with federal grant requirements, PATH providers submit a PATH annual data report, which
includes key information about the national impact of SAMHSA’s PATH program. The report
details how grant funds were used and confirms that funds were spent in accordance with federal
grant requirements. PATH annual reports are made available to the public on the SAMHSA
website at https://pathpdx.samhsa.gov/public?tab=searchdatareports. The goal of the current
evaluation is to respond to the federally mandated evaluation questions, listed below, for the PATH
program. The evaluation design for this report was determined by the Federal program staff and
conducted internally at SAMHSA in August 2020.
Purpose of the Evaluation
Section 528 of the Public Health Service Act requires SAMHSA’s Office of the Assistant Secretary
for Mental Health and Substance Use (OAS) to evaluate the expenditures of the PATH grants at
least once every three years to ensure consistency with legislative requirements and to allow an
opportunity to recommend changes to the program design or operations. To this end, the Center for
Behavioral Health Statistics and Quality (CBHSQ) in partnership with the Center for Mental Health
Services (CMHS), within SAMHSA, administered the 2020 web survey and prepared this
evaluation report.
Conceptual Framework
The design for this evaluation is based on a logic model developed during early implementation of
the program. The logic model illustrates how inputs effect activities as well as outputs which lead
to desired outcomes at both the grantee and provider levels. For this evaluation report, it was not
feasible to examine all the constructs within the logic model. The logic model can be found in the
appendix (Figure 1) of this document.

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2020 Triennial PATH Evaluation Report
Grant Funding
PATH operates as a formula grant program and provides funds to 50 states, the District of
Columbia, Puerto Rico, and four U.S. territories (the U.S. Virgin Islands, Guam, American Samoa,
and the Commonwealth of the Northern Mariana Islands). PATH grants are authorized under
Section 521 of the Public Health Service Act (42 U.S.C. § 290cc-21), as amended, and Section
9004 of the 21st Century Cures Act (P.L. 114-255). Funding is allocated based on a formula
detailed in Section 524 of the original authorizing legislation (Sections 521–535). The formula
determines each state’s share based on the ratio of the state’s population living in urbanized areas
compared with the total U.S. urban population. The states and territories are expected to fund
organizations in areas with the highest concentration of people who are experiencing homelessness
(SAMHSA, 2018). States—but not territories—are required to match federal PATH funds with at
least $1 in cash or in-kind services for every $3 in federal funds.
Fund Allocation and Matching Funds
The federal PATH allotments to states and territories for 2016 through 2018 indicate the total
federal allotment for the PATH program decreased between 2016 and 2018, from $58.0 million to
$57.7 million. Additionally, these allotments were lower than those reported for 2013 through 2015
($58.4 million to $61.6 million). Grant awards to individual territories remained at $50,000 from
2016 to 2018. In 2018, state awards ranged from $300,000 to $7.1 million, and actual state
allotments ranged from $269,161 to $7.1 million. Twenty-one percent (21%) of grantees received
the minimum allotment of $300,000 or below.
In meeting the match requirement, some grantees provided the match funds themselves, others
required their providers to contribute the match funds, and still other states shared the responsibility
for the match with their providers. The match sources reported by the SPCs are shown in Table 1.
Forty six percent (46%) of the grantees report that both the state/territory and the providers
provided match funds. Thirty one percent (31%) reported that only their providers contributed to
the match while nineteen percent (19%) reported that only the state or territory provided the match.
Two grantees (4%) report that neither the grantee nor the providers provided the match funds.
In 2018, among the 52 grantees required to provide match dollars (the 50 states, the District of
Columbia and Puerto Rico), the ratio of match to allotment ranged from 0.31 to 5.92. Nine grantees
(17% of grantees) provided the minimum match of $1 for every $3 federal dollars, and two states
dipping slightly below the minimum matching goal by 0.02 (0.31 out of 0.33). Three of the
territories provided match funds, though not required. A table displaying funding allocation and
matching contributions can be found in the appendix (Table 2).

Table 1. Sources of Match Funds, 2020
Match Source
Both State/Territory and
Provider
State/Territory only
Provider only
Neither State/Territory nor
Provider

Number of Grantees

Percent of Grantees

22
9
15

46%
19%
31%

2

4%

Source: PATH SPC Web Survey 2020, n= 48
Note: Data that were missing or that had responses of “do not know” (n=1) were not included in this table.

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2020 Triennial PATH Evaluation Report

2. Data Sources

Data for this report were derived from two sources:
Annual Report data for 2016, 2017, and 2018. Annual reports are required and must include
information on funding, staffing, numbers served/contacted and enrolled, client demographics,
service provision and service referrals made and attained. Data are submitted by the PATH
providers via the SAMHSA PATH Data Exchange (PDX), though some data are provided through
local Homeless Management Information Systems (HMIS). The PATH grantees’ State PATH
Contacts (SPCs) approve the data submitted by their providers. The number of PATH providers
submitting data each year were 497 (2016), 470 (2017) and 466 (2018). The submission deadline
for each year was on or before year (i.e., January 31, 2017, January 31, 2018, and January 31,
2019).
State PATH Contact (SPC) Web Survey. The SPCs are the staff within the grantee agencies that
manage the grantee PATH program. This voluntary survey collected detailed information on
program administration and oversight, provision of technical guidance and training, information
from the U.S. Department of Housing and Urban Development (HUD) Homeless Management
Information System (HMIS), information on involvement and collaboration with HUD’s
Continuums of Care (CoC) program, and perceptions of the appropriateness of the PATH program
design. The Continuum of Care (CoC) program is a framework designed to promote community
wide commitment to the goal of ending homelessness; provide funding for efforts by nonprofit
providers and State and local governments to quickly rehouse homeless individuals and families
while minimizing the trauma and dislocation caused to homeless individuals, families, and
communities by homelessness; promote access to and effect utilization of mainstream programs by
homeless individuals and families; and optimize self-sufficiency among individuals and families
experiencing homelessness. (https://www.hudexchange.info/programs/coc/).
Respondent recruitment for the web-based survey included multiple requests for participation to
maximize response rates. This included an initial email from grantees’ Government Project
Officers (GPO) to explain the purpose of the survey, a recruitment email with a link to the survey,
and up to four follow-up emails to the SPCs that had not yet completed the survey. From the total
56 SPCs who received the email, 48 surveys were completed in full (86%). A total of 53 SPCs
responded to at least some of the questions, for an overall response rate of 95%. Data were
collected in the summer of 2020.

