Homelessness and Health: The Connection Requires the Health Care Industry to Act

John Baackes, L.A. Care CEO

February 6, 2020

Frustrations are mounting over the growing number of homeless in Los Angeles County. Despite legislation that devoted hundreds of millions of dollars to address the crisis, the number of individuals experiencing homelessness in the county jumped 12 percent from 2018 to 2019. In a recent poll, a majority of county residents said it’s time for law enforcement to get more involved in “cleaning up the streets.” I say, it’s time for the health care industry to get more involved as well.

Homelessness is a public health issue. People living on the streets, often in squalor, usually lack food, clean water, and access to regular health care. The ailments that can follow, many of which can spread beyond the homeless population, leave those experiencing homelessness with a life expectancy 20 years lower than those who are housed.

The lack of affordable housing in L.A. County has contributed to the rise of homelessness. In fact, the county is short about 500,000 affordable units. Housing is directly tied to good health, so the health care industry must do everything it can to help keep families in their homes. This would ensure a healthier workforce and would lower health care costs. 

It clearly takes more than a health plan ID card in your wallet to live a heathy life. In fact, only 20% of overall health outcomes are tied to medical services. That’s why L.A. Care Health Plan, the largest publicly-operated health plan in the country, recently co-sponsored a Homeless Health Summit. More than 60 leaders from the L.A. County health care sector came together to develop an action plan. The leaders identified local, state, and federal policy priorities to purse in seven domains to address the health and social needs of those experiencing and those at-risk of homelessness.

They include:

  • Prevention
  • Transitions of care
  • Delivery of patient-centered health care
  • Behavioral health care access
  • Enhanced housing navigation and supportive services
  • Expanded supply of and access to housing resources
  • Integrated data sharing and care coordination platforms

The summit coalition plans to advocate, mobilize resources and bring actionable solutions to policymakers, but L.A. Care has already taking action on its own. In 2017, the health plan committed $20 million over five years to support the county’s Housing for Health program. The goal was to provide permanent housing and supportive services to more than 300 households experiencing homelessness. So far, 252 slots have been filled.

L.A. Care also launched a recuperative care pilot a year ago, leasing 16 beds at a National Health Foundation facility. Recuperative care programs provide immediate housing, on-site medical supervision, case management and supportive social services for patients experiencing homelessness who are transitioning out of an acute-care hospital. It’s basically a safe place to heal.

Helping those who are already experiencing homelessness is important, but L.A. Care is also taking steps to help families stay in their homes. Last summer, the health plan awarded $500,000 to four legal aid agencies as part of its new Housing Stability Initiative. The funding will be used to help low-income individuals and families avoid eviction. The agencies will offer pre-eviction counseling, landlord negotiation, and will represent people in court when needed.

There is no silver bullet when it comes to solving the homeless crisis, but with a record number of homeless individuals dying on our streets – more than a thousand in 2018 – it’s time for a comprehensive approach to deal with the problem. We have made a start, but it will take a long-term commitment to bring about a major change. Overcoming the homelessness crisis is truly a shared responsibility that will require collaboration across a variety of entities and industries. It’s hard work, but the benefits stretch far beyond the individuals and families who will gain a roof over their heads.


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