The Light of Hope: 5 Lessons from the Housing First Model

Four times a year at a housing complex in Phoenix, there’s a block party where you’ll find residents, myConnections team members, UHC volunteers, property management, and community partners gathering around good food and lively music. It might seem like an ordinary celebration at first, but what makes it truly special is that many of the residents were recently homeless and nearly all have dealt with complex chronic diseases, behavioral health issues and trauma. 

Some of the residents here are Medicaid members taking part in the UnitedHealthcare myConnections™ housing program. The goal is not only to get those in need into permanent housing, but to stabilize them with access to both physical and behavioral care. 

Arizona is just one component of a nationwide effort by the myConnections team to house 350 formerly homeless individuals in the coming year. 

“We are like family,” said Nellie Nekouie, the myConnections state director in Arizona. “We will show up no matter where they are in their stage of change.” 

In her role, Nellie manages a team of support staff to assist members, both with care coordination and day-to-day needs. This bond and trust is especially important for an extremely vulnerable population who were previously living on the street and using the emergency room for all of their care. 

So what makes a thriving community like this work? Nellie offered several insights as to how the myConnections mission helps members thrive.

  1. Compassion comes first. When Nellie hires her staff, she stresses compassion as a given, not as a “nice-to-have.” Empathy is essential to trauma-informed care. For example, when each member is welcomed to the housing complex, they receive a welcome packet with the names and pictures of Nellie and her staff. This is more than a contact list in case a member has a problem. It’s also a way to show they are in a safe community — which is so important for someone coming from an unsafe environment. “They know that when they see us on property they can come to us with any need, question, or just to talk,” Nellie said.

    Acknowledging the history of trauma in each member is crucial. Nellie stresses that compassion can’t be taught. Team members are going to have to be “comfortable with the uncomfortable,” she said.
  2. The program continues to evolve. myConnections began in 2015 with an emphasis on social determinants of health and coordinated care for the broader Medicaid population in and around Phoenix. At first, it was specifically tied to a community center. What the team soon realized, however, was that in order to make the greatest impact they would need to strategically seek out and find members who were most likely to sustain the benefits of integrated care interventions that included, but wouldn’t be limited to, set-aside housing, end-to-end care coordination, behavioral health therapy and addiction recovery support. Their focus turned to using data to hotspot, or target, members with complex socio-clinical needs who were persistent and frequent users of the health care system. 
  3. Tirelessly advocating for members. Often members have not had the opportunity to receive help from other services because of systemic barriers. This might mean connecting with local organizations that help with groceries — or sitting down with a member in order to navigate a complicated system to secure the benefits they need and deserve (such as for disability benefits).

    “We sit and talk to them, build a relationship with them,” Nellie said. “A lot people are sick and tired of being sick and tired. To give them a light of hope — and to not be seen as another box to check.” 
  4. Building relationships in the community. No single organization can tackle the systemic issues that affect the well-being of the most vulnerable members of a community. The process is ongoing and the work requires many hands. Nellie and her team have forged strong partnerships throughout the city — with organizations like Chicanos Por La Causa (which bought and refurbished the two properties after a $21 million low-interest loan from UnitedHealthcare) and Circle the City (which provides health care services for people experiencing homelessness with a best practice known as medical respite care).

    “It does not happen overnight,” Nellie said. “It’s not only with our members, but with our partners on a community level.” 
  5. Stressing the human connection. Nellie notes that relationships between the members and residents in the housing community are just as important as the relationships between the staff and members. Residents become friends with one another and help build a support system. Nellie recalls one time a member had to have his leg amputated and another resident in the program gave him his wheelchair. 

These efforts are readily apparent at the block parties. A photo booth is set up to take photos of the members to celebrate the day. Nellie said that some members are especially grateful for it, as they’ve never had their photos taken professionally before. With a new home and new confidence, they’re able to send these photographs to their children or loved ones who live in other states, and in some cases, take a first step to re-establish long-severed relationships. 

The ultimate goal of this program is about more than a roof over a person’s head or reducing the number of times a person seeks care at the emergency room. It’s about people who have faced adverse circumstances becoming healthier and more empowered to find their own path through life. 

“We’ve built an incredible community of care,” Nellie said.