Keeping people healthy while they are living on the streets or in a shelter is a difficult task, which is why a growing number of hospitals and other community organizations are fighting that battle by helping the homeless find a stable place to live.
Using what is called the “Housing First” approach, community groups — including hospitals and health systems — are giving homeless individuals relatively easy access to subsidized housing and then providing necessary physical and behavioral health care designed to limit their need for heavier duty care.
One of the latest organizations to take the Housing First approach, which was developed by the nonprofit Pathways to Housing, is the Camden Coalition of Healthcare Providers’ “Housing for Health” program. Two of the key players are Virtua Foundation, an affiliate of Virtua Health System, and Cooper University Hospital, both of which are providing grants to the program and will be among those providing care to the 50 participants in the pilot.
An important aspect to the program is that the bar to qualify for participation is relatively low because of the big jump in healthiness that comes with having a place to live. “Social determinants [of health] are just as important as the medical determinants,” says Alfred Campanella, executive vice president of strategic business growth and analytics for Virtua Health.
The federal government’s Housing and Urban Development Section 8 housing program provides the bulk of the funding for Camden’s program, and the state contributes as well, Campanella says. Certain requirements that might be typically enforced for the housing, such as sobriety, often are waived in order to get the individual into the healthier environment of the home.
“They get housing first. Then they get what are called wraparound services, which are essentially care coordination services that help guide them and facilitate access to health care services, behavioral health services and other social services, such as transportation and food,” Campanella says.
A sign of the potential success can be found by looking at utilization among participants in existing Housing First-style programs. “The readmission rate of these individuals goes down dramatically,” Campanella says.
The model fits in well with Virtua’s desire to adopt more of a population health management approach to providing health care, he says. “You’re caring for them 24/7, across the care continuum,” Campanella says. “It’s not just a one and done, it’s an ongoing activity.”
And Virtua serves two other counties beyond Camden County. “We would like to see this program expand,” he says.