Using medicaid with HUD’s Homeless Assistance Programs COSCDA Program Managers Meeting March 16, 2015 Kathy Robertson Virginia Department of Housing and Community Development

Virginia’s Housing and Healthcare (H2) Initiative Virginia selected as demonstration site for HUD TA Established local leadership/planning team – comprised of staff from the Office of the Secretary of HHR, state agencies (DMAS, DHCD), housing finance agency, CoC lead, PSH provider Provided a structure to incorporate A Healthy Virginia and the homelessness plan Focused on access to healthcare for veterans and SMI; also top priorities of the homeless plan; aligning efforts of initiatives

Virginia’s H2 Initiative Outreach to: HUD; CoCs and local planning groups of the BoS; HOPWA providers; PSH providers; PHAs; federal MCOs; QHCs; CSBs Two-day event Day one: Identifying the population at the intersection of housing and healthcare assistance Assessing the housing, treatment, and service gaps Current funding sources and assessing the funding gap Resources to close the service/treatment gap: Is coordination of care a component of the of the solution? Can Medicaid help?

Virginia’s H2 Initiative Day Two – Action Planning Core issues in program design and/or Medicaid change Who are we trying to help? How do we reach them and keep them engaged? Package of Services: What do they need? Existing resources, finances, and reinvestment strategies: Who pays for it? What can be supported with current funding sources (including Virginia’s state Medicaid plan)? What other funding sources might we tap into (including the possibility of expanding access to Medicaid through waivers or use of Virginia’s Behavioral Health Services Administrator [BHSA] managed care contract)? Operationalizing the new system: Who provides the services? How? Where? Develop a concrete action plan for closing the identified gaps Strategy for dissemination and implementation of action plan Plan components going forward and next steps

Virginia’s H2 Action Plan: Building Housing and Healthcare Systems that Work Together for People in Dire Need VA H2 Plan Objective (Mission Statement): To improve client lives, health outcomes, and housing stability by transforming and integrating the housing and health care delivery systems. VA H2 Target Population: Low Income People Qualifying for Public Assistance to Meet Their Housing and Health Care Needs Who Are: Chronically homeless Individuals with HIV/AIDS who are disabled

Virginia’s H2 Action Plan This Plan encompasses four goals, each of which focuses on a key area of activity essential to achieving the Plan’s objective. Goal A / Housing: Ensure that every person in the target population has access to housing and to the support services needed for ongoing residential stability. Goal B / Health Care: Enhance access to health and behavioral health services needed to maximize health, manage ongoing conditions and facilitate housing retention. Goal C / Coordination: Improve coordination between the housing and health care systems, at both the systems and service levels. Goal D / Data: Use data to inform decision-making in order to enhance system efficiency and improve quality of care and outcomes.

Virginia’s H2 Action Plan Goal A / Housing: Ensure that every person in the target population has access to housing and to the support services needed for ongoing residential stability. Strategy A-1:Increase the supply of permanent affordable housing units, including permanent supportive housing and move on housing Strategy A-2: Explore ways to simplify financing for permanent supportive housing (PSH), and take advantage of all opportunities to leverage resources for current and future operations and services. Strategy A-3: Develop rapid re-housing programs and resources for high need members of the target populations throughout the state. Strategy A-4: Maximize effective use of existing housing resources. Strategy A-5: Assertively link target population to housing through outreach, engagement, and education, and provide ongoing housing support to ensure continuing stability.

Virginia’s H2 Action Plan Goal B / Health Care: Enhance access to health and behavioral health services needed to maximize health, manage ongoing conditions, and facilitate housing retention. Strategy B-1: Aggressively work to identify and enroll eligible members of the target population into Medicaid and other health insurance. Strategy B-2: Ensure that people who are homeless who fall into the insurance gap have access to healthcare. Strategy B-3: Maximize effective use of existing health care resources. Strategy B-4: Support efforts to increase the health care resources available for serving the target population, including addressing their housing needs.

Virginia’s H2 Action Plan Goal C / Coordination: Improve coordination and collaboration between the housing and health care systems at both the systems and service levels. Strategy C-1: Establish a statewide Virginia H2 Leadership Team to coordinate and administer this initiative. Strategy C-2: Promote collaboration and partnerships between housing and health providers that produce positive housing and health outcomes. Strategy C-3: Promote statewide implementation of housing navigator and health home programs that link health and housing systems of care. Strategy C-4: Foster stronger linkages and communication among the universe of providers and agencies servicing the target population, both housing and health care.

Virginia’s H2 Action Plan Goal D / Data: Use data to inform decision-making in order to enhance system efficiency and improve quality of care and outcomes. Strategy D-1: Strengthen data collection, analysis and use in decision-making. Strategy D-2: Support development of analytical capacity needed for cross-systems and agency planning and decision-making.

Virginia’s H2 Action Plan Next steps: Local leadership will meet to fine tune action steps for strategies Meet with TA providers at the end of March to determine specifics: - Who will lead this strategy? Additional participants? - Output or outcome (How will we know it worked?) - Timing expectation; progress to date Present to Governor’s Coordinating Council on Homelessness (April 8)

Contact Information Kathy D. Robertson Associate Director Homeless and Special Needs Housing Virginia Department of Housing and Community Development 804-225-3129 kathy.robertson@dhcd.virginia.gov