Medicaid for Services Update

Two weeks ago I wrote a blog post titled "Medicaid -- A Path to Housing & Services." In that post I explained how California is asking the federal government for permission to use Medicaid funds contributed by Uncle Sam to pay for rental assistance for the most medically fragile and vulnerable people facing homelessness. California, New York, Massachusetts and some other states already use federal Medicaid funding/reimbursement to help cover the services so critical to making supportive housing work.

Supportive housing successfully keeps people off the streets by creating access to affordable apartments and services -- including healthcare. Not only does it prevent and end homelessness, but supportive housing costs less than what we spend now on emergency, crisis care for those experiencing long-term or recurring homelessness.

Analyses in the three states I mention and elsewhere underscore the facts that supportive housing reduces costs and produces better health outcomes for residents because the stability of being housed with access to services translates into stark reductions in emergency department use, hospital admissions, length of hospital stays, and even days in nursing homes.

This past Friday, the U.S. Centers for Medicare and Medicaid (CMS) amplified this message by issuing an official bulletin encouraging and guiding states to use Medicaid resources, where appropriate, to help provide the services complementing the affordable housing side of supportive housing.

In the words of CMS, the informational bulletin "is intended to assist states in designing Medicaid benefits, and to clarify the circumstances under which Medicaid reimburses for certain housing-related activities, with the goal of promoting community integration for individuals with disabilities, older adults needing long term services and supports, and those experiencing chronic homelessness."

This is timely and welcomed guidance from CMS, and we encourage all states, communities and providers to rely on it to enhance their resources and abilities to provide housing-related services, including housing-retention services, through the opportunities offered by Medicaid.