Housing is Healthcare

Roy Donberg shivered as he zipped up his tent, laid down on the cold tarp and listened to crickets chirping outside. He had been homeless for 18 years and had recently suffered two heart attacks and a stroke. He stared up at the night sky through a hole in the cloth ceiling, wondering whether he’d ever be able to afford medical care or if there was any hope.

An estimated 2,053 individuals were identified as homeless in Orange, Osceola and Seminole counties during a 2018 “Point-in-Time” count organized by the Homeless Services Network and staffed with hundreds of community volunteers. The U.S. Department of Housing and Urban Development requires communities across America to conduct an annual count on a single night to assess the reality of the local homeless population.

The count includes those who are chronically homeless, meaning they are suffering from physical or mental disabilities while being homeless for one or more years. Without connections to proper healthcare or a stable address to receive federal benefits or consistent care, they filter in and out of emergency rooms at public expense. To address this, the Central Florida region shifted to a new model of care called Housing First.

When Kristy Lukaszewski, policy and programs director at the Central Florida Commission on Homelessness, was asked how the Housing First initiative works to break the cycle of homelessness, she replied simply:

“Homes end homelessness.”

Through the Housing First effort, service providers across the region have housed 339 chronically homeless individuals in Orange, Osceola and Seminole counties since 2014. Of those, 98 percent have remained in permanent, stable housing.

“It sounds absurd, but it costs over $31,000 per person per year to let individuals stay on the street,” said Janine Summers, lead Orange County case manager at Health Care Center for the Homeless, one of many organizations providing case managers, physicians and specialist care through Housing First.

“The Housing First model shows a 60 percent reduction in emergency room visits, bringing that annual cost to less than $18,000 per person per year. That translates to millions of dollars saved for the community.”

Lukaszewski addresses the silent fiscal drain: “Since many of these folks have a chronic disability, they are legally able to receive federal benefits but aren’t able to access those benefits because they don’t have a permanent address. So if they go into an ER with no insurance, they won’t be turned away. The ER becomes their primary care — which is expensive care. Who is going to pay for that? We are.”

Anna Ashie, a housing specialist at Health Care Center for the Homeless, acknowledges the fiscal and moral implications that are built into Housing First model: “How often does the right thing mean the cheaper thing? The cost to do nothing is not nothing,” she said. “Our unofficial slogan is, ‘Housing is healthcare.’ With the Housing First program, we often see drastic turnaround with our clients. Once they’re in permanent housing, medical conditions can be stabilized, controlled or sometimes eradicated.”

What may be a serious health issue in the woods or on the streets often can be solved with a consistent diet of nutrientrich foods. The Housing First model allows for an entirely different and healthier lifestyle.

Donberg, a client of Healthcare Center for the Homeless, is one of hundreds who can attest to the impact of the model.

Roy Donberg

“Now that I’ve gotten involved with a program that puts you in an apartment, life is totally different,” he said. “I’m not in and out of the emergency room. I’m trying to get a job and I’d like to go to school. That makes a big difference because you're able to get something established.”

AdventHealth Gift Helps Housing First

By Shelley Lauten CEO - Central Florida Commission on Homelessness

In 2014, Central Florida made a fundamental shift in the way we serve the chronically homeless individuals in our region. No longer would they have a laundry list of prerequisites before receiving a safe space to sleep at night, but they would be placed in permanent housing and surrounded by services to help them thrive while in their new homes.

Since then, 339 formerly homeless individuals suffering with severe mental or physical disabilities are being housed and supported by a coordinated network of organizations that use the same approach to our most vulnerable neighbors. This Housing First network can now collectively monitor and measure not only how many people move from the streets to housing, but how many people stay in housing and how much this new, innovative model of care is saving our community.

This system change to the Housing First approach did not occur overnight, nor without generous support of our local jurisdictions and numerous community partners.

AdventHealth continues to be a leader in the implementation of a coordinated Housing First strategy. With its initial investment of $6 million, community leaders were able build a coordinated regional system of care — one where hundreds of organizations are working together to make homelessness rare, brief and one-time.

AdventHealth’s most recent gift of $500,000 to sustain and grow the Housing First system shows its dedication and commitment to serving the most vulnerable in our community. Learn more about how you can help by visiting www.homesaretheanswer.org.