By David Heitz / NewsBreak Denver
(Denver, Colo.) Hotels for people experiencing homelessness at risk for COVID not only prevent disease transmission, but also reduce hospital use, a new study has shown.
Although the study examined homeless hotels in San Francisco, Denver has similar programs. During the epidemic, many cities used federal money to put people experiencing homelessness in hotels. Various programs offer wraparound services such as case management and mental health care.
Some cities, like Denver, still are using the hotels.The hotels mainly serve the elderly and people with disabilities. Denver has contracts with several hotels serving people experiencing homelessness that run through the end of this year.
Residents of the Upper Downtown Neighborhood Association have complained about drug use and litter around Aloft Hotel near the convention center. That hotel has been used as a non-congregant shelter for people experiencing homelessness since 2020.
On-site services make big difference
The programs with services offered on site kept chronically homeless people out of the hospital compared to a control group, the study published in Journal of the American Medical Association showed. Scholars from University of California at Berkeley and University of California at San Francisco studied 2,500 people experiencing homelessness staying in 25 San Francisco hotels.
“Participants included people experiencing homelessness who were among the top 10 percent highest users of acute medical, mental health, and substance use services and who had three or more emergency department visits in the nine months before the implementation of the shelter-in-place hotel program,” according to the study, published June 28. Data analysis spanned from February 2021 to May 2022.
Stabilizing the roughest cases
The study whittled down the data to examine how the hotel programs affected chronic users of hospital services. “In this cohort study of 686 high users of acute county services experiencing homelessness, those who received a shelter-in-place hotel placement had significantly fewer emergency department visits, hospital admissions, inpatient days, and psychiatric emergency department visits compared with matched controls without a placement,” the study found.
Emergency services for people experiencing homeless, from ambulance rides to ER visits and psychiatric hospital stays, cost taxpayers massive amounts of money. According to a 2019 issue brief by Colorado Coalition for the Homeless, “Emergency room visits cost, on average, $3,700 which equates to $18,500 spent per year for the average person experiencing homelessness and $44,400 spent per year for the highest utilizers of emergency departments. People experiencing homelessness are often unable to pay these high medical expenses, which means that ultimately taxpayers will carry this financial burden.”
Former Quality Inn now Fusion Studios
Fusion Studios in Denver houses formerly homeless residents. (In the interest of full disclosure, the author of this article lives at Fusion.)
The former Quality Inn and Suites Hotel at 3737 Quebec offers on-site mental health services for many residents. The site, run by Colorado Coalition for the Homeless, also is visited by a medical RV run by the coalition known as The Hop.
Many communities like Denver are making the hotel model for housing the homeless permanent. Other places, like Aurora, have struggled with how they would fund them once the federal American Rescue Plan Act money runs out.
According to a commentary by Rutgers scholars accompanying the study, the experiment shows “the integration of on-site medical and nursing services is likely an effective supplement to existing permanent supportive housing models for reducing utilization of hospitals, at least for some high users of avoidable acute care services.”
Success of the SIPRA
Denver has another program called SIPRA that has demonstrated success stabilizing chronically homeless people with wraparound services.
A federal program, SIPRA stands for Social Impact Partnerships to Pay for Results Act. SIPRA uses vouchers for the homeless to be housed and offers Medicaid savings for those who get care.
Denver's SIPRA, known as Housing to Health, has served more than 300 people since it launched in 2016. Those clients are among the highest users of the most expensive services, such as ambulance rides and emergency room visits. Incarceration also proves costly.
Private investors award funds for wraparound services such as mental health care and case management in the form of a SIPRA bond. The Urban Institute will periodically evaluate whether the SIPRA grant is effective through 2030 under an $826,800 grant awarded in April.
Under the contract, the bond is forgiven “if program participants stayed housed for at least a year and spent at least 20 percent fewer days in jail,” according to Pew Charitable Trust. “If participants spent more time in housing, and less time in jail, investors would get additional money. Denver ended up saving so much money on emergency services that it repaid investors $9.6 million.”
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