Health care providers in Colorado have been drawn into America's homelessness crisis, and are adding institutional weight into a push for solutions - according to a new report by independent health journalist Michele Cohen Marill.

Marill pointed to one "aha" moment experienced by physician Sarah Stella, who saw many people experiencing homelessness seeking emergency care at Denver Health.

"She had patients coming in with severe frostbite and other types of injuries," said Marill. "They would get patched up, they would be discharged, and ended up back on the streets. And then within a brief period of time, she would see them back in the ER."

One patient living outdoors had severe frostbite, which required several toes to be amputated. He was discharged to a shelter, but because it was relatively warm he chose to sleep outside.

He awoke covered in snow and went back to the emergency room with frostbite on his remaining toes.

Stella then went to work, connecting area health providers to nonprofits and foundations to find ways to break this cycle.

In October of 2022, the Colorado Coalition for the Homeless opened the Stout Street Recuperative Care Center, which provides a recovery space for people who are well enough to be released from the hospital - but still need time to heal.

Marill said on average clients stay two weeks - although some need prolonged care, such as chemotherapy, that may last as long as two or three months.

"Patients can be discharged safely. It's really a life saver," said Marill. "Many of these individuals would be very medically fragile if they were just living on the streets."

Last December, Denver Health opened a converted floor of an administrative building to provide transitional housing for recovering patients.

Clients are connected to case managers who help them find permanent housing and other services.

Marill said these sorts of interventions show that health care institutions can play a critical role in communities.

"Poor health is both a cause and an effect of homelessness," said Marill. "Health care, and specifically health systems, are an important part of the solution."




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As urban homelessness and drug use grab the spotlight, rural areas such as Branson are left in the shadows, with critical needs going unmet. But local community organizations are stepping up to provide much-needed support.

Branson has a growing crisis where substance use and homelessness intersect, with about 1,500 people, mostly those who are working but still considered low-income, living in extended-stay motels. An estimated 20% of the population is homeless, and motel living heightens the risk of substance-use and mental-health issues.

Marietta Hagan, project coordinator, Population Health Department with Cox Health, said there are the challenges to addressing these issues in rural areas.

"Lack of transportation in rural areas, lack of that financial and other resources. Branson is considered a rural area, even though we get 9 million visitors a year - we only have a population of 12,000 and the services to support those," she said.

Also, rural areas often have fewer homeless shelters, making it harder for people to find emergency housing or long-term support. Hagan said the good news is, people who have recovered from drug use and homelessness are working together to help those still struggling.

Hagan said it's almost like a multiplying factor - and once a person starts to struggle with issues stemming from poverty, especially in rural areas, it increases their risk of struggling with other issues such as drug use and homelessness - and this leads to stigmas and a lack of support.

"If you live in a small town that has 300 people, and you are labeled as a drug user, you're often ostracized from your community and you're not given that social support and that community that you can turn to maybe when you're struggling with something," she continued.

Between 2022 and 2023, Missouri saw a 12% increase in homelessness and a 24% rise in unsheltered homelessness.


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Some University of Nebraska students are gaining career skills as they work to address the state's affordable housing shortage by making small, practical dwellings available in some of Omaha's most distressed areas.

The price of a new home in the U.S. has jumped from about $140,000 to more than $340,000 in the last two decades, making affordable homes harder to come by and leaving more people without a place to live. Omaha reflects the trend.

Jeffrey Day, professor of architecture at the University of Nebraska-Lincoln, said the city needs 30,000 additional housing units to keep up with demand, and 60% have to qualify as "affordable."

"The other challenge in Omaha is that 80% of the city's residentially zoned land does not allow multifamily, or even small multifamily, housing," Day pointed out. "It's really all zoned for single-family dwellings, which makes it very hard to increase density in the city in order to produce more units."

Day's student-run Fabrication And Construction Team is designing and building small, affordable housing units on lots in older parts of Omaha, with an eye toward serving the aging population. The lab is working with Partners for Livable Omaha to plan and build the houses.

Because Omaha's strict zoning laws prohibit multifamily housing, the design and construction teams are creating Accessory Dwelling Units and cottage clusters, sharing a common outdoor space. Day stressed multifamily homes will have to play a part in solving Omaha's affordable housing dilemma at some point.

"We're focusing on the single-family dwelling and looking at a very small, extremely efficient dwelling that's designed to be accommodating for aging people who might have mobility challenges or other kind of issues," Day explained. "It allows them to downsize what might have been a larger home."

Students are already constructing parts of the dwellings in the lab. Now they are waiting for city approval to subdivide some key Omaha lots and erect the homes.

Support for this reporting was provided by Lumina Foundation.


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The number of Colorado families experiencing homelessness rose by 134%, from 3,600 in 2023 to more than 8,500 families in 2024, according to new federal data.

Rep. Manny Rutinel, D-Commerce City, said addressing homelessness will be a priority in the legislative session kicking off on Wednesday. He plans to introduce a bill to strengthen the state's support infrastructure, in part by creating special regional homelessness response districts.

"So that localities -- municipalities, counties -- can build up resources and pool them together with other counties and municipalities," Rutinel explained. "So that they can take on this really important issue head on, together."

The annual point-in-time count conducted by the U.S. Department of Housing and Urban Development found 18,715 Coloradans were homeless, a 30% increase from 2023. Rutinel believes better coordination between state agencies, local governments and nonprofits can both prevent and reduce homelessness.

Cathy Alderman, chief communications and public policy officer for the Colorado Coalition for the Homeless, said it is important for multiple sectors touching the lives of people experiencing homelessness, including education, social services, transportation and health care, to lean into the challenge. For example, when people have access to health care, they're more likely to have stable housing, and a person's housing situation also affects their health.

"We often find that building that relationship with somebody who is living outside through the provision of health care means that we can get them on a pathway to housing," Alderman pointed out.

There are currently 28 housing units sitting vacant for every person experiencing homelessness in the U.S., according to a recent report, largely because developers make bigger profits building what are essentially tax-haven investments for hedge funds and the wealthy.

Rutinel stressed for most Coloradans living paycheck to paycheck, the risk of experiencing homelessness is very real.

"Unfortunately, if you don't have the resources saved up to be able to get yourself through a tough time or you don't have the family or friend infrastructure in place to house you in those moments, you end up on the streets," Rutinel observed.