This chapter has described specific service models in detail, including examples from case study sites. These include FQHC services, rehabilitation-oriented services, ACT and similar models, case management, housing support services and strong links with housing programs, and diversionary services.
In adapting their Medicaid programs to cover the services that people experiencing chronic homelessness or living in PSH need, it is important for states to attend carefully to the requirements of Medicaid state plan services and other Medicaid programs. It is particularly important that definitions of medical necessity focus on symptoms, functional impairments, and other indicators of need rather than simply on diagnostic categories. New ways of thinking about vulnerability and medical necessity are evolving and incorporating them into state programs can provide greater flexibility to accommodate the needs of people with complex, interacting health and behavioral health conditions that often do not fit neatly into simple diagnostic categories. We turn to these issues in the next chapter.