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Health Talk: Examples of Medicaid funding services to sustain and expand supportive housing capacity

March 7, 2017

Let’s remind our readers again, that the CSH analysis regarding supportive housing indicates that we need 1.2 million units of supportive housing to meet the need of vulnerable Americans.  While a pipeline of tax credits and other financing mechanisms exist for affordable housing development, the road to funding the supportive services component of supportive housing is not as clear.

CSH has developed a summary of state strategies we believe can lead to sustainable pipelines of services funding for many communities.  These strategies illuminate how states are using Medicaid financing mechanisms to expand supportive housing capacity, sustain programs with more long-term sources of service funding and better serve supportive housing tenants who have changing service needs over time.  All are esteemed goals.  As health care and particularly Medicaid is different from state to state, some of these strategies might apply, others might not.

CSH has developed the following summary highlighting state strategies we believe can lead to sustainable pipelines of services funding for many communities.  These strategies illuminate how states are using Medicaid financing mechanisms to expand supportive housing capacity, sustain programs with more long-term sources of service funding and better serve supportive housing tenants who have changing service needs over time.  All are esteemed goals.  As health care and particularly Medicaid is different from state to state, some of these strategies might apply, others might not.

In this blog post, we will highlight the Community Support Program for people Experiencing Chronic Homelessness or CSPECH program.  Massachusetts  has used CSPECH services to increase their supply of supportive housing and work towards ending chronic homelessness for their state. Massachusetts began using Medicaid resources to fund services in supportive housing in 2006, in a partnership between the state’s Medicaid Plan, the statewide Behavioral Health Managed Care Organization and the Massachusetts  Housing and Shelter Alliance or MHSA.  MHSA used a number of strategies that CSH recommends as supportive housing advocates use as they engage their state Medicaid plans.

Those strategies include:

  1. Make the Business Case.
    Now more than ever, state Medicaid departments are looking for ways to save money. A solid business case analysis can win over skeptics such as key legislators and state Budget Offices.

 

  1. Align your ‘ask’ with your state’s priorities.
    Massachusetts had made addressing the homelessness crisis a state priority, so the requests and their priorities aligned. What are your state’s priorities?  Addressing Chronic Homelessness? Downsizing state institutions? Criminal Justice Reform with a focus on Re-Entry? Supportive housing is a solution to all these challenges.

 

  1. Join key stakeholder groups for your state’s Medicaid plan.
    Did you know that federal Medicaid law requires a public stakeholder committee that supportive housing providers should be represented on? There are often a variety of subcommittees as well that while time-consuming will often expand your network to key advocates and stakeholders in your state.

 

  1. Propose a pilot program that is set up to succeed.
    Your goals in the pilot are not only to serve your new tenants but to document success. Success is defined in housing stability but also proving decreased health care costs and positive health outcomes. The evaluation component of your pilot will be as key as your services. Targeting your supportive housing to those with the most challenging health care needs will set you up to succeed and to document health savings.  Consider partnering with local universities or other research experts to execute your evaluation and use the data to recommend expansion in the coming years.

 

Massachusetts's plan was executed using their state’s 1115 Medicaid Research and Demonstration waiver and fit well with the priorities of their state and their Health Care Delivery System.  In the coming, weeks we will highlight other state’s efforts that matched with their state priorities and Health Care Delivery Systems.

Please see the short brief and infographic on the MHSA for more details.  If you have any questions, on this project, please contact Marcella Maguire, CSH Director of Health Systems Integration at Marcella.Maguire@csh.org  or Joe Finn, MHSA’s Executive Director at JFinn@mhsa.net.  We look forward to hearing from you.

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Health Talk: Examples of Medicaid funding services to sustain and expand supportive housing capacity



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