Tackling Homelessness Means Looking at How Health Care is Delivered

September 25, 2018 | By Lisa Chan-Sawin

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Homelessness, and being on the verge of homelessness, is both a housing and  health care problem on the rise nationwide.

According to the most recent national homeless census, on any given night, over half a million people are experiencing homelessness, with more than a third sleeping outside in cars, parks, sidewalks, and on the streets.

Despite growing public awareness that housing and health outcomes are interconnected, services for this population are usually disconnected and provided in times of crisis. The result — a seemingly endless cycle of continued homelessness, poor health outcomes, and high health care and government costs.

It’s no surprise that cities and counties across the nation are grappling with how to support this vulnerable population while simultaneously addressing the economic impact of homelessness.

Case in point is the City of Seattle. Described as having one of the nation’s worst homeless problems, Seattle has reached a tipping point in dealing with its homeless crisis. With public concern mounting and the 2018 Point in Time Count showing that over twelve thousand homeless on the street at any given point in time, local policymakers are intently focused on finding ways to make a real impact on homelessness.

As part of this effort, Seattle City Councilmember Teresa Mosqueda recently asked Transform Health to share our work for the City of Sacramento in spearheading a new, innovative pilot program to address homelessness through a health and social determinants lens. Called Pathways to Health + Home(Pathways), Sacramento’s pilot is part of the state’s Whole Person Care program initiated through the California 1115 Medicaid waiver.

To a packed room filled with Seattle City Councilmembers, King County Board of Health leadership, and community leaders and stakeholders, my colleague Jessica Kendall and I described how Transform Health is helping Sacramento transform the way care is delivered to individuals experiencing homelessness. By intentionally developing technology and care models designed to bridge the divide between health care providers, housing organizations, and social service sectors, Pathways is delivering high-touch services that focus on the “whole person.”

Sacramento has already begun to see success stories from this effort leveraging community health workers for enrollment and patient navigation. One example is a dynamic partnership between a short-term winter triage shelter, housing specialists, healthcare partners, and the Sacramento Police Departments. One of the program’s enrollees was able to get housing after living on the streets for 30 years, which she says she owes to her team of “navigators” that convinced her off the streets and into the shelter and continued to help her get the necessary documents she needed to get housing and medical care.

Changing how systems work is complicated and hard work. It means bringing providers from different sectors together, asking them to get outside their comfort zones and change how they work together to coordinate and deliver services. It entails creating a culture of applying collective impact strategies, buy-in, and a shared understanding of the broader goals. It demands setting clear expectations, along with technical support to providers, to drive systems change and achieve results. And it requires helping providers exchange and use actionable data to give them the information they need to improve care. This is exactly what Transform Health is helping the City of Sacramento achieve.

To learn more about our work on Pathways to Health + Home contact Heather Bates at heather@tranformhc.com