Read our interview with Hawaii State Senator Josh Green, MD, & policy news.
Read our interview with Hawaii State Senator Josh Green, MD, & policy news.

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February 1, 2018 | Volume 22, No. 1 | Archives
A Prescription for Housing (Literally)
Josh Green
He’s an ER doctor and a state senator. Last year, Senator Green introduced legislation that classified homelessness as a medical condition and would allow doctors to prescribe housing, directing 2% of the state’s Medicaid budget to housing for people without homes. In fact, he introduced nearly three dozen bills that focus on issues related to homelessness. The Council’s Senior Director of Policy, Barbara DiPietro, recently spoke with him about his experience integrating service and advocacy. Below are highlights from the discussion. 
Barbara DiPietro (BD): You have an extensive list of legislation you introduced or co-sponsored last legislative session that seeks constructive solutions to homelessness. What is driving your interest in this issue?
Josh Green (JG): My interest comes first as a physician and then as a legislator. I did my residency with the National Health Service Corps and saw how economic inequality and social determinants of health were damaging a lot of people and creating severe access to care issues.
BD: How have your fellow colleagues in the Hawaii Senate responded to your initiatives, particularly those across the aisle? What messaging or strategies have you found work well?
JG: NPR and Rush Limbaugh both liked the concept of prescribing housing. Rush was focused on cost and liked that it saved money. NPR liked it because it ended homelessness. So changing the model appeals to both sides.
BD: As someone who sees the problem directly in the health care system and as someone who holds public office, what do you think are the barriers to fixing the systemic problems that create homelessness?
JG: Political will is the #1 barrier. Less than 4% of Medicaid patients use 61% of the Medicaid budget in Hawaii. When a very small group uses a lot of resources, it’s a problem you have to fix. Changing our thinking as providers is the #2 barrier. We have to accept that we have to prove the cost savings are there. It’s not really what we do because we’re not normally bean counters, and this has been a barrier to making our case for changing the system.
“Waikiki Health strongly supports affordable housing as a critical social determinant of health. Once patients receive shelter, they can more fully concentrate on their employment, health, and family.”

— Sheila Beckham, MPH, CEO of Waikiki Health
This interview is edited and condensed. Click below to view the broader conversation.
Read the Full Interview
News to Know
Health Center Funding: On January 22, Congress passed a six-year extension for the Children’s Health Insurance Program (CHIP) as part of a spending package that will keep the government running through early February. This agreement did not include funding for Community Health Centers. As it currently stands, HRSA only has enough money to fund Health Centers in full through March. We must continue to take action and keep Health Centers on the top of Congress’ list. February 6 is a National Day of Action for health center funding. See the Take Action sidebar. This has gone on long enough. Follow the latest news from our partners at the National Association of Community Health Centers.
Work Requirements: On January 11, the Center for Medicare & Medicaid Services (CMS) issued a letter to state Medicaid Directors providing guidance on work requirements as a condition for Medicaid eligibility. Soon after, CMS approved a Medicaid waiver in Kentucky with work requirements and other harmful provisions (lawsuits are already in the works). Nine other states have proposals waiting for approval (AR, AZ, IN, KS, ME, NH, UT, WI, MS). The Council opposes the implementation of work requirements, as these provisions do nothing to promote good health, create significant barriers to care for vulnerable people, and impose unnecessary administrative burdens on health care providers. In the coming weeks, keep an eye out for Council guidance on this issue. In the meantime, learn more from Kaiser and follow the status of waiver approvals.
Protections for Providers Refusing Services: The U.S. Department of Health and Human Services (HHS) has proposed new rules that allow health care workers to refuse to provide certain services or treat certain individuals based on religious or moral beliefs. The provisions of this rule go far beyond abortion and assisted suicide and can apply to services for vaccinations, mental health treatment, contraception, and more. This will likely have the largest impact on children, women and the LGBTQ community, but the provisions are wide-ranging so this rule impacts everyone. Learn more from NPR and read an in-depth analysis from Health Affairs. Comments are due by March 27, 2018.
UN Reports Shows U.S. Has an Urgent Poverty & Human Rights Problem: The UN’s special rapporteur on extreme poverty and human rights recently made an investigative tour of the United States. The subsequent report concluded that “The United States is one of the world’s richest […] countries; but neither its wealth nor its power nor its technology is being harnessed to address the situation in which 40 million people continue to live in poverty.” While visiting homeless encampments in Oakland, CA, the UN representative commented, "Every person I spoke to today has told me, 'We are human beings.' But if you need to assert to a UN representative that you are a human, well, something is seriously wrong." Read more.
Opioid Public Health Emergency Extended: In October President Trump declared the opioid epidemic a national public health emergency which was set to expire on January 23. On January 19, the U.S. Department of Health and Human Services extended the Emergency Declaration for another 90 days. Unfortunately, no new funds have been allocated to help address the crisis. Read more and find out how to Take Action on capacity-building legislation from our partners at the National Council of Behavioral Health.
New HHS Secretary Confirmed: Alex Azar, former pharmaceutical executive and supporter of work requirements, was confirmed by a 55-43 vote in the Senate as the new Secretary of the U.S. Department of Health and Human Services (HHS). Azar follows Tom Price, who resigned in September after scandal over his use of private jets. As Secretary, Azar will oversee critical health programs like Medicaid and decide how to administer the Affordable Care Act. Read about Azar’s top priorities.
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Regina Reed, MPH
National Health Policy Organizer
National HCH Council
Baltimore, MD
(443) 703-1337 
Take Action!
Mark Your Calendars for Tuesday, Feb. 6, a Day of Demonstration for America's Health Centers!
At a minimum we ask that all Health Care for the Homeless organizations and supporters wear red. Take pictures and post on social media with #RedAlert4CHCs (and tag us @NatlHCHCouncil).
Add to Calendar
Template social media posts, shareable images, printable signs and flyers, and more are on the HCAdvocacy website. Don’t forget to incorporate HCH-specific messaging using our talking points and let us know how we can assist you in your efforts.
Find More Resources
Do More
We encourage you to join us for a conference call with a staff member in your Congress person’s office. Calls usually last less than 15 minutes, require no policy expertise on your part, and are a quick and easy way to remind our lawmakers how important Health Center funding is for those experiencing homelessness. Contact us and we will set something up that works with your schedule!.
Get In Touch
What We're Reading
This publication and all HCH advocacy are funded by dues from Organizational Members of the Council and by private donations. Consider joining the Council to support this work.
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National Heatlh Care for the Homeless Council
PO Box 60427 | Nashville, TN 37206 US
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