Capacity Building for Health and Housing Equity


I started Gilvar Consulting Services to partner with organizations providing health care, housing, and homeless services and help expand their capacity to meet the needs of patients, residents, clients, and the broader community.  I especially wanted GCS to support community partnership development and efforts to bring to scale cross-agency collaborations integrating physical and behavioral health care as well as housing and shelter services.  As the director of large Health Care for the Homeless programs in both Texas and Washington, I developed and managed numerous successful collaborative initiatives with these same goals. I’m now using my strategic planning, advocacy, policy development, and operations management experience in a variety of new ways.

I want to strengthen leaders coming together from different sectors with a realization that they need to work together to transform systems in service of greater health and housing equity.  Increasingly, Continuum of Care planning entities, Managed Care Organizations, hospitals, Community Health Centers, community mental health agencies, substance use disorder treatment providers, housing authorities, Public Health Departments, Medicaid agencies, and city and county governments are finding ways to break down silos, reduce fragmentation, and more systematically address homelessness and racial disparities in health and housing outcomes.  Some examples of how I can help support such efforts include:

  • Executive coaching
  • Leadership development, mentoring, and team building
  • Strategic planning, including facilitation, research, analysis, and workplan preparation
  • Facilitating health and housing collaborations
  • Diversity, Equity, and Inclusion work
  • Training and technical assistance, including:
    • Board of Directors development
    • Federal grant compliance, including Operational Site Visit preparation
    • Community Needs Assessments involving patients and front-line service providers
    • Public-entity Community Health Center special issues
    • Mobile medical, dental, and behavioral health services
    • Medicaid 1115 waivers
    • Communicable disease prevention
    • Disaster planning
    • Medical respite care program development, financing, and management
    • Provision of clinical services in shelters, supportive housing buildings, and other non-traditional settings
    • Outreach-based health services for unsheltered individuals and families
    • Grant proposal development and writing
    • Integrating services across disciplines, agencies, and sectors, including:
      • Medical care
      • Oral health care
      • Mental health care
      • Harm reduction and other Substance Use Disorder services
      • Vision care
      • Social work
      • Outreach and case management
      • Communicable disease prevention
      • Benefits enrollment

Other Articles

Accelerating Organizational Anti-Racism Work with Adaptive Leadership and Mindful Communication Practices

Transformational change at an organizational or systems level requires both deep listening and the willingness of leaders possessing decision-making authority to collaborate with those most directly impacted by the problems necessitating change. Few leaders I know would dispute this premise in the abstract, but many might struggle to explain in concrete terms how they walk the walk as well as they talk the talk. Moving organizations and communities from words to action around redressing institutionalized racism requires leaders not only to put listening and collaboration skills to the test, but to leap beyond the comfort zone of routine approaches to problem solving. Adaptive leadership and mindful communication practices can provide an excellent platform from which to dive into the deep water of acknowledging racism and other structural forms of oppression as powerful drivers of inequities in the areas of health, housing, and economic advancement.

Cross-silo Partnerships Boldly Tackling Inequities in the Midst of the Pandemic

New COVID-19 hospitalization data shine a stark light on the connection between homelessness and poor health.  The Minnesota Department of Health found that people residing in homeless shelters who were diagnosed with COVID-19 were 4 times more likely to be hospitalized and 3 times more likely to be admitted to an intensive care unit (ICU) than the overall population of Minnesota residents with a COVID+ diagnosis.  The hospitalization and ICU rates for people living unsheltered were even worse:  almost 10 times more likely to be hospitalized and 7 times more likely to receive treatment in an ICU. 

A Compassionate and Effective Port in a Storm: The Case for Investing in Medical Respite Care for People Experiencing Homelessness

Stories like the one related by Dr. Leslie Enzian during a panel discussion at this month’s annual Washington Conference on Ending Homelessness have helped me appreciate the critical role that medical respite care (aka recuperative care) plays in homeless response systems. Medical Director of Seattle’s Edward Thomas House medical respite program, Dr. Enzian joined Washington Health Care Authority Deputy Chief Medical Officer Dr. Charissa Fotinos, Ben Miksch of United Health Care, and myself to talk about medical respite care’s unique approach and contributions to local COVID-19 responses. We also discussed efforts to bring medical respite care to a scale that can better meet community demand — in Washington and around the country. Early in the discussion, Dr. Enzian described the experience of Edward Thomas himself, the African-American formerly homeless man for whom Seattle’s medical respite care program is named and who granted permission to share his background and path to stability. Depicted in the photo above, Mr. Thomas…

2020’s Converging Housing, Health Care, and Racial Inequity Crises

The current pandemic has shined a spotlight on pre-existing structural problems that lie beneath the massive inflow of people into homelessness and how federal policies perpetuate them.  In a brief slide deck, I recently highlighted for Congressman Derek Kilmer how federal labor and housing policies seed homelessness, particularly for Black, Indigenous, and People of Color (BIPOC), making it virtually impossible for many communities, even those with robust homeless services systems, to keep up with the inflow of new people losing their housing and needing shelter and other assistance.