Empowering Formerly Homeless Older Adults to Engage in Advance Care Planning in Permanent Supportive Housing (ACP-PSH): A Randomized Controlled Trial. Advance care planning (ACP) prepares people to make informed medical decisions that are best for them so their wishes can be honored in the case of serious illness or at the end of life.

The number of Americans older than 65 will double in the next 40 years, reaching 80 million by 2040. Alongside this growth, many more older adults will need access to affordable and secure housing. UCSF BHHI’s research on aging focuses on California’s older population, the housing supply available to older adults, affordability issues, the connection between housing, health, and public services, and the residential patterns of older homeless adults.

The stress of experiencing homelessness can amplify previous mental illness and trigger anxiety, depression, fear, substance use, and sleeplessness.

The UCSF Benioff Homelessness and Housing Initiative recently completed a new study to better understand homelessness across the state of California.

In the United States, 30% of the homeless population are families with children, and 6% are unaccompanied youth younger than age 25.

As communities struggle to address unsheltered homelessness with limited resources, it’s more important than ever to understand the most effective solutions. In January 2025, the City of Berkeley launched an effort to resolve a longstanding encampment at 2nd and Cedar Street, where most residents lived in oversized vehicles (primarily RVs). The City offered to buy oversized vehicles from residents and provided low-barrier non-congregate shelter with enhanced case management. Residents could choose to participate in one part of the program or both. At the City’s request, the UCSF Benioff Homelessness and Housing Initiative (BHHI) is conducting a scientifically rigorous, independent evaluation

The COORDINATE Home (CrOss-sectOR Data INtegrAtion To End HOMElessness) team analyzes San Francisco’s Coordinated Case Management System (CCMS) to evaluate policy-relevant questions. CCMS links data on the use of the homeless, public health, substance use and mental health systems, jail, and ambulances.

In collaboration with community partners in the Bay Area, UCSF BHHI is conducting the only randomized controlled trial in the U.S. focused solely on family homelessness.

The link between health and homelessness may frequently be overlooked. Homelessness worsens health, with homeless individuals in their 50s experiencing the same health concerns as their housed counterparts in their 70s and 80s. With medical care, recovery, and healing made more difficult by homelessness, it’s clear that housing is health care.

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. In 2019, UCSF and CDSS conducted a mixed-methods evaluation of the Home Safe Pilot Program and found evidence that Home Safe successfully stabilized many APS clients who were at risk of, or experiencing homelessness. Building on the findings of the pilot evaluation, CDSS engaged UCSF to

Prevention means stopping someone from becoming homeless in the first place. Homelessness prevention must include broader structural reforms addressing the drivers of homelessness, not only interventions targeted at individuals.

Health Outcomes of People Experiencing Homelessness in Older Middle Age (HOPE HOME) Since 2013, Dr. Margot Kushel has led the Health Outcomes of People Experiencing Homelessness in Older Middle Age (HOPE HOME) project, an NIA-funded longitudinal study involving hundreds of older adults (age 50 and older) experiencing homelessness. Based in Oakland, the study includes semi-annual visits for structured interviews, cognitive and physical assessments, as well as qualitative interviews, and ethnographic observations. With more than 30 peer reviewed publications thus far, the study has produced numerous findings relevant to exploring the causes and consequences of homelessness among older adults. For the

Housing instability is one of the most pressing policy issues in the United States currently, with traditional policy levers failing to create the change needed to provide affordable, safe housing for all populations. UCSF BHHI conducts wide-ranging research into housing and shelter through a strategic science and lived experience approach, collaborating with communities to pilot and test new practices. We bring them to scale while acting as a bridge between the methods to foster lasting, positive change.

The solution to homelessness is housing. Rehousing interventions to quickly connect people to housing and necessary services can help prevent and end homelessness. UCSF BHHI establishes evidence-based strategies and interventions to mitigate homelessness and housing instability. Our solutions address structural barriers that negatively impact the prevention and exiting of homelessness.

As California’s homelessness crisis has continued to grow, so has the range and scale of efforts to address it. To understand these efforts in greater depth and inform their ongoing implementation, the UC Berkeley Terner Center, UCSF’s Benioff Homelessness and Housing Initiative (BHHI), and Abt Associates collaborated on a research project focused on homelessness in California. Our findings come from hundreds of in-depth interviews with people experiencing homelessness, government officials, non-profit leaders, front-line workers, and other stakeholders from local homelessness and housing organizations throughout California. We also analyzed quantitative data from local homelessness services, shelter, and housing programs. The Statewide

On any given night, more than half a million Americans are homeless; 58% of those experiencing homelessness are unsheltered.

The COVID-19-Oriented Resident of Oversized Vehicle Assessment (COROVA) report consists of 48 in-depth qualitative interviews with people who live in oversized vehicles, such as RVs or school buses, to understand their housing and service needs.