Expanded Opportunities with Federal Funding for Housing and Services | Transcript 1

Expanded Opportunities with Federal Funding for Housing and Services

HSRC Webinar | Transcript | 3/7/22

Presenters:

● Michelle Daly, MSW, Lead Public Health Advisor, Co-Occurring and Homeless 

Activities Branch, Center for Substance Abuse Treatment, Substance Abuse and 

Mental Health Services Administration (SAMHSA)

● Richard Cho, PhD, Senior Advisor for Housing Services, US Department of Housing 

and Urban Development (HUD)

● Martha Egan, Technical Director, Division of Community Systems Transformation, 

Disabled and Elderly Health Programs Group, Center for Medicaid and CHIP Services, 

Centers for Medicare and Medicaid Services (CMS)

Facilitator: Lori Gerhard, Director of the Office of Interagency Innovation, Administration for 

Community Living

LORI GERHARD:

Hi everyone. We will get started in one minute. Yes, everyone is muted. Hello and welcome 

to the Housing and Services Resource Center March webinar series.

Thank you so much for joining us. I’m Lori and I lead the Office of Interagency Innovation 

at the Administration for Community Living, an operating division within the US Department 

of Health and Human Services. I will be serving as the facilitator for today's webinar. It is 

great to see so many of you here today and with your support we are hoping today's 

webinar will include an engaging discussion.

Before we get started, we have a few housekeeping items. This meeting is being recorded; 

by staying to participate you’re consenting to the recording. Also, all attendees’ 

microphones have been muted for audio quality. But please note that we very much want to 

hear from you today. Please frequently use the chat to make comments and submit your 

questions any time in the Q&A feature in this dashboard. You may also email a question or 

comment to HSRC@ACL.HHS.GOV. We have reserved time to address your questions and 

will compile all the questions and make available an FAQ document.

Please use the chat or email if you have a technical issue, and our technical support team 

will work to resolve it.

So who is with us today? The work under the Housing and Services Resource Center or 

HSRC is designed to serve professionals in multiple sectors. We like to get an idea of who is 

in the audience by using a poll. It will display on the side of your screen. What sector is your 

organization in? Please select one of the responses.

While you are responding to the poll, I'd like to introduce our fellow agency partners and 

Housing and Services Resource Center colleagues who will be today's speakers.

With us today is Ms. Michelle Daly. She is the Lead Public Health Advisor, Co-occurring and 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 2

Homeless Activities Branch, Center for Substance Abuse Treatment, Substance Abuse and 

Mental Health Services Administration, or SAMHSA. Also joining us is Doctor Richard S. Cho, 

who's a Senior Advisor for Housing Services, US Department of Housing and Urban 

Development, or HUD.

Also joining us is Ms. Martha Egan, the Technical Director, Division of Community Services 

Transformation, Disabled and Elderly Health Programs Group, Center for Medicaid and CHIP 

Services.

Today our focus is spending opportunities for federal and housing services. You will hear 

about key funding streams such as the American Rescue Plan, to help more people get and 

keep affordable and accessible housing with home and community based services and/or 

the behavioral and mental health services they are seeking and need.

They can live full lives in the community. Our intention is that you leave today's webinar 

with new openings for action, as it relates to the funding and flexibilities that are available. 

And that you will also be thinking about other organizations that you could be partnering 

with. We reserved about 20 minutes to address your questions at the end of the webinar. 

After the webinar, we will share a PDF with the slides in this presentation, and some 

additional ones we think are helpful, along with an evaluation.

We are likely all here today because we are grappling with challenges we have in common. 

The data are quite sobering. We know that the stock of affordable units has been shrinking 

for many years and competition for that limited supply of affordable rentals and rising rents 

makes it difficult if not impossible for many older adults and people with disabilities to 

effectively and sustainably live in the community.

HUD’s 2021 worst-case housing report found there were only 40 affordable and available 

homes for every 100 extremely low income renter households nationwide. Adding to that 

lack of affordable housing is the fact that under 1% of US housing stock is wheelchair 

accessible and less than 5% can accommodate individuals with moderate mobility 

disabilities, making finding units that are both affordable and accessible a huge challenge. 

Homelessness among adults aged 51 to 61 years old and 62 and older is also rising. About 

one in 4 adults in the sheltered homeless population are 62 and older.

In addition, many studies have documented that finding, navigating and obtaining services 

and supports for living in the community can be difficult. However, even in states that have 

put in place necessary community services, to help people transition from institutions, the 

challenge of finding affordable and accessible housing is an issue that slows down or 

prevents the transition back to the community.

So to address these challenges, we recognize that we need to form and facilitate greater 

partnerships across the disability, aging, health and housing sectors at all levels. So the US 

Department of Health and Human Services, specifically the Assistant Secretary for Planning 

and Evaluation (ASPE), the Administration for Community Living (ACL), the Centers for 

Medicare & Medicaid Services (CMS), and Substance Abuse and Mental Health Services 

Administration (SAMHSA) partnered with the US Department Housing and Urban 

Development (HUD), to create a Housing and Services Resource Center. 

In December 2021, the Housing and Services Resource Center launched with a website that 

brings together, for the first time, a wide variety of federal resources and guidance on both 

housing and services that support community living, including Medicaid funding, home and 

community-based services, behavioral health support, vouchers, and other housing 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 3

programs. You can access this information at ACL.gov/HousingandServices. It will take all of 

us working together so people have access to both affordable, accessible housing and the 

individualized services and supports needed to live in the community.

Our shared goal is to enable all older adults, people with disabilities, those living in 

institutions seeking to return to the community and people experiencing or at risk of 

homelessness, to live stably in their homes and engage in the community.

The Housing and Services Resource Center serves as a hub of our federal partnership and, 

in collaboration with national state and local partners, we work together to coordinate 

technical assistance, training and research efforts of each agency to reach a broad audience 

of aging, disability, housing, health and homeless networks and stakeholders.

We facilitate partnerships between housing and service systems to expand affordable, 

accessible housing and access to home and community-based services and health.

We recognize and share state and local innovations, and we assist communities in 

leveraging and aligning new housing and services resources available through the American 

Rescue Plan.

Please close the poll.

Let's see here. It looks like 42% of those joining us today are from health or human service 

agencies, followed closely by housing or homelessness services and associated research or 

advocacy organizations, and it looks like we also have some consumers in the group and a 

group of others.

We are so delighted to have participation across the full spectrum of housing, disability, 

aging, home and community services and health. I just want to remind everyone to please 

use the chat and that Q&A function throughout this webinar. We really want to hear from 

you and get your comments and questions. Next slide.

Now I'd like to share some information about the Administration for Community Living, or 

ACL. We strive to make community living a reality for all people regardless of disability or 

age. And by that we mean living in their own home, in the community of their choice. 

