2017 Top 25
County of San Diego, CA
January 1, 2017

Project 25 is a 3-year pilot program to identify at twenty-five chronically homeless individuals in San Diego who are among those placing the heaviest burden on public services and resources such as emergency room visits and arrests. The program is operated by Father Joe’s Villages, a non-profit organization in San Diego, and followed the approach of Housing First, which is based on the premise that individuals need to be placed in affordable, permanent housing as quickly as possible and then offered a comprehensive set of services. Although the project’s initial goals were to identify and provide services to the top twenty-five users of public systems, the pool of participants was soon expanded to thirty-six people. Individuals identified for participation in the project ranged in age from 22 to 61, with a median age of 47; five of whom were Veterans. Participants all had some combination of mental illness, a serious physical disability, and/or a substance use disorder. The individuals analyzed were enrolled in the program and housed in their own apartments by the end of 2011. Their use of various public and behavioral health and other services was tracked during 2012 and 2013 and compared with the usage of 2010 prior to program enrollment. At the end of the pilot period, all individuals demonstrated a dramatic decrease in both utilization and costs of public services. A third of the participants still required supportive services to maintain their housing stability and continue their improved quality of life. This intense level of support may be required indefinitely. Another third “graduated” from the program and are utilizing a reduced level of services. The final third is anticipated to graduate after some additional time of receiving intensive support." The County and United Way supported key components of the project and was initially funded through a United Way grant. When United Way funding ended, the project received a three year-funding grant from SAMHSA, through which sustained savings were successfully demonstrated to Medicaid Managed Care plans, resulting in the Plans agreeing to continuation funding.