9% of members; a larger share of spending
Share of each spending category attributed to this cohort in the Council deck:
Council behavioral-health presentation · September 9, 2026 · slide 7 ↗~18,000
on the county's by-name list
up from 14,361 a year earlier
+67%
tri-county one-night count, 2023 → 2025
10,526 counted in one night
$1.3B
raised by the homeless-services tax
region-wide since 2021
372
died homeless in 2024
most from overdose · average age 48
01 · The one insight
Capacity, access and flow work together
In January 2025, 1,277 people joined Multnomah County's active by-name list and 865 left it (Multnomah County). Leaving the active list includes housing and inactivity; it is not a count of confirmed housing exits. This historical snapshot illustrates flow. Better prevention and handoffs still need suitable homes, staffed care and sustainable funding.
Try
Close the inflow · cheapest
90%
One-time arrears for a verified crisis, paid to the landlord.
90%
No release from jail, hospital, or foster care to the sidewalk.
Open the outflow
0
Lease existing apartments: homes this year, not in construction-years.
0
Detox and residential beds.
80%
A bed you can't staff is a press release.
People on the by-name list, next four years
Do nothing, year 4
37,776
from 18,000 today
Your scenario, year 4
15,696
22,080 fewer people
Does growth stop?
Yes
list shrinks 48/month
Cost to run, per year
$33.4M
≈ 10% of what the homeless-services tax raises now
$33.4M
Prevention· economic group, kept housed$33.4M
Leased housing· economic & episodic groups$0
Treatment beds· chronic & severe group$0
Educational scenario, not a forecast. The treatment assumptions below are not validated for acute psychiatry, psychiatric subacute care or respite. A blocked receiving placement can occupy an upstream hospital bed. Faster discharge helps only when appropriate care and continuing housing work are funded.
Assumptions and unit costs
A simplified stocks-and-flows model with visible, contestable assumptions: 25% of inflow is eviction-driven and 15% is institutional discharge; a staffed treatment bed serves four people a year and 35% of stays exit homelessness durably; leased units come online over twelve months. Net flow varies month to month; the +412 figure is January 2025 (Multnomah County). Unit costs: eviction prevention ~$2,500 per household (National Alliance to End Homelessness), shelter and master-leasing from the county's own studies (Multnomah County HSD, Multnomah County JOHS), staffed treatment ~$55k per bed per year (French, Popovici & Tapsell, J. Subst. Abuse Treat. (2008)).
02 · First contact
Three doors, and the third one is phone calls
Is there a crime? Is there a mental-health hold? If neither, the only tool is a voluntary offer, and that is the branch where Portland loses the moment. The person says yes now; the system answers later.
First contact
A worker meets a person on the street
Is a crime being committed?
→ Criminal justice route
Legal authority is clear, but the back end only helps if court, jail, deflection, or treatment creates an actual service path.
Does it meet a mental-health hold?
→ Civil hold / hospital route
Only available when the person is a danger to self or others or cannot care for themselves. Many visible street crises fall below that threshold.
No crime, no hold. Will they say yes?
the gap→ Voluntary shelter or treatment referral
This is the gap PDX Help targets: if the person says yes now, the worker needs an eligible option, phone confirmation, hold, and transport before the window closes.
When they say yes, the worker needs, in minutes:
- 1an eligible bed→
- 2phone confirmation→
- 3a hold on it→
- 4transport
Today that mostly means calling lists and hoping the information is current. The window closes before the calls do.
In the fieldPortland Street Response ·Portland Solutions ·Portland Fire CHAT ·Northwest Community Conservancy ·ImpactNW Recovery Navigation
03 · Who is on the street
Three different problems wearing one coat
The loudest myth is that everyone outside is the same. The evidence says three populations, three fixes, and most of the wasted money comes from matching the wrong fix to the wrong person.
372
died homeless in Multnomah County in 2024
214 by overdose, 183 involving fentanyl. The first year-over-year decline since 2013 (Multnomah County Health Department / Street Roots).
Who is on the street
Multnomah 2023 count · 6,297 people
The count only separates chronic from not. The economic vs. episodic line inside the majority is a typology, not a measured split.
