Introduction
Providing necessary care is one of the government’s major responsibilities to citizens. For this reason, the existing system and legislation are designed to consider the needs of various population groups and provide them with everything they need to preserve the desired quality of life. Thus, homeless people are part of local communities requiring specific care.
For this reason, numerous attempts have been made to address the problem and improve their condition. For instance, the bill HB 1866 – 2021-22, Assisting persons receiving community support services through medical assistance programs to receive supportive housing, was introduced to the legislature to address the problem and promote positive change. By analyzing the bill, it is possible to understand the problem’s background, scope, history, and importance to specific population groups.
Background
The significance of the discussed bill and the causes of its introduction are linked to the scope of the problem. Currently, the government recognizes the homelessness epidemic observed in Washington (“Engrossed substitute House Bill 1866,” 2022). It is viewed as one of the major social concerns threatening the nation’s health and well-being.
The official statistics show that 17 of every 10,000 people experience this condition (Alpert, 2020). In 2019, the government reported that around 500,000 homeless individuals were living in the USA (Alpert, 2020). In Washington, the situation remains similar as the state’s communities experience numerous hardships associated with the issue (“Engrossed substitute House Bill 1866,” 2022). At the same time, despite attempts to address the situation, it remains complex, and the numbers remain high. For this reason, it must be regulated at the state and federal levels.
Another aspect indicating the problem’s topicality and importance to the state is the number of health concerns associated with homelessness. Homeless people suffer from poor health and premature death because of limited access to necessary services (Bedmar et al., 2022). In accordance with the official statistics, this group has high rates of various diseases, such as Human immunodeficiency virus, hepatitis A infections, alcohol and drug addiction, mental disorders, tuberculosis, and other severe health issues (Sleet & Francescutti, 2021).
The lack of housing, discrimination, barriers to accessing the necessary treatment, inadequate public health infrastructure, and the absence of safe locations to recover after treatment negatively impact this cohort (Sleet & Francescutti, 2021). Homeless people addressing the emergency department for assistance will be released back onto the street (Sleet & Francescutti, 2021). As a result, there is an increased risk of new hospital visits and the need for additional care. It becomes a severe burden for the state and deteriorates the nation’s health. This means that homelessness prevention has become one of the authorities’ major tasks, shaping the state’s work and evolution.
Public health and the health care system, in general, are viewed as critical institutions for homeless prevention. The existing programs to improve the nation’s health are funded to achieve specific outcomes and, if possible, prevent new cases. For instance, Medicaid should collaborate with clinicians and state incentives to offer supportive housing and resolve the problem (Charania, 2021).
At the same time, the lack of housing and mechanisms to assist homeless people in finding shelter leads to the persistence of high homelessness rates and the continued significance of the problem (Sleet & Francescutti, 2021). For this reason, addressing the given dilemma has become one of the government’s primary tasks. Health programs might be viewed as the basis for promoting improvement within the sphere and achieving the goal.
In such a way, the bill has a specific summary that explains its goals and nature. Thus, the Health Care Authority administers the Medicaid program, which supports low-income state residents who meet specific inclusion criteria (“HB 1866,” 2022). Moreover, the Washington Medicaid program, Apple Health, offers a medical benefits package to all eligible individuals, such as low-income adults, children under 19, pregnant women, and people with disabilities (“HB 1866,” 2022).
In November 2017, the Centers for Medicare & Medicaid Services approved a waiver allowing the state to use federal funds for additional services, including community support activities (“HB 1866,” 2022). The initial waiver period ended in 2021 but was extended, and a new request for extension emerged (“HB 1866,” 2022). One of the goals of the requested extensions was to resolve the problem of homeless people and the critical deterioration of their health due to the lack of housing.
Bill’s Summary
Given the importance of the issue and the negative impact of homelessness on the state’s situation, the bill was introduced. The Apple Health and Homes Program was offered to provide eligible individuals with a 12-month renewable, permanent, and supportive housing benefit (“House Bill report. HB 1866,” 2022). It means there is no length-of-stay requirement for those who need it regarding various health benefits (“HB 1866,” 2022). Permanent supportive housing also helps lower entry barriers and makes the offering more available to various population groups. The bill views housing as an indispensable element of adequate healthcare (“HB 1866,” 2022).
Moreover, the ability to find housing is critical for all Washington residents. For this reason, the legislature aims to treat chronic homelessness as a medical condition and offers a healthcare solution (“HB 1866,” 2022). Thus, the program implies that a coordinated entity issues a housing benefit authorization for a person meeting all necessary criteria to the Office of Health and Homes (“HB 1866,” 2022). The Apple Health and Homes Program rests on the Foundational Community Supports (FCS) program (“Engrossed substitute House Bill 1866,” 2022).
The proposed bill also establishes the Office of Health and Homes to create supportive housing (“Engrossed substitute House Bill 1866,” 2022). This will lead to the construction of more housing and support for people who need this assistance. The state’s investment expansion will help bridge the gap between expensive treatment and independence, which is vital for outcomes.
