Baumohl, J., J.A. Swartz, and R.D. Muck (eds.). 2003. The multi-site study of the termination of Supplemental Security Income benefits for drug addicts and alcoholics. Contemporary Drug Problems , 30(1-2): 1-537.
SSI is extremely important for chronically homeless people now and will continue to be so even after the vast majority of chronically and other homeless people become eligible for Medicaid in 2014. SSI provides income that lets people contribute to rent, thereby greatly increasing the odds that they will become stably housed.
Agencies that serve chronically homeless people might be able to cover many of their health-related costs if their clients were on Medicaid, so one would expect them to routinely help clients qualify for SSI. However, quite a few agencies serving homeless people, including major health care providers such as hospitals, do not mount active campaign
Disabling conditions wholly or partly attributable to drug addiction and alcoholism (DA&A, in SSA terminology) have been controversial since Congress established the SSI program in 1972. Over the more than two decades--from program inception to the end of benefits on January 1, 1997 for people whose substance use was material to their disa
SSA requires that the documentation to establish diagnosis, duration, and disability come from acceptable medical sources, which are usually charts or records made by doctors or letters from doctors detailing the contents of those charts and records. If such evidence is not readily available--and it usually is not to chronically homeless people ac
Homeless people have two compelling reasons to seek enrollment in Supplemental Security Income (SSI): (1) obtaining a reliable income source that will help them afford housing; and (2) increasing their access to appropriate health care through "categorical" eligibility for Medicaid for people who participate in SSI. 1 Housing and health care pr
Agencies providing services to PSH tenants with SMI get the funds to cover service costs from many of the same sources as are used for Groups 1 and 2. Big differences for people in Group 3 include contracts from state and local mental health agencies that are supported by federal block grants or state or local general fund dollars, and the availab
Many PSH tenants who are Medicaid recipients will have qualified because the SSA has determined them to be disabled enough to qualify for SSI, and being an SSI recipient makes them categorically eligible for Medicaid. In some states, chronically homeless people will have qualified for Medicaid and fall into Group 2 because their state offers M
In many communities, some PSH serves all three groups of chronically homeless people--whether or not people are eligible for or enrolled in Medicaid, and whether or not people have a SMI that makes them eligible to receive specialized mental health services. Before we describe the types of housing and services most often available to members of ea
Members of all three groups may receive care and supports in a number of ways. The scope and intensity of supportive services to PSH tenants varies substantially from one provider or community to another, probably almost as much as it varies among members of Groups 1, 2, and 3, although funding limitations make it difficult for PSH programs to off
Supportive services are required during all phases of the persons engagement with PSH. The types of services vary, and are described below.
1.2.1. From First Contact to Moving Into P ermanent Supportive Housing
The supportive services that bring people into PSH have three elements that are conceptually distinct but often happen concurren
For the most part, people living in institutional settings are not homeless, although a growing number of older and vulnerable homeless adults are entering nursing homes or other long-term care facilities, often after a period of inpatient hospitalization for an acute medical and/or psychiatric crisis.
In most states persons with substance use disorders are not eligible for Medicaid enrollment unless they are part of a group with categorical eligibility for another reason. Among chronically homeless people this is most likely to be another disabling health conditions such as SMI, a physical disability or a disabling medical condition. When p
The communities we visited for this project offered excellent examples of collaboration to deliver integrated primary care and behavioral health care services, both among separate organizations and across programs operated by the same organization. Mental health programs and FQHCs can be co-located programs that operate within the same building bu