Homelessness has become one of the most significant and challenging social problems facing communities across the United States. The lack of housing goes hand-in-hand with a host of severe health conditions. Many homeless individuals struggle with at least one substance abuse problem, at least one chronic physical condition, and a psychiatric illness. As a result, they are frequent users of high-cost public services including emergency medical and psychiatric services. This results in poor outcomes for the individuals and places communities under crushing financial burdens. The reason communities are urgently looking for ways to address the homeless public health crisis is because the costs of not treating homelessness is becoming higher, in both financial expenditure and population health outcomes. Homelessness is expensive to treat but even more expensive to ignore.


Housing for Health initiatives are based on the idea that stable housing is an essential component of improved medical care. Studies have shown that homeless individuals who are placed in permanent housing with wrap around support services are better able to manage their conditions and achieve better health outcomes at a lower overall cost. Housing for Health programs include:

  • Permanent supportive housing
  • Primary care
  • Substance use treatment and referrals
  • Counseling
  • Patient care coordination
  • Referrals to health-related support services (e.g. transportation, food support, and translation services)

While the topic of providing healthcare for homeless individuals has been discussed for decades, medical providers and community support organizations have maintained separate spheres of influence with separate data systems and no ability to view all aspects of an individual’s health. Unfortunately, you can’t treat the whole person with only part of the data. Communities that have the most success with their Housing for Health programs use a community-wide care coordination platform that connects all providers and facilitates collaboration. Under Housing for Health programs, a patient’s interaction with all types of providers is recorded in a comprehensive health record and shared among agencies through data integration.

Community Care Coordination

ClientTrack is a comprehensive care coordination and housing solution that focuses on meeting the needs of community collaborations looking to address all aspects of a homeless individual’s needs. ClientTrack helps providers manage intakes, perform assessments, provide real-time referrals, and show outcomes to funding sources. For example, ClientTrack is the technology back bone for the Los Angeles County Department of Health Services Housing for Health (LA HFH) Program. LA HFH has successfully reduced the inappropriate use of healthcare resources and improved outcomes for homeless individuals with complex physical and behavioral health conditions.

ClientTrack includes:

  • Coordinated screenings for medical health, mental health, behavioral health, and health-related social needs
  • Real-time communication, care coordination, and data sharing across organizations
  • Single point of entry assessment and referral for services
  • Standard data collection and reporting functionalities
  • Real-time housing management
  • Performance measurement tools
  • Prioritization and Risk Stratification
  • Security protocols that meet or exceed HIPAA, HITECH, and 42 CFR Part 2 regulations
  • Real-time data sharing (HL7 FHIR standards framework)

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