The Health Prescribed Housing (HPH) model represents a paradigm shift in how we address the intertwined crises of homelessness, housing insecurity, and healthcare over-utilization. Our comprehensive approach integrates housing and healthcare services, creating a sustainable ecosystem that benefits individuals, communities, and healthcare systems.

Identifying and Serving High Utilizers:
We focus on populations with the highest need who are also high utilizers of the healthcare system. This includes individuals experiencing homelessness, transitional aged youth, those re-entering society from the carceral system, domestic abuse survivors, and families in high-emission neighborhoods. For these individuals, stable housing often proves to be a more cost-effective intervention than repeated emergency medical care.

Innovative Capital Reallocation & Financing:

Unlike traditional affordable housing finance, HPH leverages investments directly from health insurers and Managed Care Organizations (MCOs). Our funding approach is rooted in the principle that reducing healthcare utilization for housing-stable individuals generates significant cost savings for insurers. We achieve this by:

Monetizing Healthcare Cost Savings: Calculating and demonstrating healthcare cost savings as a monetizable return on investment, incentivizing insurers and self-insured employers to invest in housing.

Subordinate Debt Structures: Utilizing innovative financial mechanisms, similar to the Health Prescribed Housing Fund (HPH Fund), which employs subordinate debt to attract private capital for housing development, achieving competitive risk-adjusted returns (e.g., 6-7% IRR).

CalAIM and Medicaid Integration: Structuring funding to incorporate Medicaid/CalAIM reimbursement dollars into supportive housing operations and MCO reinvestment dollars into new housing development, creating a financially sustainable model. California's CalAIM initiative is a critical pathway for this funding.

Integrated Health and Housing Services:

• The HPH model embeds essential healthcare and social support services directly within the residential environment. This integrated approach ensures residents have consistent access to:

• Comprehensive Care Coordination: Including behavioral health services, case management, and preventive care.

• Housing Stability Services: Such as Housing Transition Navigation Services, Housing Deposits, and Housing Tenancy and Sustaining Services, which are evidence-based and proven to help people get and keep housing. These are often covered under CalAIM Community Supports.

• Community Support Positions: Creating quality jobs (e.g., Housing Counselors, Legal Support Specialists, Information Record Specialists) funded by healthcare reimbursements, providing direct resident support and career pathways.

Data-Driven Framework and Measurable Outcomes:

• Accountability and measurable impact are central to our model. We implement a rigorous data-driven framework that includes:

  • Multi-level Analytics: Linking resident health and cost data, property performance, and portfolio strategy to demonstrate value and inform resource allocation.

  • Readiness Metrics: Predicting outcomes and tailoring interventions based on individual and system capacity.
     

Key Performance Indicators (KPIs):

• Tracking reductions in emergency room visits and preventable hospitalizations, increases in workforce participation and earnings, and stabilization of housing retention rates. This data strengthens the case for expanded Medicaid reimbursement for housing interventions.

Scalability and Replicability:

• The HPH model is designed as a pilot program with a clear path to scalability. We aim to create a replicable framework that can be implemented across various sites and regions, leveraging partnerships with community-based organizations and healthcare providers. Our strategic advantages, such as existing site ownership (e.g., the YMCA's Central Y in Sacramento), established partnerships (e.g., with Elevance), and experienced leadership, enable rapid deployment and expansion.

 

By combining innovative finance, integrated services, and robust data, Health Prescribed Housing offers a powerful solution to some of society's most pressing challenges, proving that investing in housing is investing in health and economic well-being.