Homeless Patients Get Novel Treatment From Chicago Hospitals: Housing
Glenn Baker loves his one-bedroom apartment on the South Side of Chicago, and it shows: on his walls hang pictures of his favorite superheroes, and a note above his sink reminds visitors to do their dishes.
But Baker says his favorite thing about his apartment is simply the fact that it is his.
“I never have to worry about a place that I can lay down at night to stay warm,” Baker said. “I’ve only been to the emergency room a few times since I moved in here. I’m very happy about that.”
Since May 2016, Baker has lived in an apartment paid for largely by the University of Illinois Hospital — the rest is paid for by a federal housing grant. Before that, he was homeless and a frequent patient of Chicago emergency rooms. He told WBEZ in 2016 that he spent up to 20 nights a month in the ER, sometimes faking an illness to get a warm bed. Baker is one of 26 ER “super utilizers” that the University of Illinois began providing housing for in 2015 as part of a pilot project.
Baker, who suffers from asthma and high blood pressure, says his health has improved dramatically since then. “90, 95 percent,” he said. “Because I don’t have to worry about whether it's cold outside, or raining, or if the weather is too dry [which] affects my breathing.”
The pilot’s overall results are in, and the hospital thinks the program is worth continuing. Health care costs per patient housed dropped 18 percent on average each month, according to the hospital. The University of Illinois Hospital will expand the program to house 25 additional homeless patients. And at least three other Chicago hospitals are launching or recently launched similar programs.
Modest investment, big impact
Half of the top 100 heaviest users of the University of Illinois Hospital emergency room are homeless, according to Stephen Brown, director of Preventive Emergency Medicine at the hospital. “They come through all the time.”
Brown said these initial results show the project is good for patients and cost-effective for the hospital. The hospital pays $1,000 a month for patient housing. One day in the hospital can run about $3,000, a cost generally shared by the hospital, the patient, public assistance programs, and insurance companies.
"If every hospital in the area agreed to house 10 chronically homeless patients, which would be a relatively modest investment, we could collectively make a huge impact on reducing homelessness, and it would be near cost-neutral to every hospital,” Brown said.
Brown said that, anecdotally, the health of the patients seems to have improved since the hospital got them into housing. Many residents, though, had far more severe health problems than the hospital team initially realized.
Of the 26 initial patients, eight left the program for various reasons, two left because they could not live independently, one entered hospice, and four have died, according to the hospital.
“The people in this project were particularly ill,” said Peter Toepfer, executive director for the Center of Housing and Health, which has partnered with University of Illinois Hospital on the housing project.
Toepfer said, even knowing that homelessness exacerbates health conditions, they were surprised by how sick this group was. “By the time people were referred to this project and we were able to house them, some people were already so ill that whatever we could do, both in terms of social work and health care, wasn't going able to help them … and that’s really sad.”
Toepfer said that, going forward, the project will do more screening of patients to make sure they are well enough to live independently.
Starting a trend
And other local hospitals are following their lead. Swedish Covenant, Rush, and Stroger, all in Chicago, recently launched or are launching similar projects to house homeless patients who frequently end up in the ER.
- Swedish Covenant has recently begun a partnership with the Center for Housing and Health to provide housing support services to 10 homeless patients for one year, according to hospital spokesperson Bill Ligas.
- Rush spokesperson Deb Song said that hospital will also partner with the Center for Housing and Health to house five patients, beginning this spring.
- Stroger hospital began funding the creation of 33 housing units since last August — 30 for singles and three for families — for chronically homeless and medically vulnerable patients throughout the year, according to spokesperson Alexandra Normington.
Spokespeople for Rush and Swedish Covenant say they are modeling their programs on the one at the University of Illinois hospital.
The city of Chicago is also getting in on the idea. It recently created a “Flexible Housing Pool” fund to pay for homeless services. The fund, which will total $1.8 million in 2018, will pay for 50 homeless people in the city to get into housing and receive support services for a year.
“What we are after here is a systemic solution, that takes some of the best practices and lessons learned from [University of Illinois] health and applies them at a scale that can meet greater need,” Chicago Department of Public Health Managing Deputy Commissioner for Strategy and Development Megan Cunningham said.
Glenn Baker feels happier and healthier living in his own home. But he said that, occasionally, he misses the emergency room.
He said that he taken the 45 to 60 minute bus ride to the University of Illinois hospital’s emergency room in Chicago’s Medical District a few times since he moved into his apartment “just to pop in and say hello” to his favorite nurses.
“The most blessed part is being able to go there and not have to worry about whether I have to stay here tonight,” Baker said. “I can just say, ‘I’m fine. I’m perfect.’”
Editor's note: A previous version of this story contained erroneous information provided by the University of Illinois Hospital about one patient's average monthly medical cost. This story has been updated.