Meet MISHA – the Medicaid Institute for Supportive Housing Agencies

Several provisions in the Affordable Care Act are intended to expand access, utilization and delivery of health care and health related services to low-income populations. With an emphasis on home and community based services, and direct efforts to incentivize and support care coordination and systems integration, advocates around the country are working to create new sources of funding for the delivery of supportive housing and homeless services.

While it is no mystery that efforts are underway in several states around the country to capitalize on Medicaid expansion to create new mainstream sources of funding for services, just exactly what may be in store for service agencies can be more bewildering. The majority of agencies providing supportive housing services have no experience as Medicaid providers. The labyrinth of Medicaid programs, unfamiliar business model, administrative requirements, terminology and different orientation to services creates some trepidation, and many questions: How exactly does Medicaid work? What services are supported, or not? What would our agency need to bill Medicaid services? How do we become accredited? What training and credentialing is required for our staff? Will this medicalize our service model? Will Medicaid require a culture change in our agency?

In Connecticut CSH is leading an effort to answer these questions, to demystify Medicaid, and especially to support agencies to prepare to maximize the opportunities that may be available to them through emerging Medicaid programming. With the generous support of the Melville Charitable Trust, CSH is sponsoring the Medicaid Institute for Supportive Housing Agencies (MISHA). Eight agencies[1] that provide supportive housing services in CT were selected through a competitive application process to participate in Round One of MISHA.

CSH has enlisted the Technical Assistance Collaborative to assist in the development and delivery of a comprehensive curriculum that includes seven full day sessions of information, instruction, and guidance from key individuals and agencies around the state. MISHA guests have included the CT State Medicaid Director, Kate McEvoy, providing an overview of the entire Medicaid system, programs and services; representatives from the two major Medicaid Administrative Services Organizations; state agency administrators of CT Medicaid waiver services; CT Medicaid policy experts; and the services administrator of the CT mental health waiver.

The first MISHA cohort has met six times for a full day beginning in March through September, 2014.  Through ongoing consultation and feedback, MISHA agencies have completed internal needs assessments and developed comprehensive Medicaid Business Plans to either become a Medicaid billable organization or develop strategic partnerships with Medicaid providers in order to increase capacity of supportive housing services. MISHA agencies have also created plans to ensure Medicaid enrollment and reauthorization for the population they are serving.

As the final session of MISHA Round One approaches, most MISHA agencies are now crafting applications for Capacity Building grants. These awards of up to fifty thousand dollars, also provided through the generosity of the Melville Charitable Trust, will provide the critical resources needed for agencies to realize the objectives laid out in their Business Plans.

Feedback on MISHA Round One has been overwhelmingly positive. CSH is busy designing the delivery of MISHA Round Two to commence in early 2015.  CSH will continue to support MISHA Round One participants who will also play a key role in Round Two, advancing our effort to prepare the entire network of supportive housing providers in Connecticut to enhance our collective efforts to deliver the high quality and effective services needed to end homelessness in our communities.



[1] Columbus House, CHD, Immaculate Conception Shelter and Housing, My Sister’s Place, New London Homeless Hospitality Center, Newreach, St. Vincent’s Behavioral Health Services, The Connection

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