This report presents findings from the impact evaluation of California’s Veterans Support to Self-Reliance initiative, which is designed to provide enhanced supportive services to veterans living in permanent supportive housing. The authors documenting trends in service utilization and well-being outcomes, including health-related behaviors, health care utilization, social support and connectedness, and perceived quality of life.

Veterans Support to Self-Reliance Pilot Program

Final Evaluation Report

Maya Buenaventura, Ben Senator, Sarah B. Hunter

ResearchPublished Sep 30, 2026

This research was made possible by a grant from Swords to Plowshares.

Topline

California’s Veterans Support to Self-Reliance pilot kept formerly homeless veterans housed at a fraction of the cost of nursing facilities or assisted living—and their health outcomes improved.

More than 9,000 veterans experienced homelessness in California in 2024, and roughly 69 percent of the state's veteran population is 55 or older. Veterans who have experienced chronic homelessness often arrive in permanent supportive housing (PSH) with serious health and functional challenges that standard subsidies and case management may not fully address.

In 2023, the California Department of Veterans Affairs (CalVet) launched the Veterans Support to Self-Reliance (VSSR) pilot at 13 PSH locations across six counties. RAND researchers evaluated whom the pilot reached, how participants fared over three years, and what it cost relative to alternatives.

Key Takeaways

Housing stability was the pilot’s strongest result.

Only 20 of 560 participants exited to an unstable situation over three years—an adverse exit rate of 3.6 percent, compared with 15 percent reported for a comparable veteran population.

Acute health events dropped sharply in the first year.

Falls fell 59 percent, emergency medical visits fell 75 percent, and the share of residents with no acute events rose from 74 to 90 percent.

Residents’ health behaviors improved.

Missed medical appointments fell 54 percent, the share eating three meals daily rose from 37 to 53 percent, and alcohol, stimulant, and opioid use each fell 40 percent or more.

VSSR costs less than every residential alternative.

Total public investment ran roughly $42,800 to $66,200 per veteran per year—23 to 50 percent below assisted living and between one-quarter and just under one-half the cost of semi-private nursing facility care.

Recommendations

CalVet and grantee organizations should:

  • Prioritize peer support specialist and service assistant roles in any continuation or successor program; all four grantees rated these highest-value, and the group programming they enable is associated with fewer habitability complaints and more time outside residents’ units.
  • Close remaining unmet need in housekeeping, which was reported by 13 percent of residents at the end of their first year, along with meal preparation and laundry, each near 7 percent.
  • To enable a future causal evaluation, establish a data linkage with the U.S. Department of Veterans Affairs and regional Homeless Management Information Systems to build a propensity-matched comparison group of veterans who did not receive VSSR services.
  • Report VSSR’s negative exit rate against published Continuum of Care benchmarks, noting that exit destination data can be unreliable.

Methodology

RAND researchers analyzed program data from 560 veterans enrolled in the VSSR pilot between June 2023 and May 2026. The evaluation included descriptive analysis of participant characteristics and housing exits; mixed-effects models linking quarterly service use to health and housing outcomes; and paired survey comparisons tracking self-rated quality of life, health, and housing conditions over time. Researchers also estimated annual cost per veteran using grantee expenditure data and compared those figures with California residential care alternatives. Semistructured interviews with leadership at all four grantee organizations and a structured review of 16 evaluations of housing interventions informed recommendations for a future causal evaluation.

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Buenaventura, Maya, Ben Senator, and Sarah B. Hunter, Veterans Support to Self-Reliance Pilot Program: Final Evaluation Report. Santa Monica, CA: RAND Corporation, 2026. https://www.rand.org/pubs/research_reports/RRA4660-1.html.
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This research was funded by a grant from Swords to Plowshares. This work was conducted in the Infrastructure and Justice Program of RAND Education, Employment, and Infrastructure.

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