A pilot program in the Chicago area aims to break the cycle of homelessness through better health.
The program stresses the importance of collaboration and cost sharing. McLean County is working on a similar model.
Organizers in Cook County say they have taken nearly 50 people get off the streets and into housing in the first six months of the flexible housing pool program. Nonprofits secured promises from hospitals and health insurers to pay for housing for the homeless that the hospitals identify as frequent users of the health care system.
Carlos DeJesús Rivera is director of Housing and Special Initiatives at the Center for Housing and Health, the lead agency for the program. DeJesús Rivera said many without a roof over the head get caught in a vicious health cycle.
“If you take housing into account, the health conditions of the participants will significantly improve and therefore it’s a savings of health dollars when that happens. So housing is tantamount to health care,” he said.
Others say the program also addresses racial inequality. Julie Nelson with the Corporation for Supportive Housing (CSH) noted 80% of the homeless population in Chicago is African-American.
“People of color are targeted for arrests, convictions look different,” Nelson said. “That then impacts ability to get work, that impacts evictions and so that drives people toward homelessness.”
The program creates a flexible housing pool. Case workers help homeless clients with insurance and housing and try to make sure they get to the doctor.
Patricia Stokes is with Housing Forward, an agency contracted to provide case workers. She said the program goes beyond the sustainable housing the federal government offers because health care staff see first-hand who needs housing assistance.
“They know that a person is physically vulnerable because the hospitals, the medical systems are working with them, but they don’t necessarily have to be homeless in the same way,” Stokes said.
The U.S Department of Housing and Urban Development offers supportive housing funding only for those it defines as chronically homeless and disabled.
The original model for the Cook County service is in Los Angeles. That effort reports sharps drops in emergency room visits, days in the hospital, and fewer mental health hospitalizations over the first seven years of the program.
Nelson said the flexible housing pool is adaptable anywhere you have health care and community partners willing to work together.
“A lot of it can be driven by data within their own community,” Nelson said. “Understanding who your frequent utilizers, creating partnerships, building those relationships across these partners between the private sector, between hospitals, between government, between your homeless service providers and really going from there to identify a common goal.”
CSH has also been working with McLean County in its efforts to stem homelessness by identifying those who most frequently need health care or homeless services or go to jail. That's through the county's new FUSE program. It stands for Frequent User Systems Engagement.
McLean County Mental Health Program Supervisor Trisha Malott said FUSE's goal is to provide mental health and substance abuse services and help the homeless find stable housing and employment.
Malott said the program has located only two frequent users in the first two months. The startup plan is for service to 10 clients per year. She said once the program has reportable results, the county will ask hospitals and health insurers to help defray costs.
“That’s a goal, so we continue to have dialogue with both hospitals (Advocate BroMenn and OSF St. Joseph medical centers) to try to be able to incorporate that, so that we truly can get to the folks who are intersecting all high-need, high-cost systems,” Malott said.
The county has set aside about $670,000 for FUSE annually through a sales tax increase Bloomington and Normal approved a few years ago.
Chicago Mayor Lori Lightfoot has pledged an additional $5 million for that city's flexible housing pool.
Several foundations have joined forces in Peoria to offer housing for the homeless through a variety of funding sources, including local lenders and tax credits for low-income housing and for historic properties.