Housing and Services Partnership Accelerator 

Application Worksheet and Instructions

Advancing Housing Stability and Community Living through 

State and Community Partnerships for People with Disabilities and Older Adults

Who Are at Risk of or Are Experiencing Homelessness

Opportunity for Medicaid Programs and Partners

Letters of intent due: November 15, 2023

Applications due: December 1, 2023

Interviews conducted: December 6-16, 2023

Announcement of selection: December 21, 2023

Accelerator launch meeting: January 2024

Accelerator closes: December 2024 

Accelerator Application Form

The purpose of this application form is to help the Housing and Services Partnership 

Accelerator (HSPA) selection committee to learn more about your state’s current goals 

and technical assistance needs around housing-related supports and services for 

persons with disabilities and older adults who are at risk for or experiencing 

homelessness to expand community living opportunities and increase housing stability 
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for Medicaid beneficiaries. The technical support available for states, requirements, 

and selection criteria are detailed in the Program Overview document. 

Note: Only states with an approved section 1115 demonstration or section 1915(i) state

plan benefit covering housing-related supports and services for people experiencing or

at risk of experiencing homelessness are eligible to apply and only one application from 

each state will be accepted.

Overview of Accelerator Opportunity & Team Composition

HSPA will bring together states interested in developing or expanding innovative

housing-related supports and services targeted to Medicaid-eligible to persons with

disabilities and/or older adults who are experiencing or are at risk of experiencing

homelessness for peer-to-peer learning activities. Up to four states will be selected to

participate, based on meeting the criteria outlined in the program overview document.

General Information

1. Lead Organization:

2. Lead Organization Type:

a.

3. Name of your State Medicaid Agency:

4. Name of your State Medicaid Director:

5. The State Medicaid Director acknowledges that the state is seeking this technical

assistance opportunity (If the applicant is not the State Medicaid Agency, please

attach a letter of commitment from the State Medicaid Director.):

Yes No

6. The State Medicaid Director acknowledges that the team has or will have sufficient

staff time and resources committed to participating in this effort:

Yes No
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7. Please provide contact information for the State Medicaid Agency lead for this work:

8. State Staff Assigned to Participate: Provide names, titles, and e-mail addresses of

senior and mid-level leaders in Medicaid (required) and other eligible agencies such

as the state housing agency, State Unit on Aging, state agency that administers

programs or advocates for people with disabilities, Single State Agency (SSA) for

Substance Abuse Services and State Mental Health Agency (SMHA), who will

regularly participate in Accelerator activities.

Name Organization Title Email address

Form Field Information

Name

Title 

Email Address

Phone Number
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9. Aging and Disability Network Organizations to Participate: Provide names,

titles, and e-mail addresses of senior and mid-level leaders from organizations. (See

Program Overview document for additional guidance.)

Name Organization Title Email address

10.Housing and Homeless Network Organizations to Participate: Provide names,

titles, and e-mail addresses of senior and mid-level leaders. (See Program Overview

document for additional guidance.)

Name Organization Title Email address
5

Name Organization Title Email address

11.Other Health and Housing Network Organizations to Participate (Optional): 

Provide names, titles, and e-mail addresses of senior and mid-level leaders from 

organizations within your state’s Health and Housing ecosystem such as state or 

local public health agencies, federally qualified health centers (FQHCs), certified 

community behavioral health clinics (CCBHCs), community care hubs (CCH),

managed care organizations (MCOs), hospitals and health systems, behavioral 

health providers, community-based organizations, (CBOs) and other service 

providers.

Name Organization Title Email address

Description of Accelerator Goals and Technical Assistance Needs

1. Through the Housing and Services Partnership Accelerator, ACL and partner 

agencies will provide selected states with individualized coaching support from 

housing and services subject matter experts and the opportunity to learn from 

peer states through facilitated sharing of information, resources, best practices, 

and lessons learned from states’ experiences over a twelve-month period. The 

goal is to support up to four participating state Medicaid agencies as they 

implement or expand innovative strategies for providing housing-related supports 
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and services under Medicaid to Medicaid-eligible to persons with disabilities 

and/or older adults who are experiencing or are at risk of experiencing 

homelessness. 

