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Define the Services in Supportive Housing

Understanding the evidence-based services included in a successful supportive housing models can guide state strategies for covering the full range of pretenancy and tenancy support.

Supportive Services Housing45

Tenancy Support46

  • Intake;
  • Income eligibility;
  • Health insurance eligibility;
  • Needs assessment;
  • Development of housing plan;
  • Housing search;
  • Housing applications;
  • Landlord engagement;
  • Deposits;
  • Eviction prevention;
  • Obtaining furniture, household items;
  • Case management/care coordination;
  • On-site monitoring; and
  • Housing respite.
Supportive Services Health, Well-Being and Community

Health Care

  • Medical respite
  • Referrals to or provision of:
    • Primary care;
    • BH;
    • Substance use services;
    • Medication management;
    • Vision; and
    • Dental.
  • Documentation and application for:
    • Disability47; and
    • Health insurance.
  • Accompanying tenant to appointments:
    • Transportation to medical appointments;
    • Pain management; and
    • Palliative care.
  • Case management/care coordination.

Behavorial Health

  • Assertive Community Treatment for high
    mental health MH/SUD-needs populations;
  • Intensive case management for mild to
    moderate MH/SUD needs populations;
  • Mobile crisis services including peer-based crisis;
  • Peer support services;
  • Psychosocial rehabilitative services (e.g., supported employment, skill building
    interventions, community supports);
  • Nonemergency medical transportation;
  • Medication services including medication
    management and reconciliation;
  • SUD services (e.g., medication-assisted
    treatment for opioid dependence);
  • Individual and group therapies (e.g. integrated dual disorders treatment,
    illness management and recovery); and
  • Case management/care coordination.

Referrals to Social Support

  • Employment supports;
  • Apprenticeships;
  • Education supports;
  • Nutrition education, including grocery shopping;
  • Legal services;
  • Budgeting and finances;
  • Documentation and application for food stamps;
  • Family counseling, mediation;
  • Crisis management;
  • Transportation (job-related);
  • Access to child care;
  • Activities of daily living; and
  • Case management/care coordination.

*Note: This list is not exhaustive but rather intended to serve as an example of the most commonly offered services. For more information on supportive housing, see: https://www.usich.gov/solutions/housing/supportive-housing

Key Considerations

  • Would any of these services not be reimbursable under the proposed Medicaid waiver or state plan amendment?
  • If requiring MCOs to provide these services, which services would be considered an administrative versus direct medical expense?
  • In order for states to more clearly define the full range of pretenancy and tenancy support services covered through the
  • Medicaid program, consider listing them as their own services within the Medicaid waiver or state plan amendment.48