Community living involves access to community services, healthcare, housing, employment, 

education, transportation and more.

Community living requires partnership across these sectors. I will share some information 

about the nationwide disability and aging infrastructure that we support.

The disability and aging networks are available in each of the states and US territories, and 

communities throughout the nation. Organizations and the networks are staffed by people 

who live in and know the people, the community, the culture, and the services that are 

available in the community. They serve a diverse population, and work in partnership with 

other organizations to support people with disabilities, older adults, and caregivers to access 

and obtain the care, services and supports, and assistive technology that they need; enroll 

in publicly funded programs; understand and use their healthcare benefits, their 

transportation services and benefits; and find and obtain accessible, affordable housing. 

They are skilled in helping people with disabilities or older adults and caregivers to navigate 

the array of public programs, private resources and community programs so that people can 

fully activate the person-centered plan.
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 4

Please visit ACL.gov for more information about these organizations. Next slide.

The American Rescue Plan provided ACL with $1.4 billion in Older Americans Act funding so 

that states and communities can provide services and supports to older adults to live in the 

community. The aging and disability networks are using these resources to expand or 

enhance the delivery of in-home supports, transportation, assistive technology, preventative 

services, meals, care transitions out of institutions and hospital and programs to address 

social isolation. Additional American Rescue Plan support for meals, nutrition services, and 

home and community-based services were dedicated to the Native American aging nutrition 

and supportive services program.

You can find your local network organizations through the disability information and access 

line, or dial Elder Care Locator in the AT3 find your state assistive technology program 

website. I will put those links in the chat. Now is my distinct honor to introduce Michelle 

Daly, from SAMHSA to tell you more about the opportunities with behavioral health, mental 

health and health .

MICHELLE DALY:

My name is Michelle Daly and I'm with SAMHSA of HHS. I will highlight some programs in 

which grant funds support housing-related services for those with mental and/or substance 

use disorders. On behalf of Dr. Delphin-Rittmon, Assistant Secretary for Substance Abuse 

and Mental Health, and all of SAMSHA, I'm pleased to join my other federal colleagues 

today. 

We collaborate and coordinate to support community living for people with disabilities, older 

adults, and people experiencing or at risk of homelessness, through accessible, affordable 

housing and voluntary community services. We view this effort as crucial to the work we do. 

So much of our respective agency missions are interconnected, and those we serve deserve 

this type of collaboration and coordination.

For those of you who might be unfamiliar with SAMHSA, our mission is to reduce the impact 

of substance abuse and mental illness on America's communities. SAMHSA believes that 

behavioral health is essential to health, prevention works, intervention is critical, treatment 

is effective and people recover. Our mission is supported through grant funding, public 

education and training, surveillance, regulation and standard [...] and practice 

improvement. 

Behavioral health is our focus. Our work must acknowledge and align with the social 

determinants of health. We all know that the environments where people are born, live, 

learn, work, play, worship and age affect a wide range of our health, functioning and quality 

of life outcomes and risk. The COVID-19 pandemic has placed additional strains on 

individuals, families and our systems of care. That has required us to make adjustments to 

the collective work that we do at the local state, tribal and federal levels.

In fiscal year 2021, SAMHSA distributed approximately $13.82 billion that included $4.25 

billion of COVID-19 supplemental funding with spending through 2023, and $3.56 billion of American 

Rescue Plan Act funds with spending through 2025. These funds were primarily funneled through our 

block grants that we will talk about in just a little bit.

This slide includes results from our most recent national survey on drug use and health in 

2020. Please note that as a household survey, information from those in institutional 

settings and those experiencing homelessness are underreported. You can see that for 

those 18 and above, 15.4% had a substance use disorder, 21% had a mental illness (of 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 5

which 1 in 4 had a serious mental illness), and 6.7% had both a substance use disorder and 

a mental illness. If you were to look at HUD's homeless populations and subpopulation's 

report, specifically 2020 to align with this data, just over 25% are categorized as severely 

mentally ill and about 20% as having chronic substance abuse. Those experiencing 

homelessness have higher percentages of mental or substance use disorders than those 

with housing stability.

I will discuss some of the SAMHSA programs that may be utilized to support housing-related 

and behavioral health services. I want to emphasize while I discuss a few programs, these 

are just some of many of the few SAMHSA programs that can support behavioral health 

services, treatment and recovery support services, and also pre-and post-tenancy services.

The first of which is the Center for Mental Health Services, Community Mental Health 

Services Block Grant, or an MHPG. This provides funds and technical assistance to all 50 

states, District of Columbia, Puerto Rico, US Virgin Islands and six specific jurisdictions to 

provide comprehensive community-based mental health services to adults with serious 

mental illnesses, or SMI, and to children with serious emotional disturbances, or SED. And 

to monitor progress in implementing a comprehensive, community-based mental health 

system.

The state mental health authorities receive the mental health block grant funds and allocate 

funds to a variety of different types of subrecipients within their states.

As part of the mental health block grant funding, states must submit a comprehensive 

community plan that demonstrates a system of integrated social services, educational 

services, juvenile services, substance abuse services, health and mental health services, 

including health and mental health services needed for a person to function outside of an 

institution, or inpatient care. It must describe the state's outreach to and services for 

individuals experiencing homelessness who have an SMI or SED.

This slide provides some examples on how the mental health block grant funds can be used 

to maintain housing through delivery inside and outside the home, such as intensive case 

management, treatment peer support services and state, tribal and local coordination of 

these services.

This slide includes housing-related activities that are allowable with mental health block 

grant funds. They are examples from state plans that include pre- and post-tenancy 

supports, such as housing identification, overall housing support and crisis stabilization. 

Specifically, coordinating with public housing authorities and other housing providers to 

support people with SMI and SED, including those transitioning from institutions.

In addition, they provide benefit assistance in developing and maintaining supportive 

housing. So, many of the examples in the far right column show approvals received for use 

with either the COVID-19 funds or the ARP funds that I mentioned at the beginning.

Another program of the Center for Substance Abuse Treatment (CSAT) and Center for 

Substance Abuse Prevention (CSAP) is the Substance Abuse Prevention and Treatment 

Block Grant (SABG), which provides funds to the same 59 entities as the mental health 

block grant, plus the Red Lake band of Chippewa Indians of Minnesota, to prevent and treat 

substance use disorders.

CSAP and CSAT administer the SABG. Not less than 20% of the allotment must be spent on 

primary prevention strategies that are directed at individuals not identified to be in need of 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 6

treatment.

The single state agencies for substance abuse services or SSA's receive the SABG funds and 

allocate funds to a different variety of sub-recipients in their states.

