The 10th Decile Project is a collaborative effort in Los Angeles County to connect frequent users of emergency health services to housing and appropriate care. More than 25 organizations, including five Health Center Program grantees, are involved in six neighborhood networks throughout the county to address the needs of the top 10% highest-cost, highest-need individuals experiencing homelessness in the community.
CSH Initiatives and Products: Social Innovation Fund Initiative
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Share on facebook Share on facebook Share on facebook Share on facebook Share on facebook Share on facebookFUSE Washtenaw County, MI
Bring together community partners from a variety of sectors to connect frequent users to housing, healthcare, and care coordination is both the goal and lasting outcome of the Frequent Users Systems Engagement (FUSE) initiative in Washtenaw County, Michigan – a subgrantee of the CSH’s Social Innovation.
The FUSE project targets individuals who meet threshold criteria for frequent utilization of crisis systems, including homelessness or housing instability, low income, behavioral health conditions, chronic physical health conditions, and frequent emergency room utilization and/or hospitalizations.
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Share on facebook Share on facebook Share on facebook Share on facebook Share on facebook Share on facebookRequest for Qualifications (RFQ): Persons/Firms to Develop & Implement Evaluation of Pay for Success
Description
The Ending Community Homelessness Coalition (ECHO), Social Finance, and The Corporation for Supportive Housing (CSH), are soliciting Requests for Qualifications from qualified persons/firms with demonstrated capacity and experience to develop and implement a rigorous evaluation of a Pay for Success (PFS) initiative that will provide supportive housing to chronically homeless individuals who are frequent users of both the health and criminal justice systems and struggle with mental health and substance use challenges.
Target Population
The initiative will target chronically homeless high utilizers of public crisis services. This RFQ will be used to identify evaluation persons/firms to conduct a rigorous evaluation to assess the impact and cost-effectiveness of the PFS initiative.
High utilizers are those individuals who are frequently before the court, in jail, and habitually using a spectrum of resources including:
- Healthcare — emergency rooms, emergency medical services (EMS), and psychiatric inpatient hospitalizations.
- Criminal justice — arrests, jail admissions and bookings.
Evaluation Goals/Scope of Services
ECHO, Social Finance, and CSH are requesting expressions of interest from qualified respondents and have identified three primary goals for the evaluation:
- Develop and implement a rigorous experimental or quasi-experimental evaluation design to measure the impact of the programmatic intervention on participant outcomes.
- Respondents proposing an experimental evaluation design (e.g. RCT) are encouraged to also briefly describe how you would approach evaluating the PFS project using a quasi-experimental research design, as the review committee desires to consider multiple methodologies to answer the core research questions outlined in this RFQ.
- Assist with building a PFS agreement; in particular assist in the development and refinement of success benchmarks and key outcome metrics that will be used to determine performance-based payments; and work with relevant parties to develop data tracking/collection systems and strategies to accurately measure and validate outcomes.
Application Process
All proposal items must be submitted ELECTRONICALLY by 5 pm CST on June 4, 2018 to: austinrfq@csh.org . Note: hard copies of proposal or application materials will not be accepted.
Proposal narrative must be submitted in Microsoft Word or PDF format and should not exceed twenty (20) single-spaced pages using Times New Roman 12-point font and one-inch margins.
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Share on facebook Share on facebook Share on facebook Share on facebook Share on facebook Share on facebookCNCS Releases Evaluation of CSH-SIF
The Corporation for National and Community Service Posts Evaluation of CSH’s Social Innovation Fund
Homelessness among the chronically ill drives significantly higher health care costs and exacerbates chronic illnesses by increasing exposure to trauma and high-risk behaviors.
CSH led a five-year national demonstration to create and evaluate supportive housing for healthcare’s highest need, highest cost beneficiaries experiencing homelessness. The evaluation examines the theory that when individuals with significant health costs experiencing homelessness have access to affordable housing and wraparound services, they will experience increased housing stability and improved health, and decrease the use of costly, crisis health care services.
