Los Angeles health officials have selected about 100 ill homeless people to live in a newly-built apartment building called the Star Apartments, which includes a medical clinic on the bottom floor. It's part of a multimillion-dollar trial to see how providing housing to chronically ill homeless people can improve healthcare and reduce costs, according to Kaiser Health News.
Without shelter and sufficient resources to fulfill basic health needs, homeless people continually cycle through the healthcare system, as they cannot sustain good health once they are discharged.
"If we don't [provide housing], they tend to die young on the streets," Marc Trotz, director of the Housing for Health program in Los Angeles County, which officially began in 2012, told Kaiser Health News. "And they just continually recycle through expensive healthcare settings."
California now wants to implement a statewide housing initiative. It is asking the federal government to approve the state's use of Medicaid funds to provide housing for the most medically vulnerable homeless, according to the report.
This approach to preventive care is relatively new, as healthcare and housing have traditionally been viewed as separate issues. However, getting the federal government's approval won't necessarily be easy. CMS previously denied a request from New York to provide housing for chronically ill homeless patients because it essentially said it isn't in the business of paying rent, according to the report. Currently, New York pays for this housing with state Medicaid funds.
California's proposal would allow Medicaid to cover a wider population on a consistent basis, making it one of the most comprehensive proposals of its kind. Federal dollars would be used to pay for case managers to help people get what they need to stay in housing, except for rent, including transportation, job assistance and substance abuse treatment, according to the report. California does not yet have a complete estimate of how much federal money it would need.
Critics of California's proposal argue Medicaid funds are limited and should only be used to pay for healthcare. However, studies in several states — including Illinois and Oregon — have shown lower numbers of emergency department visits and reduced length of hospital stays when homeless people move into housing.
Currently, the Los Angeles County Department of Health Services is helping provide housing for 700 people at dozens of sites, and it plans to serve 1,500 more over the next year, according to the report. However, that is merely a fraction of the estimated 12,000 chronically homeless people in Los Angeles. Mr. Trotz said with federal Medicaid dollars, the department could expand its services even further.