Project Summary
The City of Boise’s Permanent Supportive Housing Pipeline Pay for Success project (“PSHP project”) has been awarded $7.5 million by the U.S. Department of the Treasury under the Social Impact Partnerships to Pay for Results Act (SIPPRA).
This award supports the PSHP project which will provide permanent supportive housing and services using an intensive case management model including wrap-around services to households who are experiencing long-term homelessness and have high service needs.
The award includes:
- $6.5 million project grant.
- $985,000 for independent evaluation.
Boise’s primary outcome is to reduce the rate of homelessness among their most vulnerable populations. Specifically, they expect to realize a 25 percent reduction in healthcare expenditures covered by Medicaid, including emergency room visits, hospital overnight stays, ambulance rides, detox visits, and savings due to a reduction in arrests and cost associated with county correctional facilities.
Outcome Goals:
- Reductions in emergency room visits.
- Reduction in hospital overnight stays.
- Reductions in ambulance rides.
- Reductions in arrests and costs associated with county correctional facilities.
The PSHP project will provide Permanent Supportive Housing (PSH) and services using an Intensive Case Management (ICM) model including wrap-around services to 143 prioritized households who are experiencing long-term homelessness and have high service needs. These households are at increased risk for avoidable, high-cost service utilization paid through local, state, and federal outlays.
The PHSP project will target a population defined of individuals and families experiencing longtime homelessness with high service needs which will significantly reduce the otherwise costly justice system and healthcare system interactions and improve their health outcomes – all while reducing government expenditures.
PSHP will target households experiencing long-term homelessness and have significant service needs identified by Our Path Home (OPH). These households are at increased risk for avoidable, high-cost service utilization paid through local, state, and federal outlays. PSHP will enroll 143 households (95 adult-only households and 48 households with children).
- Reduced rates of homelessness among the most vulnerable populations.
- Reduced utilization of emergency medical services.
- Decreased criminal justice involvement.
- Increased housing stability and retention
| Role | Entity | Responsibilities |
|---|---|---|
| Local government | City of Boise, ID | Coordinate with the Treasury program team on administration of the program. |
| Intermediary | N/A | |
| Service providers | Terry Reilly Health Services | Facilitate housing accesses with program enrollment using coordinated entry referrals. Provide intensive case management. |
| Independent evaluator | Idaho Policy Institute, Boise State University | Conduct a rigorous evaluation to estimate the impact and cost effectiveness of the intervention. Provide evaluation progress reports. |
| Investors | Idaho Community Foundation | Provide upfront capital for the program from the Supportive Housing Investment Fund (SHIF). |
Treasury is scheduled to make five payments each year from 2028 to 2032. Payments are based on the total adjusted benefits and associated net reduction in outlays of emergency medical services (e.g., emergency transport, emergency care, in-patient stays, and outpatient services), reductions in criminal justice involvement (e.g., arrests and jail stays), and increased well-being (e.g., housing stability, access to mental and physical health services, and substance abuse treatment) during the evaluation period.
| Service Delivery | $ 13,007,802 |
| Evaluation | $ 985,000 |
| Total Project Costs | $ 13,992,802 |
- Project Period of Performance Start Date: May 2026
- Project Period of Performance End Date: December 2031
- Evaluation Start Date: May 2026
- Evaluation End Date: December 2031
In Boise, households are identified as eligible through a coordinated entry system that works to ensure people are prioritized for limited available resources based on a variety of characteristics related to overall need. The coordinated entry process will refer eligible households from the PSHP target population. To ensure referred households are made up of individuals experiencing long-term homelessness with high service needs, eligible households must meet specific criteria (e.g., length of time experiencing homelessness, income, legal system engagement, and barriers to accessing housing).
The independent evaluator will use a regression discontinuity (RD) design to evaluate the impact of providing permanent supportive housing with intensive case management to 143 households (95 adult-only households and 48 households with children). The evaluator will conduct various balance tests to rule out the possible interferences of covariates in the outcomes including a continuity-based approach of RD designs and falsification tests such as examining the density score, and placebo cutoffs.
The project expects to achieve success by reducing the rate of homelessness among their most vulnerable populations and realizing a 25 percent reduction in healthcare expenditures covered by Medicaid. The evaluation will measure 1) costs per arrests and per jail day, 2) cost per day for mental health and substance abuse treatment, and 3) cost per paramedic call and cost, cost per emergency department visit, and cost of day in the hospital.
| Entity | Estimated Savings | Description |
|---|---|---|
| Federal government | $14.5 million | This is the federal portion of the reduction to expected Medicaid and Medicare outlays. |
| State government | $4.7 million | This is the state portion of the reduction to expected Medicaid outlays. |
Further information is available through the official press release and federal registry notice. These documents provide detailed background on the SIPPRA award and program expectations.