Participating sites provided affordable, stable housing and case management to improve connections to health care services, improve health outcomes, and reduce health care costs. Sites differed in terms of population size, type of jurisdiction, housing market, and policy landscape. A research team at New York University conducted an implementation evaluation that included site visits, a pre-post participant survey, a cost effectiveness study, and analyses of program impacts using a randomized controlled trial (RCT) design and intent to treat (ITT) analyses and a quasi-experimental design with a treatment on the treated (TOT) approach.
Overall, the evaluation found that these programs can reduce utilization of shelters and costly health care in some populations, and these reductions can substantially offset program costs. The findings from the impact and cost analysis were mixed, but reflect the impact of variations in state and local regulations, services, and homeless populations.
It is possible to develop and deliver a medically-oriented supportive housing program targeted at homeless individuals who are high utilizers of health care using a data-driven approach. CSH is working to increase access to supportive housing for high need populations and embed supportive housing as a health care solution.
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Share on facebook Share on facebook Share on facebook Share on facebook Share on facebook Share on facebookCSH-SIF Webinar Forum Announced
Through the CSH Social Innovation Fund Initiative (CSH-SIF) nonprofits in four communities are implementing an enhanced supportive housing model. A five year Randomized Control Trial (RCT) evaluation of CSH-SIF has been conducted by an interdisciplinary team of researchers from New York University, led by Principal Investigator Beth C. Weitzman, PhD. This evaluation is the first RCT evaluation of a national supportive housing demonstration of this scale.
Join us for a webinar on CSH-SIF Evaluation results on Thursday, March 29, at 1pm ET. You can register for the webinar by clicking here.
Purpose of the Webinar
This webinar will present the results of the evaluation.
Learning Objectives for the Webinar
- Know the results of the CSH-SIF five-year RCT Evaluation conducted by researchers from New York University.
- Utilize lessons from data-driven targeting, healthcare-focused supportive services, and other design elements incorporated in the CSH-SIF program.
- Understand what outcomes and potential cost avoidance to expect when funding or delivering supportive housing for high utilizers of healthcare.
Agenda for the Webinar
CSH-SIF Eval & Overview of Service Models | Sarah Gallagher | 15 min |
Service Model by Site | 1 or 2 Local CSH-SIF Sites | 15 min |
NYU Findings | Beth Weitzman | 25 min |
Facilitated Q&A | Sarah Gallagher (Facilitator) | 5 min |
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Share on facebook Share on facebook Share on facebook Share on facebook Share on facebook Share on facebookAvalon Housing, CSH and NYU to host FUSE Social Innovation Fund key findings briefing
Ann Arbor, Michigan – February 5, 2018- Spurred by investments from the Corporation for National and Community Service, the Corporation for Supportive Housing (CSH) has been leading a five-year national demonstration to create and evaluate supportive housing as a solution to addressing the needs of our health care system’s highest-need, highest-cost patients who are experiencing homelessness. Ann Arbor-based non-profit Avalon Housing was one of the four grantees who led this demonstration known locally as FUSE (Frequent Users Systems Engagement). During the five-year project, Avalon worked closely with numerous service providers, including the University of Michigan Health System, St. Joseph Mercy Health System, Packard Health, Community Mental Health, the Shelter Association and the Ann Arbor Housing Commission, among others.
This demonstration was one of the first initiatives to investigate whether supportive housing has a significant impact on health care utilization and costs among homeless adults who are high utilizers of the health care system. The project was independently evaluated by an interdisciplinary team of researchers from New York University, led by Principal Investigator Beth C. Weitzman, PhD. This evaluation is the first randomized controlled trial (RCT) evaluation of a national supportive housing demonstration of this scale. The evaluation included several key components to assess both program implementation and impacts across sites, including a series of visits to all program sites, a pre/post participant survey and cost effectiveness- and impact analyses.
Using data matching across multiple systems, FUSE targeted 150 individuals who met threshold criteria for frequent utilization of crisis systems, including homelessness or housing instability, low income, behavioral health conditions, chronic physical health conditions and frequent emergency room utilization and/or hospitalizations. Through housing navigation, intensive case management and care coordination for primary and behavioral health services, the FUSE project aimed to demonstrate an increase in housing stability for homeless individuals. The project also sought to demonstrate a reduction in the use of emergency systems, improved health outcomes for medically vulnerable individuals and cost savings across multiple systems.
