This resource is a part of our “snapshot” series. A snapshot is a point-in-time window into our process for developing, testing, and implementing programs and partnerships. Snapshots let us share our hypotheses, workflows, and early observations and findings quickly with other innovators who are interested in what’s happening on the ground right now.

For more up-to-date and comprehensive information about the Medical-Legal Partnership, please visit the program page.

Issue

Stable housing is an important protective factor for the health and well-being of people with complex health and social needs. Eviction from stable housing can lead to a cycle of health crises and long-term homelessness, which are more difficult and expensive to address than preventing eviction before it happens.

Project goals

To help individuals in our community avoid eviction by providing legal services through our Medical-Legal Partnership, connection to community services through our community health workers, and one-time payment of back rent directly to landlords as needed.

Background

When the federal COVID eviction moratorium ended on January 1, 2022, our care teams saw an increase in individuals with complex health and social needs facing housing instability, including eviction. Housing insecurity is widespread in New Jersey, with 17% of New Jersey households reporting they are severely cost-burdened, spending 50% or more of their income on housing (2024).Evictions disproportionately impact households of color and households with children (Graetz et al., 2025), and can lead to permanent displacement, exacerbating socioeconomic and public health crises that threaten entire communities.

Individuals with substance use disorders (SUDs) are especially vulnerable to housing instability, due to complex needs and frequent discrimination from landlords and neighbors. Legal support can be especially impactful for these individuals due to the likelihood of criminal justice involvement for drug use, oversight from child protective services, struggles obtaining government benefits, and more.

From our experience running a Housing First program, an evidence-based supportive housing model, in South Jersey that provides permanent housing to individuals experiencing chronic homelessness, we know that the lack of affordable housing makes it extremely difficult for people to find appropriate, stable housing once they have lost it. We also know that homelessness and housing instability profoundly impact people’s mental and physical health, particularly for those who already have multiple chronic conditions.

Since 2017, the Camden Coalition has operated a Medical-Legal Partnership (MLP) with Rutgers Law School to address the health-related social needs of community members involved in the Coalition’s complex care interventions. In many cases, legal issues — like a threatened eviction, a benefits denial, or a utility shut-off — become barriers to better health. The MLP model integrates attorneys into healthcare settings to resolve needs that can undermine a patient’s health and well-being and can be better met through the legal system. MLPs follow the principle that leveraging legal services and expertise can advance individual and population health by addressing structural problems at the root of so many health inequities.

Project design

From fall 2023 through spring 2024, we had the opportunity to pilot an intervention to prevent eviction for individuals with behavioral health needs. In order to set up a process that was both thorough and responsive to the time-sensitive nature of eviction, we formed an internal, interdisciplinary committee with representation from our care management team, our Housing First program, our Medical-LegalPartnership, and our finance team. The team created a rigorous and person-centered process for reviewing eviction cases and working either with the courts or directly with landlords, as needed.

In the initial pilot phase, the committee reviewed potential cases to determine whether financial assistance would lead to sustained success. This included ensuring that the participant had ongoing support in place to maintain rental payments, that the eviction case could be settled or dismissed, and that all other rental assistance programs or opportunities had been exhausted. The participant was also required to give us permission to contact their landlord directly.

If the committee determined that funds would be appropriate, our legal team required the landlord to provide documentation within 10 days to confirm they were either withdrawing any pending legal action seeking eviction or agreeing to not commence an eviction case for unpaid rent to date.

Participants who were not approved for financial assistance continued to be supported by our care team and MLP attorneys in whatever ways were appropriate, including representation in eviction proceedings, support in finding anew place to live, and connection to community-based care for other medical and health-related social needs.

The success of the pilot led to a larger partnership with the New Jersey Department of Community Affairs (DCA)through the state’s Comprehensive Eviction Defense and Diversion (CEDD) program. As a CEDD grantee, our team provides eviction-related services to patients with behavioral health needs across Camden County. This larger program is allowing our team to provide critical preventative services to more individuals and families in our community.

Building on the pilot’s interdisciplinary team and process, for the state CEDD program we added a community health worker and a housing specialist to our team to provide navigation services and support for participant households.We offer support to individuals and families at risk of eviction identified to us by the state. Where the appropriate consents are in place, we leverage our Camden Coalition Health Information Exchange to identify up-to-date contact information and understand any additional risk factors or needed support.

Progress to date

Data from the pilot

During the pilot period of fall 2023 through spring 2024, the team identified 16 patients with mental/behavioral health needs who were at risk of eviction. Of those 16, 12 were approved for the program: 2 individuals received assistance by other means, and 10 received financial assistance from our pilot program.

Through financial assistance and legal negotiation, nine participants were able to stay in their housing and had their eviction cases either prevented or settled and dismissed. One was required to move out, but was able to stay for two months free, received reimbursement from the landlord due to habitability issues, and successfully found new housing before their eviction date. In June 2024, our attorneys conducted surveys with program participants and confirmed that all 10 remained stably housed.

Since scaling this work across the county, the team prevented 30 evictions within the first two months, with 25more active cases pending. The team has also saved the state nearly $10,000 in rental payments so far by negotiating with landlords prior to payment – in many cases related to habitability issues. The program has opened up partnerships with other legal firms and rental assistance programs in our county to ensure individuals are getting access to all available support systems.

Observations and lessons learned

Crucial to the success of the initial pilot was our finance team’s ability to handle time-sensitive requests. The team often has to contact landlords, negotiate terms, and make a payment within a matter of days, requiring our process to be both thorough (e.g., ensuring appropriate documentation, landlord agreements, and bank documents) and nimble (e.g.,able to turn around a check or electronic payment quickly).

Each interdisciplinary team member is critical to the process including the lawyer (providing legal negotiation and representation as needed), the navigator (conducting intake and case management), and our organization’s finance and contracting team.

Landlords were more willing to participate than we expected, but through surveys they also expressed frustrations with renting to individuals with complex health and social needs. They suggested having organizations more involved with tenants living with mental health needs, and shared that things often run more smoothly when a case manager is involved.

Next steps

We are conducting 12-month post surveys with the original pilot cohort to evaluate the long-term impact of this pilot.

We are also working directly with the state of New Jersey to scale the program for Camden County residents. TheComprehensive Eviction Defense and Diversion Program(CEDD) prevents evictions for residents across the state, with the goal of working upstream to keep individuals and families housed ahead of an eviction filing. We regularly provide data and findings to the New Jersey Department of Community Affairs CEDD team to help shape a more effective and efficient statewide effort.

Our data team is working to build a framework to link court eviction data with health data in the Camden CoalitionHealth Information Exchange (HIE) to quickly and efficiently identify potential clients.