Supportive Housing for Chronically Homeless Medicaid Enrollees: State Strategies

This Center for Health Care Strategies (CHCS) brief, supported by NYHealth, outlines eight key strategies and practical action steps to help states advance supportive housing options.

People who experience chronic homelessness often also struggle with serious mental illness, substance use disorders, physical and mental disabilities, and chronic medical conditions. These individuals, many of whom are eligible for Medicaid, are more likely to frequently visit emergency departments and, as a result, often have high annual health care expenditures. Policymakers are increasingly focused on more cost-effective opportunities to address the housing and health care needs of chronically homeless individuals.

In July 2015, CHCS convened state Medicaid officials; federal policymakers from the Department of Health and Human Services, the Department of Housing and Urban Development, the Office of Management and Budget, and the United States Interagency Council on Homelessness; and experts in the fields of managed care, housing, and homelessness to address this issue. The discussion, made possible by NYHealth, the California HealthCare Foundation, and the Conrad N. Hilton Foundation, sought to identify strategies for expanding access to housing for Medicaid beneficiaries who are chronically homeless. Drawing on insights from the session, this brief highlights key opportunities for Medicaid programs to better address the housing needs of these individuals. It can inform states that are seeking ways to use Medicaid funding for essential housing-related services.