Los Angeles County has the greatest number of individuals experiencing homelessness in the country. To address this, the Los Angeles County Department of Health Services (LA DHS) launched Housing for Health (HFH) in 2012, a program focused on reducing homelessness, improving the health of those experiencing homelessness, and reducing spending for low-income individuals with at least two hospitalizations or emergency department visits within the last year. This report describes HFH program and implementation strategies, lessons and challenges. The program follows a “housing first” approach, which allows individuals to enter housing before initiating substance abuse or mental health treatment.

Program strategies included partnering with various types of housing authorities, initiating whole-person support services such as case management and employment assistance, engaging local community health services, and improving care transitions from jail and prison. To successfully implement the program, LA DHS leadership had to identify creative funding sources, align with cross-sector stakeholders, and track quality improvement data. Some challenges remain in implementing this program, including limited supply of affordable housing units, complex funding sources, limited homeless service provider capacity, staff recruitment and retention issues, and balance between county-wide standardization of social services with local community cultures. One key lesson from LA County’s experience is the importance of partnering across sectors to align local financing streams, which may generate the most long-term value for communities.