Toolkit

Fall, 2023

States recognize that addressing Health Related Social Needs (HRSN) will improve individual health outcomes and the health of communities while reducing Medicaid spending. An increasing number of states have approved Medicaid waivers and State Plan Amendments or SPAs that cover HRSN services.  All of those waivers have included Housing Related Services (HRS) as one of the HSRN services.  Using Medicaid funding for Supportive Housing services gives states the potential to scale the evidenced based model of Supportive Housing. CSH is also advocating for six strategies combined with these new services to create more supportive housing. The first and most important of these strategies is to align affordable housing with the services at the system level.

Black, Indigenous, and People of Color (BIPOC) are overrepresented among people experiencing homelessness and housing instability, families involved with the child welfare system, people impacted by mass incarceration and those forced to live in congregate care settings.  All these populations are impacted by systemic and structural racism. One aspect of health equity strategy would be to grow supportive housing capacity and make access more equitable. States are looking to both increase supportive housing capacity and supportive housing quality via new HRSN programs. 

States are also looking to expand supportive housing to serve new people and populations to ensure people live in the most community-integrated setting possible to ensure compliance with the Olmstead decision.

Approved Medicaid 1115 waivers in a number of states now cover recuperative care (what the homeless sector calls Medical Respite) and 6 months of housing assistance. CA’s CalAIM programs gives Managed Care Plans the option to cover 90 days of recuperative care and up to 6 months of post hospitalization housing.  CA is applying to cover Transitional Rental Assistance to cover a broader population that just those leaving the hospital. Arizona, New Jersey, Oregon and Washington are also approved for up to 6 months of housing for broader populations including those experiencing or at risk of homelessness, those leaving institution care or congregate settings and child welfare involved families. Given the nation’s housing crisis, linking those persons to long term housing options such as Permanent Supportive Housing or other long term affordable options will be crucial to this demonstration model’s success.

Over twenty states already have some type of supportive housing services program or benefit in place, and the Corporation for Supportive Housing’s (CSH’s) map can help you find where your state is in this process.

Since CMS views these services as part of the state’s Home and Community Based Services (HCBS) program, states are commonly required to administer the program as a component of the state’s current HCBS program. Twenty-two states have Managed Long-Term Services and Supports (LTSS) programs, so states may choose to administer the program through a Managed Care delivery system with providers billing MCOs for these services. In states that do not have Managed LTSS, tenancy support services can be added to the state’s current HCBS system and bill the state directly via the state’s Medicaid Management Information System (MMIS).  States may also choose other delivery systems options such as Third-Party Administrator, which gives a single Managed Care like entity the administrative oversight of the program. In either model, supportive housing providers will need startup funding AND technical assistance to make this shift with distinctive administrative implications for agencies.

Use the dropdown menu below to learn how states have taken to improve service delivery and financing of the services that cover Housing Related Services (HRS) and are now commonly delivered by supportive housing providers.

Summary of State Activity

Program Name

Housing and Health Opportunities (H2O)

Medicaid Authority

1115 Waiver

Target Population includes:

People experiencing homelessness, those leaving institutions or congregate care and child welfare involved families.

Services Include

Pre and Post tenancy services, 6 months housing costs including enhanced shelter and outreach

Key Administrative Details

Waiver includes Capacity building funds for CBOs

Status

State Planning Post CMS approval
 
Health related Social Needs (HRSN) Waiver approved 9/28/22.  
 
Draft Implementation Protocol

Program Name

Cal AIM

Medicaid Authority

1115 waiver and 1915(b) State Plan Amendment

Target Population includes:

People experiencing homelessness is one of many priority populations

Services Include

Pre and Post tenancy services, 90 days of recuperative care, 6 months housing costs

Key Administrative Details

State using In Lieu of Services (ILOS) in which MCPs decide what services to offer and to whom.
 
$1.3 billion in Capacity Building and Technical Assistance support for CBOs.

Status

Operating
 
The waiver was approved with a January 1, 2022, start date.
 
