Alaska's largest hospital is quietly financing a big piece of Anchorage's strategy to move hundreds of people from the street to permanent homes.
Close to $1 million was distributed earlier this month by Providence Health and Services Alaska, the corporate name for Providence Medical Center, to a dozen agencies that are working to bring services to people ranked most likely to die on the street.
Those services include a database of homeless adults and families being shared between agencies for the first time, and case managers to ensure referrals occur and people don't slip through the cracks. There's money for emergency shelter and meals, short-term housing for families and a pool of money to help people pay security deposits or late rent to avoid eviction.
There's a strategy behind how the money is being allocated. It's based on a framework developed by United Way of Anchorage and a methodology being espoused by the city of Anchorage and other homeless advocates — that homeless men and women will be listed and ranked by vulnerability and get housing and treatment that most directly meet their needs. Agencies will function like rungs on a ladder out of homelessness and into long-term housing, instead of individual organizations trying to end homelessness alone.
A faith-based organization that receives property-tax exemptions, Providence donates millions of dollars annually to charity.
Now the hospital is trying to help finance a major change in how Anchorage confronts homelessness. Last year, a survey conducted by Providence, the city, United Way and several other agencies found poverty and substance abuse are among the top priorities in the community.
That result was expected. But in the fall, Michele Brown, executive director of United Way, presented Providence with a new proposal.
Could the hospital system do a better job of focusing on homeless individuals, instead of on activities and agencies?
Hospital executives "got really intrigued," said Richard Mandsager, the chief executive of Providence Alaska Medical Center, in an interview. Over the winter, Providence paid United Way $150,000 to develop a plan for how that system would work, Mandsager said.
A four-part theory underpinned United Way's work:
* Know the homeless person or family by name.
* Find out what kind of housing will work best and get them to it as quickly as possible.
* Bring in services that will help the person or family stay housed.
* Track how that person or family is doing.
Mandsager emphasized that Providence isn't the expert in homelessness, nor is it trying to seek attention for the work.
As for the size of the financial commitment, Mandsager acknowledged high health care costs in the community. He said he expected some people to wonder why the hospital wasn't instead using its resources to offset those costs.
But he said the money was viewed as an investment by hospital executives as a step toward long-term savings. Over the years, reports have shown that the chronically homeless seek expensive emergency room treatment on a regular basis.
"We have an incentive to try to reduce unnecessary ER usage," Mandsager said. "The state needs us to do everything we can to reduce unnecessary use of health care resources. But that requires an investment."
And housing, Mandsager said, is viewed by the hospital as the "first prescription." The system being financed by Providence is geared at quickly housing people who are homeless and helping them stay in housing long term.
"It's not a matter of legislating people out of existence. We need to work with people," Mandsager said.
That's what's been changing in Anchorage the past few years, Mandsager said.
"There is a bigger sense of, let's work together, not just be our own agency."