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

October, 2024

Kate Gallego, Mayor

Phoenix City Hall, 200 W. Washington Street, Phoenix, AZ 85003

Respected Mayor, 

I am writing this letter to bring your attention to a critical healthcare financial problem of homelessness in Phoenix, Arizona. 7,419 individuals were homeless in 2020 in Phoenix, with 51% without shelter (Phoenix, 2020). Homeless individuals have threats of physical health issues, morbidity, fatality, and higher admissions. This problem causes overloaded emergency rooms due to complex conditions, lengthy waits, and high care expenses. Homeless patients spend an extra 2.32 days in hospitals and incur $1000 in expenses for each release (Franco et al., 2021). It is vital to address this issue as it results in severe community outcomes, putting economic pressure and harming public health. 

Adopting actions to alleviate homelessness in Phoenix will have significant outcomes. It will enhance community health results, resolving homelessness leads to reduced HIV and other infection rates and a reduction of admission and emergency care usage. Offering adequate housing reduces health costs by 85%, $US28.98 monthly (Carnemolla & Skinner, 2021). If this problem is ignored, the Phoenix community could encounter increased health inequities, prolonged crowded emergency units, and rising financial demands. Such people have medical complications like hepatitis (36%) and chronic issues (61%) more than general people (Central Arizona Shelter Service, 2022). Ignorance will worsen medical inequities and the state’s costs.

The problem has an immense effect on medical facilities, communities, and the state. Health systems face a greater need for emergency care because homeless people depend on them for health care, resulting in overcrowded emergency units and high expenses (Franco et al., 2021). At the community level, homelessness causes wellness problems as unhoused people have a higher rate of infections, raising the potential for infection spread (D’Souza & Mirza, 2022). At the state level, homelessness demands extra social and care services, utilizing resources of other crucial services leading to disparities. Integrated efforts are needed to resolve homelessness. Our multifaceted approach, based on offering preventive and primary care community initiatives with mobile health clinics, housing assistance, and an integrated cross-disciplinary approach, boosts health outcomes and fiscal stability.

NHS FPX 6008 Assessment 4 Lobbying for Change

According to Serchen et al. (2024), using an integrated care team approach can reduce homeless hospital stays by 35% and emergency demand by 19%. It aligns with the principle of justice by offering holistic services, reducing disparities, and meeting the health and social needs of homeless patients. Offering housing assistance services for secure housing will improve medical results and reduce costs (Carnemolla & Skinner, 2021). Offering primary and preventive care community programs aids in addressing the chronic and mental illnesses of homeless people, improving safety, and reducing emergency visits and costs. Primary care community programs cause $1.31 to $1.93 in revenue with $1.00 in spending (Arbour et al., 2024). It boosts homeless people’s health results by aligning with the nonmaleficence principle. 

Professionally, I witnessed during the pandemic that when homelessness surged in Phoenix, the medical conditions worsened, led to longer waits, and increased stress among staff, creating an undesirable situation. As the emergency unit’s Nurse Manager, I have personally experienced the influx of unhoused patients that caused strain on staff, the assets, or emergency services, impeding patient care. In practical experience during COVID-19, I performed robust threat assessment strategies and fiscal planning by partnering with community groups to manage homeless people as it impacts the health system or community. 

NHS FPX 6008 Assessment 4 Lobbying for Change

Therefore, I urge you to prioritize funding for primary care efforts and partnerships with local groups for homeless management. Your role is vital to building a robust system for Phoenix’s homeless people.

 Thank you for your consideration.

Sincerely,

Travisha

References

Arbour, M., Fico, P., Atwood, S., Yu, N., Hur, L., Srinivasan, M., & Gitomer, R. (2024). Primary care–based housing program reduced outpatient visits; patients reported mental and physical health benefits. Health Affairs, 43(2), 200–208. https://doi.org/10.1377/hlthaff.2023.01046

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

Central Arizona Shelter Service. (2022). Homelessness as a health crisis. Central Arizona Shelter Services.org. https://www.cassaz.org/2022/02/homelessness-as-a-health-crisis/

D’Souza, M. S., & Mirza, N. A. (2022). Towards equitable health care access: Community participatory research exploring unmet health care needs of homeless individuals. Canadian Journal of Nursing Research, 54(4), 451-463. https://doi.org/10.1177/08445621211032136

NHS FPX 6008 Assessment 4 Lobbying for Change

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

Phoenix. (2020). Strategies addressing homelessness. Phoenix.gov. https://www.phoenix.gov/humanservicessite/Documents/Final%20Report_Homeless%20Strategies_061820_52.pdf#search=data%20related%20to%20homelessness

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