Healthcare and Housing
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Transcript of Healthcare and Housing
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How to get healthcare to pay for housing?
Joshua D. Bamberger, MD, MPH
Associate Clinical ProfessorFamily and Community Medicine
University of California, San FranciscoSan Francisco Department of Public Health
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Why do we provide healthcare?
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Mortality DAH vs Regular Care1996-2003
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Plaza High Utilizer Study
• 106 Chronically homeless adults• Cost year before housing: $3,132,856 • Cost year after housing: $906,228• Reduction in healthcare costs: $2,226,568 • Cost of program:
$1.1million/year• Reduction in public
cost in first year: $1.1 million
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• Direct Access to Housing- 1730 units in 43 buildings– 6 buildings (N=510; 33%) with nurses
• Tailor housing to the needs of an individual• Initially SRO, now new buildings• Priority to people with multiple disabilities• 7.6% HIV+• Housing first, harm reduction, supportive housing
SF Health Dept’s Housing
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DAH Portfolio
•
253 286604 678 704 704 878
0 0
177 247 339
689
020040060080010001200140016001800
99-00 2001-2 2003-4 2005-6 2007-8 2009-10
2011-2015
NewMaster-lease
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HIV, Homeless and Survival
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HIV, Homeless and Survival
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Windsor Empress LeNain PBI CCR West Folsom Dore Plaza 149 Mason 990 Polk Mission Creek
7.6
3.5
6.8
3.9
5.3
2.7
5.0
3.5
2.5
4.0
3.1
R² = 0.388887624467414
Death by Quality of Housing%death
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Death Rate/year0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
Death rate Le Nain vs. Mission Creek 2006-2011
Le Nain death %MCSC death %
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2010 2011 2012 2013 2014 20150
100
200
300
400
500
600
HennepinLexingtonTacomaFort WorthBirmingham
Measured
-------Projected
______
Number of Homeless Veterans in 5 Communities with Greater than 40% reduction 2010-2012
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“It costs less to house homeless people than to leave them on the streets and in shelters.”
-Shaun DonovanU.S. Secretary of Housing & Urban Development
The Daily Show, March 5, 2012
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We know that housing..• Improves health• Reduces cost• Improves quality of life• Delivers on a moral imperative to care for the
people who cannot care for themselves
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Tale of Two Patients
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How can we have healthcare pay for housing?
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How to get healthcare to pay for housing?
Joshua D. Bamberger, MD, MPH
Associate Clinical ProfessorFamily and Community Medicine
University of California, San FranciscoSan Francisco Department of Public Health