Los Angeles County Focuses on Pay for Success

As the Board of Supervisors in Los Angeles County continues to examine Pay for Success as a means to finance social investment, CSH was pleased to partner with the Nonprofit Finance Fund, and a steering committee composed of prominent California-based organizations, to host the “Los Angeles Pay-for-Success Symposium” on Thursday, May 28.

Held at the Music Center in Los Angeles, participants included City, County and State leaders as well as experts from around the country who are currently using Pay for Success financing models to fund crucial projects in their communities.

“Problems are big and budgets are tight. Pay for Success can help government, philanthropy, and private capital invest in what works and deliver better outcomes for the people of Los Angeles County.” 

Don Howard, President & CEO, The James Irvine Foundation

Pay for Success – also known as social impact bonds – is an innovative funding model that drives government resources toward effective social programs that provide results, actually helping people who need the services. PFS gives highly impactful service providers, including nonprofits and charities, access to flexible, reliable, and up-front resources to tackle critical social problems by tapping private funding to cover the up-front costs of social programs. Government plays a role, but only pays for programs and services that can prove they are working.PFS_LA_panel1

In a nutshell, Pay for Success:

  • Leverages new financing to invest in proven, preventative services
  • Focuses on identifying & achieving outcomes
  • Incentivizes performance, limits taxpayer risk

Los Angeles County adopted an official Pay for Success Blueprint in October 2013. Since then, the County has been considering proposals and developing a process for further input. CSH and the Nonprofit Finance Fund organized the Symposium with members of a steering committee to further the dialogue and feedback among local officials.

Deb_opening_PFSLADeb De Santis, President and CEO of CSH, welcomed Symposium attendees by pointing out that Pay for Success “reduces the burden on government by bringing others – philanthropy and corporations – to the table to assume the risk. It relies on defining real outcomes and using data and evidence to measure progress, and that means better programs and services in the long run.”

Some of the topics touched on at the Symposium centered on communities that have implemented Pay-for-Success and the leaders and champions within them who mustered local support and the political will to bring successful initiatives to fruition.

In addition, the Symposium focused on:

  • The promise of Pay-for-Success, giving communities a platform to scale up evidence-based practices
  • The high standard for tracking program outcomes, and
  • How to prepare providers and governments for the greater scrutiny of program results necessary to bring private investors to the table.

CSH and the Nonprofit Finance Fund would like to extend our gratitude to the Steering Committee Members who made the Symposium a reality with their guidance and financial support:

Chris Hubbard, California Community Foundation

Bill Pitkin and Andrea Iloulian, The Conrad N. Hilton Foundation

Melody Head and John Moon, The Federal Reserve Bank of San Francisco

Connie Malloy and Annelise Grimm, The James Irvine Foundation

Jessica LaBarbera and Jasson Crockett, Nonprofit Finance Fund

Belen Vargas, The Weingart Foundation

Why Vigilance & Advocacy are Vital

blog by CSH President & CEO, Deb De Santis

Two recent developments have produced a wave of advocacy pushing for more supportive housing and affordable housing in general.

The first in California, where a just released independent analysis by the State Legislature indicates very high housing costs and lack of affordable options are hindering economic growth, and increasing poverty and homelessness there.

California has some of the most expensive housing in the country. The average home price is about 2½ times the national norm, while the average monthly rent is about 50% higher. Rents are increasing across the state while incomes are decreasing.

We know the largest cause of homelessness is the inability of people living in poverty to afford housing. Nothing bares this fact out more than the crisis in California.

Over 114,000 Californians are homeless on any given night. With 28,200 Californians experiencing chronic homelessness, California has the highest number of chronically homeless families and individuals in the nation.

Today, those who care about individuals and families struggling with homelessness and others facing housing insecurity, gathered in Sacramento to speak out loudly for more supportive housing, access to affordable rental apartments and services addressing the needs of some of the most vulnerable people in our society.

Some residents who thrive in supportive housing joined the chorus of affordable housing supporters, meeting with legislators to share their personal stories and press for immediate action.

Organized by CSH, this kind of story sharing builds a connection between formerly homeless – now residents of supportive housing – and decision-makers.

Those who have seen their lives transformed by supportive housing are speaking up because efforts to create more affordable housing options have taken a real hit over the past four years. Cuts of 79% in major state and federal sources of housing funds – due to withering bond financing, the elimination of redevelopment agencies, and sequestration – have stopped many viable projects in their tracks.

