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MSCC’s Healthcare Access & Coordination for NYC’s Homeless – Strategies for Improvement Report

(MSCC) Jennifer Mallicote, August 4, 2021

Your ACTION is REQUIRED to Address the Health Needs of the Unhoused Population

FOR IMMEDIATE RELEASE:  August 4, 2021 —Midtown South Community Council (MSCC), a 501 (c) (3), engaged the Columbia Consulting Practice (CCP) at Columbia University to focus on healthcare obstacles confronting the unhoused population in New York.  The results ARE stunning, and the suggested actions by the MSCC and CCP team to provide New York communities with a way forward.  

The Report Findings

  • Job loss, eviction, lack of affordable housing, and poor health are the leading causes of people losing their homes  
  • NYC faces extraordinarily high rates of homelessness: 1 in 106 of the population are homeless in NYC, 1 in 4 of people who are homeless in the USA live in NYC or LA
  • The average age of the unhoused population is 50; as this group ages, healthcare needs shift, and this population has 30 fewer years of average life expectancy.  The COVID 19 pandemic had a devastating effect, with a 20% jump in homeless deaths in 2020
  • People without housing suffer 1/3 more deaths attributed to substance abuse and HIV/Aids compared to 5% of the NYC housed population.  People who are unhoused often seek emergency department treatment.  In these settings, the unhoused population (street and sheltered) become more likely to catch advanced pneumonia (89% higher than housed-population), asthma, substance abuse, and are 5x more likely to contract TB
  • The mismanaged and under-treated physical and cognitive conditions impede steady incomes, stability, healthcare, and social support. The patchwork of the mental healthcare system in the US places many on the brink of homelessness simply due to inaccessible care
  • People who are not housed are difficult to track as they have multiple touchpoints with different healthcare systems.  This is often due to factors including moving to other areas of the City, seeking out new shelters, and visiting a variety of local clinics  
  • Service care providers in both healthcare and homelessness arenas lack coordination and overlap.  Unhoused people often end up in ER, and these patients are usually discharged without communicating care or tracking progress—posing barriers to integrated health and housing services  
  • There is mistrust due to the complexity of the healthcare system; the unhoused population faces numerous barriers when attempting to gain access to their records; they are not fluent with their records. Critical information such as diagnoses, prescription dosages, and allergies is not communicated between providers and medical professionals due to a lack of integrative care. The population is often given an unfair diagnosis. They are discriminated against, and there is no patient buy-in as part of the decision making
  • Financial barriers diminish the dignity afforded to people; 30% presented to ER are uninsured, although most of the homeless population is eligible for Medicaid
  • The NIMBY effect is rooted in harmful tropes creating misinformed stereotypes of people who are unhoused

The Solutions

  • Health systems that have ongoing, updated information on homeless statistics and resources are better positioned to offer effective and respective care.  Clear communication between different services providers is vital to address patients’ comprehensive needs.  Discharging with clear pathways, follow-ups, checks, and balances ensure greater success
  • Electronic Health Records (HER) create more trusting relationships, services, and improved outcomes
  • There are four promising responses: Safe havens, medical respite beds, Medicaid enrollment efforts, and street medicine outreach. Medical Respite Program fills a fundamental gap in healthcare for homeless individuals.  Successful funding models are essential and need to be lobbied at state and federal levels
  • BRC Safe Haven has a successful program that has been replicated by several other community organizations and has had enough success to warrant rapid expansion across all boroughs.  Successful programs and partnerships are also in place at NYC Health + Hospitals at Bellevue, Mount Sinai partners with Comunilife to run part of its medical respite program and also with the Institute for Community Living (ICL) after respite to a transitional housing program
  • MetroPlus Health Plan (a Medicaid MCO) provides over 470,000 New Yorkers, including marginalized populations.  Create publicly funded programs to target Medicaid enrollment for people with complex care needs and those classified as hospital/ER heavy users, including people who are not housed 
  • The Navigator Program and the Facilitated Enrollment Program targeting people who are not housed, and several non-profits already function as certified enrollment assistance centers.  Train more people, such as shelter staff and community members, to become facilitated enrollers
  • Expand street medicine programs grounded in compassionate, dignified, patient-centered care.  Street outreach teams are composed of medical and health providers, along with other services
  • Storytelling and providing fact-based policy will help limit misinformation and Nimbyism to build compassion and engage warm hearts to make way for change for all people

Summary 

An effective healthcare system + supportive services + permanent housing = quality of life for all

Your Action is needed to support people who are unhoused to address their health and medical needs as part of the broader effort to dismantle the causes of homelessness. YOU are invited to our meetings to proceed with input and ways forward. 

Join us at 5:30 pm, Wednesday, August 11, 2021, for the screening and panel discussion of the Healthcare Access & Coordination for NYC’s Homeless – Strategies for Improvement: The screening’s ZOOM LINK, Meeting ID: 886 489 7042 Passcode: 925241

History

The Midtown South Community Council was established in 1983 to enhance the quality of life by addressing the concerns of its residents and local businesses.  In the late 1980s, John Mudd became President of the Council and currently holds that position.   

Meeting Times: The MSCC Community Engagement Meeting is at 6.00 pm on the 4th Thursday of every month (except for July, August, and December). The MSCC Homeless and Housing Meeting is at 9.30 are on the 1st Tuesday of every month (except January). Contact hello@midtownsouthcc.org for more information and your Zoom invitations.

The Healthcare Access & Coordination for NYC’s Homeless – Strategies for Improvement  Report: The Promo Trailer for the Report for “Truths Worth Telling,” Full Report, PowerPoint Presentation, and the Zoom Presentation

MSCC John Mudd, Executive Director; Sharon Jasprizza, Director of Community Services; Jennifer Mallicote, Press