Early in 2011, Governor Cuomo established a Medicaid Redesign Team (MRT) to devise strategies to reduce costs and improve care in New York State’s Medicaid system. Recognizing that supportive housing can be a significant factor in reducing the cost trajectory among the 20% of high need Medicaid recipients who drive up to 75% of Medicaid expenses, the Affordable Housing Workgroup was convened. Over a six week period, CSH COO Connie Tempel and Director, Diane Louard-Michel, helped evaluate barriers to the efficient use of resources for supportive housing, propose solutions for overcoming those barriers and identify opportunities to invest in the expansion of supportive housing for high need, high cost Medicaid recipients.
The final report and recommendations were accepted by the MRT on December 15. Some highlights or the recommendations from the report include:
Develop a “NY/NY IV” supportive housing development agreement with New York City and other interested localities to create thousands of new supportive housing units targeting high-cost, high need Medicaid users;
Request funding for ongoing housing-based services and operating costs in the MRT 1115 Medicaid waiver to be submitted by the State to the U. S. Centers for Medicaid and Medicare Services in 2012;
Establish a formal mechanism to set aside a portion of Medicaid and non-Medicaid savings related to any reduction of inpatient hospital, psychiatric center or nursing home capacity to a fund dedicated to supportive housing development;
Starting in SFY 2012-13 transfer a portion of $75 million in MRT funding allocations to state affordable housing, behavioral health and safety net agencies to spur supportive housing creation;
Implement a series of specific reforms to the Assisted Living Program that will increase provider flexibility and effectiveness;
Explore a pilot program of “social impact investment bonds to pay for supportive housing;
Establish an interagency council of state agency representatives to coordinate and implement supportive housing policy; and
Develop working groups to streamline the capital development process, improve housing placement and targeting mechanisms, and create incentives to supportive housing tenants to more independent housing.
CSH thanks Governor Cuomo and the Medicaid Redesign Team for their insight, and the Department of Health and all the state agencies and workgroup members for their contributions to this effort. We commend Co-Chairs Deputy Secretary Jim Introne and Ed Matthews of United Cerebral Palsy for their leadership of the workgroup and Mark Kissinger of NYS DOH and Andrea Cohen from the New York City Deputy Mayor’s Office who so ably staffed and wrote the report. CSH looks forward to helping implement these far-reaching statewide initiatives to improve the nexus of supportive housing and health care reforms in New York State.
The entire report and recommendations approved by the MRT can be found here.