State Considerations for Provision of Support Services to Affordable Housing Tenants

CMS Announced Medicaid Can Cover Housing Support Services - Now What?

Authors: Betsy Walton, Jason Gerling 

Systematic failures to acknowledge the need for coordinated services between affordable housing units and Medicaid waiver programs results in potential homelessness and increased services expenses that could be avoided. States can receive federal Medicaid funding to provide housing supportive services, and they can achieve significant Medicaid savings, but they must be able to identify beneficiaries at risk of homelessness or at risk of using otherwise avoidable health services and forge new partnerships with housing authorities to coordinate communication, risk assessment, and service delivery. Even though business requirements for integrating Medicaid, social, and housing services are complex, it is possible to develop the critical partnerships needed to stabilize tenancy, avoid homelessness from occurring, and thus avoid unnecessary spending.

This paper explores how Medicaid agencies, Units on Aging and Disabilities, Home and Community Based Service (HCBS), and housing providers can collaborate to assure effective and sustained care delivery in community-based settings. The focus of this paper is specifically on those Medicaid beneficiary tenants in the Department of Housing and Urban Development (HUD) Housing Choice Voucher Program (HUD HCVP) and other subsidized housing programs, including:

  • The unique barriers faced by elderly and disabled HCVP participants
  • How a Medicaid-funded housing support program could address these challenges
  • Program design elements prospective partners must consider to implement housing support roles within existing HCBS systems

Although they offer strong potential for cross-sector benefit, collaborative efforts and formal partnerships pose significant challenges, because affordable housing and Medicaid programs operate under distinct and separate regulatory frameworks.

Betsy Walton



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