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Affordable Housing , Homelessness , Supportive Housing

Which Comes First? Health Issues? Or Homelessness?

2 September 2014

Amanda Girardin, Deputy Executive Director, Journey Home

Coming to the housing and homeless field with an educational background in sociology and biology, the intersection between health and housing has always drawn my attention.  I used to constantly debate the chicken and the egg conundrum: What comes first?  Does someone experience homelessness and wind up with serious physical and behavioral health issues?  Or, does someone have behavioral and/or physical health conditions and wind up experiencing homelessness?  
I can confidently say, after four years in the field, that I still have no idea.

The one undisputable truth that I have come to realize is that neither health, nor housing stability, can truly be attained without addressing both problems together. It is hard to work on one's health issues while worrying about where you are going to sleep that night. At the same time, it's hard to work on finding housing if you struggle to remember appointments, or are overwhelmed by chronic pain in your joints. Consequently, what most people experiencing homeless need is comprehensive support.

I am thrilled to be working in this field at a time when so many systems-change innovations are converging to radically improve the way we serve this vulnerable population.  As a Medicaid expansion state, a state that funds its own housing subsidies, and a state where numerous providers who -- now more than ever -- are working together both within their field and across silos, we are learning that we can all work more efficiently and effectively and, as a direct result, are seeing significant improvements and better outcomes for the clients we all serve.

I am proud to be working in Greater Hartford as part of statewide collaboratives to bridge the gaps between the health and housing fields. Through the work of CT Integrated Healthcare and Housing Neighborhoods we have housed just short of 100 individuals experiencing homelessness with high Medicaid costs, while providing patient navigation and case management to make sure each client gets the attention he or she requires to address all of their needs.  In various locations throughout Connecticut, hospitals and community based health and housing/shelter providers are working together to implement Community Care Teams aimed at ending the revolving door of shelter and healthcare that so many of our clients experience.  Still other communities are developing medical and social respite programs ensuring that clients do not have to recover in hospital beds or out on the streets. 

All of this work excites me!  I dream of a world in which the person on the street who needs major surgery or a minor procedure does not need to wait until she or he finds a permanent home to receive this life-saving treatment.  A world in which people are not told they must seek out and comply with healthcare treatment in order to have a home of their own.  I am motivated because now that dream is very close to becoming a reality.

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