Area of Expertise: Medicaid

The 2026 Kentucky Medicaid Crosswalk provides a comprehensive analysis of how Kentucky’s Medicaid program aligns with evidence-based supportive housing services. Developed in partnership with the Kentucky Housing Corporation, the report examines current policies—including the 1915(i) RISE program—alongside provider insights and national best practices to identify strengths, gaps, and opportunities for improvement. It explores how Medicaid-funded services can better support people experiencing homelessness or housing instability, highlights the critical role of cross-sector coordination, and offers actionable recommendations to expand access to stable housing, improve health outcomes, and strengthen system efficiency across Kentucky.

H.R.1 is estimated to reduce federal spending on Medicaid by more than $1 trillion over ten years, and cause as many as ten million people to lose their health insurance.

The new law enacts policy and funding changes to key housing development financing tools: the Private Activity Bonds (PABs) and 4% Low Income Housing Tax Credit (LIHTC) Program and the 9% LIHTC Program.

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

This brief titled Supportive Housing and Olmstead: State of the Conversation, February 2024, delves into critical considerations for policymakers and advocates amidst implementing state HCBS settings rule transition plans and endeavors to ensure compliance with the landmark Olmstead v. L.C. decision. The essence of Olmstead lies in its vision to empower individuals with disabilities by fostering their seamless integration into communities and affording them the autonomy to choose supportive housing as a pathway to realizing this vision. This document recognizes the pivotal role of quality supportive housing in advancing these objectives and bolstering Money Follows the Person (MFP) initiatives across states.

A Resource for Housing and Homeless Programs Considering Options for Billing for Medicaid Eligible Services

This review of Medicaid models is designed to assist supportive housing providers and homeless service organizations consider strategies to enhance their services (and services funding) through partnerships or through securing new resources. Included are comprehensive overviews of three options: Becoming a Medicaid Billable Agency; Collaborating to Increase Services and Capacity; and Contracting with an Administrative Services Organization.

This material is based upon work supported by the Corporation for National and Community Service (CNCS) under Social Innovation Fund Grant No.16PSHNY002. Opinions or points of view expressed in this document are those of the authors and do not necessarily reflect the official position of, or a position that is endorsed by, CNCS.