CSH and our supportive housing resident-advocates are urging California lawmakers to endorse Assembly Speaker Toni Atkins’ package of bills to create more affordable housing in the Golden State by:

  • Establishing a “California Building Homes & Jobs Fund,” a permanent source of funding for affordable housing
  • Increasing the state’s Low Income Housing Tax Credit
  • Using a portion of existing funds to reduce recidivism through investment in housing and supports for formerly incarcerated Californians

Other key proposals championed by advocates would:

  • Incorporate “Bringing Families Home” into the State budget, providing grants to counties to house child-welfare-involved families experiencing homelessness
  • Strengthen the CalWORKS Housing Support Program

California’s current predicament should send a stark message to other parts of the nation, but not everyone seems to be getting it.

In Illinois last week, those who care about homeless individuals and families joined with providers of supportive housing (for the homeless and disabled) to warn officials of “unprecedented and costly increases” in homelessness unless they reverse plans to slash the state’s successful safety-net programs.

According to Mike Bach, Executive Director of the Supportive Housing Providers Association in Illinois, the proposed budget eliminates all funding for supportive housing services for individuals and families experiencing homelessness; withholds funds for projects to serve the mentally ill; jeopardizes housing for the most vulnerable; and discontinues or severely reduces related human services. Mike points out the cuts would reduce funding for supportive housing for those exiting homelessness by over 80%, denying homes and services not delivered by Medicaid to nearly 13,000 Illinoisans.

What concerns all of us is the reductions could drive very vulnerable people into the streets, jails, nursing homes or state institutions – expensive alternatives they have no choice but to turn to when they cannot access supportive housing. The result will be higher costs to taxpayers for emergency room visits, incarcerations and other expensive crisis response measures.

Whether it’s the housing crisis in California or the potential one in Illinois, our leaders must take action now to ensure there are more, not less, opportunities for Americans to access affordable housing and community-based services crucial to ending and preventing homelessness.

Early Results of TAY Triage Tool: Confirming Validity Outside of Los Angeles

With support from the Conrad N. Hilton Foundation, the TAY Triage Tool was developed by Dr. Eric Rice for CSH in conjunction with community partners in Los Angeles during 2012 and 2013. The purpose of the TAY Triage Tool is to identify youth who are at greatest risk of experiencing “long term” homelessness, which we defined as five or more years of homelessness.  The intention of the TAY Triage Tool is to identify youth and young adults most in need of a long-term housing intervention with supportive services, such as supportive housing. However, in working with different communities to utilize the TAY Triage Tool, it became clear that the tool could also be implemented to inform system-level housing and service planning.

This report details the results of preliminary implementation of the TAY Triage Tool in several communities, and resulting findings regarding the validity of the tool and its generalizability.

Stable Homes, Brighter Futures: 2nd Year Evaluation Report

CSH is pleased to share the 2nd year report of our Stable Homes, Brighter Futures initiative, a three-year demonstration project to better understand supportive housing for youth and young adults, ages 18-24, also known as transition age youth (TAY).  With support from the Conrad N. Hilton Foundation, the W.M. Keck Foundation, and The California Wellness Foundation, the Stable Homes, Brighter Futures initiative contributes to broader systems-level efforts to:

  • Increase the capacity of organizations in Los Angeles County to develop and operate high-quality supportive housing for transition age youth in areas of high need.
  • Create a safety net of housing and services for TAY that includes health, mental health, education, and employment.
  • Collaborate with government agencies and partner organizations to secure adequate and coordinated public funding mechanisms.

While the first-year report provided a level of initial baseline data and immediate impacts of supportive housing, this second-year report provides a more comprehensive understanding of the service needs of TAY in supportive housing, factors associated with their level of risk of long-term homelessness, the longer-term impacts of living in supportive housing, and a descriptive look at TAY who exited supportive housing.

It’s clear that supportive housing providers are serving young people who face significant barriers to accessing and retaining housing:

  • More than half of the youth were literally homeless prior to living in supportive housing, and 40% of those youth were homeless for over one year.
  • About 70% of youth in supportive housing report mental health challenges that interfere with their daily living and ability to live independently.
  • 18% of youth in supportive housing self-reported substance abuse challenges.
  • supportive housing providers are serving young adults who have incomes significantly below the poverty threshold and have lower levels of educational attainment compared to the general youth population.

