Guaranteed Income for Homelessness and Housing Stability

(SVGIP Trial)

Recruiting in Palo Alto (17 mi)

+1 other location

Overseen by Oanh K Nguyen, MD, MAS

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of California, San Francisco

Disqualifiers: Substance use, Alcohol use, others

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

This trial aims to see if giving $1,000 a month to homeless families in Santa Clara County can help them find stable housing and improve their health. The study will also look at different payment methods to see which works best.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Guaranteed Income for Homelessness and Housing Stability?

Research shows that interventions similar to basic income can have positive effects on health outcomes like mental health and birthweight, and may improve housing stability for homeless individuals. Additionally, financial incentives have been linked to better service engagement among homeless people with mental illness. ^{1 2 3 4 5}

Is Guaranteed Income safe for humans?

Research on Guaranteed Income and similar interventions shows positive effects on health, such as improved mental health and reduced homelessness, with no significant negative safety concerns reported. ^{2 4 6 7 8}

How is the treatment Guaranteed Income different from other treatments for homelessness and housing stability?

Guaranteed Income is unique because it provides regular, unconditional cash payments to individuals, which can help stabilize income and improve mental health, unlike traditional treatments that may focus on providing housing or specific services. ^{2 4 9 10 11}

Research Team

Oanh K Nguyen, MD, MAS

Principal Investigator

University of California, San Francisco

Eligibility Criteria

This trial is for adults over 18 in Santa Clara County who are homeless or have unstable housing, with or without children. They must be at risk of eviction or living temporarily in hotels/motels or doubled up due to lack of housing. Participants should score 4-8 on the VI-SPDAT, indicating they're suitable for rapid rehousing programs. Those with severe substance abuse issues or alcohol disorders can't join.

Inclusion Criteria

Being in a shared living situation intended to be temporary

I am 18 years old or older.

VI-SPDAT score within the eligibility range for referral to rapid rehousing assistance programs in Santa Clara County (score of 4-8 for households)

Exclusion Criteria

Substantial to severe level of problematic substance use as defined by the validated Drug Abuse Screening Test (DAST-10)

Hazardous or harmful alcohol consumption

Active and severe alcohol use disorder as defined by the validated Alcohol Use Disorders Identification Test (AUDIT)

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive guaranteed income payments of $1,000/month for 24 months or a hybrid payment schedule

24 months

Monthly assessments

Follow-up

Participants are monitored for housing stability, health, and well-being outcomes

12 months

Assessments at 6, 12, 18, 24, 30, and 36 months

Treatment Details

Interventions

• Guaranteed Income (Behavioural Intervention)
• Public Benefits Information Session (Behavioural Intervention)

Trial Overview The study tests if guaranteed income ($1,000 monthly for two years) improves homelessness and housing stability among affected families. It also examines health and well-being impacts and compares preferences between consistent monthly payments versus a larger initial sum followed by smaller amounts.

Participant Groups

Group I: Guaranteed Income Experimental Treatment 2 Interventions

Participants in the intervention group will receive guaranteed income gift payments equivalent to $1,000/month for a total of 24 months in addition to usual care. They will also have the option to attend the same Public Benefits Information Session being offered to the control group as above.

Group II: Usual Care Active Control 1 Intervention

Participants in the active comparator control group will receive usual care, which includes usual public benefit, assistance and social service programs that are available at the local, county, state, and federal levels to all residents of Santa Clara County. They will also be offered the option to attend a Public Benefits Information Session.

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials

2,636

Recruited

19,080,000+

Suresh Gunasekaran

University of California, San Francisco

Chief Executive Officer since 2022

MBA from Southern Methodist University

Dr. Lukejohn Day

University of California, San Francisco

Chief Medical Officer

MD from Stanford University School of Medicine

Destination: Home SV

Collaborator

Trials

1

Recruited

300+

Sí Se Puede Collective

Collaborator

Trials

1

Recruited

300+

Sacred Heart Community Service

Collaborator

Trials

1

Recruited

300+

County of Santa Clara Office of Supportive Housing

Collaborator

Trials

1

Recruited

300+

Findings from Research

The Doorway program, which allows participants to choose their own rental properties with support, significantly improved mental health outcomes for 55 out of 59 participants, as indicated by reductions in behavioral symptoms and distress.

Participants also experienced a notable decrease in the use of mental health services and hospital admissions, leading to substantial cost savings for the government, suggesting that this innovative housing model could be effective and beneficial on a larger scale.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of an integrated housing and recovery model for people with severe and persistent mental illnesses: the Doorway program. Dunt, DR., Benoy, AW., Phillipou, A., et al.[2022]

A systematic review of 27 studies on basic income-like interventions found mixed health effects, with notable positive impacts on outcomes like birthweight and mental health, but no significant effects on other health measures.

Employment outcomes varied, showing mostly small effects for men and larger positive effects for women with young children, suggesting that basic income may not lead to significant job loss and could improve certain socioeconomic conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The public health effects of interventions similar to basic income: a scoping review. Gibson, M., Hearty, W., Craig, P.[2023]

A systematic review of 43 studies involving various housing interventions found that these programs significantly reduce homelessness and improve housing stability compared to usual services, with most studies conducted in the USA.

