Health and Housing: Where Should the Money Come From?
Posted by Miriam Axel-Lute on April 8, 2013
When we published our focus issue on health and housing and neighborhoods, one of the themes that came up in a few different ways was that properly funding stable, permanent housing and healthy neighborhoods could drastically save us money that is currently being spend on medical care, both emergency and chronic. This, many of us thought, meant that perhaps some of the vast amount of resources being spent on health could be better and more efficiently used if it were devoted to housing.
The savings—not to mention, of course the better outcomes in terms of both health and housing!—are pretty clear cut, at least when it comes to some basic provisions like a Housing First approach to homelessness or supportive housing.
I, and others in our pages, have lamented that it is hard to make that funding leap, though, because the budget lines are separate and the health savings are longer-term than the upfront costs of providing housing and our budget cycles and pots are too divorced from each other to allow the big picture win-win to get political momentum. Speculation about the possibilities for the Affordable Care Act to increase partnerships in that direction are also ramping up.
So imagine my surprise when at a workshop at the National Low-Income Housing Coalition's recent conference panelists questioned whether that was even a good goal.
In response to a suggestion about it from the audience Ann O'Hara of the Technical Assistance Collaborative and Andrew Sperling of the National Alliance on Mental Illness responded that they were uncomfortable with the idea of turning to funds marked for health to fund housing for a couple reasons:
First, people with disabilities, for example, should still get their housing needs met by housing funds. To suggest otherwise is to stigmatize them, make them patients first, and relieve those responsible for providing housing from the responsibility of figuring out how to do it appropriately for everyone.
Second, that housing funding, especially rental assistance, needs to be a long term commitment. One of the main things that we need more of in housing in order to improve health is stability. So turning to a funding source for whom housing might be the flavor-of-the-day way to experiment with collaborations is an unhelpful precedent.
Ted Houghton of the Supportive Housing Network of New York told me later he shared these concerns.
They definitely have some ring to them, though I'll say that while the need is so high and the resources so constrained, I wonder if there isn't some way to do it without running into those problems. Gap funding for development, for example, rather than ongoing operating subsidy or rental assistance? What do you think?
About the author more »
Miriam Axel-Lute is editor of Shelterforce and associate director of the National Housing Institute. Her email is miriam at nhi dot org.