Housing is Health Care—and Health Care Can Build Housing

When Pamala Deffee found housing at Kelly Cullen Community in San Francisco, her health and sense of well-being greatly improved. Photo courtesy of Tenderloin Neighborhood Development Corporation.

Before Pamala Deffee was living and working at one of our buildings, she didn’t have a home. She had been in and out of health facilities, battling breast cancer and addiction, until she found Kelly Cullen Community in San Francisco.

Kelly Cullen is a unique example of how health care can fund supportive housing, or homes coupled with onsite support services. The San Francisco Department of Public Health funds two-thirds of the building’s rent. Another source of funding comes from the California Department of Health Care Services’ Mental Health Services Act.

As one of the four projects in the pioneering CSH Social Innovation Fund Initiative, Kelly Cullen houses 172 formerly homeless adults. The Innovation projects were evaluated in a four-year New York University study that ended last year. The study demonstrates how supportive housing improves the quality of life for people who were previously homeless and creates significant reductions in health care spending.

Stable housing “was a very big change for me,” said Deffee, who has been living at Kelly Cullen Community for a year. “It has saved my life actually.”

Don Falk

A home greatly improved Deffee’s physical health, sense of well-being and ability to thrive independently. Housing Deffee was also less expensive to the health care system than allowing her to remain homeless.

When Deffee was homeless, she had to rely on the city’s health care and shelter systems to survive. Days spent in a hospital or shelter, visits to the emergency room, and medical and psychiatric hospitalizations—it all added up.

The national average for an emergency room visit is $1,233, medical hospitalization is $12,600, and a psychiatric hospitalization is $6,300, according to recent statistics.

Not housing someone costs all of us.

Organizations across the country see supportive housing as an opportunity to end homelessness and save money. The Massachusetts Pay for Success Initiative already saved the Commonwealth $14,368 per person within the first six months of housing 712 people. The University of Illinois’ Better Health Through Housing pilot program estimates it will cut nearly two-thirds of emergency service costs by providing homes for its emergency room “super-users.”

Traditionally, the housing and health care industries have viewed one another as distinct. This distinction has prohibited us from seeing our broader intersections with economic, social and racial equity—and the solutions.

When we invest in supportive housing, we invest in communities that our country has historically discriminated against. Communities that are still facing serious consequences like a lack of healthy foods, public transportation, quality education and health care.

We have the power to change that reality and invest in everyone’s health and well-being.

We need to start by pushing for policies that make it easier for health care to fund supportive housing. Health care can treat supportive housing as a service. Supportive housing can create more opportunities for people who heavily rely on health care. Shelter Force, a nonprofit publication covering affordable housing, shares more about how health care can fund housing.

You can make a significant impact in the battle against homelessness by advocating for health care to invest in supportive housing.

Only when we embrace the intersection between our industries can we make real progress on our shared vision: to see everyone living a happy, healthy life.

Don Falk is the CEO of Tenderloin Neighborhood Development Corporation, a nonprofit that builds affordable homes and supportive communities in San Francisco.

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