Delivering quality, comprehensive healthcare to patients experiencing chronic homelessness, extreme poverty and disease is not easy. Whether patients find “housing through healthcare” or “healthcare in housing” Los Angeles Christian Health Centers (LACHC) understands the critical connection between healthcare, housing and wellness. The challenges of managing chronic illnesses like diabetes, hypertension, substance abuse and depression become extraordinary obstructions when patients are homeless. At LACHC there is hope, help and 20 years’ worth of commitment and innovative partnerships aimed at overcoming the barriers to wellness created by homelessness, poverty and disease.
For patients who are homeless and able to make it to an LACHC Clinic, LACHC provides social services to help make a way to housing and health. For those unable to make it to a clinic, LACHC reaches out through street medicine in partnership with agencies striving to help the most vulnerable by providing supportive housing with on-site healthcare.
Gina Jones, Director of Social Services at LACHC says, “One of the largest barriers to good health and mental health outcomes is the instability that comes from living on the streets or in emergency shelters. Over and over, we have seen that stable housing has been a foundation on which the patient can build to achieve positive health, mental health, and social outcomes.”
Housing through Healthcare
Joe experienced homelessness on and off since he was 17. When his wife died 5 years ago he was devastated and slid into the grips of depression and landed homeless on Skid Row. It wasn’t until he ended up on the steps of LACHC’s Joshua House clinic that his life and health began to change for the better. In addition to coming in for medical visits, Joe met with Gina at LACHC regularly for months.
Joe says, “I would cry every time I met with Gina, because of her kindness.”
Gina worked to guide Joe through the process of accessing benefits and connecting him to a program which provided housing vouchers and ended his homelessness. Joe is stably housed now and still visits the Joshua House clinic for health care and social services. Joe found housing through healthcare.
Social Services at LACHC prioritizes housing for patients experiencing homelessness and disease. Their case managers use LA County’s Coordinated Entry System (CES) to streamline the process of finding housing for patients. CES is the coordinated effort of more than 200 agencies connecting homeless adults to the best resources for them.
Gina says, “After years working on Skid Row I finally feel like we are working together, it used to take me 2 years to house my most vulnerable patients, With CES it took 6 months.”
This year LACHC case managers have placed more than 30 patients into housing. This cooperative effort is part of the kind of innovation that can work to end homelessness and grow wellness amongst the most vulnerable.
Gina suggests that, “In a way, obtaining permanent housing is an intervention that can improve health outcomes. Indeed, it offers patients the ability to cook healthy food instead of eating whatever is given to them, it allows them to have a secure place to store and organize their medication, and it gives them the ability to obtain regular sleep so that they are more likely to attend their medical appointments. Social determinants such as homelessness directly impact an individual’s health and make it imperative that housing resources are able to be accessed through the patient’s medical home.”
Healthcare in Housing
Barbara remembers the day three years ago, November 8, 2012, when Maurice (Exodus case manager) came to her tent at 19th and Hope to deliver the news that her homeless days were over. A warm bed is what she remembers most about the first days in her New Genesis apartment on Main Street. What came next was regular meals, help for the depression that caused the suicide attempt just months before, and medicine to manage her hypertension and depression. Barbara says she got, “happy, stable and well.”
Having a medical home located on the first floor of her apartment home makes an incredible difference in her health and wellness. Now she sees LACHC Medical Provider, Cindy Kang, PA, regularly and stays on top of her medical care. When Barbara was sick with a cold for more than 2 weeks, she went downstairs in her pajamas to see Cindy. For Barbara, this would not be possible living on the streets. Barbara found healthcare in housing.
LACHC’s satellite clinic at the New Genesis Apartments is another example of the kind of cooperative effort it takes to make a difference for someone like Barbara. LACHC works with the Skid Row Housing Trust (The Trust) and Exodus Recovery, Inc., Integrated Mobile Health Team (Exodus) to provide the support Barbara needs to stay well. The Trust provides the housing and supportive services, Exodus provides the mental health care and LACHC is the on-site medical clinic serving the 67 formerly chronically homeless men and women now stably housed and healthier at New Genesis Apartments. LACHC is also the medical partner for the Exodus Integrated Mobile Health Team and Cindy goes out weekly with the team to care for patients who aren’t able to make it to a clinic and don’t have stable housing.
A recent survey completed by Practice Based Research Network on these collaborative efforts revealed a staggering 82 percentof Exodus participants reported fewer emergency room visits and 72 percent reported improvement in access to healthcare 2 years into the program.
Cindy says, “Many previously chronically homeless patients in supportive housing have not had consistent medical care for much of their lives and many have mental illness or substance abuse history too, which is a huge barrier to get care. Having a clinic where they live helps to break through many of those barriers and really meets them where they are at so it becomes easier to ask for care.”
LACHC takes a patient centered, team-based approach and wraps services around every patient throughout their network of two full-time clinics and 10 satellite sites.
The motto, “Serving All, With Open Hearts” means LACHC is here to serve everyone and that there is no ‘wrong door’ to access services at LACHC. The mission, “To show God’s love by providing quality, comprehensive healthcare services to the homeless and underserved.” reflects a commitment to share compassion and sincere desire to be a source of healing for their neighbors suffering through poverty, homelessness and disease.