As data continues to grow showing the cost-saving virtues of permanent supportive housing, advocates in the state of Washington are advancing a proposal to create a new Medicaid benefit that would contribute to the cost of permanent supportive housing with the goal of helping to end chronic homelessness.
The Washington Low Income Housing Alliance (the Housing Alliance), an NLIHC State Coalition Partner, recently joined with the Corporation for Supportive Housing and the Washington State Chronic Homeless Policy Academy to produce Creating a Medicaid Supportive Housing Services Benefit: A Framework for Washington and Other States. The report explores the benefits of permanent supportive housing and describes the types of services that could potentially be covered by Medicaid, newly expanded by the Affordable Care Act (ACA). The recommendations of the report will inform a new statewide advocacy campaign in the upcoming legislative session.
The annual point in time count found that there were 6,289 homeless people living outside of shelter in Washington in 2014. While there are numerous permanent supportive housing programs throughout the state, funding for them is not adequate to meet the need. To end chronic homelessness, advocates are looking to new revenue through ACA Medicaid expansion.
According to HUD’s definition, chronic homelessness includes people who have a disabling condition, and have been homeless four times in the previous three years or continuously homeless for longer than one year. Many people who are chronically homeless have significant barriers to accessing and maintaining housing, such as addictive disorders, mental illness, or physical disability.
Most chronically homeless individuals have difficulty reliably accessing medical treatment, leading to expensive and inefficient over-reliance on emergency medical services and avoidable hospitalizations. According to the Housing Alliance’s report, the top 10% of adult Medicaid beneficiaries from the state’s chronically homeless population had an average annual healthcare cost of $33,459 per person in 2012.
Providing supportive services can lead to housing stability, better health outcomes, and reduced costs to public systems. The ongoing care coordination, housing-based case management, and intensive housing support services provided by permanent supportive housing have consistently shown savings in public services budgets. According to advocates, permanent supportive housing can provide better health results at one-third of $33,459 per person.
“It seems every analysis of permanent supportive housing demonstrates there is incredible cost savings to public services when people have access to ongoing support in their own homes,” said Rachael Myers, the Housing Alliance’s Executive Director. “The high costs for emergency medical services and interactions with the criminal justice system are inefficient and unnecessary. More permanent supportive housing just makes sense.”
The ACA is creating new space for advocacy on homeless issues across the nation. For example, ACA Medicaid expansion can be used to address chronic homelessness by providing capital funding to build new healthcare facilities for chronically homeless individuals and families, or to provide mental and physical health evaluations that support claims for disability income.
The Housing Alliance is finalizing their campaign to build support in the state legislature for the idea of creating a new Medicaid benefit for permanent supportive housing. The coalition to advance the new Medicaid benefit is already coming together. Key stakeholders from the homelessness and health care advocacy communities will be working to mobilize their field of advocates in support of the new effort.
“A Medicaid benefit for supportive services can be a game changer,” said Kate Baber, Homelessness Policy and Advocacy Specialist at the Housing Alliance. “We are going to need a broad coalition of advocates educating and influencing their representatives."
For more information, contact Kate Baber at firstname.lastname@example.org.
Creating a Medicaid Supportive Housing Services Benefit: A Framework for Washington and Other States is at http://bit.ly/1x9c7e9.