Supportive Housing Model

The supportive housing model combines subsidized or affordable housing options with access to a range of coordinated health and human services. The National Governors Association Center for Best Practices’ report describes the services available in the supportive housing model—including tenancy support, health care, behavioral health, and referrals to social support. Supportive housing is relevant for individuals experiencing chronic homelessness, people with disabilities, or people with substance use disorders. Supportive housing may be temporary or permanent. In permanent supportive housing programs, residents typically lease their own subsidized housing units without limits on the length of stay.

Many different organizations can create and operate supportive housing programs, including health care agencies, community-based organizations focused on homelessness or affordable housing, and private developers. Supportive housing programs often involve case managers who help residents connect to services. In addition to coordinating with primary care and behavioral health providers, case managers may help residents enroll in public assistance programs, job skills training, and support groups.

Examples of Supportive Housing Models

• The Alaska Department of Health and Social Services’ Division of Behavioral Health is implementing a permanent supportive housing model to serve individuals who are experiencing co-occurring homelessness, mental illness, and/or substance use disorders. The program includes partnerships with the Alaska Housing Finance Corporation, the Alaska Mental Health Trust Authority, and the Alaska Coalition on Housing and Homelessness.
• Rum River Health Services is a community health agency that funds a permanent supportive housing project in rural Princeton, Minnesota called the Belle Haven Townhomes. The program offers a range of services to residents, including case-management, job training, and other activities. The multi-unit project also co-locates a local child and family services agency that addresses behavioral health needs for multiple generations.

Considerations for Implementation

Supportive housing programs can be resource- and time-intensive. Housing options may be limited in some rural and frontier communities. Program planners may also face barriers to securing funding to build new supportive housing units in rural areas. For example, rural programs may need to compete for community development funds that could also be allocated to improving infrastructure or directed to other community priorities.

Rural program planners should explore different funding sources to provide supportive housing services. One critical source of funding for supportive housing is the U.S. Department of Housing and Urban Development (HUD). To receive HUD funding for supportive housing, rural programs must work through a Continuum of Care organization, which aims to promote community-wide coordination of resources and services for homeless individuals.

Many states are using Medicaid funding as sustainable financing models for supportive services. The Office of the Assistant Secretary for Planning and Evaluation provides two resources with additional information about using Medicaid to fund supportive housing: A Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants in Permanent Supportive Housing and Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field.

Resource to Learn More

Supportive Housing Helps Vulnerable People Live and Thrive in the Community
Document
This policy brief provides a comprehensive overview of the key components of supportive housing and reviews evidence related to cost savings and health outcomes.
Author(s): Dohler, E., Bailey, P. Rice, D., & Hannah, H.
Organization(s): Center on Budget and Policy Priorities
Date: 5/2016

Creating a Medicaid Supportive Housing Services Benefit: A Framework for Washington and Other States
Document
This report describes the interaction between supportive housing and improved health outcomes and outlines strategies for using Medicaid funding to integrate supportive services.
Author(s): Thiele, D.
Organization(s): CSH
Date: 2014

Alaska Supportive Housing Plan
Document
This plan describes how the State of Alaska will implement a permanent supportive housing model that will serve residents will behavioral health conditions and coordinate resources among partner agencies.
Author(s): Holland, P. & Martone, K.
Organization(s): Technical Assistance Collaborative, Alaska Department of Health and Social Services: Division of Behavioral Health
Date: 12/2015