Here you see, similar with the mental health block grant, some examples that the SABG 

funds have supported. You will see a number of states actually received approval to do 

enhanced recovery housing. Recovery housing is actually allowed in the SABG through a 

revolving loan fund, but for the COVID-19 and ARP funds, states can put in for more direct 

housing and recovery housing with their plans.

You see that some of the pre-and post-tenancy supports listed are expanding the recovery 

housing, additional housing stabilization and coordination, and all of these are also 

coordinated with voluntary treatment and recovery support services.

Another CSAT program is the State Opioid Response program. This program awards states 

and territories through the SSA, which is similar to the SABG, to treat the opioid crisis by 

increasing access to medication-assisted treatment, reducing unmet treatment needs and 

reducing opioid overdose deaths through prevention, treatment and recovery support 

services for those with opioid use disorders. This program was expanded in FY 22 to support 

evidence-based prevention, treatment and recovery support services to address stimulant 

misuse and use disorders, including for cocaine and methamphetamines.

Here are a couple of examples from Connecticut and DC that are both coordinated with 

other housing and services systems. The DC example includes outreach services that 

integrated connections to coordinated entry if people were not already included.

Another two examples: the Pennsylvania example shows SOR funds being used to increase 

case management services in a broad framework including housing related employment and 

education and benefit enrollment assistance and transportation, to name a few. In Ohio, the 

SOR funds supported services within a faith-based recovery housing program.

The next few programs I will mention are services for people who are experiencing or at risk 

of experiencing homelessness. The CMHS Projects for Assistance in Transition from 

Homelessness (PATH) is a formula grant to reduce or eliminate homelessness for individuals 

with serious mental illness or SMI or co-occurring substance use disorders who are 

experiencing or at imminent risk of becoming homeless.

PATH funds are distributed to 56 states and territories ranging from half a million dollars to 

$8.8 million annually. States use PATH funds to provide a menu of services, and most states 

used these dollars for outreach and case management. This slide shows some other 

services.

Here is a list of housing services states can select from for the PATH program. Most states 

use it for security deposits, the cost associated with matching eligible homeless individuals 

with their appropriate housing situation, and one-time rental payments to prevent evictions. 

For more information on the PATH program in your state, I recommend you reach out to the 

state PATH contact. Each state has local provider agencies that are doing a lot of 

coordination and collaboration with HUD continuum of care and public housing authorities.

If you are unable to locate your state PATH contact, please visit the SAMHSA website that 

includes a list of both state PATH contacts along with provider organizations for your state.
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 7

Here's an example of an Ohio Columbus house, which has both PATH funds and a program 

I'll mention shortly, grants to benefit homeless individuals, and they are kind of linking 

those with other housing opportunities through the COC and public housing authorities. 

They are also working with, across other benefit areas and doing a number of employmentbased services for those enrolled.

Another CMHS program is the treatment for individuals experiencing homelessness, a

discretionary program that serves people with SMI, SED, or co-occurring disorders who 

were experiencing homelessness. Grants are awarded for up to five years to states, 

territories, or community-based public or nonprofit entities with annual funding of up to $1 

million for a state government and territory, and up to half a million for tribes and 

community-based organizations.

Grantees that received TIEH funds are expected to do the required services listed here. In 

addition to strengthening behavioral health treatment, the TIEH program requires 

enrollment in HUD's coordinated entry system.

Here's an example of a Public Housing Authority that had applied and received TIEH funds. 

The Grand Forks Housing Authority in North Dakota, and it lists some of the direct services 

they are doing with these funds and coordinating across different service areas.

The final grant program I will mention is the Center for Substance Abuse Treatment GBHI 

program, which is the Grants to Benefit Homeless Individuals that focuses specifically on 

individuals and families experiencing homelessness who have substance use disorder or cooccurring mental and substance use disorder. This five-year program has annual funding of 

up to $400,000 a year, and there are 85 current grantees across 33 states to expand 

community treatment and recovery support services.

This slide shows GBHI required services, and we’ll also see that the FY20 cohort that we 

awarded were also allowed to use grant funds for up to 90 days of rental assistance and 

other housing initiation costs such as security deposits and utility activation.

Grantees ensure that people are included in coordinated entry, and you can look at GBHI 

and all their SAMHSA discretionary programs as two-way referrals for HUD housing funds. 

This point is really important. We've been hearing a lot of states and communities having 

difficulty with wrapping service dollars around.

So, in addition to what you will hear later from CMS on Medicaid and use of Medicaid funds 

and their programs, please think about utilizing SAMHSA funds and interacting with multiple 

systems. Our service dollars are available, and a lot of the coordination and programming 

goes through your state. But in addition you will find many discretionary programs that are 

both programs for targeted people experiencing homelessness, and general discretionary 

programs that might be of benefit to those who have been or are needing to be placed in 

housing.

In addition to grant programs and funding, SAMHSA provides many other resources for 

policymakers, administrators, clinicians and individuals and families. These include our 

Office of Behavioral Health Equity.

Also, we have a section on practitioner training which has a number of different technical 

assistance centers, and a couple of them are the SOAR, SSI, SSDI outreach access and 

recovery which helps get individuals enrolled in SSI or SSDI.
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 8

We have our Homeless and Housing Resource Center. We have a variety of centers of 

excellence, one of which is the E4 Center that addresses behavioral health disparities in 

aging.

We also have our SMI Adviser program around clinical support systems for serious mental 

illnesses. And we have a peer run center to help on recovery peer support services, as well 

as many technology transfer centers or TTCs, which are all in your communities and 

organized on a regional aspect.

And then in addition I would also just like to make sure that you are aware that SAMHSA 

has an Evidence-based Practices Resource Center that has many specific evidence-based 

practices and guidelines to delivering those systems.

Here is my contact information, and I just want to note that the slides that will ultimately be 

posted are more thorough and contain additional information but feel free to reach out if 

you do have any questions. And I will turn it right back to Lori.

LORI GERHARD:

Thank you so much Michelle, and before Dr. Richard Cho begins, we would like to learn 

more about you and your partnerships. Please use the chat to tell us, for your organization, 

the name of your organization, who is one of your primary partners that is in a different 

sector than your organization? So a partner that you work with, for example, for my town 

housing authority, a key partner is our town independence center. If you can put that in the 

chat, that would be great. We would really like to hear what kind of housing services 

partnerships already exist across the country.

Now it’s my distinct honor to hand the presentation to Dr. Richard Cho from HUD to share 

housing funding opportunities and highlight great partnership models.

RICHARD S. CHO:

Thank you so much Lori, and it's great to be on here, alongside of you and Michelle and 

Martha. I am here as Senior Advisor to Secretary Marcia Fudge, HUD, where I advise her on 

all of the ways that HUD can connect housing with services for populations who need that 

combination of housing and services to remain successful and stably housed and that 

includes people experiencing homelessness, but also older adults where provision of longterm services and support coordinated with housing can enable them to stay in place as 

long as possible and avoid institutional care, as well as people with disabilities who need the 

combination of housing and services in order to fully participate in community and live in 

the community.

