FOR HOSPITAL LEADERS, the need for more safe, non-congregate, affordable housing has perhaps never been clearer than during this pandemic. The Eviction Lab at Princeton University reports that since the pandemic began, more than 280,000 evictions have been filed by landlords in just the 5 states and 27 cities currently tracked by the center’s researchers. Meanwhile, the U.S. Department of Housing and Urban Development recorded over 580,000 individuals experiencing homelessness on a single night in 2020, of whom 39 percent were unsheltered. By forming innovative partnerships and programs to address the housing and supportive service needs of vulnerable populations, health care entities have the opportunity not only to improve people’s well-being but to reduce costs and strengthen communities as well.

In December 2020, TAC completed its second round of the Housing and Healthy Communities Learning Network — a six-month, peer-to-peer learning opportunity supported by the Melville Charitable Trust — which brought hospital and health system leaders together with experts on the kinds of innovative partnerships that can expand housing opportunities for high-need, high-cost patient populations. Through this opportunity, TAC assisted hospitals to understand how to take key steps in forming a hospital-housing partnership:

• Make the case for housing investments by documenting the evidence of best practices in such partnerships for improving health and wellness while reducing the use of high-cost emergency services.
• Leverage hospital resources for housing investments; examine the diversity of investment types and populations served; and determine community-based health care and housing partners to engage.
• Determine other hospital resources that can be leveraged, and explore how to build multi-hospital partnerships.
• Examine housing investment challenges.
• Illuminate health and housing inequity by conducting Racial Equity Impact Assessments (PDF) and build the partnerships required to address disparities and meet fair housing standards.
• Identify short and long-term investment performance measures that are aligned with the mission of hospitals.

Much of the literature and support for hospital-housing partnerships is focused on large hospital systems with investment fund sources that are both broader and deeper than what is often available in smaller communities. TAC’s experience leading the Housing and Healthy Communities Learning Network since June 2019 has shown us that hospital systems are eager to partner with the housing sector — and that smaller investments, too, can make an impact:

• In Eugene, Oregon, four health care organizations invested a total of $2.5 million in the development of a $13 million permanent supportive housing project with 51 units dedicated to persons experiencing lengthy episodes of homelessness; the project uses a Housing First approach for engagement and supportive services.
• A small hospital in rural Washington State invested $44,000 in the development of a six-unit housing project serving highly vulnerable patients.
• One Tennessee hospital system funded a hospital-based housing navigator position to support members of vulnerable populations in locating and attaining both affordable housing and the kinds of associated supportive services that have been shown to improve housing stability and tenure.

Other examples of successful investments attainable by smaller organizations include housing contingency funds that can be used to cover security deposits; furniture and moving costs; or the payment of a “bridge” subsidy for rent while an individual or family is awaiting placement in subsidized affordable housing.

Every hospital — regardless of its size or investment capacity — can play a role in addressing not only COVID-19 but also the nation’s housing crisis.