Healthy Homes: Housing as Health Care

For most of us the financial burden of healthcare coverage is often covered by your employer, but what happens when your employment is impacted by your health? Let's walk through an all too common scenario that our clients face:

  1. You contract an illness that takes you several weeks to recover from. During this time you use all of the sick leave your employer offers for the calendar year.

  2. A couple months later, you trip walking down the stairs of your apartment and break your foot. Without any more sick leave to use, you are forced to take an unexcused absence to go to the doctor. Your employer has a three strike policy for unexcused absences, so you are okay with just using the first strike.

  3. After getting a boot and returning to work, you realize that your foot isn’t healing the way it should and your doctor wants you to attend physical therapy. The only appointments available are during your shift at work, so you decide not to do physical therapy.

  4. In the following months you experience a growing pain. The decision to not go to physical therapy means your foot does not heal correctly and you are left with huge amounts of pain. Being in a position where you are standing all day on your feet, this becomes unbearable.

  5. Despite not wanting to miss work, you can’t take the pain anymore and miss two shifts, earning yourself the remaining two strikes.

  6. Your boss, even though they are understanding of the situation, is forced to fire you because of the established unexcused absence policy.

  7. Before long your emergency fund is spent and bills are piling up. The unemployment checks are not enough to pay your rent while you are looking for a new job. Since your experience is in retail, you are struggling to find a position where you can sit or have reasonable accommodation for your injury. You’re no longer able to pay for your apartment and are left with no other options than to go to a shelter.

Now what? I sat down with Willis Dady’s Employment Services Director, Kelsey Culver, to learn how we support individuals returning to work at Willis Dady.

Q: How would you define a healthy home?

A healthy home has access to primary care and mental health care and the ability to provide for their basic needs. People have clothing, food, and hygiene items to be properly cared for.

Q: How does employment contribute to a healthy home?

Employment supports stability in a home. It creates opportunity for growth in the long-term, but in the short-term is allows people to pay for their basic needs.

Q: What is supportive staffing?

Supportive staffing functions very similar to a temp agency where Willis Dady is the employer of record and our employees are working at partner agencies. Our goal (both Willis Dady and partner agencies) is to have our employees hired on with that partner agency.

Q: What kind of supports do clients get from Willis Dady staff?

Staff having one-on-one case management with clients where they get weekly feedback and ongoing communication. Willis Dady also provides transportation and teaches clients how to advocate for themselves. This can include asking for a day off of work or learning how to talk to their manager when they are struggling at home.

For example, we got feedback from a manager that “Bob” was leaving the floor and going to the bathroom fifteen minutes before every break every day. The manager didn’t have time to address it so they told Willis Dady staff. Our case manager was able to sit down with Bob and found out he wasn’t sleeping (he worked third shift) so he was drinking a lot of coffee. This meant he needed to use the bathroom a lot. The case manager was able to connect him with a place to get an alarm clock and room darkening blinds. In the end, Bob was hired on full time. Q: What are barriers to employment that clients face?

  • Unstable housing

  • Not having access to mental health care or not knowing about it

  • Criminal background

  • Lack of transportation

  • Lack of affordable and accessible daycare

  • Need for part-time work

Q: Why is employment important? Willis Dady is a housing first agency. We know that housing leads to stability and the longer you keep your housing the more stable you will be over the long-term. Having employment, and a living wage, helps you maintain your housing and buy your basic needs. It also contributes to general self-esteem and confidence.

Q: How does having an income increase someone’s health outcomes?

Having an income means someone is able to go to the doctor and afford hygiene items. Part of the case management includes teaching clients how to schedule appointments outside of work or ask for time off to go. We also encourage clients to receive ongoing care with a primary care provider.

Q: What are some reasons someone might not be able to work?

Sometimes people have physical or mental limitations. They might have tried to work in multiple employment programs (through other agencies) and it just doesn’t work out because of their health. When that’s the case we keep working with them and making appropriate accommodations. We can also help them fill out social security applications.

Q: On average, how long are clients employed through Willis Dady?

Our goal is 90 days in the supportive staffing program. We also have representative programs (like litter abatement or light janitorial work) where clients can stay in them until they feel ready to leave.

Q: How often are clients hired on full-time?

In 2021, we served 120 individuals through all our employment programs. 80% exited successfully with 25% being hired on full-time.

Q: What happens when clients exit the program (besides full-time employment)?

Sometimes clients voluntarily resign to find different employment. We continue to support them even if they are not at a partner agency.

Check out the National Health Care for the Homeless Council’s fact sheet to read more about the connection between homelessness and health: https://nhchc.org/wp-content/uploads/2019/08/homelessness-and-health.pdf.

We know that stability takes time for our clients, especially when they are navigating health issues, transitioning to new housing and a new job. We are glad to offer follow up with our clients in our housing, employment, and shelter programs that helps build their long term stability.