Chronic Individuals

5.1. Supportive Services Funding for People in

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 5.1. Supportive Services Funding for People in Group 2

People in this group will most likely enter PSH that has been developed by (or in partnership with) a homeless service-provider, a HCH program, an affordable housing developer, or an organization that provides a fairly comprehensive array of social services such as a community action agency. 7 These agencies often provide PSH to people in all t

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 5. Group 2: Eligible for Medicaid But Not for Specialized MENTAL/BEHAVIORAL Health Services

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

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 4.2. What Agencies Are Most Likely to Serve People in Group 1?

Chronically homeless people in this group are often served in PSH that does not deliver Medicaid-reimbursed services, as well as in PSH models (described earlier) that serve homeless people in all three groups. People in this group will not, however, live in PSH that restricts occupancy to people who qualify to receive services funded through stat

4.1. Supportive Services Funding for People in

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 4.1. Supportive Services Funding for People in Group 1

Because they are not eligible for or enrolled in Medicaid, people in Group 1 will most likely receive health care and behavioral health services that will be less intense and less comprehensive than services that are available for people covered by Medicaid. In some cases, PSH service-providers use non-Medicaid funding to offer the same services t

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 4. Group 1: Poor Enough But Not Eligible for Medicaid

Under current conditions, people in Group 1 are often the least well-served among the chronically homeless population in many communities. This group includes some people with very high levels of unmet health needs, because they have limited access to health care or treatment services because they are uninsured, or they may be disaffiliated from f

3.3. Some Supportive Housing Models Serve All

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 3.3. Some Supportive Housing Models Serve All Three Groups of People

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

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 3.2. Where Care is Delivered

Care for people in all groups may occur in a variety of locations in relation to housing: In the clients home--case managers or teams visit clients in their own apartments, whether scattered throughout the community or in buildings dedicated to PSH or mixed-use buildings.

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 3.1. How Care is Delivered

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

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 3. How the Supports in Permanent Supportive Housing Work

2.2. Likelihood of Being in Permanent Supportive

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 2.2. Likelihood of Being in Permanent Supportive Housing

In comparison to group membership in the overall population of chronically homeless people, group membership of tenants in PSH appears to be somewhat skewed toward those in Group 3, although the skew may not be very large in some jurisdictions.

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 2.1. Likely Size of Each Group

These estimates cover a broad range, in part reflecting the different populations surveyed. Variation is also influenced by differences in methods used to collect data and among states or communities in the availability of housing and supports for people with SMI who might otherwise experience long-term homelessness.

2. THREE GROUPS WITHIN THE CHRONICALLY HOMELESS

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 2. Three Groups Within the Chronically Homeless Population

As noted in the Introduction , chronically homeless peoples access to health and behavioral health services varies greatly depending on client characteristics, which in turn affect whether a person is eligible for Medicaid. Because this papers focus is the potential to have Medicaid contribute its resources to the support of people living in

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 1.2. Supportive Service Components

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

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 1.1. Housing Configurations

The housing component of PSH is almost always structured in one of three ways: As projects or buildings in which all units are PSH (dedicated building or site-based model). As apartments scattered around the community in private rental housing (scattered-site model). As buildings in which PSH tenants occupy some, but usually fewer

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. 1. Introduction

People with complex physical and behavioral health conditions are at high risk of losing housing. Once homeless, many make frequent and often avoidable use of emergency rooms and inpatient hospitalization. Their health conditions can usually only be ameliorated if they have a safe, stable, and secure living environment, but their homelessness ofte

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. Highlights

In 2014, nearly all chronically homeless people who are currently uninsured will become eligible for Medicaid, along with millions of other poor people. Homeless people with complex health and behavioral health conditions need a wide range of health and other services and supports if they are to get and keep housing, pursue recovery, manage chroni

Second Phase: Case Studies of New Strategies

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. Second Phase: Case Studies of New Strategies

The second phase of this study involves case studies of six communities that are on their way toward early implementation of the ACAs Medicaid provisions or other Medicaid-related policies and practices designed to deliver care to chronically homeless people. The study will follow the six communities through fall 2012, watching as they design an

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. The Study's First Phase: Literature Synthesis, Environmental Scan, and Site Visits

The chronically homeless people on whom this study focuses have multiple, complex, and interacting physical and behavioral health conditions. Achieving the best results for these clients and the public institutions and systems from which they get care requires effective engagement, service delivery, and care coordination. To understand how this ca

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness. Preface to the Issue Papers

In 2014, most homeless people will become Medicaid-eligible under the Affordable Care Act (ACA) of 2010 based on their low incomes. Many homeless people have complex physical and behavioral health conditions for which they seek care through frequent use of emergency rooms and inpatient hospitalization, at considerable cost in public resources.

Health, Housing, and Service Supports for Three Groups of People Experiencing Chronic Homelessness

This Issue Paper describes three subgroups of the people experiencing chronic homelessness, and the services and housing configurations currently supporting them.

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