United States Interagency Council on Homelessness - No on should experience homelessness. No one should be without a safe, stable place to call home.
October 22, 2013

By Barbara Poppe, Executive Director of the US Interagency Council on Homelessness Barbara Poppe


October 1st was an important day as the first day of open enrollment in private insurance through the health insurance marketplaces and in Medicaid in the states that are expanding. But it's also important to remember that this is only the beginning, not the end, of the road to health care transformation. The Affordable Care Act won't bring about changes to our nation's approach to health care overnight, nor will it fix everything in our nation's approach to health care. But it's an important first step. 


These changes won't happen by themselves either. The Affordable Care Act is a tool, but a tool is only as good as its user. It will take our collective efforts to help implement the law and fully leverage it to end homelessness. 


So how can we make the best use of the Affordable Care Act to solve homelessness? I share five questions for your consideration in my blog. 



New Medicaid Opportunities to Pay for the "Support" in Permanent Supportive Housing

As much as a flexible "do whatever it takes" approach to case management and supportive services is essential to permanent supportive housing's success for people experiencing chronic homelessness, it is also very difficult to finance. Providers have often had to patch together multiple streams of public and private funds-each with different eligibility and coverage rules-in order to provide the "support" in supportive housing. Funding these services often feels like solving a complex mathematical equation, where providers have to solve for multiple variables at once. 


Through changes under the Affordable Care Act, providers may finally have found a solution to that equation: Medicaid.  With states having the choice to expand Medicaid eligibility, more people experiencing chronic homelessness may be eligible for Medicaid. At the same time, the Affordable Care Act is shifting the focus of Medicaid to "whole person" health needs rather than just medical and physical health needs. This means that states will have incentives to pay for things like case management and behavioral health services under Medicaid, alongside hospital stays, doctor's visits, and prescription drugs. 


So what can providers of permanent supportive housing do to tap Medicaid as a way to pay for the services in permanent supportive housing?  Four emerging and exciting trends offer some ideas. 


How Medicaid Expansion Will Help People Experiencing Homelessness 


By Jack Tsai, Assistant Professor of Psychiatry, Yale University School of Medicine
Many states are still opting out or remain undecided about whether to participate in Medicaid expansion. One factor these states might consider in evaluating or re-evaluating their decision to participate is the impact of Medicaid expansion on homelessness in their state.


But the benefits don't stop there. State budgets, hospitals, health care providers, and Americans in general also stand to gain from Medicaid expansion.  



Affordable Care Act Resources  
We know that the ACA is a game changer in our nation's effort to end homelessness. But how can you capitalize on the new opportunities? Check out these resources USICHhealthcare.gov and our council member agencies have created to help you navigate the new system. 
Visit www.usich.gov and marketplace.cms.gov for the latest information and resources on the Affordable Care Act. 

US Labor Department awards nearly
$24 Million in Pay for Success grants 
Seal of the Dept. of Labor The U.S. Department of Labor announced nearly $24 million in Workforce Innovation Fund grants to pilot the Pay for Success program, a new model of financing social service programs to help federal, state and local governments ensure that public funds only go to programs that achieve positive, measurable outcomes. Under this model, independent investors provide the financial capital to cover the operating costs for the programs, and the Department of Labor disperses funds when and if those programs demonstrate that they have achieved the targeted outcomes. 

Two grants were awarded: one to the New York Department of Labor in the amount of $12,000,000 and the other to the Massachusetts Executive Office of Labor and Workforce Development in the amount of $11,670,000. These grants will support programming that aims to increase employment and reduce recidivism among formerly incarcerated individuals.



Social Security Administration Clarifies Identification Requirements
The Social Security Administration (SSA) has made some recent changes to its identification requirements for individuals seeking a printout of their Social Security Number. USICH and SSA have received many questions and concerns regarding the impact of these new requirements of people experiencing homelessness, because of their difficulty obtaining forms of photo identification.  In response to these questions, SSA has provided clarification of its requirements. 

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By Mike Nardone, Principal, Health Management Associates

The unprecedented changes now unfolding in the health care marketplace present supportive housing providers with opportunities to strengthen linkages with health care payers. 


The expansion of Medicaid coverage under the Affordable Care Act (ACA) will mean that millions of currently uninsured adults will be eligible for coverage, including many formerly homeless individuals residing in supportive housing.


Likewise, the ACA encourages new models of health care delivery focusing on the "Triple Aim" of improving health outcomes, improving the patient care experience, and reducing health care costs.




The Day that Really Matters for the ACA
Richard Cho
By Richard Cho, Policy Director, USICH

There's been a lot of attention lately on certain dates in the implementation of the Affordable Care Act, not least of which has been the first of October, when enrollment opened for health insurance and Medicaid through the Affordable Care Act's new health insurance marketplaces. 
There's no doubt that October 1st was an important date. At the same time, I think too much of the wrong kind of attention has been placed on that single day. It's not as if it's the only date that matters.  

Upcoming Events

December 21, 2013
National Homeless Person's Memorial Day
More Information




March 12-14, 2014
Housing First Partners Conference
Swissotel, Chicago 

March 27-28, 2014

CSH Eastern Regional Supportive Housing Conference
DoubleTree Philadelphia City Center

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