A Call to Action: Pathways to 38 offers a bold vision for supportive housing in Pennsylvania

By Brian McShane 

Pennsylvania is at a crossroads. Across the Commonwealth, tens of thousands of residents face daily instability, not because they lack resilience or drive, but because they lack one fundamental necessity: a safe, stable place to live. From individuals experiencing chronic homelessness to families entangled in the child welfare system, from veterans to survivors of domestic violence, the need for supportive housing is urgent and undeniable. 

The bold but achievable vision is this: Create 38,000 new units of supportive housing over the next 20 years to meet the needs of Pennsylvanians with disabilities and complex health needs. This is not just a number — it is infrastructure that supports independence, reduces public costs, and benefits us all. It is a roadmap to stronger and more stable communities across Pennsylvania. And it is a call to action for policymakers, advocates, and residents alike. 

The Crisis We Can’t Ignore 

Supportive housing is a proven intervention that combines affordable housing with wraparound services including mental health care, substance use treatment, case management, and more. More than three decades of evidence demonstrates that supportive housing helps people with disabilities and complex health needs live with stability and independence. It is especially critical for those with extremely low incomes (often less than $1,500 per month) and high needs for services that keep them stable, healthy, and thriving. 

Pennsylvania faces a staggering shortfall in supportive housing. According to estimates, the state needs at least 38,000 units — a number that reflects not just homelessness, but the broader spectrum of housing insecurity affecting people with chronic mental health issues, individuals with substance use disorders, families involved in child welfare, individuals with intellectual and developmental disabilities, and other members of the community in need of housing and support.  

This shortfall forces many into institutional settings or cycles of crisis that strain public systems and fail to meet individual needs. It is a system that costs more, overburdens first responders and health care professionals, and delivers less. The Pennsylvania Supportive Housing Coalition has worked to analyze supportive housing budgets and has determined that this intervention is a more cost-effective way to address the needs of those who might otherwise be reliant on institutional care.  

Supportive Housing Works 

Supportive housing is not just the most ethical way to address and reduce homelessness, it is also the most fiscally responsible and cost-effective. Studies consistently show that every dollar invested in supportive housing programs saves $1.44 in public spending. That is because stable housing reduces reliance on emergency rooms, shelters, jails, and other crisis services. 

In Pennsylvania, one year of supportive housing costs less than nine days in a hospital or four months in prison. If the money is to be spent, what will Pennsylvanians get for it? The choice is clear: Ongoing increases in homelessness and strained institutions versus strong and vibrant communities for everyone.  

People with stable housing are better neighbors. They engage in their communities, access care proactively, and avoid public crises. Supportive housing improves health outcomes, reduces incarceration, and fosters community integration. It’s a win-win for individuals and for neighborhoods. 

The Cost of Business as Usual  

A preliminary cost analysis based on actual developments in Pennsylvania is as follows: 

• DEVELOPMENT COSTS:  
   $458,000 to $585,000 per unit  

• OPERATING COSTS:  
   $8,460 to $10,244 per unit annually  

These figures reflect the realities of land acquisition, construction, staffing, maintenance, and utilities. Simply put, it is just as expensive to build supportive housing as it is any other type of housing. However, supportive housing is designed to enable those with the lowest incomes, disabilities, and complex health needs to become more independent and contribute back to their communities. Supportive housing tenants consistently contribute 30 percent of their income towards rent. However, because many tenants earn between 0 and 30 percent of the Area Median Income (AMI), their rent contributions fall significantly below market rates. This creates a structural funding gap that rent alone cannot fill. To ensure the sustainability of supportive housing projects, it is essential to cover rent shortfalls, building operations, and the cost of supportive services. While the upfront investment is significant, the long-term savings in reduced emergency service use, improved health outcomes, and increased community stability are even greater. 

Without decisive action, Pennsylvania will remain dependent on fragmented systems and crisis-driven responses at a cost measured not only in dollars, but in disrupted lives and strained communities. 

Learning from Others 

One of the most striking findings in Pathways to 381 is how Pennsylvania lags behind peer states. While other communities have embraced innovative solutions, Pennsylvania’s progress has often been marginal. This is true even though there are dedicated efforts from state agencies, local and county governments, and a vast array of local development and supportive services experts. We have the people and expertise to employ resources and become a national leader in this space. In Pennsylvania, we know how to build housing really well. We know how to employ evidence-based practices to support those who need them. Communities across the Commonwealth simply lack the resources that other states have invested to address this need.  

The good news? Pennsylvania doesn’t have to reinvent the wheel. There is a concise and actionable menu of funding and policy recommendations, drawn from successful models across  

the country. These include: 

• Leveraging federal and state funding streams  

• Streamlining zoning and permitting processes  

• Expanding Medicaid reimbursement for supportive services  

• Creating dedicated funding for operating costs  

• Building cross-sector partnerships between housing, health, and human services  

• Enhancing and standardizing data collection, sharing, and public access  

Each recommendation is backed by evidence and examples. Together, they form a blueprint for scalable, sustainable progress. 

Governor Josh Shapiro has championed an “all of the above” approach to state policy — one that mobilizes every part of government to tackle complex challenges. If we are to address the gap in supportive housing that our communities are experiencing, that same philosophy can and should be applied to housing. 

Supportive housing is not a niche issue. It touches health care, criminal justice, education, and economic development. It affects every corner of the Commonwealth. Solving this crisis requires all-hands-on-deck collaboration across agencies, alignment of funding, and bold leadership. 

As the Governor likes to say, it is about “getting stuff done.” And there is no better place to start than with housing. 

The Human Impact 

Behind every statistic is a story. A veteran sleeping in his car. An individual with mental illness struggling to connect to care. A mother fleeing domestic violence with nowhere to go. A young adult aging out of foster care without a safety net. These are not isolated cases: They are the faces of systemic failure. 

Supportive housing offers more than shelter. It offers hope. It offers stability. It offers a chance to rebuild. 

And when individuals thrive, communities thrive. Neighborhoods become safer, schools become stronger, and public systems become more efficient. 

The goal of 38,000 supportive housing units is ambitious, but it is achievable. This need is a challenge that demands urgency, innovation, and collaboration. But it is also an opportunity to build a more equitable, resilient Pennsylvania. 

We have the tools. We have the expertise. We have models. We have the need. 

Now we need the will 

Let’s make Pennsylvania a leader in supportive housing. Let’s invest in people. Let’s build communities where everyone has a place to call home, homeless encampments are a thing of the past, and individuals and families with disabilities and complex health needs can be active and contributing members of healthy neighborhoods. 

If you are interested in helping to create the supportive housing opportunities that our communities need or want access the full Pathways to 38 report, please visit the the Pennsylvania Supportive Housing Coalition website: www.csh.org/about-csh/where-we-work/pa-supportive-housing-coalition/.   

BRIAN MCSHANE is the Associate Director for Pennsylvania and New Jersey for the Corporation for Supportive Housing. 

CITATIONS  

1. https://www.thecommunityguide.org/media/pdf/he-ajpm-ecrev-housing-first.pdf  

2. https://www.kff.org/health-costs/state-indicator/expenses-per-inpatient-day/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D  

3. https://www.pa.gov/content/dam/copapwp-pagov/en/cor/documents/resources/statistics/budget-documents/Cost-Per-Day-FY-21-22.xlsx