The New York University RCT evaluation concludes that supportive housing can reduce utilization of shelters and costly health care in some populations and can be an important care coordination approach for people with complex health conditions who also experience homelessness. These reductions can substantially offset program costs. This is the first randomized control evaluation of a national supportive housing demonstration of this scale.
Says Aubrey Patiño, Executive Director of Avalon, “FUSE has made an incredible impact on our community at large, paving the way for housing and healthcare partnerships across the state. At Avalon, we know that housing is fundamental to people’s health and wellbeing. We see that every day. FUSE allowed us to build the evidence base for this intervention while leveraging systems change that permanently shifted our community’s approach to effectively serving this population. The end result is that people cycling out of homelessness and crisis systems are stably housed, have access to the health care they need and are living with dignity. We are also more effectively using our community’s resources, and supportive housing now serves as a platform for recovery.”
On Friday February 16, 2018 from 1:00-3:00 pm at the St. Joseph Mercy Education Center, 5305 Elliott Drive, Ypsilanti, the CSH and NYU evaluation team members, including Senior Program Manager Lauren Fulton from CSH, Beth C. Weitzman, Ph.D., Professor of Health and Public Policy, NYU Steinhardt, and Carolyn Berry, PhD, Associate Professor, Department of Population Health, New York University School of Medicine, will discuss key evaluation findings from Avalon’s FUSE initiative, in addition to evaluation findings across the other three SIF sites, including Los Angeles, San Francisco, and the State of Connecticut.
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Avalon Housing, Inc. is a non-profit organization created in 1992 as a long-term solution to homelessness. Avalon develops, owns and manages supportive housing for over 750 of Washtenaw County’s lowest-income residents, including 200 children. We serve people who have been chronically homeless and who have behavioral and physical health challenges, including mental illness and substance use disorders. To learn more, visit avalonhousing.org.
Contact: Marcia Luke-van Dijk
(734) 904-4822
mluke-vandijk@avalonhousing.org
CSH has been the national leader in supportive housing for over 25 years. We have worked in 48 states to help create stable, permanent homes for individuals and families. This housing has transformed the lives of over 200,000 people who once lived in abject poverty, on our streets or in institutions. A nonprofit Community Development Financial Institution (CDFI), CSH has earned a reputation as a highly effective, financially stable organization with strong partnerships across government, community organizations, foundations, and financial institutions. Our loans and grants totaling over $700 MM have been instrumental in developing supportive housing in every corner of the country. Through our resources and knowledge, CSH is advancing innovative solutions like CSH-SIF and FUSE that use housing as a platform for services to improve lives, maximize public resources, build healthy communities and break the cycle of intergenerational poverty. Visit us at csh.org to learn more.
Contact: Robert Friant
212-986-2966, x245
robert.friant@csh.org
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Share on facebook Share on facebook Share on facebook Share on facebook Share on facebook Share on facebookCSH-SIF Evaluation Summary Released
Spurred by investments from the Corporation for National and Community Service, CSH has been leading a five-year national demonstration to create and evaluate supportive housing for healthcare’s highest need, highest cost beneficiaries experiencing homelessness. An evaluation of that demonstration now examines the theory that when individuals with significant health costs who also experience homelessness are identified and have access to affordable housing and wrap around services, they will experience increased housing stability and improved health, and decrease the use of costly, crisis health care services.
A five year Randomized Control Trial (RCT) evaluation of CSH-SIF has been conducted by an interdisciplinary team of researchers from New York University, led by Principal Investigator Beth C. Weitzman, PhD. This evaluation is the first RCT evaluation of a national supportive housing demonstration of this scale.
Through the CSH Social Innovation Fund Initiative (CSH-SIF) nonprofits in four communities are implementing an enhanced supportive housing model. Programs across all four demonstration sites encompass the following five elements found to be essential to the achievement of Initiative goals:
With an initial target of housing 549 people nationally, all four CSH-SIF sites far exceeded their original targets.
