Tri-Cities homelessness rate outpacing WA state. Survey reveals other health concerns too

Homelessness and lack of affordable housing for young Tri-Cities families ranked as one of the top health concerns identified in the recently completed Community Health Needs Assessment for Benton and Franklin counties.

Other top concerns were access to health care, as some people wait months for a doctor’s appointment, and addressing mental health and substance abuse.

The assessment developed by the Benton Franklin Health District and other health agencies will be used as a focus for addressing health needs in the two counties over the next three to five years.

Housing: Costly and in short supply

The population in the Tri-Cities area is growing rapidly, but available housing is not keeping pace, particularly for people with low and moderate incomes, the assessment said.

At the same time housing costs are rising, with the rate of growth of household income in the area about one-third the growth rate of rent.

“I sit there and I think when a young family, they’re both working but not making a huge salary and they maybe have a kid or two, I don’t know how they are going to be able to purchase a home or even, in a lot of situations, rent,” said one person quoted anonymously in the study.

The study gathered information through a survey, interviews and community forums for a variety of observations from professionals, people working with nonprofits and the public, including people with unmet needs.

“If we’re trying to attract the young workforce to our community, there’s certainly challenges related to that,” one person said. “When we look at a lot of the hospitality workers, particularly the people that haven’t worked their way into managerial roles, the incomes that they make, housing becomes a challenge.”

People are willing to pay above market rent, meaning landlords are able to charge high prices for apartments, those interviewed said.

Landlords are increasing rent by $400 or $600 a month, leading them to spend less on other needs, and in some case contributing to overcrowding as families double up in apartments, they said.

One in five households who rent pay more than half their income on rent, the assessment said.

Apartment vacancy rates are low, leading to competition for rentals, and leaving people with a poor credit score or criminal history shut out of the rental market, said people who were interviewed.

Young people often need a cosigner to rent an apartment, which not every young person has available. The rising cost of housing also can be challenging for older adults, the study said.

Homeless: Outpacing WA state

The rate of people homeless in the Tri-Cities consistently has outpaced the rate in the state since 2016, the assessment said.

And people are homeless for longer than in the past.

In 2016, 39 days was typical and that increased to 82 in 2019, the assessment said.

The Homeless Management Information System lists almost 4,000 residents of the greater Tri-Cities area as the homeless, with the number growing while the number in the state as a whole is decreasing, the assessment said.

Those who are homeless include not only those people who live on the streets or camp in tents, but people who live in cars and other vehicles, moving them from place to place, and people who move from house to house of friends and family to sleep on couches.

“Homelessness is a symptom,” said one person who commented for the assessment. “It’s a symptom of issues that have occurred, probably over time, that we really need to keep focusing in my view on the upstream, which is mental health, substance abuse disorder, health care.”

Major medical needs can result in bankruptcy and the loss of a place to live, the person said.

More services are needed for the homeless, including hygiene services for students and bringing “street-based care” to those who are homeless, said people sharing information on the homeless issue.

Access to health care

The Health Resources & Services Administration has designated Benton and Franklin counties as an area with a shortage of health care providers.

In Washington state, every primary care doctor or other provider has an average of 1,180 potential patients. But that increases to 1,430 potential patients in Benton County and 4,720 in Franklin County, with patients often crossing county lines for care.

Wait times for an appointment can be long and turnover of providers is too high, said those interviewed for the assessment.

Having more primary care providers and specialists would reduce wait times and help reduce the pressure on emergency departments, the assessment said.

But recruiting health care professionals to relocate to the Tri-Cities area can be challenging, particularly with the high cost of living, the assessment quoted health care agencies as reporting.

The local health care system is particularly challenging for people who don’t speak English well or who have a disability.

Transportation is an issue, both for people who live in rural areas and those with limited mobility, including elderly people.

People who depend on Medicaid or have no health insurance have even more limited options.

In addition, continuity of care is lacking for veterans, people with developmental disabilities may be unable to find providers trained in their needs, and LGBTQ young people have trouble finding respectful care and not feeling judged by health care providers, said people who were interviewed.

Telehealth options with online appointments have increased, but may not be appropriate for many people, including those who don’t speak English, as well as those who don’t have access to or familiarity with technology; and elderly and other people with hearing or visual disabilities.

Having access to health care is just part of the solution to overall access to health, the assessment said.

The Tri-Cities area also needs increased access to nutritious food, transportation, licensed and affordable childcare, health education, chronic disease prevention and more awareness of the available resources, the assessment said.

Mental health services

Mental health was overwhelmingly identified as the most pressing community need, by people providing input from the community for the assessment.

More mental health treatment services, and particularly services for people in crisis and inpatient services for children, are needed, they said.

Turnover in the mental health work force is high, with burnout and low wages for entry level jobs contributing to that.

The COVID-19 pandemic increased mental health needs and contributed to stress for families and a lack of social connection for the elderly, said those commenting on the need for more mental health services.

The Tri-Cities area also lacks substance abuse treatment options, but there is hope that the proposed Recovery Center for mental health and substance abuse issues that Benton and Franklin counties plan to locate at two Kennewick locations will help.

Working on solutions

“People are doing amazing things to improve the health of our community,” said Kirk Williamson, program manager of the Benton Franklin Community Health Alliance. “Our challenge is to find where their energy and passion overlap and help find ways to bring even more partners to the table.”

Agencies that collaborated on the assessment including the Benton Franklin Health District, Benton Franklin Community Health Alliance, Prosser Memorial Health and Kadlec Regional Medical Center in Richland.

The assessment found that Benton and Franklin counties are fortunate to have strong community coalitions and committees working to support community health and also businesses that support promoting Tri-Cities area health and social initiatives.

Coordinating efforts with shared goals and outcomes has the potential to improve health in the Tri-Cities, the assessment said.