Agreement for a Social Impact Partnership Project

<NOTICE> DEPARTMENT OF THE TREASURY <SUBJECT>Agreement for a Social Impact Partnership Project</SUBJECT> <HD SOURCE="HED">AGENCY:</HD> Department of the Treasury. <HD SOURCE="HED">ACTION:</HD> Notice. <SUM> <HD SOURCE="HED">SUMMARY:</HD> In accordance with the Social Impact Partnerships to Pay for Results Act (“SIPPRA”), the U.S. Department of the Treasury (“Treasury”) has entered into six agreements for social impact partnership projects (the “Project Grant Agreement”) with the following recipients; (1) City of Boise, ID ($7.5 million), (2) City of Jacksonville, FL ($5.8 million), (3) City of New York, NY ($6.3 million), (4) School Board of Leon County, FL ($4.6 million), (5) County of New Castle, DE ($11 million), and (6) County of Spartanburg, SC ($11.5 million) for a total award amount of $46.9 million. </SUM> <SUPLINF> <HD SOURCE="HED">SUPPLEMENTARY INFORMATION:</HD> <HD SOURCE="HD1">The Project Grant Agreement for the City of Boise, ID (Boise) Contains the Following Features</HD> <E T="03">1. The outcome goals of the social impact partnership project:</E> Boise expects to realize a reduction in healthcare expenditures covered by Medicaid, including emergency room visits, hospital overnight stays, ambulance rides, detox visits, and savings due to a reduction in arrests and cost associated with county correctional facilities. The project objective is to decrease these expenditures by 25 percent. <E T="03">2. A description of each intervention in the project:</E> Boise and its partners (the Idaho Community Foundation (ICF), and Terry Reilly Health Services (TRHS)) propose the Permanent Supportive Housing Pipeline Pay for Success project (the PSHP). The PSHP will provide Permanent Supportive Housing (PSH) and services using an Intensive Case Management (ICM) model including wrap-around services to 143 prioritized households who are experiencing long-term homelessness and have high service needs. These households are at increased risk for avoidable, high-cost service utilization paid through local, state, and federal outlays. <E T="03">3. The target population that will be served by the project:</E> The target population is households with and without children experiencing long-term homelessness with at least one household member with at least one morbidity condition (chronic health condition, mental health condition, or substance use) in Ada County, Idaho. In Ada County, 765 households meet these criteria. Boise expects the project to reach 159 adults and 64 children. <E T="03">4. The expected social benefits to participants who receive the intervention and others who may be impacted:</E> The primary expected social benefits from the project include: • Reduced rate of homelessness among the most vulnerable populations; • Reduced utilization of emergency medical services; • Decreased criminal justice involvement; and • Increased housing stability and retention. <E T="03">5. The detailed roles, responsibilities, and purposes of each Federal, State, or local government entity, intermediary, service provider, independent evaluator, investor, or other stakeholder:</E> <GPOTABLE COLS="3" OPTS="L2,nj,tp0,i1" CDEF="xs90,r25,r75"> <TTITLE> </TTITLE> <CHED H="1">Role</CHED> <CHED H="1">Entity</CHED> <CHED H="1">Responsibilities</CHED> <ROW> <ENT I="01">Government</ENT> <ENT>City of Boise, ID</ENT> <ENT> Repay investors with SIPPRA funds if performance benchmarks are met. Coordinate with the Treasury program team on administration of the program. </ENT> </ROW> <ROW> <ENT I="01">Intermediary</ENT> <ENT>n/a</ENT> <ENT>n/a.</ENT> </ROW> <ROW> <ENT I="01">Service Provider</ENT> <ENT>Terry Reilly Health Services</ENT> <ENT> Facilitate housing accesses with program enrollment into program using coordinated entry referrals. Provide intensive case management. </ENT> </ROW> <ROW> <ENT I="01">Independent Evaluator</ENT> <ENT>Idaho Policy Institute (IPI), Boise State University</ENT> <ENT>Evaluate the project using a regression discontinuity design.</ENT> </ROW> <ROW> <ENT I="01">Investor</ENT> <ENT>Idaho Community Foundation</ENT> <ENT>Provide the upfront capital for the program from the Supportive Housing Investment Fund (SHIF).