SANTA CLARA COUNTY may have just gotten one step closer to solving chronic homelessness.
According to a recent study by the UCSF Benioff Housing and Homeless Initiative, permanent supportive housing has been successful in housing the county’s most impaired and desperate homeless individuals, including frequent users of emergency medical and psychiatric services and jails.
Researchers found that 86% of participants in a study of Project Welcome Home, a permanent supportive housing program offered by nonprofit Abode Services and Santa Clara County, were successfully housed and stayed in housing for an average of two and half years.
“If we can house the hardest to house, we can house everyone,” said Margot Kushel, professor of medicine and director of UCSF Benioff Homelessness and Housing Initiative, during a webinar about the study hosted by nonprofit partner, Destination: Home.
Launched in 2015, Project Welcome Home provides homeless residents with subsidized housing along with voluntary, community-based services, including case management, counseling and addiction treatment.
Between 2015 and 2019, researchers assessed the use of county-funded health care and criminal justice services to determine the homeless individuals most in need. Of the 424 who were identified, 199 were randomly selected via lottery to move into Project Welcome Home’s housing units at multiple sites. while the rest were used as a control group.
In the two years before their enrollment in the study, these homeless individuals averaged 20 emergency department visits and three jail stays per person.
Helping those most in need
Santa Clara County’s Deputy Executive Ky Le said the county chose to focus on the most difficult homeless cases to show the public that addressing homelessness could reduce the strain on other public systems.
“We were making the argument for the board and the public that by allocating and providing these intensive services to people with the highest need, that we could improve the rest of our systems, whether that means the cost savings or reducing the unnecessary utilization of the ER and emergency psychiatric services,” said Le during the webinar.
The study found that participants who were housed by Project Welcome Home remained housed for 93% of the time in the study.
Researchers also saw a decline in use of psychiatric emergency services among the housed, while use of scheduled, outpatient mental health services increased.
“Even if our mental health systems are perfect, we wouldn’t solve the homelessness problem.”Margot Kushel, UCSF Benioff Homelessness and Housing Initiative
But housing did not solve everything. Officials said 37 of those in the supportive housing program died before the study was over. Meanwhile, those in the program continued to visit the emergency room at similar rates as the unhoused.
Kushel said many people came into the program already very sick after years of being homeless.
“We did not see a miraculous cure. These people are very sick and it’s not like they suddenly stop needing to go to the hospital. But we saw that people stayed housed and lots of evidence of the organization of care,” she said.
Kushel argued that the study refutes claims that homeless people are on the street because of mental illness.
“Even if our mental health systems are perfect, we wouldn’t solve the homelessness problem. I would argue that we can’t expect our mental health systems to be perfect, if they are trying to solve the massive policy failure that is homelessness,” she added.
Homeless numbers increasing
Nearly 10,000 people were unhoused in Santa Clara County, according to the county’s most recent count. That’s up from over 6,500 in 2015 when Project Welcome Home first launched.
Project Welcome Home was California’s first project to adopt the “Pay For Success” model, which requires government entities to pay for services only when they have demonstrated their effectiveness. Private entities can cover the upfront costs of the program.
The Sobrato Family Foundation, The California Endowment, Abode Services and Google were among Project Welcome Home’s funders.
“This is a case of the process is the product,” said Supervisor Dave Cortese. “Tying those four sectors together, with the leadership of Destination: Home, the brainpower over at the county and obviously the great work by our CBOs, particularly Abode, really created a model here that I was hoping would be replicated over and over again and that we would just start growing exponentially.”
Contact Devin Collins at firstname.lastname@example.org or follow @dev_collins2 on Twitter.
Editor’s Note: Destination: Home’s CEO, Jennifer Loving, serves on San José Spotlight’s Board of Directors.