The National Alliance to End Homelessness, the Technical Assistance Collaborative, and CSH have developed this “how to” guide to help Continuum of Care (CoC) and other service system leaders work with health care systems to explore how Medicaid can finance supportive services in permanent supportive housing. While the strategies may be informative to many audiences, including individual supportive housing providers, this guidance is primarily geared toward individuals who have the authority to work on behalf of the entire CoC or state. It is also geared to those focused on securing housing and ending homelessness.
This guide is organized around five steps, each of which includes concrete ways to get started as well as links to additional resources. These five steps will help you build a case for why and how Medicaid can be structured at the state and local levels to pay for services in permanent supportive housing. When building a case you need to know some basics of Medicaid and the types of services you want Medicaid to cover. In order to convince Medicaid administrators and other health care payers to support your efforts, you need to have evidence of need for and impact of supportive housing and you need a coalition of many stakeholders at your side. The five steps are summarized below and do not need to be taken sequentially.