3. Evaluation Goals and Provider Background
PATH Evaluation Questions
The PATH triennial evaluation, at a minimum, must determine:
1. Are services funded with PATH monies appropriate?
2. Are services well administered?
3. Are PATH outcome and process goals achieved? Measures include:
a. What is the number of homeless persons contacted?
b. What is the percentage of eligible contacted homeless persons with serious mental illness
who are subsequently enrolled in services?
c. What percentage of enrolled homeless persons receive community mental health services?
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2020 Triennial PATH Evaluation Report
Types and Numbers of Provider Agencies Funded
Section 522 of the Public Health Service Act, as amended, requires that states and territories only
make grants to political subdivisions or to nonprofit private entities. Fifty-six percent (56%) of the
PATH grantees report that they limit the types of political subdivisions or nonprofits that can
receive PATH funds.
Of those 27 PATH grantees that place restrictions on the types of organizations that can apply for
PATH funds, the majority allow funding for community mental health centers (78%). Forty-four
percent (44%) of the PATH grantees allow other mental health agencies to receive funding. Less
than half of the PATH grantees allow consumer-run mental health centers (41%), and more than
one-third allow social service agencies (37%), other housing agencies (37%), or health care for the
homeless agencies (33%) to receive PATH funding.
In 2018, a total of 466 PATH providers received PATH grant funds. Grantees used different
strategies to distribute these PATH dollars. Most states/territories distribute these funds to one or
more providers. Table 3 in the Appendix lists the amount of the grantee PATH allotments, the
number of PATH providers funded by each grantee, and Table 4 the types of agencies funded. The
distribution suggests that PATH grantees favor different strategies in handling their allotments.
California, which receives the largest allotment ($7,133,257), funded 40 PATH providers in 2018.
Massachusetts, on the other hand, received the eleventh-largest allotment ($1,558,333) but funded
just a single provider. The same variation in the number of PATH providers supported with PATH
dollars can be seen among the grantees receiving the lowest allotments. Among the grantees
receiving up to $300,000, the number of providers funded ranged from one to seven.
In terms of provider types funded across all grantees, community mental health centers accounted
for 48%; social service agencies accounted for 16%; shelters or housing agencies accounted for
9%; health care for the homeless agencies and consumer-run mental health agencies accounted for
2%; substance use treatment agencies each accounted for 1%; and other types of agencies
accounted for 23%.

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2020 Triennial PATH Evaluation Report

Figure 2. Types of Organizations That Apply for PATH Funds, 2020
Community mental health center

78%

Other mental health agency

44%

Consumer-run mental health center

41%

Other housing agency

37%

Social service agency

37%

Health Care for the Homeless/other health agency

33%

Shelter or other temporary housing resource

30%

Substance use treatment agency

26%

Other

22%
0%

50%

100%

Source: PATH SPC Web Survey 2020, n= 27
Notes: Grantees that did not limit the types of organizations eligible to receive PATH funds or that had missing data or
responded, “do not know” (n= 21) were not included in this figure.
The other types of organizations that can apply for PATH funds include a CoC and a public agency.

Process for Selecting PATH Provider Agencies
Grantees used a variety of strategies to select provider agencies to deliver services, and some used a
combination of strategies. Sixty-five percent (65%) of PATH grantees report that they applied a
competitive procurement process to select PATH providers. SPCs were asked to describe the
criteria they use to distribute PATH funds to providers. They were allowed to enter multiple
responses. Less than two thirds (62%) of the PATH grantees reported that they allocated PATH
funds by level of need, and under half (44%) report that they used a population formula to allocate
PATH funds. Eighteen percent (18%) reported other means of allocating PATH funds. These other
means included an RFP process, consideration of past performance, an annual Point-in-Time count,
an intended use report, and consideration of the originally approved provider proposals.
Number of Persons Outreached/Contacted and Enrolled
According to the 2018 PATH Annual Report Provider Guide, the term “contacted” is used to refer
to people reached through outreach activities. Outreach includes active outreach (e.g., face-to-face
interactions in streets, shelters, under bridges, and other non-traditional settings) and indirect
methods (e.g., distributing flyers and information, public service announcements) as well as inreach methods (e.g., staff placed in a service site and individuals who are homeless seek out the
outreach workers) regardless of enrollment, eligibility, relocation, or refusal of services. Enrollment
is defined as involving a person who has been determined to be PATH eligible, someone who has
an agreement that services will be provided, and a person for whom the provider has started an
individual file or record (SAMHSA, undated).
As shown in Table 5, there was a decrease in the total number of people outreached/contacted
between 2016 and 2018. The annual reports also report information on those contacted but found to
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2020 Triennial PATH Evaluation Report
be ineligible, primarily due to not having a serious mental illness. The number of individuals
contacted who were found to be ineligible also declined over the three-year period.

Table 5. Summary of Outreach/Contacts, Eligibility and Enrollment, 2016-2018
2016
174,978
86,591
50,261

Number outreached/contacted
Number of active enrolled
Number of outreached/contacted who were
ineligible

2017
120,048
72,231
27,602

2018
121,561
70,792
22,011

Source: PATH Annual Reports 2016–2018
Note: The number of providers reporting data for this table: 2016=497, 2017=470, 2018=466.

Demographics of Persons Enrolled by PATH Providers
From 2016 through 2018, PATH providers continued reporting demographics for people
outreached/contacted by the PATH program. Demographic data available are only for individuals
enrolled.
Age: Adults are the primary target population for the PATH program. However, according to the
2018 PATH Annual Report Provider Guide, transition-age youth may be eligible if they meet the
state’s definition of serious mental illness. Table 6 displays the number and percent of people
enrolled by the PATH program over the three-year period. As shown in the table, each year over
90% of people enrolled in PATH programs nationally were ages 18–61 (compared to 53% of the
national population ages 20-59 in 2018), with the greatest proportion (46%-50% each year) ages
31–50 enrolled by PATH (compared to 26% of the general population ages 30-49). Roughly 5%7% each year were age 62 or older (compared with 22% of the general population ages 60 and
older) (U.S. Census, 2020).

Table 6. PATH-Enrolled Persons by Age, 2016–2018
2016
2017
2018
Number Percent Number Percent Number Percent
Less than 18
51
>1%
91
>1%
128
>1%
18–23
6,491
8%
4,830
7%
4,487
6%
24-30
13,165
15%
9,908
14%
9,765
14%
31-50
42,986
50%
34,004
47%
32,538
46%
51-61
18,415
21%
18,722
26%
18,264
26%
62 and over
4,407
5%
4,172
6%
5,088
7%
Totals
85,515
71,727
70,792
Age

Source: PATH Annual Reports 2016–2018
Notes: The number of providers reporting data for this table: 2016=497, 2017=470, 2018=466. The number of people
for whom age was reported as unknown: 2016=1,076, 2017=504, 2018=531.

Sex: The majority of individuals enrolled by PATH programs, for each of the three years, reported
as male (approximately 60% each year). Over the three-year period, the percentage of people
enrolled by PATH who reported as female averaged 40%—comparable to the national percentage
of all homeless individuals who report as women (41%), as reported in the 2018 Annual
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2020 Triennial PATH Evaluation Report
Homeless Assessment Report (Henry et al., 2018).
Race and Hispanic Ethnicity: Table 7 includes the number and percentage of individuals
enrolled in PATH programs by race. In each year, over half of persons enrolled report as White
(57%-60%), followed by Black or African American (36% - 37%). Individuals who identify as
multiracial were counted in all categories they select and thus the percentages may not be equal to
100%. For each of the three years, approximately 14% of participants reported as Hispanic
(2016=10,642;
2017=9,676; 2018=9,628).
Since 2013, report of Hispanic/Latino ethnicity for PATH has been separated from race. Across the
three years, 13% to 14% of enrolled individuals reported as Hispanic/Latino.

