CSH - SIF National Demonstration Sets Path to End Homelessness

Sarah Gallagher

We enter 2016 with momentum, opportunity and a confluence of national initiatives uniting local and state-level stakeholders in the movement to end homelessness. Over the last year, with the support of the US Interagency Council on Homelessness (USICH) and the US Department of Housing and Urban Development (HUD), such places as Virginia, Las Vegas, Houston and New Orleans have announced an end to veteran homelessness.  And Salt Lake City and Utah are on their way to ending chronic homelessness.

However, in order to truly end chronic and veteran homelessness on a national scale that lasts, we must make sure communities have the resources and systems in place to prevent people from becoming homeless.  Communities must have an adequate supply of supportive housing, and systems and practices that ensure people with the highest needs have priority access to the housing and supports.  Among the people who must be prioritized are those who cycle in and out of crisis services (e.g. emergency rooms, hospitals, detox, correctional health, etc.), rarely finding the stability required to exit homelessness.

Through administration of a Social Innovation Fund (SIF) grant from the Corporation for National & Community Service, CSH has been working with four communities across the country to reach and end homelessness among individuals with complex health needs and housing instability who also turn to high-cost emergency and crisis health services on a regular basis. CSH’s approach entails a strategic, phased (five-year) grant-making and model development effort that provides supportive housing connected to coordinated health services to the highest-cost users of publicly funded crisis health services.

The core components of this SIF effort are: 1) the use of data to target and identify the cohort of homeless high utilizers in each community, 2) intensive outreach and engagement in several settings, 3) a Housing First approach, 4) facilitated access to health care and behavioral health care and 5) care coordination for each participant through a patient navigator or community health worker.

To date, the SIF initiative has identified and placed 573 vulnerable individuals into housing nationwide—individuals with severe and complex health conditions who may not have gained access to supportive housing without this data-driven program.

Through data-driven targeting and efforts to bridge the gap between systems of care, SIF is changing lives: 91 percent of participants in CSH-funded supportive housing initiatives have located stable housing, and 85 percent are currently connected to a primary health care provider.[1]

Four years into our five year initiative, tenants and their case managers are reporting utilization of primary care services coupled with drops in hospitalizations and emergency room visits. Moreover, tenants are reporting that they are overall satisfied with their housing, health care and quality of life and self-rated health.

Philanthropy, healthcare providers, public systems, and all levels of government have begun to recognize the potential for innovative programs like SIF to have tremendous impact.

In a recent interview, Fred Karnas of the Kresge Foundation said:

“People don’t come with a HUD problem, or an HHS problem, or a VA problem. They come with a set of issues …. These new partnerships that are emerging in communities between the housing world, managed care organizations, and hospitals are really the key to recognizing we can’t operate in two siloed systems …. Building this network at the local level is critical …. The hospitals I’ve talked to … are really looking at this partnership as a new way of doing business … The ability to meet their bottom line, have better outcomes for their clients, and create a better working system is high on the list.” Click here to watch Fred share Kresge's perspectives on CSH and SIF.

Federal partners, such as USICH, have also noted SIF’s efficacy:

“CSH’s SIF demonstration provides a clear blueprint for how to end chronic homelessness—the smart use of data, partnerships with the health care system, and the proactive targeting of people with the highest needs in permanent supportive housing.  That’s why USICH is partnering with CSH to integrate the lessons learned from this demonstration as part of our national strategy to end chronic homelessness,” said Matthew Doherty, Executive Director, USICH.

Through SIF, we are refining a valuable approach for how to achieve and sustain an end to homelessness. We are building the evidence and ensuring the practices and systems will stand the test of time.

As we move forward in 2016 and beyond, CSH and our partners are eager to learn as much as we can and want to work with even more communities to widely embed the innovations found in SIF.

For more information on SIF and how your community can get involved, please contact Sarah Gallagher at sarah.gallagher@csh.org

[1] Damian Thorman, Director, Social Innovation Fund. http://nationalservice.tumblr.com/post/133406470407/finding-what-works-and-making-it-work-for-more

Read the first in a series of papers on the CSH - SIF initiative: Supportive Housing for Homeless Super-Utilizers of Crisis Health Services.

In addition to the Corporation for National and Community Service, a number of philanthropic organizations have supported CSH - SIF throughout the years, including: Conrad N. Hilton Foundation, Melville Charitable TrustSan Francisco Foundation, Hearst Foundations, Henry E. Niles Foundation, L.A. Care, Glendale Memorial Hospital & Health Center, Fairfield County’s Community Foundation, California Hospital Medical Center Foundation, Robert Wood Johnson Foundation, and Kresge Foundation.



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