Data and Scalability

If you ask me why CSH chose to pursue the Social Innovation Fund (SIF) housing-health initiative and also SIF Pay for Success - the answer is DATA and SCALABILITY.

For 25 years, CSH has worked with government and organizations to create supportive housing - affordable housing with services to improve the lives of the most vulnerable in our country.

As a result of our work we can point to reductions in chronic homelessness in communities across the country. And we can cite the cost savings associated with housing someone with chronic health issues as opposed to allowing them to continue utilizing costly crisis health services.

For over two decades we funded or participated in countless local studies that bolstered the hypothesis that it is less expensive for someone to be housed and have access to services than to repeatedly access a hospital emergency room or frequent the county jail.

And we built a reservoir of real examples of people whose lives were changed because of supportive housing, like a gentleman who likes to be called Popeye.

Popeye is now in supportive housing because of SIF.

But before SIF he lived most of his adult life on the side of a highway in Pasadena. He was so well known to passing motorists; a local radio station once described him as a landmark in a traffic report.

Local hospital workers and first responders also knew Popeye very well. In the course of just one year Popeye had visited the hospital emergency room or a clinic 63 times. 63 times in one year!

One day, intoxicated and high, Popeye wondered from the side of the road into traffic and was hit by an oncoming car. He spent two months recovering in a hospital and two weeks of that extended stay in a coma.

The costs associated with his healthcare were astronomical.

Fortunately, after leaving the hospital, Popeye was introduced to SIF and supportive housing and his life changed immediately.

He was off the side of the freeway, safe, a roof over his head. He went into recovery from his addictions, getting the treatments he needed. He found a part-time job. He reconnected with family, including a grown son he had only seen when the boy was a baby and a granddaughter he never knew.

Now his short visits to medical facilities average just 3 times a year.

If CSH had so much research and experience then what would we gain from participating in SIF? Complete data!

We had plenty of local evaluations from communities throughout the country including Chicago, Los Angeles, New York, Denver, Columbus and Maine but what we didn't have was a multi-site rigorous evaluation.

Participating in SIF is providing us with a multi-site randomized controlled trial evaluation or as I fondly refer to it - The Holy Grail.

Now when we advocate for supportive housing among federal, state and local agencies and make the case for supportive housing as a platform for improving health outcomes - we will be armed with a multi-site evaluation that is part of the SIF federal initiative.

I can tell lots of stories about Popeye and people like Popeye but what often compels decision makers to act is the data. Of the over 570 people housed through our SIF initiative, 91% are still in affordable housing and 85% have access to the primary care they need.

Scalability is what attracted us to the other SIF signature, Pay for Success. We see Pay for Success as a vehicle for scaling supportive housing.

It changes the way government allocates resources by investing in what works.

It increases accountability in the provider community by setting metrics.

We believe SIF and Pay for Success will diversify and expand investments in proven interventions like supportive housing and will change how government allocates resources for the better.