Evaluation of California’s Housing for a Healthy California Program, January 2024


Summary: In this report, the UCLA Center for Health Policy Research provides analysis and findings from their evaluation of the Housing for a Healthy California (HHC) program. HHC was implemented by the California Department of Housing and Community Development (HCD) under the statutory authority of California Assembly Bill (AB) 74. The goal of HHC was to improve access to supportive housing, improve access to primary and behavioral health care services, and to reduce inappropriate utilization of emergency departments, hospitals, nursing homes, and correctional resources for eligible Medi-Cal beneficiaries who are  a high-cost health user and experiencing chronic homelessness. 

HHC funds were allocated through competitive awards to counties through Article I, which consisted of funds for acquisition or development of new construction projects or grants for project-based operating assistance, and Article II, which consisted of funds for long-term rental assistance, capitalized operating subsidy reserves, and acquisition, new construction or rehabilitation of a project. As of December 2022, none of the Article I awardees had completed construction or started housing, and therefore only Article I project descriptions and intentions are detailed in this report. Similarly, two Article II grantees had not yet completed their HHC projects and therefore were not included in the analyses presented in this report. This report primarily focuses on the implementation and outcomes of Article II funding in Kern, Los Angeles, Marin, and Sacramento counties from January 2021 (when the first beneficiary was housed) through December 2022. HHC continued after December 2022, but the evaluation findings do not reflect beneficiaries that were housed later on or the potential changes in their outcomes following being housed.

The HHC evaluation findings demonstrate notable progress in identifying scattered site and project-based rental units by four Article II grantees that led to housing of Medi-Cal beneficiaries experiencing homelessness. Evidence showed that HHC participants were referred to and often received an array of supportive services designed to address their medical and social needs, promote retention, prevent incarcerations or involvement with law enforcement, and improve health and well-being. Findings further indicated declines in short-term use of acute services, including emergency department visits and hospitalizations, and estimated Medi-Cal payments that were attributable to housing individuals under HHC.

Additional information on the program can be found at California Department of Housing and Community Development: Housing for a Healthy California Landing Page.

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