|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$1,597||Benefits minus costs||($18,996)|
|Participants||$3,125||Benefit to cost ratio||($0.18)|
|Others||$193||Chance the program will produce|
|Indirect||($7,878)||benefits greater than the costs||0 %|
|Net program cost||($16,033)|
|Benefits minus cost||($18,996)|
|Detailed Monetary Benefit Estimates Per Participant|
|Benefits from changes to:1||Benefits to:|
|Labor market earnings||$1,322||$3,106||$0||$0||$4,429|
|Property loss associated with alcohol abuse or dependence||$0||$0||$0||$0||$0|
|Health care associated with illicit drug abuse or dependence||($3)||($1)||($4)||($2)||($9)|
|Health care associated with general hospitalization||$101||$4||$99||$50||$255|
|Health care associated with psychiatric hospitalization||$131||$2||$30||$66||$228|
|Health care associated with emergency department visits||$45||$12||$67||$23||$147|
|Mortality associated with illicit drugs||$0||$0||$0||$0||$0|
|Mortality associated with alcohol||$0||$0||$0||$1||$1|
|Adjustment for deadweight cost of program||$0||$0||$0||($8,016)||($8,016)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$13,950||2009||Present value of net program costs (in 2018 dollars)||($16,033)|
|Comparison costs||$0||2009||Cost range (+ or -)||10 %|
|Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||No. of effect sizes||Treatment N||Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
|Alcohol use disorder||40||2||478||-0.051||0.144||40||0.000||0.000||41||-0.051||0.723|
|Emergency department visits||40||5||570||-0.164||0.064||40||0.000||0.000||41||-0.164||0.011|
|Illicit drug use disorder||40||1||332||0.062||0.105||40||0.000||0.000||41||0.062||0.553|
|Primary care visits^||40||3||733||0.157||0.052||40||n/a||n/a||n/a||0.157||0.003|
Basu, A., Kee, R., Sadowski, L.S., & Buchanan, D. (2012). Comparative cost analysis of housing and case management program for chronically ill homeless adults compared to usual care. Health Services Research, 47, 523-543.
Cheng, A.L., Lin, H., Kasprow, W., & Rosenheck, R.A. (2007). Impact of supported housing on clinical outcomes: Analysis of a randomized trial using multiple imputation technique. The Journal of Nervous and Mental Disease, 195(1), 83-88.
Culhane, D.P., Metraux, S., & Hadley, T. (2002). Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing. Housing Policy Debate, 13(1), 107-163.
Gilmer, T.P., Stefancic, A., Ettner, S.L., Manning, W.G., & Tsemberis, S. (2010). Effect of full-service partnerships on homelessness, use and costs of mental health services, and quality of life among adults with serious mental illness. Archives of General Psychiatry, 67(6), 645-52.
Gulcur, L., Stefancic, A., Shinn, M., Tsemberis, S., & Fischer, S. (2003). Housing, hospitalization, and cost outcomes for homeless individuals with psychiatric disabilities participating in continuum of care and housing first programmes. Journal of Community and Applied Social Psychology, 13(2), 171-186.
Johnson, G., Kuehnle, D., Parkinson, S., Sesa, S., & Tseng, Y. (2014). Resolving long-term homelessnes: A randomized controled trial examining the 36 month costs, benefits, and social outcomes from the journey to Social Inclusion Pilot Program. Sacred Heart Mission, St. Kilda.
Johnson, G., Kuehnle, D., Parkinson, S., Sesa, S., & Tseng, Y. (2012). Resolving long-term homelessnes: A randomized controled trial examining the 24 month costs, benefits, and social outcomes from the ourney to Social Inclusion Pilot Program. Sacred Heart Mission, St. Kilda.
Larimer, M.E., Malone, D.K., Garner, M.D., Atkins, D.C., Burlingham, B., Lonczak, H.S., et al. (2009). Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems. JAMA, 301(13), 1349-1357.
Lipton, F.R., Nutt, S., & Sabatini, A. (1988). Housing the homeless mentally ill: A longitudinal study of a treatment approach. Hospital & Community Psychiatry, 39(1), 40-45.
Mares, A., Rosenheck, R.A. (2007) HUD/HHS/VA Collaborative to Help End Chronic Homelessness National Performance Outcomes Assessment Preliminary Client Outcomes Report. West Haven, CT: VA Northeast Program Evaluation Center.
Rosenheck, R., Kasprow, W., Frisman, L., & Liu-Mares, W. (2003). Cost-effectiveness of supported housing for homeless persons with mental illness. Archives of General Psychiatry, 60(9), 940-951.
Sadowski, L.S., Kee, R.A., VanderWeele, T.J., & Buchanan, D. (2009). Effect of a housing and case management program on emergency department visits and hospitalizations among chronically ill homeless adults: A randomized trial. JAMA, 301(17), 1771-1778.
Shern, D.L., Felton, C.J., Hough, R.L., Lehman, A.F., Goldfinger, S., Valencia, E., ... (1997). Housing outcomes for homeless adults with mental illness: Results from the second-round McKinney program. Psychiatric Services, 48(2), 239-241.
Srebnik, D., Connor, T., & Sylla, L. (2013). A pilot study of the impact of housing first-supported housing for intensive users of medical hospitalization and sobering services. American Journal of Public Health, 1039(2), 316-21.