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| Supportive housing | |
|---|---|
| Name | Supportive housing |
| Settlement type | Social housing model |
| Established title | Origin |
| Established date | 1970s–1980s |
| Subdivision type | Country |
Supportive housing is a social intervention combining long-term Housing First-influenced affordable housing with on-site or linked social services to assist individuals experiencing homelessness, mental illness, or substance use disorder. It integrates permanent rental assistance with case management drawn from models used by Community Mental Health Act programs and informed by advocacy from organizations such as National Alliance to End Homelessness, Corporation for Supportive Housing, and National Coalition for the Homeless. Practitioners draw on research by institutions like RAND Corporation, Urban Institute, and Johns Hopkins University.
Supportive housing is defined as long-term permanent supportive housing that pairs subsidized housing units with voluntary supportive services to promote housing stability, health, and community integration. The purpose aligns with objectives advanced in policy frameworks such as the McKinney–Vento Homeless Assistance Act, the Affordable Care Act, and local continuum of care planning processes. It aims to reduce repeated use of emergency departments, jail bookings, and shelter stays by providing coordinated case management modeled on programs like Assertive Community Treatment and SAMHSA best practices. Funders and advocates include Department of Housing and Urban Development, Department of Health and Human Services, and philanthropic entities like the Robert Wood Johnson Foundation and Kresge Foundation.
Origins trace to transitional experiments in the 1970s and 1980s alongside deinstitutionalization movements catalyzed after the Community Mental Health Act and litigation such as Olmstead v. L.C.. Pilot projects emerged in cities like New York City, San Francisco, Los Angeles, and Chicago, influenced by advocacy from Coalition for the Homeless and researchers at Columbia University and University of California, Berkeley. The 1990s saw expansion fueled by federal policy shifts in the McKinney–Vento Homeless Assistance Act and private initiatives from organizations like Habitat for Humanity International and Enterprise Community Partners. International precedents include Housing First trials in Finland, Canada (e.g., Vancouver programs), and Denmark's social housing sectors.
Models vary: permanent supportive housing pairs indefinite tenancy with supports, whereas transitional housing offers time-limited stays. Scattered-site models use vouchers like Section 8 in dispersed units; congregate models concentrate residents in single buildings such as projects developed by Mercy Housing or The Salvation Army. Hybrid approaches adapt rapid rehousing for shorter-term stabilization. Service delivery frameworks include Assertive Community Treatment, Housing First fidelity models, and Supportive Housing Institute curricula. Financing structures involve Low-Income Housing Tax Credit projects, HOME Investment Partnerships Program grants, and Community Development Block Grant investments.
Common target groups include veterans served by Veterans Affairs Supportive Housing (VASH), survivors of domestic violence aided by National Network to End Domestic Violence, people with serious mental illness connected to National Alliance on Mental Illness referrals, individuals with chronic substance use histories engaged via SAMHSA grantees, and youth exiting foster care linked to Child Welfare agencies. Additional cohorts comprise older adults coordinated with Administration on Aging programs, people returning from incarceration coordinated with Bureau of Prisons reentry initiatives, and families identified through Emergency Shelter Grants.
Funding blends federal, state, municipal, and philanthropic sources: Department of Housing and Urban Development programs including Continuum of Care grants, Low-Income Housing Tax Credit, and Shelter Plus Care historically; health funding via Medicaid waivers and Affordable Care Act provisions; and supportive services financed by SAMHSA grants and state behavioral health authorities. Policy frameworks include Olmstead v. L.C. precedent, HUD strategic plans, Veterans Affairs directives, and local Continuum of Care plans coordinated by Corporation for Supportive Housing consultants. Private capital and social impact mechanisms such as Pay for Success and Social Impact Bonds have been employed in projects by organizations like Enterprise Community Partners and National Equity Fund.
Implementation integrates housing development and service provision: developers such as Mercy Housing, Enterprise Community Partners, and PATH Ventures collaborate with service agencies like Catholic Charities USA, The Salvation Army, and Urban Ministries to deliver case management, behavioral health treatment, substance use counseling, employment services tied to Workforce Investment Act programs, and primary care linkages through Community Health Centers. Key components include tenant-centered tenancy supports, harm reduction models endorsed by SAMHSA, lease agreements informed by Fair Housing Act protections, and coordinated entry systems developed under HUD guidance. Data systems often leverage Homeless Management Information Systems built using standards from USICH and research partnerships with Johns Hopkins Bloomberg School of Public Health.
Evaluations by RAND Corporation, Urban Institute, University of Pennsylvania, and University of Washington report high housing retention rates, reductions in emergency department use, and decreased incarceration for participants compared to usual care in randomized and quasi-experimental studies. Cost analyses show savings via reduced public expenditures in health and criminal justice budgets in studies associated with Centers for Medicare & Medicaid Services demonstrations and Medicaid 1115 waivers. Outcomes vary by model fidelity, local housing markets such as New York City and Los Angeles County, and service intensity; rigorous trials including those in Finland and Canada support the efficacy of Housing First-aligned supportive housing for chronically homeless populations.
Category:Housing