Permanent Supportive Housing
Permanent Supportive Housing (PSH) is a model that combines low-barrier affordable housing, health care, and supportive services to help individuals and families lead more stable lives. PSH typically targets people who are homeless or otherwise unstably housed, experience multiple barriers to housing, and are unable to maintain housing stability without supportive services. This page includes resources that address clinical challenges, financial options, and implementation strategies related to PSH.
Technical Assistance and Training Program
The National Health Care for the Homeless Council is partnering with the Corporation for Supportive Housing (CSH) to support health centers that are interested in establishing or expanding services in permanent supportive housing. Training and Technical Assistance is available at no cost to health centers. To take advantage of this opportunity, please send inquiries to Joey Kenkel at JKenkel@nhchc.org.
To view past webinars from this Technical Assistance and Training program, visit the CSH Supportive Housing Training Center and search “HRSA”. Topics covered have ranged from care coordination, building partnerships, and working with MCOs, to data sharing, and funding resources.
- Comments to the Joint Commission re: Permanent Housing Support Services (August 2015) | The Council provided feedback on the Joint Commission’s Proposed Standards for Permanent Housing Support Services. These comments reflect the Council’s position on health center involvement in Housing First initiatives.
- Program and Policy Alert: Medicaid Financing for Housing-Related Services (June 2015) | This alert, released in partnership with the National Alliance to End Homelessness, CSH, and the Technical Assistance Collaborative, provides an overview of an Informational Bulletin released by the Centers for Medicare and Medicaid Services, which discusses how communities can use Medicaid to fund housing-related services.
- Medicaid & Permanent Supportive Housing: A Quick Guide for Health Centers (April 2015) | This fact sheet provides a brief outline of elements discussed in two documents published by the U.S. Department of Health and Human Services Assistant Secretary for Planning and Evaluation.
- Policy and Practice Brief: Case Studies Illustrating Clinical Challenges in PSH (August 2013) |This brief complements our 2011 report (Clinical Challenges in Permanent Supportive Housing), discussing two specific consumers and the challenges they face with their care teams. It is intended to further illustrate both the clinical and policy practices that should be considered to maximize the effectiveness of PSH for those clients with more complex needs.
- Clarification of the 12-Month Rule, HRSA clarified the definition of homelessness in response to language included in the Senate Appropriations Committee Report and confirmed in the Conference Committee Report on the FY2012 Appropriations Act. Read this Policy Advisory from John Lozier, executive director of the National Health Care for the Homeless Council. Here is the memo from Jim Macrae, Bureau of Primary Health Care at HRSA.
CSH & NHCHC Joint Publications
Data Integration Best Practices for Health Centers & Homeless Services (December 2020)| This guidance will help health centers evaluate and make decisions regarding data collection, utilization, and sharing to improve health outcomes for vulnerable patients.
- Addressing Health Equity through Health and Housing Partnerships (May 2019) | This guide provides a background on health and housing disparities and explores how health and housing partnerships can work to address health inequity in their community.
- Stopping the Revolving Door: How Health Centers Can Serve Justice-Involved Populations (July 2018) | This publication explores the various ways three health centers meet the health and social needs of individuals exiting correctional institutions.
- Health Centers and Coordinated Entry: How and Why to Engage with Local Homeless Systems (May 2017) | This report outlines how health centers can be partners in local coordinated entry systems and make change by helping to prioritize the most vulnerable for housing.
- Resources for Building Health Center & Housing Partnerships: Literature Review & Resource Bank (May 2017) | This resource guide provides a user-friendly summary of evidence of the impact of supportive housing across different populations and outcomes.
- Health Outcomes & Data Measures: A Quick Guide for Health Center & Housing Partnerships (April 2017) | This guide provides an overview of how health centers and supportive housing providers are tracking and utilizing data to demonstrate progress with the most medically and socially complex patients.
- Project Profiles. Developed in partnership with CSH, this series highlights collaborative health and housing initiatives.
- 10th Decile Project: Los Angeles, CA (September 2015)
- Integrated Care for the Chronically Homeless: Houston, TX (January 2016)
- Frequent Users Systems Engagement (FUSE): Washtenaw County, MI (July 2016)
- Housing the First 100: Orlando, FL (September 2016)
- Improving Care for Medically Complex Patients: Medical Respite and Supportive Housing (April 2017) | Features Yakima Neighborhood Health Services (Yakima, WA) and Circle the City (Phoenix, AZ).
- Community Based Supportive Housing Serving Persons with Disabilities at Risk of Institutional Care (April 2017) | Features partnerships in Chicago, IL and Washington, D.C.
- Health & Housing Partnerships for Older Adults: Aging in Place in Supportive Housing (November 2017) | Features partnerships in Seattle, WA and New York, NY.
- Promising Practices for Health Centers: Serving Youth Experiencing Homelessness (April 2018) | Features partnerships in Hennepin County, MN and Portland, OR.
- Health & Housing Partnerships: Strategic Guidance for Health Centers and Supportive Housing Providers (December 2015) | This guide, developed by CSH, lays out the steps to creating and maintaining strong partnerships between the health and housing sectors.
- Health Equity: Permanent Supportive Housing with Housing First (Housing First Programs) (June 2019) | This systematic review by The Community Preventive Services Task Force (CPSTF) describes the economic benefit of supportive housing.
- States Freed to Use Medicaid Money for Housing (November 2015) | This article by the Pew Charitable Trusts explores the opportunity to use Medicaid funds to cover housing related supportive services.
- Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field (August 2014) | Prepared for the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services.
- A Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants in Permanent Supportive Housing (July 2014) | Prepared for the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services.
- New Housing Resources to Support Olmstead Implementation (June 2012) | This informational bulletin released by the Center for Medicaid and CHIP Services (CMCS) describes HUD actions, policies, and resources that are available to assist states in developing strategies to better integrate services and housing.
- Medicaid-Financed Services in Supportive Housing for High-Need Homeless Beneficiaries: The Business Case (June 2012) |Developed by the Center for Health Care Strategies, this brief outlines the rationale for states to consider designing Medicaid-financed, supportive housing-based care management services to improve care for at-risk beneficiaries while lowering costs associated with avoidable hospitalizations and other crisis services.
- Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities (February 2012) | U.S Department of Health and Human Services, U.S. Assistant Secretary for Planning and Evaluation.
- Toolkit for Developing and Operating Supportive Housing | Compiled by CSH, this toolkit covers everything from financing supportive housing to providing supportive services.
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