In Camden, Housing the Homeless to Ease Strain on Health Resources

Andrew Kitchenman | February 24, 2015 | Health Care
State, county, city, hospitals, nonprofits unite to support Housing First pilot, with eye to potential expansion

Shunting the homeless into shelters, according to some experts, does little or nothing to cure the medical problems that plague this population — addiction, frequent hospital visits, untreated physical and mental illnesses — and overburden healthcare providers.

That’s why doctors and hospitals in Camden County are working with an initiative that finds homes for the homeless as a first step toward helping them and reducing the strain on healthcare providers.

Housing First has established a track record in Mercer County over the past seven years. But the Camden pilot announced yesterday, which is scheduled to begin with up to 50 residents later this year, could be expanded statewide if it’s successful.

The program gives housing vouchers to the homeless so they can rent homes in their communities. It also supplies variety of individually tailored healthcare services, including mental-health and addiction treatment if necessary.

While the financial outlay for the housing alone is significant — the Department of Community Affairs expects to spend $500,000 annually — it may be justified by the reduction in emergency-room and inpatient hospital visits. A similar program in New York saved an estimated $10,000 per resident.

Dr. Jeffrey Brenner, a nationally recognized Camden specialist in population health, worked with his employer — Cooper University Health Care — as well as Virtua, another hospital system; the Camden County government; Camden City officials; and state officials to garner support for the program.

Brenner noted studies finding that Housing First recipients are much more likely to stay in their homes than those given housing through conventional programs.

“You can cure homelessness,” Brenner said.

Brenner used an analogy to make the case for Housing First. He described the 19th century medical practices of bloodletting and of doctors delivering babies without washing their hands, both of which caused large numbers of deaths.

“The current model that we use for homelessness is completely ineffective, and a homeless shelter is the equivalent of bloodletting or not washing our hands,” he said.

Brenner said that the current system uses permanent housing as a reward for good behavior. Since homelessness contributes to cycles of poor mental health, homeless people often have to apply repeatedly after committing infractions.

In Housing First, the services follow once a permanent home is found for a homeless person, which reduces the rate of re-hospitalization.

The program is the first of several Housing First initiatives being considered by the state in the coming months, with the later projects aiming to help homeless veterans and families who are in danger of losing custody of children due to unstable housing situations, according to Charles A. Richman, deputy commissioner for the state Department of Community Affairs.

The approach is also likely to be included in a report expected this year by an interagency task force assigned by Gov. Chris Christie in 2012 to address homelessness.

Richman said task force members heard testimony from national experts on reducing homelessness.

“Invariably they heard from the experts that the most important way to affect homelessness is to provide housing first,” Richman said.

Richman added that he could “confidently say” that if Camden uses all 50 Housing First vouchers, more would be made available.

“We will probably model similar tests around the state,” based on the approach in Camden, he said.

Janel Winter, housing director for the state Department of Human Services, said the department “knows” that Housing First works.

“It’s a marriage of two things that people really need” — housing and individually tailored services that help people become healthier, Winter said.

Winter said she was encouraged by the range of organizations committed to the program, as well as the crowd of more than 100 that gathered in Cooper University Hospital’s Robert Pavilion Lobby for the announcement of the initiative.

A key component of the program is the range of services provided to residents. These can include assistance in basic skills like how to cook and clean that many homeless residents struggle with.

Brenner pointed out that if the state includes Housing First in its Medicaid program, it could receive as much as 90 percent of its funding from the federal government. But it would first have to go through a rate-setting process through Medicaid to justify the federal funds. Brenner also is hopeful that Christie will include money for the Housing First in the state budget proposal to be unveiled today.

Kristin Miller of the Corporation for Supportive Housing said that the assumption that homeless people aren’t ready for permanent housing is frequently wrong.

“It’s going to help the people who work in the hospital who are frustrated because they see the same people again and again and cannot truly help them,” Miller said of Housing First. She added that Camden has already moved past the first challenge to launching a successful Housing First program by gathering all of the necessary stakeholders in support of the concept.

Trenton resident Traci Pinto, a participant in Housing First, visited the Camden announcement to provide a testimonial about her own positive experience with the program. She was homeless from 2008 to 2010 and made six hospital visits in those two years. She’s had a total of two hospital visits in the five years since she received permanent housing, she said.

She said that without the program “I probably wouldn’t be alive right now,” since it provided treatment for bipolar disorder that led her to try to kill herself when she was homeless. Now she’s looking to get job training to rejoin the workforce.

The request for proposals to launch the pilot program is expected in March, with an eye on a July launch. It’s expected that Camden County and the nonprofit Corporation for Supportive Housing will bid. Participating residents would be chosen from those chronically homeless people who have required the most healthcare.

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