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Card 11

How Is It Funded?

CVI funding differs from mobile crisis funding. There is no 911 call to bill. There is no clinical encounter that fits neatly into a Medicaid reimbursement code. What follows maps the documented funding sources, their structural gaps, and what the April 2025 federal contraction revealed about program fragility.

The Cost of the Status Quo

Each shooting generates emergency response costs exceeding $100,000 when police investigation, ambulance, emergency surgery, ICU stay, and follow-up are combined, per multiple economic analyses. Prosecution and incarceration cost $30,000 to $60,000 per year per person. Medical costs for a single gunshot injury range from $30,000 to $100,000.

Against those costs, the documented CVI returns: Baltimore’s Safe Streets returned $7.20 to $19.20 per dollar invested, per the Johns Hopkins evaluation covering operations from 2007 through 2022. Orlando’s Advance Peace saved taxpayers $8.3 to $8.9 million, per UC-Berkeley’s 2024 evaluation. The 2024 READI RCT produced $182,000 to $916,000 in social savings per participant, representing a 4-to-1 to 18-to-1 return on investment (p=.03), per the QJE publication.

The Structural Funding Mismatch

Angela Kimball of Inseparable, a national mental health and public safety advocacy organization, described the structural mismatch: cities pay police and fire departments for the capacity to be ready — officers are funded whether or not they respond to a call in a given hour. CVI programs are funded for active response — Medicaid reimburses billable encounters, grants fund specific deliverables. The unfunded gap, per Kimball’s analysis: training, supervision, travel time, community relationship-building, follow-up contacts below billing thresholds, and staff availability time.

Federal Funding: Expansion and Contraction

At the peak, the federal government proposed $15 billion in CVI funding, later reduced to $5 billion, per Reuters. A White House Office of Gun Violence Prevention coordinated investment. A February 2024 White House estimate credited CVI with contributing to the 12.4% national homicide decline.

In April 2025, the DOJ terminated more than 360 grants valued at $811 million, per Reuters and the Council on Criminal Justice. The White House Office closed. Baltimore’s ROCA lost $1 million overnight, per Baltimore Sun reporting. LifeBridge Health lost $1.2 million. Detroit’s FORCE lost approximately $2 million, per Bridge Michigan. Memphis HEAL 901’s executive director dipped into personal savings, per Stateline. A class-action lawsuit was filed in May 2025 but dismissed in July; the case is on appeal in the D.C. Circuit. The FY2026 federal budget proposes eliminating CVI grant funding entirely, per Giffords. ARPA funds, which provided roughly $2 billion for CVI across dozens of communities, must be fully spent by December 31, 2026.

Medicaid Reimbursement

Nine states have established Medicaid reimbursement for CVI services: California, Colorado, Connecticut, Illinois, Maryland, Michigan, New York, North Carolina, and Oregon, per HAVI tracking. Connecticut pioneered the pathway in 2021. Michigan became the ninth when Governor Whitmer signed legislation in January 2025.

Dr. Kyle Fischer, who advocated for Medicaid reimbursement “for more than a decade” through HAVI, has described the historical funding problem: CVI programs face “persistent challenges” from “short-term and often inconsistent funding sources” that “hindered their ability to reach programmatic sustainability,” per a Health Affairs article by Fischer, Morris, and Piening. The mechanism Fischer championed allows programs to “adapt and expand more easily when the need for their services grows,” per the same article.

Dr. Kyle Fischer described Medicaid reimbursement as providing “stability” for CVI programs but cautioned it is “not a panacea.” The limitations, per Fischer: Medicaid covers only Medicaid-eligible individuals and only billable encounters — not training, supervision, community canvassing, or organizational capacity.
Eligible Medicaid services include “peer support, psychological services, or case management” when provided to covered individuals. Connecticut pioneered the approach as “the first state in the nation to sponsor Medicaid reimbursement for community services to do violence intervention outreach,” per state reporting. The pathway provides “stability and certainty” that helps “shield a city’s violence prevention programs from the downstream effects of different political priorities,” per Fischer.