People pushed out by a rent hike, a lost job, a medical bill — no serious addiction or mental-illness barrier. Often homeless for the first time and not for long.
The right fix
Rapid rehousing — a unit plus light, short-term help.
The expensive mistake
Park them in expensive permanent supportive housing and you burn scarce, intensive resources on people who didn't need them.
Cost of the right fix, per household per year
≈ $8,486
rapid rehousing $8,486supportive housing $20,115
The transitional / episodic / chronic typology is Kuhn & Culhane (1998). Per-household costs are national averages (National Alliance to End Homelessness); the chronic share is Multnomah's 2023 count (Multnomah County).
04 · Twelve cohorts
The first placement has to match the person
A real offer is not a generic shelter referral. A family, a survivor, someone in withdrawal, and someone leaving jail each need a different first door, on a different clock. Housing First is one of those doors, not all of them.
Twelve cohorts, by the clock they run on
tap a row
Same day
hours
Capacity needed
- Family motel rooms
- Family shelter
- Childcare
- Rent subsidies
Who owns it
- County
- Schools
- State
Measure
- Unsheltered family nights
- School continuity
- Housing placement
24–72 hours
days
Before discharge or release
the institution's clock
30–90 days
weeks
90–180 days
months
Repeated, documented offers
no single deadline
September 9 update
Housing needs a clinical-capacity plan, too.
Local evidence · Council briefing, September 9, 2026
Behavioral-health needs follow people across the housing system.
The presentation’s high-acuity behavioral-health cohort is defined by a claims diagnosis of stimulant use disorder, opioid use disorder, psychosis, or unintentional substance-associated overdose. Our pathways describe the help someone needs now. These claims records describe diagnoses recorded for a population.
A recorded diagnosis is not a current clinical assessment. These figures do not estimate the share of homeless people who need inpatient care.
Overlap extends into permanent housing
Reported high-acuity share among people represented in each program:
Council behavioral-health presentation · September 9, 2026 · slide 8 ↗Housing and care can proceed together. Someone may need hospitalization today while housing planning begins immediately. A need for clinical care does not establish a general sobriety or treatment-completion requirement for housing. Psychiatric services also do not replace prevention or affordable homes.
Read the spending units and all program categories
| Service | High-acuity cohort | Comparison cohort |
|---|---|---|
| Emergency department | $81 | $16 |
| Medical inpatient | $389 | $54 |
These monthly averages are across cohort members, not costs per visit, hospital day or homeless person. The deck does not supply the observation period or full comparison-cohort exclusions. Medical inpatient spending is distinct from psychiatric inpatient spending. The difference is not an estimate of avoidable cost or savings from new psychiatric beds.
| Program | High-acuity share | Reported high-acuity count |
|---|---|---|
| Emergency shelter | 56% | 4,184 |
| Permanent supportive housing | 52% | 886 |
| Street outreach | 51% | 1,260 |
| Homelessness prevention | 13% | 1,718 |
| Transitional / treatment housing | 70% | 1,003 |
| Coordinated entry | 44% | 2,815 |
| Supportive services only | 40% | 2,253 |
| Rapid rehousing | 37% | 1,631 |
| Other | 35% | 1,043 |
| Permanent housing with services | 45% | 149 |
Do not sum categories, extrapolate to everyone outside, or interpret the percentages as need for institutional care. The transitional category is treatment housing; the slide notes alcohol-use disorder is outside this cohort definition.
Council behavioral-health presentation · September 9, 2026 · slides 7–8 ↗Conflicting estimates and claims awaiting clarification
Returns to homelessness: two published estimates
Council slide 9 reports 3.5× greater likelihood. An earlier County KPI document reports preliminary returns of 9% versus 5% (about 1.8×), across rapid rehousing, PSH and other long-term placements with services.
Unresolved comparison: periods, definitions, adjustment and follow-up coverage may differ. Neither estimate establishes a housing model’s causal effect. Request the underlying cohorts; do not present this as a measured worsening.
Council behavioral-health presentation · September 9, 2026 · slide 9; County KPI pp. 5–6 ↗County HRS KPI definitions · November 2025 planning document ↗Membership and costs: versions, not a trend
October 2025 Health Share guidance describes 8% of adult members and 24% of spending; the Council deck reports 9% and 29%.
