Taxonomy of Health Care Related Strategies

HomeBase has developed a framework of key health care related strategies every community should consider as part of its efforts to end homelessness.

Addressing the health-related needs of people who are homeless or at-risk has long been recognized as a key component of efforts to prevent and end homelessness. Likewise, housing as a social determinant of health is an increasingly accepted view, supported by numerous studies and emerging evidence.

More recently, the passage of the Affordable Care Act (ACA), with its expansion of eligibility to include most people who are homeless, has changed the landscape within which homeless assistance providers are operating, providing significant opportunities to advance efforts to address homelessness.

  • Housing Stability: With access to preventative, acute, and chronic care as well as to mental health and substance abuse services, more people will be able to achieve housing stability and ongoing wellness.
  • Mainstream Funding of Services: With more of their clients receiving Medicaid, permanent supportive housing and other homeless programs may be able to claim Medicaid reimbursements for services they provide, thus offering access to a new source of badly needed funding.
  • Information Sharing Across Systems: The possibility of greater integration between the homeless and health care systems also raises potential opportunities for data sharing regarding client eligibility, service utilization and costs, and outcomes achieved. This information has the potential to inform and improve existing practices. Service delivery will also likely evolve due to a stronger focus on performance outcomes.

Based on decades of experience, and incorporating the latest research, findings, and best practices in the field, HomeBase has identified five major health care related strategies that every community should consider as part of its efforts to end homelessness.

  1. Medicaid Enrollment: Facilitate Enrollment of People Who Are Homeless and At-Risk in Medicaid.
  2. Access & Engagement: Facilitate Access to Care, Engagement with Providers, and Appropriate Use of Health Services.
  3. Integration of Services: Integrate Housing, Health and Other Services to Facilitate Housing Retention and Ongoing Wellness.
  4. Data-Driven Interventions: Develop Data-Driven Service Interventions Targeted to Priority Sub-Populations.
  5. Medicaid and Other Financing Options: Maximize Use of Medicaid to Finance Services that Support Housing Stability, including Permanent Supportive Housing services and Recuperative / Transition Care.

HomeBase developed its Taxonomy based on these five key strategies, each supported by a number of detailed sub-strategies. The Taxonomy also includes cross-cutting issues (such as training/education and creating partnerships) that should be considered as part of implementation.

Having created this detailed, evidence-based framework of model strategies, HomeBase has the expertise to help communities:

  • Identify, adopt, and adapt the strategies and sub-strategies that will fit their needs;
  • Complement and expand upon ongoing efforts toward ending homelessness; and
  • Determine specific action steps to successfully implement the strategies.