Early outcomes reporting.

Program Name

State Wide Supportive Housing Expansion (SWSHE)

Medicaid Authority

ARPA HCBS Plan for services and HUD Emergency Housing Vouchers (EHV) for housing subsidies.

Target Population includes:

Persons experiencing homelessness, multiple disabling conditions, and high health/crisis system utilization.

Services Include

Pre and Post Tenancy Support Services

Key Administrative Details

Program is currently grant funded via HCBS ARPA funds with the state planning for a Medicaid financing method when grant funds run out in 2024.

Program Name

The CT Housing Engagement and Support Services (CHESS) Initiative

Medicaid Authority

1915 (i) State Plan Amendment (SPA)

Target Population includes:

Homeless and higher health care utilization than to be expected based on diagnosis

Services Include

Pre and post tenancy support services

Key Administrative Details

Administered by Beacon Health

Program Name

Housing Supportive Services  | dhs (dc.gov), including Housing Stabilization Services and Housing Navigation Services

Medicaid Authority

1915(i) SPA

Target Population includes:

Homeless as identified by the city’s Coordinated Entry System

Services Include

Pre and post tenancy support services

Key Administrative Details

Assessment for the services is integrated into the Coordinated Entry process.
Providers are aid by DC Medicaid on a Per Member, Per Month (PMPM) rate raised to $770.31 in FY 2023.
 
Taxonomy Code: Case Management, 251B00000X
 
Procedures Codes: H00044 U1- Housing Navigation Services
 
H00044 U2:  Housing Stabilization Services

Status

Opertaing

SPA approved March 25, 2022

 

Program Name

Housing Assistance Waiver
 
Pilot Program in HHS regions 5 and 7.

Medicaid Authority

1115 Waiver Amendment

Target Population includes:

Homelessness

Services Include

Pre and post tenancy support services

Key Administrative Details

Administered by the Managed Care Organizations (MCOs) in the pilot regions.
State Snapshot of MCOs

Status

Opertaing

Implementation starting.
CMS Approved Waiver amendment approved March 26, 2019.

 

 

Program Name

Community Integration Services (CIS)

Medicaid Authority

1115 Waiver 

Target Population includes:

Individuals with a behavioral health, physical illness, or substance use diagnosis and are chronically homeless.

Services Include

Pre and post tenancy support services

Key Administrative Details

Administered by state’s Medicaid Managed Care Organizations (MCOs). State MCO listing
 State modifying implementation guidelines to improve access for target population.

Status

Opertaing

Waiver approved by CMS October 31, 2018.
 
State Program Web page

Program Name

Permanent Supportive Housing (PSH) Initiative

Medicaid Authority

State Plan Services

Target Population includes:

Low-income populations with disabilities.

Services Include

Pre and post tenancy support services

Key Administrative Details

State plan process integrated across housing and services sectors.

Status

Opertaing

State PSH Website

Program Name

  1. Community Supports Program for Homeless Individuals (CSP-HI)
  2. Flexible Services to evolve to Health-Related Social Needs (HRSN) services

Target Population includes:

  1. Chronically Homeless and being expanded to homeless in the new waiver
  2. TBD by each ACO and their community partners. 

MA ACO and MCO listing.

Services Include

 

 

Key Administrative Details

  1. Administered by state’s MCOs
  2. Administered by ACOs to members of their choosing to reduce costs and improve health

Opertaing

For CSP-HI- Code- H2016 Modifier HK and rate is a per diem of rate of $27.72
 
CSPECH Cost Savings Report- 2017
 
New Waiver approved 9/28/2022.
 
DSRIP HRSN Protocol Approved June, 2023

Program Name

Assistance in Community Integration (ACIS) program

Medicaid Authority

1115 Waiver

Target Population includes:

Homeless or at risk, institution or high risk of institutional placement AND 4 or more hospital visits in a year & 2+ chronic conditions.

