Harnessing Medicaid to Help Solve Homelessness




United States Interagency Council on Homelessness - No on should experience homelessness. No one should be without a safe, stable place to call home.





May 8, 2015

Harnessing Medicaid to Help Solve Homelessness


Five years since the passage of the Affordable Care Act, many of the major objectives of the law are being met; more than 16 million Americans have gained health coverage, bringing the number of people without insurance down to historic lows. Included in the newly insured are approximately six million of the lowest income Americans, who have gained access to public health insurance through Medicaid and the Children's Health Insurance Program (CHIP). And while the data is limited on the specific number of people experiencing homelessness who have gained coverage, we have numerous reports that enrollment in Medicaid and other types of health insurance among people experiencing homelessness has grown significantly. With so many people now able to access health care coverage, the results are in: the Affordable Care Act is working. 

Of course, increasing access to health coverage is only one objective of the law. The other major objective is to shift the focus of health care away from procedures and treatments and towards the overall quality of care and people's health outcomes. For people who experience homelessness, we know that having stable housing is essential to health. Stable housing not only has direct benefits on health-reducing exposure to high-risk behaviors and the negative effects of life on the streets, but it also creates a platform for better care. Thus, for people experiencing homelessness, the ultimate measure of whether or not the Affordable Care Act is working may be the degree to which it can incentivize the health care system to address housing needs as a foundation for better health.

It is important to note that attending to housing needs does not mean the health care system should pay for housing costs--things like rent subsidies or capital for construction costs. We already have a set of housing programs (like Housing Choice Vouchers, public housing, low-income housing tax credits, and the Continuum of Care) that can cover these costs, though we need to increase investments in these programs. The role of the health care system is to finance and provide the health and social services that not only address people's physical and behavioral health conditions, but that also help people find housing, obtain housing, and remain in housing. 

For the full article to learn more on how Medicaid can help end chronic homelessness.


The Affordable Care Act has given us important resources to serve those experiencing homelessness
Remarks delivered by U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell, at the National Health Care for the Homeless Council Conference


Secretary Sylvia Mathews Burwell
I know many of you have worked with Richard Frank, our Assistant Secretary for Planning and Evaluation here at the Department, and we're glad to have him. When Richard told me more about the work of this Council, he said, and I quote, "To put it simply, they are doing God's work."

And it's hard to disagree.

I've always believed the Biblical proverb that that our compassion and generosity for the least of us-the sick, the hungry, the stranger and the imprisoned-is felt by God himself.

This idea of service is at the heart of our American values as well. As President Johnson said: "There is [a] tradition that we share today. It calls upon us never to be indifferent toward despair. It commands us never to turn away from helplessness. It directs us never to ignore or to spurn those who suffer untended in a land that is bursting with abundance."

During my time at the Gates Foundation, I had the opportunity to get involved in this work.
While many people know the state of Washington for its innovation, fewer might know that across the state, 20,000 people are homeless on any given night. In partnership with Bill Gates Sr., we led the Foundation's Pacific NW Giving Initiative - which to this day focuses on creating opportunities for families across the state, with homelessness as one of its focus areas. Together, we visited with homeless men, we met women and their children on the brink of losing their homes, and we learned firsthand the impact we can have working together across the public and private sectors.

The important work that you do every day serves hundreds of thousands of men, women and children all over this nation, including over 20,000 veterans.
You give people a second-and sometimes third and fourth-chance at life. You give people a path forward. You give them dignity.
Read Secretary Mathews Burwell's full remarks where she goes on to discuss Medicaid expansion, permanent supportive housing, and her work as Vice Chair of the U.S. Interagency Council on Homelessness. 


New Tools to Help Increase Medicaid's Role in Supportive Housing
Use these resources to learn how to incorporate Medicaid benefits into supportive services for people experiencing homelessness.

