People who experience chronic homelessness often also struggle with serious mental illness, substance use disorders, physical and mental disabilities, and chronic medical conditions. These individuals, many of whom are eligible for Medicaid, are more likely to frequently visit emergency departments and, as a result, often have high annual health care expenditures. Policymakers are increasingly focused on more cost-effective opportunities to address the housing and health care needs of this high-risk population.

In July 2015, the Center for Health Care Strategies (CHCS) convened state Medicaid officials; federal policymakers from the Department of Health and Human Services, the Department of Housing and Urban Development, the Office of Management and Budget, and the United States Interagency Council on Homelessness; and experts in the fields of managed care, housing, and homelessness to address this issue. The discussion, made possible by the California HealthCare Foundation, the Conrad N. Hilton Foundation, and the New York State Health Foundation, sought to identify strategies for expanding access to housing for Medicaid beneficiaries who are chronically homeless. Drawing on insights from the session, this brief highlights key opportunities for Medicaid programs to better address the housing needs of these individuals.

The brief outlines eight key strategies and practical action steps to help states advance supportive housing options. It can inform states that are seeking ways to use Medicaid funding for essential housing-related services.

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