For programs in the nine Medicaid states, the pathway provides a revenue floor that federal grants do not: it is recurring, it scales with service volume, and it does not expire with a grant cycle. For programs in the other 41 states, Medicaid is not currently available.

State Funding

State CVI funding grew from $70 million across five states in 2017 to more than $520 million across thirteen states and Washington D.C. in 2024, per Giffords Law Center. Ohio appropriated $51 million under Republican Governor DeWine. Montana allocated $8 million. Indiana established competitive grants of up to $1 million per organization. Texas appropriated $2 million in its first-ever state CVI funding. Florida and South Carolina enacted new violence prevention funding in 2024, per Giffords.
Montana’s allocation includes $500,000 specifically for workforce development, per state reporting. Indiana created a competitive grant program offering up to $1 million per organization, per state reporting. North Carolina established a statewide Office of Violence Prevention under Governor Roy Cooper, who described the goal as replicating programs “across our state”.

Colorado voters approved a 6.5% tax on firearms and ammunition to fund victim services and violence prevention, implemented April 2025 and expected to generate approximately $39 million annually, per the Colorado Department of Revenue.

What state funding typically does not cover, per multiple program reports: organizational capacity infrastructure — supervision, trauma support, office space, data systems, and administrative overhead. A state grant that pays for credible messengers’ salaries but not for the organizational infrastructure around them creates the same capacity gap Kimball described.

Local Government Funding

Dallas allocated $1.6 million with Mayor Eric Johnson’s support. Louisville invested significant city funding with Mayor-elect Craig Greenberg pledging to “fully implement a community violence intervention plan”. Pittsburgh committed $50 million to support 13 local nonprofit CVI programs.
Louisville, Philadelphia, and Baltimore have embedded CVI in their budgets as permanent line items, per city government reporting. Those programs proved more durable when federal funding contracted in April 2025.

Philanthropic and Private Sector Funding

Chicago’s $400 million public-private partnership includes support from Hyatt Hotels (CEO Mark Hoplamazian stated: “Our goal is to be the safest big city in America,” per the Chicago Tribune), Crown Family Philanthropies, and multiple foundations. More than 40 companies in 17 industries hire CVI program graduates. Blommer Chocolate Senior VP Bob Karr wrote in a 2023 Chicago Tribune op-ed: “Business leaders cannot sit back and hope that others will solve crime.”
Karr’s full statement, per the Chicago Tribune: “Our hardworking police enforce the laws to the best of their ability. Organizations like Chicago CRED give young people at risk the guidance to choose a pathway out of danger. But we can give them a paycheck and a career.”

Hospital-Based Funding

HVIP programs can potentially bill for services delivered during a hospital stay — bedside crisis intervention, safety planning, discharge coordination — as part of the patient’s medical care, per the HAVI. Connecticut specifically enables Medicaid billing for violence intervention outreach in hospital settings.

What Each Funding Source Does Not Cover

No single funding source covers the full cost of a CVI program, per the structural analysis described by Kimball and Fischer.

Medicaid covers billable clinical encounters for enrolled individuals — not training, supervision, community presence, or non-enrolled participants. Federal grants provided startup capital — they are time-limited and currently contracting. Programs that treated them as operational funding were the most exposed when the 2025 contraction hit, per Stateline (May 2025) and Bridge Michigan reporting. State appropriations typically fund operations but not organizational capacity infrastructure. Philanthropic funding provides flexibility but depends on donor priorities that shift.

The programs that survived the 2025 contraction had built at least three revenue sources from different levels of government and different sectors, per reporting across Baltimore, Chicago, and Orlando.

Training pipeline costs represent a specific unfunded gap. The University of Chicago Leadership Academy takes six months per cohort, per the Chicago Defender. During that period, trainees do not generate billable encounters or grant deliverables. The training cost — salaries, instruction, materials, facilities — must be funded separately.

