The Home Safe program is a statewide effort to prevent and end homelessness among older adults and adults with disabilities served through Adult Protective Services (APS). Administered by the California Department of Social Services and implemented by county APS agencies, Home Safe provides flexible, short-term assistance to stabilize housing and respond to housing crises
At the request of the California Department of Social Services, the UCSF Benioff Homelessness and Housing Initiative (BHHI) conducted an independent, statewide evaluation to examine how Home Safe operates across counties and what it achieves for the people it serves.
Key Findings
- Home Safe filled a critical unmet need in local homelessness response systems by enabling APS staff to meet the housing needs of older and dependent adults.
- The most common interventions included enhanced case management, rent payment, and housing navigation.
- Flexible funding was key to the program’s success, enabling staff to respond quickly and tailor interventions to participant needs.
- Among participants for whom we have housing data, most (93.9%) who were housed at program entry remained housed at exit; more than half (58.4%) homeless at program entry were housed at exit.
- Home Safe preserved naturally occurring affordable housing by interrupting evictions from rent-controlled units.
- Home Safe had lasting positive impacts on California’s social support infrastructure by breaking down silos between APS and homelessness services staff.
- For most populations, staff did not report specific barriers to accessing Home Safe. However, they identified barriers for rural populations, including spotty cell service and transportation issues. Fear, and stigma limited reach in Latine and undocumented communities.
- Program leaders expressed concern that their investment in staff training and program-building would be lost if program funding ended.
- The high cost and low availability of housing limited the program’s effectiveness.
Recommendations
- Provide sustained funding and technical support to ensure continuity of Home Safe services and preserve program capacity.
- Maintain flexible funding structures to allow counties to tailor programs to their needs and meet diverse participant needs.
- Leverage CalAim reimbursement to expand reach and better support Home Safe participants with complex needs.
- Use Home Safe provider experience to train and guide other organizations.
- Reduce fear and stigma around APS and Home Safe, through educational campaigns that reduce barriers to engagement.
- Partner with trusted community groups to reach eligible populations that Home Safe is not serving.
- Increase the supply and affordability of housing accessible to low-income older adults and people with disabilities.
Read the full report for detailed findings and methods.
Resources
Related Resources
Policy Brief
Home Safe Interim Evaluation: Key Findings
September 10, 2021
This brief on the Home Safe program summarizes key findings from the UCSF Benioff Homelessness and Housing Initiative’s (BHHI) interim evaluation of the program. It includes a brief description of the program, an overview of the evaluation’s design, and an assessment of the Governor’s 2021-22 budget proposal to expand Home Safe eligibility.
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Reports
Toward Dignity: Understanding Older Adult Homelessness
May 23, 2024
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To better understand the experiences of older adults experiencing homelessness, the UCSF Benioff Homelessness and Housing Initiative examined findings from the California Statewide Study of People Experiencing Homelessness (CASPEH), the largest representative study of homelessness since the mid-1990s. This report reviews who experiences homelessness in late life, how they lost their housing, their experiences during homelessness, and the barriers they face to regaining housing. These findings highlight the urgent need for research-backed solutions and policy interventions to address the unique challenges faced by older adults experiencing homelessness.
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Videos
Webinar: Aging, Health, & Homelessness: Findings from CASPEH and HOPE HOME
December 13, 2023
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Half of people experiencing homelessness are older than 50, and almost half of older homeless adults became homeless for the first time after they turned 50. This webinar is about the causes and consequences of homelessness in late life. Margot Kushel, MD, and other BHHI presenters will discuss findings from the Health Outcomes of People Experiencing Homelessness in Older Middle Age (HOPE HOME) project—a longitudinal cohort study following older adults experiencing homelessness in Oakland, CA, and the California Statewide Study of People Experiencing Homelessness (CASPEH)—the largest representative study of homelessness in the United States since the mid-1990s.
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Our Research
Factors Associated With Mortality Among Homeless Older Adults in California: The HOPE HOME Study
JAMA Internal Medicine
October 1, 2022
Our Research
Factors Associated With Mortality Among Homeless Older Adults in California: The HOPE HOME Study
JAMA Internal Medicine
October 1, 2022
In this long-term study of 450 homeless adults age 50 and older, BHHI researchers examined how factors like regaining housing, using drugs, and having various chronic conditions, such as diabetes, affected participants' risk of dying. They found that 26% of the participants died within a few years of being enrolled, and people who first became homeless at age 50 or older were about 60% more likely to die than those who had become homeless earlier in life, and those who remained homeless were about 80% more likely to die than those who were able to return to housing. These findings illustrate an urgent need for policy approaches to prevent and end homelessness among older adults in the United States and suggest that addressing older adults’ barriers to health care and high rates of institutionalization may prevent premature mortality.
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Our Research
Factors Associated With Exits From and Returns to Homelessness Among Older Homeless Adults: Results From the HOPE HOME Study
November 20, 2025
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Our Research
Factors Associated With Exits From and Returns to Homelessness Among Older Homeless Adults: Results From the HOPE HOME Study
November 20, 2025
Homelessness is dynamic; some individuals cycle between homelessness and housing. BHHI examined the prevalence of and factors associated with exits from and returns to homelessness among adults aged 50 and older. With a median 4 years of follow-up, 80% of participants exited homelessness into housing. Having a permanent rental subsidy was associated with retaining housing.
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