Health Center and Supportive Housing Partnerships
Friday, April 10, 2015
Health Center and Supportive Housing Partnerships:
Connecting vulnerable frequent users of crisis healthcare to CHCs and supportive housing
By Deborah De Santis, President and CEO, CSH (Corporation for Supportive Housing)
[Note that housing as a social determinant of health will be a key theme in our Primary Care Conference May 16-19, including a tour of Central City Concern.]
The health sector is now a-buzz with the recognition that housing is a “social determinant of health.” At CSH, a leader in the supportive housing industry, we could not agree more.
We see housing as a platform for services for stabilizing the most vulnerable members of our society. People who are high-cost and frequent users of emergency departments, 911 systems, and costly inpatient hospitalizations are all too often homeless, with mental health and/or substance use issues to go along with serious physical health conditions.
The Affordable Care Act has provided many opportunities and incentives for the health care industry – including all health centers – to address these conditions and provide quality health care at reduced costs. Supportive housing is one intervention that, when targeted at the highest-cost consumers, can help achieve both goals.
The opportunity has arrived for health centers and hospitals to partner with housing providers – and vice versa – to redirect frequent users from emergency systems to the primary and behavioral health care offered by community health centers (CHCs), and to provide housing with wraparound support services in the community to help the targeted individuals on the road to recovery.
CSH, a HRSA-funded training and technical assistance provider, brings a combination of webinars and on-the-ground assistance to health centers to foster and expand health center coordination and collaboration with a wide range of partners - managed care, hospitals, state and local Medicaid agencies, behavioral health services, and supportive housing providers. Our goal is to help health centers streamline service delivery and improve healthcare outcomes for extremely low-income individuals who frequently use crisis health systems, have housing instability, and lack a connection to primary and preventive care services.
In Washington state, CSH has been working with Building Changes, an intermediary focused on ending homelessness in Washington state.
Building Changes has funded Westat, an external evaluator, to conduct a multi-year evaluation of the Washington Youth and Families Fund High-Needs Family Program, which includes an examination of the behavioral and physical health outcomes of families with high needs in permanent supportive housing. The evaluation includes input by supportive housing providers concerning the use of emergency departments by families with high-needs patients.
Preliminary findings from providers have pointed to key barriers that need to be addressed, including access issues at local CHCs and client perceptions of health center staff attitude toward homeless patients. Bridging the health care and housing practice culture differences by discovering shared goals for shared patients will help identify opportunities for establishing better partnerships with CHCs to coordinate care for formerly homeless, high-needs families.
In Oregon, Home Forward, the housing authority for the City of Portland and the surrounding county, has forged a unique partnership to connect high-cost health users in supportive housing at Bud Clark Commons with three local federally qualified health centers (FQHCs).
The FQHCs help conduct vulnerability assessments for housing and refer homeless frequent-user patients to Bud Clark. Residents stay connected with the health centers after moving in, and care is coordinated between the housing and health sides. For the FQHC run by Central City Concern, this arrangement provides the benefit of knowing what is happening with the most vulnerable patients even when they are not present at the clinic. This unique partnership is highlighted as part of CSH’s webinar series featuring health and housing partnerships.
If you would like to learn more about other featured partnerships, and the full training and technical assistance offerings from CSH, please visit our website at www.csh.org/hrsaTA or email us at CSHHRSA@csh.org.
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