Project Summary
City of New York Department of Homeless Services’ CBHT-3 Initiative has been awarded $6.3 million by the U.S. Department of the Treasury under the Social Impact Partnerships to Pay for Results Act (SIPPRA).
This award supports the CBHT-3 Initiative which seeks to bring individuals who are experiencing unsheltered homelessness and have complex needs into transitional housing, connect them to services, and put them on a path to permanent housing.
The award includes:
- $5.5 million project grant.
- $825,000 for independent evaluation.
The CBHT-3 Initiative expects to see a 25-percentage-point increase in the rate of stable housing or stable shelter (achieving 50% for the treatment group versus 25% of the comparison group).
- Outcome Goals:
- Increased stable housing or stable shelter
- Reductions in hospitalizations and emergency room visits
- Reductions in transports to emergency housing
- Reductions in arrests
Since every individual experiencing homelessness has a unique circumstance with a different set of barriers to accepting housing and support services, the CBHT-3 initiative provides an individually tailored intervention for each client. The CBHT model pulls together representatives from multiple State and Local agencies and organizations to provide case management services to individuals experiencing unsheltered homelessness, ensures that such individuals are getting access to the services each of the provider agencies and entities offers, and creates service plans which actively move the individual from street homelessness into housing and connections to services through target interventions.
Service plans may include enrollment in a wide range of different interventions, depending on client needs. Examples of potential interventions for CBHT-3 clients include, among others:
- Assisted Outpatient Treatment (AOT), which assists individuals with mental illness and a history of hospitalizations or violence in participating in community-based services that are appropriate to their needs. AOT includes services such as case management, individual or group therapy, alcohol and substance abuse treatment, and counseling and supervision of living arrangements.
- Intensive Mobile Treatment (IMT), which provides mental health and substance use support and treatment. IMT’s intensive structure uses psychiatric care, social services, and community care.
- Safe Options Support (SOS), which uses a Critical Time Intervention (CTI) approach to provide services to unstably housed individuals. CTI teams help individuals transition from homelessness to housing by helping them integrate into their community.
The CBHT-3 Initiative is targeting three different subgroups within the larger population of individuals who are experiencing unsheltered homelessness in New York City. Those subgroups are: 1) high needs individuals experiencing unsheltered homelessness within the subway system, 2) high needs individuals experiencing unsheltered homelessness above ground, and 3) End-of-(subway) line high service utilizers.
CBHT-3 anticipates serving 135 individuals at any point-in-time during the intervention. In total, the initiative expects to serve approximately 400 individuals with another 400+ individuals assigned to control groups.
- The city aims to find evidence-based and cost-effective solutions to break the cycle of chronic homelessness for individuals with the most acute needs, transitioning vulnerable New Yorkers from unsheltered situations into stable long-term housing and healthcare.
- This initiative serves the city's broader responsibility to support the wellbeing of all residents, not just those directly receiving services through the pilot program.
- The CBHT-3 Initiative is designed to improve quality of life for NYC residents and visitors by promoting cleaner, more orderly conditions in transit systems, parks, vestibules, and civic spaces, enhancing access to essential public amenities.
| Role | Entity | Responsibilities |
| Local government | NYC Department of Homeless Services (DHS) | Coordinate with the Treasury program team on administration of the program. Also serves as the investor of the program. |
| Intermediary | NYC Department of Health and Mental Hygiene (DOHMH), NYC Health and Hospitals (H+H) | Actively participate in CBHT meetings. Review eligibility of CBHT participants for key service interventions and facilitate enrollment as applicable. |
| Service providers | Bowery Residents Committee, Manhattan Outreach Consortium, Project Hospitality, Bronxworks, Breaking Ground Queens, and Breaking Ground Brooklyn | Contracted outreach teams that will provide the services to the target population. |
| Independent evaluator | MDRC | Conduct a rigorous evaluation to estimate the impact and cost effectiveness of the intervention. Provide evaluation progress reports. |
| Investors | N/A |
Treasury is scheduled to make a single payment of up to $5.5 million in 2030. Treasury will pay $55,000 for each person that the CBHT-3 Initiative places into stable housing above the comparison group up to the cap of $5.5 million. This difference must be found to be statistically significant at the 80 percent level according to the independent evaluator.
| Service Delivery | $ 25,039,430 |
| Evaluation | $ 825,000 |
| Total Project Costs | $ 25,864,430 |
- Project Period of Performance Start Date: July 2025
- Project Period of Performance End Date: December 2029
- Evaluation Start Date: June 2025
- Evaluation End Date: June 2030
Eligibility is determined by the three subgroups defined in the intervention.
To be eligible for the “high needs individuals experiencing unsheltered homelessness within the subway system” subgroup or the “high needs individual above ground” subgroup, an individual must have met four of the following ten criteria: 1) have a serious medical vulnerability, 2), be 50 years or older, 3) be homeless for more than one year, 4) have more than one involuntary and/or emergency hospitalization in a period of less than six months, 5) have been removed from the subway system more than once in a period of six months, 6) consistently refused placement, case management, or other forms of assistance, 7) have a formal diagnosis/history of suspected symptoms associated with a serious mental disorder, 8) have heightened interactions with the New York City Police Department and Metropolitan Transit Authority, 9) have more than two bags or a shopping cart worth of belongings, and 10) have a history of assault or violent behavior.
The ”end-of-line high service utilizers” subgroup focuses on individuals on the platform and on trains as they arrive at the first or last stop subway station (i.e., end of the line). Eligibility will focus on those individuals who have been previously identified as experiencing unsheltered homelessness and who have repeatedly cycled between shelter and end-of-line stations, with several shelter check-ins documented by the DHS end-of-line outreach initiative.
The CBHT-3 Initiative is using a randomized control trial to determine the causal effect of the program. The independent evaluator will estimate regression-adjusted impacts that incorporates covariates including demographic factors (e.g., age, gender, and race/ethnicity) as well as constructed metrics for history of shelter, and serious mental health diagnoses. The random assignment selection process is expected to yield largely balanced treatment and control groups. At any time during the project’s period of performance, the CBHT-3 Initiative can serve a total of 135 individuals with another 135 individuals as part of the control group. A total of 400 individuals are expected to be enrolled in each of the treatment and control groups.
An implementation evaluation will offer further insight into the initiative’s activities and participants’ experiences.
The project expects to achieve success by transitioning 50% of the treatment group into stability, compared with a 25% of the comparison group, with stability defined as a permanent housing placement or a continuous stay in shelter that lasts at least 6 months. The evaluation will also measure any associated reductions in hospitalization (after an expected initial increase to stabilize health and mental health conditions), emergency room visits, transports to emergency housing, and arrests.
| Entity | Estimated Savings | Description |
|---|---|---|
| Federal government | $5.4 million | This is the federal portion of the reduction to expected Medicaid and Medicare outlays over the period of performance. |
| State government | $2.6 million | This is the state portion of the reduction to expected Medicaid outlays over the period of performance. |
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.