I want to talk a little bit about HUD’s mission and some of our programs, but I really want 

to send a clear message about the importance of partnerships. You’ve heard a lot already, 

and I'm curious to hear about some of the responses in the chat. If we can go to the next 

slide...

So I just want to make clear our role is to help provide stable housing for all as well as to 

create strong and inclusive and sustainable communities, and we see home and communitybased services as vital to our mission. We have a number of programs that are housing 

programs that are specifically intended to provide affordable housing or housing assistance 

to older adults, and people with disabilities and people experiencing homelessness, where 

we essentially know that the success of that housing can be stronger to the degree to which 

our residents have access to long-term services and supports, home and community-based 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 9

services or other wraparound services that are coordinated with housing that can help 

people to again maintain long-term tenancy as well as live with dignity and independence. 

So that is what a lot of this is about.

On the next slide, I'm going to go through some of categories of the housing programs that 

we administer. And starting with the programs we have specifically for older adults, which 

at HUD we define as households in which at least one person's age 62 or older. We have a 

couple of different ways that we provide housing assistance. One and the most commonly 

known way is through our multifamily programs, in particular the section 202 program, 

which specifically provides capital funding to help build housing units for people who are 

older adults, as well as provides some long-term rental assistance. So we essentially pay for 

the bricks and mortar as well as the rental assistance to keep those units affordable.

Nationally, we have about 6,800 properties that includes about 330,000 units across the 

country. In addition, through many rental assistance contracts, some of which are no longer 

new, we have renewed those contracts, which we refer to as project-based rental 

assistance, there is another say 11,800 properties that have about 1 million units, and what 

our data shows is that about 50% of those units serve older adults. Those were not units 

specifically targeted to older adults, they are really based on people who are low income, 

but we have found that 50% of those project-based rental assistance properties actually are 

serving households at least in which one member is an older adult.

And then of course we have public housing, which is administered by our public housing 

authorities, as well as housing choice vouchers, and what we found is that about 150,000 

households living in public housing have at least one member that is an older adult, and 

about 220,000 households who have housing choice vouchers, so these sometimes referred 

to as Section 8 vouchers but they are essentially vouchers that people can use to rent units 

on the private market and keep those rents affordable, about 220,000 of those households 

have an older adult, so quite a few households that HUD serves at least one member that is 

an older adult. As much as most folks think about section 202 as the place where we 

provide older unit housing, we provide older adult housing across most of our programs.

We also administer a number of programs that provide housing assistance specifically for 

people with disabilities, that includes physical disabilities, intellectual and psychiatric 

disabilities, and that includes our Section 811 program, we have both a capital advance 

program where we provide a combination of capital funding as well as rental assistance, for

about 2,700 properties with 30,000 units nationally, and a newer version of the program is 

our project rental assistance program where rather than providing bricks and mortar, we 

enter into rental assistance contracts. The Section 811 project rental assistance program is 

one where we provide funds not directly to housing owners, but rather to state housing 

finance agencies where they are required to partner with Medicaid and agencies that serve 

people with disabilities to really provide a combination of housing and services and so the 

811 program is what the places where we have reinforced the need for those state-level 

partnerships between housing agencies who administer not only the 811 program but also 

low income housing tax credits as well as the agencies that fund and finance support 

services.

And then again, many people with disabilities live in our public housing programs in our 

regular

housing choice vouchers, but we also have some special voucher programs that are 

intended to serve households that have a disability. That includes our mainstream vouchers, 

about 50,000 vouchers, actually I think is about 60,000 now, that serve a household with at 

least one member with a disability. And also nonelderly disabled vouchers, which we call 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 10

Ned vouchers, about 55,000 vouchers as well. So we have a couple of voucher programs 

intended to serve people with disabilities. One of the primary intents of that is not only to 

serve people with disabilities who are transitioning from homelessness or need to avoid 

homelessness but also people who are currently in institutional settings, where the provision 

of the voucher plus Money Follows the Person programs and home and community-based 

services can live in the communities, so there is a particular opportunity there.

And then of course we have our targeted housing assistance programs for people 

experiencing homelessness. Our primary vehicle is through the Continuum of Care program, 

where we provide grants on a competitive basis annually to communities across the country

who have to apply as part of the continuum of care. A number of homeless service 

organizations that receive HUD grants, they apply as part of a sort of collaborative at the 

local level, and that collaborative is known as a continuum of care and sets local priorities 

for how HUD dollars will be used and then serve as the umbrella for how a number of 

homelessness grants are used. So in the continuum of care program, HUD funds both in 

permanent supportive housing, which is intended to provide long-term rental assistance 

along with wraparound services, or the services are leveraged through partnerships, we 

have about 3,700 permanent support housing projects throughout the country, as well as 

rapid rehousing programs where people experiencing homelessness are provided with timelimited rental assistance typically up to 2 years, but sometimes less, as well as case 

management assistance that is primarily about finding housing as well as helping people 

stabilize in that housing. So those are the 2 ways that we fund target housing systems for 

people experiencing homelessness.

The message I really want to send today, and you have heard this from Michelle and you 

will hear this from Martha, is that there are so many opportunities. I continually hear from 

many communities that they struggle and they may have HUD resources, but they are 

struggling to figure out how to find funding or resources to provide wraparound supports 

that enable them, whether an older adult or person with a disability or person experiencing 

homelessness, to be able to use that housing effectively and also stay in the housing. And 

the message that I want to send is that we actually have these tools. We need more 

resources on the housing side and we could use a lot more resources on the supportive 

services side, we essentially have the tools that enable us to kind of put these puzzle pieces 

together so we can better coordinate housing assistance with long-term services and 

supports for home and community-based services.

First and foremost, I think Medicaid is probably the most effective way to cover a range of 

home and community-based services and long-term services and support to help support 

people's ability to obtain housing, as well as retain housing, as well as support their 

community living and their ability to live with independence in the housing.

A number of HUD programs could coordinate with those services to provide rental 

assistance or affordable housing, including for people that are transitioning from institutions 

or homelessness. The key is really to break down the silos, so I'm really curious what many

of you have commented in terms of who your most important partners are, but really how 

to build that bridge across sectors working between housing and the health and service 

sectors, and not only just building that bridge, but really to engage in what we hope to see 

as high level planning at the state level where you can take a birds-eye view and say, how 

can we look at the entirety of housing that is available for older adults, people with 

disabilities and/or homeless programs to really design a package of supportive services that 

can be coordinated with those existing housing programs as well as to design ways that 

streamline assistance so that when people apply for homelessness assistance or housing, 

they can also figure out how to obtain access to those supportive services so they can 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 11

obtain that as a sort of a coordinated package. 

