People experiencing chronic homelessness often need a broad array of health and behavioral health services to help them succeed in housing and to achieve individual health outcomes. For many, Medicaid did not figure largely as a source of financial support for these services because, until January 1, 2014, many of these people were not eligible for Medicaid. Most are single adults between the ages of 18 and 64; unless they had qualified for SSI on the basis of disability, most would not have met the criteria that would have placed them in an eligible category, with the consequence that most Medicaid providers would not have developed experience in meeting their needs.
Because most people experiencing chronic homelessness are new to Medicaid, as well as to Medicaid managed care plans and many Medicaid providers, this Primer has been developed to describe the opportunities available for delivering the most effective service approaches. It offers information to state Medicaid officials and service providers working with people experiencing chronic homelessness that is designed to help them adopt the most innovative and successful strategies currently in the field for helping this population improve its health conditions, reduce costly and avoidable hospitalizations and emergency room visits, and leave homelessness.
The remainder of this introductory chapter sets the scene for the Medicaid-related strategies described later in the Primer. It briefly describes the population of interest--people who have experienced chronic homelessness--including the complexities of their health and behavioral health conditions. It notes a growing body of evidence that PSH may save Medicaid money, as the services available through this housing model help homeless users of expensive crisis care reduce such use after becoming stably housed.