Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


Zvart Onanian School of Nursing



Date of Original Version



An average of 4,000 Rhode Islanders experience homelessness and housing insecurity each year. A policy analysis of screening tools for Social Determinants of Health (SDOH) was conducted for Neighborhood Health Plan of Rhode Island (NHPRI), Inland Empire Health Plan, The Veteran Health Administration (VHA), The Medicaid Medical Directors Network (MMDN), Executive Office of Health and Human Services (EOHHS), RI Office of Housing and Community Development, U.S. Department of Housing and Urban Development, Keiser Permanent School of Medicine Health Systems Science, Canadian Observatory on Homelessness, and primary care offices in Indianapolis, Florida, and Indiana. The analysis revealed ineffective screening when addressing SDOH, specifically housing insecurity and homelessness. Ineffective SDOH screening within managed care organizations (MCOs) and by healthcare providers contributed to health instability. The average cost to Rhode Island taxpayers for emergency room visits for persons experiencing homelessness is $18,000 a year. A literature review of key evidence demonstrated that a standardized SDOH assessment screening tool is needed to determine the appropriate plan of care and treatment such as the Vulnerability Assessment Tool (VAT). A policy update for proper assessment and screening of SDOH is needed by local MCOs and healthcare providers to address the rising costs of healthcare and the increased needs of high-risk populations. Recommendations to adopt a similar version of the VAT as part of the health plan assessment is a possible solution towards increasing health equity.

01 Hernandez_A MSN Poster 2023.pdf (213 kB)
Presentation Poster