10/31/2013 - ACA Takes First Steps toward Ending Homelessness

We often talk about the Triple Aim of health reform—better quality, better experience, lower cost.  But I think there is a fourth aim—ending homelessness.

The Affordable Care Act is shifting the focus of health care to the whole person, rather than on tests and procedures.  The law makes it possible for people with the most complex and chronic health conditions—those who need health care the most but who have the hardest time navigating it—to have health care wrap around them, instead of having to wrap themselves around the health system.  It creates the possibility for Medicaid to pay for case management and life skills in permanent supportive housing.

Obamacare gives us the tools we’ve long needed to bring permanent supportive housing to scale—a giant leap in our goal of ending chronic homelessness. 

But before giant leaps come small steps.  Anyone who has ever seen a toddler slip and tumble as she learns to walk knows that first steps are full of missteps. But they are also exciting. They lead to great things and are worthy of celebration. We cannot let a little fear stand in the way of progress. Instead, progress needs support and a helping hand.

Those of you who work on the front lines of the effort to end homelessness know this better than anyone.  You’ve seen those of us with the most challenging health problems and fear of change take those tiny first steps towards a healthier and more stable future. 

At USICH, we’re fortunate to be able to hear from so many of our partners about the first steps that are happening every day across this country.

We hear about people like John from Denver who was uninsured while experiencing a sudden decline in his physical mobility and became homeless.  With the help of Health Care for the Homeless, John enrolled in Medicaid after Colorado’s early expansion effort. With his new benefits, he was finally diagnosed with Multiple Sclerosis, began receiving physical therapy, and took his first steps towards regaining independence and a better quality of life. 

We hear about folks like Scotty in Santa Monica, who was born with a rare genetic disorder that made him unable to metabolize anything but baby formula. He lived most of his adult life in and out of hospitals and on the streets.  But with patient and persistent engagement by a hospital social worker and case managers at Ocean Park Community Center, Scotty agreed to enter permanent supportive housing and get primary care services at a community health center. He was able to take his first steps towards housing stability and health.

We hear about Sarah and Maggie from Framingham, Massachusetts, whose personal tragedies and experience with domestic violence led them down a path of addiction and homelessness. But through Massachusetts Housing and Shelter Alliance’s Home and Health for Good program, Sarah and Maggie obtained permanent housing linked to Medicaid-covered supportive services and took their first steps towards recovery.

And right now, all of us are witnessing our nation takes its own first steps on a journey that extends the right to health care for all Americans, and towards ensuring that the most vulnerable among us, including people experiencing homelessness, are given a path out of homelessness and into stability.  These first steps will no doubt be wobbly.  And they will need support and a helping hand from all of us.

That’s why USICH and our partners have been working to provide useful information on how to help people enroll in Medicaid and health insurance.  That’s why we’ve partnered with the National Health Care for the Homeless Council to develop materials that can help front-line workers to engage and educate people experiencing homelessness about the importance of health care coverage and about their health insurance options.  Over the coming months, we will be providing more information on how to fully make use of the tools Obamacare has given us to prevent and end homelessness. 

So here’s to taking the first steps together on this journey to bring health care to all Americans and to reach our goal of ending homelessness.  I am honored to be on this journey with you.  Thank you.

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