California health leaders discuss efforts to provide permanent housing in Southern California


Hannah Saunders


At the 2023 Southern California State of Reform Health Policy conference, leaders discussed a key issue facing both the state of California and the entire country—permanent and affordable housing. 

Earlier this year, the Los Angeles County Board of Supervisors declared a state of emergency to accelerate resources to individuals experiencing homelessness. A primary issue contributing to the prevalence of homelessness in California is a lack of affordable housing. The Public Policy Institute of California stated that as of 2022, of all individuals experiencing homelessness in the United States, 30 percent resided in California. 

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“Homelessness doesn’t fall solely on the health plan. It doesn’t fall solely on [the] local government or [the] city [or] county… it’s a collective problem that we’ve all collectively created.” 

— Kristopher Kuntz, program director, Anthem

Kuntz said at its core, homelessness is a housing issue, and that partnerships with health plans, local governments, continuum of care agencies, and nonprofit providers are crucial. Kelly Bruno-Nelson, executive director of Medi-Cal and CalAIM for CalOptima, spoke about initiatives CalOptima has undertaken to increase permanent and affordable housing, sayingt she can sign up every unhoused individual in Orange County for housing navigation services, but that doesn’t hold much meaning if there’s no housing available to navigate them to.

“We recently funded an ADU [Accessory Dwelling Unit] project in our county, where we’re encouraging homeowners in Orange County to put ADUs in their backyard. In exchange for making that affordable housing for up to ten years, we help give them zero percent interest rates,” Bruno-Nelson said. “They put an affordable housing unit in their backyard, they say they are going to rent it to somebody—affordably—but not a family member, somebody in the program, for up to ten years.”

Bruno-Nelson said CalOptima’s funding for this initiative is a way of increasing the affordable housing stock in a nontraditional way. 

Nick Weinmeister, project specialist at USC’s Homelessness Policy and Research Institute, explained how he’s interested in Denver’s Supportive Housing Social Impact Bond Initiative, a housing program that adds wraparound supportive services to assist with the stabilization of individuals who are experiencing chronic homelessness or incarceration. Weinmeister said the initiative resulted in healthcare cost savings and reduced interactions with the justice system. 

Weinmeister said it’s difficult to recruit workers in the housing and homelessness sector, especially young individuals. He explained how there’s a lack of modern technology that young people expect and want, while wages are “nowhere where they need to be” to attract those with expertise and skills. He added that there’s a lack of structure to develop the professional homeless service sector. 

“Even within the field, it’s already at the point of extreme difficulty. Not to even account that now, you have a high percentage of folks who themselves have experienced homelessness, or at the very least, housing precarity, and are still within that realm of instability—housing instability—and with wages being so low, we’re probably going to continue to be there.” 

— Weinmeister

Kuntz said what is needed is strong, local housing provider networks, and data sharing. He said Anthem is using some of the Housing and Homelessness Incentive Program funding to entice new providers to come in as a contracted organization.

“Housing navigation is our most requested, referred support up and down the state. I mean, it blows everything else out of the water,” Kuntz said.