Table 7. PATH-Enrolled Persons by Race, 2016-2018
Race
White
Black or African
American
American Indian or
Alaska Native
Asian
Native Hawaiian or
Other Pacific Islander
Totals

2016
Number Percent
49,859
60%

2017
Number Percent
40,378
57%

2018
Number
Percent
41,010
58%

29,786

36%

26,419

37%

25,515

36%

2,228
718

3%
1%

2,256
720

3%
1%

2,827
945

4%
1%

669
83,260

<1%

1,011
70,784

1%

942
71,239

1%

Source: PATH Annual Reports 2016–2018
Notes: The number of providers reporting data for this table: 2016=497, 2017=470, 2018=466. The number of people
for whom race was reported as unknown: 2016=6,000, 2017=2,931, 2018=2,397.

Veteran Status: The Public Health Service Act Title V mandates that PATH programs are
prohibited from funding organizations that do not have the capacity to provide adequate services to
veterans. Additionally, it mandates that states should give priority to those organizations with
demonstrated capacity to work with veterans. Across all three years, veterans constituted 7% to 8%
of all individuals enrolled in PATH programs: 2016=6,363; 2017=5,405; and 2018=4,539 (PATH
Annual Report 2016-2018). The proportion of veterans enrolled is slightly lower than the 9% of all
homeless individuals who were veterans as reported in the 2018 Annual Homeless Assessment
Report to Congress (Henry et al., 2018).
Co-Occurring Substance Use Disorders
In addition to individuals with severe mental illness, the PATH program also prioritizes individuals
with co-occurring mental and substance use disorders. Across all years, approximately 47% of
persons enrolled in PATH had co-occurring mental and substance use disorders.
Residence the Night Prior to Enrollment
PATH enrollees’ residence on the night prior to their enrollment is shown in Table 8. The greatest
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2020 Triennial PATH Evaluation Report
proportion of individuals were unsheltered on the night prior to enrollment. This number is
followed by sheltered (35% to 40%, and 32% to 36%, respectively across all years), followed by
people who had permanent housing (15% to 19% across all years).

Table 8. PATH-Enrolled Persons by Residence Night Prior to Enrollment 2016–
2018
Residence
Unsheltered Situations
Sheltered Situations
Institutionalized Care
Permanent Housing
Totals

2016
Number Percent
29,986 35%
31,283 36%
7,525 9%
15,065 17%
83,859

2017
Number Percent
26,732
37%
22,982
32%
6,598
9%
14,034
19%
70,346

2018
Number Percent
28,220
40%
23,969
34%
5,901
8%
10,817
15%
68,907

Source: PATH Annual Reports 2016–2018
Notes: The number of providers reporting data for this table: 2016=497, 2017=470, 2018=466. The number of people
for whom residence was reported as unknown: 2016=2,732, 2017=1,885, 2018=1,885.

Unsheltered = Place not meant for habitation (i.e., vehicle, street, abandoned building, bus/train/
subway station/airport or anywhere outside), inclusive non-housing service sites + emergency
shelter
Sheltered = Emergency shelter + Safe Haven + Hotel or Motel (paid for without emergency shelter
voucher) + Transitional Housing for homeless persons + Interim Housing
Institutionalized care = psychiatric hospital + substance use treatment facility + hospital + jail +
long-term care facility + foster care
Permanent Housing (Subsidy) = Permanent housing for formerly homeless persons + rental by
client (VASH subsidy) + rental by client (non-VASH subsidy) + owned by client (subsidy)
Permanent Housing (No Subsidy) = Rental by client (no subsidy) + owned by client (no subsidy)

4. PATH Evaluation Findings and Achievements
Are Services Appropriate?
The first evaluation question relates to the appropriateness of services provided through the PATH
program. Two dimensions of appropriateness are addressed in this section: the degree to which the
services delivered conform to program guidelines; and SPCs’ assessments of the appropriateness of
the PATH program design.
To assess the first dimension, Table 9 below displays a menu of allowable services that may be
supported with PATH funds.

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2020 Triennial PATH Evaluation Report

Table 9. PATH Allowable Services

PATH Services
Outreach services
Screening and diagnostic treatment services
Habilitation and rehabilitation services
Community mental health services, including recovery support services (e.g., peer
specialist/recovery coaches)
Alcohol or drug treatment services
Staff training—including the training of individuals who work in shelters, mental health
clinics, substance abuse programs, and other sites where homeless individuals require
services
Case management services, including:
• Preparing a plan for the provision of community mental health services to eligible
homeless individuals, and reviewing such plan not less than once every 3 months
• Providing assistance in obtaining and coordinating social and maintenance services
for eligible individuals who experience homelessness, including services related to
daily living activities, peer support services, personal financial planning,
transportation services, habilitation and rehabilitation services, prevocational and
vocational services, and housing services
• Providing assistance to eligible individuals who experience homelessness in obtaining
income support services, including housing assistance, food stamps, and supplemental
security income benefits
• Referring eligible individuals who experience homelessness for such other services, as
may be appropriate
• Providing representative payee services in accordance with section 1631(a)(2) of the
Social Security Act if the eligible individuals who experience homelessness are
receiving aid under total XVI of such Act and if the applicant is designated by the
Secretary to provide such services
Supportive and supervisory services in residential settings
Referral for primary health services, job training, educational services, and relevant
housing services as specified in Section 522 (b) (10) of the Public Health Service Act, as
amended, including: Minor renovation, expansion, and repair of housing; Planning of
housing; Technical assistance in applying for housing assistance; Improving the
coordination of housing services; Security deposits; Costs associated with matching
eligible homeless individuals with appropriate housing situations; One-time rental
payments to prevent eviction

Source: FY2018-2019 PATH FOA (SAMHSA, 2018)

Services Delivered

As stated in the Funding Opportunity Announcement (FOA), SAMHSA prioritizes certain services
for the PATH program, including street outreach, case management, and services not supported by
mainstream mental health programs. Although providers are able to offer and provide the full range
of PATH allowable/eligible services, PATH grantees have clearly heeded the encouragement to
prioritize these services within their state programs. As shown in Figure 3 below, all PATH
grantees report that outreach services were an eligible service within their program and 98% report
that it was a primary focus of the program. PATH providers conduct both street outreach and inreach (98% and 86%, respectively) in their PATH programs. As stated earlier, ‘in-reach’ is defined
as contacts with clients who are already connected to their services in some way.
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2020 Triennial PATH Evaluation Report

Additionally, case management was noted as being an eligible service by 98% of the grantees and a
priority service by 86% of the grantees. Supportive and supervisory services in residential settings
are included by 43% of grantees in their menu of eligible services (a percentage that has not
changed since the last evaluation or the results of 2018 SPC Web Survey). This might be explained
by the fact that supportive and supervisory services are provided in residential settings, whereas the
majority of the PATH providers are community mental health centers (78%) and a few are shelter
or housing providers (33%) as shown in Figure 2. The numbers vary depending on the service and
the SPCs’ reporting of whether the service is an eligible or priority service.

Figure 3. PATH Eligible and Priority Services, 2020
Outreach services

98% 100%

Case management services

100%

89%

Referrals

98%

91%

Allowable housing services

87%

66%

Staff training

96%

68%

Community mental health services

85%

74%

Habilitation and rehabilitation services

75%

55%

Screening and diagnostic treatment services

71%

Alcohol or drug treatment services

66%

Supportive and supervisory services in residential settings

39%
0%

83%

65%

43%

10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Eligible Service

Priority Service

Source: PATH SPC Web Survey, 2020
Note: Data that were missing or that had a response of “do not know” were not included in this figure. Referrals may be
to primary health services, job training, educational services, and relevant housing services.

