by Richard Cho
Two new documents released by HHS on October 10 make it clear, once and for all, that the services provided in permanent supportive housing can indeed be covered and financed by Medicaid. These documents include Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants of Permanent Supportive Housing and Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field. Specifically, Medicaid can cover things like case management, services goal setting and services coordination, health care navigation, rehabilitation, skill building around activities of daily living, and other supports that are critical to tenancy. The time is now to seize the opportunity, bring supportive housing to scale, end chronic homelessness, and bend the Medicaid cost curve.
By Laura Green Zeilinger, USICH Executive Director
Whether as a result of a health or economic crisis or fleeing domestic violence, the experience of homelessness is extremely traumatizing for families generally, and can be especially traumatizing for children. We know that there is not a one-size-fits-all solution for every family experiencing a housing crisis. Connecting families to housing interventions and services that are appropriate to their specific needs is an essential part of the actions we identified as critical to meeting the goal of ending homelessness.
By Debbie Thiele and Katy Miller
This week CSH, in partnership with the Washington Low Income Housing Alliance, published Creating a Medicaid Supportive Housing Services Benefit. In the white paper CSH lays out an easy-to-follow framework for states that want to create a Medicaid benefit to pay for the services in supportive housing. The framework consists of five action steps: 1) Determine benefit eligibility criteria; 2) Define the package of services to be delivered; 3) Align the state Medicaid plan; 4) Establish a financing and reinvestment strategy; and 5) Operationalize the benefit.
By Richard Cho, USICH Policy Director
President Obama has requested an increase of $301 million in HUD’s Homeless Assistance Grants. At a time of budgetary and fiscal challenges, $301 million sounds like a lot of money. In my view, it’s a small price to pay to achieve an end to chronic homelessness and save the lives of roughly 100,000 people. It’s especially small when compared to the cost of doing nothing, not only in terms of human lives, but also in real taxpayer dollars.
The cost of doing nothing is simply too high.
The expansion of Medicaid coverage under the Affordable Care Act (ACA) will mean that millions of currently uninsured adults will be eligible for coverage, including many formerly homeless individuals residing in supportive housing.
Many states are still opting out or remain undecided about whether to participate in Medicaid expansion. One factor these states might consider in evaluating or re-evaluating their decision to participate is the impact of Medicaid expansion on homelessness in their state. But the benefits don’t stop there. State budgets, hospitals, health care providers, and Americans in general also stand to gain from Medicaid expansion.
06/20/2013 - Ending Chronic Homelessness: A Message to Continuum of Care & Ten-Year Plan Leaders from Barbara Poppe
Not long ago, I sat in the same place that you are sitting, managing the Continuum of Care and leading our community's ten-year plan to end homelessness. You have challenging jobs to do and I know you are balancing many competing issues and priorities. I've been fortunate to visit communities that are making great progress, and to support and work with communities that still struggle. Now I would like to share some reflections on the lessons I've learned from you, my colleagues, in our mission to end homelessness. Thank you for listening and especially for acting.
Today I want to address chronic homelessness, which is the first goal in Opening Doors. We have fewer than 1,000 days to bring the number of people experiencing chronic homelessness to zero; every day and every minute counts. For people living with disabilities and disabling conditions, every day or minute spent on the streets is another day or minute spent struggling to survive. So this message is a call to action. I am reaching out to ask, are we doing everything we can do to end chronic homelessness by 2015? Here are the top-ten questions you and the leaders of your ten-year plan should consider (not likely to be picked up by David Letterman but hopefully useful nonetheless).
Starting in 2014, the Affordable Care Act allows states to expand Medicaid to most people earning at or below 133% of the federal poverty level (FPL), which is about $14,856 a year for an individual and $25,390 for a family of three in 2012. (To their credit, some states have gone ahead and expanded early.) This provision helps unify the current “categories” of Medicaid, where very low income children, pregnant women, adults who can prove a permanent disability, and parents in some states are eligible for Medicaid, but those without a proven disability or dependent children are not—creating a significant disparity in access to care among those at the lowest income levels. A recent Urban Institute analysis found 15 million uninsured adults will now be eligible for Medicaid, which would allow them access to the health care services needed in order to treat and manage chronic illnesses, prevent new health conditions from developing, and protect against financial ruin due to inability to pay medical bills.
What We're Talking About is a weekly column from USICH Communications on the topics and issues in the news and on our minds. Topics range from international and national conferences, news from around the country, innovative work to highlight, and more. We look forward to catching you up news you may have missed and connect you to articles and resources.
USICH released a general newsletter this week which compiled news from federal agencies, national partners, and cities revamping their approach to homelessness. If you missed it, you can check it out here.
A Reminder of the Needs of Veterans Two Years After End of Combat Operations in Iraq
Today marks the two year anniversary of combat missions in Iraq, a milestone to be sure, but one that must remind the country of the needs of Veterans of that conflict as well as Veterans of previous wars. In Yuma, Arizona, the allocation of the city’s first HUD-VASH vouchers will enable Veterans in that community to have stable housing and access to coordinated supportive services for their recovery. The HUD-VASH program continues to expand to both more communities and to more Veterans because of its ability to stabilize vulnerable Veterans in the long-term.
08/13/2012 - A Unique Permanent Supportive Housing Plan and Using Medicaid to Make it Happen: My time in Louisiana
I spent August 8, 9, and 10 in Louisiana with Don Moulds, the Acting Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services. Don is also Secretary Sebelius’ point person for USICH. We went to talk with people operating and overseeing the Louisiana Permanent Supportive Housing project. For those who aren’t familiar with this incredible project, you can find more information from the Corporation for Supportive Housing, which highlighted this state-wide project as part of their Focus on Health Care Series in February 2012. If you don’t have time to listen to the webinar now, here’s the short version: after the hurricanes in 2005 and 2006, the state, advocates, and community providers worked together to figure out how to help people with one-time federal recovery investments. What has emerged is a unique model to use these new resources for housing and supportive services to provide permanent supportive housing across the region. Federal investments included Community Development Block Grant funds, Shelter Plus Care and Section 8 Housing Choice Vouchers.