Homelessness in America has hit a record high and housing instability is widespread. Millions of Americans are vulnerable to inadequate housing and half of all U.S. renters are spending far more than the recommended 33% of their income on rent.
For many Americans, housing costs are out of reach, as 13 of the 20 largest occupations in the U.S. pay less than the housing wage. This housing crisis is impacting overall health and well-being and utilization of healthcare. Individuals and families struggling with homelessness often experience lower infant birthweights, mental health challenges, chronic disease, and higher mortality.
HMA works at the intersection of housing and healthcare in a variety of ways, including policy, programs, financing, and evaluation. A safe and secure place to live is fundamental to all of the healthcare and human services work we do at HMA. Our experts have developed and worked within programs in public housing authorities, hospital housing partnerships, shelters and transitional housing, post-incarceration transition and 1115 waiver supports, rural housing, and other housing supports.
HMA experts are former state and local public health leaders, directors of community-based organizations, and former senior officers from key federal agencies, setting us apart from other consulting companies.
We understand the complexity of designing and implementing change beyond the theoretical level – we have walked in the shoes of our clients and understand how to provide insight that is meaningful, actionable, and realistic.
Organizations we support
Federal, state and local government agencies
Managed Care Organizations
Public Housing Authorities
Community-based health/behavioral health and human service organizations
Provider organizations (FQHCs, CCBHCs)
Schools and universities
Departments of behavioral and public health
Healthcare systems and providers
Philanthropic organizations
Jails and correctional facilities
We Help Our Clients
Transform their community’s response to homelessness
Improve local housing delivery systems
Facilitate new or expanded community partnerships
Address systemic barriers
Build capacity of local partners and resources
Help with targeted impact improvements
Scale interventions to match resources and need
Increasing system capacity
Provide management tools for improved decision making
Planning and implementation support for continuum of homeless services
Affordable housing needs assessment
Consultation on shelter and outreach team best practices
Project Spotlight
The problem:
With new funding available and a homelessness crisis growing more acute, the JOHS requested an evaluation of the department’s effectiveness and barriers, as well as the governance model over all homelessness response functions.
How we helped:
HMA conducted a discovery process consisting of 40 stakeholder interviews with local elected officials, County and department staff, and contracted service providers. We also reviewed key contracts, policies and procedures, and other foundational documents; and completed a summary of national best practices to inform future program development. This resulted in a summary of gaps, opportunities and recommendations that HMA presented to a joint meeting of County and City Commissioners, and HMA continues to assist in implementation
The outcome:
HMA presented leaders with findings and recommendations, including reforms to provider payment, system governance, inter-agency partnerships and more). Subsequent contracted initiatives to support implementation include the renegotiation of an Inter-Governmental Agreement and action plans to improve to the shelter system and street outreach systems.
The problem:
Tens of thousands of residents of HUD assisted senior housing in California are dually eligible for Medicaid and Medicare and have complex medical, behavioral health, and health-related social needs. Affordable housing developers, owners and operators do not have financing to enhance resident supports to prevent homelessness, avoidable hospitalizations, or institutional care transitions. While evidence shows that Medicaid, Medicare and D-SNP plans and healthcare providers would reduce avoidable inpatient and urgent care costs from enhanced resident services, mechanisms to partner with housing organizations have been elusive due to different incentive structures, infrastructure, and cultures in each sector.
How we helped:
Through contracts with LeadingAge California, HMA supported California housing organizations to develop a compelling value proposition for strategic discussions with payers, providers, and foundations. HMA is developing a financing plan and gap analysis to braid and blend Medicaid, Medicare, D-SNP, workforce, behavioral health, and other funding streams to sustainably support enhanced services provided by trusted, culturally and linguistically responsive on-site service coordinators.
The outcome:
California DHHS and Department of Aging leadership endorsed the goals of the CICH model and are guiding next steps to develop the infrastructure and braided/blended financing plans. Two health plans in southern California are interested to partner in piloting the model.
The problem:
Housing and community development organizations are trusted resources in low-income rural and urban communities across the US; and they were instrumental during COVID in engaging high-risk communities in prevention activities. While housing and community development organizations are a natural place for successful CHW programs, most CHW models and training programs have been developed for healthcare organization environments.
How we helped:
HMA co-led a cohort of NeighborWorks network organizations to co-design three housing and community-development organization-centered CHW program models and a toolkit covering every element of standing up and sustaining a CHW program within housing and community development structures, values, and resources. We provided coaching and technical assistance to learning cohort participants to test toolkit components.
The outcome:
Web-based toolkit Community Health Workers: A Promising Program Model to Advance Health & Well-Being in Affordable Housing and Community Development – NeighborWorks America
The problem:
The organization has requested assistance with establishing healthcare partnerships, designing health care services to meet resident health needs in each affordable housing development, and identifying opportunities to expand health and wellness services.
How we are helping:
HMA is providing guidance in service planning, partnerships, resources, budgeting, and strategies. This may include identification of potential health care partners, design of the health care model, assistance with budgeting for health care service costs, and other consultation as requested.
The outcome:
HMA presented leadership with insight on how to expand embedded health services to optimize resident health across their housing portfolio, assisted with the design of health care services, and helped to build healthcare partnerships.
Our HMA experts are ready to help your organization support your communities.
Contact our experts:
Boyd Brown
Associate Principal
Kirsten Bryan
Senior Consultant
Michael Butler
Associate Principal
Tia Cintron
Managing Director, Housing Services and Supports
Anthony Federico
Senior Consultant
Paul Fleissner
Managing Principal
Dena Hasan
Associate Principal
Trish Marsik
Principal
Charles Robbins
Principal
Madeleine (Maddy) Shea
Principal
