Senate OKs pilot program addressing chronic homelessness

Public-private ‘Pay for Success’ program – included in state budget bill — expected to be more effective, save millions


STATE HOUSE – The Senate today approved legislation sponsored by Senate Health and Human Services Committee Chairman Joshua Miller to launch a five-year pilot program to create permanent supportive housing for 125 chronically homeless Rhode Islanders. 

The “Pay for Success” program aims to proactively support participants to improve the services they receive, prevent crises, reduce the use of emergency medical services and reduce their engagement with law enforcement and the criminal justice system while supporting more effective spending on preventive services.

The $6 million program, which is funded in the state budget bill (2021-H 6122A) that the Senate will vote on this week, establishes a public-private partnership model supported by social impact bonds. It is expected to save the state between $1.8 million and $2.6 million each year and will be evaluated annually for effectiveness.

“Chronic homelessness correlates with high rates of many adverse health conditions, such as unaddressed mental health or behavioral health issues, poor nutrition and diabetes. Those issues and many more are further aggravated when a person doesn’t have a home, because when a person is struggling to find shelter every day, the other needs take a back seat. People dealing with chronic homelessness struggle to connect with and stay connected to the services that are available, resulting in more serious and expensive problems,” said Chairman Miller (D-Dist. 28, Cranston, Providence). “Connecting people who experience chronic homelessness to housing and all the services they need to stay healthy and safe will help ensure that when they face a struggle in one area, they don’t lose their homes or their other services. Investing in consistent and better supports for them is both more effective in helping them and less expensive than allowing unaddressed issues to become more serious emergencies.”

The state funds will leverage funding through the U.S. Department of Justice and the U.S. Department of Housing and Urban Development and will open up the opportunity to access additional grant funding during the course of the program’s implementation. The multi-agency collaboration funded through this appropriation will include partners from the Executive Office of Health and Human Services, the Rhode Island Coalition to End Homelessness and other frontline agencies currently serving chronically homeless individuals.

A 2017 feasibility study performed by the Rhode Island Coalition for the Homeless identified chronically homeless individuals who were the highest users of emergency services, including both medical services and interactions with law enforcement.

That study found it to be 70% less expensive for the state to house someone in that group than to have them using the shelter system, and that the state spends $5.5 million to $7.5 million annually trying to help the population targeted by the program. By intervening with permanent housing and wraparound supportive services, the state could save between $1.8 million and $2.6 million annually, the study found.

The program is expected to increase the housing stability of participants, reduce the number of days per year they spend incarcerated and reduce their use of emergency medical facilities and Medicaid costs.

A similar program began in Denver in 2016, and a majority of participants remained housed three years into the program at the end of 2019.

“In passing Pay for Success, Rhode Island will provide our neighbors most in need with the best possible path to safe and stable housing, while also realizing significant savings. Rhode Island spends millions each year systemically trying to end chronic homelessness, yet the rate keeps rising fast. On any given night, 357 Rhode Islanders will be chronically homeless (over a hundred more people than 2020). The vast majority of people experiencing homelessness in Rhode Island are not facing chronic homelessness. For those who are, permanent supportive housing is the most proven intervention. The model demonstrates a nearly 90% reduction in shelter days alone. Now Rhode Island will have 125 more permanent supportive housing vouchers, plus about $1 million for the program in federal funding. This change comes at a critical time,” said Kristina Contreras Fox, Senior Policy Analyst at the Rhode Island Coalition for the Homeless, which advocated strongly for the bill.



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