Total Number Housed by CSH-SIF
|
Housing Retention Rate
Based on program data |
Primary Health Insurance Retention Rate
Based on program data |
726 |
86% |
93% |
The New York University evaluation contains several key components to assess both program implementation and impacts across sites, including a series of visits to all program sites, a pre/post participant survey, and cost effectiveness and impact analyses.
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Share on facebook Share on facebook Share on facebook Share on facebook Share on facebook Share on facebookVirginia Supportive Housing SIF PFS Feasibility Report
Read the complete Social Innovation Fund Pay for Success Feasibility Report for Virginia Supportive Housing by clicking here.
This new report released today summarizes the conclusions and next steps resulting from the Technical Assistance provided by CSH to Virginia Supportive Housing from June 2016 to March 2017. The feasibility report focuses on the following components:
Key component | Successes | Next steps | Priority Areas |
Pay for Success education and profile raising
|
Discussions with state and city entities | Deeper engagement with potential end payer entities
|
High |
Target population | Priority population defined | Detailed eligibility and enrollment criteria
|
High |
Cost benefit analysis | Local value case examples show compelling impacts using pre/post analysis | Analysis of local health data if further health system involvement
|
High |
Service design | Framework for service design agreed
|
Deeper exploration of best practice through new awards for TA
|
Medium |
End payer identification | Interest from local healthcare systems | Work with City officials to determine interest
|
Low |
Payment terms | Options for payment terms included in report | Deeper exploration of metrics and terms following end payer commitment
|
Medium |
CSH believes Virginia Supportive Housing, alongside its partner Homeward, has the opportunity to successfully finish designing, structuring and implementing a Pay for Success supportive housing project if there is commitment from the City of Richmond or a health system payer to making success payments for outcomes achieved.
CSH has documented a number of next steps for finalizing outcomes of interest, success metric payment terms and evaluation design for when an end payer is identified.
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Share on facebook Share on facebook Share on facebook Share on facebook Share on facebook Share on facebookScaling Data Integration Request for Proposals: Advancing Pay for Success
CSH is seeking eligible and qualified state and local governments or tribes that are interested in participating in a new project that will inform the development and use of an integrated tool focused on criminal justice and homelessness data. Selected participants will receive technical assistance to access and integrate data from the homeless and criminal justice systems to target supportive housing in order to spur greater coordination/integration between the homeless/housing and criminal justice systems, and to advance Pay for Success. Access the full RFP here.
Release Date of this RFP: March 8, 2017
Live Bidders’ Webinar/Teleconference: March 20, 2017; 1:00pm ET
Registration Link: Register here for the March 20 introductory webinar. All Webinars will be recorded and made available at www.csh.org/pfs
Instruction for Submitting Written Questions
Submit to: pfs@csh.org
Please submit all questions by 5pm Eastern Standard Time on April 5, 2017 in order to ensure a response.
Due Date/Time and Instructions for Submission of Optional Notices of Intent to Apply
Interested applicants are strongly encouraged to submit Notices of Intent indicating the intention to submit full proposals. Notices of Intent should be submitted via email.
Due Date: March 27, 2017
Submit by email to: pfs@csh.org
Due Date/Time and Instructions for Submission of Full Proposal
Applicants must submit all application materials electronically. The application narrative must be submitted using the provided PDF application form. Attachments must also be submitted electronically. Late submissions will not be accepted.
Due Date/Time: April 7, 2017; 8:00pm Eastern Standard Time
Submit by email to: pfs@csh.org
Interview Stage
Following the review and ranking of the written applications, CSH will schedule phone interviews with the top-ranked applicants. Final determinations will be made based on the results of the interview stage.
Anticipated Announcement Date of Service Recipient Awards
Approximately May 5, 2017
Register here for the CSH Webinar that will review the RFP seeking eligible projects and discuss the new tool in more detail. This technical assistance opportunity provided by CSH is made possible through grants CSH received through the Pay for Success (PFS) program of the Corporation for National and Community Service’s Social Innovation Fund (SIF) and the Laura and John Arnold Foundation.
