New standards aim to improve housing-first models

The Joint Commission recently issued a report that offers an overview of behavioral healthcare accreditation standards for housing support services programs, applying to providers that use a “housing first” model. The standards, which took effect last July, do not require mental health and addiction treatment providers to engage clients in other services as a condition of their securing or remaining in housing.

Two leaders with the Joint Commission tell Behavioral Healthcare Executive that more than 150 accredited organizations, mostly community mental health centers and Department of Veterans Affairs (VA) sites, fall under the housing support services requirements. The standards apply to organizations already offering housing support services.

The accrediting organization’s R3 Report on the standards offers a basis for why the standards were established.

“The literature defines housing as a social determinant of health,” says Peggy Lavin, the Joint Commission's senior associate director for behavioral health care accreditation. “The idea is that the burden of a housing problem is so extreme that the person cannot even think about addressing other problems.”

The housing first model, often used for individuals with a history of chronic illness and homelessness, envisions secure housing as a conduit to being able to take advantage of other needed services and supports for the individual. While the Joint Commission’s establishment of standards applying to services under this model doesn’t amount to an outright endorsement of that approach over all others, “I think we are saying at least that these are good, solid models,” says Lynn Berry, project director in the accrediting organization’s Department of Standards and Survey Methods.

Requirements for organizations

The standards for housing support services programs reside in the Joint Commission’s behavioral health care accreditation manual and apply to organizations with at least some services that are subject to the behavioral health standards. The standards require organizations that offer housing support services to make patients aware of these services and to ask them about their housing preferences.

The standards also require providers to offer move-in assistance, including securing needed furniture and other items, and to facilitate these patients' access to other services. As part of the effort to help patients secure housing quickly, “We hope that [agencies] establish a relationship with the people who own or run housing,” Berry says.