A recent Health Affairs health policy brief, “Medicaid and Permanent Supportive Housing,” highlights a growing interest in the role of state Medicaid programs in addressing homelessness through supportive housing, a model that prioritizes providing affordable housing and optional wraparound services (like case management) to chronically homeless individuals. Findings from the brief echoed those of a recent AcademyHealth Rapid Evidence Review on the impact of housing-related services and supports among chronically homeless individuals. Although the Health Affairs brief includes a greater focus and explanation of states’ policy options, both reports found a promising, if somewhat limited, body of evidence around the impact of supportive housing on the health outcomes of the chronically homeless.

Of the approximately half a million homeless individuals on any given night, about 15 percent, are chronically homeless, defined by the federal government as having “long-term or repeated episodes of homelessness coupled with a disabling condition.” Without access to stable housing, these individuals typically experience a combination of mental, physical, and substance use issues that worsen over time. Supportive housing provides both housing and wraparound health and mental health services but does not require participation in mental illness or substance use treatment. This “housing first” approach has gained significant attention and interest as various states have piloted and evaluated programs involving supportive housing.

The Health Affairs brief provides background on chronic homelessness, describes recent evidence on the impact of supportive housing models, and details the various options states have for covering supportive services included in permanent supportive housing.  AcademyHealth’s Rapid Evidence Review intentionally focuses on recent evidence around the impact of supportive services (such as supportive housing and case management) on health outcomes among the chronically homeless. Both reviews found promising, but limited, evidence that supportive housing is associated with reductions hospital admissions, spending on Emergency Department services, and overall spending on health care services for residents.

Staff

Samantha Smith, M.S.P.H.

Research Associate - AcademyHealth

Samantha Smith is a research associate at AcademyHealth, where she supports the work of the Translation and Di... Read Bio