Evaluation of housing for health permanent supportive housing program

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.