The published definitions differ, and the deck omits its observation period. Do not plot a trend until the membership denominator and claims rules are reconciled.
Council behavioral-health presentation · September 9, 2026 · slide 7; Health Share strategy pp. 1–2 ↗Health Share HABH strategy · October 2025 ↗Mortality: comparator not supplied
Council slide 9 reports a fourfold mortality risk.
The slide does not specify the comparison population, period, absolute death rates or adjustment. Retain this as an attributed, unresolved claim rather than a headline or a forecast of deaths prevented.
Council behavioral-health presentation · September 9, 2026 · slide 9 ↗What the peer-reviewed local study adds
A study of 2023 Health Share adult members found a medical inpatient admission among 29.7% of housing-insecure members with the specified substance-use or psychotic disorders, compared with 12.4% of housing-secure members with those disorders. These are proportions within the two housing-status groups, not admission rates for Portland’s homeless population.
The study concerns the Portland tri-county service region. It excludes members without medical claims; housing insecurity is broader than street homelessness. Its cross-sectional association supports studying housing and health together, but does not establish causality or validate the deck’s retention or mortality multipliers.
Housing insecurity, behavioral health and acute care · Published April 27, 2026 · 2023 observations ↗Compare psychiatric care, addiction treatment, medical respite and bridge housing →
05 · The cost of doing nothing, and who holds it
Who pays for the current response—and what could change?
Homelessness carries health, emergency-response and public-service costs. Housing and care can change those costs, but spending avoided, capacity freed and cash available for another program are different outcomes. The financing map shows who pays and what would make reinvestment possible.
Street-cost figure is a central estimate; studies range from ~$35k a year (National Alliance to End Homelessness) to far higher for the costliest individuals. Federal matching rates describe funding shares, not an automatic split of savings. Payer mechanics: Oregon Health Authority, Oregon Health Authority. The full analysis is in the Civic Lab research memo “Who Pays for the Street.”
500
Leave them on the street$20M/yr
ER, jail, EMS, sanitation, across a dozen budgets
House them with support$10M/yr
rent plus case management
The street costs more by
$10M /yr
≈ $20,000 per person per year
The honest caveat: most of that saving is federal Medicaid money (ER and hospital care), not the city or county budget. Housing doesn't pay for itself locally; the fix is pulling the federal payer into funding what saves it money. Street figure $40,000, within a national range of $35,000–50,000.
Panel 1 · Who pays, and what changes when use falls
Financing mechanics reviewed September 9, 2026
Federal and state funds finance Medicaid. OHA pays CCOs predetermined monthly capitation amounts; the plans pay for covered care under their contracts. A reduction in claims does not immediately change that month’s capitation payment.
Funding shares and captured savings are different. Lower claims can affect plan finances under their risk arrangements and later rate-setting. The federal matching rate does not divide each avoided claim into federal savings and a CCO remainder.
OHA: OHP rate development · Reviewed September 9, 2026 ↗Federal Medicaid
Public funding rulesPays for
The federal matching share of eligible Medicaid expenditure
Possible financial effect
No automatic claim-by-claim share of savings under CCO capitation
Changes depend on payment arrangements, eligible expenditure and future rate-setting; federal financing is not a local reinvestment account.
OHA and the State
Public funding rulesPays for
State share, CCO capitation and applicable directly funded services
Possible financial effect
Budget effects depend on rates, contracts, service obligations and future appropriations
Identify the funding authority and recurring operating commitment separately from construction funding.
CCOs and health plans
Conditional reinvestmentPays for
Covered care under capitation, subcontracts and risk arrangements
Possible financial effect
Lower claims can affect plan finances; retained amounts depend on the contract
SHARE depends on financial conditions and spending requirements. Its housing priority does not automatically fund the County’s chosen pipeline. See the 2026 guidance below.
Hospitals
Has co-investedPays for
Staffed emergency and inpatient capacity, including uncompensated care
Possible financial effect
Changes in uncompensated care, costs and revenue vary by payer and service
Past housing co-investments provide precedents. New commitments require a service and financing agreement.