The PATH Annual Report provides data on the number and percentage of PATH enrollees
receiving each PATH-eligible service. The non-housing services are displayed in Table 10. Case
Management was the most common service received by enrolled consumers (64% to 66% across all
years), followed by Screening (48% to 61% across all years), community mental health services
(43% to 54% across all years), and reengagement (22% to 45% across all years). Roughly ten
percent of consumers received alcohol or drug treatment—lower than what was reported in the
2018 PATH Evaluation Report (12-13%).

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2020 Triennial PATH Evaluation Report

Table 10. PATH Services (Non-Housing): Number and Percent of Enrolled
Individuals Receiving Service, 2016–2018
2016
Number
Percent
of
of
Enrolled
Enrolled
Persons
Persons
Receiving Receiving
Service
Service
55,391
64%

Service

Case management services
Screening and diagnostic
treatment services
Community mental health
services

52,979

61%

38,868

45%

46,484

Reengagement
Clinical Assessment
Habilitation/rehabilitation
Substance use treatment

54%

38,962

54%

18,606

26%

35,194

23,164

27%

22,549

10,378

12%

7,133

11,027

Residential supportive

2017
Number
Percent
of
of
Enrolled
Enrolled
Persons
Persons
Receiving Receiving
Service
Service
48,032
67%

9,885

13%

10,638

11%

7,214

2018
Number
Percent
of
of
Enrolled
Enrolled
Persons
Persons
Receiving Receiving
Service
Service
46,783
66%

49%

33,987

48%

15,235

22%

30,546

31%

18,006

15%

9,237

10%

5,095

10%

6,723

43%
25%
13%
7%

10%

Source: PATH Annual Reports 2016–2018, 2016 n=86,591, 2017 n=72,231, 2018 n=70,792
Note: The number of providers reporting data for this table: 2016=497, 2017=470, 2018=466Table 11 displays the

number and percent of enrollees receiving allowable housing services across all years. Housing Eligibility Determination was
the most utilized housing-related service across all three years varying from approximately 19% to 25%.

Table 11. PATH Services (Housing): Number and Percent of Enrolled Persons
Receiving Service, 2016–2018
2017

2016

Service

Housing
Eligibility
Determination

Number of
Enrolled
Persons
Receiving
Service

Percent of
Enrolled
Persons
Receiving
Service

Number of
Enrolled
Persons
Receiving
Service

2018

Percent of
Enrolled
Persons
Receiving
Service

Number of
Enrolled
Persons
Receiving
Service

Percent of
Enrolled
Persons
Receiving
Service

16,284

19%

18,285

25%

16,218

23%

Housing
moving
assistance

3,836

4%

3,364

5%

2,854

4%

Security
deposits

3,171

4%

2,655

4%

2,622

4%

One-time rent
for eviction
prevention
Housing
minor
renovation

2,103

2%

1,240

2%

1,207

2%

82

<1%

64

<1%

181

<1%

Source: PATH Annual Reports 2016–2018, 2016 n=86,591, 2017 n=72,231, 2018 n=70,792
Note: The number of providers reporting data for this table: 2016=497, 2017=470, 2018=466

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2020 Triennial PATH Evaluation Report

Referrals Made and Attained

Table 12 displays the number of times referrals were provided for different service types across
2016 and 2018. Over one half (54%) of the referrals provided in 2016 and 2017, and 46% in 2018
were for community mental health services. Referrals were provided for: primary health services
(26% for 2016, 19% for 2017, and 15% for 2018); temporary housing services (up to 18% of all
referrals across 2016 to 2018); permanent housing services (up to 28% in 2017); and income
assistance (20% in 2016). The services with the fewest referrals were employment assistance (10%
down to 7%) and medical assistance (11% to 10%).

Table 12. Referrals Provided: Number and Percent of Times Referral Type
Made, 2016–2018
2016
Referral
Type

Community
mental health
Primary
health
services
Permanent
housing
Income
assistance
Substance use
treatment
Temporary
housing
Medical
assistance
Employment
assistance
Totals

Number of
Times
Referral
Type
Provided
46,435

54%

Number of
Times
Referral
Type
Provided
36,660

20,057

23%

19,897

16,490

9%

22,364

17,280
13,633
9,535
9,040

154,834

2018

2017
Percent of
All
Referrals
Provided

26%

13,352

51%

Number
of Times
Referral
Type
Provided
32,308

28%

17,246

Percent of
All
Referrals
Provided

19%

10,591

20%

13,204

18%

10,306

16%

13,050

18%

8,664

11%
10%

11,325
9,238
6,737

123,463

16%
13%
9%

Percent of
All
Referrals
Provided
46%

15%
24%

15%

9,317

13%

6,927

10%

5,224

100,583

12%
7%

Source: PATH Annual Reports 2016–2018
Notes: The number of providers reporting data for this table: 2016=497, 2017=470, 2018=466

Shown in Table 13 are the percentages of enrolled individuals receiving a referral for each service
type and the percentages of referrals in which the service was attained for 2016 through 2018. The
majority of individuals receiving a referral did follow through with attaining the service. In 2016,
54% of enrollees received a referral for community mental health, and 41% of enrollees (76% of
those who received this specific referral) attained the service.

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2020 Triennial PATH Evaluation Report

Table 13. Referrals Provided: Percent of Enrolled Individuals Receiving a
Referral and Percent of Enrolled Individuals Attaining Referral, by Type, 20162018

Referral Type
Provided

Community
mental health
Primary health
services
Permanent
housing
Income
assistance
Substance use
treatment
Temporary
housing
Medical
Insurance
Employment
assistance

2016
Percent of
Percent of
Enrolled
Enrolled
Persons
Persons
Receiving
Attaining
Referral
the Referral
54%
41%
26%

18%

Percent of
Enrolled
Persons
Receiving
Referral
51%
19%

2017
Percent of
Enrolled
Persons
Attaining the
Referral
39%
14%

Percent of
Enrolled
Persons
Receiving
Referral
46%
15%

2018
Percent of
Enrolled
Persons
Attaining the
Referral
33%
10%

23%

11%

28%

13%

24%

12%

19%

11%

16%

10%

13%

7%

20%
16%
11%
10%

14%

18%

9%

18%

8%

13%

6%

9%

12%

12%
9%
5%

15%

12%

12%

10%
7%

8%

7%
4%

Source: PATH Annual Reports 2016–2018
Notes: Number of providers with data for this table: 2016=497, 2017=470, 2018=466; percent of enrolled persons that
completed the referral: 2016–2018, 2016 n=86,591, 2017 n=72,231, 2018 n=70,792
Calculations: percent of enrolled persons receiving a referral = number of persons receiving a referral (assisted)/total
number of people enrolled*100. Percent of Enrolled Persons that complete the referral = number of persons attaining a
referral/total number of persons receiving a referral (assisted)*100.

