Denver Housing First Collaborative Cost Benefit Analysis and Program Outcomes Report

Jennifer Perlman and John Parvensky

December 11, 2006

The Colorado Coalition for the Homeless created the Denver Housing First Collaborative (DHFC) in 2003 with funding provided by a collaboration of federal agencies.  The DHFC is designed to provide comprehensive housing and supportive services to chronically homeless individuals with disabilities. Initial federal funding created the capacity to house and serve 100 chronically homeless individuals. The program uses a housing first strategy combined with assertive community treatment (ACT) services, providing integrated health, mental health, substance treatment and support services. The cost-benefit analysis focused on examining the actual health and emergency service records of a sample of participants of the DHFC for the 24 month period prior to entering the program and the 24 month period after entering the program.  Participants provided releases of information for their medical, psychiatric, legal and substance treatment records and associated costs for the four year period. Cost data from the clinical records were analyzed to determine the emergency room, inpatient medical or psychiatric, outpatient medical, detox services, incarceration, and shelter costs and utilization.  The findings document an overall reduction in emergency service costs for the sample group. The total emergency related costs for the sample group declined by 72.95 percent, or nearly $600,000 in the 24 months of participation in the DHFC program compared with the 24 months prior to entry in the program. The total emergency cost savings averaged $31,545 per participant.  In addition to saving taxpayers money, the local and national evaluations of the DHFC program document overall improvement in the health status and residential stability of program participants. For these persons, who averaged nearly 8 years of homelessness each prior to entering the program, 77 percent of those entering the program continued to be housed in the program when the study concluded. More than 80 percent had maintained their housing for 6 months.  Fifty percent of participants had documented improvements in their health status, 43 percent had improved mental health status, 15 percent had decreased their substance use, and 64 percent had improved their overall quality of life.  Furthermore, the overall quality of life for the community improved as the negative impacts of individuals living and sleeping on the streets were reduced.

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