Amid the expiration of eviction moratoriums around the country, providers are gearing up for a wave of houselessness that will have cascading effects on population health.
A recent study examining Medicaid claims in New York found a correlation between evictions and Medicaid disenrollment as well as higher healthcare spending.
Some providers, like Strong Children Wellness, a network of primary care practices in Queens, have already been screening for social determinants and partnering with community organizations to address them. When Strong Children Wellness first launched in 2020, it was entirely virtual. Digital screening, therefore, was a top priority. The practice works with Phreesia, a patient intake software, to screen patients, asking about topics like employment and food security.
When the practice launched in person that same year, preserving that digital screening was a natural step since it was already built into the workflow, explained Suzette Brown, M.D., the practice’s chief operating officer.
“We knew that we had to screen for material hardships,” Brown told Fierce Healthcare.
Patients can complete the screening questionnaire, which is available in multiple languages, on their phone ahead of an in-person visit. Those who can’t fill it out in advance digitally may fill it out in person upon arrival. The benefit to doing so ahead of time, however, is that the provider can be better prepared for the appointment and more strategic in the resources they provide, Brown noted.
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But that wasn’t enough. Strong Children Wellness knew that to best serve its patients, it needed to build out an “ecosystem of support” by partnering with local organizations, Brown said.
One partner is RiseBoro, a Brooklyn-based housing nonprofit. The practice has referred several families to the partner, Brown said, which has successfully gone through remediation with landlords and saved several families from eviction.
To facilitate community referrals, the network hired a family navigator to help patients throughout the process and to ensure they have engaged with and received the assistance they need.
“You kind of have to be intentional about looking for that ecosystem or network of organizations locally in your community that are addressing a particular issue,” Brown said.
Strong Children Wellness’ process began with outreach to organizations and setting up introductory meetings. The practice now has nearly a dozen partners and hopes to continue growing that network, Brown said.
“Unstable housing, in particular, is a major toxic stressor—this wave of evictions that we know is coming, or that has started in many parts of the country, is just really going to impact both child and parental health in major ways,” Brown said. “As practitioners, we need to really be cognizant of that and try to devise ways to address it.”