Better Health Through Housing

The program transitions chronically homeless patients from the Emergency Room into permanent supportive housing. Their partner, the Center For Housing & Health, has developed a network of 27 supportive housing providers representing ~4,000 scattered site one bedroom apartments dispersed throughout Chicago. The project has housed 59 patients to date, and has found very high mortality (34%) and high rates of uncontrolled chronic disease. Housing is health - it is as a dangerous health condition.

Innovation Summary

Innovation Overview

When the program started there were no obvious, solid business reasons for a hospital to pay for housing. However, as a state institution that serves the indigent of the state, the University of Illinois Hospital & Health Sciences System  (UI Health) began to recognize their obligation to focus on the health of the communities that we serve, not just individual patient care.

They have discovered that homelessness carries significant health risks, with a 34% mortality rate in their first cohort of 26 patients, and high rates of uncontrolled disease, serious mental illness and substance use. Once housed, they saw healthcare utilization and cost decrease significantly (45% overall).

UI Health is actively encouraging other hospitals to view this as an intractable issue that can only be solved through collective impact, and "all-in" approach where competitors and stakeholders cooperate to address a serious public health concern. To that end, UI Health is one of the founding members of the cross-sector partnership, the Flexible Housing Pool, a common funding mechanism that aggregates fragmented funding sources into a unified stream. Working with government agencies, and supportive housing providers, UI Health have garnered $8m with a goal of $12m from the city, county, insurance companies, other hospitals, and philanthropic organizations. UI Health hope to have financial contributions from the jails and prisons, since they know that homelessness is a key driver of recidivism.

The multiplier effect of the FHP is that it will create increased housing capacity - once fully funded, there will be approximately 750 more supportive housing units available throughout the city.

Another innovation is the use of Natural Language Processing (NLP) to identify homelessness in an electronic medical record. When the program began in 2015, less than 100 homeless patients had been identified. Using data mining techniques, we have found evidence that since 1997, 10,000 patients may have been homeless. In 2019, we have found approximately 1,700 patients are currently homeless.

Finally, UI Health have come to believe that homelessness is not a failure of the individual, but of systems. The patients in the program had significant interaction with law enforcement, emergency medical services, the courts, jails, prisons, hospitals and social service agencies. UI Health has created a new position, Associate Vice Chancellor for Systemic Social Justice, whose responsibility is to seek alignment and shared priorities among public sectors who have traditionally worked in isolated silos.

Innovation Description

Innovation Development

Innovation Reflections

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Year: 2015
Level of government: Regional/State government

Status:

  • Identifying or Discovering Problems or Opportunities - learning where and how an innovative response is needed
  • Evaluation - understanding whether the innovative initiative has delivered what was needed
  • Diffusing Lessons - using what was learnt to inform other projects and understanding how the innovation can be applied in other ways

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