Permanent Supportive Housing Program Improves Mental Health and Reduces Homelessness, Emergency Room Visits, and Public Costs

A new report by researchers at the RAND Corporation, Evaluation of Housing for Health Permanent Supportive Housing Program, examines Los Angeles County’s permanent supportive housing (PSH) program called Housing for Health (HFH) launched in 2012. The report found the program succeeded in stable housing homeless individuals with complex medical and behavioral health issues, while generating cost-savings through reduced service utilization that more than offset the cost of the program.

The HFH program provides federal housing assistance through tenant-based and project-based vouchers in partnership with the housing authorities of the City and County of Los Angeles and a local rental subsidy program. The local rent subsidy provides HFH greater flexibility to provide housing assistance to households who may not qualify for federal assistance. The households may have, for example, a prior conviction or may not have a documented disability. The services component of PSH involves case management to connect participants with supportive services.

The outcomes of the HFH program show promising results. The program supported 890 individuals, most of whom (83%) were experiencing chronic homelessness, which is defined as being continuously homeless for at least one year or having four experiences with homelessness that add up to a year over the last three years. Ninety-six percent of the program’s participants were stably housed for at least one year, showing the program is an effective intervention for reducing homelessness.

Of the participants, 88% suffered from medical and mental health issues, including substance abuse disorders. Such individuals are more likely to use public services, particularly health services like the emergency room (ER). Following program participation, participants made an average of 1.64 fewer ER visits during the year, and inpatient hospital stays declined by at least 4 days. Participants received assistance for an average of 1.38 fewer months from Los Angeles’s financial assistance program for homeless individuals who do not qualify for federal or state programs. In total, the cost of public services used by participants decreased by 60%, outweighing the cost of the HFH program. Additionally, participants’ self-reported mental health functioning improved.

Evaluation of Housing for Health Permanent Supportive Housing Program is available at: