Housing is Health Care

This story was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.

At first housing may not sound like a relevant health care issue, but research shows that lack of housing leads to increased rates of physical trauma, chronic diseases, dental issues, behavioral health problems, and exposure. Affordable housing was ranked as the #1 need in the University of Vermont Medical Center's 2016 Community Health Needs Assessment. In turn, The Medical Center and its partners in the community have come together to address housing issues to improve the health of not only UVM Medical Center patients, but the community as a whole.

Improving the lives of the communities it serves is inherent in the UVM Medical Center's mission. Not only does hospital leadership feel this is the right thing to do, but using hospital resources to address housing issues has proven to be an increasingly smart investment as the health care system moves away from a model that pays providers for the number of procedures they perform to a model that rewards keeping people as healthy as possible.


The UVM Medical Center is involved with several housing initiatives, but three programs that really demonstrate community collaboration in addressing a need are Harbor Place, Beacon Apartments, and Bel-Aire Apartments.



Harbor Place is a renovated motel that has 39 single units, and 20 one and two-room kitchenettes. The UVM Medical Center discharges patients who have nowhere else to go to Harbor Place. The average length of stay is 13.4 days.



Beacon Apartments is a motel that has been transformed into 19 permanent housing units.



Bel-Aire Apartments is also a renovated motel that has 5 permanent stay apartments and 3 apartments designated for medical respite for complex patients. These patients are able to stay temporarily for up to 6 months.

All three facilities have on-site support services provided by community organizations. First, a case manager from the community's Federally Qualified Health Center, The Community Health Centers of Burlington (CHCB), connects residents with various resources such as medical insurance and permanent housing applications. In addition, mental health services are provided by clinicians from the Howard Center, the region's designated mental health agency, on an ad-hoc basis. Lastly, medical services are provided by several organizations such as the Visiting Nurse Association and CHCB. 

Data Behind the Action

Housing in Vermont

  • Vermont is no.9 in the country for per-capita homelessness.
  • Cost of housing and low vacancy rates contribute to unstable housing conditions in Chittenden and Grand Isle County

Chittenden County

Grand Isle County

Vermont

Median monthly housing cost$1,139$989$913
Total housing units67,5235,117326,812
Rental vacancy rate2.2%8.2%4.2%
Percent of units where gross rent more than 35% of household income43.6%40.3%41%
Source: U.S. Census Bureau, 2016


Housing and Health Care

Housing and health care are linked in many ways. Lack of housing leads to increased rates of physical trauma, chronic diseases, dental issues, behavioral health problems and exposure. Additionally, those experiencing homelessness have reduced access to primary care and increased difficulty in self-managing health issues. However, getting treated for health care issues while experiencing homelessness can be costly to both the individual and the health system.

Making it Happen

Partnerships

Harbor Place was the first of the three collaborative housing initiatives to come to life.

In 2012 Champlain Housing Trust (CHT), the community's local land trust and affordable housing provider, initiated a partner survey project as part of its three-year strategic plan. The survey revealed that several community organizations were feeling the impact of increasing rates of homelessness. 

Additionally, the annual Point-in-Time count showed that homelessness had more than doubled between 2010 and 2012, and something needed to be done. In response, CHT purchased a motel in 2013. CHT re-branded it to Harbor Place and made agreements with community agencies that they would send clients in need to the facility.

In addition to the UVM Medical Center, CHT engaged other community partners to make this effort a success. See the Partner/Role table.

Harbor Place's success strengthened the partnership between CHT and The UVM Medical Center. The two organizations moved forward with a second initiative, Beacon Apartments, which permanently houses residents who had been chronically homeless and medically vulnerable. On-site social services are provided by the Community Health Centers of Burlington and their homeless health care program. The UVM Medical Center has helped to fund these on-site services.