housing as health care nph conference
DESCRIPTION
Housing As Health Care NPH Conference. Sharon Rapport, CSH October 3, 2014. Our Mission. Advancing housing solutions that:. CSH Social Innovation Fund. z. An Innovative & Effective Model - PowerPoint PPT PresentationTRANSCRIPT
Housing As Health Care
NPH Conference
Sharon Rapport, CSH
October 3, 2014
Our Mission
Improve lives of vulnerable
people
Maximize public
resources
Build strong, healthy
communities
Advancing housing solutions that:
CSH Social Innovation Fund
GOAL: National replication of integrated supportive housing and health services model as a viable alternative to the “revolving door” for homeless people who are frequent users of crisis health care services
FUNDING: $1.15 M annual award from Corporation for National and Community Service (CNCS): 5 yrs
$425,000 annual award to Tenderloin Neighborhood Development Corporation $375,000 annual award to Economic Roundtable
A Solid Base of Evidence
A rigorous evaluation on supportive housing‘s effectiveness as a health care intervention for reaching Medicaid‘s high-need, high-cost individuals
A Blueprint for Scaled Replication
Develop a viable policy for Medicaid-funded intensive care management services are paired with federal, state, & local housing resources
zAn Innovative & Effective Model
Develop and refine a model of housing linked to care management and coordinated primary and behavioral care through community partnerships.
STRATEGIES:
SITES:SAN FRANCISCO, CA
LOS ANGELES, CA
HARTFORD, CT
ANN ARBOR, MI
TENDERLOIN NEIGHBORHOOD DEVELOPMENT CORP.
THE ECONOMIC ROUNDTABLE
CONNECTICUT AIDS RESOURCE CORPORATION
CATHOLIC SOCIAL SERVICES OF WASHTENAW COUNTY
Kelly Cullen Community in San Francisco: Key Partners
TNDC SUPPORT
SERVICES
TNDC PROPERTY MANAGEMENT
SAN FRANCISCO
DEPT OF PUBLIC HEALTH
LUTHERAN SOCIAL
SERVICES
TENANT
10th-Decile Model in Los Angeles
Apr 19, 2023
10th Decile triage tool
highest-cost, highest-need 10% of homeless
individuals
Collaboration hospitals, FQHCs, homeless services
Health Homes intensive case
management/ care coordination
Permanent Supportive
Housinghousing navigation
and retention
5
PRIMARY CARE
BEHAVIORAL HEALTHSUBSTANCE ABUSE
SUPPORTIVE HOUSING
NAVIGATORFREQUENT USERS
The Glue: Intensive Case Management i.e., Care Coordination + Housing Navigation
Apr 19, 20236
Average cost avoidance per person: $59,415Largest individual cost avoidance: $2.2 million
25% of the cohort avoided costs in excess of $100,000
Source: FUSE/SIF hospital cost data, September 2013
ER utilization down 71%Hospital readmissions down 85%
Inpatient days down 81%
ER visits IPT admits IPT days
9.8 8.5
28.6
2.8 1.2 5.5
FUSE Hospital Utilization Pre- and Post-Enrollmentaverage per person, n=60
12 mos before 12 mos in program
ER costs IPT costs Total cost
$7,534
$65,799 $73,333
$2,527
$11,391 $13,918
Hospital Cost Avoidance Pre- and Post-Enrollment
Costs not charges $59,416 average per person, n=6012 mos before 12 mos in program
ER costs down 66% Inpatient costs down 83% Total costs decreased 81%
10th Decile Hospital Utilization and Cost Avoidance (Actuals): 81% Average Decrease In Total Costs Per Client Per Year
AB 361. “Health Homes” Bill (Mitchell)
Health Home = Virtual “Home” for Addressing the “Whole Needs” of a Beneficiary
Uses an option under Affordable
Care Act to create a “Medi-Cal health home benefit” to Medi-Cal beneficiaries who are—
FREQUENT HOSPITAL USERS
and
CHRONICALLY HOMELESS PEOPLE
Bill signed by Governor Oct 2013
Frequent Hospital User Beneficiaries
Chronically Homeless
Beneficiaries
Health Home ServicesServices to Address the Needs of the “Whole-Person”
COMPREHENSIVE CARE MANAGEMENT
CARE COORDINATION & HEALTH
PROMOTION
COMPREHENSIVE TRANSITIONAL CARE
INDIVIDUAL AND FAMILY SUPPORTS
REFERRAL TO COMMUNITY &
SOCIAL SERVICES
HEALTH IT, DATA AND EVALUATION
OUTREACH & ENGAGEMENT
Implementation of AB 361
Define Services: Frequent face-to-face contact (1:20 ratio)
Comprehensive care management: Outreach/engagement Motivational interviewing to identify all needs (not just health)
& plan to meet all health-impacted needs Assist beneficiary get into housing Promote housing stability: help beneficiaries learn to manage
finances, pay rent, shop for or gain access to healthy food, maintain eligibility for benefits, communicate with neighbors & management, and participate in community
Care coordination & health promotion: Include HH staff advocacy with health providers
Referral to social services & supports: Include partnerships with permanent housing
Next Steps on Health Homes
Webinar: Oct-Nov
Stakeholder Process
Draft State Plan
AmendmentImplement (mid-2016)
Concept Paper
Advocacy w/DHCS
Ongoing Stakehold
er Meetings
