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Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals


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It is always a challenge to assemble the resources to sustain supportive housing tenants in their housing, due to long histories of homelessness and complex health and behavioral health conditions.  Current strategies in the United States for financing supportive services are far from optimal.  Funding for homeless, behavioral health and other health care services currently in use is often fragmented across many public sector programs and agencies and the non-profit service providers they support.

The hardest element of care to fund is “the glue” that holds them all together in the service of providing PSH tenants with holistic care. “The glue” includes:

  • Early activities to induce prospective tenants to accept housing and stabilize new tenants in housing and to engage them in the services and supports that will address their health, mental health, and addictions problems.
  • Care coordination, including planning, involving staff able to offer all the different services needed, assuring regular consideration by team members of the tenant’s well-being and challenges to it, and, most of all, establishing a relationship of trust, openness, and support with each tenant.
  • Team-building with support staff from multiple disciplines, training, and agency affiliation, independent of handling individual cases, including cross-training. Making this happen often requires external influence to bring the relevant parties together and keep them together.

This document, from the U.S. Department of Health and Human Services’ Environmental Scan, reflects existing published and unpublished literature on permanent supportive housing (PSH) for people who are chronically homeless. 

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Showing 1 reaction

  • Terrence Alexander
    commented 2019-10-12 13:22:41 -0400
    I have a question.

    Was Medicaid expanded for payment of additional services to help the Homeless?

    Why are case managers here in Los Angeles, California not aware of the above mentioned Medicaid expansion?

    What should I do to address this serious issue?

We joined Funders Together because we believe in the power of philanthropy to play a major role in ending homelessness, and we know we have much to learn from funders across the country.

-Christine Marge, Director of Housing and Financial Stability at United Way of Greater Los Angeles

I am thankful for the local partnerships here in the Pacific Northwest that we’ve been able to create and nurture thanks to the work of Funders Together. Having so many of the right players at the table makes our conversations – and all of our efforts – all the richer and more effective.

-David Wertheimer, Deputy Director at Bill & Melinda Gates Foundation

Very often a lack of jobs and money is not the cause of poverty, but the symptom. The cause may lie deeper in our failure to give our fellow citizens a fair chance to develop their own capacities, in a lack of education and training, in a lack of medical care and housing, in a lack of decent communities in which to live and bring up their children.

-President Lyndon B. Johnson, 1964 State of the Union Address

Funders Together has given me a platform to engage the other funders in my community. Our local funding community has improved greatly to support housing first models and align of resources towards ending homelessness.

-Leslie Strnisha, Vice President at Sisters of Charity Foundation of Cleveland

Our family foundation convenes local funders and key community stakeholders around strategies to end homelessness in Houston. Funders Together members have been invaluable mentors to us in this effort, traveling to our community to share their expertise and examples of best practices from around the nation.

-Nancy Frees Fountain, Managing Director at The Frees Foundation

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