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Scaling Up: Overcoming Barriers to Supportive Housing and Healthcare Integration

Poor health both contributes to homelessness and is exacerbated by prolonged periods of housing instability. Stable housing provides a secure foundation for treating underlying health conditions and ensuring regular access to primary and preventive care.

Supportive housing – affordable housing coupled with supportive services – is proven to help vulnerable people stay housed and stabilize their lives. Linking supportive housing and healthcare enhances the effectiveness of each, and integrated supportive housing/health models have been shown to: lower homelessness recidivism; improve health, mental health, and substance use outcomes; and simultaneously lower overall public spending.  Federally Qualified Health Centers (FQHCs) are particularly well-positioned to meet the healthcare needs of supportive housing residents, providing patient-centered, comprehensive and culturally sensitive primary and preventive care.

There are a number of supportive housing/healthcare partnership models possible, among them FQHCs located within or nearby a supportive housing development and collaborating with the supportive services staff to help manage residents’ care.

From the market assessment that CSH and PCDC (Primary Care Development Corporation)  have been undertaking, with support from the Kresge Foundation , we have learned that, despite powerful individual stability/health and system outcomes, integrated supportive housing/healthcare models remain on the periphery of health systems and only exist on a small scale in the four states we have assessed - Arizona, California, Connecticut and Oregon. This is largely a result of siloed program payment streams that make it difficult to fund such cross-sector collaboration and service delivery coordination.    We do, though, see movement in the payment and delivery reform efforts underway, especially in California and Oregon, that could support integrated care delivery in the coming years.

CSH and PCDC are looking to develop technical assistance activities to further lay the foundation for increased integration.  Please sign up to receive updates.

RELATED RESOURCES

Defining and Funding the Support in Permanent Supportive Housing: Recommendations of Health Care Centers Serving Homeless People (CSH)

Integrating FQHC Health Care Services with Permanent Supportive Housing in Los Angeles (CSH)

Medicaid-Financed Services in Supportive Housing for High-Need Homeless Beneficiaries: The Business Case (Center for Health Care Strategies)

Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities (U.S Department of Health and Human Services)

Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Literature Synthesis and Environmental Scan: Clinical Challenges in Permanent Supportive Housing (U.S Department of Health and Human Services)

National Healthcare for the Homeless Council- Supportive Housing Overview

The Role of Supportive Housing Providers: Creating Health Care Homes for Chronically Ill Residents (CSH)

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