Keona Serrano is a Program Director in The Department of Supportive Housing and Health Policy at BronxWorks. She oversees the Stable Homes to Health program, which provides care management and supportive housing to 20 individuals across the Bronx. BronxWorks is an integral member of BPHC’s projects and governance and plays a leading role in BPHC’s ED Care Triage and Care Transitions projects.
“Someone just can’t focus on their health without stable housing, without getting basic needs met,” says Keona Serrano, the Program Director of Stable Homes to Health at BronxWorks. Ms. Serrano oversees the Stable Homes to Health program, which provides supportive housing and care management for 20 individuals across the Bronx.
“We’re working with individuals facing housing instability, who are also chronically sick with very complex diagnoses,” Ms. Serrano says. “We see sickle cell, cancer, diabetes, and a lot of co-occurring behavioral health issues too.”
Before enrolling in Stable Homes to Health, Ms. Serrano’s clients relied heavily on hospitals and Emergency Departments for medical care, or for a place to lay their head. As part of BPHC’s ED Care Triage project, BronxWorks helps to divert these high-utilizing patients from the hospital and to more appropriate, sustainable, and effective services like supportive housing.
Ms. Serrano has found that medical providers jump at the opportunity to connect their patients with Stable Homes to Health. “We receive a lot of referrals from hospitals and health homes,” she says. “Montefiore in particular has a housing at-risk program. They are alerted when anyone who’s homeless comes into the ED, and if the patient qualifies for Stable Homes to Health, they will link us up.”
Once patients are enrolled, Ms. Serrano and her team sees to their every need, from moving in to managing care. “We go with clients to doctor’s appointments, follow up afterwards, make community referrals, or help with entitlements,” she says. Weekly home visits and phone calls help Ms. Serrano “stay up to date on the client’s medical appointments and care plan goals, or see if they need any repairs done at their apartment, or learn what’s going on in their personal life.”
“These interventions have really kept people out of hospitals,” Ms. Serrano says. “Many clients have started to take ownership of their health, they’re going to their appointments on their own. Of course it’s an ongoing process, but we’ve seen a huge improvement.”
“And then there’s the improvement in quality of life,” she continues. “It’s invaluable! Clients find stability that they never had before, with their whole lives, their housing and their health.”
(Published May 6, 2016)