California’s homelessness crisis highlights need for optimized data sharing

OPINION – More than half the people facing homelessness or housing instability in our country live in California.

Homelessness is more than just the lack of stable housing; it is a complex issue that affects nearly every facet of a person’s life, such as their ability to access healthy foods, gain employment, and effectively manage health conditions. The result of these traumas can reduce life expectancy by more than 20 years.

To address the homelessness epidemic, California is enacting aggressive policies and pouring billions into funding to further require communities to support the unhoused. One key initiative is California Advancing and​ Innovating Medi-Cal (CalAIM), a long-term commitment from the state to transform and strengthen Medi-Cal, which includes new resources and coordinated, community-based approaches to address homelessness.

The success of CalAIM — and many other initiatives — hinges on our collective ability to share timely data across the health and social care ecosystem. However, much of our data remains in silos today, inhibiting our ability to effectively coordinate care and meet the needs of people facing homelessness.

There are statewide efforts to address this. California’s first-ever statewide data sharing agreement, the California Health and Human Services Data Exchange Framework (DxF), is designed to accelerate and expand the exchange of health and social care information. The DxF sets up the necessary data sharing requirements and elements critical to providing high quality care for the more than 170,000 Californians without a stable home.

Early applications of data sharing show promising results.

Most health care organizations supporting populations facing homelessness collect data on their patients and clients at the point of care, acting on and analyzing that data at the organizational level. However, that information is not readily available to other organizations, including emergency shelters, housing navigators, and capacity-building services like Samaritan. This lack of coordinated data results in missing information about a patient’s medical and social history, which drives down the effectiveness of care all while increasing public costs.

The success of CalAIM — and many other initiatives — hinges on our collective ability to share timely data across the health and social care ecosystem.

For startups like Samaritan, data is essential to quickly finding individuals and delivering critical aid. Samaritan is a platform that helps its members gain the financial and social support needed to find a stable home. Samaritan enters communities with frontline partners to reach targeted individuals with a Samaritan membership. Members get a smart wallet, and then share their needs and develop action steps. From there, members receive the help they need to move toward their goals.

Unfortunately, Samaritan’s process is often derailed by lack of access to critical data on individuals they aim to help. Each day spent waiting on requested data for target populations affects the likelihood of full restoration to a long-term, independent life for people going through homelessness. Delays also decrease the quality of recovery, further increasing future costs of care.

Samaritan care partners frequently find themselves with no historical social or medical information when addressing a person’s needs, and instead, must rely on the individual’s personal recollection of past, often traumatizing events. When interviewing a client, Samaritan care partners collect their own data and enter it into at least two, sometimes three siloed platforms.

Time spent on duplicate data entry means less time spent on more valuable tasks focused on the people they want to help. While Samaritan waits on data requests, unhoused people must also wait on the critical, sometimes life-saving care they need.

Access to relevant, connected data has immense value. When health system CommonSpirit, Samaritan’s provider partner in Los Angeles, was able to collate early data on unhoused patients using Samaritan, they found that the social determinants of health (SDoH) outcomes and improved transitions to community-based care reduced medical spend by 36%. Having this aggregated data was key to CommonSpirit making an informed decision to continue the intervention.

Homelessness is a crisis that is devastating to California’s communities and the hundreds of thousands of people without a safe place to live. Organizations that want to improve health equity should be wholeheartedly working to make high quality data sharing a reality. Every day matters to people facing homelessness, and we all have a responsibility to make a difference.

Shruti Kothari is the Director of Industry Initiatives at Blue Shield of California. Jonathan Kumar is the founder of Samaritan