New prescription: Housing

October 17th, 2016

Average lifespan is said to be 64 for people who are chronically homeless, compared to 78 years for the general population. James Burrus of Fort Worth is feeling all of his 58.

His gait is unsteady since the winter night that he slept under a sheet of plastic during a storm. “My feet still hurt to this day,” he says. But here’s his big problem: “It got to where I couldn’t breathe,” he says. His chronic obstructive pulmonary disease (COPD) has advanced and he needs supplemental oxygen.

Burrus is among this country’s over-50 homeless population, which now makes up nearly a third of the total, according to the federal government. He is also among a group of people in Fort Worth who use emergency rooms often — more than 50 times a year — for chronic conditions that are not uncommon but create emergencies if unmanaged. An analysis found 24 such patients with annual E.R. costs exceeding $900,000 and borne by publicly funded institutions.

James Burrus Pathways to Housing PatientA pilot program in Fort Worth has a new prescription: Housing. Burrus is one of the first 14 JPS patients enrolled in Pathways to Housing. He has been moved into a modest apartment. Members of the JPS Care Connections team make house-calls, helping him stay on track and navigate support services. Sixty more people could be enrolled over the next two years.

“I’m surrounded by people trying to help me,” Burrus said one afternoon as Physician Assistant Joel Hunt checked his vital signs. “It doesn’t get much better than that.” He sleeps in a bed, next to the window where an air conditioner hums. A sister in Mississippi is back in his life. He has not been to the emergency room since moving in.

Who’s eligible?

People identified as chronically homeless who are frequent patients in emergency departments in Tarrant County.

HUD defines chronically homeless as an unaccompanied person with a disabling condition, homeless for at least a year or at least four times in the last three years.

Pathways brings to Fort Worth the concept of Housing First, applied successfully in several cities to reduce the cost of homelessness. The simple concept upends tradition, providing shelter first and then addressing entrenched psychosocial, mental health and substance abuse issues.

“This is housing as healthcare,” said Tammy McGhee, JPS project manager, “and it’s awesome to see.”

The program, funded by the federal Department of Housing and Urban Development (HUD,) includes permanent supportive housing, “prescribed as part of a comprehensive care plan” that includes JPS medical and behavioral health services, intensive case management by The Salvation Army and care coordination by Amerigroup, the largest Medicaid health plan in Tarrant County.


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