Interventions such as High Intensity Case Management and Housing First showed similar effectiveness, but the review highlighted a need for better quality evidence and identified gaps in research, particularly regarding disadvantaged youth and non-abstinence contingent housing.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of interventions to reduce homelessness: a systematic review and meta-analysis. Munthe-Kaas, HM., Berg, RC., Blaasvær, N.[2023]

Permanent supportive housing significantly improved long-term housing stability for homeless individuals, particularly those with high support needs, compared to usual care, with a rate ratio of 1.42.

Income assistance interventions, especially housing subsidies combined with case management, also led to increased days of stable housing, demonstrating effectiveness in reducing homelessness, although their impact on mental health and employment outcomes remains unclear.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review. Aubry, T., Bloch, G., Brcic, V., et al.[2022]

This study will assess the impact of financial incentives on service engagement among adults experiencing homelessness and mental illness, with participants receiving $20 for weekly meetings with program providers over a 6-month period.

The research aims to provide valuable evidence on the effectiveness and acceptability of financial incentives in improving health-related outcomes, using both quantitative measures of service engagement and qualitative insights from participant interviews.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Financial Incentives on Service Engagement Among Adults Experiencing Homelessness and Mental Illness: A Pragmatic Trial Protocol. Reid, N., Nisenbaum, R., Hwang, SW., et al.[2021]

A study involving 131 individuals receiving a $500 monthly guaranteed income for 2 years showed significant improvements in health and financial stability, including lower income volatility and reduced mental distress.

Participants reported better physical functioning and greater agency in pursuing employment and caregiving opportunities, suggesting that guaranteed income can be an effective public health intervention to enhance overall wellbeing.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of Guaranteed Income on Health, Finances, and Agency: Findings from the Stockton Randomized Controlled Trial. West, S., Castro, A.[2023]

Basic income interventions, such as unconditional cash transfers, have shown potential to improve health and wellbeing outcomes, including reductions in poverty and improvements in quality of life, based on a review of ten studies.

While the existing trials indicate positive impacts, more long-term studies are needed to strengthen the evidence on how basic income programs can effectively reduce health inequities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How, why and for whom does a basic income contribute to health and wellbeing: a systematic review. McKay, FH., Bennett, R., Dunn, M.[2023]

A one-time unconditional cash transfer of CAD$7,500 to individuals experiencing homelessness led to fewer days spent homeless, increased savings, and no rise in spending on temptation goods over one year, indicating effective financial management by recipients.

The study also highlighted public mistrust regarding homeless individuals' ability to manage money, suggesting that targeted messaging could enhance public support for cash transfer policies aimed at reducing homelessness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Unconditional cash transfers reduce homelessness. Dwyer, R., Palepu, A., Williams, C., et al.[2023]

Cash transfers and guaranteed income programs are being explored as effective solutions to address income volatility, particularly in the context of recent economic challenges.

Stockton's guaranteed income experiment demonstrates that these programs can be designed to work alongside existing safety net benefits, ensuring that recipients do not lose essential support while receiving additional financial assistance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mitigating loss of health insurance and means tested benefits in an unconditional cash transfer experiment: Implementation lessons from Stockton's guaranteed income pilot. Baker, AC., Martin-West, S., Samra, S., et al.[2020]

Less than half of the homeless adults in the study were receiving entitlement income at the start, and many lost their benefits over the 15-month follow-up period, highlighting the instability of these income sources.

Certain groups, such as black women with children and those reporting disabilities, were more likely to continue receiving entitlement income, while individuals with dual disorders faced a significantly higher risk of benefit termination.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A longitudinal perspective on entitlement income among homeless adults. Zlotnick, C., Robertson, MJ., Lahiff, M.[2022]

Implementing a Universal Basic Income (UBI) could significantly reduce cases of anxiety and depression among young people in England, with potential prevention of up to 550,000 cases by 2030 depending on the scheme level.

The financial benefits of UBI are substantial, with estimated savings to the National Health Service and social services ranging from £330 million to £930 million, and total cost savings potentially reaching £4.2 billion, highlighting its economic viability alongside mental health benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quantifying the mental health and economic impacts of prospective Universal Basic Income schemes among young people in the UK: a microsimulation modelling study. Chen, T., Reed, H., Parra-Mujica, F., et al.[2023]

References

1. Australia pubmed.ncbi.nlm.nih.gov

Evaluation of an integrated housing and recovery model for people with severe and persistent mental illnesses: the Doorway program. [2022]

2. England pubmed.ncbi.nlm.nih.gov

The public health effects of interventions similar to basic income: a scoping review. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of interventions to reduce homelessness: a systematic review and meta-analysis. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review. [2022]

5. Switzerland pubmed.ncbi.nlm.nih.gov

The Impact of Financial Incentives on Service Engagement Among Adults Experiencing Homelessness and Mental Illness: A Pragmatic Trial Protocol. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Impact of Guaranteed Income on Health, Finances, and Agency: Findings from the Stockton Randomized Controlled Trial. [2023]

7. England pubmed.ncbi.nlm.nih.gov

How, why and for whom does a basic income contribute to health and wellbeing: a systematic review. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Unconditional cash transfers reduce homelessness. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Mitigating loss of health insurance and means tested benefits in an unconditional cash transfer experiment: Implementation lessons from Stockton's guaranteed income pilot. [2020]

10. United States pubmed.ncbi.nlm.nih.gov

A longitudinal perspective on entitlement income among homeless adults. [2022]

11. England pubmed.ncbi.nlm.nih.gov

Quantifying the mental health and economic impacts of prospective Universal Basic Income schemes among young people in the UK: a microsimulation modelling study. [2023]