SPCs’ Assessments of the Appropriateness of the PATH Program Design
The PATH grantees’ SPCs were asked to assess the appropriateness of the overall design and
service emphasis of the Federal PATH program. Grantees consistently gave the program high
marks on all dimensions listed. Ninety percent (90%) of respondents believed that the program
focuses on the appropriate client population. Over eighty percent (81%) also believed that the
PATH program design incorporates an appropriate mix of housing and treatment services. Seventythree percent (73%) reported that the program has had a positive effect on moving clients into
permanent housing.

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2020 Triennial PATH Evaluation Report

Are PATH Programs Well Administered?
Sound program administration is one of the three goals SAMHSA has identified for the PATH
program. Program administration is a multidimensional concept that includes, at a minimum, the
following aspects:

Providing oversight of PATH providers and monitoring performance;



Providing staff with opportunities to improve skills;
Developing collaborative relationships to ensure that state and local PATH programs make
maximum use of community resources.

The following section provides information on how PATH grantees tackle these functions and
demonstrates that the PATH programs are well-administered in terms of quality management, staff
mentoring, and integration of community resources.

Providing Oversight and Monitoring Performance
The majority of PATH grantees do not utilize an intermediary organization to manage their PATH
programs. Only a quarter of the grantees (11 grantees) report that they use intermediary
organizations; only nine of these 11 PATH grantees (75%) report that the intermediaries provide
financial and programmatic oversight of PATH providers. Therefore, the majority of PATH
grantees retain the responsibility of overseeing and monitoring the performance of PATH
providers. Figure 4 displays the strategies that PATH grantees report using to monitor PATH
provider performance.
PATH grantees use different mechanisms to monitor performance. Using the HUD Homeless
Management Information System (HMIS) was the most common (88%), followed by site visits and
review of financial documents or billing (85% of grantees for each category). Reporting on the use
of HMIS showed a 15% increase from the previous PATH Evaluation Report conducted in 2015,
which reported a 73% implementation. Additional methods of monitoring included: site visits
(85%), meetings and teleconferences (69%), evaluation of performance goals (67%) and audits
(50%).

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2020 Triennial PATH Evaluation Report

Figure 4. Methods for Monitoring PATH Providers, 2020
Review of HMIS or other data

88%

Review of financial documents or billing

85%

Site Visits

85%

Regularly scheduled meetings or teleconferences

69%

Review of progress reports

71%

Evaluation of performance goals

67%

Audits

50%

Other

6%
0%

50%

100%

Source: PATH SPC Web Survey 2020, n=48
Note: Examples of other methods used for monitoring include reviewing Intended Use Plans (IUPs), quarterly reports
uploaded to PDX and other documents; onsite visits from other providers; and discussions during conferences and CoC
meetings.

As shown in Figure 5, grantees use positive approaches to address concerns about provider
management or effectiveness. The two most commonly used strategies in this regard are the
provision of technical assistance (TA) and training (84% and 75%). Over half (64%) of the grantees
report using corrective action plans to handle concerns with providers. Almost a third of the
grantees (29%) report using quality improvement projects to handle concerns with providers.

Figure 5. Methods for Handling Concerns with PATH Providers, 2020
Technical assistance

91%

Training

78%

Corrective action plans

64%

Quality improvement projects

29%

Other

7%
0%

50%

100%

Source: PATH SPC Web Survey 2020, n=48
Note: Data that were missing or that had responses of “do not know” (n=3) were not included in this figure.
Examples of other methods of handling concerns with PATH providers include learning communities, face-to-face
meetings, and participation in Learning Communities.

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2020 Triennial PATH Evaluation Report

Providing Supports for PATH Providers
In addition to regular performance monitoring, sound administration also includes providing staff
with opportunities to increase skills. As shown in Table 14, the vast majority of grantees report that
they make both TA and training available for performance enhancement: 81% report the use of TA;
60% indicate the use of training. These proportions are less than what was reported in the 2018
PATH Evaluation Report (83% and 67%, respectively).

Table 14. Methods for Supporting Provider Performance, 2018
Number of
Grantees
38

Method
Provide TA to PATH providers
Provide training to PATH providers

Percent of Grantees
81%

28
60%
Source: PATH SPC Web Survey 2020, Provide TA to PATH providers n=47; Provide training to PATH providers
n=47
Note: Data that were missing or that had responses of “do not know” (Provide training to PATH providers n=1; Provide
TA to PATH providers n=1) were not included in this table.

Topic Areas of Technical Assistance and Training
PATH grantees are very active in making TA and training available to PATH providers; the top
eight topics are illustrated below (Figure 6). Sixty-five percent (65%) of PATH grantees report
providing TA/training on PATH-eligible services in 2020. Slightly more than half of the grantees
report providing TA/training on Evidence-Based Practices (EBP), Enrolling Consumers for PATH
Services, HMIS, and Determining Consumer Eligibility for PATH Services. In the 2018 report, the
most commonly provided training topics were on HMIS, Data Reporting, Data Collection, PATHEligible Services, and Enrolling Consumers for PATH Services. The most commonly reported
EBPs included SSI/SSDI Outreach, Access, and Recovery (SOAR), Housing First Model, and
Trauma-Informed Care.

Figure 6. Topic Areas of TA or Training Provided to PATH Providers, 2020
PATH-eligible services

65%

Evidence-based practices

57%

Enrolling consumers for PATH services

57%

Homeless Management Information System

54%

Determining consumer eligibility

52%

Development of intended use palns

50%

Data collection

50%

SSI/SSDI

50%

Data reporting

50%

Annual survey report

37%

Transition clients out

30%

Other topic areas

11%
0%

10%

20%

21

30%

40%

50%

60%

70%

2020 Triennial PATH Evaluation Report

Source: PATH SPC Web Survey 2020, n= 48
Notes: Data that were missing or that had a response of “do not know” (n= 3) were not included in this figure.
Other topic areas included COVID-19 response, PATH program manual, and invoicing.

Figure 7 provides additional detail on TA/training related to PATH-eligible services. SAMHSA
has emphasized the importance of outreach and case management services. Most grantees reported
that they had provided TA/training on services related to outreach (77%). Fifty-six percent
provided TA/training on case management and allowable housing services; just under half provided
TA/training on staff training (47%) and community mental health services (40%); and less than
one third of grantees provided TA/training related to screening and diagnostic services (30%),
habilitation and rehabilitation (23%), and alcohol or drug treatment services (20%).

Figure 7. TA or Training Provided on PATH-Eligible Services, 2020
Outreach services

77%

Case management services

56%

Allowable housing services

56%

Staff training

47%

Community mental health services

40%

Screening and diagnostic treatment services

30%

Habilitation and rehabilitation services

23%

Alcohol or drug treatment services

20%
0%

10%

20%

30%

40%

50%

60%

70%

80%

90% 100%

Source: PATH SPC Web Survey 2020, n=48
Notes: Data that were missing or that had a response of “do not know” (n=20) were not included in this figure.
Examples of allowable housing services include planning of housing, TA in applying for housing assistance, and
security deposit

Homeless Management Information System (HMIS)
According to the FY2018 Funding Opportunity Announcement, all PATH providers should be
collecting PATH client data through HMIS or another system approved by SAMHSA that supports
interoperability with the local HMIS. Out of the 48 SPCs who responded to this question, 94%
reported all providers using HMIS, two percent reported some providers used HMIS and four
percent reported not using it yet. Figure 8 shows that 92% of PATH grantees report that HMIS data
are used to report Annual Report/PATH data; three quarters (75%) of the PATH grantees use the
HMIS data to monitor PATH providers. PATH grantees also report using HMIS data to monitor
PATH client outcomes (71%), monitor PATH client participation in services or housing (52%), to
plan for PATH services or activities (42%), and report to other state or federal agencies (40%).
Only two percent report that they are not using HMIS data.

