For several years our firm has advocated providing support services at home to ensure improved well-being and cost savings. In doing so we have run into the silo mentality that exists in most government organizations. The US Department of Housing and Urban-Development (USHUD) insisted until recently that housing was just a roof, whatever happened under that roof was not an issue for them. In 2003, with several successful projects under our belt, we approached both USHUD and the Department of Health and Human Services (HHS) to collaborate so that appropriate services could be combined with housing. It took several years for them to accept that this concept was vital to serving the very individuals for whom they existed. A recent article published by USHUD speaks of housing as the platform to improve health and that stable housing was essential in addressing the health needs of chronically homeless individuals. What a novel idea!
The article highlights several programs undertaken in Boston, New York and Chicago. In Boston it was revealed that health issues impeded the ability of residents to obtain and retain housing. New York Common Ground organization found that in order to meet the needs of the homeless population a partnership between health and services was essential. The Chicago project demonstrated that a strategy to marry healthcare and stable housing was successful and cost-effective by reducing unnecessary hospitalizations and emergency calls.
All of the collaborating institutions, however, realize the difficulty of establishing collaboration and integration among disparate systems, programs and organizations. They call for a focus on individual needs, system reforms and elimination of existing barriers to collaboration and integration. All is well you may say. However, in our experience there is a chasm between identifying the issues and doing something about them. Time will tell if we can do it right.