Services Include

Pre and post tenancy support services

Key Administrative Details

Administered by the counties who are responsible to align with housing resources.

Status

Opertaing

State ACIS Project Website
 
State Report on program
 
An updated waiver in 2022 took the program statewide

Program Name

Community Support Services, including Housing Assistance, Skill Building Assistance, and Supportive/ Integrated Employment

Medicaid Authority

1115 Waiver transitioning to a 1915 (i) SPA October, 2023

Target Population includes:

Persons with serious mental illness, serious emotional disturbance and/or intellectual/developmental disabilities.

Services Include

 

Key Administrative Details

Services are a component of the state’s Behavioral Health Transformation Plan. The benefit is offered through the Prepaid Inpatient Health Plans or PIHPs  that manage community behavioral health provider network.

Status

Opertaing

CMS approved 1915(i) SPA

Program Name

Housing Stabilization Services

Medicaid Authority

1915 (i) SPA

Target Population includes:

People with disabilities, homeless or housing unstable.

Services Include

Pre and Post tenancy services  

Key Administrative Details

Benefit administered by MCOs, approved by the state.

Housing Transition reimbursed at $17.17 per 15-minute increment. The code is H2015 U8.

Housing Sustaining reimbursed at $17.17 per 15-minute increment. Code- H2015 U8/TS.[1]

Program Name

HEART Waiver, including tenancy support services

Medicaid Authority

1115 Waiver

Target Population includes:

Persons with behavioral health challenges who are experiencing homelessness or housing instability.

Services Include

Pre and Post tenancy services  

Key Administrative Details

TBD-  Montana is one a few states that does not have Medicaid Managed Care

Status

Opertaing

The waiver is approved, but the state is still negotiating with CMS on the tenancy support services benefit.
 
State Waiver Website

Program Name

Housing Support Services

Medicaid Authority

1915(i) SPA

Target Population includes:

TBD

Services Include

TBD

Key Administrative Details

 

Status

Opertaing

For a Medicaid funded tenancy support services benefit.

 

Program Name

Housing Stabilization Services

Medicaid Authority

1915(i) SPA, which is a Home and Community Based Services (HCBS) program

Target Population includes:

Homeless or at risk of homelessness and needing assistance for community living.

Services Include

TBD

Program capped at 50 people

Key Administrative Details

Administration is TBD but the state’s current Home and Community Based Services programs is administered by Managed Care

Status

State Planning post CMS approval
 
The State Plan Amendment is approved and the state is developing regulations to govern operations

Program Name

Housing Transition and Tenancy Sustaining Services as part of a Health-Related Social Needs program

Medicaid Authority

1115 Waiver

Target Population includes:

Persons with disabilities, formerly incarcerated, formerly homeless or at risk of homelessness, transitioning from institution and/or beneficiaries who are transitioning out of high-risk or unstable housing situations.

Services Include

TBD

Key Administrative Details

TBD

Status

State Planning post CMS approval
 
State Planning post CMS approval
 
The 1115 waiver is approved as of 3/30/2023 and the state is developing regulations to govern operations

Program Name

Supportive Housing Units, including capital funds

Medicaid Authority

1115 Waiver

Target Population includes:

Those with Serious Mental Illness

Services Include

 Pre and post tenancy services

Key Administrative Details

The Services are administered by Managed Care

Status

Operating
 
Program is called Linkages and provides state funded rental assistance with Medicaid services for those with Behavioral health Challenges
 
Updated 2023 waiver includes growing the program.

Program Name

Social Determinants of Health (SDOH) Initiatives can include Housing Support Services.

Medicaid Authority

1115 Waiver

Target Population includes:

Three regions in the state, all rural, were awarded funding to operate Healthy Opportunities Pilots to offer SDOH services.

Services Include

 Services Definitions

Key Administrative Details

Operated by Lead Pilot Entities (LPE)

Status

Operating
 
State Program Website
 
Services Definitions and Fee Schedules updated March, 2023

Program Name

Housing Support Services

Medicaid Authority

1915 (i) SPA

Target Population includes:

People with behavioral health challenges who are experiencing homelessness and housing instability.

