Housing First: Building trust, changing lives

Housing First patients Jackson and Sandra
Date
November 8, 2016
Camden Coalition patients and staff advocate for New Jersey state policy change around state-issued ID.
February 19, 2020
Proposed changes to Medicaid threaten people with complex needs
Proposed changes to Medicaid and the social safety net pose real threats to people with complex needs.
Shelby Kehoe
January 9, 2020
On the Health Affairs blog: RCT results show a way forward for the Camden Coalition and complex care
In this blog post published on the Health Affairs blog, CEO Kathleen Noonan discusses lessons from the Camden Coalition RCT.
Kathleen Noonan
January 8, 2020
The Camden Core Model RCT shows us a path forward for complex care
A message from our CEO Kathleen Noonan on next steps after the evaluation of our care management intervention, published today in NEJM
Kathleen Noonan
Camden Coalition staff review a whiteboard with patient enrollment information
January 8, 2020
Sharing evidence to inform the future of healthcare delivery and complex care: Lessons from the Camden Coalition and J-PAL North America partnership
Part 2 of a Q&A blog series describing the partnership between the Camden Coalition and researchers affiliated with J-PAL North America.
Kathleen Noonan, Aaron Truchil, Amy Finkelstein
Camden Coalition staff hold whiteboard showing RCT enrollment numbers
January 8, 2020
Evaluating the Camden Core Model: How a research partnership between the Camden Coalition and J-PAL North America was built
Part 1 of a Q&A blog series describing the partnership between the Camden Coalition and researchers affiliated with J-PAL North America.
Kathleen Noonan, Aaron Truchil, Amy Finkelstein
November 14, 2019
It takes an ecosystem: Finding success in complex care
Read the Putting Care at the Center 2019 opening remarks by Kathleen Noonan, CEO
Kathleen Noonan

Robert Jackson is one of fifty patients experiencing chronic homelessness who received a voucher for permanent affordable housing from the New Jersey Department of Community Affairs as part of our pilot Housing First program. During a recent visit to his new apartment in Voorhees, NJ, he talked enthusiastically about the impact that working with a Camden Coalition care team has had on his health, his outlook, and his motivation. “It was the team, the team aspect, I think that helped a lot…. Not wanting to disappoint the team. Everybody’s going to bat for me, I better take care of myself, do what I have to do.”

For Jackson, doing what he had to do included a stay in a shelter while he and our care teams undertook the long, frustrating process of securing housing. “Oh lord I hated that,” he scowled, describing his time in the shelter. “But I stayed because of all the work you’re doing for me. I felt so violated every night being searched. They’d search you every time you clear the door they searched you. I didn’t like that.”

Under a true Housing First model, patients should be housed as quickly as possible after being identified. While we are working toward a true Housing First model here in Camden, there are some serious challenges. A fragmented social services system, tight housing market, and high prevalence of criminal history and physical disability among our patient population have all made immediate access to permanent housing more difficult to achieve than we hoped.

The fact that patients stick with us through the months it takes to work through the system is a testament to the hard work our care teams put into building trust with patients who have often been failed over and over again.

“Patients often don’t believe we will connect them to housing,” says Laura Buckley, Senior Program Manager for Social Work Operations at the Camden Coalition. “There is even a level of skepticism when patients sign their lease and get the keys! Not until patients use those keys to officially unlock the door to their new home does it start to sink in as reality.”

 

 

It’s those moments after unlocking the door to their new home that makes the wait worth it. On November 1, 2016, Sandra Holmes walked into her new apartment, giddy with excitement. It was the first home she could call her own in over 30 years. She danced around the kitchen, unpacking dishes, towels, and a coffeemaker between animated phone calls to family members. Laying down on her newly made bed, bathed in natural light from her windows, she said, “I could just sleep here until tomorrow.” And unlike in the shelter, “there would be nobody to wake me up!”

Jackson has been living in his new home for over four months now, and hasn’t been back to the hospital since moving in. Now he sees a primary care doctor, a therapist, and a psychiatrist regularly. “If you’re going to go to the doctor and do preventative maintenance, and you’re going to be indoors, it’s got to be cheaper on the whole society, it’s got to be cheaper,” he explained. “And I think you’ve proved that in spades just in the short time I’ve been here.”

Thirty patients have been housed so far through our Housing First pilot program, and we’re working hard to house the next twenty. We are also undertaking a rigorous evaluation of our Housing First pilot program, including a fidelity scaling as well as surveys and interviews of both providers and housed patients. Look out for preliminary outcome data in the coming months, and listen to Jackson talk about the impact Housing First has made on his life in the video above.

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