Promoting housing-based asset building programs in healthcare

OBJECTIVES: Wealth building programs remain underutilized, and Medical Financial Partnerships serve as a potential solution. We aimed to assess the reach and adoption of an underutilized asset building program, Family Self Sufficiency, with a national uptake of 3%, when integrated into a healthcare system. METHODS: First, a hospital-affiliated "known provider" introduced Family Self Sufficiency to clinic patients. Second, hospital staff unknown to families conducted outreach to clinic patients. For both pilots, we tracked eligibility, interest, and enrollment rates. We evaluated the pilots using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework in addition to reviewing the qualitative feedback from the staff who introduced the program. RESULTS: The reach of each pilot varied: the first pilot (n = 17) had an enrollment rate of 18%, whereas the second pilot (n = 69) had an enrollment rate of 1%. Adoption factors included prior relationship with the family and barriers to understanding the program families. However, adoption was limited by bandwidth of family to complete paperwork, staff to do outreach, and timing of the outreach to maximize benefit. CONCLUSIONS: Increasing uptake of underutilized asset building programs could be part of the solution to building wealth for families with low incomes. Healthcare partnerships may be an approach to increase reach and adoption by eligible populations. Areas to consider for successful future implementation include: (1) timeline of outreach, (2) families' relationship with individuals performing outreach, and (3) current bandwidth of the family. Systematic implementation trials are needed to study these outcomes in more detail.