Services Include

Pre and post tenancy services

Key Administrative Details

Providers bill the state for the traditional Medicaid population or an MCO for those who are part of the Medicaid Expansion population.

Status

Operating
 
The state has an approved 1915(i) SPA. Services began on February 2, 2021.

The rate is $10.49 per 15-minute increment. The code is H2021 U4.

Enrollment and Service Delivery Report

Program Name

Health-related services can include housing services. Housing services are optional for   Coordinated Care Organizations (CCOs) to fund.


Housing support services for persons with substance use disorders (SUD)


Health Related Social Needs services including Housing Related Services

Medicaid Authority

1115 Waiver that creates Coordinated Care Organizations


1115 Waiver


1115 Waiver

Target Population includes:

The target population is not specified in the waiver. CCOs can choose to include services as an optional benefit under health-related services.


Persons with SUD who are leaving residential substance use treatment


Persons experiencing or at risk of homelessness, those leaving institutions or congregate care and child welfare involved families

Services Include

TBD by the CCOs


Pre and post tenancy services


Pre and post tenancy services

Key Administrative Details

Coordinated Care Organizations or CCOs are Oregon’s community focused evolution of Managed Care.


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State working with CCOs to implement

Status

Operating
 
The state is working to incentivize CCOS to offer tenancy supports to pair with new housing-related resources that are coming online.
 
State Health-Related Services Overview


State Planning post CMS approval
 
The waiver was approved in April 2021 as part of the state’s SUD services demonstration.


State Planning post CMS approval

Waiver approved 9/28/22

Program Name

Tenancy Support Services for intellectual or developmental disability/developmental disability (IDD/DD) population

Medicaid Authority

1915 (i) SPA

Target Population includes:

Those already eligible for IDD waivers. The process remains the same as before the waiver.

Services Include

 

Key Administrative Details

 

Status

Operating

The state has added tenancy support services to the menu of services for persons eligible for the IDD waiver.

Program Name

Home Stabilization Services

Medicaid Authority

1115 waiver

Target Population includes:

Persons with behavioral health or intellectual disabilities and those institutionalized or at risk of institutionalization.

Services Include

 

Key Administrative Details

 

Status

Operating

CMS approved waiver.

State Project Website

The state has created a Certification Standards and Provider Manual.

The per month rate per member is $331.84 and the code is H0044.

Program Name

Adult Mental Health

Medicaid Authority

1915(i) SPA

Target Population includes:

Persons with serious mental illness.

Services Include

Supported home living services that could be used in Supportive Housing

 

Key Administrative Details

 

Status

Operating

CMS approved SPA on August 31, 2020

Program Name

Housing Related Services and Supports

Medicaid Authority

1115 Waiver

Target Population includes:

TBD

Services Include

 

 

Key Administrative Details

 

Status

Operating

The legislature approved the state Medicaid office to develop tenancy support services.

Program Name

Supportive Housing Assistance Pilot Program

Medicaid Authority

1115 Waiver

Target Population includes:

Persons who are 18 and older and need assistance with at least one needs-based criteria and have one or more risk factors.

Services Include

 

 

Key Administrative Details

 

Status

Operating

The state’s 1115 Waiver was approved on June 28, 2022, and includes a PSH Pilot

Program Name

High Needs Support Benefit

Medicaid Authority

1115 Waiver

Target Population includes:

State to develop target criteria that include health-related needs-based measures and risk factors

Services Include

 

 

Key Administrative Details

 

Status

Operating

CMS approved the waiver as of July 9, 2020.
 
The state timeline for implementation is TBD.
 
High Needs Support (virginia.gov)

 

Program Name

Foundational Community Supports (FCS) for supportive housing and supportive employment services.

