How to Make the Case for Supportive Housing

By Robert Davis, Freelance Reporter; Shelterforce

Federal attacks on permanent supportive housing (PSH) have revived conversations among advocates about how to better demonstrate the impact of housing and wraparound support on people exiting homelessness.

Against this backdrop, housing providers say there has never been a more important time to articulate the benefits of PSH, not only for those living in PSH but also for the communities in which these properties are located.

Facing the Federal Threat

The National Alliance to End Homelessness defines PSH as “an intervention that combines affordable housing assistance with voluntary support services to address the needs of chronically homeless people. The services are designed to build independent living and tenancy skills and connect people with community-based health care, treatment and employment services.”

It’s no secret that the Trump administration is threatening to reduce federal funding for these programs. For instance, Trump signed an executive order in July 2025 that directed federal agencies to end support for Housing First programs and increase support for substance abuse treatment programs.

In a similar vein, last November, the U.S. Department of Housing and Urban Development (HUD) proposed a series of changes to its Continuum of Care (CoC) grant program—the largest source of federal funding for homelessness assistance—that sought to shift funding away from supportive housing toward more temporary solutions.

Those changes included a proposed 30 percent cap on the amount of CoC funding a grantee can spend on PSH. It’s worth noting that about 87 percent of CoC funds go toward supporting PSH services, according to the National Association of Counties. This one policy change puts at risk just over 170,000 PSH units nationwide that rely on CoC funding, according to an analysis by the Urban Institute. 

A federal judge in Rhode Island has blocked HUD from making these proposed changes. Congress added language to the most recent appropriations bill that requires HUD to renew CoC funding for any projects expiring before April 1, 2026. But that doesn’t mean the fight to preserve PSH funding is over.

Making the Case for Permanent Supportive Housing

Sarah Gillespie, associate vice president of the housing and communities division at the Urban Institute, tells Shelterforce that the best way for housing providers to make the case for PSH is to clearly articulate the theory of change.

Broadly speaking, the theory of change advanced by PSH advocates states that providing immediate, stable, and non-time-limited housing options combined with voluntary supportive services breaks the cycle of homelessness at a lower cost than jailing people who are homeless. This same framework can be applied to different populations that PSH properties seek to serve, such as senior citizens or those who are chronically homeless.

Several studies have confirmed the value of this approach. For instance, a four-year randomized controlled trial in Santa Clara County, California, found that 86 percent of PSH participants remained housed after one year and tallied one-third as many days in shelters as the control group. Similarly, a 2012 study from New York City found that people who live in PSH spent 40 percent less time in jail than those in the control group.

“It’s really important for us to state the theory of change,” says Gillespie. “What is it that we think supportive housing is meant to do, and who is it that we are seeking to serve with this program?”

There are still some open questions about the subjective health benefits for people living in PSH properties. It’s easy to assume, for instance, that moving someone from the streets or a shelter into housing would reduce stress levels, but designing scientific studies to measure the health benefits of stress reduction can be tricky, Gillespie says.

“We can assume things are not magically all going to get better in year one,” Gillespie says, adding that measuring one-year impacts can present a biased picture of someone’s journey through PSH. She also notes that people may enter PSH with preexisting issues, such as a criminal record or significant health problems, that can skew a one-year dataset.

“The longer we can track these data points, the better,” she adds.

Collecting Data: What Is Known and Unknown

Two common ways housing providers measure the impact of PSH are comparative studies, which offer insight into how wraparound supports affect global numbers, and individual-oriented studies.

One comparative study, conducted in Denver, was funded by a “social impact bond.” The city’s Social Impact Bond program for PSH was launched in 2016, with a five-year evaluation later conducted by the Urban Institute. One group received PSH support, which was paid for by money raised from a group of “social impact bond” funders. By contrast, the Urban Institute noted, the control group received “usual care services in the community.”

The randomized trial found that the 363 people in the treatment group who received PSH support spent 560 more days of housing assistance over a three-year period than the 361 people who received usual care services. Additionally, 77 percent of PSH recipients remained stably housed at year three of the program; compared to the control group, these beneficiaries also saw a 65 percent reduction in the use of city detoxification services, a 40 percent reduction in shelter stays, a 34 percent decline in police contacts, a 40 percent decline in arrests, and a 27 percent reduction in total days spent in jail.

All told, the Urban Institute calculates that about half of the total per person annual cost of the PSH program was “offset by cost avoidances in other public services, with some of the biggest avoidances in reduced jail, ambulance, and emergency department costs.”

But while comparative studies are useful for showing overall effects, individual-oriented studies are better at explaining how, why, and for whom a policy intervention like PSH is effective. For instance, Dejernette Beaty, senior vice president of housing at Volunteers of America National Services (VOANS), tells Shelterforce that her organization tracks how well residents complete their individual service plans. This approach allows VOANS to tailor its on-site housing stability and wraparound services to better meet the needs of PSH-supported residents.

VOANS also employs a quarterly resident survey to help track people living in their PSH units. Addressing the results could mean adding new services, like mental health counseling or financial literacy classes, as the needs of residents evolve, says Beaty.

Beaty points to the Girard Place Apartments in Denver, Colorado, as an example of how VOANS approaches PSH. The apartment complex has 15 units of PSH for those who are chronically homeless and people with severe mental health challenges. The property primarily serves older adults, and the services offered include social security assistance, Medicaid enrollment, and access to other public benefits like food stamps. People who are interested in job training can also access those services at Girard Place, Beaty says.

“It goes back to meeting with that individual, understanding what they need, and then connecting them to the resources or bringing those resources into the site,” Beaty adds.

Other firms are developing new ways of measuring the impacts of PSH. For instance, Shopworks Architecture, a trauma-informed design firm in Denver, is developing a method to measure stress levels in PSH residents. The firm recently completed a feasibility analysis for its methodology in conjunction with the Yale Human & Animal Integrated Research Lab and plans to begin outcome-based testing at PSH properties it designed in Denver.

What Does the Field Know? What Does It Need to Learn?

Balancing both global program data and individual-level data is paramount in PSH evaluations, Gillespie says. The key to striking the right balance is to consider the outcomes a particular PSH property is expected to produce, she adds. 

It may not make sense, for example, to measure the impact of a PSH property like the seven-bedroom Adamstown House in Elk Grove, California, which serves people aged 55 and over, by the number of days residents stay at shelters because homeless seniors often do not stay in shelters. But the impact of that property can still be measured using global data points, like whether the property increases someone’s housing stability and reduces the time they spend in emergency rooms.

Conversely, PSH properties for chronically homeless individuals and families, such as the 200-unit Commons at Acequia Trails in San Antonio, Texas, should be evaluated based on their ability to interrupt someone’s journey between homeless shelters and jail. Measuring the ability of those who are chronically homeless to access supportive services and improve their overall quality of life is also an important data point in this scenario.

“The outcomes that you’re expecting to see should flow from who you are serving and what you’re expecting supportive housing to do,” Gillespie says.