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The needs of people living in supportive housing have become increasingly complex, yet the systems, funding structures, and service models designed to support them have not always evolved at the same pace. This paper explores how changes across housing, healthcare, behavioral health, and homelessness response systems have contributed to growing challenges in serving individuals with high-acuity needs, particularly in Los Angeles County.
Developed through a partnership between CSH and Housing Works of California, the paper emerged from conversations among leaders from Los Angeles County’s housing, healthcare, behavioral health, and supportive housing sectors who recognized the need for a more coordinated and sustainable approach. Drawing on lessons from the Los Angeles Mobile Integrated Services Team (MIST) model, which closely reflects the evidence-based Pathways to Housing’s Housing First model, the authors developed a High Acuity Pilot Framework to improve outcomes for individuals with the most complex needs.
The paper examines the historical, policy, and operational factors shaping supportive housing today and offers recommendations to strengthen service delivery, workforce capacity, funding alignment, and cross-system coordination. It is intended as a resource for policymakers, funders, housing providers, healthcare partners, and community leaders working to build a more responsive and sustainable supportive housing system.
In addition to the full report (here and to download above), here is a short, executive summary.
