In many ways, the revolution in housing philosophy is part of a widespread series of changes in Spokane’s safety net services.
Recent years have seen several innovative approaches, from adding in-shelter medical services to the creation of a community court system. The Affordable Care Act has brought a broad expansion of access to health care to populations that have traditionally not had it, like the homeless, but it also has created programs that aim to support and reward innovation in delivery of such services.
One of Spokane’s bright spots in homeless care has been the Hot Spotters program. It’s a collaboration among those who work with the chronically homeless to track and manage the “super-users” of public services – those who end up in the emergency rooms and jails constantly. The basic idea is that officials keep an eye on the super-users, surround those people with help, and communicate with each other.
Hot Spotters started somewhat informally among local doctors, fire and police officials, and social workers. Lee Taylor, the former head of strategic initiatives for the Spokane Medical Society, and Darin Neven, an ER doctor, were among those initially leading the effort. Now it has moved into an organization run by the Empire Health Foundation known as Better Health Tomorrow.
BHT is a “regional health improvement collaborative” – an umbrella of programs and services set up to attract and manage funding through the Affordable Care Act and state programs. It was created to operate the Health Benefit Exchange under the Affordable Care Act for the 15 counties in Eastern Washington, helping to sign up 94,000 people for health insurance. That was far higher than expected, said Alison Carl White, the executive director of BHT.
That alone results in a lot more money flowing into the community and its health care systems. Beyond that are grant opportunities supporting innovations in health care and delivery. White said this has made it a fertile time for creative thinking in the way we provide help to people in need.
“Like the Affordable Care Act or not, it really has prompted a whole bunch of conversations,” she said. “I think it kind of freed up some thinking: How do we do this differently?”
In its Hot Spotters work, BHT assigns individual community health workers to play a “linking role” for the chronically homeless – making sure they get connected to what they need and following up with them.
White said there are a lot of forces in play right now, including federal funding and new approaches, that make it an exciting, innovative time in social and health services.
“You have all these forces pulling in the same direction,” she said.
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