Medicaid Authority

1115 Waiver

 

Target Population includes:

People experiencing chronic homelessness, individuals with frequent or lengthy adult residential care stays, individuals with frequent turnover of in-home caregivers, and those at highest risk for expensive care and adverse outcomes.

Services Include

Pre and Post tenancy services and supported employment services

 

Key Administrative Details

State is using a Third Party Administrator to simplify administrative processes. Amerigroup won the bid to be the initial TPA.
 
Amerigroup FCS Provider Manual

 

Status

Operating

The waiver was approved and implemented as of January 1, 2018.
 
State Program Website

Using Billing Codes H0043 Community Support services: daily rate of $112 with a benefit limitation of 30 days over 180 days.

 

Program Name

CHIP Housing Support Initiative


Housing Support Services

Medicaid Authority

Children’s Health Insurance Program (CHIP)


1915(i) SPA

Target Population includes:

Low-income families experiencing homelessness to address equity issues in both health and homeless assistance systems.


Medicaid beneficiaries with Behavioral Health needs, who are experiencing homelessness or at imminent risk of homelessness

Services Include

-Housing Consultation

-Transition Supports 

-Sustaining Supports  

-Relocation Supports


-Housing Consultation

-Transition Supports 

-Sustaining Supports  

-Relocation Supports

Key Administrative Details

State is granting funds to8 family supportive housing agencies in 4 COCs


Status

Start date was 5/21/2023


Negotiating with CMS
 
State Housing Supports web site. 

What Health Centers Need to Know to Support Patients

Spring, 2024

As of early 2024, twenty-three states are covering or in the process of implementing Housing Related Services (HRS) to help Medicaid recipients obtain and maintain housing in their community. It is understood that housing status has a significant impact on a person’s ability to effectively connect with the healthcare system and maintain good health and as such, Federally Qualified Health Centers serving individuals experiencing homelessness or housing instability will want to assist their patients with accessing these services. Communities wishing to improve health equity will also need a specific equity strategy to ensure access to services for BIPOC (Black, Indigenous, and People of Color), considering that these populations suffer from higher rates of homelessness, housing instability and institutionalization.
CSH provides regular updates in a state by state Policy Brief with analysis on HRS program implementation. This brief builds on that analysis with focus on accessing these services for health center patients and other health care and community systems now screening for the Social Drivers of Health (SDOH).  While waivers may have broad populations listed as eligible, our analysis will focus on state’s implementation plans and what populations are eligible for these services and when.

Most states cover a similar range of services including pre-tenancy or housing navigation services, tenancy sustaining services and move in assistance. Some states are covering short term rental assistance via Health-Related Social Needs Waivers as an additional service.

As health system providers learn of their patient's Health-Related Social Needs, they will want to have on hand easy ways to refer for assistance.

Use the dropdown menu below to learn how to access these services in each state that has been implemented or is in the process of implementation. In states with recently approved waivers, the process may not be in place yet, but CSH will update this summary as state processes are determined and therefore the acronym TBD (To Be Determined) is used. While CSH updates the research regularly, if you are aware of changes needed to this brief, please reach out to CSH via our Health Systems Integration Director, Marcella Maguire via email- Marcella.Maguire@csh.org.

Summary of State Activity

Program Name

Housing and Health Opportunities (H2O)

Delivery System

Third Party Administrator (TPA). Statewide TPA expected to be on board as of 7/1/2024.

Eligibility:

State’s initial focus is on people who are experiencing homelessness with serious mental illness.

Recommended referral action

State “GO LIVE” date to offer HRS is 10/1/2024.  Contact the TPA AFTER this date for a referral.

Program Name

Medi-Cal Transformation Community Supports; Housing Transition, Navigation; Housing Deposits; Housing Sustaining Services

Delivery System

Managed Care Plans (MCPs).

Eligibility

State’s initial focus is on people who are experiencing homelessness with serious mental illness.

Recommended referral action

Contact member’s MCP to determine if the person is eligible and how to access services.

Program Name

The CT Housing Engagement and Support Services (CHESS) Initiative

Delivery System

Carelon Behavioral Health of Connecticut (ctbhp.com) manages the benefit.

