Experts Explore Integrating Housing and Health Care Programs to Better Help Vulnerable Populations
Jill Khadduri, principal associate and senior fellow, Abt Associates Good health and stable housing are inextricably linked. That was the message heard by more than 100 housing and health care policy leaders who packed Abt Associates’ forum – “The Intersection of Housing Policy and Health”— at the National Press Club in Washington, D.C. on September 12. They gathered to explore ways that limited housing funds can be leveraged for better health outcomes and potential savings. The forum featured two expert panels who responded to a paper by Abt’s housing experts Jill Khadduri, principal associate and senior fellow, and Gretchen Locke, senior associate. The paper, “Making Subsidized Rental Housing a Platform for Improved Health for Vulnerable Populations,” explored nine changes to federal housing and health care programs that could provide better support vulnerable populations and wider access to services. The three-hour discussion, described by Khadduri as “an energetic and enlightening debate about the opportunities and challenges raised by our paper,” was credited with bringing visibility to an important topic. Of the paper and event, Bill Kelly, president and co-founder of Stewards of Affordable Housing for the Future, said they were “real contributions to the effort to integrate affordable housing and health care.”
View videos from the event. “Evidence shows stable housing sometimes is the best medicine,” said Carol Wilkins, an expert and consultant on supportive housing and health with more than 25 years of experience at state and local levels. Much of the dialogue by panelists – who included federal housing and health care program administrators, policy experts, and private sector housing leaders – focused on:
- Opportunities for collaboration provided by the Affordable Care Act
- Challenges to the strategic distribution of an inadequate supply of subsidized housing
- Administrative barriers to integrating programs between the U.S. Department of Housing and Urban Development (HUD), the U.S. Department of Health and Human Services (HHS), and state and local governments.
Congress’ funding of housing and health care is divided between congressional committees, which pay for the programs with separate budgets, noted Carol Galante, acting Federal Housing Administration commissioner and assistant secretary for housing. Medicaid services are committed to people, not buildings, said panelist Ann O’Hara, co-founder and associate director of the Technical Assistance Collaborative, an affordable housing consultancy.
Barbara Sard, vice president for housing policy, Center on Budget and Policy Priorities Also, housing programs are generally managed at the federal and local level, while states have a key role in Medicaid and other federal health programs. But the White House has the ability to lead by proposing budgets to support collaborative housing and health efforts, said Barbara Sard, vice president for Housing Policy at the Center on Budget and Policy Priorities. “HUD and HHS working together is incredibly important,” said John O’Brien senior policy advisor for the Disabled and Elderly Programs Group at the Centers for Medicare & Medicaid Services, part of HHS. O’Brien noted that HHS’ Office of the Assistant Secretary for Planning and Evaluation has had ongoing discussions with HUD on how to better care for people who are homeless, among other goals. More and more Medicaid programs are turning to managed care to control costs and ensure care coordination. The Affordable Care Act includes subsidies for better health care coordination, which may spur managed care plans to consider housing as part of the care they provide, panelists suggested. However, any combined health care and housing efforts will have to make financial sense for the plans, which may lack the expertise to carry out such groundbreaking work, said Don Moulds, principal deputy assistant secretary for planning and evaluation at HHS. Proponents must demonstrate improvements in health care and lower costs. “We hope the conversations begun at the forum continue and produce changes that lessen the risk of housing and health care crises and improve people’s resilience during such turmoil,” Locke said.
QUESTIONS WE'RE ADDRESSING: How can housing policies improve health for vulnerable populations?