NHS FPX 6008 Assessment 4 Lobbying for Change

Name

Capella university

NHS-FPX 6008 Economics and Decision Making in Health Care

Prof. Name

Date

Lobbying for Change

December, 2024
Governor Gavin Newsom
1021 O Street, Suite 9000
Sacramento, California 95814

Respected Governor,

I am writing to focus on a significant healthcare problem of homelessness facing the Stanford Hospital and its impact on the healthcare system of California. Current data from early 2022 reveals that around 173,800 persons in California lack stable housing (Crisis House, 2023). Homelessness exposes individuals to a range of critical health risks. It includes physical disorders, psychological health issues, substance use disorders and a higher risk of mortality. These factors contribute to increased hospital admissions, straining emergency facilities, increased communicable diseases and escalating healthcare costs.

Homeless patients spend, on average, an extra 2.33 days in the hospital and incur an additional $1,000 in treatment costs per discharge (Franco et al., 2021). Addressing this issue is crucial to prevent detrimental effects on public health while improving the financial strain it places on the healthcare system.Implementing measures to address homelessness at Stanford Hospital will produce considerable benefits. It will expand community health outcomes by reducing the spread of communicable diseases and decreasing hospital admissions and emergency care utilization.

NHS FPX 6008 Assessment 4 Lobbying for Change

Stable housing has been shown to lower healthcare expenses by 85%, resulting in savings of $28.99 per month (Carnemolla & Skinner, 2021). Addressing this problem is vital to reducing health inequalities, overcrowded emergency departments and rising economic loads. Homeless persons are more susceptible to health complications, with 1.4% of new HIV cases in California attributed to those facing homelessness or unstable housing. Additionally, 11% of adults living with (Human Immunodeficiency Virus) HIV in the state stated being homeless in the last few years (Liu et al., 2020). Overlooking this challenge will worsen healthcare discrimination and increase the state’s economic strain.

The problem of homelessness affects medical services, communities and the healthcare system in California. Health systems encounter an increased demand for emergency care as homeless persons depend on them for medical facilities. It leads to overcrowded emergency departments and increasing expenses (Franco et al., 2021). Homelessness contributes to health challenges. The homeless population is more vulnerable to infections. It amplifies the risk of disease transmission. On a state level, homelessness places additional strain on social services and resources. It exacerbates prevailing discrepancies (Liu et al., 2020).

NHS FPX 6008 Assessment 4 Lobbying for Change

Addressing this crisis needs coordinated and inclusive efforts. Our approach focuses on delivering preventive and primary care through community-based mobile health clinics, telehealth services, housing support, and an integrated, cross-disciplinary strategy. It enhances health outcomes and financial stability. Serchen et al. (2024) advocate that employing a team-based care model can reduce hospital stays for the homeless by 35% and decrease emergency care demand by 19%. This model aligns with the principle of justice by offering inclusive services that lessen disparities and address homeless persons’ health and social needs.

Executing Housing First initiatives that safeguard stable housing will address mental health challenges. It improves health outcomes and lowers expenses (Carnemolla & Skinner, 2021). Community-based preventive care programs help manage chronic and mental health conditions. It enhances safety and reduces emergency visits and associated expenses. Studies show affordable housing initiatives yield a significant Social Return on Investment (SROI). It estimates a $2 to $8 return for every $1 invested (Drabo et al., 2021). It reflects the efficacy of such programs in cultivating health outcomes while adhering to the principle of nonmaleficence.

During the pandemic, I observed firsthand how the rise in homelessness in California worsened medical conditions. It leads to longer wait times and heightened stress among staff, creating a challenging environment. As the Nurse Supervisor of the emergency unit, I encountered an overwhelming influx of unhoused patients. This flow placed considerable stress on staff, resources and emergency services. It hinders the quality of patient care. During the COVID-19 crisis, I took practical measures. It executes inclusive threat evaluation protocols and financial planning by collaborating with community organizations to address homelessness’s effect on the healthcare system and the broader community.

NHS FPX 6008 Assessment 4 Lobbying for Change

I strongly support you prioritizing funding for primary care initiatives and collaborating with local organizations to address homelessness. Your leadership is vital in developing a strong system for Stanford Hospital and the broader California healthcare infrastructure to support homeless persons.

Thank you for your consideration.

Sincerely,

Gurpal

References

Carnemolla, P., & Skinner, V. (2021). Outcomes associated with providing secure, stable, and permanent housing for people who have been homeless: An international scoping review. Journal of Planning Literature, 36(4), 508-525. https://doi.org/10.1177/08854122211012911

Crisis House. (2023, April 21). Homelessness in California. Crisis House. https://crisishouse.org/blog/homelessness-in-california/?gad_source=1

Drabo, E. F., Eckel, G., Ross, S. L., Brozic, M., Carlton, C. G., Warren, T. Y., Kleb, G., Laird, A., Porter, K. M., & Pollack, C. E. (2021). A Social-Return-On-Investment analysis Of Bon Secours hospital’s “housing for health” affordable housing program. Health Affairs, 40(3), 513–520. https://doi.org/10.1377/hlthaff.2020.00998

Franco, A., Meldrum, J., & Ngaruiya, C. (2021). Identifying homeless population needs in the emergency department using community-based participatory research. Bio Med Central Health Services Research, 21(1), 428. https://doi.org/10.1186/s12913-021-06426-z

NHS FPX 6008 Assessment 4 Lobbying for Change

Liu, C. Y., Chai, S. J., & Watt, J. P. (2020). Communicable disease among people experiencing homelessness in California. Epidemiology and Infection, 148(e85). https://doi.org/10.1017/s0950268820000722

Serchen, J., Hilden, D. R., & Beachy, M. W. (2024). Meeting the health and social needs of America’s unhoused and housing-unstable populations: A position paper from the American college of physicians. Annals of Internal Medicine, 177(4), 514–517. https://doi.org/10.7326/m23-2795