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Pay For Success: Permanent Supportive Housing for the Chronically Homeless (PFS:PSH-CH)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT02440360
Recruitment Status : Recruiting
First Posted : May 12, 2015
Last Update Posted : December 20, 2019
Santa Clara Valley Health & Hospital System
Information provided by (Responsible Party):
University of California, San Francisco

Brief Summary:

Santa Clara County has partnered with Abode Services to provide 112 units of permanent supportive housing (PSH) for up to 6 years for chronically homeless individuals with multiple co-morbidities who are high cost users of services in the County. Because the target population of high cost users who are chronically homeless greatly exceeds the supply of permanent supportive housing to be made available via this mechanism, the County plans to use this opportunity to examine the effectiveness of PSH compared to treatment as usual by ethically allocating a limited resource using a lottery type system for eligible individuals who consent to participate in the Pay For Success (PFS) initiative. Specifically, while there are estimated to be over 2,500 people in Santa Clara who would be eligible for participation on any given night, the PFS program will only provide 112 PSH units at any given time. As the study duration will last six years, the investigators anticipate that approximately 150-200 people will be housed via this mechanism. Outcomes will be reported to the Institutional Review Board (IRB) on a quarterly basis and will be based on scheduled quarterly reports provided to the county.

This evaluation will be a randomized controlled trial comparing the outcomes for chronically homeless individuals randomized to receive PSH to those who are randomized to receive usual care. The aims of this study are to:

  1. measure months of stable tenancy for individuals who are placed in PSH;
  2. examine differences in utilization of health services and the criminal justice system; and
  3. monitor the changes in use of longitudinal care.

All data utilized for this evaluation will be County administrative data. The investigators hypothesize that some costly and acute health services utilization will decrease over time for the intervention group, while other more sustaining health services will increase.

Condition or disease Intervention/treatment Phase
Homelessness Behavioral: PSH Behavioral: Usual Care Not Applicable

Show Show detailed description

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 300 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: Evaluation of Provision of Permanent Supportive Housing for Chronically Homeless Individuals Through Pay for Success
Study Start Date : May 2015
Estimated Primary Completion Date : July 2021
Estimated Study Completion Date : July 2021

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: Permanent Supportive Housing
Permanent Supportive Housing (PSH) is subsidized housing with closely linked or on-site supportive services that typically include case management, physical and mental health care, substance use treatment services and vocational support.
Behavioral: PSH
Please see arm description.
Other Name: Permanent Supportive Housing

Placebo Comparator: Usual Care
Usual Care consists of public benefits (e.g., General Assistance and CalFresh), integrated medical and behavioral health services provided by Valley Medical Center and the rest of the County Health & Hospital System including those offered by Valley Homeless Healthcare Program, specialty mental health and substance abuse treatment services and housing programs, and approximately 2,000 year-round beds of emergency shelter and transitional housing.
Behavioral: Usual Care
Please see arm description.

Primary Outcome Measures :
  1. Stable tenancy [ Time Frame: Six years ]
    evaluated in months

Secondary Outcome Measures :
  1. Utilization of health services and the criminal justice system [ Time Frame: Six years ]
    We will evaluate various categories of health services utilization (including, but not limited to, inpatient medical and psychiatric hospitalizations, emergency department use, and ambulance use) and use of the criminal justice system (including, but not limited to, arrests and jail stays).

  2. Longitudinal health care [ Time Frame: Six years ]
    We will examine longitudinal health services utilization (including, but not limited to, regular attendance at primary care, and engagement with ambulatory mental health and substance use treatment).

  3. Shelter days [ Time Frame: Six years ]
    We will calculate the number of days in shelter for both the treatment and control groups

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Chronically homeless (HUD definition)
  • Past high utilization of County health services and/or the criminal justice system

Exclusion Criteria:

  • Currently incarcerated or in custody
  • Individual has been recently housed
  • Individual no longer lives in the County
  • Individual is currently connected to and chooses not to leave another specialty Mental Health or other intensive case management program
  • For hospitalized potential participants, treating physician(s) plan to discharge the potential participant to a skilled nursing facility or inpatient hospice
  • Individual is not able to give informed consent, (see below) as determined by inability to complete teach-back

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02440360

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Contact: Maria Raven, MD, MPH, MSc (415) 353-8309
Contact: Margot Kushel, MD (415) 206-8655

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United States, California
Santa Clara Valley Medical Center Recruiting
Santa Clara, California, United States, 95118
Contact: Phuong Le, MD    408-299-5942   
Sponsors and Collaborators
University of California, San Francisco
Santa Clara Valley Health & Hospital System
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Principal Investigator: Maria Raven, MD, MPH, MSc University of California, San Francisco
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Responsible Party: University of California, San Francisco Identifier: NCT02440360    
Other Study ID Numbers: 15-016
15-16168 ( Other Identifier: UCSF CHR )
First Posted: May 12, 2015    Key Record Dates
Last Update Posted: December 20, 2019
Last Verified: December 2019
Keywords provided by University of California, San Francisco:
chronic homelessness