Health and Housing

The Health and Housing Initiative will improve and document the link between housing with health care and its impact on vulnerable populations in Oregon, including formerly homeless people, low-income families, older adults and persons with mental, behavioral and physical disabilities.
The initiative focuses on aligning and coordinating the shared objectives of housing and health care entities; supporting housing providers with grants and technical assistance to develop integrated health care models; and sharing research and establishing best practices locally and nationally.
The initiative’s long-term goals are

  • Improve and document health and services outcomes for low-income vulnerable residents
  • Improve connections between the affordable housing and health care industries
  • Make policy, legislative and regulatory recommendations to encourage more, cost-effective housing with health care

Flexible Funds Pilot Program

Enterprise, along with a number of partners including FamilyCare Health, Human Solutions and Project Access NOW, is implementing the first Flexible Funds Pilot program in Portland, Oregon. Started in January, 2016, the two-year pilot will use grant funds and actual Medicaid Flexible Benefits funds to provide short-term rental assistance for people experiencing both a health and housing crisis. These funds coupled with case management will help to reduce evictions, support rapid rehousing and increase positive health outcomes. The pilot will serve approximately 50 Multnomah County families with a focus on transition age youth, ages 15-25, experiencing a housing and health crisis due to physical or mental health challenges, by providing assistance for a period of up to 12 months. 

The pilot will evaluate the use of health care resources to support housing stability as an effective, early intervention to improve the health of Medicaid enrollees. To conduct the Flexible Funds Pilot, a system and partnerships with healthcare providers have been created that can be replicated across the state. If successful, it is hoped that this will lead to more health care systems using Medicaid Flexible Funds to keep people stably housed while experiencing a health crisis. 

In its first five months of serving clients, the program has served 24 families, including a working mother who needed time off to care for her son after corrective hip surgery. After the procedure, the 15-year-old boy required 24-hour care as well as months of rehabilitation. Because of the Flexible Funds Pilot, the family’s housing was stabilized until the youth recovered and mom returned to work full-time.

The pilot is made possible thanks to our funders: Meyer Memorial Trust, Providence Health Systems, FamilyCare Health and the Collins Foundation. 

Oregon Health and Housing Learning Collaborative

Enterprise has established a peer-to-peer collaborative to coordinate and support efforts by nonprofit affordable housing providers and their service partners to develop strategies that improve the health and well-being of residents, while demonstrating cost savings to the health care system. The Oregon Health and Housing Learning Collaborative (OHHLC) provides support to improve, test and scale participants’ models, strengthen partnerships with health care payers, identify best practices in service delivery models and measure success in improving outcomes and cost savings to the health care system.

OHHLC members comprise nine housing organizations that provide affordable apartments to thousands of residents including low-income families, seniors and people with histories of homelessness, criminal convictions, substance abuse and serious mental and chronic physical conditions. Participating organizations are Cascadia Behavioral HealthCatholic CharitiesCedar Sinai ParkCentral City ConcernHome ForwardHuman Solutions,Innovative Housing, Inc.Northwest Housing Alternatives and REACH CDC.

To learn more, view our case studies that document how our housing partners are improving health outcomes while demonstrating cost-savings:

  • Home Forward's Bud Clark Commons property showed an average 45% decrease in health care expenses after resident move-in.
  • Breaking ground on a new delivery model, Housing with Services, LLC brings together housing providers, health insurers and service providers to create affordable housing with integrated health services.  

Connecting Housing and Health Care Cost Savings with Research

Enterprise partnered with Providence’s Center for Outcomes Research and Education (CORE) on the 2016 report Health in Housing: Exploring the Intersection between Housing and Health Care to assess the impact of stable housing and services on health outcomes, cost and quality. The in-depth study analyzed Medicaid claims data for more than 1,600 residents in 145 affordable housing properties in Portland, Oregon.

Build Capacity of Affordable Housing Providers

Enterprise is providing technical support and health care system knowledge to housing providers to improve their health and services models.

Grant Support for Promising Models

Enterprise is providing more than $195,000 through HUD Section 4 Grants to four housing providers that are developing housing plus health care integration strategies.

Cascadia Behavioral Health will enroll 50 residents at its scattered site independent housing in the Oregon Partnership for Health Integration. The grant will fund a full-time, peer-to-peer wellness specialist, data collection and client support.

Innovative Housing, Inc. will expand their proficiencies in delivering services and resources by developing new partnerships in the health and housing community and piloting a replicable primary care project at Musolf Manor, which serves formerly homeless and disabled adults.

Cedar Sinai Park will provide on-site health and social services at eight Section 8 housing facilities in Portland to reduce nursing home costs, frequency of hospitalization and ER visits and to increase resident participation medical care decision making to improve health outcomes.

Central City Concern (CCC) will create assessment tools and resources for resident services staff to connect high-risk and high-cost individuals to health care. CCC will develop a collaborative model between service providers, health providers, and housing providers, identify financing for affordable housing and services, and recommend policy to make health care and housing more replicable and cost effective.

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