This report also explores the impact of supportive housing from the perspective of preventing adult chronic homelessness.  Through the utilization of the TAY Triage Tool, a predictive tool that identifies a young person’s risk of experiencing five or more years of homelessness, the report provides a snapshot of how many youth and young adults in supportive housing were on a trajectory to becoming chronically homeless adults.

  • 72% of youth in supportive housing had at least one lifetime experience that doubled their risk of experiencing 5 or more years of homelessness.
  • 10% of youth tenants were at a high risk of experiencing long-term homelessness, as indicated by the endorsement of 4 or more experiences itemized on the TAY Triage Tool.
  • Youth who reported mental health challenges were at a high risk.
  • Youth who experienced the foster care and juvenile justice systems were at a high risk.

The report offers recommendations that not only reflect data findings, but also reflect discussions with providers learned through our TAY Learning Community, and the voices of TAY tenants.

“They try to get us out of survival mode and do little events to learn how to deal with life… learn how to be around other people besides ourselves.” – Youth Tenant, Age 21

Overall, this second year report presents quantitative and qualitative data that inform how the supportive housing model has evolved to serve homeless youth and young adults, and how it can further adapt to improve the operation of, and service delivery in, supportive housing for youth and young adults.

To download the full report, click here.

Stable Homes, Brighter Futures Evaluation Report – Year 2 Interim Report

As part of a broader effort to address the unique needs of highly vulnerable homeless TAY and build supportive housing capacity in diverse regions of Los Angeles County, CSH launched Stable Homes, Brighter Futures, a three year demonstration project supported by the Conrad N. Hilton Foundation, the W. M. Keck Foundation, and the California Wellness Foundation.

This interim report focuses on the first two years of the initiative and describes the young adults served and their experiences in supportive housing. This report provides a better understanding of the housing needs of TAY, factors associated with their level of risk of long-term homelessness, the impact of living in supportive housing, and a descriptive look at TAY who exited supportive housing.

Face-to-Face SIF Convening Offers Cross-Site Sharing after Three Years of Implementation

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SIF Participant Displays Contents of Overdose Prevention Bag during Harm Reduction Discussion

CSH convened its third annual Face-to-Face gathering in Los Angeles this October for sub-grantees of the of the Social Innovation Fund demonstration project focused on high utilizers of healthcare, now entering its fourth year. Continuing the cross-site learning opportunities that have been a key part of the project, representatives from the four sites participating in the initiative – Connecticut; San Francisco, California; Los Angeles, California; and Washtenaw County, Michigan — spent two days at the California Endowment for the Arts engaged in discussion guided largely by the providers who have been implementing SIF on the ground for the past three years. This year’s gathering centered on the theme of sustainability beyond the five-year grant program, with each site presenting a detailed financial sustainability plan for feedback from an expert panel including representatives from HUD, the Technical Assistance Collaboration, Health Management Associates, and the Hilton Foundation.

Other sessions addressed strategies for programmatic sustainability, building on the sites’ collective body of experience and expertise. One of the key emerging lessons of the work on the ground with these high-utilizing cohorts is that the majority of individuals being served have an array of medical, behavioral, and social challenges resulting in a need for support that is both acute and complex. Participants engaged in rich discussions on innovations and best practices in harm reduction, cross-sector coordination, and nontraditional models for engagement with healthcare.

“I really appreciated being in a space where everyone was so focused on shared tasks and challenges.  SIF has been a huge resource for our agency, helping us learn how to add housing support services to our emergency shelter operation.  It was encouraging to hear from colleagues around the country who have successfully implemented on a larger scale many of the measures we have built into our own sustainability plan.” -David Gonzalez-Rice, Housing Support Team Manager at the New London Homeless Hospitality Center in Connecticut

CSH staff also had the opportunity to partner with the Skid Row Housing Trust to have dinner on the garden terrace of a new supportive housing residence for medically vulnerable high-utilizers, the Star Apartments. To learn more, click here.

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SIF Sites Share On-the-Ground Experiences with Harm Reduction and Housing First

CSH Partners with White Lilac for Magical Evening at Star Apartments

CSH hosted a Face To Face dinner for our Social Innovation Fund (SIF) grantees and the residents of the Star Apartments in Los Angeles, a Skid Row Housing Trust development, on October 23. CSH’s SIF grantees were on the West Coast marking the 3rd year of the national initiative, which provides supportive housing and care coordination to medically vulnerable homeless individuals in Los Angeles, San Francisco, Washtenaw County, Michigan, and Connecticut.

