Cost-Savings Associated with Reductions in Public Service Utilization with Provision of Permanent Supported Housing in Midsized City in the United States.

Severe and persistent mental illnesses are frequently associated with homelessness and extensive use of public services. Cost savings after the provision of permanent supportive housing (PSH) have been examined in large metropolitan areas but not in medium-sized communities. Administrative and clinical data were collected to determine use of public services, such as use of emergency services, inpatient psychiatric and medical services, and correctional facilities, in the year preceding and the year subsequent to placement in PSH. Costs of the housing and the utilized services were also calculated. Ninety-one subjects were in housing first (HF) programs and 19 were in treatment first (TF) programs. Overall there was a net cost savings of over $1.2 million or $6134/consumer/year of PSH. Nearly all cost savings were in reduced service utilization which implies prevention of both medical and psychiatric morbidity. In HF the average per patient cost savings ($21,082.12) was not significantly greater than TF ($12,907.29; p = 0.33). Provision of PSH in a mid-sized city provides significant cost savings.