Housing and health are deeply intertwined. Poor physical health and mental health issues are a driving cause of unemployment, poverty, and ultimately, homelessness. Given the close connection between these two challenges, CMS has recently begun to view housing as a healthcare issue that can be addressed through Medicaid-funded programs. Now, more states, providers, and managed care plans are exploring solutions in Medicaid to help individuals get the care they need to secure housing.
We recently sat down with Senior Strategic Advisor of Sellers Dorsey and former Arizona state Medicaid Director, Jami Snyder, to discuss housing challenges in relation to social determinants of health and how innovative Medicaid funding can provide solutions.
Q: What is the biggest challenge you’ve faced as you work to address housing issues?
JS: The biggest challenges are connecting with and understanding the needs of community-based housing organizations. Many of the organizations haven’t engaged with Medicaid and are not interested in becoming a Medicaid provider or billing for services. However, they are interested in accessing funding available for transitional housing approved as a part of the state’s 1115 waiver. Additionally, there’s a lack of affordable housing in communities around the country. According to the National Low-Income Housing Coalition, in the U.S. there is a shortage of more than 7 million affordable homes for our nation’s 10.8 million plus low-income families. This is a pervasive issue and the gap continues to widen.
Q: With a nod to “right place, right time, right approach,” what’s the smartest point of entry to address these issues? Where do you start?
JS: The ability to fund “street outreach” is critical. Historically, Medicaid programs have not been able to reimburse for outreach to individuals experiencing homelessness. More recently, a handful of states have received approval to fund street-based outreach, which is critical to engaging some of the most vulnerable individuals served by the Medicaid program and ultimately ensuring they are connected to permanent, supportive housing. Street outreach seeks to build trust and ease barriers to care by meeting people experiencing homelessness exactly where they are with the goal of increasing utilization of preventive services and ensuring appropriate follow-through on care.
Q: What obstacles have you encountered along the way?
JS: Connecting with and understanding the needs of community-based housing organizations has certainly been an obstacle. Additionally, there are challenges associated with the availability of affordable housing. Plus, challenges associated with landlords’ willingness to rent to individuals using housing subsidies. There are also difficulties related to data sharing between Medicaid, housing-focused organizations, and other key partners.
Q: Where has your organization made the biggest investment to tackle these mission-critical challenges? And where do you feel you’ve made the biggest impact?
JS: The strategy to address housing challenges is rooted in a multi-faceted approach, combining both regulatory and operational initiatives. Here’s a breakdown of the Arizona Health Care Cost Containment System’s (AHCCCS’ – Arizona’s Medicaid program) key investments and the significant impact we’ve achieved:
Bonus Question – How has the team at Sellers Dorsey supported its clients in their efforts to address beneficiaries’ health-related social needs?
JS: Impact is a key focus of Sellers Dorsey. Part of the Firm’s mission is to partner with our clients to deliver innovative solutions that enhance equity, access, and quality in the Medicaid program. The team at Sellers Dorsey understands that initiatives that seek to address individuals’ foundational needs related to housing, employment stability, food security, and educational attainment are critical to eliminating health disparities and improving member health outcomes.
Click here to learn more about Jami’s Medicaid financing and consulting experience.