President and CEO of CSH (Corporation for Supportive Housing)
GET UPDATES FROM Deborah De Santis
Housing and Health Care Must Come Together to Serve Vulnerable People Better
Those of us in the supportive housing field have recently become
eager students of national health reform efforts. The changes in
coverage, access, delivery and quality of care have the potential to
significantly improve and lengthen the lives of the vulnerable men and
women who live in supportive housing.
Supportive housing is affordable housing used as a platform for
services like health care, employment services, substance abuse
treatment and case management. Study after study has documented
supportive housing's ability to improve health and behavioral health
status. And it's also shown to lower emergency room, hospitalization and
Medicaid costs among individuals with some of the most complex health
problems. Some studies showing Medicaid cost reductions of 41%.
These days, my and my staff's calendars are filled with meetings with
health policy experts, Medicaid officials and managed care executives.
I've come to appreciate that health care in the United States involves a
complex (some would say convoluted) health care delivery system,
replete with multiple payers, providers, benefit packages, coverage
rules and limitations, and payment rates. After many years working in
housing, I well know that affordable housing is no easier to connect to
than health care. Our nation's "housing delivery system" is just as
difficult to navigate as our health system--especially for the most
vulnerable and poorest families and individuals. The terminology may
differ, but the housing delivery system has its own equivalent multiple
payers, coverage limitations, regulations, eligibility restrictions and
payment standards.
By recognizing the complexities and challenges associated with our
respective delivery systems, health care and housing professionals see
clearly that we need to work better and more closely together. We need
to find new ways to do our best by our residents and patients by
aligning and integrating health care and housing at the delivery system
level.
We must streamline bureaucratic obstacles to increase access to both
health care and housing. We must provide the appropriate levels of
housing assistance and health service to people based on their levels of
need. We must deliver packages of coordinated, patient-centered health
care and affordable housing. We must build collaborations between local,
state and federal systems to align public resources including Medicaid
and mainstream housing capital and rental subsidies. And, we must as a
society invest in interventions like supportive housing, which is the
premier example of how communities can align health care with housing.
If we don't, we leave vulnerable men and women to fend for themselves
in navigating not one, but two complex and convoluted systems.
