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Housing As Health Care NPH Conference. Sharon Rapport, CSH October 3, 2014. Our Mission. Advancing housing solutions that:. CSH Social Innovation Fund. z. An Innovative & Effective Model

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housing as health care nph conference

Housing As Health CareNPH Conference

Sharon Rapport, CSH

October 3, 2014

our mission
Our Mission

Advancing housing solutions that:

slide3

CSH Social Innovation Fund

z

An Innovative & Effective Model

Develop and refine a model of housing linked to care management and coordinated primary and behavioral care through community partnerships.

A Solid Base of

Evidence

A rigorous evaluation on supportive housing‘s effectiveness as a health care intervention for reaching Medicaid‘s high-need, high-cost individuals

A Blueprint for Scaled Replication

Develop a viable policy for Medicaid-funded intensive care management services are paired with federal, state, & local housing resources

GOAL:National replication of integrated supportive housing and health services model as a viable alternative to the “revolving door” for homeless people who are frequent users of crisis health care services

FUNDING:$1.15 M annual award from Corporation for National and Community Service (CNCS): 5 yrs

$425,000 annual award to Tenderloin Neighborhood Development Corporation

$375,000 annual award to Economic Roundtable

STRATEGIES:

SITES:

slide5

10th-Decile Model in Los Angeles

Collaboration

hospitals, FQHCs, homeless services

Health Homes

intensive case management/ care coordination

10thDecile triage tool

highest-cost, highest-need 10% of homeless individuals

Primary care

Permanent Supportive Housing

housing navigation and retention

Behavioral health

Substance abuse

Frequent Users

Navigator

Supportive Housing

The Glue: Intensive Case Management

i.e., Care Coordination + Housing Navigation

slide6

10thDecileHospital Utilization and Cost Avoidance (Actuals): 81% Average Decrease In Total Costs Per Client Per Year

  • ER utilization down 71%
  • Hospital readmissions down 85%
  • Inpatient days down 81%

ER costs down 66%

Inpatient costs down 83%

Total costs decreased 81%

Average cost avoidance per person: $59,415

Largest individual cost avoidance: $2.2 million

25% of the cohort avoided costs in excess of $100,000

Source: FUSE/SIF hospital cost data, September 2013

ab 361 health homes bill mitchell
AB 361. “Health Homes” Bill (Mitchell)

Health Home = Virtual “Home” for Addressing the “Whole Needs” of a Beneficiary

Uses an option under Affordable Care Act to create a “Medi-Cal health home benefit”to Medi-Cal beneficiaries who are—

FREQUENT HOSPITAL USERS

and

CHRONICALLY HOMELESS PEOPLE

Bill signed by Governor Oct 2013

Frequent Hospital User Beneficiaries

Chronically Homeless Beneficiaries

health home services services to address the needs of the whole person
Health Home ServicesServices to Address the Needs of the “Whole-Person”

OUTREACH & ENGAGEMENT

implementation of ab 361
Implementation of AB 361

Define Services: Frequent face-to-face contact (1:20 ratio)

  • Comprehensive care management:
    • Outreach/engagement
    • Motivational interviewing to identify all needs (not just health) & plan to meet all health-impacted needs
    • Assist beneficiary get into housing
    • Promote housing stability: help beneficiaries learn to manage finances, pay rent, shop for or gain access to healthy food, maintain eligibility for benefits, communicate with neighbors & management, and participate in community
  • Care coordination & health promotion:
    • Include HH staff advocacy with health providers
  • Referral to social services & supports:
    • Include partnerships with permanent housing
next steps on health homes
Next Steps on Health Homes

Webinar: Oct-Nov

Stakeholder Process

Draft State Plan Amendment

Concept Paper

Implement (mid-2016)

Ongoing Stakeholder Meetings

Advocacy w/DHCS