The city of Baltimore and 10 local hospitals, including Johns Hopkins Hospital and University of Maryland Medical Center, are partnering to provide housing and services for 200 people and families, a program they hope will be a model for ending homelessness.
The aim of the two-year pilot effort is to show that its “wraparound” treatment keeps people healthy, productive and in permanent homes. Leaders also hope to show the program is sustainable because they believe it will reduce health care spending over time.
“Baltimore is committed to ending homelessness and not just managing it,” Democratic Mayor Bernard C. “Jack” Young said in announcing the program Tuesday at City Hall. “And the best way to end homelessness is through access to affordable housing. As our administration identifies more housing opportunities for our most vulnerable individuals and families, we are thankful to our hospital partners for investing in the essential services necessary to truly end homelessness.”
The hospitals contributed $2 million to cover the cost of support services, such as help with utilities, furniture and rides to doctors’ offices.
City officials have been working to find housing for Baltimore’s estimated 2,500 homeless residents, but they have been stymied not just by lack of housing supply, but also by the need for those support services, said Terry Hickey, director of the Mayor’s Office of Human Services, who worked on the deal.
He and Kevin Lindamood, president and CEO for the service provider Health Care for the Homeless, began approaching hospitals about a year and a half ago and asking for help. The hospitals saw an opportunity to improve the lives of their patients and their own bottom lines, as many people return routinely with health problems caused or exacerbated by a lack of stability in their housing situation.
Under the plan, the city identified public housing units and units supported with federal vouchers. A small number of units were renovated by private developers for the program.
Then, the city won approval from federal authorities to use money from Medicaid, the public health care program for the poor, for the extra support services that aren’t directly related to health care delivery. Such costs are not normally allowed. The hospitals’ money will pay for the local share of the Medicaid costs.
Lindamood said the services are crucial, as many people coming off the streets have no means of navigating basics of life and have no network of family or friends to help. Some people don’t know how to fill out a rental application. They often have acute medical needs or chronic conditions, but can’t regularly access care or medications. Sometimes, they suffer from psychiatric emergencies.
“You can’t just throw someone in a house and expect them to be successful,” he said. “This program will test our assumptions in Baltimore and around the country that these services help keep people in homes.”
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Dr. Mohan Suntha, president and CEO of the University of Maryland Medical Center, said about 10% of the patients admitted to the center’s downtown or midtown campuses are homeless. A third have housing instability. And that means they can’t go home and properly care for their health.
“Safe, supportive housing is a primary driver of the social determinants of health,” he said, “and every day we see the impact of those who do not benefit from consistent housing.”
Dr. Redonda Miller, president of Johns Hopkins Hospital, said some research already shows supportive housing efforts locally and around the country improve health and reduce costs from emergency room visits and hospital care.
She and the other hospital and city officials say they will collect evidence from this program. What they find could lead to long-term changes for the Medicaid program.
“For the past year, my colleagues and I have met regularly with the city to explore innovative ways we can work together to address the social and economic stressors that impact health and wellness outside the walls of our hospitals,” Miller said. “This investment in supportive housing services is an important next step in our care of our communities.”
About 100 units in the program are spoken for. City officials expect to begin reviewing more applications soon, once state Medicaid administrators approve support services through the program for the next 100 units.
Participating hospitals include Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, University of Maryland Medical Center-Downtown, University of Maryland Medical Center-Midtown, Sinai Hospital, Mercy Medical Center, MedStar Union Memorial Hospital, MedStar Harbor Hospital, MedStar Good Samaritan Hospital and St. Agnes Hospital.