The projects will serve more than 250 residents through innovative initiatives that tackle complex health, substance use, and aging challenges.
The Challenge: Rising Acuity Among Supportive Housing Residents
Over the last five years, New York City’s supportive housing system has been stretched by a growing number of people experiencing homelessness who need more intensive, coordinated support to stay housed.
More people are experiencing prolonged homelessness due to obstacles in accessing health care, housing, and community-based services. Many individuals entering or living in supportive housing are navigating complex trauma and health conditions, often without consistent access to coordinated and person-centered care.
Supportive housing providers have seen a drastic rise in serious health challenges for their residents. At the same time, the population within supportive housing is aging. Older adults, age 50+, now represent the fastest-growing group of New Yorkers facing housing instability, with many entering homelessness and crisis systems for the first time. Providers are struggling to support aging residents who have lived with substance use disorder for decades, often experiencing cognitive decline and aging issues nearly 20 years earlier than those who have never been homeless.
The COVID-19 pandemic also led to the closure of many nonprofit service providers, and the sector continues to feel the devastating impact of a critical service infrastructure that has been reduced in scale. Further, the sector has received insufficient public and private investments to meet the needs at the required scale.
CSH’s Response: A Multi-Year Initiative
Funded by a three-year grant from The Leona M. and Harry B. Helmsley Charitable Trust, CSH launched a three-phased project to both identify service gaps and surface solutions that better address the needs of supportive housing residents with complex health challenges in New York City (NYC). CSH’s NYC metro team, led by Lauren Velez, launched this project by engaging teams of collaborators and advisors on key phases of the project: starting with establishing partnerships with network leaders at The Supportive Housing Network of New York (the Network) and The Health and Housing Consortium to bring their expertise and membership’s perspectives to the project; followed by convening an advisory committee for input and feedback that includes providers, government leaders, and people with lived expertise.
The first official phase of the project was to complete a full landscape assessment aimed at understanding the local and national challenges, and opportunities to serving this population in the supportive housing field.
Informed by and in response to these findings, Phase Two included the creation and announcement of a competitive RFP to solicit ideas with the most promise to improve the service levels in the sector to better meet these unmet needs. In November 2025, CSH selected four proposals to be the pilot projects for the “High Health Acuity in Supportive Housing Initiative”, awarding a total of $1,000,000 in grants over 2 years. The selected pilot projects will holistically address the high acuity health needs of supportive housing residents through increased capacity and innovative interventions.
Evidence Towards Innovation
Phase Three of this project involves CSH choosing and engaging an evaluation partner, L&G Research and Evaluation Consulting, Inc., to evaluate learnings from the initiative and, together with CSH’s deep expertise in the field, and the input from their expert advisory committee, coordinate the evaluation for the pilots projects with an eye towards opportunities for scaling and sustainability for those that are successful. The evaluation partner will also develop education materials to share with policy makers and other stakeholders.
“I couldn’t be more excited about this initiative as it combines grant funding with CSH’s tailored technical assistance and policy expertise to help providers better support residents living with multiple co-occurring physical and behavioral health conditions,” said CSH NYC Metro Director, Lauren Velez. “Pilot programs test innovations that include hiring additional specialized staff, implementing flexible service models, and strengthening collaboration across homelessness and health systems. We need to reimagine our investment in supportive housing services. Cost effective measures don’t mean that we can fail to provide adequate funding- it means that the return on that investment is greater and more stable than alternatives. “
Private funding is often needed to create the evidence and testing needed to advocate for public adoption. “A project like this with three important ingredients of evidence-based innovation – research, testing, and evaluation – bolstered by the deep bench of expertise from CSH and their partners to find solutions to this growing challenge for New Yorkers living with complex health issues in Supportive Housing, is one of the strongest doses of philanthropic support that we could apply to the problem,” said Tracy Perrizo, NYC Program Officer from the Leona M. and Harry B. Helmsley Charitable Trust. The project’s aim is to show why making the necessary investments to meet these needs at scale is smart and cost-effective policy. Decades of research have proven that supportive housing offsets public costs of crisis systems and creates safe, thriving communities.
“This project gives us the ability to explore the impact of interventions that are truly person-centered, responsive to need, and properly funded on the overall health and well-being of high-need supportive housing tenants,” added Velez.
Meet the Four Pilot Projects
CSH and evaluation partners selected these four organizations from an extremely competitive applicant pool of New York City supportive housing providers.
Alliance for Positive Change
Alliance for Positive Change will integrate a housing-focused social worker to provide comprehensive clinical support services to residents of their Bronx supportive housing building. Residents have complex health needs including HIV and other chronic illnesses, mental health concerns, aging issues, and other challenges. The new full-time staff member will provide frequent, one-to-one counseling to improve residents’ financial skills, apartment-care skills, self-efficacy, and independence.
Lantern
Lantern’s Adapted-Intensive Case Management (A-ICM) pilot project will adapt the most effective elements of the traditional Intensive Case Management (ICM) model to make it more sustainable and scalable for organizations with limited resources. Case managers will receive training to support residents with complex needs through intensive services. Within the A-ICM model, services will include needs assessments, referrals and warm handoffs, health navigation, and accompaniment to health appointments. The pilot also includes hiring new Tenant Peer Navigators who will leverage their lived expertise to help residents navigate complex health systems.
Project Renewal
Project Renewal’s High-Acuity Response Team (HART) project will pilot a care team consisting of a nurse care manager and occupational therapist who will support their highest-need supportive housing residents. The new full-time staff members will manage a shared caseload to serve residents with complex needs including substance use, serious mental illness, aging, generational trauma, and/or chronic health issues. This pilot project will bring coordinated in-house care that specializes in complex needs, while increasing capacity for frontline staff who are strained in supporting 100 of their highest need residents across multiple supportive housing sites.
St. Nick’s Alliance
The St. Nick’s Alliance project will pilot a new mobile Wellness Outreach Team to support residents of their scattered-site supportive housing program. Tenants living in scattered-site supportive housing can be more difficult to reach, as they live in units rented from private landlords throughout the city. This multidisciplinary team will conduct comprehensive in-home assessments and provide ongoing support services including medication management, behavioral health support, and health education. This new team will coordinate with existing case managers and be integrated with community providers to facilitate warm hand-offs when clients stabilize. The outreach team plans to serve around 60 tenants during the pilot period.
