New Medicaid Resources from CSH Focus on State Efforts

CSH has created four new resources examining  how states are using and are looking to use Medicaid for supportive housing. The new resources include a deeper look at New York State's activities, a new Crosswalk focused on Arizona, and two new overviews on Medicaid usage for housing unit creation and supportive housing services.



As states and communities look to target supportive housing for high cost, unstably housed individuals and families, the lack of available housing subsidies becomes readily apparent. This population not only needs intensive services and supports, they require a housing subsidy to make available housing affordable.

Federal housing resources such as Section 8 Housing Choice Vouchers have not grown to meet the need and with housing costs always rising, the reach of these programs has been diminishing in recent years. Service delivery and financing improvements alone will not allow health care payers to maximize health cost reductions for this segment of the population. Housing and the subsidies needed to access it are also essential.

Recognizing this, Medicaid agencies and health system payers are experimenting with ways to create state and local housing subsidy programs for specific Medicaid subpopulations. Federally, Medicaid resources are not used for housing capital development or rental assistance. However, state and local entities have flexibility with their Medicaid resources and this is leading to innovative strategies. This resource summarizes initiatives in New York, Illinois and Minnesota to couple housing and Medicaid reimbursed services together for people who need supportive housing to stabilize and reduce health system


States recognize that supportive housing directed at the right population can reduce Medicaid spending. They also understand supportive housing services need to be financed in a way that is more sustainable than through short-term government and philanthropic grants. Therefore, states, localities and health services payers such as managed care organizations are experimenting with ways to more comprehensively finance outreach and engagement, tenancy supports and general case management.

This resource highlights actions states and other entities have taken to improve delivery and financing of the services delivered by supportive housing providers.


Achieving New York’s Medicaid Redesign Goals through Supportive Housing

As New York State (NYS) continues to restructure how health care services are delivered under its Medicaid program, there is increasing opportunity to better position the supportive housing industry to help the state meet its desired goals of achieving the Triple Aim: improved health outcomes, quality and reduced health care costs for some of its most vulnerable members. This paper summarizes the state’s efforts under the Medicaid Redesign Team (MRT) to reduce avoidable health care expenditures and increase quality of services using supportive housing as an intervention to stabilize its neediest, high-cost utilizers of health care. It also examines the opportunities and challenges in leveraging Medicaid as a potential funding source for supportive housing services.


IMPROVING ACCESS TO MEDICAID BEHAVIORAL HEALTH SERVICES For Arizona Medicaid Beneficiares Needing Supportive Housing

As evidence continues to establish supportive housing as an intervention that stabilizes people with chronic illnesses, states are exploring ways to ensure Medicaid programs cover the services that supportive housing residents need. To this end, CSH has analyzed Arizona’s Covered Behavioral Health Services Guide and accompanying documents to determine the extent to which Medicaid benefits extend to non-SMI Medicaid members living in supportive housing and offers recommendations to align state Medicaid policy and supportive housing services.

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