A groundbreaking analysis revealed that supportive housing reduced crisis responses, jail bookings, and public costs for individuals who frequently cycled through the justice and emergency health systems. The analysis was conducted through a joint effort with the Corporation for Supportive Housing (CSH), Health Share of Oregon, the Joint Office of Homeless Services, and the Local Public Safety Coordinating Council.
The Frequent Users Systems Engagement (FUSE) methodology represents the first time that the homeless and housing, health and justice sectors in Multnomah County came together to share data. The effort resulted in a comprehensive, cross-sector analysis that showed the impact supportive housing has on people who experience homelessness and have complex needs. CSH led the coordination necessary for this effort based on its national FUSE initiative that integrates data and systems engagement to determine if people who often cycle through jails, shelters, hospitals and other crisis services could benefit from supportive housing.
“The Multnomah County FUSE effort was one of the most dynamic systems work that CSH has seen. The findings are revealing and timely, just as some voices in Portland and municipalities across the country are advocating for more public investment in emergency shelters rather than supportive housing. The data could not be more crystal clear that supportive housing is a more effective, lasting and fiscally responsible solution to homelessness,” said Deborah De Santis, President and CEO at CSH.
“The FUSE analysis offers the strongest evidence so far that combining accessible housing with supportive services is a potent, cost-effective strategy for helping our neighbors break the cycle of homelessness to find lasting safety, stability and wellness. This is the approach that drives the ways in which Multnomah County serves people experiencing homelessness, transforming the lives of thousands of people who can now go to sleep in homes of their own with the assurance that they have the support they need to stay in it. And thanks to the Supportive Housing Services measure that voters passed last May, we look forward to scaling up these solutions to finally meet the level of need in our community.” Multnomah County Chair Deborah Kafoury
James Schroeder, CEO at Health Share of Oregon said, “The FUSE initiative for supportive housing represents exactly the kind of cross system collaboration and innovative thinking needed to address a crisis of this scale and size. At Health Share of Oregon, we believe that health equity can be achieved by addressing social determinants of health and integration. Housing status is an incredibly powerful social determinant. Supportive housing not only creates better health outcomes, but now we can also clearly see how it directly reduces health care costs, jail bookings, emergency room visits, and more.”
Highlights of the study include:
- With supportive housing as an intervention, there were more than:
- 5,000 avoidable emergency department visits,
- 400 fewer jail bookings,
- 50 fewer inpatient psychiatric stays.
If all chronically homeless individuals in the study (n = 1,138) either avoided or ended their experience of chronic homelessness with supportive housing, $10.2 million would be realized in Medicaid savings.
Racial disparities were observed across communities and across system indicators. The greatest disparities were for people identifying as:
- American Indian/Alaska Native
- Black/African American
Nationally, The Corporation for Supportive Housing (CSH) has been involved in FUSE in more than 35 communities. Each is distinctly based on the systems engaged in the effort, focus populations, and identified programmatic and policy needs.
The FUSE analysis in Multnomah County concluded that making equitable investments in long-term solutions, such as supportive housing, showed a significant decrease in systems uses.