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Biden-Harris Administration Partners with States to Address Homelessness

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HHS and HUD’s Accelerator Program will Help States Expand Services to Make it Easier for People with Complex Medical Needs to Get and Keep Stable Housing

The U.S. Department of Health and Human Services (HHS) and Department of Housing and Urban Development (HUD) are announcing that eight states and the District of Columbia (DC) have been selected to participate in a new federal initiative, known as the “Housing and Services Partnership Accelerator” (Accelerator), to help strengthen partnerships across housing, disability, aging, and health sectors; access available federal programs and resources, and maximize federal flexibilities to help keep people healthy.

The Accelerator will help eight states and DC unlock critical resources to reduce homelessness by addressing health-related social needs, such as housing-related services. The program provides technical assistance to states implementing HHS’ recently issued guidance regarding clinically appropriate and evidence-based services that can be covered under Medicaid and the Children’s Health Insurance Program (CHIP). For example, states can support health care access through Medicaid section 1115 demonstrations that provide services like housing transition services and case management that helps people avoid lease violation. In addition, states can provide services that connect people to HUD housing programs by covering short-term housing costs, like security deposits and rental application fees, for specific transitions.

“Nobody in America should experience homelessness. Today we are taking important steps to help communities better access HHS’ programs to address homelessness and connect people with housing-related services and supports – which could be life changing,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration has worked tirelessly to help people experiencing homelessness to provide needed services and supports that help them maintain that housing. We will continue to work on strengthening partnerships across housing, disability, aging, and health sectors and do everything we can to prevent and address homelessness.”

“Since Day One of the Biden-Harris Administration, HUD has worked to not only expand the availability of housing assistance, but to ensure people experiencing homelessness have access to supportive services so they can permanently transition to housing,” said HUD Secretary Marcia L. Fudge. “We are proud to partner with HHS and Secretary Becerra to take that work even further.”

The Accelerator was announced by HHS and HUD in November 2023 as a competitive technical assistance opportunity for states. States with approved federal Medicaid section 1115 demonstrations or section 1915(i) state plan amendments covering housing-related support services for people experiencing or at-risk of homelessness when clinically appropriate were eligible to apply. As part of their Accelerator application, states were asked to form collaborative teams comprised of partners from their health, housing, and aging and disability sectors, and outline the status of their implementation of Medicaid-covered housing-related services and supports, their goals under the Accelerator, and areas where technical assistance was needed.

HHS and HUD received an overwhelming response with applications from fifteen eligible states and DC. A rigorous review and scoring process, including interviews with state teams, led to the final selection of the following states:

  • Arizona
  • California
  • District of Columbia
  • Hawaii
  • Maryland
  • Massachusetts
  • Minnesota
  • North Carolina
  • Washington

Over the next twelve months, HUD and HHS will provide these eight states and DC with intensive federal technical assistance and opportunities for state peer-to-peer exchange to support their implementation of clinically-indicated housing-related services and supports under their Medicaid programs for people with complex health needs experiencing or at-risk of homelessness, including people with disabilities, older adults, people with mental health disorders, people with substance use disorders, and people with other chronic medical conditions.

By receiving this federal technical assistance, these states can improve coordination and delivery of services like navigation services, ongoing individualized case management, one-time transition assistance, and home modifications that can help people experiencing or at-risk of homelessness to obtain and maintain stable housing. Synopses of each state’s areas of focus and goals under the Accelerator can be found here.

The Housing and Services Partnership Accelerator helps fulfill a federal commitment to “scale housing and supports that meet demand” made in All In: The Biden Administration’s Federal Strategic Plan to Prevent and End Homelessness, which was developed by the United States Interagency Council on Homelessness (USICH) with input from stakeholders across the U.S., including people with lived experience of homelessness. Secretary Becerra serves as Chair of USICH and has made expanding supportive services to prevent and address homelessness a priority.

Last week, HUD announced $3.16 billion in funding to fund 7,000 housing and services projects for people experiencing homelessness – the largest expansion of annual federal funding provided through HUD’s Continuum of Care program in history. In November 2023, HHS, through the Centers for Medicare & Medicaid Services (CMS), published guidance (PDF | 266 KB) and a framework (PDF | 386 KB) clarifying the flexibilities available to states under their Medicaid section 1115 demonstrations or 1915(i) state plan amendments to cover services to help meet eligible enrollees’ health related social needs like housing and nutrition, and to receive federal matching funds for their Medicaid expenditures on those services when clinically indicated. The Accelerator will provide tailored support to the selected eight states and DC who are early adopters of these flexibilities.

States not selected to participate in the Accelerator may apply to participate in a related technical assistance opportunity, the National Academy for State Health Policy’s Health and Housing Institute (HHI) , funded by HHS through the Health Resources & Services Administration. Now in its third year, the HHI also supports states pursuing cross-agency and federal-state-local strategies to increase access to safe, affordable housing and wrap-around services and supports for people experiencing homelessness or housing instability. Applications for the HHI are due on February 13, 2024.

Later this year, HHS, HUD, and USICH will host an in-person convening for the eight states and DC participating in the Accelerator, states that applied but were not selected for the Accelerator, states participating in the HHI, and the seven communities participating in USICH’s ALL INside initiative to address unsheltered homelessness to share and discuss their efforts to align housing, health, and supportive services to address and prevent homelessness.

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The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

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