BMC’s investment, the first in Boston, joins a growing national trend of hospitals prescribing housing for health

(Boston) – Dec. 7, 2017 – Boston Medical Center is investing $6.5 million over five years to support a wide range of affordable housing initiatives, in an innovation lab approach that will be studied closely to determine the best ways that health care systems can improve both community and patient level health and reduce medical costs by addressing homelessness and housing insecurity.

BMC isn’t building its own housing units or serving as a landlord; instead, the hospital is investing in a diverse group of community partnerships in neighborhoods where many of our patients already live, which will enable them and other residents to access a larger pool of stable, affordable housing. Some examples include:

  • $1 million for a no-interest loan and a $400,000 operating subsidy to support a new, Good Food Markets in a new housing development in Roxbury. The market’s lease will subsidize affordable rental housing in the Dudley Square development.
  • $1 million for a stabilization fund that will provide grants to community-based organizations to help families avoid eviction in and around Boston.
  • $1 million to the Pine Street Inn, the Boston Health Care for the Homeless Program and other community partners to create a housing stabilization program for individuals with complex medical problems, including substance use disorder.

“BMC has long been on the leading edge of innovation in social determinants of health, and supporting affordable housing is the perfect complement to the medical care we offer at BMC,” said Kate Walsh, BMC’s President and CEO. “Too often, we prescribe medicine to a family, when what they need just as much for long-term health is a prescription for stable housing. This investment remedies that and saves cost to the health care system in the process.”

“The leadership at Boston Medical Center have shown time and time again that BMC is a true community partner, and will continue to be invested in the well-being and long-term success of all Boston residents,” said Mayor Martin J. Walsh. “I thank them for their investment, which shows that not only do they recognize the underlying issues facing many of our residents, but they are committed to being part of a solution.”

BMC’s $6.5 million investment also represents the first time that a Massachusetts hospital has put all its required community health investment into one social determinant of health –  in this case, housing – to satisfy the requirements of the Massachusetts Department of Public Health for a Determination of Need (DON). BMC won approval for its DON for a clinical campus redesign, which will be completed at the end of 2018.

“We are pleased with BMC’s decision to invest in affordable housing as part of its community health initiative,” said Public Health Commissioner Monica Bharel, MD, MPH. “We hope this investment in housing and other social determinants of health becomes a model for how to improve health outcomes for patients.”

BMC is making a long-term commitment to housing for health, and will reinvest loan repayments, equity fund returns and tax credits from this initiative back into affordable housing.

At Boston Medical Center, 25 percent of patients admitted to the hospital are homeless. Children’s HealthWatch data from BMC’s pediatric Emergency Department shows that one in three families are housing insecure, meaning they have unstable housing or are in jeopardy of eviction.

Housing insecurity has been tied to a wide array of health problems, including asthma, lead exposure and depression. Families in that situation are often forced to choose between paying for medication or rent. And children whose parents are behind in rent are more likely to suffer from food insecurity and related health problems, studies have found.

It’s also expensive for health care systems. Patients living in poverty in the United States are often the most costly to treat, in part because of their lack of a stable home. Nationally, five percent of hospital users are responsible for half of health care costs in the U.S., and most of those patients are living below the poverty line and are housing insecure

Megan Sandel, MD, a BMC pediatrician, has studied housing insecurity for decades, after seeing children come to her office with illnesses or conditions that could be improved with stable, safe housing. Sandel recently co-authored a JAMA Viewpoint on housing insecurity, highlighting the body of research supporting investments in housing by hospitals and health systems.

“The return on investment for projects like these is two-fold,” said Sandel, who is also a principal investigator at Children’s HealthWatch and an Associate Professor of Pediatrics at Boston University School of Medicine. “There is a direct health benefit, but that in turn creates significant savings in health care spending. Most importantly, we are building healthy communities, where families can thrive financially and physically.”

