Supportive housing is designed to serve those who would not be able to stay housed without a wide range of supportive services. People living in supportive housing usually have a long history of homelessness and often face persistent obstacles to maintaining housing, such as a serious mental illness, a substance use disorder, or a chronic medical problem. Many tenants face more than one of these serious conditions. While services are necessary to help tenants maintain stability, being housed is an essential first step in addressing these conditions that often have gone untreated for many years. Therefore, the combination of housing and supportive services creates a synergy that allows tenants to take steps toward recovery and independence.

This brief describes the characteristics of supportive housing tenants in three CSH initiatives – Health, Housing, and Integrated Services Network (HHISN), a partnership of six San Francisco Bay Area counties1; Closer to Home, an initiative in New York and California funded by the Conrad N. Hilton Foundation;2 and Taking Health Care Home (THCH), a national initiative funded by The Robert Wood Johnson Foundation.3

The tenants of supportive housing tend to have long histories of homelessness. In two of the HHISN supportive housing projects, 59% of the tenants had been homeless for two to eight years before their move-in date, and all participants had been homeless for at least eight months. Similarly, 68% of the people served through the Closer to Home initiative were homeless for two years or longer (37% were homeless for over 47 months).

The evaluation of the THCH initiative, which surveyed 149 supportive housing projects across the country, found greater variation in the number of long-term homeless people being served by supportive housing. On average, about one-third of the tenants were chronically homeless (according to the federal definition) before moving into supportive housing, which varied from 21% in Maine to 57% in Seattle/King County. The rest of the tenants had either been homeless for shorter periods of time or were at risk of becoming homeless.

Disabilities are very common among tenants of supportive housing. As shown in Table 1, severe mental illness and substance use disorders are most prevalent, and many tenants suffer from a dual diagnosis. Chronic health conditions are also fairly common, and the prevalence of HIV/AIDS is much higher among supportive housing tenants than among the general population. Other health conditions, such as hypertension, heart disease, and diabetes, are also very common and often occur

1 The HHISN tenant characteristics described in this brief are from only two of the supportive housing projects involved in this initiative – the Canon Kip Community House and The Lyric Hotel, both located in San Francisco. Gerald Lenoir, The Network: Health, Housing and Integrated Services, (Corporation for Supportive Housing, 2000).

2 S Barrow, G Soto, P Cordova, Final Report on the Evaluation of the Closer to Home Initiative, (Corporation for Supportive Housing, 2004).

3Martha Burt, Taking Health Care Home: Baseline Report on PSH Tenants, Programs, Policies, and Funding, (Corporation for Supportive Housing, 2005). Corporation for Supportive Housing: Who Lives in Supportive Housing? January 2007 2

together. Over two-thirds of the tenants in the Closer to Home initiative had more than one chronic health condition.