Eligibility

For Patients 18+

HUD Homeless or HUD homeless prior to institutionalization.

Individuals have a higher-than-expected inpatient rate based upon a state predictive analytics score of expected health care usage, called the HEDIS ALL Cause Readmission measure. 

1 Critical need or difficulty with Activities of Daily Living (ADL).

Recommended referral action

Apply CT CHESS - Home (ctchessdss.com)
 
For people without an Intensive Case Manager or ICM , contact Carelon.

Program Name

Housing Supportive Services | dhs (dc.gov), including Housing Stabilization Services and Housing Navigation Services

Delivery System

Coordinated Entry is the access point to the benefit.
 
Coordinated Entry is the system by which all housing referrals are processed within a local Homeless Continuum of Care.

Eligibility:

Patient must require assistance with maintaining housing due to issues with:

  1. mobility,
  2. decision making,
  3. healthy social relationships
  4. help with one basic need such as self-care or money management AND

Is experiencing or at risk for chronic homelessness, homelessness or housing instability

Recommended referral action

Contact the City’s Coordinated Entry System or collaborate with an agency that offers homeless outreach services.

Web Resources

Housing Supportive Services | dhs (dc.gov)

Program Name

Housing Assistance Waiver
 
Pilot Program in HHS regions 5 and 7.

Delivery System

Community Mental Health Providers either offer services directly or subcontract with other agencies.

Eligibility

Persons who are homeless or at risk of homeless and suffer from a serious mental illness and/or substance use disorder

Recommended referral action

Ensure the patient is connected to the local behavioral health system services.  If you are not sure, contact the local Managing Entity for your county.

Web Resources

Housing Assistance Waiver

 

Program Name

Community Integration Services (CIS)

Delivery System

Delivered via MCO health plans: AlohaCare, HMSA, Kaiser Permanente, ‘Ohana Health Plan, and UnitedHealthcare Community Plan  

Eligibility

Individuals with a behavioral health, physical illness, or substance use diagnosis and are chronically homeless.

Recommended referral action

Submit Referral Form  and CIS-Consent-Form to individual’s Health Plan.

Web Resources

State Program Web page

 

Program Name

Permanent Supportive Housing (PSH) Initiative

Delivery System

A mix of providers and the state. The state web site explains how to apply.

Eligibility

Low-income populations with disabilities.

Recommended referral action

Process differs for south and north Louisiana. Contact info and process for each is found on the State PSH website

Web Resources

State PSH website

Program Name

  1. Community Supports Program for Homeless Individuals (CSP-HI)
  2. Flexible Services to evolve to Health-Related Social Needs (HRSN) services

Delivery System

  1. Administered by MCOs
  2. MA ACO (Accountable Care Organization) and MCO (Managed care organizations) listing

 

Eligibility

  1. Persons experiencing homelessness or housing instability with behavioral health challenges that interfere with their ability to access health care services.
  2. TBD by the ACOs (Accountable Care Organizations).

Recommended referral action

Contact the ACO that covers the individual you are serving.

 

Web Resources

Program Name

Assistance in Community Integration (ACIS) program

Delivery System

Counties / Lead Entities to administer the program.  Only Baltimore City, Cecil, Montgomery and Prince George’s counties are participating.

Eligibility

Homeless or at risk, institution or high risk of institutional placement AND 4 or more hospital visits in a year & 2+ chronic conditions.

Recommended referral action

In Baltimore City, contact the Mayor’s Office of Homeless Services.  In the other three counties, contact the local Health department and ask how to access the ACIS program.

Website Resources

State ACIS Project Website
  

Program Name

Community Support Services, including Housing Assistance, Skill Building Assistance, and Supportive/ Integrated Employment

Delivery System

Administered by the Prepaid Inpatient Health Plans (PHIPs) and in some cases by the Community Mental Health (CMH) clinics

Eligibility

Persons with serious behavioral health challenges. 
Process and other eligibility criteria determined by the PHIPs.