BMC’s community partners in the affordable housing initiatives include the Massachusetts Department of Public Health, the Boston Public Health Commission, the Boston Housing Authority, the Boston Alliance for Community Health, Health Resources in Action, the Center for Community Health, Education and Research at Northeastern University, the Pine Street Inn, Boston Health Care for the Homeless Program, Nuestra Comunidad Development Corporation, the Codman Square Neighborhood Development Corporation, The Community Builders, the Madison Park Community Development Corporation, and the Healthy Neighborhood Equity Fund.

The Boston Foundation and the Blue Cross Blue Shield of Massachusetts Foundation have been early supporters of BMC’s Housing Prescriptions as Healthcare Program.

“By studying the best ways to provide housing supports, as well as working with community partners, we are putting the whole patient first, and in many cases addressing the root causes of chronic disease and illness,” said Thea James, MD, Associate Chief Medical Officer and Vice President of Mission at BMC. “Health care leaders across the nation will be watching the results of our investments very closely, as they consider the best ways to help patients and communities lead healthy and fulfilling lives.”

A growing number of health care systems are investing in affordable housing or providing housing vouchers, including Bon Secours Health System in Baltimore, Nationwide Children’s Hospital in Columbus, Ohio, and the Camden Coalition of Healthcare Providers in New Jersey.

List of Investments:

Housing Project Investments

  • $1 million no-interest loan for Good Food Markets to build a supermarket in Bartlett Station, which is currently under construction by Nuestra Comunidad and Windale Developers and will have 323 units of affordable and market-rate housing in Dudley Square. BMC is also providing a $400,000 operating subsidy to support the market over four years. Besides selling fresh produce and creating employment opportunities, the market will reach out and support other local businesses.
  • $800,000 over four years to rehabilitate 35 units of Codman Square NDC’s permanent, supportive housing for individuals with mental health and/or disability issues on Waldeck Street in Fields Corner. Only 23 units are currently in use due to capital needs.

Housing Project Investments and Support Service Collaborations

  • $1 million over two years to the Pine Street Inn, the Boston Health Care for Homeless Program, and other community partners to create a housing stabilization program for medically complex individuals, including those with substance use disorder.
  • $200,000 over two years to support modest unit upgrades at Boston Housing Authority (BHA) properties to better meet tenants’ health needs.
  • $80,000 over two years to support a Community Wellness Advocate who will be based at BMC and serve as a liaison with BHA when tenants are in need of comprehensive health care. The advocate will also train BHA staff on difficult health issues, such as domestic violence and substance use disorder.

Community Engagement and Housing Stabilization Initiative

  • $1 million to be distributed as mini-grants to seed fund organizations with promising housing stabilization initiatives and financial assistance through a flex fund to help individuals and families avoid an eviction. BMC will collaborate with the Center for Community Health, Education and Research, Health Resources in Action, Boston Alliance for Community Health and other community partners to design and implement the mini-grant program and stabilization fund, as well as conduct ongoing community engagement around affordable housing
  • $450,000 investment over three years for the Healthy Neighborhood Equity Fund’s evaluation team, to study BMC’s investments to see what can be replicated locally and nationally. The evaluation team includes representatives of the Conservation Law Foundation, MIT, the Metropolitan Area Planning Council and the Massachusetts Department of Public Health.
  • $105,000 over three years to study the impact of the housing investments on BMC’s accountable care organization by reducing health care costs and improving quality of care.

Social Impact Fund

  • $500,000 investment in the Healthy Neighborhood Equity Fund, a private equity fund led by the Conservation Law Foundation and the Massachusetts Housing Investment Corporation for socially responsible development that supports health, the environment and public transportation.

Housing Support Service Collaborations

  • $360,000 over three years to The Community Builders to support a full-time, Community Life Program Coordinator, a new position, in the New Franklin Park housing development in Franklin Field to help connect residents and neighbors in the surrounding community with complex health needs to appropriate services.
  • $300,000 over three years to support a full-time service coordinator, a new position, at the DeWitt Community Center in Madison Park Village, and $225,000 over three years to support one full-time Elders Living at Home Senior Care Coordinator at Smith House, also part of Madison Park Village. Both positions will help tenants and neighbors in the surrounding community with complex health care needs connect to services.

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