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Linking Medicaid and Supportive Housing: Opportunities and On-the-Ground Examples

Introduction
  1. Healthy People 2020 Topics and Objectives: Social Determinants of Health, Office of Disease Prevention and Health Promotion, https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health. Also, Healthy People 2020: An Opportunity to Address the Societal Determinants of Health in the United States, Secretary’s Advisory Committee on Health Promotion and Disease Prevention Objectives for 2020, U.S. Department of Health and Human Services, July 26, 2010, http://www.healthypeople.gov/2010/hp2020/advisory/SocietalDeterminantsHealth.htm

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  2. What Housing-Related Services and Supports Improve Health Outcomes among Chronically Homeless Individuals? Rapid Evidence Review, 2016, AcademyHealth, http://www.academyhealth.org/files/publications/files/publications/RER%255FHomelessness%255FHousing%255F2016%255FFinal.pdf

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Issue Brief
  1. Buchanan D et al., “The Health Impact of Supportive Housing for HIV-Positive Homeless Patients: A Randomized Controlled Trial,” American Journal of Public Health 99 (Supplement 3), November 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774195/; and Reid K et al., “Association between the Level of Housing Instability, Economic Standing and Health Care Access: A Meta-Regression,” Journal of Health Care for the Poor and Underserved 19.4, November 2008, http://search.proquest.com/docview/220586779/fulltextPDF/874CBF1D7D4F4CC0PQ/1?accountid=39486

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  2. Raven M et al., “Medicaid Patients at High Risk for Frequent Hospital Admission: Real-Time Identification and Remediable Risks,” Journal of Urban Health 86(2), March 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2648879/

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  3. Maqbool N et al., The Impacts of Affordable Housing on Health: A Research Summary, Center for Housing Policy, April 2015, http://www2.nhc.org/HSGandHealthLitRev_2015_final.pdf

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  4. Op. cit., Buchanan et al. Wollitski R et al., “Randomized Trial of The Effects of Housing Assistance on the Health and Risk Behaviors of Homeless and Unstably Housed People Living With HIV,” AIDS Behavior 14(3), June 2010, https://www.ncbi.nlm.nih.gov/pubmed/19949848

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  5.  Martinez T and M Burt, "Impact of Permanent Supportive Housing on the Use of Acute Care Health Services by Homeless Adults," Psychiatric Services 57(7), July 2006, https://www.ncbi.nlm.nih.gov/pubmed/16816284; Sadowski L et al., “Effect of a Housing and Case Management Program on Emergency Department Visits and Hospitalizations among Chronically Ill Homeless Adults,” Journal of the American Medical Association 301(17), May 6, 2009, https://www.ncbi.nlm.nih.gov/pubmed/19417194; and Home &Healthy for Good - Permanent Supportive Housing: A Solution-Driven Model, January 2016 Progress Report, Massachusetts Housing and Shelter Alliance, http://archives.lib.state.ma.us/bitstream/handle/2452/393621/ocn887735103-2016.pdf?sequence=1&isAllowed=y

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  6. CMCS Informational Bulletin: Coverage of Housing-Related Activities and Services for Individuals with Disabilities, Centers for Medicare and Medicaid Services (CMS), June 26, 2015,  http://www.medicaid.gov/federal-policy-guidance/downloads/CIB-06-26-2015.pdf.

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  7. Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field, August 2014, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, https://aspe.hhs.gov/sites/default/files/pdf/77116/EmergPrac.pdf

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  8. Medicaid Health Homes: An Overview, Fact Sheet, CMS, September 2016, https://www.medicaid.gov/state-resource-center/medicaid-state-technical-assistance/health-homes-technical-assistance/downloads/hh-overview-fact-sheet-sep-2016.pdf

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  9. Smith V et al.,  Implementing Coverage and Payment Initiatives: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2016 and 2017, October 13, 2016, http://kff.org/medicaid/report/implementing-coverage-and-payment-initiatives-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-years-2016-and-2017/

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Appendix
  1. See, for example, the Whole Person Care Pilots included in California’s “Medi-Cal 2020” section 1115 demonstration waiver, available at http://www.dhcs.ca.gov/services/Pages/WholePersonCarePilots.aspx. These pilot target particularly vulnerable groups of Medi-Cal beneficiaries who have been identified as high users of multiple systems and continue to have poor health outcomes. They involve collaborative leadership and systematic coordination among public and private entities, which may include housing entities, with the goal of providing comprehensive coordinated care for the beneficiary resulting in better health outcomes.

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