The UC Davis Center for Healthcare Policy and Research (CHPR) has published two reports that follow up on the Center’s previously published “Integrating Care for People Experiencing Homelessness: A Focus on Sacramento County.” The initial report, published in March 2020, outlined options for innovative, coordinated care programs that could be provided for people experiencing chronic homelessness in Sacramento. It highlighted examples of integrated service models being utilized in the United States that combine healthcare, social services, and housing options for homeless individuals with complex, co-occurring conditions, including mental illness, substance use disorders and/or physical conditions.
CHPR’s newly published “Governance Options and Funding Sources for an Integrated Care Organization Serving Sacramento’s Chronically Homeless Population” provides details on how such integrated care organizations could be governed and funded, while “Economic Analysis of Options for Helping People Experiencing Homelessness in Sacramento” examines the costs and outcomes associated with the different options for providing integrated care services.
The economic analysis was conducted by CHPR Associate Director and Chief of the UC Davis Division of Health Policy and Management (HPM), Jeffrey Hoch, Ph.D., and Logan Trenaman, Ph.D., an HPM Post-Doctoral Scholar. Their results indicate that, under base case assumptions, an integrated care option would incur $70 million more in building costs and $77 million more in staffing costs relative to the status quo, but would reduce emergency department (ED) costs by $20 million (25,000 fewer ED visits), inpatient costs by $45 million (16,000 fewer inpatient days), victimization and criminalization costs by $17 million, and other costs by $14 million over five years.
Hoch and Trenaman suggest that a key next step in helping Sacramentans experiencing homelessness would be to embark on a collaborative approach to financing an integrated care organization. They cite “Social Determinants as Public Goods: A New Approach to Financing Key Investments in Healthy Communities” (Nichols & Taylor, 2018) in concluding that taking such a collaborative approach could not only finance the provision of integrated care to the chronically homeless, but also enable all stakeholders to enjoy the benefits of their investment in this public good.