Housing For a Healthy California

A Joint Blog by California Assemblymember David Chiu and
Deborah DeSantis, President and CEO, Corporation for Supportive Housing (CSH)

California is experiencing a homelessness crisis. While the state has 12 percent of the US population, it has 20 percent of our country's homeless, 25 percent of our country's homeless veterans and 33 percent of our country's chronically homeless.

We all know that many homeless Californians experience a combination of chronic medical, mental health, and substance abuse conditions. For those of us with a roof over our heads, we take for granted the positive impact of housing on our health. In contrast, typically a homeless person can't get sufficient rest, is constantly exposed to the cold and rain, can't get a healthy or adequate diet, doesn't have a place to store medications, and is disconnected from health providers.

This leads to an endless cycle through the revolving doors of emergency rooms, inpatient facilities, treatment centers, jails and nursing homes. This pattern is very expensive for our public systems, costing thousands of dollars per month for each chronically homeless person. And these individuals die young, on average twenty-five years younger than people who are housed with similar conditions.

We need to shift the paradigm. Rather than throw healthcare dollars at treating homelessness after the fact, we need to invest in stable housing before the fact.

There is a great deal of evidence that providing housing to chronically homeless individuals reduces public costs within a short period of time. There is also a moral imperative for housing homeless individuals who are frequent users of healthcare services: it ends their downward spiral and puts them on a path towards improving their lives.

To this end, we proposed Assembly Bill 2821, supported by an overwhelming majority of the California Legislature and now sitting on the desk of Governor Brown, awaiting his signature. AB 2821 would create Housing for a Healthy California (HHCP), a new program to provide rental assistance to individuals who are both homeless and receive healthcare services from federal, state, and local funding.

Early last year, the State of California asked the federal government for permission to use Medi-Cal dollars (California's program providing healthcare to low-income individuals) to fund services and housing assistance -- based on research showing that supportive housing decreases medical, mental health, and substance use treatment costs among homeless individuals. The federal government approved the use of federal Medicaid dollars to fund services in supportive housing and indicated California could use its own State dollars (through Medi-Cal or otherwise) to fund housing assistance.

This is not an untested concept. New York State as well as several local jurisdictions, including San Francisco, Los Angeles, and Santa Clara Counties, pay for housing costs through savings generated by their health systems. Housing grants through the HHCP would reduce healthcare costs, with significant savings possible for California.

The challenges California faces with respect to its housing crisis, homelessness, and rising healthcare costs are not going away anytime soon. Local officials are overwhelmed and need innovative funding to address problems that have grown out of hand. This new program would provide a valuable tool state and local officials can use to create the affordable housing desperately needed by those who live on our streets.

Earlier this year, the California Legislature reacted to the need to build a stronger state and local partnerships to address homelessness, authorizing significant budget expenditures that would have included HHCP funding. But while the Governor indicated support for expanding housing assistance in the budget, he made this and other programs contingent on passage of other legislation that did not make it through the Legislature.

Nonetheless, recognizing the overwhelming benefits of the HHCP, the California Legislature has taken the critical step of approving a stand-alone bill creating this program, with the goal of securing relevant funding in the coming year.

We urge Governor Brown to sign AB 2821. Let's house homeless Californians and keep them healthy with a program that is fiscally responsible.

The author of AB 2821, Assemblymember David Chiu chairs the California Assembly Housing and Community Development Committee.