On the next slide, for those of you who work in the health and supportive services and 

human services arena, I know that it can be a dizzying thing to sort of navigate the housing 

system landscape, so here's an attempt, to try to give an oversimplified view of how the 

housing system looks.

Certainly you have HUD, and we fund housing for state agencies, and some of them go to 

directly to municipal or local housing agencies as well as funding programs where we fund 

public housing authorities, and we also provide funds through continuum of care to 

homeless service organizations. In some cases, a public housing authority provides direct 

assistance to, say, an individual, either through public housing or through vouchers. In 

some cases they actually are providing rental assistance contracts within a privately owned 

housing development which is owned by housing for owner or provider who might also be 

obtaining capital funds, or tax credits from state housing agencies or municipal housing 

agents.

I think the key message here is that we need to really understand what housing landscape 

looks like in your own state, and identify who those partners are, and see if you can kind of 

bring as many of them together to the table, to say that we have an opportunity to provide 

supportive services, for many of the people that provide services to need better access to 

housing, or we need to figure out how to coordinate this. This is the kind of mapping 

exercise that I'm hoping many of you who work in the services base can engage in to 

identify who the partners are that we need to meet with.

Similarly on housing side, understand who is your Medicaid agency, who provides Money 

Follows the Person services and currently provides home and community-based services 

and what services are covered for what populations, how does your state behavioral health 

agency fit into the mix and your Area Agencies on Aging, Centers for Independent Living 

and other agencies that serve people with disabilities.

There’s a mapping exercise that needs to happen at the state level so we can engage in a 

birds-eye view of comprehensive planning to get full advantage of these resources to create 

housing services opportunities for populations we’re speaking about.

I want to give 2 examples here of states that have engaged in this. One of them is in 

Vermont, and where back in 2011, Vermont engaged in a multi-pair of advanced primary 

care practice demonstrations, where they took their Medicare payers and Medicaid managed 

care organizations are brought them to the table and said how can we improve access to 

care in the delivery of care and health outcomes for older adults, also look at ways that we 

can integrate our efficiency, and they engaged a process where they said let’s map where 

all of the older adult housing is, whether it is Section 202 housing and public housing and 

other low-income housing and figure out if there's a better way to ensure that older adults 

in the housing can have access to the services that can be tailored to their needs as well 

their needs go up or down, as their health needs may increase as they in, and they need 

more services, how can we provide a way to deliver services to as many older adults and 

low income housing as possible, and where we are not doing it on a sort of person by 

person basis, we don't actually know who the service providers are, but in a sort of 

statewide context. 

So they engaged in this proactive collaborative redesigned way that they are providing longterm services and supports to older adults, and they sort of organized service delivery into 

55 regions and appointed a service coordinator and wellness nurse to coordinate the care of 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 12

all the residents of multiple HUD assisted housing in their area or region. And then also to 

serve people who may not be living in HUD housing but are living in surrounding 

communities.

Those coordinators and wellness nurses are the glue that are brokering connections to a 

broader array of services and supports. That's the kind of model I think that may be unique 

to Vermont but a similar approach can be taken if states engage in a proactive birds-eye 

view to design coordination of housing services at the state level.

Another example is in Louisiana. Back in the aftermath of Hurricanes Katrina and Rita where 

the state of Louisiana was facing significant disasters, many people experiencing 

homelessness were displaced, they actually received an allocation of 3,000 special vouchers 

to house people experiencing homelessness who were affected by those hurricanes and 

disasters and place them into permanent housing. Recognizing that they were getting a 

windfall of housing resources, Louisiana decided they had an opportunity to figure out how 

can they pair and coordinate wraparound services for people who are going to receive those 

vouchers, people experiencing homelessness, as well as people in institutional settings with 

disabilities, and what they decided to do was engage in a partnership with a Medicaid 

agency, Louisiana Department of Health, to work with Louisiana Housing Corporation and 

housing authorities across the state to design a new approach to providing wraparound 

services. 

Through a variety of Medicaid authorities and state plan amendments and waivers, which I 

won't get into, they essentially designed a way to ensure as many people as possible who 

were experiencing homelessness, who have disabilities, could receive wraparound services 

and came up with a way for people to apply for both vouchers as well as Medicaid-funded 

services in a coordinated fashion.

So, that was Louisiana, and they had this opportunity to partner because of those special 

resources. I think in many ways, nationally speaking, we have our own Hurricane Katrina 

and Rita moment which is that COVID-19 has exacerbated and laid bare the degree to 

which we are dealing with a housing crisis and homelessness crisis in our country. According 

to the American Rescue Plan, there has been a windfall of resources provided to 

communities in the form of new housing resources to address homelessness. $5 billion in 

new emergency housing vouchers; there are now 70,000 emergency housing vouchers that 

are intended to serve people experiencing or at risk of homelessness that have been 

awarded across the country. 

HUD has also awarded $5 billion in grants through our Home Investment Partnerships 

Program that enables communities to build more permanent supportive housing, other 

affordable housing including where they’re purchasing and converting hotels and 

dormitories really quickly into affordable housing, as well as provide short-term rental 

assistance and supportive services. There's been funds at the Treasury to provide 

emergency rental assistance for people falling behind in rent or facing evictions, and 

another $350 billion in Treasury, state and local fiscal recovery funds, and many 

communities are looking at how they can use those to support housing and homelessness 

activities. There's more resources than perhaps I've seen in certainly my long career in this 

field, but perhaps really in our lifetime in this particular moment to address homelessness.

And so this is the moment when I'm hoping to see many more housing and services 

partnerships and collaborations at the state level to figure out how we capitalize in this 

moment where we have significant housing resources to figure out how we also finance 

wraparound services so that people can have that package together.
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 13

And then finally on the last slide one of the other opportunities is that HUD has launched a 

national initiative. Secretary Fudge has invited mayors, governors and county leaders into a 

partnership called House America, where is asking them to pledge to HUD how many people 

who are experiencing homelessness will be re-housed, how many additional units of 

supportive housing will be created. I think this is another opportunity through House 

America to identify which leaders to partner with at the state and local levels. I'll place the 

House America information in the chat. I'll turn it over to you, Lori.

LORI GERHARD:

Thank you for that and for sharing House America resources. We really want to encourage 

communities to join. The chat has been busy, and people like the flowchart idea. I'd like to 

take a moment and thank all of you for sharing your partnership information with us. We 

are seeing lots of different types of partnerships in the chat, and I will just mention some of 

the types of organizations. Housing, Area Agencies on Aging, community action centers, 

senior centers, Centers for Independent Living, State Councils on Independent Living, Los 

Angeles homeless services authorities, CSH, Mayor’s Council on Disabilities, organizations 

supporting people who are leaving jails, housing authorities, Federally Qualified Health 

Centers, State Housing Finance Agencies and many more.