Explain 1) how this goal aligns with your state’s Medicaid priorities and 

activities and other relevant housing and service activities in the state (e.g., 

state Olmstead Plan, state aging plan, relevant SAMHSA grant activities, 

State Opioid Response Task Forces, plans to end homelessness); and 2) 

what your state intends to achieve towards this goal by participating in this 

technical assistance opportunity. (1,000 word limit) 
2. Provide a brief description of your state’s recent and current activities

developing or expanding housing-related supports and services under

Medicaid to Medicaid-eligible to persons with disabilities and/or older adults

who are experiencing or are at risk of experiencing homelessness. Identify

the roles of key partner agencies and any notable accomplishments to date

associated with these activities. (500 word limit)

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3. Provide a brief description of your state’s planned goals and

activities involving housing-related supports and services under

Medicaid to Medicaid-eligible to persons with disabilities and/or older

adults who are experiencing or are at risk of experiencing

homelessness. States may identify priority geographies/counties/

areas to focus on during the accelerator. If selecting specific

geographic/counties/areas, provide describe how solutions and

practices will be scaled and implemented statewide. (500 word limit)

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4. Identify the roles of key partner agencies, organizations, and team

members that will be involved. (500 word limit)

9
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5. Select up to eight areas of technical assistance that would be most

helpful to your state’s Medicaid housing-related supports and services

for Medicaid-eligible to persons with disabilities and/or older adults who

are experiencing or are at risk of experiencing homelessness:

Strategies for creating new partnerships/strengthening existing 

partnerships between Continuums of Care (CoCs) (and other housing 

entities), aging and disability network organizations, and state Medicaid 

agency/operating agency(s) 

Braiding funding from CoCs, public housing authorities, Medicaid, and 

other funding for health and community living to link/connect people to 

housing resources and supportive services and/or to create supportive 

housing models 

Services and benefits design (e.g., Assertive Community Treatment, 

community support program, peer recovery services, etc.)

Developing medical appropriateness or needs-based criteria based on 

health and social risk factors for Medicaid housing-related services

Best practices in contracting with managed care organizations and 

community care hubs with aging, disability, health and housing 

organizations

Strategies for service delivery and billing in fee-for-service environments

Payment models and rate-setting, including bundled payment models 

(e.g., per member per month rates, case rates) and other value-based 

purchasing strategies 

Creating flexible funding pools to cover housing and supportive 

services/activities not covered under the Medicaid program 

Aligning/coordinating housing assistance matching (e.g., via Coordinated 

Entry Systems, PHA waitlists, and other housing waitlists) and 

eligibility/approval for Medicaid housing-related services and supports with 

consideration to disability, aging and health organizations that support 

individuals 

Building disability, aging, health, behavioral health, and supportive 

housing provider network capacity to deliver, track, and receive payment 

for Medicaid housing-related services 

Data strategies to identify and prioritize individuals for housing and 

services, including establishing data use agreements and cross-system 

data matching and other infrastructure at multiple levels: system, network, 

and service provider

Strategies to implement a partnership with a PHA to administer short-term 

rental assistance covered under Medicaid and to seamlessly transition an 
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individual from short-term rental assistance to a federal rental assistance 

program 

Strategies to support persons with disabilities and older adults to transition

from hospitals, nursing homes or institutions to stable housing in the

community through aging, disability, health and housing partnerships

Evaluation methods to assess the performance and impact, including on

measures of equity, of housing-related activities/supports

Approaches in rural areas

Scaling up existing pilot or geographically-based programs

Other

6. Please indicate how the topics selected in Question 5 will support your

state’s planned goals and activities related to the development and/or

expansion of housing-related supports and services under Medicaid for to

persons with disabilities and/or older adults who are experiencing or are at risk of

experiencing homelessness.

Letter of Intent

Interested states are asked to submit a simple letter of intent to ACL by midnight (EDT)

on November 15, 2023, online on the HSPA web page at:

ACL.gov/HousingAndServices/Accelerator . 

Please also direct any questions to HSRC@acl.hhs.gov.

Applications are due to ACL by midnight (EDT) on December 1, 2023. The full

application can be found online on the HSPA web page at: [Website]. 

The top highest rated applications from states will be invited to participate in an

individual state interview with an interagency panel of federal partners as part of the 

application process. Please indicate your team’s availability for this conference call by

placing an X next to those dates and times when your team is available. 

December 4, 2023; 1:30 – 2:30 pm ET

December 4, 2023; 3:00 – 4:00 pm ET
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December 5, 2023; 2:00 – 3:00 pm ET

December 6, 2023; 10:00 – 11:00 am ET

December 6, 2023; 12:00 – 1:00 pm ET

December 6, 2023; 1:00 – 2:00 pm ET

December 7, 2023; 11:00 am – 12:00 pm ET

December 7, 2023; 12:00 – 1:00 pm ET

December 7, 2023; 1:00 – 2:00 pm ET

December 11, 2023; 12:00 – 1:00 pm ET

December 11, 2023; 1:00 – 2:00 pm ET

December 11, 2023; 2:00 – 3:00 pm ET

December 11, 2023; 3:00 – 4:00 pm ET

December 12, 2023; 12:00 – 1:00 pm ET

December 12, 2023; 1:00 – 2:00 pm ET