Carrfour Supportive Housing’s Coalition Lift High Needs/High Cost Pilot tested whether permanent supportive housing could deliver measurable cost savings and improved outcomes for Miami-Dade County’s highest utilizers of public systems — producing local evidence to inform state and county housing policy.
Overview
In Miami-Dade County, a small group of individuals cycle repeatedly through jails, emergency rooms, crisis units, and shelters — driving significant public costs while remaining disconnected from healthcare, stability, and community. Recognizing the urgent need for systemic change, the Florida Housing Finance Corporation (FHFC) launched a statewide pilot to test permanent supportive housing (PSH) for “highest needs, highest cost” individuals experiencing chronic homelessness. Carrfour Supportive Housing, a leader in combining affordable housing with on-site services, was selected as one of only three Florida sites.
BSRI joined the Coalition Lift Advisory Council to design and guide a rigorous evaluation, measuring local outcomes, calculating cost savings, and generating policy-relevant findings to support sustainable, scalable housing solutions.
Our Approach
BSRI developed a research-driven, collaborative evaluation framework to measure the impact of Coalition Lift’s housing-first model. Using countywide data, a high-need/high-cost list of 802 individuals was identified and ranked for potential participation.
Participants received intensive wrap-around services, including case management, Motivational Interviewing, Trauma-Informed Care, SSI/SSDI Outreach (SOAR), peer support, behavioral health services, employment training, and community-building activities. Multi-agency governance brought together housing providers, healthcare systems, diversion programs, funders, and researchers to oversee implementation.
The evaluation compared three groups — residents in Coalition Lift housing with intensive services, residents in other PSH programs, and individuals who remained unhoused — analyzing cost and outcome data for two years before and after housing.
Impact
The evaluation confirmed that permanent supportive housing delivers both human and fiscal benefits for high-utilizer populations.
Tangible Outcomes
- $27,292 average annual savings per person to publicly funded systems.
- 65.1% reduction in physical health costs ($984,933 saved).
- 67% reduction in mental health costs ($115,958 saved).
- 96.2% drop in shelter costs and 20.7% drop in jail costs.
- 19% increase in participant income, with more residents securing benefits or employment.
Human Outcomes
Residents reported better health, stronger relationships, and a renewed sense of safety and dignity. One participant shared, “Here my mental health is better because there is more security & I have a bed to sleep in. I feel better.”
Systems Outcomes
Findings validated permanent supportive housing (PSH) as a cost-effective intervention for high utilizers, supporting local and state policy efforts to expand access to this model.
What We Learned
This study reinforced that housing is healthcare. The largest cost savings came from reducing physical and mental health crises once residents had stable housing. It also demonstrated that community matters. Peer support, recreational activities, and relationship-building were just as essential as medical and case management services.
Sustainability is critical. Ongoing funding for rental subsidies and supportive services is necessary to maintain gains beyond the pilot period. Finally, the project proved that integrated evaluation builds credibility. A rigorous design not only delivered measurable returns on investment but also influenced funders and policymakers to consider scaling this model
Team Behind the Work
Lead Organizations
- Carrfour Supportive Housing
- Citrus Health Network
- Miami-Dade County Homeless Trust
- Behavioral Science Research Institute (BSRI)
Funding Partners
- Florida Housing Finance Corporation
- JP Morgan Chase
- Health Foundation of South Florida
- Corporation for Supportive Housing
Research Partners
