Transforming Lives Through Supportive Housing

The Denver Housing to Health (H2H) Project is a groundbreaking initiative aimed at addressing the challenges of homelessness, frequent criminal justice interactions, and emergency health care needs in Denver. The H2H evaluation hopes to demonstrate how supportive housing can lead to significant reductions in expensive emergency care, thereby providing better value for participants and taxpayers. Informing policy decisions and expanding housing access and health care services across Colorado, can enhance the well-being of our most vulnerable residents.

Addressing Complex Challenges with Innovative Solutions

Launched in 2022, early implementation of H2H focused on outreach, quality supportive housing, and navigating the criminal justice and health care systems with initial findings indicating successful housing placements and promising retention rates. The project’s goal is to provide 125 supportive housing units over seven years to individuals who experience frequent interactions with the criminal justice system and emergency departments due to homelessness and lack of access to essential services. This specific population often faces a cycle of low-level offenses, arrests, and repeated use of emergency services, leading to significant personal and public costs.

Evaluating Impact through Data-Driven Insights

Modeled after the successful Denver Supportive Housing Social Impact Bond Initiative (SH-SIB), H2H introduces an additional focus on medical vulnerability. Helping determine progress in this area is a robust evaluation framework leveraging data from the Colorado All Payer Claims Database (CO APCD). By analyzing health care service access and Medicaid costs, they plan to measure the impact of supportive housing on this vulnerable population. Participants were enrolled on a rolling basis, with 220 individuals randomized to receive supportive housing and 220 to a control group. This design ensures a rigorous assessment of the project's outcomes. The key research questions that H2H wants to answer are:

  1. Does supportive housing impact the use of primary care, emergency, and hospital care, as well as mental health and substance use treatment?
  2. Can supportive housing reduce avoidable emergency department and hospital services?
  3. Does supportive housing decrease net federal expenditures for Medicaid and Medicare claims?
Early Findings and Financial Model

The financial model involves a $11.75 million investment from private investors, grantors, and the US Treasury Department under the Social Impact Partnership Pay for Results Act (SIPPRA) program. Success payments are based on housing stability, reduced jail days, and decreased Medicaid expenditures. The project aims for an 83% housing stability rate, a 34% reduction in jail days, and significant Medicaid savings.

From July 2022 to December 2023, 69 participants met the housing stability payment requirements, with 59 remaining in housing for at least one year. The total adjusted days in housing, after accounting for jail stays, were 29,459, resulting in a payment of $567,085.75 from the City of Denver. This outcome surpasses base case projections, indicating promising .

A Bright Future for Supportive Housing

The Denver H2H project exemplifies the potential of supportive housing in improving lives and reducing public costs. Looking ahead, future evaluation reports will compare participant outcomes to similar individuals not referred to the H2H project, providing a more comprehensive understanding of the program's impact on system utilization and costs. By combining compelling stories and robust data, the H2H program hopes to provide the necessary evidence for the expansion of supportive housing as a vital health care solution.

Stay tuned for more updates on this impactful project and its progress in transforming health care outcomes for Denver's most vulnerable residents.