Health care providers partner on housing access and care for people who are homeless
By JULIE MINDA
Kenton Women's Village in Portland, Ore., provides wraparound health and social services along with transitional housing — an integrated service model favored in the Catholic Charities USA's Healthy Housing Initiative. Here volunteers put finishing touches on one of more than 20 new single-occupancy residences for women exiting chronic homelessness. Kevin Perkins for Catholic Charities of Oregon
Catholic Charities USA has launched a five-year, multimillion-dollar initiative to improve housing options and health care services for people who are homeless. One of the nation's largest social service providers, the agency will begin the effort in five cities, working with a network of organizations, including Catholic health systems and facilities.
The goal of Catholic Charities' "Healthy Housing Initiative" is to reduce chronic homelessness by 20 percent over five years in the selected cities, to connect at least 35 percent of newly housed clients to primary care and behavioral health services and to decrease homeless clients' hospital readmission rates by at least 25 percent.
Catholic Charities expects to expand the initiative based on the pilot city results, says Curtis Johnson, Catholic Charities' vice president of affordable housing. He and others will present a breakout session at the Catholic Health Assembly in Dallas, June 10, on "Social Determinants of Health: Healthy Housing."
Local Catholic Charities agencies will lead the Healthy Housing Initiative efforts in their respective cities. Their dioceses and archdioceses have agreed to work with their parishes to identify outmoded church and school buildings for redevelopment as affordable housing. Catholic Charities has established more than 35,000 units of affordable housing across the U.S. One goal of the pilot is to add about 500 new permanent supportive housing units to that inventory. The types of housing units will vary by city but may include private apartments, group homes and rental houses.
Catholic Charities of Oregon's Kenton Women's Village has private sleeping pods for formerly homeless women. The women receive case management, employment assistance, mental and medical health care and other support. The village in Portland, Ore., is one model for housing/health care partnerships that are being fostered under Catholic Charities USA's new Healthy Housing Initiative.
Kevin Perkins for Catholic Charities of Oregon
While the particulars of the partnerships also will vary by city, in general Catholic health providers in each community will support the effort by collecting and analyzing data related to health care services needed by people who are homeless; creating a plan for meeting those health care needs; providing clinical services, potentially on-site in Catholic Charities housing complexes; and partnering on efforts to sign homeless individuals up for health insurance.
Johnson says Catholic Charities chose demonstration cities where its local affiliates have expertise and relationships around housing and health care, where it has church leadership endorsement and where it has the promise of securing property. The pilot cities — and the work planned in each — are:
• Detroit: Catholic Charities of Southeast Michigan plans to convert surplus church property into 44 affordable housing units and to work with Ascension on wraparound services.
• Las Vegas: Catholic Charities of Southern Nevada initially will develop up to 75 affordable housing units with on-site clinical and social services. It will work with CommonSpirit's Dignity Health and others.
• Portland, Ore.: Catholic Charities of Portland aims to add at least 300 housing units to existing affordable housing stock, and to ensure easy access to health services for tenants. Providence St. Joseph Health is among the partners.
• St. Louis: St. Patrick Center, which is a Catholic Charities member providing social services to people who are homeless, will work with Mercy and SSM Health and other partners to provide housing, and behavioral medicine and other health services to people who are homeless.
• Spokane, Wash.: Catholic Charities Eastern Washington will partner with Providence St. Joseph Health to expand upon an existing collaboration around housing and supportive services for people who are homeless.
Students and instructors from the occupational therapy program at Washington University in St. Louis help clients of the St. Patrick Center in St. Louis with life skills-building. Founded by the Archdiocese of St. Louis and Catholic Charities of St. Louis, St. Patrick Center provides social services and job training for people who are homeless. Here, St. Patrick Center clients Tommy Tolliver, at left, and Todd Tonell, foreground, receive coaching from instructor Hunter Yeats.
St. Patrick Center
Catholic Charities says it is undertaking this initiative because there is a critical national shortage of housing options for chronically homeless people — those homeless for at least two years — and particularly those with serious mental and physical illness. According to late-2018 information from the U.S. Department of Housing and Urban Development, more than 550,000 Americans are homeless. Nearly 89,000 of them have "chronic patterns of homelessness," according to HUD.
Johnson says of the pilot, "It's a wonderful opportunity for Catholic Charities and its Catholic health care partners to come together, put our heads together and say, 'This is not easy, but we'll work hard to work through the challenges, so we can have a really meaningful impact for the most vulnerable.'"
