Geography: National

This guide is intended for supportive housing administrators and practitioners who are developing and involved in supportive housing efforts that serve families with children. Families being served by supportive housing efforts face a complex set of challenges including long-term and repeated homelessness, child welfare involvement, mental health issues, domestic violence, and a parental history of trauma. The instability, trauma and complex needs of these families not only impact their housing outcomes, but also their parenting and child development outcomes. Permanent supportive housing for these families provides a platform for adult healing, family strengthening and a healthier life course for the children and youth. To support a family’s ability to use the opportunity that supportive housing provides fully it will be important for supportive housing providers to build an environment that is both developmentally appropriate to the needs of children and responsive to the unique needs and pressures of parents.

This sample tenant manual was developed by the Center for the Study of Social Policy in collaboration with the Corporation for Supportive Housing. It is specifically designed as a resource for supportive housing providers working with families, especially those families involved with the child welfare system. The goal was to develop a tenant manual that could be easily adapted for sites that are providing supportive housing for families. While it may be most useful to programs serving families at a single site such as an apartment building or a cluster of apartment units managed by the same housing provider, we encourage providers of scattered site housing to review and adapt with landlords as you find useful.

H.R.1, as signed into law on July 4, 2025, contains more than three hundred provisions that change tax policies and entitlement programs, including many that impact the supportive housing industry and the people we serve. CSH’s initial impact analysis is focused on three sections of the law that will require state-level decisions in the short term.

H.R.1 includes requirements and budgetary changes that will make continuous health care coverage a challenge for individuals who are experiencing homelessness or have experienced homelessness and housing instability, including most supportive housing residents. This brief summarizes solutions to help states ensure that Medicaid eligible individuals remain enrolled and compliant with the new law.

The purpose of the CSH Supportive Housing Services Staffing and Budget Tool is to support agencies, communities, and project planners to estimate comprehensive costs for supportive housing services. The tool uses a template that includes built-in assumptions around best practice for four staffing models: Assertive Community Treatment (ACT), Intensive Case Management (ICM), Tenancy Support Services (TSS), and Critical Time Intervention (CTI). Each of these models is well-researched and has a strong evidence base for efficacy with supportive housing tenants across a variety of constituencies. The tool allows the user to model out scattered site and project-based programs and input their average staffing costs, budget assumptions, and productivity expectations to determine rates needed by agencies for a fiscally sustainable program.

Last updated: August 2025

The Strong Families Fund is the largest pilot pay-for-performance project to finance Resident Service Coordination (RSC) in affordable housing for lower-income families. The initiative was created to measure the impact of resident service coordination on tenant and building performance within affordable housing. The performance-based contract approach helps to align all collaborating partners with a shared vision of success. This report reviews the results of the data collected through the first phase of the initiative. It demonstrates that using this performance-based approach to resident service coordination in affordable housing is a powerful way to increase economic mobility, health & well-being, housing stability, and community engagement and safety.

View the Executive Summary

New Challenges for Supportive Housing After Reconciliation Bill Passes the House

Congress has now passed the reconciliation bill, finalizing a set of policy changes that will have far-reaching effects on individuals experiencing homelessness and those living in supportive housing.  

Supportive housing is effective because it combines affordable homes with access to healthcare and services. When those services become harder to access, the foundation of supportive housing becomes less stable and its impact more difficult to sustain. 
 
While this legislation includes significant new resources for affordable housing and facility development by expanding Low-Income Housing Tax Credits and preserving the New Market Tax Credit program, it makes it harder for states to fund critical housing-related services. The bill restricts the ability of states to pay for Medicaid and adds administrative and eligibility barriers to healthcare and nutrition programs, making it harder for people to access services that help them remain stably housed. States now face making difficult budget decisions to close gaps or cut enrollment and services to balance their budgets. 

CSH remains committed to supporting the field through this transition period. In the coming weeks, we will share a thorough analysis of the bill and materials to help providers and policymakers understand the implications, navigate the challenges, and take advantage of the new affordable housing resources. We will also monitor the proposed consolidation and funding reductions to the Continuum of Care program and rental assistance programs that are still being considered as part of the broader fiscal year 2026 appropriations process.  

Our focus remains on ensuring that supportive housing remains a viable and effective solution to homelessness and housing insecurity. CSH will continue to advocate for sustained funding and infrastructure for supportive housing as Congress takes up additional budget legislation in the months ahead.   

We are grateful to stand with all who have weighed in with their congressional delegations, and who we know will continue to fight for people and communities where no one is left behind. 

Deborah De Santis
CSH President and CEO

CSH Calls for Balanced Policy That Protects Both Housing and Health Supports

The Senate’s passage of the reconciliation bill presents a deeply mixed outcome for the supportive housing field. While we acknowledge the inclusion of important housing provisions such as expanding and making permanent the Low-Income Housing Tax Credits and the New Markets Tax Credit, we cannot overlook the harmful trade-offs embedded in this legislation.

These housing investments, while significant, are not sufficient to offset the damage caused by provisions that undermine access to essential healthcare and basic supports for people experiencing homelessness and housing instability. The bill imposes new barriers to Medicaid and nutrition assistance that will disproportionately impact individuals with complex health and housing needs. These are the very people supportive housing is designed to serve.

Supportive housing succeeds because it pairs affordable homes with the services that help people stay housed and maintain their health. When the government restricts access to those services, it weakens the entire model. Limiting state Medicaid funding tools, imposing burdensome recertification requirements, and expanding work requirements for vulnerable populations all threaten the stability and well-being of those we serve.

CSH remains committed to advancing effective policies that recognize the interconnectedness of housing, healthcare, and human services. We urge Congress to consider the full impact of this legislation, not just its housing investments, but also the barriers it creates for those most in need and the burdens it places on the communities in their districts. We will continue to work with partners across sectors to ensure that supportive housing remains a viable and effective solution to homelessness and housing insecurity.
 
Deborah De Santis
CSH President and CEO

This guide enhances understanding of the health conditions experienced by individuals navigating housing instability. Utilizing existing data elements monitored at the intersection of health and housing allows professionals to reduce the administrative burden associated with new data tracking mechanisms while streamlining operations to improve health outcomes.