A Qualitative Evaluation of Housing for Health in Los Angeles County

Published in: Journal of Social Distress and Homelessness (2021). doi: 10.1080/10530789.2021.1908486

Posted on RAND.org on April 13, 2021

by Alina I. Palimaru, Kathryn G. Kietzman, Nadereh Pourat, Ricardo Basurto-Davila

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Homelessness is a widespread and challenging social and public health problem across the United States. Homelessness exacerbates poor health, social, and economic functioning. Permanent supportive housing (PSH) is a housing program model that provides housing as well as a range of supportive services to address co-occurring physical, mental, and social needs. The Housing for Health (HFH) program is modeled on PSH and was launched by the Los Angeles County Department of Health Services in 2012 with the aim of providing permanent supportive housing to individuals experiencing homelessness identified as frequent users of health services. This study uses data from 14 qualitative interviews with senior leaders and nine focus groups with tenants and program staff to understand tenant experiences with HFH and non-HFH programs, as they relate to care coordination. We report linkages to care and social services, variations in care coordination intensity, and the impact of workforce issues on tenant experience. The findings from this study underscore the value of housing programs that promote care coordination across service delivery sectors, and that adopt person-centered approaches to care. Lessons learned from programs like HFH are relevant for many stakeholders that may become providers of housing, as incentivized by recent Medicaid expansions.

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