Affordable Housing Alliance Announces Medicaid Effort Combining Health and Housing

The program was introduced by Kate McEvoy (left), director of the Division of Health Services at the Connecticut Department of Social Services, and Christi Staples (right), New England Director of the Corporation for Supportive Housing, at the Affordable Housing Alliance annual meeting on Wednesday.


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ROCKY HILL — A new Medicaid supportive housing benefit for high-cost, high-need individuals is in the works and will combine affordable housing with social services needs. 

The program, which is in development and may be ready to implement in about six months, was presented by Kate McEvoy, director of the Division of Health Services at the Connecticut Department of Social Services, and Christi Staples, New England Director of the Corporation for Supportive Housing, at the 2019 membership and annual business meeting of the Connecticut Housing Coalition — newly renamed the Affordable Housing Alliance — at the Sheraton Hartford South Hotel on Wednesday morning. 

“We have been very influenced by housing advocates and providers in examining how we can best address the needs of individuals on Medicaid who have very complex presenting health scenarios,” said McEvoy.

She said a pattern repeats itself with some individuals who go to the emergency room, end up in the hospital as in-patient, move to a nursing facility, and then may not meet the standard for a long-term stay in a nursing facility, which can lead to living in unstable conditions.

“We saw people cycling back out into either unstable housing or homelessness in the community. This shows we are not doing enough to integrate and coordinate services,” McEvoy said.

“Supportive housing” combines affordable housing with individualized supports, such as case management, employment supports, daily living skills, social and family connections, and access to medical, behavioral health and substance use care and recovery. 

Gov. Lamont’s proposed coverage of a supportive housing benefit in Connecticut Medicaid was included in the biennial budget enacted by the legislature, she said. 

“We have now the authorization and a new imprimatur to implement a new benefit under the Medicaid state plan in Connecticut that address the cycle that has been occurring for many members served by Medicaid,” she said. 

The program is a federal-state partnership that can be considered sustainable because Medicaid is a stable financing mechanism at the federal level, she said. 

Based on a data match between Medicaid eligibility and any occurance in shelter in the 12-month period from October 1, 2017 to Sept. 30, 2018, the program will benefit up to 850 individuals who experience homelessness and whose average Medicaid costs exceed $40,000 per year. Department of Social Services savings are projected at $580,000 in fiscal 2020 and $3.1 million in fiscal 2021. After factoring in the federal share, total Medicaid expenditures are expected to be reduced by 42.7 million in fiscal 2020 and $13.9 million in fiscal 2021.

After the presentation, Carol Martin, chair of the Affordable Housing Alliance, praised the advocacy and collaboration which made this program possible.

“It’s a really heavy lift, but it’s a huge accomplishment,” she said. “I think the biggest thing I heard today from Christi and Kate is they’re reaching out to everyone — they want this to be successful and there’s no one way to do it.”

Martin said the program may help create more housing units specifically targeted for individuals who need special services, something the state hasn’t done before. 

“Depending on the advocacy, because it’s in the incubation stages, but it might help folks like myself trying to create more housing in our community because it will bring some funding sources,” she said. “Housing is a continuum, there are slivers of populations in the state that are not being served — we’re talking about the hardest to house populations, these folks have the hardest struggles, and for the state to recognize it and create what I’ll call a demonstration program is pretty cutting edge.” 

Housing is essential for mental and physical health but the two concepts are rarely combined, she said. 

“Health is housing and housing is health,” she said. “They’re connected, one without the other is typically not going to work or would put you at greater risk or a greater disadvantage. Housing is really part of healthcare. Folks don’t look at it through that lens.”