全球智库信息集成服务系统

• Clients' use of public services, especially medical and mental health services, dropped substantially, including emergency room visits and inpatient care. Costs, correspondingly, also decreased.
• Across all the services examined, the associated costs for public services consumed in the year after receipt of supportive housing declined by close to 60 percent.
• Participants' self-reported mental health functioning improved after receiving housing, though self-reported physical health was largely unchanged.
• Although the number of individuals arrested and the number of jailed arrests decreased during the year after receiving housing, the number of jail days increased following PSH entry by an average of 2.76 days.

Housing for Health (HFH), a division within the Los Angeles County Department of Health Services (DHS), was established to provide supportive housing to DHS patients with complex medical and behavioral health issues who were experiencing homelessness. HFH goals are to improve patients' health, reduce costs to the public health system, and demonstrate DHS's commitment to addressing homelessness within Los Angeles County. RAND conducted a formative evaluation to provide early feedback on program implementation and performed an outcome evaluation examining the effects of the PSH program on county service utilization and service costs. RAND also analyzed data from a survey on health functioning both at housing entry and a year later among a small convenience sample of HFH participants. Our findings suggest that DHS succeeded in implementing the HFH PSH program. Thousands of individuals who formerly experienced homelessness, many with complex chronic physical and mental health conditions, have been stably housed. Los Angeles County data demonstrate a dramatic reduction in service use, especially for medical and mental health services. Overall, the cost reductions more than covered the year's worth of supportive housing costs, as we observed a net cost savings of 20 percent.

• Chapter One

  Introduction

• Chapter Two

  Methodology

• Chapter Three

  Results

• Chapter Four

  Key Findings, Recommendations, and Conclusions

• Appendix A

  Comparisons of Cost Studies' Results

• Appendix B

  Interview Protocol

• Appendix C

  Sensitivity Results