Funder: Kate B. Reynolds Charitable Trust and the Blue Cross and Blue Shield of North Carolina Foundation

Author: Matthew Ralls, Kathy Moses, and Rob Houston, Center for Health Care Strategies

July 2021 | Brief


Local health departments (LHDs) in rural communities are often the crossroads for key services in resource-deprived settings. They are frequently the first or only providers to offer physical or behavioral health services, resources to expecting or new parents, and health education and outreach programs. This makes LHDs ideal partners to work with stakeholders, including state and local housing authorities, Medicaid managed care plans, and public and private housing developers, in addressing housing needs in rural communities. LHDs can use their experience with Medicaid, as well as their deep ties to the community, to position themselves as key facilitators in identifying and connecting individuals with housing instability to the appropriate services.

This brief is designed to guide LHDs in using Medicaid managed care levers to address homelessness and housing insecurity in rural communities, which can in turn help states improve health outcomes for Medicaid enrollees. While lessons in this resource are informed by the experiences of LHDs in rural North Carolina counties, they can inform other states seeking to reduce homelessness among Medicaid populations. The brief was produced by the Center for Health Care Strategies and the University of North Carolina-Wilmington Center for Healthy Communities, with support from the Kate B. Reynolds Charitable Trust and the Blue Cross and Blue Shield of North Carolina Foundation.