Bill’s Support
The existing body of evidence supports the effectiveness of the measures in the bill and their ability to address homelessness in Washington. First, the research shows that addressing homelessness will help achieve the UN’s Sustainable Development Goals, which are vital to the nation (Zhao, 2022). Moreover, preventing and reducing homelessness requires significant effort from local authorities, and creating a new body might be a practical step toward achieving desired outcomes (Zhao, 2022).
Considering the issues from a public health perspective is also a practical way to achieve desired results. The statistics show that while 61% of homeless people reside in sheltered locations, the others, or around 226,000 individuals, are in unsheltered areas, such as streets or abandoned buildings (Sleet & Francescutti, 2021). For this reason, the current research on the problem offers a conceptualization of an interdisciplinary collective approach to address the chronic cycle of homelessness (Sleet & Francescutti, 2021). The proposed legislation also establishes a collaborative approach to assisting homeless people.
The positive effects of providing housing to individuals after their treatment are proven by other programs. For instance, the Bridge Healing Program in Edmonton, Alberta, offers a similar perspective (Wong et al., 2020). Local hospital emergency departments serve as a gateway to temporary housing (Wong et al., 2020).
Before placing individuals in permanent homes, care providers ensure that all their needs are met and their health is stabilized (Wong et al., 2020). It helps achieve better outcomes by reducing emergency department visits, lengths of stay, and overall healthcare costs (Wong et al., 2020). Moreover, programs of this sort reduce the number of homeless people in the region and promote their health outcomes (Wong et al., 2020). In this way, the existing evidence demonstrates the benefits of the proposed legislation and its ability to promote positive change in Washington by addressing the cycle of homelessness.
The existing body of research shows that positive effects can be achieved by treating homelessness as a healthcare problem. Washington has the necessary tools to address the issue, including a well-developed network of health and behavioral health care providers across all areas, public and nonprofit affordable housing providers, and financial resources (“Engrossed substitute House Bill 1866,” 2022). This means the problem can be addressed by combining these actors’ efforts and adopting a collaborative approach as offered by the legislation (“Engrossed substitute House Bill 1866,” 2022). Providing a place to recover after emergency department visits and long-term cooperation with local authorities will contribute to positive shifts within the sphere and lay the foundation for future improvement.
History of Bill Introduction
Considering the scope and importance of the abovementioned problem, the bill HB 1866 – 2021-22 was introduced to the Washington State Legislature. It was prefilled for the introduction on January 7, 2022, and on January 10, the first reading occurred (“HB 1866 – 2021-22,” 2022). On January 20, the public Hearing in the House Committee on Health Care & Wellness was organized (“HB 1866 – 2021-22,” 2022). Later, on February 2, 2022, the first substitute bill was substituted (“HB 1866 – 2021-22,” 2022). On February 13, the floor amendments were adopted, and the Bill passed through the third reading (“HB 1866 – 2021-22,” 2022).
The first reading in the Senate occurred on February 16, 2022, and several amendments were offered (“HB 1866 – 2021-22,” 2022). On March 3, the amendments were accepted during the second reading, and the Bill passed the third reading (“HB 1866 – 2021-22,” 2022). The House concurred with all changes offered by the Senate, and the speaker signed the legislation (“HB 1866 – 2021-22,” 2022). Finally, on March 10, the President signed the Bill, thereby granting it legal status (“HB 1866 – 2021-22,” 2022). The Bill’s introduction became essential to addressing the state’s poverty problem.
Sponsors
The bill’s introduction for consideration requires the support of numerous lawmakers to demonstrate its importance and the need to adopt it. Committees might also be viewed as sponsors explaining the peculiarities of the document. Numerous representatives sponsored the bill HB 1866 – 2021: “Chopp, Riccelli, Macri, Bateman, Davis, Fey, Goodman, Leavitt, Ortiz-Self, Peterson, Ramel, Ryu, Santos, Orwall, Wylie, Cody, Simmons, Slatter, Valdez, Wicks, Pollet, Taylor, Stonier, Ormsby, Hackney, Harris-Talley and Frame” (“HB 1866,” 2022, p.1). The support was vital to the legislation’s introduction in the Washington State Legislature and its discussion during the first readings. Moreover, representatives outlined the existing problem, its current status, scope, and the need for action to improve the situation and achieve better outcomes.
Current Status
The discussed Bill has passed all procedures necessary for its discussion and acceptance. That is why, currently, it is a law that regulates the work of the healthcare sector and agencies responsible for providing support to homeless people who need a residence. The legislation’s effective date is 6.9.2022, meaning the Bill is currently operative and enforceable.
The parties mentioned in the legislation must follow the regulations and approaches outlined by the representatives and organize care in line with the ideas of The Apple Homes program. Moreover, the amendments offered during the bill’s consideration are also vital and should be considered an essential part of the bill. In this way, the acceptance of the proposed document and its legal status evidence the topicality of homelessness in Washington and the critical need to address it and find an effective solution.
