Health Forward Foundation

Reducing Homelessness Could Help Cut Health Care Costs in the U.S.

KANSAS CITY, Mo. – Reducing homelessness is a good prescription for cutting the nation’s health care costs, according to housing activists who gathered here for a two-day meeting this week.

The event was billed as a “boot camp” for community officials interested in participating in the 100,000 Homes Campaign, a national effort to house the chronically homeless.

More than 50 people attended the seminar, including a contingent from the U.S. Virgin Islands. Officials from Kansas City and around Kansas also attended.

“You have an argument to make,” Leslie Wise, a 100,000 Homes Campaign official from Los Angeles, said in urging officials to engage with health care professionals in their areas to help solve the problem.

The point to make, she said, is that helping the homeless find shelter can save them money in reduced usage of emergency rooms and lower Medicaid costs.

National Field Organizer Linda Kaufman cited various findings that have linked housing problems and medical costs.

Nearly two-thirds of Medicaid recipients who are high cost due to frequent hospital admissions are homeless or near homeless, according to 2009 research published in the Journal of Urban Health.

The Massachusetts Housing and Shelter Alliance, a statewide program that placed chronically homeless individuals in housing, reported for 2009 a 67.5 percent decrease in those individuals’ annual average Medicaid costs.

In interviews with homeless people around the country, Common Ground, a New York City-based nonprofit, found that about one in five reported at least three hospitalizations or emergency room visits in the year before the survey.

Wise also pointed to a 2009 report by the Economic Roundtable, a nonprofit research organization in Los Angeles.

The report said monthly public spending per person in Los Angeles County dropped from $2,897 to $605 after placement in supportive housing. Some of the steepest drops came in inpatient hospital costs.

The 100,000 Homes Campaign, which was launched two years ago, has a “Hospital to Home” appendix to its playbook. The appendix provides tips and strategies on engaging the health care community in the campaign.

Thus far, according to campaign officials, 151 communities have housed about one-fifth of the overall goal. Organizers on the Missouri side of the Kansas City area are in the early stages of their effort.

As part of the campaign, field workers gather information, including photos, from homeless people who consent to take part.

Part of the interview includes questions for the Vulnerability Index, developed from work a medical researcher in Boston did on the causes of death among the homeless. Questions include frequency of emergency room visits and hospital admissions.

Linda Stange and Jami Crowder, who both operate emergency homeless shelters in southeast Kansas, were among those at the boot camp.

Crowder manages the CHOICES shelter in Pittsburg, and Stange is executive director of Faith House Inc. in Chanute.

Seizing on a recommendation from the meeting, Stange said one of her first orders of business back home would be to see if the local emergency room would administer the Vulnerability Index.

“A lot of times they see people we never see,” she said.

For Crowder, talk of working with health care providers was preaching to the choir.

She said her shelter works closely with safety-net officials, including one agreement where the shelter pays for services provided to its residents by the Community Health Center of Southeast Kansas, which has its main clinic in Pittsburg.

Pairing shelter residents with physicians establishes a “stable medical climate” for individuals and families, Crowder said, and it cements a relationship that can continue even after more permanent house is found.

“I think it has a long-term effect,” she said.

Officials at reStart Inc., which operates a homeless shelter and supported housing in Kansas City, Mo., pointed to Hubert Sneed as one of the program’s success stories.

The 62-year-old native of Kansas City, Mo., spent decades on the streets after his discharge from the military in the early 1980s. He has lived in a reStart apartment since 2006, receiving regular treatment for his medical needs.

He demonstrated his sleight of hand with a card trick and a cup-and-ball shuffle when boot camp attendees visited his apartment.

“I do feel like I’m doing a whole lot better here,” he said. “I would not have lasted this long on the streets at all.”

The Health Forward Foundation is proud to partner with the Kansas Health Institute news service to provide weekly health stories about health and policy issues impacting the greater Kansas City region. This News Service is an editorially independent program of the Kansas Health Institute and the Health Forward Foundation and is committed to objective coverage of health issues.

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