Going Beyond a Room and a Key Works

Housing is not the end of homelessness — it’s the starting point for long-term stability.  

Through a statewide pilot administered by the California Department of Veterans Affairs (CalVet), Swords to Plowshares and our partners implemented a straightforward yet critical shift: embedding enhanced services within permanent supportive housing sites across California for over 560 veterans with complex needs.

We examined whether this pilot would enable aging and high acuity veterans who have experienced chronic homelessness to retain housing, improve quality of life, and age in place in their community. The final findings, produced by independent impact evaluators from RAND, point to a model that reduces acute health events and improves outcomes.

I encourage you to dig into the final report here.

CalVet launched the pilot in 2023 with Swords - we designed the model and provide technical assistance. Four veteran service organizations operate the services model at 13 housing sites, which includes medical care navigation, in-unit assistance for daily living and habitability, mental health counseling, peer support, transportation to appointments and grocery shopping, and group engagement activities. The pilot enrolled 560 veterans against a goal of 425. Most are age 56 or older, and many live with multiple chronic conditions.

RAND followed participants from June 2023 through May 2026. Among the findings:

• + Veterans stayed housed. Only 20 of 560 had a negative exit over three years. That’s 3.6%, and the rate didn’t rise as the group aged.

• + Fewer crises. Falls dropped 59% and emergency medical visits dropped 75%. Alcohol, stimulant, and opioid use declined by 40% or more. The share with no acute health events rose from 74% to 90%.

• + Daily needs met. Missed medical appointments fell 54%. Unmet need for companionship fell 87%. The share of veterans eating three meals a day almost doubled.  

• + More connection. Three times as many veterans joined three or more group activities. Group programs were associated with fewer habitability complaints and more frequent time outside the unit.

• + Lower cost than the alternatives. Services cost $17,437 per veteran per year. With housing included, the total public cost is 23–50% below the California median for private assisted living.

If the numbers aren’t enough, take it from the veterans themselves. Harry Gonzalez, a 68-year-old U.S. Army veteran was living in his car before accessing permanent housing with Swords to Plowshares in San Francisco. Having a stable home has allowed him to focus on his health, recover from substance abuse, and reconnect with family.

“This program is keeping me alive,” Harry said. “When I go to medical appointments, I go by the Tenderloin and see all these folks living on the street. It gives me such a feeling of relief that I am not down there anymore and suffering. This program is a blessing.”

The evaluation results arrive as the need for housing support among seniors grows nationwide. More formerly homeless people are growing older in supportive housing, and older adults are now among the fastest-growing groups entering homelessness. Adults 55 and older now make up nearly 20% of everyone experiencing homelessness in the U.S. In California, nearly half of older homeless adults became homeless for the first time after turning 50.

Housing alone is not enough to help aging veterans remain in their communities; they need consistent, on-site support that helps manage their increasing health needs and keeps them socially connected.  

Sustaining and scaling this model requires partners who believe what the evidence shows: that housing paired with consistent and integrated support saves lives. Interested partners, including service providers, funders, and policymakers, are encouraged to reach out to me and our Policy team at policy@stp-sf.org.

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