When resources are scarce, leveraging program dollars through coordination of housing-related programs can improve outcomes for clients and programs alike. This is at the heart of One Touch, a model for collaboration between energy conservation services, healthy homes programs, and housing rehabilitation efforts that is generating early successes around the country.
When the National Center for Healthy Housing launched One Touch with the City of Boston in 2005, targeting the neighborhoods of Dorchester and Roxbury, they focused on:
• Well-known causes of ill health and disability in children,
• Low-cost interventions that offer a big return on investment, and
• Improving efficiency through coordinating services delivery, so that a household has one intake or “touch” rather than many interactions with different agencies.
For Boston children, housing-related health and safety issues such as asthma, lead poisoning, and falls in the home could be addressed through relatively low-cost and effective measures. These included referrals for smoking cessation for residents, integrated pest management instead of using pesticides, weatherization to improve air sealing and insulation, and addressing moisture build up through ventilation and minor home repairs to fix leaks.
The Boston pilot demonstrates the value of the One Touch approach for clients, agencies, and funders. Lowering high rates of asthma and lead poisoning improves the quality of life and life chances of children, while promising cost savings to the state Medicaid program. Installing energy-saving appliances and conservation measures reduces home energy bills, lessening financial burdens on households and improving indoor air quality at the same time.
A great example of the success of One Touch Boston is 7 Sussex Street, a single family brick rowhouse purchased by an income-eligible family using HUD HOME and private financing. Through the Residential Development Program of the City of Boston’s Department of Neighborhood Development, city program staff and NCHH advisors walked through the development of a rehabilitation work plan, producing a set of specifications that contractors successfully implemented within the budget constraints. Coordination at the point of intake for the housing unit itself –the preparation of a scope of work for rehabilitation –reaped benefits in terms of greater energy efficiency, lower bills, and better health for children. The Boston effort also involved work with the City’s Department of Neighborhood Development to incorporate healthy homes building practices into the City’s rehab specification.
With funding from HUD’s Office of Healthy Homes and Lead Poisoning Prevention and support from the US Department of Agriculture, entities are scaling up and piloting One Touch in three new locations: the city of Manchester, New Hampshire, the counties of Merrimack and Belknap, New Hampshire and Omaha, Nebraska. These locations focus on coordination and referrals during intake, using three new tools and approaches:
1. Short checklists, providing an energy and health checkup, that add 15- 40 minutes to intake (varies by project as checklists are tailored to meet local needs);
2. New client education; and
3. Expanded scope of work for housing repairs.
Both New Hampshire community pilots use One Touch checkup forms for homes visited by WAP or Head Start to determine the opportunities to leverage program services through referrals. The chart below details the needs of homes determined in the initial checkups performed by Merrimack Belknap:
|| Number of Units
|| 91 units
|| 24 units (17 with children, 7 with Adults)
|| 47 units
|| 12 units
|| 63 units
|| 12 units
In addition to agreeing to use the energy and health checkups as part of intake, the New Hampshire pilot partners began to negotiate Memoranda of Understanding among the health, housing, and energy programs to facilitate referrals on behalf of clients at the point of intake. Partners also agreed to expand the scope of repairs permitted under selected programs, for example, adding moisture and integrated pest management interventions to weatherization.
Partners at the Omaha site include a mix of public agencies similar to the New Hampshire and Boston pilots (health, housing, and energy), as well as new public partners (the Omaha Public Power District, and the DOE Better Buildings project), and nongovernmental organizations including the Healthy Kids Alliance, Habitat for Humanity, and Rebuilding Together. The initial group of 40 homes in Omaha’s One Touch project participate in reEnergize, an energy upgrade funded through an Energy Efficiency and Conservation Block Grant (ARRA and local funds). Over the summer of 2011, an expanded group of partners began using the energy and health checkups together with referrals and coordinated services provision.
Each year in both New Hampshire and Nebraska, public programs that deliver health and energy services help thousands of low-income families. Publicly administered housing renovation and rehabilitation programs benefit hundreds more. Using the One Touch approach to identify areas where coordination and referrals for healthy homes and energy interventions are cost-effective builds working relationships among partners committed to improving housing for low-income families, promising both economies of scale and program sustainability.
Kate Kuholski, Ellen Tohn, and Rebecca Morley. Healthy Energy-Efficient Housing: Using a One-Touch Approach to Maximize Public Health, Energy, and Housing Programs and Policies. J Public Health Management Practice, 2010, 16(5) E-Supp, S68–S74.
- Ellen Tohn (Tohn Environmental), Beverly Drouin (NH DHHS), Ryan Clouthier (Southern NH Services). “One Touch Healthy & Energy Efficient Housing New Hampshire Pilot,” Unpublished The National Center for Healthy Homes with Peggy Hegarty-Steck, NCHH; Naomi Mermin, Naomi Mermin Consulting; Ellen Tohn, Tohn Environmental Strategies. “Boston One Touch Action Steps for Healthier and Greener Homes for Boston Families”, (2008). Available at www.nchh.org
- Presentation, NASCSP Weatherization Plus Health Regional Conference, Portland, ME (May 2011). Available at nascsp.org .
- Personal Communication with Ellen Tohn, Tohn Environmental Strategies, October 2011.