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2020 Triennial PATH Evaluation Report

Figure 8. Grantees’ Use of HMIS Data, 2020
To report Annual Report/PATH data

92%

To monitor PATH providers

75%

To monitor PATH consumer outcomes

71%

To monitor PATH consumer participation in services or
housing

52%

To plan PATH services or activities

42%

To report to other State or Federal agencies

40%

Not yet being utilized

2%
0%

10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Source: PATH SPC Web Survey 2020 n=48
Note: Data that were missing or that had a response of “do not know” (n= 2) were not included in this figure.

Collaboration with the Continuum of Care (CoC) Program
As shown in Figure 9, the majority of PATH grantees report that they participate in the CoC
program (94%), and work with the CoC to facilitate the use of HMIS for data collection (91%) and
to facilitate timely service coordination (80%). Almost all grantees require providers to collaborate
with CoC (89%).

Figure 9. PATH Grantees Involvement with CoC Program, 2020
Grantee Participates in CoC Program (N=48)

94%

Grantee works with CoC to facilitate use of HMIS for PATH
data collection (N=45)

91%

Grantee Requires Providers to Collaborate with CoC
(N=47)

89%

Grantee works with CoC to facilitate timely service
coordination (N=41)

80%
70%

75%

80%

85%

90%

95%

Source: PATH SPC Web Survey 2020
Note: Data that were missing or that had responses of “do not know” (Participates in the CoC n=2; Works with CoC to
facilitate HMIS n=5; Requires providers to collaborate with CoC n=3; Works with CoC to facilitate timely service
coordination n=9) were not included in this figure.

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2020 Triennial PATH Evaluation Report

Involvement with Local Planning Activities
Eighty-nine percent (89%) of providers participate in local planning activities and program
coordination although only seventy-eight percent (78%) of grantees report that they require their
providers to participate. Planning activities include initiatives such as coordinated entry and
coordinated assessments.

Collaboration with Other Organizations
Figure 10 displays the state/territory agencies that PATH grantees report that they collaborated
with in the past year regarding the PATH program. In 2020: eighty-five percent (85%) of the
PATH grantees reported working with the mental health agency regarding the PATH program;
eighty-three percent (83%) reported working with the housing agency; seventy-seven percent
(77%) reported working with the substance abuse treatment services agency; and sixty-three
percent (63%) reported working with the benefits agency.
In addition, PATH grantees reported collaborating with health organizations (56%), veteran’s
affairs (52%), a criminal justice system agency (50%), employment agencies (50%), other
departments or offices within their own agency (44%), transportation (40%), education (25%), and
other types of agencies (10%).

Figure 10. State/Territory Agencies that Grantees Worked with, 2020
Mental health

85%

Housing

83%

Substance abuse treatment

77%

Benefits

63%

Health

56%

Verterans administration

52%

Criminal justice system

50%

Employment or vocational rehabilitation

50%

Other offices within your agency

44%

Transportation

40%

Education

25%

Other agency

10%
0%

10%

20%

30%

40%

50%

60%

70%

80%

90% 100%

Source: PATH SPC Web Survey, 2020
Note: Data that were missing or that had a response of “do not know” (n=2) were not included in this figure.

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2020 Triennial PATH Evaluation Report

Have Outcome and Process Goals Been Achieved?
The PATH program has had considerable success serving individuals with mental or co-occurring
mental and substance use disorders who are homeless or at imminent risk of homelessness. This
section provides information on the outcomes achieved by the program. Table 15 summarizes the
PATH program achievements on each measure for 2016 through 2018. Targets referenced below
are created by PATH programs using baseline data as a guide.
In 2016, the PATH program met PATH targets for one of the three measures:

Number of homeless persons contacted (target was not met – under by 38%)




Percentage of enrolled homeless persons with SMI who received community-based
mental health services (target exceeded –by 25%)
Percentage of enrolled homeless persons who receive community mental health services
(target not met – under by 17%)

In 2017, the PATH program met PATH targets for one of the three measures:

Number of homeless persons contacted (target was not met – under by 15%)




Percentage of enrolled homeless persons with SMI who received community-based mental
health services (target not met – under by 21%)
Percentage of enrolled homeless persons who receive community mental health
services (target exceeded by 15%)

In 2018, the PATH program met PATH targets for one of the three measures:






Percentage of enrolled homeless persons with SMI who received community-based mental
health services (target not met – under by 15%)
Percentage of enrolled homeless persons with SMI who received community-based mental
health services (target not met – under by 16%)
Percentage of enrolled homeless persons who receive community mental health
services (target exceeded by 21%)

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2020 Triennial PATH Evaluation Report

Table 15. Performance Statistics, 2016–2018
FY2016

Numbers of
homeless
persons
contacted
(outcome)
Percentage
of contacted
homeless
persons with
SMI who
became
enrolled in
services
(outcome)
Percentage
of enrolled
homeless
persons who
received
community
mental
health
services
(outcome)

FY2017

FY2018

Target

Actual

191,926

119,471

%
+/−
-38%

Target

Actual

158,135

%
+/−
-15%

174,978

147,952

%
+/−
-15%

58%

73%

+25%

58%

46%

-21%

57%

48%

-16%

66%

55%

-17%

66%

76%

+15%

54%

65%

+21%

Target

Actual

185,524

Source for FY2016: https://pathpdx.samhsa.gov/Content/preGen/national/18/PATH_Annual_Report_For_FY_2016.pdf
Source for FY2017: https://pathpdx.samhsa.gov/Content/preGen/national/19/PATH_Annual_Report_For_FY_2017.pdf
Source for FY2018: https://pathpdx.samhsa.gov/Content/preGen/national/23/PATH_Annual_Report_For_FY18.pdf
Note: The performance statistics reported above are the most current and accurate data for each FY. These statistics
may not match previous congressional justifications, as additional data might have been reported by grantees after the
Congressional Justification was published.

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2020 Triennial PATH Evaluation Report

Conclusion and Recommendations

The Projects for Assistance in Transition from Homelessness (PATH) program was created to
reduce or eliminate homelessness or imminent risk of homelessness for individuals with serious
mental illness (SMI) or co-occurring disorders. In 2016-2018, funds were provided to all 50 states,
the District of Columbia, Puerto Rico, and four U.S. territories. Program funds are to be used to
provide services such as street outreach, case management and services that are not supported by
mainstream mental health programs, and all grantees are required to provide a match of at least $1
for every $3 in federal funding. The data in this report were collected from two sources: a triennial
report covering activities in 2016, 2017, and 2018, as well as a state PATH contact (SPC) webbased survey administered in August 2020. The PATH triennial evaluation suggests that:
1. Services offered through the PATH program are appropriate.
Specifically, the evaluation suggests that:
•
•
•
•

Enrolled PATH clients match the eligibility profile and intent of the PATH legislation;
PATH providers offer a wide range of priority services from the PATH menu;
A significant proportion of enrolled clients participate in these services; and
The PATH program emphasizes the engagement of clients into services and their transition
to mainstream services.

