Promising Practices
Medicaid Innovator Accelerator:
Housing Partnerships
Meghan Davey, Medicaid Director
Division of Medical Assistance and Health Services
Department of Human Services
March 28, 2017
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Building the Case for Supportive Housing
Studies that demonstrate successful community integration for individuals in
need of long term services and supports who receive housing-related
services:
Money Follows the Person (MFP) Rebalancing Demonstration Program
States providing specific housing-related services and activities had more
success and a higher rate of transitioning individuals out of more costly
nursing homes and other institutions and into community living than
those programs without these services.
Real Choice Systems Change Grant
Showed that building relationships between state Medicaid agencies and
state and local housing organizations and stakeholders resulted in the
capacity to take advantage of other federal and state funding
opportunities to expand community-based housing resources for
Medicaid eligible populations.
CMCS Informational Bulletin, Coverage of Housing-Related Activities and Services fro Individuals with Disabilities, June 26, 2015.
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Bending the Cost Curve: Health in Housing
Studying the link between affordable housing and health care
20%
18%
40%
Increase use of
outpatient
primary care
Decrease use
of emergency
department
Residents who reported
improved access and
quality after move-in
 Housing with integrated health services was a key driver of health-care outcomes,
suggesting that increasing these services may result in even greater cost savings.
 State can consider using supportive housing to bend the Medicaid cost curve,
namely, by improving outcomes and reducing costs among homeless or
precariously housed high-cost Medicaid beneficiaries.
Center for Outcomes Research & Education (CORE). Access to an Affordable Home Improves Health Care. March 9, 2016.
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Driving Factors Behind the
Medicaid Innovator Accelerator Program (IAP)
Consistent with statute, CMS does not provide Federal
Financial Participation (FFP) for room and board in home and
community-based services, but can assist states with coverage
of certain housing-related activities and services.
A recent CMCS Information Bulletin articulated activities and
services that Medicaid can provide to people who need home
and community-based services (HCBS).
Unprecedented Collaboration between CMS, SAMHSA, ASPE
(Assistant Secretary for Planning & Evaluation), US Interagency
Council on Homelessness (USICH), HUD and States
CMCS Informational Bulletin, Coverage of Housing-Related Activities and Services fro Individuals with Disabilities, June 26, 2015.
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New Jersey’s Medicaid IAP:
Housing Partnership Workgroup Vision
 To conduct an environmental scan to identify best-practices
or gaps under the current housing landscape.
 To work together to develop a comprehensive, permanent
supportive housing package of services that builds upon
work underway already in New Jersey.
 To identify funding opportunities to create new housing
stock or additional housing vouchers that complement
reimbursement for the permanent supportive housing
services.
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New Jersey’s Medicaid IAP:
Housing Partnership Workgroup
The workgroup represented the following
Agencies, Departments, Divisions and Programs:
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•
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Department of Community Affairs (DCA),
New Jersey Housing and Mortgage Finance Agency (NJHMFA),
Department of Human Services (DHS),
Division of Medical Assistance and Health Services (DMAHS),
Division of Mental Health and Addiction Services (DMHAS),
Division of Aging Services (DoAS),
Division of Developmental Disabilities (DDD),
Department of Children and Families (DCF),
Office of the Ombudsman for the Institutionalized Elderly (OOIE), and
Money Follows the Person (MFP).
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1115 Waiver Renewal Application
• New Jersey understands the direct link between people’s
physical health and their housing needs.
• The state has a long history of funding supportive housing and
recently has made critical investments in connection with its
Olmstead program (i.e. Community Support Services offered
through the Division of Mental Health and Addiction Services)
• There remains a significant need for attainable housing and
supported housing-related activities and services.
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Expanding the Use of
High Fidelity Housing First Model
Choice of
Housing
Flexible,
voluntary
services
Access to
all housing
options
Substance Abuse and
Mental Health Services
Administration
(SAMHSA) developed
evidenced-based
approach to end
homelessness
Rights of
Tenancy
Separation
of Housing
and
Services
Decent,
safe, and
affordable
housing
Integration
in the
Community
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Medicaid Permanent
Supportive Housing Services
New Jersey proposes to provide housing-related services to Medicaid
recipients, including individuals who are homeless, chronically
homeless and at-risk for homelessness as defined by the U.S.
Department of Housing and Urban Development
Populations of special interest will include repeat emergency shelter
users and other housing service users with disabilities, behavioral
health diagnoses, and multiple chronic physical health conditions.
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Moving Forward: External Partnerships
DMAHS is considering opportunities for including
external stakeholders in the discussions to
implement and operationalize the program.
Through its partnership with DCA and MFP, DMAHS
will be participating in many housing Stakeholder
meetings and looks forward to continuing to build
relationships with DCA and MFP Stakeholders, such
as the Continuums of Care and Housing Developers.
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Next Steps
Await CMS feedback on the 1115 Waiver Renewal Application.
The Medicaid IAP Workgroup continues to meet and is
working on developing:
 Contract language for July 2017 to strengthen the current
requirement for MCO’s to employ a housing specialist.
 Detailed pre-tenancy, tenancy, and post tenancy definitions,
assessments, etc.
 Ways to address gaps and challenges identified by the
environmental scan. Ex: Availability of housing stock,
identifying quality and monitoring measures, funding
differences between similar programs, etc.
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