Health Care Systems

Actions to measurably end homelessness

Health care systems across the country are playing a catalytic role in helping communities measurably end homelessness.


Across the country, health systems are proving they have a critical role to play in helping communities end homelessness at a population level. Health institutions have embraced this role understanding that promoting positive health outcomes — and advancing the overall health and well being of their communities— extends beyond the delivery of medical care. 

Health systems committed to advancing and upholding the overall health of their communities have embraced an “anchor” mission. This concept, developed by The Democracy Collaborative, emphasizes the commitment to deploying long-term, place-based economic power, people-power, and other resources to better the long-term welfare of the community in which the institution is anchored. As institutions with roots in communities, health systems can hold a vision for long-term success, which can both withstand and outlast short-term political concerns.  

“At Providence, we know it is important to care for our neighbors. We can’t solve housing instability and homelessness alone, but we can be an active part of the solution,” said Justin Crowe, Senior Vice President, Community Partnerships at Providence. “This is evidenced by our long-term relationships with partners in Anchorage, AK, and the learnings that we are scaling across our footprint to the communities that are ready to understand homelessness differently, from Anchorage, to Lubbock, TX, and several places in between.”

“We can’t solve housing instability and homelessness alone, but we can be an active part of the solution.”

Justin Crowe, Senior Vice President, Community Partnerships at Providence

They can leverage a range of assets to catalyze system change in the homelessness response system. This includes everything from investments to communications, public affairs, data and technology expertise, real estate, and political influence.

Health institutions are rich with expertise that they can share with homeless response systems to help build effective capacity. Built for Zero communities have demonstrated that problem-solving skills like quality improvement, data analytics, and human-centered design are essential to building an operating system to drive population-level reductions.


Questions to ask

Are we all aligned behind a commitment to population-level reductions in homelessness as the critical measure of our success as a health care system? 

How will this support the community’s shared aim of functionally ending [target population] homelessness?

Is the community currently driving population-level reductions in homelessness? 

How will this [effort, investment, intervention] help communities drive population-level reductions in homelessness, and how would we know? 

Is real-time, by-name data informing these decisions? Where is that data coming from?


Actions to take

1. Create accountability for addressing homelessness within your system.

Strengthen and maintain the connections necessary to ensure high-quality care coordination for patients experiencing homelessness. 

2. Create accountability for measurably ending homelessness across your entire community.

Leverage your influence to create accountability for key actors — including but not limited to funders, elected officials, and other peer institutions — to measure and drive success at the population level.

3. Find out your community’s shared aim around population-level reductions in homelessness and help promote and protect it.

Communities can accelerate their progress when influential institutions help them hold ground for the focused systems improvement work needed to sustainably end homelessness. 

4. Champion a culture focused on using quality data for improvement.

Support the development and use of quality, by-name data, which includes every person in a community experiencing homelessness, which is updated at least monthly. Working with homeless response systems partners, use this by-name data to drive decision-making for care coordination and strategies to drive population-level reductions in homelessness. Develop data-sharing mechanisms to target and prioritize high utilizers of the health care system that are on the by-name list.

5. Ensure investments in ending homelessness create incentives for population-level reductions.

Make investments in the coordinated system that catalyze reductions and an end to homelessness for one or more populations. Encourage funders to foster accountability to ending homelessness and accelerate progress by aligning their resources toward the shared aim.


Read more about health care systems working to end homelessness

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Homelessness is solvable.

Communities in the Built for Zero movement are proving it.

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