Report Shows Good Results in Denver's Pay for Success Housing Model
Published on June 04, 2024
Partners in Denver’s Housing to Health (H2H) pilot program, which provides supportive housing to individuals at the intersection of homelessness, the criminal legal system, and emergency healthcare, celebrated the release of the results of the program’s first independent evaluation and announced the subsequent payment to investors. According to the first report from the Urban Institute research team conducting the independent evaluation, the program has had early success, achieving 29,459 days of housing for participants in its first six quarters, resulting in a payment to investors of $567,085.75.
“Our community has shown time and time again that when you offer housing and intensive wraparound services to individuals facing the most trying episodes of homelessness, you can save lives and build a more vibrant city,” said Mayor Mike Johnston. “In Denver, we believe that our toughest problems are solvable, and this innovative, Housing First model shows that we can deliver housing outcomes for Denverites that are not only successful, but reduce costs across the system.”
In partnership with two local service providers, Colorado Coalition for the Homeless and WellPower, the H2H pilot program was launched July 1, 2022, and is Denver’s second pay-for-success initiative designed to save public dollars traditionally spent on societal impacts resulting from chronic homelessness while successfully housing and stabilizing individuals most in need. The project goals focus on participant outcomes, including increasing housing stability, reducing time in jail, and reducing emergency federal health care expenditures.
The program leverages local housing resources, $11.75 million from six private funders, and up to $5.5 million in the form of a Social Impact Partnership Pay for Results Act (SIPPRA) grant from the U.S. Department of the Treasury to deliver permanent supportive housing to at least 125 people experiencing chronic homelessness and suffering from frequent mental and behavioral health crises requiring emergency care.
The H2H program specifies payments for investors based on outcomes. This first report, “Denver Housing to Health Project Housing Stability Payment Outcomes,” details housing stability outcomes, which are based on a measure of total adjusted days in housing observed from July 1, 2022, through December 31, 2023. Overall, 69 participants met the payment requirement, 59 of whom remained in housing for a full year. After deductions, the project achieved 29,459 total adjusted days in housing for these participants.
“Launching an evidence-based program designed to make a significant impact across multiple systems is no easy task,” said Urban’s Sarah Gillespie, who is leading the evaluation team. “The Housing to Health partners are again demonstrating what it takes to do this through strong outreach, quality housing and services, intentional navigation of the criminal legal and health care systems, and promising housing retention. These early outcomes are key to building the foundation necessary to achieve the results the program seeks in the years to come."
The companion report, also released on June 4, on the H2H program model details partners’ initial success engaging and housing program participants. The report shows most participants—80 percent—who entered housing were able to successfully retain their housing after six months.
“For more than 40 years, the Colorado Coalition for the Homeless has demonstrated that housing with supportive services is a proven solution to homelessness,” said Britta Fisher, President/CEO of the Colorado Coalition for the Homeless. “We’re honored to partner with the City of Denver and private investors again to provide lasting solutions to members of our unhoused community while saving tax-payers money and taking pressure off our community safety net system.”
“WellPower is thrilled to be included as a key partner in the City’s Housing to Health program,” said Carl Clark, MD, WellPower’s president and CEO. “Meeting the vast and critical needs of our community is something we cannot fulfill as a single provider. By providing solutions to complex behavioral health needs and homelessness through partnership, we can do more together than we could ever do alone.”
The H2H program draws on the experience of several partners of the successful Denver SIB initiative, while bringing in funds awarded by the U.S. Department of the Treasury under the Social Impact Partnership to Pay for Results Act (SIPPRA). Denver was awarded a SIPPRA project grant of up to $5,512,000, to be received if the program demonstrates a reduction in net federal healthcare expenditures. The program aims to improve health outcomes and reduce Medicaid costs by improving access to primary and preventative healthcare services and supports in order to reduce avoidable high-cost healthcare services.
The Urban Institute team’s evaluation work will continue through the end of the program in 2029 and will include reports on housing stability outcomes annually through the program’s completion. Jail day payment outcomes will be reported in 2026 and 2029, and Medicaid cost reduction payment outcomes will be reported at program completion. Subsequent payments to investors are anticipated to occur annually.
Program Partners:
U.S. Department of the Treasury (Grantor)
Colorado Coalition for the Homeless (Service Provider)
WellPower (Service Provider)
Corporation for Supportive Housing (Project Manager, Fiscal Agent)
Denver Health & Hospital Authority (Referral Partner)
Urban Institute (Evaluator)
Social Impact Solutions (Consultant)
Investors:
Northern Trust (lead investor)
Colorado Access Foundation
The Denver Foundation
Gary Community Ventures
H2H grantors:
Colorado Trust
Kaiser Permanente