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Share on facebook Share on facebook Share on facebook Share on facebook Share on facebook Share on facebookNew Profit – America Forward Blog – Supportive Housing & Pay for Success
Thanks to the persistence of social innovators across the country, every day we see strategies that are working and delivering results in a rapidly changing world. This ongoing blog series will highlight the voices of our Coalition of 70+ social innovators and their solutions to our country’s most pressing social problems, as well as examples of how this powerful work can be transformed into national change. Today we will hear from Deborah SeSantis, President and CEO of the Corporation for Supportive Housing (CSH) about leveraging Pay for Success to create supportive housing, one of the dominating topics of discussion during the 2016 CSH Summit in Chicago.
Supportive housing is an innovative and proven solution to some of communities’ toughest problems. It combines affordable housing with services that help people who face the most complex challenges, such as the chronically homeless and individuals with acute health conditions, mental illness, substance abuse disorders, family instability and trauma, to live with stability, autonomy and dignity. Supportive housing is a significant and long-term investment, and identifying the necessary resources to ensure supply meets demand is an ongoing challenge. Fortunately, innovative financing tools such as Pay for Success can help make a difference.
The Corporation for Supportive Housing (CSH) is a national leader in the supportive housing space that works with communities and special populations such as veterans and low-income families to uncover ways to implement innovative housing solutions even in the most complex environments, so our partners can achieve stability, strength and success for the most vulnerable people in the communities they live. Many of our efforts are focused on “super-utilizers,” people with very high utilization of crisis services, i.e. homeless shelters, emergency rooms, jails, and other public facilities.
Sadly, too many veterans fall into the super-utilizer category. After serving their country, they return to their communities with untreated medical, substance abuse or mental health challenges. Soon they find themselves impoverished, homeless, and getting temporary, often inadequate, attention wherever they can find a port in their personal storms. Supportive housing changes the trajectory of their lives. It provides them with the stability that comes with a permanent home and access to services to treat the problems that likely caused their instability in the first place.
Supportive housing benefits families too – some of whom are facing trauma that threatens to rip them apart. For these families, lack of adequate housing contributed directly to the decision to open child welfare cases, place children in out-of-home care, or delay reunification of children with parents. Reports indicate 50% of children in foster care were removed from homeless or unstably housed families. Supportive housing offers affordable, stable housing and allows families to stay together.
CSH is active in more than a dozen communities designing and implementing supportive housing initiatives through Pay for Success. We leverage this model because at the very core of Pay for Success, performance rises above promises. Under the premise of the Pay for Success model, private and philanthropic organizations and investors form strong partnerships with local or state governments and agree to provide upfront dollars to launch an initiative to combat a societal problem such as homelessness, high rates of incarceration and recidivism, or over-reliance on hospital emergency rooms for routine medical care. Providers must prove their programs or services are working before government pays a dime, and outcomes are rigorously scrutinized by independent evaluators to guarantee results are actually addressing the problem. Pay for Success has support on both sides of the political spectrum because it is based on the common-sense approach that taxpayers should not have to fund a program unless it works.
Supportive housing is a big investment for communities, but we know it can improve outcomes and brings down costs once housing and access to regular and preventative care is achieved. It is for this reason that CSH is exploring the promise of Pay for Success to secure and expand the resources necessary to move family supportive housing forward.
As we elevate supportive housing to serve more vulnerable individuals and families, collaborative advocacy with other Pay for Success advocates, such as America Forward, has been critical. Their efforts are bringing Pay for Success achievements and its potential to the forefront of conversations in Congress, state legislatures, city councils and the 2016 Presidential election cycle.
As the Presidential election cycle pivots to the general election, CSH is thrilled to partner with America Forward to engage candidates and channel support for expanding supportive housing opportunities for the individuals and families that need it. By highlighting what works for vulnerable people and taxpayers, we are shaping the movement for smarter government, and America Forward is helping its Coalition of organizations, including CSH, realize our collective goals of leveraging high-impact, results-driven solutions to transform many more lives across the country.
Read more about how social innovators in the America Forward Coalition, like CSH, are solving America’s biggest problems in communities across the country every day in our briefing book, Moving America Forward: Innovators Lead the Way to Unlocking America’s Potential, and join the conversation. Follow @CHSInfo and @America_Forward, and tell us how Pay for Success and supportive housing have impacted your community using #AFPresidential16.