Housing to Health Initiative

Last updated Monday, January 23, 2017

Quick Facts

Current Phase
Issue Area
Term of Project
Housing to Health Initiative building in Denver

Taxpayers end up spending millions of dollars each year on emergency services for homeless people.  In Denver, it costs approximately $7 million per year to serve just 250 homeless people with temporary fixes that do not ultimately help them lead safer or more stable lives.  The Housing to Health Initiative aims to provide much needed supportive services that will help keep Denver’s homeless population out of the criminal justice system, while providing stable housing for those in need.  Through a five-year, $8.7 million social impact bond, 250 individuals who frequently use safety-net services will receive Assertive Community Treatment, an evidence-based model designed to provide treatment, rehabilitation and support services to people with mental health needs, ultimately reducing time spent in jail, detox programs, and emergency rooms.  A successful outcome will mean a better quality of life for these 250 individuals and potential to broaden the program’s reach to a larger population in need.       

Analysis

  • Market Overview

    • Year Launched
      2016
    • Service Delivery Term (Years)
      5
    • Motivation for Project
      The City of Denver spends $7 million annually on emergency and criminal justice services for 250 chronically homeless people who lack access to affordable housing and supportive services.
    • Project Objective(s)
      Achieve housing stability; Decrease jail bed days; Access to affordable housing and supportive services
    • Individuals Served
      250
    • Geography
      Denver, CO
    • Issue Area
      Homelessness
    • Initial Private Investment ($ millions) [Note 2]
      8.7
  • Project Partners

    • Service Provider(s) [Note 1]
      Colorado Coalition for the Homeless; Mental Health Center of Denver
    • Payor(s) [Note 2]
      City/County of Denver, Colorado
    • Transaction Coordinator(s) [Note 3]
      Enterprise Community Partners; CSH; Social Impact Solutions, Inc.
    • Evaluator [Note 4]
      Urban Institute
    • Validator [Note 5]
      TBD
    • Project Manager [Note 6]
      Enterprise Community Partners; CSH
    • External Legal Counsel [Note 7]
      Kutak Rock
    • Technical Assistance Provider(s) [Note 8]
      Government Performance Lab
  • Evidence and Program Design

    • Service Intervention(s) Model and/or Type
      Permanent supportive housing; Assertive Community Treatment
    • Evidence base for intervention
      Permanent Supportive Housing: 15 experimental/quasi-experimental studies [Note 7]; Assertive Community Treatment: 27 experimental/quasi-experimental studies [Note 8]
    • Has effectiveness of the intervention for PFS project target population been evaluated?
      Yes
    • Has the service provider provided this intervention previously?
      Yes
    • Is PFS project: Scaling an existing intervention by replicating at a larger scale? Demonstrating the effect of a new program model or combination of services? Transplanting an existing intervention(s) to a new target population and/or service delivery setting?
      Demonstrating; Scaling
  • Evaluation

    • Evaluation Design Methodology
      Validated service provider data; RCT [Note 5]
    • Data Source(s) for Evaluation
      Service providers; Denver Sherriff Department
    • Outcomes Tied to Success Payments
      1) Housing stability; 2) Jail days
    • Outcomes Tracked, Not Tied to Success Payments
      Emergency services, shelter and criminal justice system utilization
    • Length of Evaluation Period
      5.25 years
  • Service Provider Characteristics and Service Delivery

    • Single or multiple service providers?
      Multiple
    • Service provider type(s) (nonprofit, government, private)
      Nonprofit
    • Service provider OR site selection method
      RFP
    • Service Provider Experience with PFS Intervention
      Experienced providers of ACT, permanent supportive housing and other health and supportive services
    • Referral Method for PFS Target Population
      Voluntary enrollment of participants identified by Denver Police Department with referrals coordinated by Denver Crime Prevention and Control Commission
    • Did the project have a ramp-up phase? (Y/N; brief description)
      Yes: 6-month pilot period after project start date, prior to transaction launch; Individuals engaged during pilot period included only in housing success payments
  • PFS Contracting and Governance

    • Operational Oversight Structure [Note 1]
      Operating Committee includes Denver Department of Finance and Division of Behavioral Health Strategies, service providers, evaluator, and project manager
    • Frequency of meetings and/or reports
      2 times/month for first six months of project; monthly thereafter
    • Executive Oversight Structure [Note 2]
      Governance Committee includes City of Denver Chief Financial Officer, evaluator, service providers, project manager and investors
    • Frequency of meetings
      Quarterly
    • Investor role in project governance?
      May attend any operating committee meeting;Included in governance committee
    • Frequency of reporting to investors
      Quarterly
    • Non-standard Contract Termination Events [Note 3]
      1) Inadequate volume of referrals or housing units/subsidies; 2) Changes to Medicaid; 3) Policy changes that affect jail bed days; 4) Housing stability rate <50% by end of Year 3
    • Appropriations Risk Mitigation Strategy [Note 4]
      Success payments held in set-aside account
  • Investors

    • Senior Investor/ Lender and Total Senior Investment ($MM)
      Housing Stability Outcome: Northern Trust ($3); Walton Family Foundation ($1); Piton Foundation ($0.5); Jail Bed Day Outcome: Laura and John Arnold Foundation ($1.7); Colorado Health Foundation ($1); Living Cities ($0.5); Denver Foundation ($0.5); Nonprofit Finance Fund ($0.435); ($8.6 total)
    • Subordinate Investor/ Lender and Total Subordinate Investment ($MM)
      None
    • Deferred Fee Source and Total Deferred Fees ($MM)[Note 1]
      None
    • Recoverable Grant Source and Total Recoverable Grants($MM)[Note 2]
      None
    • Non-recoverable Grant Source and Total Non-recoverable Grants ($MM)[Note 3]
      None
    • Guarantor and Guarantee ($MM) [Note 4]
      None
  • Basic Repayment Structure

    • Initial Investment ($Millions)
      8.6
    • Maximum Repayment Funds Committed by Payor ($Millions)
      11.4
    • Full service delivery term (years)
      5
    • Full repayment period (years)
      5
    • Interim outcomes reported? Tied to payments?
      Yes/Yes [Note 6]
    • Sustainability/ Recycling of Funds
      None specified
  • Detailed Repayment Terms

    • Interest
      None
    • Trigger for initial repayment of principal [Note 1]
      1) Housing Stability: Client achievement of 12 months of housing stability; 2) Jail Days: 20% reduction
    • Threshold for full repayment of principal
      1) Housing Stability: 83%; 2) Jail Days: 30% reduction
    • Threshold for full repayment of principal plus maximum success payments
      1) Housing Stability: 100%; 2) Jail Days: 65% reduction
    • Repayment timing
      1) Housing Stability: annually, starting after Quarter 6; 2) Jail Days: after Year 5
    • Return to Investor [Note 2]
      3.5% (expected rate of return)
    • Success Payment to Other Stakeholders? [Note 3]
      No
  • Project Costs

    • Project Development Costs Not Covered by PFS Capital Raise
      Evaluation design; Evidence review; Legal services; Government Performance Lab fellow; Transaction coordinator fees
    • Funding source(s) for project development costs, if any
      Urban Institute (partial in-kind services); Pro bono legal support; Social Innovation Fund; The Piton Foundation; Denver Foundation; Kaiser Permanente; Rose Community Foundation
    • Project Implementation Costs not covered by PFS Capital
      $10.8 million in housing vouchers; $5.2 million in Medicaid funding; Evaluation
    • Funding sources for implementation costs not covered by PFS capital
      State of Colorado; City of Denver