NCT02440360

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

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
423

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started May 2015

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 1, 2015

Completed
4 days until next milestone

First Submitted

Initial submission to the registry

May 5, 2015

Completed
7 days until next milestone

First Posted

Study publicly available on registry

May 12, 2015

Completed
6.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2021

Completed
Last Updated

May 12, 2022

Status Verified

May 1, 2022

Enrollment Period

6.2 years

First QC Date

May 5, 2015

Last Update Submit

May 10, 2022

Conditions

Keywords

chronic homelessness

Outcome Measures

Primary Outcomes (1)

  • Stable tenancy

    evaluated in months

    Six years

Secondary Outcomes (3)

  • Utilization of health services and the criminal justice system

    Six years

  • Longitudinal health care

    Six years

  • Shelter days

    Six years

Study Arms (2)

Permanent Supportive Housing

ACTIVE COMPARATOR

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

Usual Care

PLACEBO COMPARATOR

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

Interventions

PSHBEHAVIORAL

Please see arm description.

Also known as: Permanent Supportive Housing
Permanent Supportive Housing
Usual CareBEHAVIORAL

Please see arm description.

Usual Care

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

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

You may not qualify if:

  • 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

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Santa Clara Valley Medical Center

Santa Clara, California, 95118, United States

Location

Related Publications (3)

  • Kushel MB, Vittinghoff E, Haas JS. Factors associated with the health care utilization of homeless persons. JAMA. 2001 Jan 10;285(2):200-6. doi: 10.1001/jama.285.2.200.

    PMID: 11176814BACKGROUND
  • Kushel MB, Perry S, Bangsberg D, Clark R, Moss AR. Emergency department use among the homeless and marginally housed: results from a community-based study. Am J Public Health. 2002 May;92(5):778-84. doi: 10.2105/ajph.92.5.778.

    PMID: 11988447BACKGROUND
  • Kushel MB, Evans JL, Perry S, Robertson MJ, Moss AR. No door to lock: victimization among homeless and marginally housed persons. Arch Intern Med. 2003 Nov 10;163(20):2492-9. doi: 10.1001/archinte.163.20.2492.

    PMID: 14609786BACKGROUND

Study Officials

  • Maria Raven, MD, MPH, MSc

    University of California, San Francisco

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 5, 2015

First Posted

May 12, 2015

Study Start

May 1, 2015

Primary Completion

June 30, 2021

Study Completion

June 30, 2021

Last Updated

May 12, 2022

Record last verified: 2022-05

Locations