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Article
Publication date: 11 December 2018

Lisa Wood, Nicholas J.R. Wood, Shannen Vallesi, Amanda Stafford, Andrew Davies and Craig Cumming

Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting…

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Abstract

Purpose

Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.

Design/methodology/approach

This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.

Findings

This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.

Research limitations/implications

While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.

Practical implications

This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.

Originality/value

Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.

Details

Housing, Care and Support, vol. 22 no. 1
Type: Research Article
ISSN: 1460-8790

Keywords

Available. Open Access. Open Access
Article
Publication date: 24 October 2018

Andreja Siliunas, Mario L. Small and Joseph Wallerstein

Today, low-income people seeking resources from the federal government must often work through non-profit organizations. The purpose of this paper is to examine the constraints…

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Abstract

Purpose

Today, low-income people seeking resources from the federal government must often work through non-profit organizations. The purpose of this paper is to examine the constraints that the poor must face today to secure resources through non-profit organizations.

Design/methodology/approach

This is a conceptual paper. The authors review cases of non-profit organizations providing federally supported resources to the poor across multiple sectors.

Findings

The authors find that to accept government contracts serving the poor, nonprofit organizations must often engage in one or several practices: reject clients normally consistent with their mission, select clients based on likely outcomes, ignore problems in clients’ lives relevant to their predicament, or undermine client progress to manage funding requirements. To secure government-supported resources from nonprofits, the poor must often acquiesce to intrusions into one or more of the following: their privacy (disclosing sensitive information), their self-protection (renouncing legal rights), their identity (avowing a particular self-understanding) or their self-mastery (relinquishing authority over daily routines).

Originality/value

The authors show that the nonprofits’ dual role as brokers, both liaisons transferring resources and representatives of the state, can complicate their relation to their clients and the predicament of the poor themselves; the authors suggest that two larger trends, toward increasing administrative accountability and demonstrating deservingness, are having both intended and unintended consequences for the ability of low-income individuals to gain access to publicly funded resources.

Details

Journal of Organizational Ethnography, vol. 8 no. 1
Type: Research Article
ISSN: 2046-6749

Keywords

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