Street Roots • Nov. 18-24, 2016
News
Page 7
Oregon Health Authority narrows
focus on housing as health care
BY CORINNE ELLIS
STAFF WRITER
n a report released in late
October, Oregon Health
Authority examined
the role of housing as a
social determinant of
health.
The report,
which surveyed 15
of the state’s 16
coordinated care
organizations, or
CCOs, showed CCOs
offer a variety of housing-
related services and have an eagerness to
invest and expand upon what already
exists.
A CCO is a network
of different types of
health care providers
working together to serve
people in their
community insured under
the Oregon Heatlh Plan.
The report found all 15
networks provide some
type of housing service,
ranging from transitional
housing support to
integrated housing and
health services. The
depth of services
provided varies greatly,
and many reported that
they were offered on a
case-by-case basis.
Increased investment has begun in
Portland with a newly announced health
and housing alliance.
In September, Central City Concern
unveiled its plan for a $21.5 million
affordable-housing donation it received
from a coalition of six health organizations
including Oregon Health & Science
University and CareOregon.
The donations will help fund three new
housing and health care centers that will
provide 382 new units: The Eastside
Health Center will provide housing with
on-site addiction and mental health
services for 176 people, the Stark Street
Apartments will provide 155 units of
workforce housing, and the Interstate
Apartments will offer 51 units for families.
Gov. Kate Brown met with Centers for
Medicaid & Medicare Services, Oregon
Health Authority and Central City Concern
to discuss the important role that this
project would play in providing a well-
rounded vision of health care.
The proposed sites would provide safe
and secure housing, on-site health
programs and improved coordination
between patients and their health care
providers.
According to a Providence Health &
Services study realeased in February, there
is a significant correlation between housing
and improved health. The study found that
I
Health organizations
donated $21.5M for
affordable housing
including on-site
health programs for
Oregon's most
vulnerable residents
access to affordable and stable housing
resulted in a 20 percent increase in use of
primary care, an 18 percent decrease in
emergency room visits and a 12 percent
decrease in spending on medical services.
Of the 1,625 survey participants, the
average person’s health expenditures
decreased by $48 per month after one year
in permanent housing, saving participants a
total of $936,000 over the course of a year.
Getting health providers on board with
transitional housing was crucial, Central
City Concern Executive Director Ed
Blackbum said, because of the assistance
that many people need to address physical
or mental illness.
“People are completely capable if they
could just get off the streets for six to eight
months and get their health issues in
check,” Blackbum said.
Oregon Health Authority’s report echoed
Blackburn’s call for more health-centric
housing. When asked for their top reason
for providing housing support, most CCOs
reported a high need from their patients.
One common thread throughout the
report was that despite the enthusiasm of
CCOs to help get people housed, it often
comes with a financial burden.
Under Oregon’s current Medicaid
waiver, services such as this health and
housing initiative fall outside of the scope
of health-related services despite the direct
impact housing status has on an individual’s
health.
Instead, these services are called
“flexible services.” A flexible service can
be anything from assistance in paying an
overdue utility bill to offering healthy
cooking classes. These extra services can
factor into the overall health and wellbeing
of a person.
Flexible services are considered
administrative costs, so they
aren’t included in a CCO’s rate
setting.
Under Oregon’s current
Medicaid waiver, CCOs can use
Medicaid dollars on services such as
housing support, but many have expressed
a need to expand upon what already exists.
Of Oregon’s 16 CCOs, 12 report they use
flexible services to cover housing-related
services. Two-thirds say they would likely
participate in a collaborative learning with
other CCOs to explore the relationship
between housing and health.
Oregon Health Authority recently
submitted a new Medicaid waiver that, if
approved, would redefine flexible services,
making housing-related costs much easier
to fund. This change would give CCOs
much more flexibility when it comes to
providing services that aren’t inherently
health related but have a positive effect on
health and wellbeing.
In the meantime, there are still many
other barriers to health care access.
Lynne Saxton, director of Oregon Health
Authority, said one of the ways to increase
effectiveness of health care is through
improved communication.
“Health care access is, in part, about
communication and education. So I think
we’re already on that path to having access
be dependent on that education, and that
clarity,” Saxton said.
With an application coming in at a
whopping 25 pages, signing up for Oregon
Health Plan can be daunting. If we are to
break down barriers to health care access,
we must first be willing meet the people
where they are, Saxton said.
“To have informed consumers, you have
to simplify, you have to focus, and you have
to do the outreach in a way that they are
prepared to receive,” she said.
Blackburn, of Central City Concern, said
he’s interested in ways this project can
inspire more progress and hopes to see
similar collaborations in the future.
“Can we inspire other health care
entities and businesses to invest in stuff
like this if they really want to do something
about homelessness?” he asked.