U.S. flag

An official website of the United States government

Homelessness Initiatives

Advancing Access to Affordable Housing as a Means to Maximize Opportunities for Community Living

In support of President Obama’s Year of Community Living initiative, the Departments of Health and Human Services (HHS) and Housing and Urban Development (HUD) furthered their collaborative efforts and identified another initiative to increase the availability of affordable and accessible housing for people with disabilities who receive long term services and supports in the community funded by Medicaid.

On September 30, 2011, the Centers for Medicare & Medicaid Services (CMS) announced the award of $1,980,000 in grants to six states to develop sustainable partnerships with state housing agencies under the Real Choice Systems Change Grant Program. These grants will result in long-term strategies to provide permanent and affordable rental housing for people with disabilities who receive Medicaid services, who are homeless and participants under the CMS Money Follows the Person demonstration.

Updating Medicaid Information Relevant to Homeless Individuals

In conjunction with the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE), CMS has updated two reports. Both reports examine the use of Medicaid to cover services for individuals experiencing chronic homelessness, particularly in Permanent Supportive Housing (PSH). The Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants in Permanent Supportive Housing provides a “how-to” guide on the various ways that Medicaid can cover such services, including the Medicaid authorities and new options provided under the Affordable Care Act. The Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field describes existing practices in the field of communities currently serving homelessness and formerly homeless individuals Medicaid beneficiaries.

In anticipation of changes stemming from the Affordable Care Act, HHS, ASPE, contracted with Abt Associates in October 2010 to conduct a study to explore the roles that Medicaid, Health Center, and other HHS programs might play in providing services for people who had experienced chronic homelessness before moving into permanent supportive housing (PSH). 

This study examined the intersection of three pieces of a complex puzzle that if assembled correctly can end chronic homelessness:

  • Chronic homelessness itself
  • Permanent supportive housing
  • Medicaid's potential to fund health-related services for people experiencing chronic homelessness or living in PSH