Multnomah County
Depends on actual costsPays for
Jail, County health and homelessness services
Possible financial effect
Variable costs or freed capacity may change; larger cash savings require actual budget changes
Fewer service episodes do not automatically release the fixed costs of an operating facility.
City of Portland
Depends on actual costsPays for
Emergency response, outreach, shelter and public-space services
Possible financial effect
Effects depend on staffing, deployment and costs actually avoided
Track service demand, outcomes and spending separately; better outcomes do not require an assumption of full financial payback.
Test the financing mechanism. A health benefit, reduced utilization, freed service capacity and money available to reinvest are different results. Identify the payer, risk arrangement, recurring costs and committed investment before claiming budget savings.
Panel 2 · Examples of investment and measured outcomes
Los Angeles County
$1.20
saved per $1, year one
County costs per person fell from $38,146 to $15,358; housing cost $15,288. The county health department paid for the housing because it was the payer that saved.
RANDPortland
−12%
Medicaid spend per resident
1,600 members across 145 properties after six health systems funded Central City Concern. ER visits −18%, inpatient −15%, primary care +20%.
Providence Center for Outcomes Research & EducationDenver
81%
still housed at two years
250 frequent jail users, $8.6M private capital. Services cost $6,876 a year less than the control group. The city repaid investors on outcomes because jail days are its cost.
Urban InstituteNorth Carolina
−$164
per member per month
31,000 people, verified savings, federal authorization through 2029. The legislature declined the state share in 2025 and the program suspended anyway.
North Carolina DHHSPanel 3 · Funding routes and their conditions
waiver ends Sept. 30, 2027 · work rules Jan. 1, 2027
Match each cost to an authorized benefit, eligible person and qualified provider. Check actual payment and avoid duplicate billing before reallocating local funding. Covered clinical services, rent assistance and capital follow different rules.
- 1
most durable
Identify services an eligible benefit covers
Clinical care, case management or tenancy support may be reimbursable when the benefit, person, provider and service meet the applicable requirements. Confirm authority, authorization, contracted rates and actual payment before replacing local funding. A benefit in another state does not establish Oregon coverage.
Varies by state-plan, waiver and contract authority
Oregon Health Authority - 2
durable
Secure a specific reinvestment commitment
SHARE can support qualifying housing investments, including eligible capital. The designation depends on financial conditions; spending must meet guidance, community-priority and partnership requirements. A housing priority is not an automatic earmark for the County’s pipeline. Verify the approved plan and funding commitment.
Review each CCO’s applicable financial calculation and spending plan
Oregon Health Authority - 3
time-limited
Help eligible households obtain rent benefits
Oregon’s HRSN benefit can provide qualifying households with time-limited rent support. Effective enrollment requires staffed outreach, documentation, eligibility decisions and payment follow-through. Budget those operations and measure rent actually paid; intake improvement is not cost-free.
Waiver ends Sept. 30, 2027; check eligibility and renewal decisions
Oregon Health Authority - 4
least controllable
Defend the federal housing grant, and plan for its loss
The $37.7M Continuum of Care grant is the region's permanent-supportive-housing backbone. Two 2026 court rulings blocked HUD's attempts to cap it. The FY2027 budget request would abolish the program; the House bill keeps it with a cut.
HUD weighing appeal; 2027 appropriation pending
National Association of Counties
Every door narrowed in 2025–26: CMS rescinded its housing-benefit guidance in March 2025, and Oregon expects 100,000–200,000 people to lose OHP once work requirements start. Loss of OHP can interrupt Medicaid-funded supports; it does not automatically eliminate HUD, local or other safety-net assistance.
Reduced demand may avoid variable costs or free capacity. Larger budget savings require actual changes in spending; they do not follow automatically from fewer visits or calls. Capital and continuing services need their own funding commitments.
06 · Deflection vs. treatment
A referral is not a treatment bed
Eligible drug-possession cases go to the Coordinated Care Pathway Center at 980 SE Pine instead of a citation (Multnomah County). Better than nothing. But follow the numbers down the funnel and count what “success” actually contained (Multnomah County).
