Tenancy support may lead to better housing — and health

A home is more than a roof over a person’s head. It’s a place to cook meals with family and a place to feel safe. It’s also a key social determinant of health — a crucial external factor that determines a person’s overall quality of life. Simply put, it is impossible for a person to stay healthy without housing, particularly those with chronic diseases and complex conditions.

Yet in some cases, access to housing is only the beginning. A key challenge of state and local communities is to make sure that when people find housing, they are able to stay in it. These housing-based services that help people obtain and maintain stable housing are known as tenancy supports.

Washington State, recognizing the connections between health outcomes and housing stability, has established systems for Medicaid plans, like UnitedHealthcare, to provide these types of tenancy supports for the members it serves. With the current rates of homelessness throughout the state, it helps fill a crucial need to get people connected to the services that can help them stay in their home.

Now in its fourth year, the tenancy support services provided include things like:

  • Identifying housing resources and completing housing assessments
  • Assistance to complete housing applications
  • Resolving disputes with landlords
  • Independent living skills development

UnitedHealthcare’s WA Housing Specialist, Ben Miksch, supports the compassionate approach to understand the issues facing tenants and help these members stabilize their housing to help improve health outcomes

“Tenancy support services are considered medically necessary for many of these individuals, who are often disabled and at-risk for, or currently experiencing, chronic homelessness,” Ben said.

Health issues that may result from unstable housing include:

Not to mention the toll on one’s mental health. Just the threat of eviction, especially when there has been a job loss, can be stressful, if not traumatizing. When someone becomes homeless, those traumas and impacts on health build up, resulting in life expectancy rates that can be decades shorter than national averages.

With this added support for tenants, Medicaid and homelessness systems become more aligned on the common goal of improving health outcomes, and reducing emergency care visits, through stable housing.

Preliminary evaluation findings released by the Washington Health Care Authority show increases in transitions out of homelessness as well as reductions in inpatient and emergency room utilization – but that’s only half the story,” said Ben. “To me, the real story is the impact in peoples’ lives. To go from living outdoors to being stably housed and connected to appropriate behavioral health and primary care services is totally life-changing. As one program participant put it, ‘I felt like a human being again.’”

Finding the right combination of organizations in order to offer wraparound services is critical to creating lasting, sustainable change. For example, someone may need assistance finding affordable housing and later may need connections with legal assistance to help with a landlord situation. Funding these resources through Medicaid helps create more stabilized housing support and drives overall health care cost savings.

“Coordinating these medical and nonmedical services will be critical to lowering care costs,” Ben said, “and improving health outcomes for today’s unhoused populations.”  

Read more about tenancy support on the UnitedHealthcare Community & State blog.

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