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Using Medicaid’s Housing Related Services (HRS) to Create New Supportive Housing

An increasing number of states are including coverage of Housing Related Services (HRS) in their Medicaid programs. These new services aim to provide more units of supportive housing and higher quality services. CSH has found that states who include these six strategies in their efforts are more likely to be successful. Learn more about these efforts, examples and concrete next steps your state can take to ensure these programs lead to greater supportive housing capacity and higher quality supportive housing statewide.

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White House Budget Cuts Critical Affordable and Supportive Housing Programs

Last week, the White House released the topline fiscal year 2026 (FY26) budget, which outlines significant changes and reductions in various programs, particularly within the U.S. Department of Housing and Urban Development (HUD). As the national leader in supportive housing, we are deeply concerned about the proposed budget, which includes significant cuts to affordable housing and critical community resources.

More than 30 years of data show that extreme cuts to federal housing and service funding at this magnitude would be catastrophic for millions of Americans teetering on the edge of homelessness and would devastate communities.

At a time when the nation is facing record homelessness and severe shortages of affordable housing, the proposed budget:

  • Cuts funding to HUD by 45% – a staggering reduction of $33 billion from FY24.
  • Eliminates affordable and supportive housing development tools, then restructures and cuts the massive federal rental assistance programs (housing vouchers) by $26.7 billion, compelling states to either fund or drastically reduce these programs. These cuts jeopardize the stability of more than 5 million households nationwide, which would force hundreds of thousands into homelessness and overwhelm emergency shelters.
  • Makes significant policy changes to cap housing assistance at two years and “encourage” a 50% match from state and local governments, rewriting and reducing the federal role in this key aspect of the national safety net.
  • Merges the Continuum of Care (CoC) grants and Housing Opportunities for Persons with AIDS (HOPWA) into the Emergency Solutions Grants (ESG) program, cutting total spending by $532 million.
  • Eliminates key capital tools that create and preserve affordable housing development, including the Community Development Block Grant (CDBG), HOME Investment Partnerships Program, while significantly reducing funding for the Community Development Financial Institutions (CDFI) Fund in the Treasury budget.

The proposed budget also includes cutting over a quarter of funding for health services across multiple departments. This reduction targets critical community-based services that help people access healthcare and mental health support. It will make it harder for individuals to stay economically stable during challenging times. It proposes to eliminate programs that older adults and people with disabilities rely on, including $770 million in reductions for Community Services Block Grants, over a billion in cuts for Substance Abuse and Mental Health Services Administration (SAMHSA) grants, and the Low-Income Home Energy Assistance Program (LIHEAP) by more than $4 billion.

The budget released by the White House is a topline funding request, with more details expected in the coming weeks. Ultimately, Congress is responsible for making budget decisions.

CSH will continue to monitor the developments, share key information and advocacy alerts for the supportive housing field, and work with congressional members to ensure they preserve critical housing and services funding for the communities they represent.  

In the coming days, we will share ways you can send advocacy messages to your congressional members. If you want to receive our advocacy alerts, please sign up.

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CSH Selected as Central Convener for Health Share of Oregon’s Social Health Network

April 4, 2023

(Portland, OR) – Health Share of Oregon announces the selection of CSH to serve in the role of the Central Convener for Health Share’s Social Health Network. CSH is a 501(c)(3) with over 30 years of experience leading supportive housing and health-related initiatives both in Oregon and nationally.

The Centers for Medicare and Medicaid Services (CMS) recently approved the State of Oregon’s application for a Section 1115 Medicaid Waiver. This waiver allows providers to bill for a set of Health-Related Social Needs services as Medicaid benefits. “Medicaid is critical to scaling health related social needs that allow people to thrive in permanent housing. Oregon’s Waiver is unique in many ways, especially its approach to healthcare access, which addresses the needs of communities of color that have historically had disproportionate access to physical and behavioral health support,” said Deborah De Santis, President and CEO of CSH.

In January 2023, Health Share sought an entity to serve as a Central Convener. The Central Convener will develop a network of community-based organizations (CBOs) who will support access to upcoming Health-Related Social Needs benefits for eligible Health Share members starting in 2024. Health-Related Social Needs are commonly defined as an individual’s social and economic barriers to health, such as housing instability or food insecurity.

Over the next two years, CSH will lead capacity building efforts, learning collaboratives and provide training and technical assistance for CBOs interested in being a part of Health Share’s Social Health Network. Mindy Stadtlander, Health Share of Oregon Interim Chief Executive Officer, said: “Investing in social determinants of health is a critical step towards improving health outcomes and promoting health. We are excited to partner with CSH to help us build local capacity and infrastructure that will support meeting the health-related social needs of Health Share members.” The proposal submitted by CSH demonstrated strengths in convening organizations, contract management, commitment to health and significant experience with supporting CBO capacity building. For example, CSH’s Medicaid Academy program covers the administrative aspects of Medicaid and helps CBOs set themselves up as Medicaid billers. Additionally, CSH can provide a national perspective and guide local efforts using expertise from their work helping other states with Health-Related Social Needs strategy development.

