A Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants in Permanent Supportive Housing. 8.3. The Need for Flexible Funding and the Role of Local Public and Private Funders


Additional flexible funding is essential to achieve better results for both Medicaid beneficiaries and state Medicaid programs. Medicaid reimbursement can pay for many of the services needed by people with disabilities experiencing chronic homelessness or living in PSH, as well as services that help people experiencing chronic homelessness access housing assistance. But Medicaid will not be able to cover all the activities needed to truly stabilize this population's health conditions and housing situations. To engage some very vulnerable people, including those who have significant untreated mental health or substance use disorders who may be reluctant to seek the care they need, and to support stabilization, it is critically important to have funding that is flexible enough to allow programs truly to do "whatever it takes."  Such funding may come from states, local governments, foundations, and other sources. In addition to Medicaid reimbursement for covered services, other support from public and private funders helps to pay for many of the services and supports without which people cannot get and keep housing.

As states take on the many administrative tasks related to Medicaid eligibility expansion, expanded partnerships with Medicaid managed care plans, and the design and implementation of new types of Medicaid benefits, support from private funders can support the planning, data analysis, and stakeholder engagement that contribute to innovation. In some states, foundations have provided funding to match or leverage state funding commitments that qualify for matching federal funds through the Medicaid program. In other cases, foundation funding has supported data analysis and planning for a state's Medicaid waiver proposal and the design and implementation of new covered benefits.

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