A Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants in Permanent Supportive Housing. 5.1. Federally Qualified Health Center Services


Health Centers and HCH programs often provide services that can be linked to housing assistance for people who experience chronic homelessness. Some organizations operate Health Centers that receive Medicaid reimbursement as FQHCs and also develop and operate affordable housing and PSH, using other sources of funding to pay for housing costs. Other FQHCs establish collaborative partnerships with housing providers, or help their clients obtain housing assistance administered by public housing authorities or other agencies. FQHCs deliver services to PSH tenants through one or more of the following models:

  • Deliver on-site services through home visits to PSH tenants or satellite clinics located in PSH buildings.

  • Operate a clinic that is easily accessible by PSH residents and designed to meet their needs.

  • Partner with a mental/behavioral health service provider to create a mobile, multi-disciplinary team of primary and behavioral health care providers that conducts outreach to vulnerable people and delivers integrated care to people experiencing homelessness and residents of scattered-site PSH.

  • Engage "frequent users" of emergency room care and people experiencing homelessness who are being discharged from hospitals and link them to permanent housing through partnerships with housing providers.

Health Centers may use multiple financing mechanisms to develop the capacity to offer a range of services to people with complex needs, including federal grant funding from HRSA, as well as Medicaid payments for services that can be reimbursed through the FQHC mechanism (described in Chapter 7) and obtaining certification to provide mental health or substance abuse treatment services in programs that may be reimbursed separately through state or county contracts, managed care plans, or separate Medicaid payments for covered behavioral health services.

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