Many thanks for sharing those ideas. We would like you to now also share with us in the 

chat a note about how you are working with partners to use American Rescue Plan Act for 

other funding to address local housing challenges. While you are providing us with your best 

examples of how you are using these funding opportunities, I'd like to turn it over to our 

distinguished colleague, Martha Egan from CMS, who will highlight opportunities with 

Medicaid and Medicare. Martha, the floor is yours.

MARTHA EGAN:

Thank you, Lori. I want to start out by saying CMS is excited to be part of this federal 

partnership panel helping people to obtain or maintain stable housing and access to home 

and community-based services. We want to start off by saying CMS really does recognize 

that access to affordable and accessible housing opportunities and high-quality HCBS is 

really dependent on strong partnership and resources at the local, state and federal level. 

Really no one agency, organization, program or provider can do the work of increasing 

affordable and accessible housing opportunities in a silo or on their own, so these 

partnerships are key.

Additionally, I think we also want to point out that CMS really recognizes that strong 

partnerships, at any one of these levels can lead to approaches that put individuals at the 

center of their care. This helps to meet people where they are and coordinate care 

seamlessly across settings. This is whether individuals are transitioning from institutional 

settings to the community, from congregate settings to integrated community-based 

housing, from the street or shelter to a home or gaining more independence and safety in 

the home of one's own.

I'm going to start with a very brief discussion of home and community-based services and 

its relationship to helping Medicaid beneficiaries to maintain affordable, accessible housing, 

and I'm going to talk about two current and very exciting HCBS initiatives under the 

Medicaid program that can provide opportunities to state Medicaid agencies to collaborate 

and partner with state and local housing agencies and organizations and all housing 

resources that are now out there to help individuals transition into affordable and accessible 

housing.
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 14

So, home and community-based services under the Medicaid program. As a very quick 

reminder, HCBS, these are optional Medicaid services. One reason we want to point this out 

is to remind folks that the state HCBS programs are very unique. One HCBS program is 

going to look very different from another program, so the packages and benefits, and the 

delivery of these services are going to look very unique and different from state to state.

HCBS services can include services and supports such as, but not limited to, things like case 

management, homemaker services, home health aides, personal care services, adult day 

health services, rehabilitation and respite programs. HCBS services support a wide diversity 

of individuals, and key to today's conversation, HCBS can provide services to help 

individuals to access affordable and accessible housing, and to achieve housing stability in 

community living.

Generally, under the Medicaid program, and under certain Medicaid authority, housingrelated support may include things like one-time moving costs, such as the security deposit 

or a setup fee for utilities.

Housing-related supports can also include pre-tenancy reports which can include activities 

such as insisting an individual with a housing search. It can include tenancy supports, which 

can help an individual to maintain their tenancy once the home has been secured or 

established in the community. It can include home accessibility supports, which can include 

things like installing wheelchair accessible ramps or grab bars in the bathroom.

Medicaid can be an integral part of collaboration with community-based programs, including 

state and local housing agencies, but as a reminder, Medicaid does not cover room and 

board except in certain medical institutions. I want to encourage you if you want more 

information on housing-related supports under the Medicaid program, to take a look at the 

CMS state health official letter on the social determinants of health, which we issued back in 

January 2021. So, about a year ago. There is a link provided to this particular letter on my 

last slide.

HCBS can cover housing-related supports under certain Medicaid authority, and these are 

the kinds of supports that can help older adults or individuals with disabilities to attain and 

maintain housing. HCBS really is a space or arena where states can employ very innovative 

strategies around helping individuals to access and maintain affordable, accessible housing 

and also to build these key partnerships between state Medicaid agencies, and state and 

local housing agencies.

For the next two slides we’re going to talk about the two new opportunities. The first one is 

Section 9817 of the American Rescue Plan Act. These are HCBS initiatives under the 

Medicaid program. Again, they can provide incredible opportunities to increase access to 

affordable and accessible housing, and opportunities for states to advance health and 

housing partnerships.

Under the American Rescue Plan, under Section 9817 of the American Rescue Plan, states 

were provided an estimated $12.7 billion to HCBS systems through a 10 percentage point 

increase in the federal medical assistance percentage, or FMAP, that states can receive for 

certain Medicaid HCBS expenditures. This increase is available for one year period from April 

1, 2021, to March 31, 2022, and states have an additional two years through the end of 

March 2024 to spend basically what is the amount equivalent to the amount of this 

additional funding that increased 10 percentage point increase that they receive on 

activities to enhance, expand or strengthen HCBS.
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 15

Under Section 9817, states are currently planning, and in some cases states are already 

implementing, activities and programs that are designed to enhance, expand and 

strengthen HCBS. While states cannot use the funds to pay for room and board, we are 

encouraging states to use the funds to build Medicaid housing partnerships to provide 

housing-related supports and services, or to implement other allowable activities that can 

help to address the housing needs of people receiving HCBS.

For instance, some states are using the funds to expand or enhance housing-related 

supports for individuals transitioning from institutional settings, and individuals experiencing 

or at risk of experiencing homelessness by providing, for example, intensive case 

management and outreach services and increasing support for community transition 

services.

Some states are looking to enhance and expand home accessibility options, by providing 

flexible funding, for home modifications, for home repair, assistive technology and 

equipment to better support people to remain in their homes. The one thing that we are 

especially excited to see, is some states are proposing to use the funds for capital 

investments, including to expand access to affordable and accessible housing and to nondisability specific settings as part of a state’s HCBS options. In fact, we strongly encourage 

and want to work with states to use the ARP funding to make investments in their system 

that will lead to structural or systemic changes and improvements. Now for example, grants 

or loans to explore, encourage or build affordable senior housing and capital or financing for 

affordable housing developments are permissible if the funding is to support the expansion 

or establishment of settings that comply with the HCBS regulations. 

These expenditures are not room and board costs but are capital investments to increase 

the capacity of settings that further community living and community integration. One 

important caveat to put it there is that the approval of the capital assessment activity under 

Section 9817 of the ARP, it does not authorize such activity for federal financial participation 

or FFP. So that is 9817 in a nutshell, and let's move on to the next slide and talk about 

another opportunity out there. 

So, as many of you probably do know, the Money Follows the Person or the MFP program, 

this is a long-standing grant-funded demonstration that has helped states to rebalance their 

LTSS, or long-term services and support systems, and to support people who are in 

institutional settings like nursing homes to move back to the community. Due to the success 

of the program, I think more than well over 100,000 people with disabilities and older adults 

have transitioned to the community under this program. In the last couple years the MFP 

demonstration has been operating under a couple of short-term funding extensions. 