2. Services offered through the PATH program are well administered.
Specifically, the evaluation suggests that:
PATH grantees offered Eligible and Priority Services including:
• Outreach services
• Case Management Services
• Allowable Housing Services
• Staff Training
• Community Mental Health Services
• Habilitation and Rehabilitation Services
• Screening and Diagnostic Treatment Services
• Alcohol or Drug Treatment Services
• Supportive and Supervisory Services in Residential Settings
PATH grantees offered appropriate housing services including:
• Housing Technical Assistance
• Housing Moving Assistance
• Security Deposits
• One Time Rent for Eviction Prevention
• Housing Minor Renovation
PATH grantees offered appropriate service referrals including:
• Community Mental Health Services
• Relevant Housing Services
• Housing Placement Assistance
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2020 Triennial PATH Evaluation Report
•
•
•

Primary Health Care Services
Income Assistance
Job Training

PATH grantees offered appropriate monitoring of providers and engaged in effective
strategies to address concerns including:
•
•
•

Regular meetings and/or conferences
Review of HMIS or other available data
Review of progress reports or performance goals

Methods of Handling Concerns with PATH Providers included
• Program/technical guidance
• Training
• Corrective actions
• Quality improvement initiatives
• Methods of Supporting Providers Performance
• Determine training needs / Fund training needs / EBPs (e.g., Supplemental Security
Income/Social Security Disability Insurance Outreach, Access, & Recovery)
• Provide program/technical guidance to PATH providers
3. Overall, PATH outcome and process goals demonstrated many successes
The PATH program has had considerable success serving individuals with mental or cooccurring mental and substance use disorders who are homeless or at imminent risk of
homelessness.
Specifically, the evaluation suggests that:
a. An average of 184,142 homeless persons were contacted each year (191,926 in
2016, 185,524 in 2017 and 147,952 in 2018);
b. 48% of eligible homeless persons with serious mental illness who were contacted
were subsequently enrolled in services; and
c. 65% of enrolled homeless persons received community mental health services.

Recommendations


SAMHSA should provide technical assistance (TA) and support to PATH grantees and
providers to improve data consistency and standardize the collection and reporting of the
PATH Annual Report data. This TA might be through webinars, quarterly meetings or oneon-one support.



SAMHSA should collect qualitative data through site visits, interviews and peer to peer
discussions to support programmatic goals, understand barriers, collect successful strategies
to overcome these barriers, understand which EBP led to the greatest outcomes, and
develop a list of best practices. These qualitative data should be collected from key
stakeholders including grantees, intermediary organizations, providers and direct care staff
to get a more comprehensive picture of the program.

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2020 Triennial PATH Evaluation Report

Table 2. Federal PATH Allotment, Required and Reported Match, and Ratio of
Match to Allotment by State/Territory, 2018
State/Territory

Alaska
Alabama
Arkansas
American Samoa
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
N. Mariana Islands
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico

2018
Allotment

$300,000
$597,813
$269,161
$50,000
$1,313,988
$7,133,257
$919,912
$792,000
$300,000
$300,000
$4,107,971
$1,701,792
$34,215
$313,111
$320,928
$297,996
$2,533,231
$962,578
$417,961
$466,166
$701,922
$1,558,333
$1,221,194
$429,203
$1,575,907
$975,900
$883,209
$50,000
$288,000
$300,000
$1,251,474
$316,667
$306,112
$288,000
$2,051,836
$300,000
$553,676
$4,186,774
$1,756,416
$434,941
$596,375
$2,630,797
$890,817

2018 Minimum
Required Match

$100,000
$199,271
$89,720
$0
$437,996
$2,337,752
$306,637
$264,000
$100,000
$100,000
$1,369,324
$567,264
$0
$104,370
$106,976
$99,332
$844,410
$320,859
$139,320
$155,389
$233,974
$519,444
$407,065
$143,068
$525,302
$325,300
$294,403
$0
$96,000
$100,000
$417,158
$105,556
$102,037
$96,000
$683,945
$100,000
$184,559
$1,395,591
$58,472
$144,980
$198,792
$876,932
$296,939

29

2018
Actual
Match
$103,326

$284,465
$89,720
$0
$449,830
$6,913,525
$527,995
$718,543
$100,000
$100,000
$1,613,984
$526,531
$119,110
$736,750
$534,731
$99,333
$4,258,758
$500,398
$263,278
$251,858
$286,940
$842,531
$1,498,972
$595,291
$525,304
$514,615
$489,113
$250,000
$1,704,633
$229,942
$461,212
$308,911
$594,859
$146,793
$1,535,484
$101,500
$484,203
$10,628,513
$842,969
$409,228
$864,903
$1,581,212
$296,948

Ratio of Match
to Allotment
0.34
0.48
0.33
0.00
0.34
0.97
0.57
0.91
0.33
0.33
0.39
0.31
3.48
2.35
1.67
0.33
1.68
0.52
0.63
0.54
0.41
0.54
1.23
1.39
0.33
0.53
0.55
5.00
5.92
0.77
0.37
0.98
1.94
0.51
0.75
0.34
0.87
2.54
0.48
0.94
1.45
0.60
0.33

2020 Triennial PATH Evaluation Report
State/Territory

2018
Allotment

2018 Minimum
Required Match

2018
Ratio of Match
Actual
to Allotment
Match
Rhode Island
$90,000
$270,000
$93,360
0.35
South Carolina
$226,119
$678,356
$225,301
0.33
South Dakota
$90,780
$272,340
$90,743
0.33
Tennessee
$347,072
$1,041,215
$397,443
0.38
Texas
$1,474,457
$4,423,370
$1,360,672
0.31
Utah
$183,857
$551,570
$450,685
0.82
Virginia
$424,364
$1,273,092
$750,599
0.59
Virgin Islands
$0
$50,000
$25,000
0.50
Vermont
$113,984
$341,951
$135,987
0.40
Washington
$349,139
$1,047,418
$545,103
0.52
Wisconsin
$264,882
$794,647
$300,200
0.38
West Virginia
$112,036
$336,108
$142,586
0.42
Wyoming
$98,333
$295,000
$97,775
0.33
Total
$18,623,160 $47,898,339
$57,754,700
0.83
Sources: 2018 Allotment, 2018 Minimum Required Match and 2018 Actual Match: Report prepared by SAMHSA
CBHSQ with funding data provided by SAMHSA CMHS. Agency Type: PATH Budget Information Mapping Report
For FY18

Table 3. Federal PATH Allocation by State/Territory, 2016-2018
State/Territory
Alaska
Alabama
Arkansas
American Samoa
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland

2016
$300,000
$605,830
$292,028
$50,000
$1,077,237
$8,358,330
$921,784
$801,500
$300,000
$300,000
$4,071,938
$1,475,927
$45,700
$299,493
$321,540
$292,580
$2,484,892
$1,037,628
$407,147
$478,450
$658,525
$1,549,529
$1,264,442