</ENT> </ROW> </GPOTABLE> <E T="03">6. The payment terms, the methodology used to calculate outcome payments, the payment schedule, and performance thresholds:</E> Boise will be eligible for a payment from Treasury if there is a statistically significant difference between the treatment and the comparison group at the 80 percent level using the evaluation design strategy defined below. Boise is eligible to be paid each year from June 2028 to June 2032 for a total of five eligible payments. <E T="03">7. The project budget:</E> <GPOTABLE COLS="10" OPTS="L2,nj,tp0,p7,7/8,i1" CDEF="s30,8,9,9,9,9,9,9,9,10"> <TTITLE> </TTITLE> <CHED H="1">Project budget</CHED> <CHED H="1">Year 0</CHED> <CHED H="1">Year 1</CHED> <CHED H="1">Year 2</CHED> <CHED H="1">Year 3</CHED> <CHED H="1">Year 4</CHED> <CHED H="1">Year 5</CHED> <CHED H="1">Year 6</CHED> <CHED H="1">Year 7</CHED> <CHED H="1">Total</CHED> <ROW> <ENT I="01">TRHS (Family)</ENT> <ENT>$254,719</ENT> <ENT>$764,157</ENT> <ENT>$802,365</ENT> <ENT>$842,483</ENT> <ENT>$884,608</ENT> <ENT>$928,838</ENT> <ENT>$975,280</ENT> <ENT>$341,348</ENT> <ENT>$5,793,798</ENT> </ROW> <ROW RUL="n,s"> <ENT I="01">TRHS (Adult)</ENT> <ENT/> <ENT>488,710</ENT> <ENT>1,172,903</ENT> <ENT>1,231,548</ENT> <ENT>1,293,125</ENT> <ENT>1,357,782</ENT> <ENT>1,425,671</ENT> <ENT>498,985</ENT> <ENT>7,468,723</ENT> <E T="03">8. The project timeline:</E> There is a seventy-six month-intervention period for the project term to provide IPI with the maximum allowed period to evaluate the impact of this project on the SIPPRA outcome of reduced net federal, state, and local expenditures. The project will begin the intervention in September 2025 and end in December 2031. <E T="03">9. The project eligibility criteria:</E> Eligible households must have at least 12 points from the Length of Time and at least 3 points from the Tri-Morbidity sections of the PSHP Prioritization Formula outlined in Table 2. Those households that are both eligible for the PSHP and score the highest on the prioritization formula will be referred for enrollment. Ties will be broken in through coordinated clinical discretion, driven by self-reported health and criminal data and corroborating system utilization data available at the time of referral. <GPOTABLE COLS="4" OPTS="L2,nj,tp0,p7,7/8,i1" CDEF="s50,r50,r50,xs100"> <TTITLE> </TTITLE> <CHED H="1">PSHP prioritization formula</CHED> <CHED H="1">Factor 1</CHED> <CHED H="1">Factor 2</CHED> <CHED H="1">Factor 3</CHED> <ROW> <ENT I="01">Length of Time Homeless: 22 points max</ENT> <ENT>1 point every month up to 12 months</ENT> <ENT>1 point for every year up to 10 years (10 max)</ENT> </ROW> <ROW> <ENT I="01">FUSE Functionality: 10 points max</ENT> <ENT>5 points max: number of emergency medical interactions</ENT> <ENT>5 points max: # criminal justice interactions</ENT> </ROW> <ROW> <ENT I="01">Tri-Morbidity: 9 points max</ENT> <ENT>3 points: chronic illness</ENT> <ENT>3 points: mental illness</ENT> <ENT>3 points: substance use.</ENT> </ROW> <ROW> <ENT I="01">DV survivor: 6 points max</ENT> <ENT>3 points: DV within last 6 mo</ENT> <ENT>3 points: currently fleeing DV</ENT> </ROW> <ROW> <ENT I="01">Dependents: 6 points max</ENT> <ENT>2 points: any dependents in household</ENT> <ENT>1 point: kids 6-18</ENT> <ENT>2 points: kids aged 0-5.</ENT> </ROW> <ROW> <ENT I="01">Age: 6 points max</ENT> <ENT>2 points: 18-24 yrs</ENT> <ENT>4 points: 55-61 yrs</ENT> <ENT>6 point: 62+ yrs.</ENT> </ROW> <ROW> <ENT I="01">Unsheltered: 2 points max</ENT> <ENT>1 point: HoH has been unsheltered more than 50% of last 6 months</ENT> <ENT>1 point: HoH facing persistent barriers in assessing emergency shelters</ENT> </ROW> <ROW> <ENT I="01">Income Level: 2 points max</ENT> <ENT>1 point: household sustainable income is at 30% AMI</ENT> <ENT>2 points: household has zero sustainable income</ENT> </ROW> <ROW> <ENT I="01">Discrimination: 1 point</ENT> <ENT>1 point: experienced discrimination based on protected class</ENT> </ROW> </GPOTABLE> <E T="03">10. The evaluation design:</E> To determine significance of impact, IPI will employ the following evaluative strategies: (1) a regression discontinuity, (2) Analysis of Variance (ANOVA) omnibus test, and (3) paired pairwise t-test. To determine the amount of any net reductions in local, state, and federal expenditures, IPI will facilitate collection of the utilization and costs data for 36 months prior to Participants entering the intervention (time 0) and annually thereafter. To determine the amount of any net reductions in expenditures, IPI will compare the associated utilization costs for enrolled Participants against those not enrolled using individual-level data. <E T="03">11. The metrics that will be used in the evaluation to determine whether the outcomes have been achieved as a result of each intervention and how these metrics will be measured:</E> The metrics used will be: • Reduction in costs related to arrests and jail. • Reduction in costs related to the number of days in mental health and substance abuse treatment. • Reduction in costs associated with paramedic calls, emergency department visits, and days in the hospital. <E T="03">12. The estimate of the savings to the Federal, State, and local government, on a program-by-program basis and in the aggregate, if the agreement is entered into and implemented and the outcomes are achieved as a result of each intervention:</E> The estimated savings to the federal government are $12,434,017. The estimated savings to the State of Idaho are $4,034,880 ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Preview showing 10k of 47k characters. 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