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How JCHE -- and other congregate housing models -- can help reform the health care system

Posted: May 5, 2013

A recent article published by the LeadingAge Center for Housing Plus Services, and written by Alisha Sanders, a good friend to JCHE, makes a few excellent points about how housing like JCHE’s can reduce health care use and costs. Below is part one of an adaptation of Alisha’s article.

The primary concerns to the Medicare/Medicaid budgets are the costs associated with hospitalization, rehospitalization, and premature nursing home placement.  More than a few health care dollars are wasted when patients transfer from one setting to another, such as a hospital to home or rehab, and then get readmitted to the hospital.  Hospital readmissions elicit myriad complaints from patients about how the discharge process let them down. Patients told interviewers that they didn’t understand their discharge instructions or those instructions were too general. They were overwhelmed by their diagnoses. Their primary care physicians weren’t kept in the loop. They had no support at home. They weren’t educated about their chronic diseases or needed support changing behaviors….

There’s obviously a lot of effort going into addressing the challenges facing our health care system. But many of those efforts, including Affordable Care Act initiatives, are based in health care settings. 

Policy makers seem to have forgotten that people don’t live in hospitals or physician offices. In the process, they seem to be ignoring the fact that housing could be one solution to these challenges.  

Resident Services Coordinators

How often do providers see their patients? Not very often. How will these physicians notice that an individual is looking or acting differently than they regularly do? Recently a service coordinator told me about a resident whose behavior was "really off" from her norm. The service coordinator visited the resident in her apartment to see if she could get some insight into what was going on. She discovered that the woman’s medications were completely mixed up. The resident had been prescribed one pill she needed to cut in half and another that she was only supposed to take every other day. You can imagine what was happening. The service coordinator helped get a better system set up to help the resident manage her medications correctly.  Service coordinators and other housing staff can help with the transition from hospital to home. They can help ensure that home health or home care services start up, or that a resident has needed adaptive equipment, gets and understands any new medications, and sets up an appointment with the primary care doctor. These staff members can also continue to keep an eye on the resident long after a hospital-based transitions program would stop calling.  JCHE employs twelve resident services coordinators who do this incredibly important work.

JCHE has built an infrastructure over many years that can help address various needs. Service coordinators can help residents identify and access a range of services and supports. They also build relationships with residents. This helps service coordinators notice changes in individuals. It also helps residents trust their service coordinators and follow through on their advice.  Resident service coordination is just one way JCHE is helping keep people healthy. 

Caren Silverlieb is Director of of JCHE's Planning Strategic Partnerships

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