However the program was provided additional funding for 3 years, under the Consolidated 

Appropriations Act of 2021, and this is really really very welcome news by many 

stakeholders, and really importantly, under this new legislation, under the CAA, a couple of 

additional MFP changes were enacted.

One, the CAA did expand participant eligibility for the MFP demonstration, and we do see 

minimum lengths of time that an individual needs to be in an inpatient facility before 

qualifying for MFP from 90 days down to 60 days. It also allows people to receive skilled 

nursing services or skilled rehabilitative services in a certified skilled nursing facility to be 

counted toward the length of stay requirements.

What’s exciting about these changes is it allows more people to qualify for these programs 

and allow people to qualify earlier in their institutional stay, which should make it easier for 

some people to return to the community.
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 16

Second, the funding extension allows CMS to provide opportunities for more states to 

participate in this program, and currently 35 states, including DC, are participating. 

However, additional states have not had this opportunity to join the demonstration in a 

number of years. So CMS we are expecting to release a notice of funding opportunity in the 

very near future, which will provide additional states the opportunity to participate in the 

program. And additionally, under the MFP program, states currently MFP participants and 

grantees were offered $5 million supplemental opportunity for what we are calling HBCS 

capacity building, and one area that the funding can support is developing and 

strengthening Medicaid and housing partnerships, and I will say that several of the MFP 

programs have, or are using the supplemental funding to strengthen their Medicaid and 

housing partnerships.

And I just want to point out under MFP why MFP is so important for this intersection of 

health and housing, is because under the MFP demonstrations, they can really cover a 

number of housing-related services and supports. Including one-time community transition 

costs. They can also employ housing specialists and housing coordinators, and these are 

staff who can either help with system-level partnership building to increase affordable and 

accessible housing opportunities for people transitioning out of inpatient facilities, and it can 

also include housing coordinators which work more at an individual level and work with 

individuals to identify and secure affordable and accessible housing in the community.

The MFP demonstration can also fund housing infrastructure activities, such as the 

development and maintenance of statewide housing registries. So there's lots of 

opportunities under the Medicaid program to really strengthen housing and health 

partnerships. So we are really looking forward to working with any current or new MFP 

grantees to advance the innovative strategies to provide housing-related supports to 

individuals who are transitioning from institutional settings or to address any gaps in 

housing services and support the states can cover under the MFP program and to build 

stronger and more-effective housing partnerships.

So again, some very exciting opportunities. Let’s go to the next slide. 

With this I will be very brief. This is a list of some resources from CMS and Medicaid that are 

available on Medicaid.gov. These may be helpful to you when working on your health and 

housing partnerships. We just want to make sure that you have these available. If you have 

any questions on any of these resources, feel free to reach out. So Lori, I’m going to turn it 

back over to you.

LORI GERHARD:

Well thank you so much Martha, that was exciting information, and thanks too to Richard 

and Michelle. You have shared incredible resources, opportunities and partnership examples 

that are already underway to support our collective work to build and strengthen our 

partnerships throughout the country.

Before we moved to the question and answer part of the session, we would like to do a 

quick lightning round with all of the speakers to share strategies to advance equity.

So in each of our focus areas–housing, home and community-based services, and health–

there are marked disparities and historically underserved communities. Each of our agencies 

is committed to advancing equity. How can states and community partners advance equity?

One way is to involve people who live in the community and are representative of the 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 17

community served in the design and delivery and systems changes of the programs. We are 

now going to do a quick lightning round with each of my federal colleagues having 2 

minutes to share one or 2 practices that state and community partnerships can use to 

advance equity. Martha let us start with you.

MARTHA EGAN:

So how prospective partnerships can advance equity. And I just want to start off by saying 

that Medicaid really is a key driver of health equity and that health equity really is at the 

forefront of Medicaid policy. But you know, CMS does fully recognize that prospective health 

and housing partnerships can really work in order to address health disparities and advance 

health equity and really, in a number of ways.

One, strong partnerships can really integrate a diversity of community perspectives. 

Secondly, health and housing partnerships can harness the collective capabilities of local, 

state, and federal governments, and community organizations and provider networks. 

Health and housing partnerships can help to break down silos that sometimes can actually 

isolate or even perpetuate disparities and sometimes create barriers to health and housing 

stability. And finally, cross-sector collaborations can really work to advance and accelerate 

systems and transformation.

Over the past several years, CMS has really been committed to supporting states in 

numerous ways around building housing and health partnerships. For example, CMS 

launched the Medicaid Accelerator Program, and this particular program offered 

opportunities for state Medicaid agencies to develop partnerships with housing agencies and 

work on detailed action plans to meet the needs of diverse Medicaid-eligible populations, 

individuals transitioning from institutional settings, individuals experiencing or at risk of 

homelessness, individuals at risk of institutional placement, among others. More recently, 

CMS convened a state learning collaborative to build state health and housing partnerships 

to focus on the needs of individuals experiencing homelessness and substance use disorders 

under the SUPPORT Act.

CMS continues to provide technical assistance to states around leveraging the flexibility 

under the Medicaid program to enable Medicaid beneficiaries to achieve community living 

goals, and to achieve and maintain housing stability. And providing services often requires 

sharing data across sectors and building relationships among community and state partners 

to inform not only decision-making but to improve community living and health for diversity 

of Medicaid populations. So CMS really wants to encourage states and communities to 

participate in these types of learning and engagement opportunities to fully leverage the 

opportunities that were presented under Section 9817. And under the MFP program and 

really participation, these types of programs can lead to strong partnerships that can 

collectively and continually address equity.

LORI GERHARD:

Michelle, we’ll turn to you next.

MICHELLE DALY:

SAMHSA promotes equity across all efforts through our Office of Behavioral Health Equity, 

utilizing the following key strategies: data, policy, quality practice and workforce 

development and communication. So you keep hearing us reinforcing partnerships and 

collaboration. This is really critical when it comes to looking at equity. Data, just to mention, 

just a lot of the data to look at outcomes and access don't come from one system. So, really 

looking hard across multiple systems to access data that can tell you a more complete 

picture of those you are serving, and/or how to set up your policies.
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 18

Through the work around health equity that we are doing, we are striving to eliminate 

structural and racial barriers to health and well-being for vulnerable and marginalized 

populations. One collaborative effort that I’d encourage you to take a look at, that SAMHSA 

is involved with, and also with the National Institutes of Health, with the National Institute 

of Minority and Health Disparities and the Annie Casey Foundation, which funds the National 

Network to Eliminate Disparities in Behavioral Health, or NNED, that coordinates the NNED 

shared collaborative space, in which partners can share with others. So we'll put some links 

for those in the chat, and I encourage you to take a look at that. Thank you Lori.

