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Homelessness & Housing

Stable, affordable, accessible housing represents a key determinant of health and well-being. ASPE conducts work on the intersection of housing and well-being including coordinating HHS's responses to homelessness. 

ASPE research identifies improved care coordination for older adults in affordable housing

ASPE-HUD research has shown that older adults in HUD-assisted housing include a large number of people with chronic health needs and/or high-risk individuals. In general, older adults receiving housing assistance report being in poorer health, having more chronic conditions, and experiencing a higher number of limitations in activities of daily living (ADL) than renters in unassisted housing. The Support and Services at Home (SASH) program in Vermont is a promising approach to providing support services and care coordination to older adults and individuals with disabilities, using affordable housing properties as a platform for service delivery. Under contract from HHS and HUD, RTI International conducted a mixed-methods evaluation of the SASH program. Below are select links to reports from the evaluation:

ASPE-HUD SASH Evaluation
•    SASH Evaluation Highlights from 2010-2016
•    SASH Evaluation Findings, 2010-2016

ASPE is a contributing partner of the new HHS-HUD Housing and Services Resource Center (HSRC). The HRSC implements a federally coordinated approach to providing resources, program guidance, training, and technical assistance to public housing authorities and housing providers; state Medicaid, disability, aging and behavioral health agencies; the aging and disability networks; homeless services organizations and networks; health care systems and providers; and tribal organizations. Visit the new HSRC webpage.

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Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities

February 23, 2012
This Issue Paper describes the ways that Medicaid is being used now and might be used in the future under provisions of the Affordable Care Act of 2010 to serve chronically homeless people. [67 PDF pages]

Public Housing Agencies and Permanent Supportive Housing for Chronically Homeless People

February 23, 2012
This Issue Paper looks at innovative ways that public housing agencies are supporting housing for formerly homeless people in the communities the researchers visited. [29 PDF pages]

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

February 23, 2012
This Issue Paper describes three subgroups of the people experiencing chronic homelessness, and the services and housing configurations currently supporting them. [48 PDF pages]

Establishing Eligibility for SSI for Chronically Homeless People

February 23, 2012
This Issue Paper describes innovative approaches to establishing SSI eligibility. [33 PDF pages]

Design of a Demonstration of Coordinated Housing, Health and Long-Term Care Services and Supports for Low-Income Older Adults

May 10, 2011
This conceptual framework examines the possible ways that housing sites can link health and long-term services and supports, and potential ways that HUD and HHS could design a demonstration of such a model. [31 PDF pages]
Environmental Scan

Medicaid and Permanent Supportive Housing for Chronically Homeless: Literature Synthesis and Environmental Scan

January 5, 2011
This report reflects existing published and unpublished literature on permanent supportive housing (PSH) for people who are chronically homeless. It has a particular focus on the role that Medicaid currently plays in covering the costs of the supportive services that help people keep their housing and improve their health and quality of life.

Roundtable on Homeless Children Discussion Synthesis

July 14, 2010
  Roundtable on Homeless Children Discussion Synthesis July 2010 Homeless Children Roundtable:  Conference Page This synthesis is available on the Internet at:

Roundtable on Homeless Children - Discussion Synthesis

July 14, 2010
This document synthesizes the discussion from the Roundtable on Homeless Children. The background paper from this meeting is also available and provides an update on the research, policy, laws, and funding for programs and services for children who are homeless in the United States. [12 PDF pages]