Jon W. Paulson Veterans Community in San Francisco (Photo: Swords to Plowshares)
A California program providing additional support to formerly homeless Veterans recorded high housing retention rates, fewer medical emergencies, and improvements in residents’ daily lives, according to a new RAND report.
The evaluation examined California’s Veterans Support to Self-Reliance (VSSR) pilot, which began in 2023 under CalVet. The program provides additional services to aging Veterans and those with serious health conditions living in permanent supportive housing.
Over 9,000 Veterans experienced homelessness in California in 2024. With approximately 69 percent of the state’s Veteran population age 55 or older, housing programs face growing challenges caring for residents who need more than rental assistance and traditional case management.
The VSSR pilot operated at 13 housing locations across six counties, including Los Angeles, Riverside, Sacramento, San Diego, San Francisco, and Sonoma. Four nonprofit organizations provided services ranging from transportation and mental health care to assistance with housekeeping, meals, and medical appointments.
The program enrolled 560 Veterans, exceeding its original target of 425. Nearly 80 percent were at least 56 years old, and 31 percent had four or more chronic health conditions.
Housing stability was the program’s strongest result.
Over three years, only 20 participants left their housing for unstable living situations, representing 3.6 percent of those enrolled. By comparison, a previous study of Veterans receiving federal housing assistance in Los Angeles reported a 15 percent negative housing exit rate, although researchers cautioned that the studies used different definitions.
Among 400 Veterans with a full year of follow-up data, falls declined 59 percent, emergency medical visits dropped 75 percent, and those experiencing no acute health events increased from 74 to 90 percent.
Researchers also documented improvements in everyday health habits. Missed medical appointments decreased 54 percent, while residents eating three meals daily increased from 37 to 53 percent. Reported alcohol, stimulant, and opioid use each declined by at least 40 percent.
Social participation improved as well. The percentage of residents attending three or more group activities increased from 12 to 37 percent.
The financial findings could influence decisions about continuing the program.
RAND estimated that enhanced services cost approximately $17,437 annually per Veteran. Including housing subsidies and case management, total public costs ranged from $42,800 to $66,200 per person annually. Those estimates were 23 to 50 percent below California’s median private assisted living costs and substantially below nursing facility care, although researchers cautioned that the figures were calculated using different pricing methods.
Despite the positive results, researchers cautioned that the evaluation did not include a comparison group of Veterans who received no VSSR services. Consequently, the findings cannot definitively establish whether the program directly caused the improvements.
RAND recommended retaining peer support specialists and service assistants, positions that all four participating organizations identified as particularly valuable. These employees helped Veterans manage appointments, arrange transportation, participate in community activities, and handle everyday responsibilities that could otherwise make independent living difficult.
Researchers also recommended addressing remaining gaps in housekeeping, laundry, and meal preparation.
CalVet approved a six-month extension allowing services to continue through February 2027. However, participating organizations told researchers that maintaining the program beyond its current funding would depend on securing additional financial support.
Author: Rikki Almanza
Rikki is a Web Content Coordinator for the American Legion, Department of California. With a deep-rooted family connection to the military, Rikki is committed to using her skills and knowledge to provide valuable assistance and resources to servicemembers and veterans.