Deflection, Jan–Mar 2026
full width = 79 referrals
Law-enforcement referrals
79
58 had not yet reached the 90-day mark when the quarter closed
Reached the 90-day window
the real denominator
21
12 did not complete
Successful 90-day completions
January 2026 definition
9
What “successful” contained
1
7
1
- 1 SUD / recovery only
- 7 SUD / recovery + care coordination
- 1 Care coordination only
Read it carefully. Eight of the nine reached substance-use or recovery services, so “success” here was not a pantry visit or one shelter night. But a completion is not a residential-treatment completion, and the snapshot does not claim it is.
The FY25 annual report used a broader completion definition that could include accessing any one recommended service (Multnomah County). The definition changed in January 2026, so quarters are not comparable across that line.
07 · The deepest problem
Which beds can someone actually use?
A June 2024 statewide study estimated a gap of about 3,714 behavioral-health residential and related beds (OHA / Public Consulting Group). That estimate is not today's shortage or a live vacancy count. Licensed, funded, staffed and accepting capacity need separate measures. A multi-million-dollar registry produced a handful of placements (Willamette Week), because a database is not a coordination system.
Bed visibility
3 of 5
things a field worker must know about a bed that no public system reports.
- Licensed · the bed is legally allowed to existreported
- Funded · someone is paying for itreported
- Staffed · there are workers to run itunreported
- Occupied · someone is in it right nowunreported
- Open tonight · a worker could place someone in it nowunreported
So the worker phones down a stale list while a suitable bed sits empty. The cheapest new bed in Oregon is the empty one nobody can see.
We're building the fix
PDX Help, a working prototype
Matches a specific person to the beds they are eligible for, with facilities reporting real openings. The prototype explores a specific placement workflow. Existing regional navigation and coordination programs provide foundations whose coverage and effectiveness still need evaluation.
08 · The continuum
What connects a shelter bed to a home that lasts?
A placement needs to fit the person, have funding and support, and become an actual arrival. The continuum guide makes those connections visible: four illustrative journeys, documented barriers, reported local costs, and the decisions that could help more people reach lasting housing. Housing work and care can happen together.
The handoff is part of the service
A shelter bed provides safety. A suitable home ends homelessness. Continuing support helps that home last. The system has to connect all three.
A suitable place
Temporary safety that fits the household.
A home
A real unit, a funded offer and a completed move.
Stability
Care and tenancy support that continue after move-in.
Shelter is optional. Housing work and care can happen together.
09 · What would actually work
Five moves, in order of speed
Pursue prevention, suitable housing, staffed care and reliable handoffs together. These priorities have different delivery timelines; their effects require measurement. The Council’s proposed 2027 behavioral-health agenda adds state payment, licensing and psychiatric-capacity decisions.
How fast each move starts working
The iron rule underneath: capacity precedes enforcement. You can't move someone off the street faster than you can build a place to put them.
- 1
Slam the inflow shut, precisely
weekscheapest per person kept housedThe cheapest 'reduction' is the person who never becomes homeless. Use time-limited eviction prevention for verified financial crises, paid directly to landlords, while preserving tools to remove dangerous or predatory tenants. Then stop institutions from releasing people from jail, hospital, or foster care straight to the street.
- 2
Make field triage immediate
monthssoftware + protocol, not constructionWhen someone says yes right now, a worker needs an eligible option in minutes: anonymous criteria, live or phone-confirmed availability, name check by phone, hold, transport, and outcome. That is the product gap PDX Help is built to close.
- 3
Build the missing continuum
yearscapital and staffingPortland needs more than shelter vs. apartment: overnight beds, 24-hour shelters, detox, residential treatment, opioid treatment, jail-discharge shelters, hospital step-down shelters, structured recovery cohorts, and supportive housing. Each has a different job.
- 4
Measure treatment, not vibes
monthsreporting rules, near-zero costDeflection, outreach, and shelter programs should report the real funnel: referral, engagement, service type, treatment admission, shelter arrival, housing exit, and retention. A contact is not a placement, and service access is not treatment completion.
- 5
Housing First, where it fits
yearscapital and ongoing servicesScattered-site housing and permanent supportive housing remain essential. But housing is one tier in a continuum, not a substitute for treatment, reentry, hospital step-down care, or structured recovery community.
