Evaluation of Provision of Permanent Supportive Housing for Chronically Homeless Individuals Through Pay for Success
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 423
- 试验地点
- 1
- 主要终点
- Stable tenancy
研究概览
简要总结
Santa Clara County has partnered with Abode Services to provide 112 units of permanent supportive housing (PSH) for up to 6 years for chronically homeless individuals with multiple co-morbidities who are high cost users of services in the County. Because the target population of high cost users who are chronically homeless greatly exceeds the supply of permanent supportive housing to be made available via this mechanism, the County plans to use this opportunity to examine the effectiveness of PSH compared to treatment as usual by ethically allocating a limited resource using a lottery type system for eligible individuals who consent to participate in the Pay For Success (PFS) initiative. Specifically, while there are estimated to be over 2,500 people in Santa Clara who would be eligible for participation on any given night, the PFS program will only provide 112 PSH units at any given time. As the study duration will last six years, the investigators anticipate that approximately 150-200 people will be housed via this mechanism. Outcomes will be reported to the Institutional Review Board (IRB) on a quarterly basis and will be based on scheduled quarterly reports provided to the county.
This evaluation will be a randomized controlled trial comparing the outcomes for chronically homeless individuals randomized to receive PSH to those who are randomized to receive usual care. The aims of this study are to:
- measure months of stable tenancy for individuals who are placed in PSH;
- examine differences in utilization of health services and the criminal justice system; and
- monitor the changes in use of longitudinal care.
All data utilized for this evaluation will be County administrative data. The investigators hypothesize that some costly and acute health services utilization will decrease over time for the intervention group, while other more sustaining health services will increase.
详细描述
Recruitment: Screening Tool
Eligible homeless individuals will be identified using a Screening Tool developed by the University of California, San Francisco (UCSF) evaluators that uses County administrative data to identify the most costly users of health and social services in the County based on their medical and behavioral health conditions, length of homelessness, and County services utilization history ("Eligible Homeless Individuals").
Abode Services (Abode) is the housing service provider selected by the County for this PFS project. Abode will obtain 112 units of permanent supportive housing over the course of the first year of this study and place referred clients into those units.
Eligibility Confirmation/Assessment/Consent
Individuals identified by the Screening Tool who have been located by the Study Team will have their eligibility confirmed through administrative data and be screened in-person to determine key inclusion and exclusion criteria. Following eligibility confirmation, a designated Study Team member who has been trained in the process of informed consent will ask the individual if he/she is interested in learning about the project.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Chronically homeless (HUD definition)
- •Past high utilization of County health services and/or the criminal justice system
排除标准
- •Currently incarcerated or in custody
- •Individual has been recently housed
- •Individual no longer lives in the County
- •Individual is currently connected to and chooses not to leave another specialty Mental Health or other intensive case management program
- •For hospitalized potential participants, treating physician(s) plan to discharge the potential participant to a skilled nursing facility or inpatient hospice
- •Individual is not able to give informed consent, (see below) as determined by inability to complete teach-back
研究组 & 干预措施
Permanent Supportive Housing
Permanent Supportive Housing (PSH) is subsidized housing with closely linked or on-site supportive services that typically include case management, physical and mental health care, substance use treatment services and vocational support.
干预措施: PSH (Behavioral)
Usual Care
Usual Care consists of public benefits (e.g., General Assistance and CalFresh), integrated medical and behavioral health services provided by Valley Medical Center and the rest of the County Health & Hospital System including those offered by Valley Homeless Healthcare Program, specialty mental health and substance abuse treatment services and housing programs, and approximately 2,000 year-round beds of emergency shelter and transitional housing.
干预措施: Usual Care (Behavioral)
结局指标
主要结局
Stable tenancy
时间窗: Six years
evaluated in months
次要结局
- Longitudinal health care(Six years)
- Shelter days(Six years)
- Utilization of health services and the criminal justice system(Six years)