Better Health Through Housing

By Jamie Cetrone | Categories: | Comments Off on Better Health Through Housing

The Better Health Through Housing pilot grew out of an awareness by UI Health leadership that in order to realize its Health Equity mission, they need to take on the challenge of improving the health of whole communities on the west and south sides of Chicago. UI Health is located about 2 miles from downtown Chicago on the near Westside, in the Illinois Medical District, in one of the highest concentrations of city homelessness. With six other nearby hospitals, the chronically homeless hop from one Emergency Department (ED) to another. The goals of their program are: to create a healthcare-to-housing pilot using the Housing First model; to evaluate the effect of housing on health outcomes, cost, and utilization (this includes studying homelessness as a heath condition); and to promote and advocate for more healthcare-to-housing programs in the Chicago area using a collective impact approach

UI Health pays their partner, the Center for Housing & Health (CHH) $1,000 per member per month. CHH created a housing collaborative consisting of over twenty housing agencies that manage 125-150 one-bedroom apartments scattered throughout the city, as well as three single room occupancy (SRO) facilities that serve as bridge units until permanent supportive housing is located. The agencies work with individual landlords that accept and tolerate patients with mental illness and/or substance abuse. There are two program staff: The Program Director and a Care Coordinator, a licensed clinical social worker who specializes working with the homeless. UI forecasts this will provide housing for between 20-30 chronically homeless patients for a year (last year’s program referred 27 homeless individuals). Identification and referral of homeless patients takes a considerable amount of care coordination, not only internally but with community-based partners. In order to strike a balance between healthcare utilization and medical vulnerability, the program utilizes a “Tumor Board” multidisciplinary team consisting of ED, oncology and psychiatry social workers, ED and psychiatry attending physicians, as well as a CHH program coordinator and an Outreach Worker who locates the patients on the street once they are referred into the program. The program consists of $250,000 of internal annual funding (a combination of both operational and philanthropic dollars).

As a result of the program internal healthcare costs have come down 21% (removing one patient in end-of-life care and the reduction is 67%), ED utilization is down 45% and inpatient admissions have been reduced by 55%. UI Health has also begun identifying the homeless in their patient population, and since 2008 have found over 1,300 homeless patients.