See the proposed 2027 agenda, responsible decision-makers and milestones →
10 · The objections
The ones that survive a hostile hearing
An honest broker holds the strongest version of every objection. These five come up at every council meeting.
The objectionWhat the evidence says
01“Housing First means no rules — that's why it fails.”
Housing First removes the preconditions to qualify (you don't have to get sober first) — NOT the rules once you're housed. Tenants still sign standard leases and must meet ordinary obligations. The model sustains ~85–90% housing retention; the out-of-control-building failures are management and over-concentration problems, fixed by staffing and scattered-site placement.
02“Housing the homeless pays for itself.”
Overclaimed locally. The biggest cost savings are federal Medicaid (ER and hospital care), not the city or county budget — Portland and the county are mostly on the hook for jail, EMS, sanitation, and the homelessness budget. The honest fix is pulling the federal payer in, not pretending it nets out for local taxpayers.
03“Just force the addicts into treatment.”
You can't punish a status, can't force treatment without due process, and can't mandate people into beds that don't exist. The legal, effective version is a real treatment pathway: drug courts, deflection that actually reaches SUD care, pre-release planning, and narrow civil commitment where legally justified.
04“We spend over a billion dollars and nothing changes.”
Spending is real, but a balance that peaked near $431 million sat unspent across fragmented budgets while the system couldn't see itself, so effort flowed to the visible lever (units built) instead of the binding one (closing the inflow, staffing beds). The highest-leverage fix is making the machine legible.
05“Housing First is either the answer or the problem.”
Wrong frame. Housing First is a strong tool for people whose binding constraint is housing instability or chronic disability with services. It is not a detox bed, a jail-reentry plan, a hospital step-down unit, or a recovery community.
Retention and the entry-vs-rules distinction: National Alliance to End Homelessness. The aggregate-vs-individual critique: Manhattan Institute (Stephen Eide).
Sources & method
Where these numbers come from
The September 9, 2026 update adds Council materials and related behavioral-health research. Older evidence retains its own date; review dates are not observation periods. The flow model remains educational, and unresolved comparisons stay visible.
City Council briefing memo · September 4, 2026 ↗Council behavioral-health presentation · September 9, 2026 ↗County HRS KPI definitions · November 2025 planning document ↗Health Share HABH strategy · October 2025 ↗Housing insecurity, behavioral health and acute care · Published April 27, 2026 · 2023 observations ↗Health Share regional behavioral-health projects · Program descriptions reviewed September 9, 2026 ↗Health Share and partners’ investment announcement · February 8, 2024 ↗County original Homelessness Response Action Plan · 2024 plan · historical deadlines ↗Mink/Bowman court monitor’s third report · March 16, 2026 ↗Mink case documents · Listing reviewed September 9, 2026 ↗OHA: OHP rate development · Reviewed September 9, 2026 ↗OHA: 2026 SHARE guidance · 2026 guidance ↗OHA behavioral-health capacity investments · Dashboard reviewed September 9, 2026 ↗CCC Recuperative Care · Provider criteria reviewed September 2026 ↗County HSD adopted budget · FY2027 ↗Homeless Services Department Data Dashboard (by-name list)Multnomah County HSD · primaryFor the first time, Multnomah County shares a monthly count of people experiencing homelessnessMultnomah County · primaryBehind Portland's homelessness data, a familial, political fight emergesOPB · news2025 Tri-County Point-in-Time Count ReportPSU Homelessness Research & Action Collaborative · researchChronic homelessness falls across tri-county region (2023 PIT)Multnomah County · primarySupportive Housing Services — funding & financial reportsMetro · primaryMetro-area homelessness persists despite $1.3 billion raised since 2021Willamette Week · newsCounties, Metro surface major disagreement over homeless services taxWillamette Week · newsCounties report SHS measure has now housed 15,724 peopleMultnomah County · primaryEvicted in Oregon — eviction filing dataPortland State University (from OJD records) · researchDomicile Unknown — deaths of people experiencing homelessnessMultnomah County Health Department / Street Roots · primaryHomelessness Assistance GuideCity of Portland (Portland Solutions) · primaryPortland SolutionsCity of Portland · primaryPortland Street ResponseCity of Portland · primaryCommunity Health Assess & Treat (CHAT)Portland Fire & Rescue · primaryNorthwest Community ConservancyNWCC · primaryRecovery Navigation ProgramImpactNW · primaryShelter Services Data DashboardsCity of Portland · primaryBybee Lakes Hope CenterCity of Portland · primaryDeflection ProgramMultnomah County · primaryDeflection Program 2024-2025 Annual ReportMultnomah County · primaryDeflection Program FY26 Q3 Data SnapshotMultnomah County · primaryEnding Chronic Homelessness Saves Taxpayers Money ($35,578/yr)National Alliance to End Homelessness · researchWhere We Sleep: The Costs of Housing and Homelessness in Los AngelesEconomic Roundtable · researchUtah Reduced Chronic Homelessness By 91 Percent; Here's HowNPR · newsPortland Way Home — plan & cost analysisPortland Way Home · advocacyCost to Provide Housing First to All Households in Shelters (RRH $8,486 / PSH $20,115)National Alliance to End Homelessness · research2024 Annual Homelessness Assessment Report (AHAR) Part 1U.S. Department of Housing and Urban Development · primaryThe Truth About Housing FirstNational Alliance to End Homelessness · researchHousing First and Homelessness: The Rhetoric and the RealityManhattan Institute (Stephen Eide) · researchBehavioral Health Residential Facility Study (gap of ~3,714 beds)OHA / Public Consulting Group · researchGov. Kotek & OHA announce 465 added treatment beds by end of 2026Oregon Governor's Office / OHA · primaryMillions in OHSU behavioral-health coordination center has aided few patientsWillamette Week · newsOHP Health-Related Social Needs — housing benefitsOregon Health Authority · primaryOregon launches Medicaid program to help pay rentOPB · newsAdult Shelter Review FY25 (per-bed shelter costs)Multnomah County HSD · primaryMaster Leasing & Landlord Engagement NOFA (per-unit cost)Multnomah County JOHS · primaryCost of residential substance-abuse treatment (per week)French, Popovici & Tapsell, J. Subst. Abuse Treat. (2008) · researchFederal Medical Assistance Percentage (FMAP) and multiplier, FY2027KFF · research2022–2027 Medicaid 1115 Demonstration WaiverOregon Health Authority · primaryHealth-Related Social Needs (HRSN) covered servicesOregon Health Authority · primaryRescission of Guidance on Health-Related Social Needs (CMCS Informational Bulletin, Mar. 4, 2025)CMS · primary'Administrative collapse': advocates blame evictions on new OHA housing programOPB / The Lund Report · newsOregon Health Plan changes in late 2026 to 2028 (H.R. 1)Oregon Health Authority · primaryOHA analysis of H.R. 1: 100,000–200,000 Oregonians could lose coverageOregon Primary Care Association (reproducing OHA) · primary2026 SHARE Guidance (CCO reinvestment formula, OAR 410-141-3735)Oregon Health Authority · primaryCCO Guidance: Housing and Medicaid Spending Programs (Dec. 2025)Oregon Health Authority · primaryFY2024 Continuum of Care award report, Oregon (OR-501 $37.7M)U.S. Department of Housing and Urban Development · primaryCourt vacates FY2026 Continuum of Care grant changesNational Association of Counties · newsHUD FY2027 Budget Request: In BriefCongressional Research Service · primaryCounty adopts FY2027 budget: $67M Homeless Services gap, 605 shelter units closedMultnomah County · primaryEvaluation of Housing for Health Permanent Supportive Housing Program (LA County)RAND · researchHousing is Health: Medicaid outcomes for 1,600 Portland residentsProvidence Center for Outcomes Research & Education · researchDenver Supportive Housing Social Impact Bond: final outcome paymentsUrban Institute · researchHealthy Opportunities Pilots reduce Medicaid costs $164/member/month; program suspendedNorth Carolina DHHS · primaryFoundational Community Supports (Medicaid-billed supportive housing services)Washington State Health Care Authority · primary