About 70 people attended a Fresh Fridays session on the economics of health and housing on Friday, June 9, 2023, to discuss a new report from ONE Neighborhood Builders (ONE|NB) and Providence Community Health Centers (PCHC) that showed that the average Medicaid-related health care spending for people who were formerly homeless and who are now living in permanent supportive housing was consistently lower than Medicaid recipients who continued to experience homelessness.


The report, which was conducted by Faulkner Consulting Group, made four key observations:

  • Medicaid costs dropped 43 percent among Rhode Island Medicaid members who had access to ONE|NB’s permanent supportive housing compared with other Medicaid members who remained in shelters.
  • Medicaid spending on hospital services and pharmaceuticals was 51 percent lower among Rhode Island Medicaid members who had access to ONE|NB’s permanent supportive housing compared with other Medicaid members who remained in shelters.
  • Emergency department utilization fell by nearly half.
  • Medicaid members who had access to permanent support housing appeared more likely to receive preventative behavioral health services than those remaining in shelter.

The report lends support to recent calls from housing advocates for state investments in the development of affordable and permanent supportive housing initiatives. Additionally, it suggests that efforts to expand programs that direct Medicaid funding toward affordable housing could save taxpayer money in reduced health care expenses.

Jennifer Hawkins, the President and Executive Director of ONE Neighborhood Builders, said ONE|NB has developed nearly 600 units of affordable homes for families in Greater Providence. Hawkins acknowledged ONE|NB’s focus on influencing policies and systems to advance their mission of fostering healthy, vibrant, and safe communities. As part of this effort, they are dedicated to sharing the examples of their work and contributing to the solution of homelessness.

Hawkins reiterated ONE|NB’s pledge to allocate 10% of units as permanent supportive housing, a model that combines permanent housing, rental subsidies, and supportive services to ensure lease compliance and stable housing for individuals. She further highlighted their ambitious project, the Taunton Avenue Collaborative, where they plan to set aside an even higher percentage — 40% — of homes as permanent supportive housing.

Hawkins explained that permanent supportive housing can benefit various populations, including individuals who have aged out of foster care, recently incarcerated individuals, and those who have experienced homelessness. For years, ONE|NB has been actively involved in connecting individuals experiencing homelessness with needed health care and support services. In 2019, she said, they partnered with Rhode Island Housing’s Continuum of Care program to provide permanent supportive housing to individuals, ensuring that the most vulnerable and chronically homeless individuals receive housing first.

Hawkins said it is ONE|NB’s belief that providing essential health-care services to individuals experiencing homelessness can ultimately save costs for the health system by shifting from emergency care to preventative and behavioral healthcare. Recognizing the need for evidence-based findings specific to Rhode Island, she said, ONE|NB commissioned an independent study through Faulkner Associates. The study aimed to understand the impact of their permanent supportive housing program on healthcare utilization and costs for previously homeless individuals.

Hawkins was joined by panelists Deb Faulkner, President of Faulkner Consulting Group; Grant Porter, a senior consultant with the Faulkner Consulting Group; Tom Douglass, Director of Finance ACO, Providence Community Health Centers; and Christopher F. Koller, President of Milbank Memorial Fund.