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Sunday, August 25, 2019
Home Health and Fitness Why Florida Hospital is housing the homeless

Why Florida Hospital is housing the homeless

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Housing programs help improve community health outcomes

From Hospitals and Health Networks/hhnmag.com

By Lola Butcher

Suffering significant health problems, the woman was in and out of hospitals constantly. She did not take prescribed medications because they made her groggy — an unsafe condition for a woman living on the streets.

“And, of course, within a week or two her medical condition would deteriorate again,” says Shannon Nazworth, executive director of Ability Housing, a nonprofit organization serving northeast and central Florida. “She was just cycling in and out of the hospital, not because anybody was not giving her good care or did not care about her, but because the system was broken.”

In the two years before the woman was placed in an apartment, three hospitals spent more than $750,000 on her care.o-homeless-facebook

“In the year after she moved in, she went to the hospital once for a couple of days,” Nazworth says. “The other factors that were affecting her health were addressed by just getting her housing. She needed a place to sleep at night, a place to store her medicine and the security of a door to lock.”

Framing the Issue

Patients like this woman exist throughout health care, but, traditionally, most health systems have not seen a way to address homelessness and other social factors that exacerbate individuals’ health problems. That is changing as health systems pivot to population health management and new payment systems that reward them for proactively improving patients’ health status.

“Whatever has been done in the past has not been working, and we have to really think very differently,” says David Perlstein, M.D., president and CEO of SBH Health System in the New York City borough of the Bronx.

In his case, that means proactively reducing inpatient capacity, selling part of the SBH campus to a developer to build low-income housing and opening an urgent care center and other outpatient facilities in the new development. In other places, provider organizations are donating cash. For example, five hospitals and a nonprofit health plan in Portland, Ore., are donating $21.5 million to help build nearly 400 housing units for homeless and low-income people. Still other health care organizations are building apartments that they own and operate themselves, and some are paying the rent for homeless people to have a place to live.homeless-man-florida-coalition-for-the-homeless_squared-300x300

Supporting Articles

What they all have in common: the goal of improving housing stability and thereby improving the well-being of their patients and their community.

“This is an opportunity that health systems are seeing,” says Donald Moulds, executive vice president for the Commonwealth Fund.

The best role for provider organizations is not yet clear; Moulds and other policy analysts are working to figure that out. But a growing body of research shows that addressing housing instability is a cost-effective approach to reducing avoidable health care utilization.

“A modest housing investment, coupled with supportive services, can actually keep people from needing much more expensive care in the long term, sometimes even in the shorter term, and can pretty dramatically improve outcomes,” Moulds said. “If you target it right, it can be a cost-effective choice for provider organizations.”

Direct support

In 2014, Florida Hospital in Orlando committed $6 million over three years to address homelessness in central Florida. The donation coincided with big commitments — $4 million from the city of Orlando and $13.5 million from Orange County — during the same three-year period.

“Our mayor set a goal to house about 300 of downtown Orlando’s chronically homeless within three years and, without a doubt, we wanted to be in on this early,” says Yamile Luna, assistant vice president of Florida Hospital Community Impact and Volunteer Services.

Pictured: Shannon Nazworth, executive director of Ability Housing in Florida, worked with hospitals, other nonprofits and the Sheriff's Office to target potential residents for the units.
Shannon Nazworth, executive director of Ability Housing in Florida, worked with hospitals, other nonprofits and the Sheriff’s Office to target potential residents for the units.

Watch: Housing Is Health Care

The city engaged the Corporation for Supportive Housing, a national nonprofit group, to strategically identify vulnerable individuals and families who need supportive housing and are high users of emergency departments and other high-cost public services.

“We knew who our frequent-flyer homeless individuals were,” Luna said. “They would come in through the emergency department, and we knew there had to be a better way to care for them. We started determining case by case, person by person, what is it that they truly need.”

The work is benefiting not just high-need patients but the health system as well. By the time $1.6 million of Florida Hospital’s donation had been spent, the hospital had avoided an estimated $2.5 million in costs for six high-utilizers who had been placed in homes.

“This is not why we did it, but it was a very big moment of ‘wow’ when that information was shared,” Luna says.

Meanwhile, Florida Hospital’s commitment to addressing homelessness caught the attention of a local charity that had operated a transitional housing community for more than 15 years. Over that time, the “housing first” model — placing homeless people in permanent housing without requiring that they overcome addictions, get jobs or hit other milestones — had gained traction in the social service world, and the charity wanted to convert its apartments to permanent housing. So, earlier this year, it donated the Wayne Densch Center for the homeless to Florida Hospital.

The health system, in turn, is leasing the property to Ability Housing for $1 per year. With funding from Orange County, Ability is redeveloping the center to provide permanent housing for individuals and families.

“We are happy to be behind the scenes,” Luna says. “Housing is not our expertise, so in order for us to be successful, we knew we wanted to partner with Ability and also the Orange County government.”

The foremost goal for the renovated Wayne Densch Center is to provide permanent supportive housing for families, but some units may be designated as transitional care units for homeless patients discharged from Florida Hospital.

  • To read the entire article, go here.

4 COMMENTS

  1. I am certainly for the homeless having a safe place to stay and not being out on the streets in the rain, heat, and cold, exposed to the criminal elements, but at the same time, I certainly hope this is not something that Florida Hospital intends to do with our old hospital in the center of Apopka that will be closing, when the new hospital is completed out off the 429. They had indicated that the old hospital would be converted into senior citizen housing, but after reading this article, I really wonder about the future of the old hospital. To me, the red flag in this article is the part that allows the people to permanently live in these places without requiring that they overcome addictions?????? Seriously????? In other words, they are going to be housing drug addicts, and alcoholics, and endangering the other residents, and the surrounding neighborhoods????? For real???? I hope this is NOT the plan for our old hospital, but now I am skeptical. We don’t want this town to be a “anything goes kind of place”…..at least, speaking for myself, I don’t! Also, not to mention the fact that Orange Co. taxpayers are helping pay the bill for millions for this. Just wait for the Obamacare to be dropped, the social security cut out, the Medicare axed and the Medicaid tossed out……start gathering your tent and camping equipment now and just hope you land a place on the waiting list of the “Florida Hospital Homeless Resort” placement program, it could be that bad!……or in other words, another form of sanctuary city.

    • You’re all for the homeless? WTF does that mean? You say that then go on a rant about imaginary nonsense and how the poor wealthy folks, with good homes and good cars would be inconvenienced and be forced to drive an extra 10 minutes to a different location. You self-righteous prick! You sound like Trump… “They’re murders and rapists…” At least Orange Hitler gave credit to at least some of them possibly being decent people… But, to honestly care about the well being and lives of other people, that would be something Christ would do and has no place in the heart or mind of a self-righteous hypocrite, does it?

  2. Not everyone homeless is a drug addict, we are homeless right now and we don’t do drugs. Because of a series of events we became homeless. Right now I would love a warm, safe bed for us. We have been out here almost a week now and have met alot of good people that are trying to get their lives going. Yes their are the ones that are on drugs and need help but I think everyone deserves a chance.

  3. My son has a drug problem he is a lot better than what he used to be. He has a job now but he does not have a place to live. Is there anywhere out there that he can live. Please help!

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