Health Talk: Including Medicaid in Supportive Housing Expansion

In October, CSH released data analysis on the number of supportive housing units our nation needs to meet the need of vulnerable Americans.  That number was-  1,200,000.  The report breaks the numbers down via state and via various populations (families, persons returning from incarceration, persons experiencing chronic homelessness etc.).  But it’s a very large number.   Such a large number powerfully reminds us that new allies, new stakeholders and new partnerships will be needed to even approach that number.

Some of the most productive work to expand supportive housing capacity is happening in states where the state Medicaid office is a key partner. In these states, Medicaid resources are being utilized to fund supportive services.  While Medicaid will likely be undergoing significant changes in the coming year, the case for Supportive Housing remains strong.  Different states have different strategies, but each are learning lessons that other states and communities can benefit from. We will use this blog to explain key concepts in Medicaid, explain proposed changes from the new federal leadership, and highlight exciting initiatives and state activities.  We hope to dialogue with the supportive housing field and build a space to help develop community specific implementation, strategic planning, analytic, or communication strategies.

2017, in the health care policy world will be a time of great debate.  Our community should remember however, that at the practice and financing level, 2017 is set in stone and 2018 is likely set in wet concrete.  2018 is not decided, but by March or April of this year, insurers will need to know if they will remain in the marketplaces and offering Medicaid “products” for 2018.  The political conversation that is occurring in Washington, DC, is primarily in regard to 2019 and beyond.  This blog will clearly communicate such details, so that you can remain informed about how these proposed changes will impact your program and the people you serve.

The initial work often starts with the federal Center for Medicare and Medicaid Services or (CMS) and a state Medicaid office. But the work quickly moves on to include other state departments, perhaps a state legislature, Managed Care Organizations (MCOs), county government, supportive housing providers who are poised ready to take advantage of the opportunity and other social service providers.  We will highlight many of these structures, options and services in the coming months and hope to hear from you about what other exciting initiatives in your community can also be highlighted.

Also on the blog we will define the terms.  If you have lived in the world of McKinney-Vento or homeless services, terms such as NOFA, COC or PIT count mean something very specific to you.  If you come from the managed care world, the term “Medical Necessity Criteria” needs no explanation.  But partnerships often require learning another language.  While partners don’t need to be fluent in each other’s language, they need to know enough to understand and communicate effectively. Other terms such as Case Management or Outreach mean something to supportive housing providers and often something completely different to folks from the health care world.  This blog will capitalize a word or phrase if it’s a term used specifically in the world of health care, Managed Care or supportive housing.  Learning these terms are likely worth your time and effort to know exactly what your new partners mean when they use the term. Collaborations and partnerships need shared language if they are to be successful.

If you have any questions, thoughts or comments about what can be included here, please contact Marcella Maguire, CSH Director of Health Systems Integration at Marcella.Maguire@csh.org for Debbie Thiele, CSH’s Director for Consulting at Debbie.Thiele@csh.org.  We look forward to hearing from you.

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