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26 Alameda Countywide Homeless and Special Needs Housing Plan Take a look at.... Integrating housing and services Alameda County's Health, Housing, and Integrated Services Network (HHISN)Pathways Project The Health, Housing, and Integrated Services Network (HHISN) Pathways Project in Alameda County has demonstrated the effectiveness of affordable, long,term supportive housing in reducing systems-level costs, while improving client outcomes for homeless individuals living with multiple diagnoses. HHISN links housing to flexible social and health services, including comprehensive primary healthcare,..client-centered mental health. and substance use treatment, independent living and personal health skills, and employment services. A totalof494 permanentsupportive housing units at seven sites inOakland and Berkeley are Iinkedto supportive services through HHISN. Multi-agency teamsotpublicand private nonprofit organizations deliver integrated services to residents. Lifelong Medical Care and Bonita House provide primary health care and mental health and substance use treatment, While Resources for Community Development, Oakland Community Housing, Inc., and Mercy Housing provide housing units. Other HHISNpartners have inCluded the City of Berkeley Mental Health, East Bay Community Recovery Project, Catholic Charities of the East Bay, Building Opportunities for Self Sufficiency, Alameda County Health Care for the Homeless Program, and West Oakland Health Council. These partnerships facilitate residents'access to off-site services, as well as the referral of multiply diagnosed homeless service users into supportive housing, An evaluation of outcomes for formerly homeless and multiply diagnosed individuals who moved into supportive housing units served by HHISN found that the service-enriched housing improved aCCess to care and. reduced total public. costs by 15 percent.. After placement in supportive . housing, . residents'useof services generally shifted toward less expensive service categories. Demand for day treatment decreasedby84 percent, and inpatient psychiatric hospital daysfell48 percent,frClm 60 to 31 days per year. These decreases were accompanied by increases in the use of ongoing and preventative care, as well as crisis intervention services, which more than doubled, and crisis residential days and psychiatric emergency services. Although psychiatric emergency services were comparatively expensive, the cost was more than offset by cost reductions from decreased inpatient and day treatment services. The mostdramatic reductions in service costs came among the topquadrantotprevioususers otbehavioraJ health services, who, before moving into supportive housing,hadbeenrespClnsibleJorthevastmajorityof service costs. At the same time, service use increased among thebotlomhalfofserviceusers,suggesting that HHISN increased access to services for individuals with previously uhtreatedmehtal health issues. (Source: The Benefits of Supportive Housing: Changes in Residents' UseotPublic Sari/ices, prepared by Harder + Company CommunityResearch for the Corporation tor Supportive Housing, February 2004.)