SIF grantees mingled with those now living at the Star, some of the most vulnerable people of Los Angeles County, including chronically homeless individuals and those with a history of frequently utilizing emergency medical services.

The Star Apartments and SIF are receiving national attention. In addition to residential tenants, the newly renovated Star is home to the offices of the Los Angeles County Department of Health Services‘ Housing for Health division headquarters.

At the dinner last month, guests were treated to the magnificent view from the Star Apartments’ garden terrace as they enjoyed a sumptuous and diverse menu of Mexican/Latina fare provided by Homegirl Cafe & Catering in stunning surroundings designed by White Lilac, Inc.


CSH is grateful to Homegirl and Sunny Ravanbach and her team at White Lilac for their generosity, and efforts that went above and beyond to “wow” our guests. Their good work ensured that the residents of the Star Apartments and SIF grantees from across the country experienced a magical evening that will be remembered for years to come.

Hilton Foundation Announces Continued Partnership with CSH


After helping create 4,000 housing units over the last ten years, a $12 million investment from the Hilton Foundation will spur innovative investments in supportive housing


Supportive Housing Community Advocates from Los Angeles celebrate at their graduation ceremony

The Conrad N. Hilton Foundation announced today that after ten years of collaboration they are deepening their partnership with CSH in order to accomplish even more. With a total $12 million investment, half in grant form and half as a loan, the Hilton Foundation and CSH will ramp up efforts to increase the supply of supportive housing throughout Los Angeles County, California, helping thousands of long-term, chronically homeless individuals to build new lives with a strategy proven to be effective. Read the full announcement here.

Read more about our long standing partnership with the Hilton Foundation.


CSH Launches Pilot to Identify Homeless Youth in CT

Two experienced youth-serving providers in Connecticut underwent training to launch a new effort to identify homeless youth at the greatest risk of experiencing long-term homelessness. The Youth Continuum in New Haven and The Connection, Inc. in Hartford will deliver a questionnaire to at least 120 youth, with the goal of utilizing the data to inform housing and services capacity planning for youth transitioning out of state care or otherwise experiencing life on the streets.

On October 9, 2014, both agencies received training from Dr.Eric Rice in the Transition Aged Youth (TAY) Triage Tool, which until this point has only been administered in California. The TAY Triage Tool is a youth-specific set of  non-invasive questions that can be quickly delivered to determine whether a homeless young person is on a trajectory to experiencing five of more years of homelessness.

The tool consists of a six point scale, with the recommendation that homeless youth with a score of 4 or higher should be prioritized for supportive housing.  For communities seeking to create or increase their inventory of supportive housing for youth and young adults, the TAY Triage Tool provides a mechanism for collecting targeted data to inform the planning process.

In 2012, CSH began working with Dr. Eric Rice, Associate Professor at the University of Southern California School of Social Work, to develop the TAY Triage Tool. The participation of Youth Continuum and The Connection, Inc. will contribute to the development of a rigorous, multi-site dataset to further establish generalizability of the TAY Triage Tool.

Learn more about the TAY Triage Tool.

CSH would like to extend thanks to Dr. Eric Rice, USC for his passion and dedication to the homeless youth population, and to recognize the efforts of Paul Kosowsky of Youth Continuum and John Lawlor of The Connection, Inc. and the staff at these agencies for their time and for their commitment to this project.

Speak Up Stories of Homelessness to Success in Housing


Through the community advocates’ stories we not only learn what works in solving homelessness, we begin to understand what life after homelessness looks like and the tremendous potential of the men and women who have made this journey. The connections between the community advocates experience, public policy and the broader social debate, allows the advocates to reinvigorate public dialogue. By understanding the human side of ending homelessness, we open the door to new allies and partners to share our common belief that homelessness can be ended. We also open the door to long time believers to see that not only can we end homelessness; we can harness the potential and energy of the people with lived experience of homelessness to be our partners in this movement.

Participants in Speak Up have advocated at the local, state and federal level, meeting with the legislators who are the decision makers on funding for supportive housing programs.


Story Snapshots






2014 Class of Advocates

Download a copy of our Yearbook  – stories of each of our participants in the 2014 Speak Up program.