John Merz, Executive Director, AIDS Connecticut.
Five years ago AIDS CT, working in collaboration with Partnership for Strong Communities and five social service agencies in CT received a grant from the Corporation for Supportive Housing using the Federal Social Innovation Fund (SIF) to create a pilot called “Connecticut Integrated Healthcare and Housing Neighborhoods” in which we sought to locate and house high-utilizers of Medicaid who were homeless using an administrative data match between Homeless Management Information System (HMIS) and Department of Social Services Medicaid claims data. This data driven strategy has truly identified the clients we wished and needed to served. Many were faced with complicated illnesses and long-term homelessness. We quickly found that we were serving some of the hardest to serve clients – often those with tri-morbidity (66%) and acute illnesses. This is reflected in the fact that at least sixteen (16 out of 44) of our clients have passed away during the duration of the project.
We hit the ground running with our entire required 1:1 match funding already locked in for 5 years when Governor Malloy committed 150 new Rental Assistance Programs (RAP) to the project. We went from concept to reality rather quickly! We got DSS Medicaid, HMIS and the New York University (NYU) evaluator, to sign the requisite paperwork and then match medical claims and homelessness data – making this happen was not a foregone conclusion! We have the spirit of Carol Walter to thank for that success. We have come to understand that we were the first in the nation to accomplish such a data match. The Melville Charitable Trust agreed to fund a dedicated Project Manager for five years much to our surprise and delight.
We’ve been remarkably successful! We’ve housed 182 persons who were homeless and of those housed, 136 remain housed. We have an 83-90% retention rate! The final analysis: Housing is essential to good health. Just building on this experience we know improvements can be made. The initial review of the evaluation showed that engaging high utilizers of emergency healthcare services with housing and support services reduces the annual cost of medical care and the number of emergency room visits. While we saved money on shelter and hospital expenses, the true vision and focus of the pilot was to improve healthcare, stabilize clients and anticipate savings in the long run. We have done that!
As we begin to wrap up being one of five national sites in this 5-year project we must remember that the lessons we have learned along the way are never going to go away. These lessons are now embedded in the fabric of how we think nationally, about homelessness and its impact on health and how we think about collaboration, on the local level. What we learned because of this project will continue to grow and expand and will be sustained as part of the Supportive Housing initiatives across the state and the nation. As the actual pilot ends, each “aha” moment will be remembered and continuing down the path of ending homelessness to improve healthcare outcomes - will be sustained.
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