Men enter the grounds of the Catholic Charities Eastern Washington's House of Charity, a Spokane, Wash., day shelter for people who are homeless. The facility includes a medical respite unit that provides clean, safe accommodations for Providence Health Care patients who do not have a place to recuperate.
Chris Ryan/© CHA
Catholic Charities last year used a Kresge Foundation grant to form a think tank to develop a new approach to this entrenched problem. The group included national and local Catholic Charities leaders, medical and behavioral health experts, housing development funders, lenders and academics.
They proposed collaborations among local Catholic Charities agencies, dioceses and archdioceses, health care partners, financiers, corporate partners and others, to expand the availability of permanent supportive housing for chronically homeless people. The housing would incorporate social and health care services, which would vary by city, but which could include on-site clinics or transportation to health care services.
Under the initiative, Catholic Charities and its local affiliates will shape the infrastructure, plans, financing, and partnerships needed to develop supportive housing. In many cases, the efforts will build upon existing programming. Catholic Charities has not specified how much capital it is putting toward the initiative. In addition to its own funds, it will work with private lenders, grantors and funders, and advocate for government funds.
Mike Butler, president of operations and strategy at Providence St. Joseph, says that when it comes to addressing the complex issues connected with homelessness and health care access, "we can't do this on our own — we need a partner, and there is no better partner than Catholic Charities."
Patrick McCruden, SSM chief mission integration officer, says, "This work is right in line with our mission and vision … to improve the health of the communities we serve, and especially for the marginalized poor and vulnerable."
Andy Kruse, Ascension Michigan director of community benefit, says chronic homelessness disproportionately affects middle-aged, black men. Catholic providers must work to address the health disparities suffered by this population as a matter of social justice.
He says the Catholic health ministry should "advocate through our actions and our words, and work with our partners to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives."
Sharon Neumeister, Mercy regional director of community health and access, says the efforts with Catholic Charities and the other church organizations and partners will dovetail with long-running work in the ministry on population health strategies, improving lives and achieving better outcomes.
"I think we'll see healthier individuals if we look at the root causes and issues," as the Healthy Housing Initiative aims to do, she says.
Ascension's Kruse adds, "We know that addressing homelessness improves health, reduces inappropriate health care utilization and lowers health care costs," and "working collaboratively with like-minded, mission-driven organizations … we can collectively address this issue."
Homelessness in Healthy Housing Initiative pilot cities
- Detroit: 1,769 homeless individuals, 221 of them chronically homeless
- Clark County, including Las Vegas: 6,083 homeless individuals in Southern Nevada, including 505 who are chronically homeless
- Multnomah County, including Portland, Ore.: 4,019 homeless individuals, with 1,384 of them chronically homeless
- St. Louis: 949 homeless individuals, with 95 of them chronically homeless
- Spokane County: 1,245 homeless individuals, with 265 of them chronically homeless
Source: 2018 Continuum of Care Homeless Populations and Subpopulations Reports from the U.S. Department of Housing and Urban Development
Healthy Housing Initiative builds on preexisting relationships
Although Catholic Charities USA's Healthy Housing Initiative builds upon relationships among local Catholic health care and social services organizations and their dioceses or archdioceses, it represents a significant expansion and elevation of the work health ministry facilities do with Catholic Charities.
Mike Butler, president of operations and strategy at Providence St. Joseph Health, says in Spokane, Wash., Providence has partnered with Catholic Charities Eastern Washington for several years on initiatives to address health care and housing needs of people who are homeless. Providence has helped fund a Catholic Charities homeless shelter and free medical clinic. Providence discharges patients who are homeless to a respite center at the shelter. And Providence and Catholic Charities have collaborated on projects to reduce Catholic Charities clients' readmission rates at hospitals, to sign people up for insurance coverage and to smooth health care access for Catholic Charities clients who are pregnant or new parents.
Sharon Neumeister, regional director of community health and access for Chesterfield, Mo.-based Mercy, says Mercy collaborates with Catholic Charities of St. Louis on a centering pregnancy program at a Catholic Charities transitional housing facility. The program provides education to young mothers in the form of group sessions that span the duration of the women's pregnancies. Mercy also partner with Catholic Charities of St. Louis on a health care job placement programs for the agency's clients.
Patrick McCruden, chief mission integration officer of St. Louis' SSM Health, says SSM, Mercy and Ascension all are working with the St. Louis Catholic Charities agency and the St. Louis archdiocese on a mobile health clinic that is to begin serving rural communities later this year.
And, in Detroit, Ascension collaborates with the archdiocese on programming "to address the social injustices that contribute to health disparities," says Andy Kruse, Ascension Michigan director of community benefit.
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