A new dynamic to reduce chronic homelessness by connecting health care and housing
OLYMPIA – Today, Governor Jay Inslee signed the Apple Health and Homes Act (HB 1866) into law to get more homeless people quickly, safely and permanently into homes. The Apple Health and Homes Act, sponsored by Rep. Frank Chopp (D-Seattle), will directly link health care and housing for those who need both.
Over 70 percent of people who are chronically homeless struggle with health conditions like mental illness, substance use disorder or major physical disabilities.
“The epidemic of homelessness in communities across Washington is creating immense suffering,” said Chopp. “It is threatening the lives of homeless people, eroding public confidence, and undermining the shared values that have driven our state’s prosperity, including public safety and access to our public streets and parks.”
Chopp continued, “with Apple Health and Homes, we will save lives, save costs and save communities.”
The legislation was enacted with strong bi-partisan support and was endorsed by over 80 organizations across the state.
Apple Health and Homes has five major components, as it:
- treats chronic homelessness as a medical condition;
- invests in preventative services, reducing costs to local emergency systems;
- creates more supportive housing statewide;
- expands the capacity of supportive housing providers; and
- ensures oversight and accountability through the Office of Health and Homes.
Apple Health and Homes will address the needs of people who are chronically homeless by pairing a health care problem with a health care solution.
“In my years of work to treat people with opioid use disorder, I have found that the single biggest obstacle to success for many of these folks is lack of housing options. Housing instability contributes to the skyrocketing overdose death rate, and the exceedingly high cost of health care for people with medical and behavioral health disabilities,” said Dr. Lucinda Grande, a practicing physician in Lacey. “Providing supportive housing and investments in services is an important means of reducing high utilization of emergency departments and inpatient wards.”
Building on the state’s Foundational Community Supports (FCS) program, Apple Health and Homes will develop more supportive housing statewide by creating a dedicated account to rapidly acquire available housing units. The new Office of Health Homes will be tasked with quickly scaling supportive housing to meet the need.
“Washington was the first state in the nation to create an FCS Medicaid benefit for supportive housing services. Each person who qualifies for the program has a medical necessity for housing. Apple Health and Homes will help provide the missing element in the current FCS program —the actual home. We know this is essential for our members and the entire community who are seeking healing,” said Derrick Belgarde, the Executive Director of Chief Seattle Club.
The legislation will also create more capacity for supportive housing providers to deliver services. Apple Health and Homes will support the provider network with upfront and incremental grants to hire at more competitive wages and deliver quality housing and services. Capacity grants will also allow providers to enhance their service packages with culturally-responsive services, on-site coordination, and connections to population-specific services.
Said Esther Lucero, President and CEO of the Seattle Indian Health Board, “the bolstered support services in Apple Health and Homes will help people with significant disabilities and life challenges to get housed and stay housed. Service providers can help complete paperwork, negotiate with landlords, work through conflicts, and provide support during health challenges to address issues that could threaten tenancy before they escalate. These services can prevent clients from facing homelessness again.”
Apple Health and Homes will ensure oversight and accountability by creating the Office of Health and Homes to coordinate between the Health Care Authority, the Department of Commerce, and other stakeholders. By developing proactive partnerships, facilitating an advisory council with diverse representation and people with lived experience, and reporting on results, the Office of Health and Homes will ensure equitable outcomes.
Debbie Thiele, Western Region Managing Director for the Corporation for Supportive Housing said, “Apple Health and Homes builds on significant research that demonstrates supportive housing is the most cost-effective and humane way to approach chronic homelessness. Apple Health & Homes will expedite housing production, ensure equitable outcomes, and create upstream solutions to cut down on the public costs of emergency room visits, hospital stays, and incarceration.
Underpinning this legislation are significant budget investments in housing and behavioral health including:
- $300 million for Rapid Capital Acquisition, including $60 million for Permanent Supportive Housing through the new Apple Health and Homes program
- $113 million for the Housing Trust Fund
- $15 million for homeless youth projects
- $55 million for supportive housing provider workforce capacity
- $35 million in operating dollars for the Apple Health and Homes program
- $6.5 million for supportive services and capacity grants.
Chopp summarized the historic legislation stating, “Apple Health and Homes will help save lives, reduce costs, and recover our communities.”