Today, health professionals across the nation are looking increasingly at social determinants of health that can lead to negative and avoidable outcomes, including chronic illnesses like diabetes. These conditions drive demand for costly services such as emergency room visits, hospitalization and nursing home admissions. Research shows that while clinical care accounts for some 10% of an individual’s health, a whopping 70% is all about factors such as food security, nutrition, and exercise, smoking, alcohol and drug use, education, income and employment, family and social supports and public safety.
With this in mind, health providers are looking beyond the usual way of doing business to keep people healthy and reduce costs, including the expansion of resident services and cross-sector partnerships which have been successful in aiding social determinants of health. In April 2016, the Low Income Investment Fund (LIIF) and Goldman Sachs Bank hosted a roundtable discussion of the need for and role of affordable housing-based resident services programs in improving health as a partner to health systems. The conversation explored what each of our organizations can do to support healthier families and communities. Documented in a new paper, Leveraging Resident Services Programs in Affordable Housing as Partners in Health Care Transformation, the emerging ideas offer a way to strengthen these connections and expand resident services for low income households.
Resident Services Address the Social Determinants of Health for Low Income Households
LIIF has always seen affordable housing as a platform for the many important factors needed to create positive health – and life – outcomes. However, it takes more than a stable and secure roof over one’s head to secure long-term wellbeing. Many affordable housing organizations staff their properties with resident services coordinators (RSCs) who connect low-income, senior and disabled residents with a range of resources that address social determinants of health. RSCs typically have social work, counseling or related backgrounds and have language and cultural competency appropriate to the community in which they work. With their physical accessibility to residents, they are able to forge more personal communication that can help reach individuals who may be reluctant to seek help. For example, they connect residents to outside resources in the community, provide case management and referrals, conduct community outreach to assess needs and obtain outcomes data, among other services.
These programs are seen as essential elements to successful housing operations, but are not consistently funded by housing subsidies. This often forces organizations to stitch together resources through fundraising, residual receipts of the property, developer fees and government funding, where available, to provide as many resident services coordinators as possible. These funding sources, however, are often insufficient to provide adequate staffing for all residents.
Ways to Connect Resident Services to Health Systems
While funding of resident services by health providers is not yet routine, some housing organizations have been able to start a relationship with a hospital or health plan that supports or works with their resident services programs. Case studies from Massachusetts General Hospital and Chicanos Por La Causa illustrate the benefits of such strategic partnerships:
- An interdisciplinary team known as Senior HealthWISE, affiliated with the Massachusetts General Hospital, regularly visits Blackstone, a 145-unit Boston property owned and managed by Preservation of Affordable Housing (POAH). The team consists of a senior nurse, geriatric social worker and resource specialist who meet with senior and disabled residents one-on-one. POAH’s RSC works closely with hospital staff and, collaborating with the Blackstone’s property management, can identify and refer residents who need medical assistance or who have been hospitalized.
- Chicanos Por La Causa (CPLC), an Arizona-based community development corporation serving urban and rural communities statewide, has piloted an integrated health and human resources partnership with UnitedHealthcare called the myCommunity Connect Center™. The wrap-around service model to address social determinants of health is based at a one-stop center staffed by community partners providing referrals and transportation to social services, jobs, health care, housing and financial counseling.
Affordable housing providers, health systems and local government can continue strengthening the role of resident services coordination to improve health through increased funding and coordination. The Learning Report issued by Robert Wood Johnson Foundation offers an additional look at ways to use social determinants of health to improve health care. At LIIF, we will continue exploring ways to promote the social determinants of health by investing in projects that support thriving communities.