Our Journey Into Supportive Housing


We often have days in our personal and professional lives that we’ll remember forever. April 16th, 2014, is one of those for me. That was the day that we as a Foundation began our formal journey into the issue of housing, with me as the lead. The request came from our Strategic Planning Committee, which asked staff to research the connection between health and housing and devise a plan to demonstrate the impact a potential housing pilot project could have. Of course I was very excited at the prospect, but a bit apprehensive as well. After all, this work was unlike almost anything else MFH had done in the past. I felt an enormous responsibility to do a good job, to get it right. Looking back now I don’t think I realized the journey we were embarking on, one that continues to this day.

At first glance some might be surprised to see a health foundation engage in housing work. However, we’ve evolved over time to look at health in a much broader way, and now include what are referred to as “social determinants of health.” Having a safe, stable, and affordable place to call home fits firmly into this category of upstream health factors.

Following that first meeting my nerves settled a bit as numerous colleagues came by my desk to offer assistance. After developing an internal housing team we derived a list of questions to ask stakeholders and set up numerous conference calls and meetings. It was important for us to speak with a variety of groups, including homeless service providers, state housing financing agencies, state departments of mental health, foundations doing similar work, housing authorities, behavioral health service providers, and others. Thankfully our participants were gracious with their time and provided invaluable information.

We soon learned how much we did not know about this incredibly vast and complicated field, but discovered an important practice that seemed to have a lot of potential: supportive housing. Our team was encouraged by the health improvements experienced by those living in supportive housing, especially for individuals who were previously homeless.

We presented on supportive housing to our Board of Directors in the summer of 2014, directly leading to the formation of what is now known as the Show Me Healthy Housing program. The goal is to improve health by increasing the availability of supportive housing in our service area and strengthening existing collaborations in the field. By the end of 2014, we provided gap financing to four nonprofits throughout the region, helping them construct housing for individuals and families with a variety of health needs.

In addition, we offered capacity-building opportunities for other nonprofits related to developing and operating supportive housing. This work included creating the first-ever Missouri Supportive Housing Institute, in collaboration with the Corporation for Supportive Housing. We also explored other ways of investing in the concept by launching the Foundation’s first loan program in 2016.

We are very interested in evaluating the impact of our inaugural investment and are already working with an outside evaluator. Preliminary reports for years one and two are in, and by early 2019 we hope to have additional findings which could help inform the future of our work. Our results will also hopefully encourage other philanthropic organizations to invest in similar efforts.

My first job as a social worker involved working with individuals who were homeless, opening my eyes to the challenging living conditions that many who are homeless experience and the systemic barriers that make it difficult for them to find safe, affordable homes. Little did I know that less than 10 years later I would be engaged in efforts to address the issue I was witnessing first hand. Much more still needs to be done with this important work, here and throughout the country. But I am hopeful that staff at other foundations across the U.S. can experience their own historic moments when they invest in housing for the first time.

Jean Freeman-Crawford is a program officer at Missouri Foundation for Health.

April is Fair Housing Month. We encourage you to continue to think about those that don’t reside in neighborhoods of opportunity. Neighborhoods of opportunity are where children and families are able to thrive and have access to quality schools, healthy environments, and economic opportunities that help them live their best possible lives.

Learn more about supportive housing here.