Housing is health care, and this bill can help provide it
It is time for our state to acknowledge what our hospitals already know: Housing is health care.
Gov. Jerry Brown can take an important step in recognizing housing is health care by signing Assembly Bill 74 by Assemblyman David Chiu, D-San Francisco.
Our emergency department staff at Santa Clara Valley Medical Center can do little to prevent a homeless patient from returning again and again to the hospital for preventable and manageable conditions.
People experiencing homelessness are more likely to be admitted as patients and stay longer than those with similar medical issues who are housed. And homeless patients develop geriatric signs as early as age 45 or 50, and die from conditions that could have been treated if only they had a safe, decent place to live.
Californians experiencing long-term homelessness face a combination of chronic medical, mental health and substance abuse struggles. They are often frequent users of hospitals and nursing homes, and incur disproportionate MediCal costs.
Because they cannot obtain sufficient rest, follow a healthy diet, store medications or regularly attend appointments, they become the sickest patients and their inpatient costs significantly increase the longer they remain on the street.
Counties like Santa Clara are taking steps forward with bonds to build housing and with programs like Whole Person Care, an innovative approach to caring for the highest-risk and most vulnerable patients.
AB 74 would be another important step forward for our county and the entire state.
AB 74 offers a whole-person-oriented approach to serving vulnerable Californians by creating the Housing for a Healthy California Program. It ties housing resources available through the national Housing Trust Fund, a dedicated source of annual federal funding, to creating supportive housing for the most expensive homeless Medi-Cal beneficiaries.
AB 74 would require the state to track Medi-Cal data on beneficiaries as they move from homelessness to supportive housing.
Outcomes of conditions, utilization of services and changes to costs would allow the Legislature to determine future investments in the program.
Many studies already confirm that supportive housing decreases emergency department visits, hospital inpatient stays, nursing home days and psychiatric inpatient admissions.
In one example, Medi-Cal beneficiaries in supportive housing reduced their hospital costs by $3,841 per person after one year and $7,519 per year after two years.
Other studies of chronically homeless people who moved into supportive housing show drastic decreases in hospital and nursing home stays within a year. Some states have documented avoidance of medical costs surpassing $17,500 for each resident in supportive housing.
More important than the potential cost savings is the undeniable fact that getting people into housing saves lives and allows our care system to focus on effective treatment, rather than the challenges of trying to help people we know will return to our streets and into a cycle of ever-deteriorating health.
For these reasons, hospitals across the country are embracing stable housing as the key to better health care and improved health for all Americans. By signing AB 74, the governor can recognize the same.
People experiencing homelessness are more likely to be admitted as patients and stay longer than those with similar medical issues who are housed.
A homeless man sleeps on the ground at St. James Park in downtown San Jose.