Boston Health Care for the Homeless Program Increased Access to Sober Living for Homeless Individuals Through Collaboration with Boston Medical Center Health System

BOSTON (Dec. 4, 2024) – A group of homeless individuals in the greater Boston area experienced improved sobriety, decreased emergency department visits, and reduced inpatient hospital stays through a pilot program, launched by Boston Health Care for the Homeless Program (BHCHP), that increased access to group sober living residences and peer support. Beginning in July 2022, the ongoing sober homes pilot program has served a total of 106 individuals. WellSense Health Plan, part of Boston Medical Center Health System, has been providing funding for the pilot program since its launch. The pilot has also received financial support from UnitedHealthcare (UHC), and Commonwealth Care Alliance recently signed on.

“Access to stable options that support sobriety after detox is often limited due to lack of funding and eligibility,” said Samantha Ciarocco, director of trauma services at BHCHP. “The patients enrolled in the program were able to move from the streets, shelter, or incarceration into a structured living environment. We’re celebrating the small steps and seeing the positive outcomes that are possible for individuals who are provided with the resources to enter a sober home and who are motivated to succeed on their journey toward recovery.”

WellSense Health Plan, a nonprofit health insurance company and the largest Medicaid managed care plan in Massachusetts, enabled access by covering the sober home fees for program participants who were enrolled in WellSense through BMC Health System’s Boston Accountable Care Organization. In the second phase of the pilot, which began in October 2023 and is still going on, UnitedHealthCare funded two full-time recovery support navigators — individuals with personal experience with substance use disorder trained to assist patients in myriad ways — as well as project management and patient transportation.

“As we’ve experienced through this successful pilot program, health plan partners are able to bridge the inequitable access to residential treatment facing individuals experiencing homelessness,” said Mary Takach, senior health policy advisor at BHCHP. “There is significant return on investment for health plans who pay treatment fees for sober homes, as it breaks the cycle of patients being treated in emergency rooms for substance use disorders and being discharged because of a shortage of beds. We look forward to expanding this program and supporting the health and recovery goals of our patients through increased investment by health plans.”

“The early results of this innovative pilot program are promising, and Boston Medical Center Health System is proud to support BHCHP in this effort,” said Jason Worcester, MD, the medical director of the Boston Accountable Care Organization and a primary care physician at Boston Medical Center, both part of BMC Health System. “We have long recognized the importance of stable housing and other wraparound supports as vital to recovery.”

Demographic and ROI data from the pilot program includes:

• Among 80 individuals studied after living in the sober homes for six months, there was a 49% reduction in emergency department visits and a 46% reduction in inpatient admissions on average. Participants’ hospital utilization in the six months prior to the start of the program was used to calculate the reductions.
• Among 78 pilot participants, 75% were able to maintain their sobriety during the program.
• Prior to joining the pilot, 35% of participants lived on the street, 31% lived in a shelter, 24% were incarcerated, and 10% were staying with friends or relatives.
• 55% of the participants were white and 25% were African American/Black; 82% of the participants were male.

About Boston Health Care for the Homeless Program

BHCHP is an integrated team of over 600 medical and behavioral health staff, social service providers, and support staff committed to ensuring and delivering equitable and dignified access to comprehensive, high-quality health care for individuals and families experiencing homelessness in Boston and beyond. At our 30+ clinic sites in shelters and hospitals, our medical respite program, and on the streets, we provide medical care, behavioral health care, youth and family services, and case management to nearly 11,000 individuals (adults and children) every year. And we serve as an innovator and thought leader at the intersection of health care and homelessness, and share our research and model of care with hospitals, medical, and other allied health professional schools, public agencies, and other homeless programs, locally and nationally. https://www.bhchp.org/