The Cost of Inaction vs. the Cost of CVI

The cost components documented across economic analyses: emergency response to a single shooting exceeds $100,000 (police investigation, ambulance, emergency surgery, ICU stay, follow-up). Prosecution and incarceration cost $30,000 to $60,000 per year per person. Medical costs per gunshot injury range from $30,000 to $100,000. Lifetime productivity losses from a single homicide exceed $1 million, per CDC and Bureau of Justice Statistics economic analyses. National analyses have found that the criminal justice response to violence costs approximately four times more than prevention-based intervention, per the Juvenile Justice Information Exchange (Keren Landman, June 4, 2020). https://jjie.org/2020/06/04/studies-showing-that-violence-prevention-saves-cities-money-lots-of-money/

Against those costs, the documented CVI returns consistently exceed the program investment. Indianapolis’s Prescription for Hope documented that reducing repeat violent injury from 8.7% to 3% generates significant medical cost savings alone, per a 2018 evaluation. The medical savings from a single prevented reinjury can exceed an entire year of program costs for the participant.

Additional City Investment Models

Dallas allocated $1.6 million with Mayor Eric Johnson’s support. Louisville invested significant city funding with Mayor-elect Craig Greenberg pledging to “fully implement a community violence intervention plan”. Pittsburgh committed $50 million to support 13 local nonprofit CVI programs, with Focus on Renewal receiving $1.3 million specifically for a “job coach and supervisor” and securing commitments from “at least 20 local businesses” to hire participants.

Montana’s allocation includes $500,000 specifically for workforce development, per state reporting. Indiana created a competitive grant program offering up to $1 million per organization. North Carolina established a statewide Office of Violence Prevention under Governor Roy Cooper. These state-level investments represent a growing infrastructure that operates independently of federal funding cycles.

Grant Funding and Private Sector Mechanisms

Orlando received $1.5 million in federal grants to expand from five to eight neighborhoods before the federal cuts. The Medical University of South Carolina launched its CVI program with grant support aimed at “reducing overall crime in identified hot spots, reducing interpersonal violence, reducing gun violence and reducing gang participation,” per the university.

The Albuquerque Foot Locker partnership illustrates a non-traditional mechanism: the company provides not just shoes but “therapy and a safe space to talk to peers” for high-risk students, per the Albuquerque Journal. Bob Karr’s full statement in his Chicago Tribune op-ed: “Our hardworking police enforce the laws to the best of their ability. Organizations like Chicago CRED give young people at risk the guidance to choose a pathway out of danger. But we can give them a paycheck and a career.”

The Current Funding Reality

As of early 2026, the documented funding landscape: programs in the nine Medicaid states (per HAVI) with diversified local and state support have a documented survival path. Programs dependent on federal grants face documented closure risk. ROCA lost $1 million overnight (per Baltimore Sun). FORCE Detroit lost approximately $2 million (per Bridge Michigan). Fresno’s Advance Peace lost $2 million (per CalMatters). Oakland’s Youth ALIVE!, operating what multiple sources describe as the nation’s first hospital-based violence intervention program, lost $2 million. Memphis HEAL 901 had its $1.7 million grant canceled after receiving only $150,000 — the executive director dipped into personal savings to keep 14 staff members on payroll (per Stateline).

The Community-Based Public Safety Collective, which was providing technical assistance to 95 federal grantees — the national infrastructure for new CVI program implementation — lost its cooperative agreement entirely (per the Brennan Center). The compound effect of ARPA expiration ($2 billion, deadline December 31, 2026), DOJ grant terminations ($811 million, per Reuters), and the proposed FY2026 CVIPI elimination (per Giffords) creates compound pressure on programs. Programs that built sustainability plans around replacing one federal source now face the loss of multiple sources simultaneously.

State CVI funding grew from $70 million across five states in 2017 to more than $520 million across thirteen states and Washington D.C. in 2024, per Giffords Law Center — a trajectory that, if sustained, represents a more durable funding architecture than the federal grant system it increasingly replaces.

