Under One Roof: Health Care and Social Services in the Same Place

Posted by David Adame on August 8, 2016

Without steady employment, Olivia and her son found themselves without housing, without food, without healthcare, and without options. It was then that Olivia decided to visit Chicanos Por La Causa (CPLC), a community development corporation based out of Arizona that is committed to building stronger, healthier communities as a lead advocate, coalition builder, and direct service provider.

CPLC helps more than 200,000 people in the southwestern United States each year through programs in four areas—housing, economic development, education, and health and human services. All programs are designed to empower families to become financially stable, healthy, and self-sufficient.

After nearly 50 years of service, CPLC recognizes that the needs of the families it serves are complex and intertwined; a family rarely approaches the CDC with only one need. Families like Olivia’s are often faced with impossible decisions like whether to forgo medical treatment to pay for rent, or forgo rent to pay for food. Unstable income, unsafe housing, or food insecurity can negatively impact health. Issues with health, housing, or basic needs may stand in the way of a client and a new job. Clearly, as the lives of family members are deeply interconnected, so are their needs.

Research supports this observation. According to findings from County Health Rankings, only 20 percent of an individual’s modifiable health outcomes are attributed to access to, or quality of, clinical care, whereas:

  • 40 percent is a result of education, employment, income, and community safety.
  • 30 percent is a result of health behaviors such as nutrition, exercise, substance use, and sexual activity.
  • 10 percent is due physical environment such as housing, air, and water quality.

This means that a full 80 percent of an individual’s health status is determined outside of the healthcare setting. Clearly, a family may require a wide range of services to make sustainable improvements in their quality of life. Unfortunately, they are often faced with the prospect of having to connect with a different service provider to meet every need when transportation and time are already scarce. A family may be provided with numerous referrals and never make their first appointment. 

In response, CPLC sought to establish cross-sector partnerships that would more fully and holistically meet the needs of families. Although CPLC provides services that address many of the social determinants of health, coordination and collaboration with other agencies was needed to ensure families consistently received the support they need to move from a place of instability to self-sufficiency. This need drove CPLC to seek partnerships with like-minded organizations to share resources, goals, and successes.

A conversation began between CPLC and United Healthcare Community and State (UHC), the arm of the UnitedHealth Group that is providing coverage for individuals eligible for Medicare, Medicaid, and Children’s Health Insurance Plans. Though it is a for-profit entity, UHC—like CPLC—has a significant interest in improving the health outcomes for the vulnerable families it serves. Through extensive conversation, the partners found they shared many mutual goals.

UHC found that approximately 20 percent of its client base is using 80 percent of the healthcare resources, representing a significant cost to the company and the community. By targeting these high-needs individuals through investments in preventative care and services addressing the social determinants of health, UHC recognizes that it can substantially reduce healthcare system utilization and consequently, reduce healthcare costs.

Together, the groups leveraged their networks to recruit partner agencies to participate in what is now known as the myCommunity Connect Center. Located in an existing 30,000-square-foot CPLC facility in a low-income neighborhood in Phoenix, the center houses a broad range of health and social services under one roof to achieve collective impact: improving the health and economic stability of vulnerable families. Services include those offered by CPLC and other nonprofit and governmental agencies. Each service is sustained by its own grants and funding mechanisms.

Services currently include primary, dental, and behavioral health care; workforce development and resources; affordable housing; financial literacy; healthy food and nutrition education; and medical transportation services.

Here’s how it works. A client enters the center and meets with a Community Health Worker to complete a comprehensive needs assessment. The staff person and client then work together to develop an individualized service plan and the client is directly connected to services provided on-site. The Community Health Worker also assists clients in navigating a variety of funding streams that are available to cover the cost of the services. A single software program developed by UHC tracks clients as they move through these services, providing shared data to partners to ensure that all partners work toward the same goal.

Olivia arrived at the center looking to be connected to a homeless shelter for her family. After meeting with a Community Health Worker, she was able to secure emergency housing for her and her son, and the center also enrolled him in a healthcare program. Because of the various resources available at the center, Olivia was also offered help in writing a resume, obtaining a business suit for job interviews, and she was connected to job opportunities in the area. She was quickly hired in a management position at a retail store. Today, Olivia and her son are living independently in their own apartment.
Although the program is in its early stages, by the date of its public grand opening it had already provided nearly 3,000 meals from its diabetic food pantry, placed more than 250 people in jobs, distributed 200 bus passes to facilitate transportation to work, and connected 200 individuals to housing support services.

Additionally, UHC has provided investment capital for CPLC to acquire and rehabilitate multi-family housing units in the low-income neighborhoods surrounding the facility. These apartment communities will include affordable housing opportunities for the center’s clients, while market-rate units will provide a sustainable funding source to support the cost of the center’s operations. Upon full implementation, the project will be financially self-sustaining.

With UHC’s data, collaboration, and financial investment, and CPLC’s programing, partners, facility, and property management, the myCommunity Connect Center will continue to provide families like Olivia’s with the promise of opportunity.
It is becoming more and more evident that health and housing are inextricably linked. As grant funds remain volatile and community needs increase, it may be necessary to seek partnerships in unlikely places to remain financially sustainable, leverage knowledge and resources, and truly achieve collective impact.

(Photo above: The grand opening of the CPLC Maryvale Community Service Center. Photo courtesy of Eric Ochoa)

About the author more »

David Adame is president and CEO of Chicanos Por La Causa (CPLC) Inc. He is a third-generation Arizonan who has a master’s degree in business administration and more than 20 years of experience in the banking industry. Since coming to CPLC, he has generated more than $250 million in resources for the organization through grants, strategic partnerships, and for-profit subsidiaries.

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