Quick Guides

A Quick Guide to Improving Medicaid Coverage for Supportive Housing Services
This guide was developed in partnership with CSH and provides a brief overview of information in the Primer and Emerging Practices documents in addition to other resources to help states, community health centers, behavioral health centers, and supportive housing providers use Medicaid more strategically.

Medicaid and Permanent Supportive Housing: A Quick Guide for Health Centers
This guide, created in collaboration with the National Health Care for the Homeless Council, is intended to briefly outline the elements contained in the Primer so that health centers serving individuals experiencing homelessness may better understand the current opportunities for promoting this model of care.

 


Medicaid Primer
The U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) released two new reports in 2014. Both the Primer and its companion piece, Emerging Practices in the Field, serve as tools for states and communities working to expand services and supports for people in supportive housing.



Healthcare and Housing (H2) Systems Integration Initiative

This initiative is a collaboration of technical assistance from HUD's Office of Special Needs Assistance Programs (SNAPS) and Office of HIV/AIDS Housing (OHH), USICH, and HHS to support states and communities in undertaking systems changes needed to enhance integration between housing and healthcare systems. 



Contents

Harnessing Medicaid to Help Solve Homelessness
HHS Secretary Sylvia Mathews Burwell's remarks from NHCHC Conference
New Tools for Using Medicaid to Fund Supportive Services
Medicaid is a Game-Changer for Ending Chronic Homelessness

Medicaid is a Game-Changer for Ending Chronic Homelessness, But to Win, We Have to Play
By Richard Cho

Richard Cho, Senior Policy Director, USICH
It has been proven time and time again that for people experiencing chronic homelessness and suffering from chronic health conditions, the path to improved health begins with stable housing, namely through supportive housing. Supportive housing (also known as 'permanent supportive housing') has been shown to improve physical and behavioral health outcomes for people experiencing chronic homelessness, while simultaneously lowering health care costs by decreasing emergency room visits and hospitalizations. In most communities today however, the services that make supportive housing so effective are still funded by a patchwork of public and private sources, or in some cases, are severely under-funded. Fortunately, thanks to the Affordable Care Act we now have the potential to create a more systematic and sustainable way to finance services in supportive housing--through Medicaid.

Read the full blog to see how communities can encourage their state Medicaid departments to finance supportive services.

Webinar Now Available

Financing Supportive Housing Services: Maximizing Medicaid Options & Promoting Practices in the Field

Financing Supportive Housing Services: Maximizing Medicaid Options and Promoting Practices in the Field
Recorded April 29, 2015

This webinar is intended to complement the HHS Primer and Emerging Field Practices (see links at left) and highlights the state-level options available and cutting-edge techniques being used to make the most of Medicaid opportunities.
Watch the webinar by clicking on the video above or by visiting our website.

Presentation slides are available in PDF format on our site as well.

Update on CSH's Social Innovation Fund Initiative

On Tuesday, May 5th, HHS and HUD convened a briefing for Federal partners by CSH and state and local practitioners to discuss their Corporation for National and Community Services (CNCS) Social Innovation Fund (SIF) Initiative. CSH's SIF Initiative is a 5-year national effort to pilot supportive housing linked to coordinated health care for high utilizers of crisis health services. The initiative aims to increase housing and health stability for at least 549 high-need, high cost individuals with chronic health challenges, develop a replicable model for integrating housing with care management and health services, build evidence of the model's impact on housing, health, and public costs, and design a policy blueprint for linking mainstream housing and health resources and payment systems to scale models. 


Upcoming Events





USICH Webinar: The Early Childhood Self-Assessment Tool for Family Shelters
May 21, 2015; 2:30 -3:30 PM, ET

USICH Webinar: Supportive Housing Opportunities Planner Tool: Setting a Path to End Chronic Homelessness Locally
May 26, 2015; 1:00 - 2:15 PM, ET

National Conference on Ending Homelessness 
July 15 - 17, 2015; Washington, DC
Register 

See Additional Events on our website

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