Recommended referral action

Contact your local Prepaid Inpatient Health Plan.

 

Web Resources

Program Name

Housing Stabilization Services

Delivery System

Services are authorized by DHS and managed and paid for by the MCOs.

Eligibility

  • Medicaid eligible
  • 18 and older Documented disability
     
    Need assistance with in at least one of the following areas
  • Mobility
  • Communication

Managing Challenging Behaviors or Decision Making

Program Name

Housing Stabilization Services

Delivery System

State Medicaid Office, Department of Health and Human Services (DHHS)

Eligibility

Needs assistance in maintaining housing due to a disability and needs assistance in:
1.    Mobility
2.    Decision Making
3.    Relationships
At least one basic need

Recommended referral action

Not clear at this time.

Program Name

Housing Transition and Tenancy Sustaining Services as part of a Health-Related Social Needs waiver

Delivery System

Managed Care

Eligibility

  • Homeless or at risk of homeless
  • Transitioning from Institution to community
  • Released from Correctional settings
  • At risk of institutionalization due to SMI (Serious Mental Illnesses) or SUD (Substance Use Disorder)
  • Transitioning out of unstable housing
  • M-LTSS MCOs can identify

Recommended referral action

GO Live date has not been set as of early, 2024, however will be administered by MCOs, so likely contact the person’s MCO.

Program Name

The Linkages program

Delivery System

Managed care

 

Eligibility

Persons with Behavioral Health Challenges identified by MCOs

Recommended referral action

Contact the person’s MCO

Program Name

Social Determinants of Health (SDOH) Initiatives can include Housing Support Services.

Delivery System

Pilot program administered by regional Healthy Opportunities Network Leads

Eligibility

Have a qualifying diagnosis and a qualifying social risk factor

Recommended referral action

If the person lives in a Healthy Opportunities Pilot Region, contact the local Network Lead

Web Resources

 

Program Name

Housing Support Services as a part of the Behavioral Health Systems Transformation process.

Delivery System

Administered by the state for the Traditional Medicaid population and the MCO for the expansion population

Eligibility

Persons with behavioral health challenges

Recommended referral action

Contact Blue Cross for expansion population members.
For Traditional Medicaid, apply through the State portal.

Program Name

Health Related Social Needs including Housing Related Services

Delivery System

Via Oregon’s Coordinated Care Organizations (CCOs)

Eligibility

OHA members who are in a variety of Life Transitions.

Recommended referral action

Referral forms will be standard statewide but differ according to HRSN service.
 
Referral forms for Climate Related Services are available
Go live date for housing services is November 2024.

Program Name

Tenancy Support Services for intellectual or developmental disability/developmental disability (IDD/DD) population

Delivery System

Via Managed Long-Term Services and Supports

Eligibility

Persons with Intellectual and Developmental Disabilities and registered with the state system.

Program Name

Home Stabilization Services

Delivery System

Services are provided in a Fee for Service System and providers bill the state.

Eligibility

Medicaid enrolled patients

Recommended referral action

Complete and submit a Home Stabilization Prior Authorization Form to the state.

 

Program Name

Supportive Housing Assistance Pilot Program

Delivery System

TBD- state operates most of the Medicaid program with a single state controlled MCO.

 

Eligibility

TBD

Recommended referral action

TBD

 

 

Program Name

Foundational Community Supports (FCS) for supportive housing and supportive employment services.

Delivery System

The state is using a Third-Party Administrator to manage the program.  Amerigroup won a competitive bid for this contract.  Amerigroup is now called Wellpoint.

Wellpoint Provider Manual

Eligibility

FCS referral guide
 
18 and older Medicaid eligible
 
(1) assessed health needs-based criteria
 
(1) risk factor including homelessness

Recommended referral action

Submit the Foundational Community Supports Referral Form to the Third-Party Administrator, Wellpoint

 

Web Resources

State Program Website