Why Homeless Advocates Should be Optimistic about 2014

written by Lisa Stand
January 27, 2014

Judging by early developments in 2014, those of us who are working to end chronic homelessness have reason to be optimistic. In addition to Medicaid eligibility expanding in about half the states, which will give vulnerable people access to health care and bring more safety net resources to communities, the new year ushered in a pair of promising news items.

First, a targeted homeless program in New York City released early results of its studies showing how Permanent Supportive Housing (PSH) can reduce public costs of caring for chronically homeless people with severe mental illness, substance use disorders, and other disabling conditions.

The findings of the New York/New York III Supportive Housing Evaluation revealed that the city saved an average of $10,000 per person annually when it offered permanent housing and supportive services to nine specific subpopulations, including individuals and families affected by behavioral health conditions or HIV/AIDS.

Its findings also showed how PSH strategies can help states and communities manage costs by avoiding or reducing inpatient psychiatric stays or treating physical health conditions. With this kind of evidence, it’s no wonder the new governor of New York is proposing more PSH solutions in his budget for next year.

Second, the federal Medicaid program issued a final rule that clarified how PSH programs can help tenants access Medicaid long-term services and supports. Such supports, including housing transition services, can make a significant difference in addressing chronic homelessness.

Similar to guidance issued last year by the Department of Housing and Urban Development, the Medicaid rule is intended to promote the rights of people with disabilities to receive publicly-funded services as fully integrated community members.

These two developments should add momentum to strategies to end chronic homelessness, as outlined in Opening Doors, the federal strategic plan created in 2010 by the U.S. Interagency Council on Homelessness. That plan recognizes the significant potential of the Medicaid expansion along with other provisions of the Affordable Care Act (ACA) in making PSH an effective intervention.

Of course, there is a still a long way to go, and much to do. As ACA implementation continues, homeless advocates have three tasks ahead of them:

  1. Join other voices calling for Medicaid expansion in all states;
  2. Inform and participate in community efforts to enroll every eligible homeless person in Medicaid; and
  3. Lead efforts to integrate effective housing strategies with community-based health care delivery.