And people participating in the program stayed housed over the long term. Not only did they access more days of housing assistance, but 77 percent remained in stable housing after three years.
Ultimately, supportive housing is a better use of taxpayer dollars than the current business as usual: in addition to the benefits to those participating in the program, the costs of providing supportive housing are largely offset by savings in other services such as jail stays, court costs, police time, and local emergency services.
You also evaluated the program’s effects on people’s use of health care services. What did you find?
There were significant findings on the use of detoxification facilities, preventive healthcare, and emergency care that indicate that supportive housing increases access to and use of preventive healthcare while decreasing the use of costly emergency care. Compared to those who received usual care services in the community, people referred to the Denver supportive housing program had:
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A 65 percent reduction in visits to short-term, city-funded detoxification facilities
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A 40 percent decrease in emergency department visits
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A 155 percent increase in office-based visits
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A 29 percent increase in unique prescription medications to support their wellbeing
The findings of the Denver SIB evaluation weren’t unique. Los Angeles County’s Housing for Health initiative provides permanent supportive housing programming (housing placement, financial subsidies, and supportive services) to people experiencing homelessness who frequently use county-provided health services. Similar to the Denver SIB findings, research from RWJF’s Systems for Action program showed the Housing for Health initiative was effective in addressing long-term housing needs, reducing jail time, and lowering the use of emergency room and inpatient visits.
What were the key components to Denver’s success with this SIB program?
Two qualities made Denver’s program stand out.
First, this was a well-targeted intervention. Participants became eligible for the program after frequent arrests and documentation of homelessness. Without this laser focus on the most vulnerable residents, it would have been harder for the Denver SIB to find such big impacts across multiple systems.
Second, the program had a very high quality of implementation. The Colorado Coalition for the Homeless and Mental Health Center of Denver were excellent service providers; both hit high benchmarks for success including engagement rates, take-up rates, and housing stability rates. Along with these providers, the Denver SIB had a high level of collaboration across many other partners in local government and national technical assistance and evaluation organizations. This collaboration helped solve implementation challenges quickly and effectively—and ultimately improved outcomes for individuals and communities.
How can this evaluation be put to use?
As chronic homelessness surges and pandemic-related eviction moratoriums end, evidence from the Denver SIB and other similar initiatives disrupts the story that homelessness is an unsolvable problem.
Housing First ends the homelessness-jail cycle. Cities need more development of and funding for subsidized housing along with services to help people access and stay in housing. We hope policymakers and practitioners use these data to advocate for supportive housing as a better solution.
Learn more about RWJF-supported initiatives and resources for communities working to ensure access to safe, stable, affordable housing for all.
* Program participants’ names have been changed to protect their anonymity.