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It ends when housing is paired with consistent, relational support that helps people age in place, stay healthy, and remain connected to care.
Veterans and service providers advocated for a better model to meet growing needs among high-acuity and aging veterans. California listened – and has piloted a service-rich housing model.
After three years of services, this Pilot has shown that enhanced services embedded in supportive housing sites can support housing stability, strengthen health and social connection, enhance quality of life, and reduce reliance on high-cost emergency care.
Swords to Plowshares provides technical assistance; RAND serves as an independent impact evaluator.
An enhanced supportive services model designed to help aging and high-acuity veterans remain stably housed, improve health and quality of life, and strengthen operations across permanent supportive housing sites.
Services are delivered by staff embedded within housing sites, ensuring veterans receive support from consistent, on-site teams. This approach builds trust, strengthens relationships, and increases engagement.
Services include:
With 560 veterans enrolled statewide and 411 completing at least one full year of participation, the final results show consistent improvements in housing stability, health, and daily life.
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Aligned with one of the Pilot’s primary aims, housing stability has been the strongest outcome.
of participants remained housed.
experienced negative exits (eviction, incarceration, return to homelessness).
decrease in emergency room visits.
decline in missed medical appointments.
decline in alcohol, stimulant, and opioid use.
decrease in falls.
decline in unmet companionship needs.
reduction in cleanliness complaints.
more veterans eating three meals a day.
Group participation increased substantially – 3x as many veterans participated in three or more group programs. Compared to those less engaged, veterans who participated in group programs saw stronger outcomes across health, stability, and service use:
more likely to report good or very good health.
spend time outside of their apartment.
reduction in habitability complaints (e.g., hoarding, cleanliness, and pests, which can lead to eviction proceedings when unaddressed).
Residents self-reported improvements in their quality of life and overall health. Comparing their answers from their first and most recent surveys:
improvement in quality of life.
improvement in general health.
The final results are in: veterans in the Pilot remain stably housed. Emergency care use is down. Emergency health events are declining. Veterans show improvements in daily life, social connection, and quality of life.
This Pilot demonstrates enhancing on-site services within permanent supportive housing can prevent returns to homelessness while potentially reducing overall public costs – by lowering emergency care use, preventing premature transitions to higher levels of care, supporting wellness, and avoiding eviction. With a modest investment of approximately $17,000 per resident annually, the Pilot model delivers a preventive, cost-effective, and scalable model – even for individuals with the most complex needs.
But while the state has funded the Pilot for an additional year of services, the Pilot’s funding ends in February 2028. Sustaining and scaling this model requires partners who believe what the evidence shows: that housing paired with consistent and integrated support saves lives.
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Email us or fill out the interest form to partner, invest, and learn more.
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