The Urban Institute and partners at The Evaluation Center at the University of Colorado Denver tracked implementation of the Denver Supportive Housing Social Impact Bond Initiative (Denver SIB) in a new report, “Housing First Breaks the Homelessness-Jail Cycle.” The 5-year randomized controlled trial compared 361 individuals experiencing chronic homelessness who received traditional community services with 363 individuals experiencing chronic homelessness who were placed into a supportive housing program. After 3 years, 77% of the supportive housing group remained in stable housing, received 560 more days of permanent housing assistance, and had fewer arrests, jail stays, and emergency room visits than those receiving traditional services. The supportive housing intervention effectively ended chronic homelessness for participants and lowered the public cost of the homelessness-jail cycle.
The Denver SIB was launched in 2016 by the City and County of Denver. The initiative provided supportive housing, including a permanent housing subsidy and intensive services through a Housing First approach. This approach does not require participants to meet any preconditions, such as agreeing to participate in non-housing programs, and is guided by the belief that people need access to food and shelter before attending to other needs. After one year, 86% of participants in the supportive housing group remained stably housed. After two years, 81% of participants remained stably housed, and after three years, 77% of participants remained stably housed. SIB program participants received an average of 653.94 days of permanent housing assistance over three years, compared to participants in the control group, who received an average of 94.28 days of permanent housing. Those receiving traditional services had 95 more days with shelter stays and 127 more unique shelter visits over the three years.
SIB participants saw a 34% reduction in police contacts and 40% reduction in arrests. Those in supportive housing had two fewer jail stays and spent 38 fewer days in jail than those in the control group. The health care of SIB participants also improved. After two years in supportive housing, SIB participants saw a 40% decrease in emergency department visits and a 155% increase in office-based visits. The SIB participants also were prescribed an average of 3 more medications over two years and saw a 65% decrease in visits to a detoxification facility over three years.
The majority of people receiving supportive housing (285 of the 363) were housed and engaged through the Colorado Coalition for the Homeless (CCH) and the Mental Health Center of Denver (MHCD). Providing these services can be costly, with a $12,078 annual per person cost for CCH and a $15,484 annual per person cost for MHCD; most of these costs were funded by state and federal vouchers and Medicaid. However, SIB participants had $6,876 less in total annual, per person costs because of a reduction in the use of other emergency public services and jail stays compared with the control group. This means about half of the total per person cost was offset by other avoided public service costs. With services provided by the city, an average of $3,733 per person annual costs were avoided. Given that the city paid $4,972 per participant at CCH and $3,975 per participant at MHCD for supportive services, 75% of the city’s costs for CCH participants and 94% of the city’s costs for MHCD participants were offset by avoided costs for the city.
To serve all 1,209 people currently experiencing chronic homelessness in Denver, it would cost Medicaid, state and federal housing services, and the city and County of Denver between $14.6 million and $18.7 million. However, such an investment could save $8.3 million would be saved from avoided public service costs.
Read the study at: https://urbn.is/3rHVyZb
Learn more about supportive housing through NLIHC’s Advocate Guide on Housing First at: https://bit.ly/3yfF0dv