July 19, 2017

Keeping Your Home During a Health Crisis: A Flexible Funds Pilot Update 

A Flexible Funds Pilot Update 

By Amanda Saul, senior program director, Pacific Northwest Market

As with many West Coast cities, Portland is experiencing a housing crisis as ownership rates decline; prices rise; rents escalate and the vacancy rate remains below three percent. Entire apartment buildings are bought, and subsequent rental increases displace residents.  

There is a shortage of housing at all income levels, but especially for the most vulnerable – those earning below 50 percent of area median income, or $37,350 or below for a family of four. One way to reduce the impacts of the housing crisis is to keep low-income people in homes, preventing them from falling into the cycle of eviction and homelessness. But many of these families are a single missed paycheck, unexpected expense or health emergency away from losing their homes. 

Enterprise and our partners – Family CareHuman Solutions and Project Access NOW – sought to prevent this predicament by intentionally linking health and housing.  

We know from our recent Health in Housing Study conducted by Providence’s Center for Outcomes Research and Education that stable, affordable housing improves how people use health care and reduces the cost to Medicaid. By using Medicaid Flexible Services we set out to ensure that when low-income people experience a health crisis, it will not impact their housing, further compromising their health.  

In Oregon, Coordinated Care Organizations can use Medicaid Flexible Services to provide cost-effective services designed to improve health and care delivery, such as food and transportation assistance and housing support related to social determinants of health like shelter, utilities and critical repairs.  

Launched in early 2016, the Flexible Funds Pilot will use health care resources to support housing stability as an effective early intervention to improve the health of Medicaid enrollees. Since the pilot began, the program has served 73 clients experiencing a health crisis affecting their ability to maintain their homes. Medicaid Flexible Services funds were used for rental assistance, security deposits and case management to better connect people to health care services and keep them in their homes.  

The flexible funds helped Janet*, a full-time construction flagger and single mother of teenage triplets, stay in her home when one of her sons developed hip pain and a pronounced limp. He needed not just orthopedic surgery but months of painful rehabilitation afterward. Resources from the Flexible Funds Pilot helped ensure that the family’s home was not in jeopardy and allowed Janet to care for her son and then return to her job.  

With so many low-income Americans surviving month-to-month, the unexpected time off work or costs associated with a health crisis results in a downward spiral of losing one’s home or job, disrupting children’s education and upending a stable home.  These additional stressors in turn result in further health consequences and costs.   

So far, the Flexible Funds Pilot has illustrated a short-term solution with the impact of allowing families to maintain stable housing during a health crisis. On average, clients needed just $725 per month for a little over two months, and all have maintained their housing.  

The pilot program evaluation, anticipated to be completed early 2018, will reveal the impact that the flexible services interventions has on controlling health outcomes and costs in the long term.  

*name changed 

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