CSH Solutions

Economic Roundtable

The Economic Roundtable, working in collaboration with the Los Angeles County Chief Executive's Office, Services Integration Branch, added up the cost of public services utilized by a large sample of single homeless adults. These persons were rank-ordered and divided into deciles by the cost of public services they received from the following LA County program and departments: Health Services , Mental Health, Public Health, General Relief (DPSS), Food Stamps (DPSS), Homeless Services, Probation and Sheriff. The ten percent of this sample with the highest public costs are the "tenth decile," who have an average of $5,857 of monthly public costs.This initiative seeks to refer the highest-cost, high-need homeless persons of the "tenth decile" into supportive housing where their lives can stabilize and they can receive support and care for medical, psychiatric and/or substance abuse problems.

The Economic Roundtable developed an innovative triage tool, or crisis indicator, that identifies homeless individuals in hospitals and jails who have continuing crises in their lives that create very high public costs. The tool is developed for use in jails, hospitals and clinics where homeless individuals with high levels of need and high public costs are most likely to be found. A partnership consisting of 38 social service, housing and health care organizations will identify, recruit and provide supportive housing, care management, and integrated primary and behavioral health care to high-need, high-cost homeless individuals to improve their health and reduce avoidable visits to emergency departments, acute inpatient hospitalizations and other crisis service use.

CSH's Role

CSH has awarded Economic Roundtable with an annual grant of $375,000 to identify and serve 107 of the highest cost users of crisis health services in Los Angeles County. CSH has also created a national learning network including Economic Roundtable and the other subgrantees which will:

create unique partnerships between community health and housing systems
engage policymakers
build an innovative model that can be replicated, extending the benefits of the pilot programs far beyond the initial tenants.

CSH is also working with a team of researchers from New York University to conduct a rigorous national evaluation testing the impact on housing and health outcomes, as well as on public costs, including Medicaid.