For many children and families in Aurora, Colorado, finding and keeping a safe place to call home has become increasingly difficult.
At Children’s Hospital Colorado, they’ve spent years watching housing insecurity needs appear in data, patient flow, and clinical operations.
But what could a children’s hospital do in a market with few housing options and overwhelming demand?
By late 2024, the hospital had a clear plan: Focus on universal screening, intensive navigation, and partnership as its housing strategy.
“We have a place and a role to support our patients in a holistic way,” said Susan Goldenstein, director of community impact. “For us, that has been through screening, referrals, and partnerships.”
Housing pressures
Housing first became a priority for the hospital in 2024, when it repeatedly surfaced across surveys, community meetings, and partner feedback during the hospital’s community health needs assessment.
“The greater Denver area has a high cost of living, and it’s something all of our families are struggling with,” Goldenstein said. “We have a lot of folks who are new to our community, and affordable housing is a severe problem.”
At the same time, leaders were feeling operational strain internally. Lengths of stay stretched. Some medically complex patients could not be discharged because their housing was not conducive to managing their condition.
“Our executives definitely saw the need and understood what was going on in our community,” Goldenstein said. “Our focus has been on the limited inventory of housing options and what we can do to keep families housed.”
Centralizing housing work
Housing demand is extreme in Aurora and surrounding communities. Clinic-based community health navigators were spending hours working per family on housing applications — time that disrupted clinic flow and limited their ability to serve other children and families.
“We listened to our navigators and looked at the data on how they spend their time, and it showed housing needs are very intense and take a lot of time,” Goldenstein said.
In response, the hospital added its first dedicated housing coordinator, funded philanthropically and filled by a former navigator who already knew about the system.
The coordinator centralizes the most time-intensive tasks: tracking application windows, gathering documentation, and sitting with families to complete their housing applications during the small open application period.
“The day applications open, they sit down and hit submit together, which increases their chances exponentially of getting approved,” Goldenstein said. “This one-on-one support is probably the biggest investment we’ve made.”
Team members also participate in housing coalitions and discover new partners for the hospital.
Megan Cook, director of clinical social work and family health navigation, serves on the board of Aurora@Home, a coalition that provides rental assistance and case management services to families with children experiencing homelessness.
“As health care providers, we see every day how housing impacts health,” Cook said. “Serving on the board allows Children’s Hospital Colorado to bring our perspective to community discussions, strengthen community partnerships, and advocate for the resources and collaborative solutions needed to address housing challenges.”
Finding the strategy
Hospital leadership explored whether the organization should partner around short-term housing or redevelopment projects. Conversations with nonprofit developers stretched over months as teams tried to identify which patients would benefit most and whether the risks and timelines aligned with hospital operations.
Those efforts stalled, but the hospital has included writing letters of support for grant and loan applications.
What did resonate was something the hospital already had: a large network of community health navigators across the system to help families connect to resources.
Children’s Hospital Colorado has invested in social drivers of health screening and navigation for years. Screening began in primary care clinics in 2016 and expanded to inpatient units in 2021. That’s often where housing-related needs are revealed.
The workflows are different in each setting. In inpatient care, families answer a short set of social needs questions and are explicitly asked if they want help to meet their needs.
“One of the biggest lessons we learned was not to assume families want help just because there is a need,” Goldenstein said.
In primary care, screening happens during well-child visits. If there is a positive screen, navigators are notified and connect with the family immediately to connect them to the housing coordinator, on-site resources, or community partners.
Stabilizing housing
The hospital’s value sits in coordination: identifying needs early, helping families access resources, and stabilizing situations that might lead to emergencies.
A community-based asthma initiative addresses environmental triggers inside homes through remediation and education. A medical-legal partnership assists with tenant rights, utilities, or unsafe conditions.
Together, these efforts support healthy housing across the hospital’s service area.
Measuring impact
Like others who do this work, Children’s Hospital Colorado is still building its measurement approach.
Most metrics are process-based: completed screenings, referrals made, applications supported.
Longer-term outcomes such as utilization, health trajectories, and avoided admissions are harder to attribute and still under study.
Some programs, like asthma prevention, show strong returns and payor interest.
Defining your role
For Children’s Hospital Colorado, screening and navigation have become the clearest way to engage in housing needs and reach all patients.
“Screening and navigation are the most universal way to address housing with our patient population,” Goldenstein said. “It’s a significant process to implement, but I feel like it’s the most equitable response.”
This approach does not solve the housing crisis. But it does give a replicable starting point for other children’s hospitals: Meet families where they are and invest in the support needed to connect patients to scarce resources.
