1. Barbara DiPietro Senior Director of Policy February 6, 2018
Housing is Health Care: Housing Instability & the Role of Health Centers
Barbara DiPietro
Senior Director of Policy
February 6, 2018
@BarbaraDiPietro
@NatlHCHCouncil

3. Already a full plate Increase number patients
Improve wide range of health outcomes
Integrate MH & SUD services
Achieve PCMH accreditation
Collect more data
XXXX
Expand sites & services
Secure funding
Recruit & retain staff
Achieve financial stability
Demonstrate value

4. Social Determinants of health

5. So much more than clinical care:

6. External factors make our job harder

8. The Big Problem with housing as a Health Determinant
HUD is vastly underfunded to meet needs
No one else pays for it
There’s a critical shortage
There’s no profit in developing affordable housing
It’s funded completely differently than health care; investments made in one budget area realized in another budget area
An entirely different area of expertise

9. Who Am I Talking About?

10. Who Am I Talking about?

11. Health Centers & Homelessness
U.S.
Arizona
Patients <100% FPL
70%
Total homeless patients reported
1,262,961 (5%)
25,690 (~5%)
Non-330H homeless reported
359,665
5,849
# Doubled up reported (330H reporting only)
258,116
3,122
Note: The doubled up population is larger than the street homeless population

12. The Housing problem
50% of all renters and 25% of homeowners are struggling to afford housing
1 in 5 eligible families receive rental assistance
35 rental units available for every 100 extremely low-income
7 million low-income people living doubled up with family or friends

13. The Housing problem XXX
8.3 million households <50% AMI w/no housing assistance (Median: $28K/family of 4)
1 in 6 renters (17%) have worst case needs
Phoenix-Mesa- Scottsdale metro area: 124K HH unassisted
XXX
Source: HUD, Worst Case Housing Needs: 2017 Report to Congress.

14. Cost of housing in arizona
1-BR fair market rent: $722
# minimum wage to afford a 1-BR unit: 56
Rent affordable with FT min wage: $520
Rent affordable to SSI recipient: $221
Rent affordable at 30% AMI ($18,600): $466
Source: National Low Income Housing Coalition, Out of Reach: The High Cost of Housing, 2017

15. Why it matters Health care comes 2nd—after basic needs
Missed appointments, communication difficult
More difficult to access care, adhere to treatment plans
Less effective delivery of medical care
Poor health outcomes
It’s expensive
Impact on value-based contracting
We’re health centers…and it’s the right thing to do

16. actions to consider: Internal
Raise awareness about the importance of housing stability throughout the organization
Ask patients about their housing status
Record it in the medical record (Z59.0/1)
Report the numbers
Do you have a safe and stable place to stay?
PRAPARE: What is your housing situation today? Are you worried about losing your housing?
Brainstorm what is possible with your case management team or others doing support services

17. actions to consider: External
Testify in support of the state and local housing budget
Support restoration of the Arizona Housing Trust Fund
Advocate for greater federal, state and local resources for housing
Engage MCOs to invest in supportive services
Raise housing as an issue on task forces/committees
Ensure value-based contracting takes SDOH into consideration
Include housing in your health care policy discussions

18. Senior Director of Policy bdipietro@nhchc.org www.nhchc.org
Barbara DiPietro, Ph.D.
Senior Director of Policy
@BarbaraDiPietro