Impact
The bill might have a significant impact on the state’s situation. As admitted above, the problem of homeless people is critical and requires funds to resolve it. For instance, Jay Inslee offers to spend an additional $815 million in 2022 to create permanent and transitional housing throughout the state and keep more people in homes to provide better supportive healthcare for people in need (Patrick, 2021). The number evidences the significant financial burden of homelessness for the state.
For this reason, the bill’s acceptance was a critical step toward addressing the problem. Its significant impact is the reduction in the number of health concerns among homeless people because of the lack of housing and support during their recovery after emergency visits. It will also substantially decrease the required financing, as the incentive correlates with the Medicaid program. In such a way, it is expected that the legislation will help to address the homelessness pandemic in Washington.
Furthermore, the discussed bill will positively impact specific groups of homeless people. First, supportive housing will help individuals who visit emergency departments and will not be sent to the streets immediately after the care is provided. Following the new incentive, this cohort will have a chance to get shelter and recover, which reduces the risk of new visits to the hospital.
Moreover, the legislation will promote positive alteration among the homeless population suffering from severe mental illness. The research proves the existence of structural factors contributing to housing instability and mental health outcomes (Padgett, 2020). The statistics show that from 20 to 25% of individuals from this group have various conditions, such as depression, anxiety, bipolar disorders, or schizophrenia (Marcus et al., 2021). For this reason, the bill helps these individuals and promotes the improvement of their current states.
Furthermore, homelessness leads to higher rates of substance abuse, which is another cause of the critical deterioration in health (Carver et al., 2020). In such a way, the measures offered by the legislation are vital for various groups existing among homeless people. At the same time, other citizens might benefit because of the reduction of the problem of homelessness in their communities.
Opposition
In general, the importance of the Bill impacted its acceptance by other legislators and the lack of serious opposition. The homelessness epidemic is a problem recognized by the state, meaning its resolution is critical for the further evolution of communities and improving their health. At the same time, most representatives support the idea that homelessness should be viewed as a healthcare issue (“HB 1866,” 2022). For this reason, there was no critical opposition in the Washington State Legislature and the House.
However, several amendments were introduced to make the bill more effective and meet the current demands of the legislature. In such a way, the only possible barrier to the bill’s passage was the problem of finding additional financing necessary to support the housing incentive and provide homeless people with the necessary shelter.
Conclusion
Altogether, Bill HB 1866 – 2021-22 was an essential step for addressing the pandemic of homelessness in Washington. The investigation shows the significance and scope of the problem. This means that the legislature aimed to provide homeless people with shelter regarding the healthcare act, which is vital for the state and its evolution.
After several amendments, the Bill was accepted by the majority and became law. Nowadays, it is the framework used to provide care to people without shelter and protect their well-being. It can also be used as the basis for new regulations and laws aimed at helping vulnerable groups and improving the state of communities.
References
Alpert, J. (2020). Homeless in America. The American Journal of Medicine, 134(3), 295-296.
Bedmar, M., Bennasar-Veny, M., Artigas-Lelong, B., Salvà-Mut, F., Pou, J., Capitán-Moyano, L., García-Toro, M., & Yáñez, A. (2022). Health and access to healthcare in homeless people: Protocol for a mixed-methods study. Medicine, 101(7), e28816.
Carver, H., Ring, N., Miler, J., & Parkes, T. (2020). What constitutes effective problematic substance use treatment from the perspective of people who are homeless? A systematic review and meta-ethnography. Harm ReductionJournal, 17(10), 1-22.
Charania, S. (2021). How Medicaid and states could better meet health needs of persons experiencing homelessness. AMA Journal of Ethics, 23(11), e875-880.
Engrossed substitute House Bill 1866. (2022).
HB 1866 – 2021-22. (2022). Washington State Legislature.
House Bill report. HB 1866. (2022). WA.gov.
Marcus, L., Johnson, C., & Ramirez, D. (2021, May 21). The complex link between homelessness and mental health. Psychology Today.
Padgett, D. (2020). Homelessness, housing instability and mental health: making the connections. BJPsychBulletin, 44(5), 197–201.
Patrick, A. (2021). Gov. Jay Inslee wants more density in Washington cities, proposes $800 million for homelessness in 2022. The Seattle Times.
Sleet, D., & Francescutti, L. H. (2021). Homelessness and public health: A focus on strategies and solutions. International Journal of Environmental Research and Public Health, 18(21), 11660.
Wong, A., Chen, J., Dicipulo, R., Weiss, D., Sleet, D. A., & Francescutti, L. H. (2020). Combatting homelessness in Canada: Applying lessons learned from Six Tiny Villages to the edmonton bridge healing program. International Journal of Environmental Research and Public Health, 17(17), 6279.
Zhao, E. (2022). The key factors contributing to the persistence of homelessness. International Journal of Sustainable Development & World Ecology, 30(1), 1-5.