Connecticut pioneered Medicaid reimbursement in 2021 as “the first state in the nation to sponsor Medicaid reimbursement for community services to do violence intervention outreach,” per state reporting. Programs can bill for “peer support, psychological services, or case management” when provided to covered individuals. Michigan became the ninth state when Governor Whitmer signed legislation in January 2025. Colorado, New York, and Pennsylvania have also implemented reimbursement pathways.
The bipartisan dimension provides a partial counterweight to federal withdrawal. Ohio’s $51 million came under Republican Governor DeWine. Montana’s $8 million came from conservative governance. Texas appropriated $2 million in its first-ever state CVI funding. Florida and South Carolina enacted new violence prevention funding in 2024, per Giffords. Colorado voters approved a 6.5% tax on firearms and ammunition expected to generate approximately $39 million annually, per the Colorado Department of Revenue. A 2024 national survey found 76% bipartisan support for federal CVI funding. These state-level developments document a funding infrastructure that operates independently of any single federal decision.

Bottom Line

CVI funding is structurally more fragile than CVI outcomes justify. The cost-benefit evidence is documented: $7-$19 returned per dollar invested in Baltimore (Johns Hopkins), 4:1 to 18:1 in Chicago (QJE 2024). But the funding architecture does not match the program architecture. Angela Kimball of Inseparable described the core mismatch: CVI depends on capacity that encounter-based and deliverable-based funding does not cover. Dr. Fischer described Medicaid as “stability” but “not a panacea.” The programs that survive braid multiple streams — Medicaid where available (nine states, per HAVI), state appropriations, local general fund, philanthropic investment, and federal grants as startup capital. The programs that collapse depend on a single source. The April 2025 DOJ termination of more than 360 grants ($811 million, per Reuters), the FY2026 proposal to eliminate CVI funding entirely (per Giffords), and the December 2026 ARPA deadline compound the federal vulnerability.

Source Appendix

  1. Cost of violence — >$100K per shooting, $30-60K prosecution/year. Multiple economic analyses.
  2. Baltimore ROI — $7.20-$19.20. Johns Hopkins, 2007-2022. https://www.thebanner.com/community/criminal-justice/safe-streets-penn-north-JLZH6TGFJFAYHCIIMMTT4J4OD4/
  3. Orlando savings — $8.3-$8.9M. UC-Berkeley, 2024. https://www.clickorlando.com/news/local/2024/08/01/gun-violence-reduced-in-orlando-neighborhoods-due-to-intervention-program-heres-how/
  4. READI cost-benefit — $182K-$916K, 4:1-18:1 (p=.03). Heller et al., QJE, 2024.
  5. Kimball / Inseparable — capacity vs. encounter mismatch. The Guardian interview with Fischer; Health Affairs article.
  6. Fischer — “stability” and “not a panacea.” Health Affairs Forefront (Fischer, Morris, Piening). https://www.healthaffairs.org/content/forefront/expand-medicaid-s-investment-community-violence-intervention Also: The Guardian, Sonya Singh, June 7, 2023. https://www.theguardian.com/us-news/2023/jun/07/gun-violence-medicaid-california-intervention-program
  7. Federal funding — $15B proposed, $5B allocated, 12.4% estimate. Reuters. White House, February 2024.
  8. DOJ terminations — 360+ grants, $811M, city impacts. Reuters, April 2025. Council on Criminal Justice. NPR, November 2025. Stateline, May 2025.
  9. Lawsuit, FY2026, ARPA deadline. Law360. Giffords, September 2025.
  10. Medicaid — 9 states, HAVI tracking. https://www.thehavi.org/ Michigan: Governor Whitmer, January 2025.
  11. State CVI funding — $70M→$520M. Giffords, January 2025. https://giffords.org/
  12. Ohio $51M, Montana $8M, Indiana grants, Texas $2M, FL/SC 2024. State reporting. Giffords.
  13. Colorado tax — 6.5%, April 2025, ~$39M/year. Colorado Department of Revenue.
  14. Louisville, Philadelphia, Baltimore — general fund. City government reporting.
  15. Chicago $400M — Hoplamazian quote. Chicago Tribune, February 2024.
  16. CRED — 40+ companies, Karr quote. Chicago Tribune, July 2023.
  17. HAVI — HVIP billing pathways. https://www.thehavi.org/
  18. Leadership Academy — six months per cohort. Chicago Defender, September 2023.
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