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Doctors could prescribe houses to the homeless under radical Hawaii bill

February 28, 2017

by : theguardian – excerpt

Newly introduced bill would classify homelessness as a medical condition, as research suggests healthcare spending falls when people have been housed

One day last month, Stephen Williams asked a passerby for help and then collapsed on the sidewalk. When the ambulance arrived in downtown Honolulu, his temperature was well over 104F.

A life-threatening staph infection had entered his bloodstream. Williams, who lives on the dusty streets of Chinatown, spent seven days hooked to an IV, treatment that can cost $40,000, according to the hospital that admitted him. But Williams didn’t pay: the bill was covered by government dollars in the form of Medicaid. Over the past four years, he has been to the hospital for infections 21 times, he said, a consequence of psoriasis flare-ups in a humid climate and unsanitary conditions…

Cases such as these have prompted a groundbreaking new proposal in Hawaii. Instead of prescribing medication to homeless patients like Williams, what if doctors could prescribe something else that might ameliorate their health problems more effectively? The prescription would be housing.

With this aim in mind, a state senator, Josh Green, has introduced a bill to classify homelessness as a medical condition. Green, who is also a physician, said the idea originated in his own work in the emergency room, where he saw many homeless patients arrive for treatment of basic conditions at great expense, but no real long-term benefit. “I’m really just applying a band-aid,” he said of his medical work. “But these problems require intensive long-term support.”…

As envisioned by Green, doctors could prescribe housing on a case-by-case basis. In order to qualify, the patient must have been homeless for at least six months and suffer from mental illness or a substance addiction.

“We’re already spending the money on homeless people, we’re just paying for it in the most inefficient, expensive way possible,” he argued. “We have a lot of capacity, but lack the political will.”

The bill is winding its way through the state legislature, and faces a key vote this week. It has already found supporters. “I think this bill is a great idea,” said Daniel Cheng, an emergency room physician at the Queen’s Medical Center in Honolulu. Last year, treatment for homeless people at the hospital cost $90m. “When emergency medical services are being heavily overused by a population that’s being poorly served, it costs everybody,” Cheng added… (more)

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