Housing for Health: Assessing the Cross-Sector Impacts of Providing Permanent Supportive Housing to Homeless High Utilizers of Health Care Services
Homeless individuals experience a higher risk for mortality, chronic illness and mental health disorders, and are often high utilizers of healthcare. The Housing for Health (HFH) initiative, created in 2012 by the Los Angeles County Department of Health Services (DHS), is designed to reduce homelessness and inappropriate use of expensive health care resources, and improve health outcomes for this vulnerable population. Homeless individuals who are high utilizers of medical services are referred to permanent supportive housing (PHS) and intensive case management services, and subsequently to benefits and services provided by agencies in multiple sectors, including substance use treatment services. To evaluate this novel mechanism for integrating the delivery and financing systems for housing, medical care, and public health services, the principal investigators are assessing the HFH cross-sector impacts and organizational and financing issues to explore:
- the effectiveness of HFH and other housing models on client referrals to services for which they are eligible in the housing and other sectors;
- the impact of HFH on housing performance indicators, service utilization, and costs across sectors;
- whether linkages of HFH clients to other sectors create synergies, leading to system-wide improved outcomes and lower costs; and
- whether HFH’s cross-sector impacts reduce health inequities by improving quality of care received and health outcomes among its most vulnerable clients.
- Ricardo Basurto Davila, PhD, MS, Health Economist, Policy Analysis Unit, Los Angeles County Department of Public Health
- Corrin Buchanan, MPP, Director, Diversion and Reentry Housing, Los Angeles County Department of Health Services
A propensity score-matched difference-in-difference research design with longitudinally-linked medical and social service record data is being used to assess the housing initiative’s impacts.