Tacoma doctors could prescribe housing for homeless — if it existed

Dr. Brianne H. Rowan is a resident physician at Tacoma Family Medicine.
Dr. Brianne H. Rowan is a resident physician at Tacoma Family Medicine. Courtesy photo

Earlier this year, Hawaii state Sen. Josh Green proposed legislation aimed at allowing doctors to literally write a prescription for “housing” and get Medicaid to pay for it.

The bill highlighted not only social benefits but economic ones as well, and recent research suggests housing the homeless leads to Medicaid savings of more than $500 per person per year.

That’s nearly a million dollars if applied to the 1,700 homeless adults in Pierce County.

While the Hawaii bill did not pass, Washington took up the charge with its own Medicaid Transformation Project. Just this month we became one of the first states to obtain federal approval to use Medicaid funds to support housing.

Although groundbreaking, Washington’s funds (unlike the Hawaii proposal) will be restricted to supportive housing services and cannot be used to pay rent or build new housing.

In Tacoma – a city with skyrocketing rental prices and a need for low-income housing that continues to far exceed the number of available units – this simply isn’t enough.

Without concrete action by the city to create additional housing and provide rent support, Tacoma is likely to find itself with newfound services funneling the homeless into housing that simply doesn’t exist.

Kristen Smith, a family medicine social worker in Tacoma, estimates that over a quarter of the patients she sees struggle with housing instability. But she says she often has little to offer.

The 2016 Tacoma Community Needs Assessment found a shortage of more than 7,000 units of low-income affordable housing. Not surprisingly, the local resource crisis line reports that the most common requests are for rent and utility assistance followed by low-cost housing.

In June, Tacoma Mayor Marilyn Strickland declared a citywide state of emergency due to the rapidly increasing homeless population and the resulting health crisis. Last week, the City Council voted unanimously to extend the declaration through 2018.

Homeless individuals are more likely to become ill, more likely to die younger, and are four times more likely to be hospitalized, resulting in significant healthcare costs.

This is not lost on Marc Provence, director of Washington’s Medicaid Transformation Project, who announced, “Washington is among the first states in the nation to act upon the evidence that social conditions – homelessness [etc.] – are tied inextricably to health.”

But the new Medicaid funds, unavailable for what Tacomans really need – to pay rent and build new housing – are not enough.

Individuals will find themselves with a plan for how to apply for non-existent housing. They will learn relationship-building skills to work with non-existent landlords.

But they will still be homeless and often sick. They will continue to visit our hospitals with preventable illness from exposure. Many will have untreated diabetes from not having a refrigerator to store their insulin.

Homelessness in this city is a health crisis, but we know how to treat it. Call your City Council members and ask them to get on board.

Brianne H. Rowan is a resident physician with Tacoma Family Medicine and has a master’s degree in public health.