Supportive housing is a multifaceted model to help homeless individuals and families that face suchcomplex challenges as addiction, mental health conditions and disabilities that can be overwhelming. In addition to permanent housing, the model provides social services that range from substance abuse programs and life skills training to case management and job training.
Many, but not all, supportive housing programs use the “housing first” approach, endorsed by the federal government. Under “housing first,” permanent housing should be made the top priority for homeless individuals and families; addressing behavioral, social and other factors comes second.
The peace of mind that comes from a safe place to live helps individuals as they tackle addiction or other challenges. Plus, service providers know where to contact the individuals to provide the help they need.
“If you provide housing stability first and then provide the wraparound supports, people are much more successful,” says Shannon Nazworth, executive director of Ability Housing, a nonprofit organization that provides supportive housing in parts of Florida.
Ability recently received a grant from the Florida Blue Foundation, a philanthropic foundation affiliated with the state’s Blue Cross and Blue Shield health plan. The grant supports a statewide pilot project to study how permanent supportive housing affects the health and quality of life of high utilizers of crisis services — and how it affects their use of health care and other publicly funded support services.
A growing body of research, in fact, suggests that the benefits of housing programs for the health care system might be substantial. Researchers at Yale University’s Global Health Leadership Institute evaluated and summarized the results of several studies in the area in their report "Leveraging the Social Determinants of Health: What Works?" (Lauren A. Taylor et al., Blue Cross Blue Shield of Massachusetts Foundation, 2015):
- A "housing first" program in Seattle found that the median per person, per month cost of incarceration, emergency medical services, hospital-based medical services, detoxification and other publicly funded programs fell from $4,066 to $958 after 12 months in housing. This added up to annual net savings — after accounting for housing costs — of $29,388 per person compared with a control group.
- A Massachusetts initiative that targeted homeless people with serious mental illness reduced the average number of hospital days per client from 102 to seven within two years after housing placement. That reduced hospital costs by about $18 million per year overall.
- A Los Angeles program that serves homeless patients with the highest public services and hospital costs documented that every $1 invested in housing and support reduced public and hospital costs by $2 the following year and $6 in subsequent years.
While Nazworth is eager to see the Florida-specific data, her experience tells her that supportive housing reduces the use of health care services.
“If we can get people into stable housing, their health always improves,” Nazworth said.