About Health Share of Oregon

Health Share of Oregon is the state’s largest Medicaid coordinated care organization, serving Oregon Health Plan members in Clackamas, Multnomah, and Washington counties. Our mission is to partner with communities to achieve ongoing transformation and the best possible health for each individual. Health Share was founded and continues to be governed by eleven health care organizations serving OHP members: Adventist Health, CareOregon, Central City Concern, Clackamas County, Kaiser Permanente, Legacy Health, Multnomah County, Oregon Health & Science University, Providence Health & Services, Tuality Health Alliance and Washington County.

Contacts:

Heather Lyons
CSH
[email protected]

Maureen Seferovich
Program Manager
Health Share of Oregon
[email protected]

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Michigan Legislature Allocates Historic $6M in Funding for Supportive Housing Services

State Senator Jeff Irwin, CSH, and state service and housing providers partner to pave the way for unprecedented funding.

The Michigan Legislature appropriated a historic $6 Million in its FY23 budget to expand supportive housing services. The state allocated the funds to the Michigan Department of Health & Human Services (MDHHS), which will distribute the funds to five eligible agencies through the PSH Supportive Services Pilot. MDHHS announced a solicitation for letters of intent to apply for the funding by February 24, 2023.

CSH worked closely with state Senator Jeff Irwin’s office, along with supportive housing providers in Michigan and the Michigan Interagency Council on Homelessness, to advocate for the funding.

“Supportive Housing models across the country have proven that when people are stably housed, they are happier and healthier. As a result, we see fewer people in crisis in our emergency rooms, jails, and community mental health services,” Sen. Irwin said. “Michigan’s investment in supportive housing will improve peoples’ lives and saves us money long-term.” 

The funds will boost services for people living in supportive housing who need additional assistance to maintain stability and currently homeless individuals moving into supportive housing.

Numerous examples in Michigan and across the nation demonstrate that a more significant public investment in high-quality support services paired with affordable housing can reduce unnecessary institutionalization and trauma for people experiencing homelessness. Michigan already implements high-quality physical and behavioral healthcare for those in need, and this funding will increase the capacity for supportive services.

“The state’s investment is following a trend among other jurisdictions and a growing acknowledgment that supportive housing services have been underfunded for many years. An abundance of rigorous data show that sufficient and ongoing support services funding can reduce long-term homelessness, improve lives, and reduce overall public costs. There is a significant return on investment,” said Catherine Distelrath, Director, CSH Michigan.

CSH has a long history of collaboration in Michigan, advancing work to bring supportive housing to scale for people experiencing homelessness and placed in institutional settings. Looking to the future, and using this allocation of $6M from the state legislature as an energizing force, CSH is working with partners to secure an additional $20M for supportive housing services over the next 2 years.

“CSH has an enduring history in the state, and we thank our partners for their collaboration, support, energy, and time advocating for the funding needed to advance supportive housing,” said Deborah De Santis, President and CEO, of CSH. “This historic investment by the governor and state legislature is a promising step to solving homelessness and cultivating our collective aspirations as a nation, namely that everyone has a safe, quality home where they can live and thrive.”

To receive a copy of the request for letters of intent, please email [email protected]. Service providers interested in applying may attend an informational webinar on Friday, January 27, 2023 at 10:30 AM or submit questions to [email protected]

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Media Contact: 
Jesse Dean
[email protected]

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California Homeless Housing Needs Assessment Authors Respond to State Budget

FOR IMMEDIATE RELEASE

Experts recognize that the Governor’s budget maintains the level of investment in addressing homelessness during a difficult budget year, and call on legislators to lay a foundation based on the state’s housing needs.

Sharon Rapport, Director, California State Policy, Corporation for Supportive Housing, made the following statement in response to the release of the Governor’s 2023-24 Budget:

“In a difficult budget year, it’s reassuring to see that 2022 spending on homelessness was not cut for the 2023 budget. However, no additional investments were made.

“The budget prioritizes unsheltered homelessness, but we can reduce unsheltered homelessness through long-term investment in housing. Shelter is critical in offering people a safe place to stay while waiting for permanent housing—but only homes end homelessness, and permanent housing must be the central focus of our strategy.

“The governor’s summary calls for increased accountability from local governments. This is correct—but it should be matched by accountability from the state for a budget plan that is predictable and grows over the coming budget cycles to meet the established needs of people experiencing homelessness in California.

“As the Legislature responds to this budget, it should lay the foundation for a year-over-year approach that uses data to meet the state’s needs with adequate housing, services and shelter—and that asserts the state’s leadership in ending a crisis rooted in our failure to build enough housing in California for decades.”

The Corporation for Supportive Housing (CSH) and the California Housing Partnership, with the support of the Conrad N. Hilton Foundation, issued the first-ever California Homeless Housing Needs Assessment last month to determine the level of public investment that would solve homelessness in California. 

It concludes that California must invest an average of $8.1 billion every year for the next 12 years to create the housing, shelter and supportive services needed to solve homelessness. 

To see the full needs assessment, visit calneeds.csh.org

Media Contact: 

Josh Kamensky
Ocean & Mountain
(323) 326-7438
[email protected]