2017
$300,000
$605,152
$255,357
$50,000
$1,316,173
$8,339,707
$989,870
$793,500
$300,000
$300,000
$4,367,611
$1,486,028
$45,700
$301,248
$322,137
$298,894
$2,419,688
$958,873
$373,435
$365,639
$640,753
$1,556,533
$1,178,831

30

2018
$300,000
$597,813
$269,161
$50,000
$1,313,988
$7,133,257
$919,912
$792,000
$300,000
$300,000
$4,107,971
$1,701,792
$34,215
$313,111
$320,928
$297,996
$2,533,231
$962,578
$417,961
$466,166
$701,922
$1,558,333
$1,221,194

2020 Triennial PATH Evaluation Report

State/Territory
2016
2017
2018
Maine
$300,000
$300,000
$429,203
Michigan
$1,472,243
$1,515,499
$1,575,907
Minnesota
$778,618
$925,608
$975,900
Missouri
$699,996
$930,312
$883,209
N. Mariana Islands
$50,000
$50,000
$50,000
Mississippi
$288,000
$217,000
$288,000
Montana
$300,000
$300,000
$300,000
North Carolina
$1,229,809
$1,085,050
$1,251,474
North Dakota
$298,683
$486,046
$316,667
Nebraska
$288,001
$288,000
$306,112
New Hampshire
$288,000
$287,997
$288,000
New Jersey
$2,051,521
$2,054,228
$2,051,836
New Mexico
$264,906
$300,000
$300,000
Nevada
$525,733
$558,400
$553,676
New York
$4,195,019
$4,083,601
$4,186,774
Ohio
$1,906,561
$1,906,370
$1,756,416
Oklahoma
$434,880
$431,816
$434,941
Oregon
$576,987
$574,666
$596,375
Pennsylvania
$2,207,154
$2,238,488
$2,630,797
Puerto Rico
$891,000
$891,574
$890,817
Rhode Island
$270,000
$267,600
$270,000
South Carolina
$678,789
$680,567
$678,356
South Dakota
$302,657
$276,610
$272,340
Tennessee
$922,500
$805,234
$1,041,215
Texas
$4,513,227
$4,497,733
$4,423,370
Utah
$563,200
$563,625
$551,570
Virginia
$1,323,432
$1,341,444
$1,273,092
Virgin Islands
$50,000
$50,000
$50,000
Vermont
$300,000
$324,900
$341,951
Washington
$1,323,809
$1,087,093
$1,047,418
Wisconsin
$790,749
$796,677
$794,647
West Virginia
$274,884
$289,898
$336,108
Wyoming
$288,151
$295,000
$295,000
Total
$58,043,008
$58,266,165
$57,754,700
Sources: 2016-2018 Allotment: Report prepared by SAMHSA CBHSQ with funding data provided by SAMHSA
CMHS. Agency Type: PATH Budget Information Mapping Report For FY16/FY17/FY18

31

2020 Triennial PATH Evaluation Report

Table 4. Federal PATH Allotment by State/Territory and Number/Type of
Providers Funded, 2018
State/ Territory

Alaska
Alabama
Arkansas
American
Samoa
Arizona
California
Colorado
Connecticut
District of
Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
N. Mariana
Islands
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon

Allotment

$300,000
$597,813
$269,161

$50,000

$1,313,988
$7,133,257
$919,912
$792,000
$300,000

$300,000
$4,107,971
$1,701,792
$34,215
$313,111
$320,928
$297,996
$2,533,231
$962,578
$417,961
$466,166
$701,922
$1,558,333
$1,221,194
$429,203
$1,575,907
$975,900
$883,209
$50,000

$288,000
$300,000
$1,251,474
$316,667
$306,112
$288,000
$2,051,836
$300,000
$553,676
$4,186,774
$1,756,416
$434,941
$596,375

Number of Providers by Agency Type

Total
Number
of PATH
Funded
Providers

CMHC

Social
Service

Shelter
or
Housing

HCH

Consumer
Run MH

SA

Other

4
40
6
8
1

0
5
4
1

0
8
5
2
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
0
0
0

0
5
4
1

1
25
10
1
3
7
1
17
13
7
8
9
1
25
2
18
11
10
1
5
1
4
8
4
7
15
2
3
25
12
4
5

0
17
3
0
0
5
0
8
10
7
6
0
0
4
1
12
5
9
1
4
1
0
8
1
6
9
2
1
1
6
3
4

1
0
0
3
0

0
2
3
1
0
1
0
3
2
0
0
7
1
2
0
1
4
0
0

1
0
0
0
0
1
1
0
1
12
1
0
0
32

1
2
0
3
0

0
0
0
0
1
0
0
0
0
0
1
0
0
2
0
3
0
0
0
0
0
1
0
0
0
1
0
0
6
5
0
0

0
1
0
0
0

0
0
3
0
1
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0

0
0
0
0
0

1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0

0
0
0
0
0

2
29
1
0
1

0
0
0
0
0
0
0
0
1
0
0
0
0

0
0
3
0
3
0
3
0
0
4
0
1
1

0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
4
1
0
1
1
1
6
1
0
0
2
0
16
1
2
2
1
0

2020 Triennial PATH Evaluation Report

State/ Territory

Allotment

Number of Providers by Agency Type

Total
Number
of PATH
Funded
Providers

CMHC

Social
Service

Shelter
or
Housing

HCH

Consumer
Run MH

SA

Other

Pennsylvania
$2,630,797
37
6
13
6
0
2
0
10
Puerto Rico
$890,817
1
0
0
0
0
0
0
1
Rhode Island
$270,000
0
1
0
0
0
0
0
1
South Carolina
$678,356
4
2
0
1
0
0
0
1
South Dakota
$272,340
5
5
0
0
0
0
0
0
Tennessee
$1,041,215
10
9
0
0
0
0
0
1
Texas
$4,423,370
1
0
0
0
1
2
16
12
Utah
$551,570
4
4
0
0
0
0
0
0
Virginia
$1,273,092
14
11
1
0
1
0
0
1
Virgin Islands
$50,000
1
0
0
1
0
0
0
0
Vermont
$341,951
0
4
1
1
0
0
0
6
Washington
$1,047,418
14
11
0
0
0
2
0
1
Wisconsin
$794,647
9
1
2
3
1
0
0
2
West Virginia
$336,108
7
2
2
3
0
0
0
0
Wyoming
$295,000
0
2
0
0
0
0
2
4
466
223
74
41
11
7
4
106
Total
$57,754,700
Percent
47.9%
15.9%
8.8%
2.4%
1.5%
0.9% 22.7%
Sources: Allotment: Report prepared by SAMHSA’s Homeless and Housing Resource Network (HHRN) with funding data
provided by SAMHSA CMHS. Agency Type: PATH Annual Report 2018, n=466
Notes: Half of the agencies listed as Other are Other Mental Health agencies. It was not possible to differentiate between the
“Other” and “Other Mental Health agencies” from the files received with the Annual Report data.
CMHC = Community Mental Health Center
HCH = Health Care for the Homeless or Other Health Agency
SA Agency = Substance Use Treatment Agency
Shelter or Housing = Shelter or other temporary housing resource and Other housing agency

33

Figure 1: Logic Model

34