How Washington treats housing as medical care

Washington State is taking a new approach to housing by treating housing as health care.

Apple Health and Homes is a multi-agency state program launched last year focused on providing housing for people with physical and behavioral health problems. Uniquely, the program leverages Medicaid dollars to pay for things like housing subsidies and tenant services.

“This is a huge paradigm shift in how this system helps people live,” said Melody Pasolt, managing director of the Apple Health and Housing Administration at the Department of Commerce.

Apple Health and Homes builds on the State Health Department’s Foundational Community Supports initiative, which provides both housing and employment services to people enrolled in Apple Health. Apple Health is a state Medicaid program.

People who are chronically homeless or who have behavioral health needs, substance use disorders, or other health problems may be eligible for basic community support benefits.

The program helps people get housing through application and housing assistance, as well as providing resident support such as rent assistance and treatment programs.

Washington was one of the first states to start using Medicaid funds for housing and related services, but now it’s becoming more common across the country, said Matt Christie, supervisor of basic community support for the Department of Health. said to have become

“We were paving the way,” Christie said.

Since its launch in 2018, more than 31,000 people have signed up for Foundational Community Supports. About 8,680 people are currently enrolled in the program’s housing service, and 3,400 are enrolled in the employment service, Christie said.

Foundational Community Supports operates under the Medicaid Section 1115 Demonstration Exemption, which allows states to use Medicaid funds for services not previously permitted under the program’s rules. Medicaid, a federal-state partnership, provides health insurance to millions of low-income Americans.

Residential Healthcare Lens

Pasolto said Apple Health and Homes takes the Department of Health’s efforts a step further by offering housing, resident support and recovery services in one system.

Eligible persons must be enrolled in Apple Health. They also had other criteria, such as mental health needs, having a substance use disorder or chronic health condition, being homeless, or having a history of staying in a shelter or other temporary housing facility. must be met.

This program helps coordinate different services for people who may have health problems. This includes housing vouchers and subsidies, units to live in, shelters and other support services for those experiencing homelessness.

The state focuses on placing people in permanent supportive housing, which it defines as housing with no length of stay. The program also provides priority access to those in need of comprehensive support services.

Pasolto said the program works to provide people with the most suitable environment. For example, try to avoid placing the person in an area where they may have started using illegal drugs.

The program focuses on thinking about housing as part of health and wellness, she said.

For example, it is difficult for people who are homeless to recover from substance use disorders and other behavioral health problems. Also, for people with health conditions such as diabetes and asthma, it can be difficult to manage medications without a home to return to.

Pasolto noted that housing can have an “incredibly dramatic” positive effect for people with behavioral health problems, and Apple Health and Homes can help. “This piece really shines a light on how to deal with homelessness and looking at it from a medical perspective,” she added.

New funding, high demand

Last year, the Department of Commerce provided $41 million in capital funding for projects across the state that provide units for the Apple Health and Homes program.

Kitsap Community Resources, Muckleshoot Housing Authority, Olympic Community Action Program and Vancouver Housing Authority are some of the winners. The award will provide an additional 119 homes for Apple Health and Homes.

And more funding is in the works.

Congress has secured more than $100 million from the state’s Housing Trust Fund for this program.

Applications are being accepted for organizations that need some of that money to build more homes.

But demand is likely to exceed available funding. The Department of Commerce estimates that Washington will need 122,000 permanent support homes over the next 20 years. Until this goal is met, Pasolto said there will always be a shortage of resources to help people.

“We will chip away at the mountains and serve people as best we can,” she added.

The Washington State Standard is part of the States Newsroom, a non-profit news network supported by a coalition of grants and donors as a 501c(3) public charity. The Washington State Standard maintains editorial independence.

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