LA Health & Housing Symposium

CSH convened the first of three Los Angeles Health and Housing Symposium on October 23, 2017 at the California Community Foundation. CSH brought together over 50 health and housing organizations involved with coordinated care for homeless Medi-Cal beneficiaries to collaborate on new Los Angeles County initiatives (Measure H, Whole Person Care LA, Drug Medi-Cal Organized Delivery System).

The Symposium was well attended – the room was packed with over 100 healthcare and housing leaders from across the County, including 48% from the healthcare sector (i.e., MCOs, hospitals, FQHCs, and the Los Angeles County Health Agency) and 52% from homeless services and supportive housing (i.e., homeless services providers, supportive housing developers, and the Los Angeles Homeless Services Authority).

This first of the three-part symposia focused on level-setting, with the goal to increase collective understanding of how healthcare institutions can collaborate with homeless services providers to access Measure H (County ¼-cent sales tax), Whole Person Care LA (1115 waiver), and Drug Medi-Cal Organized Delivery System (1115 waiver) networks to better serve their members experiencing homelessness.

The opening discussion was dedicated to sharing outcomes and best practices in collaboration from the Los Angeles 10^th Decile Project (2011-17), which created robust health and housing collaborations to house and case manage high-acuity patients. Presenters shared two diagrams that map the new set of resources coming into Los Angeles County – to set the table for the second hour presentations on Measure H, Whole Person Care, Drug Medi-Cal and Coordinated Entry as the gateway for services and housing.

In the third hour, participants engaged in a dynamic give-and-take that focused in each Service Planning Area (SPA), and reported next steps, which include: strengthening communication and collaboration with SPAs; conducting inventories of service gaps, exploring co-location, building more regional resources; and standardizing high-utilizer projects.

The main takeaways from the first Symposium were:

very strong demand for information and education around the relationship between the new health and housing funding streams, and people feel (rightly) that things are moving very quickly; CSH can play a role in education and communication across funding streams
strong desire in 6 of the 8 SPAs to move forward on integrating health and housing: SPAs 2, 4, 5 are further along while SPAs 3, 6, 8 are just beginning (see next steps above)
interest from CSH partner hospitals and MCO partners in partnering, but others need to be engaged
workforce issues like shortages and burn-out are a big concern as H and WPC ramps up
existing gaps in system: warm handoffs still difficult, inability to make real-time connections to PCPs, lack of access to specialty care, lack of 24/7 services, funding for highest-acuity/delay in HHP, lack of data sharing agreements between hospitals and HMIS

The ultimate goals of the symposia are to foster and deepen partnerships between the healthcare and housing sectors and to inspire and inform long-term commitments to expanding integrated services for homeless frequent users by moving to shared problem-solving across sectors.

The next Symposium will take place on January 23, 2017 at the California Community Foundation, and will focus on how to create, structure, and problem-solve together by mining existing partnerships between homeless services providers, FQHCs, and hospitals, and between county health and housing systems and managed care organizations.