LORI GERHARD:

And Richard we will turn to next.

RICHARD S. CHO:

I think in many ways, Martha touched on this, these housing and services partnerships that 

we are talking about, is a strategy to advance equity because we know that people who 

have housing but lack supportive services, or vice versa, the lack of having the combination 

can further increase disparities, particularly for people with disabilities, but also based on 

race. 

If you look at who lives in assisted housing who winds up in institutional care, the data will 

likely show that it is older adults of color who have a greater risk of entering institutional 

care. Similarly, people with disabilities, there is data that demonstrates that when people 

with disabilities who lack access to housing services have a higher risk of entering 

institutional settings, and certainly the data we have on homelessness shows that there are 

significant racial disparities in homelessness. Where for example, whereas Black Americans 

represent 13% of the general population, they represent 40%, sometimes higher, of the 

homeless population. 

And we had communities that have not really sort of been intentional about addressing 

equity and where they may have actually been successful in reducing rates of homelessness 

overall, but without having that kind of attention on equity, what they have done is actually 

exacerbated racial disparities where essentially, white people experiencing homelessness 

have been getting access to housing assistance.

Many of the tools that are used to prioritize access to housing assistance, as well to 

determine who is eligible for services, often have racial biases built into them, so I think it is 

really important to look at those tools. 

Then I will just echo what both Martha and Michelle said: Data is really key. As I noted, 

those disparities I mentioned come from data analysis that many communities have done 

where they look at the demographics of who experiences homelessness, or who gets

housing and services coordination in their communities, and lastly to look at who is getting 

access to those services and are we being equitable in respect to who is in need of those 

housing and services. So that is definitely key.

But I think a key part of this is to center these efforts around equity, to keep that front of 

mind, and to keep on my soapbox, these housing and services partnerships, that is a key 

strategy of the definition of equity is the recognition that people need different levels of 

assistance to be able to achieve equitable outcomes. Not everybody needs the same thing, 

we cannot assume that if we have systems and approaches that intend to serve all that 

everyone is going to have equal access. We need to provide higher touch for certain

communities and populations and do the special things, and that is what equity is all about. 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 19

To me that coordination of housing and services is key to advancing equity.

LORI GERHARD:

I have to say, we've generated lots of questions and we have probably eight minutes or so 

we can spend on Q&A. We will get started. Please note, if you asked a question that hasn't 

been responded to we will add it to frequently asked questions document and respond to it. 

Those will be posted with the slides. Our first question is for Martha.

It would be helpful to hear how Medicaid can be used to support housing needs and the 

specific allowability, including through waivers. Thank you.

MARTHA EGAN:

We would need multiple webinars on that, but I want to say obviously there are multiple 

pathways under the Medicaid program to provide housing-related support to individuals. 

Whether it's done under an HCBS waiver program, or as I mentioned earlier in my 

presentation, under some of the HCBS state plan services, there are multiple pathways. 

CMS offers all kinds of technical assistance to help states. The Medicaid program is in 

partnership with states, between CMS and states, so we can really work with states to 

figure out what these pathways are and what will work best for states. In terms of informing 

yourself around what the services and supports are and how they can be implemented 

under different Medicaid authorities, again I encourage you to take a look at that social 

determinants of health letter that we issued back in January 2021, and it really does kind of 

outline and explain all of the different types of Medicaid authority and how you can deliver 

or address social determinants of health, including housing, under the Medicaid program. 

And start there.

LORI GERHARD:

Thank you, Martha. Our next question is for Richard. Richard, how is HUD incorporating the 

planning of housing placement in relation to mobility transportation community. It is 

important that they are able to get to work, jobs, school, health care and complete daily 

tasks that require transportation, as most do not own a car. You want to take a stab at 

that?

RICHARD S CHO:

We certainly don't have it all figured out at this point, but we are looking at a couple of 

things. First is with respect to vouchers. People can take rental assistance and find housing 

in the private market. There's a lot of compelling research that shows the importance of 

certainly voucher policies and payment standards and opening up access to a lot more parts 

where housing exists, but also the role of mobility counseling and helping people to find 

communities of opportunity as well as communities where there is higher chances of having 

proximity to jobs as well as transportation and other amenities.

With respect to siting housing, I think we are doing things on a number of fronts, including 

looking at how we can help support more equitable siting of housing, looking at how 

communities’ zoning and other practices are creating barriers to providing housing, and 

communities where there may have a greater chance of access to transportation. Those are 

a couple of things we are looking at across different programs, but frankly we have a lot 

more work we can be doing in that space.

LORI GERHARD:

Thanks, Richard. I will add to your response that HHS and HUD are part of the Coordinating 

Council on Access and Mobility that’s led through the Department of Transportation, we 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 20

were looking at how to increase access to transportation. There's a website we will put in 

the chat on the CCAM. There are some resources on how to bring together some of the 

federal funding to really help increase access to transportation in communities. There are 

several resources available, but Richard is saying we are working on this together and we 

still have some work to do in this area.

Richard, have another question here. This one is, our local housing authorities do Section 8 

housing choice vouchers. How would one find out about other vouchers available in our 

community?

RICHARD S CHO:

A really good useful resource, I believe it's on the Housing and Services Resource Center 

webpage, is our housing choice voucher dashboard. We have publicly available information 

on which housing authorities have which type of vouchers, so regular housing choice 

vouchers, but there are also what we call special-purpose vouchers, and that includes the 

two I mentioned already: Mainstream vouchers and Non-elderly Disabled Vouchers. Also 

HUD/VASH Programs and Family Unification Program vouchers. I'll make sure the link is in 

the chat, but our housing voucher dashboard provides information. You can go to the 

individual state or housing authority level to see how many vouchers they have in each 

category and how many they have leased up, which if you subtract leased from that total, 

that gives you the number of available vouchers that are in the dashboard. I believe page 7 

of the housing choice voucher dashboard shows where the special purpose vouchers are 

such as vouchers for people with disabilities or veterans.

LORI GERHARD:

Take you for sharing that. We had another question about CAPABLE, and whether there are 

any grants for home modifications. I will just share that we are aware that John Hopkins 

School of Nursing does have an RFP on this, I think it closes on March 16, looking to 

establish a national center for promoting CAPABLE.

If you are interested in learning more about that opportunity, please email us at 

hsrc@acl.gov, and we will be happy to respond to you.

We got another question here.

MARTHA EGAN:

I just wanted to add really quickly, there are a number of states that are using the Section 

9817 funds under the American Rescue Plan Act to fund CAPABLE programs or CAPABLE 

models, I can work to identify those and let you know what states are actually working on 

CAPABLE programs under 9817.

LORI GERHARD:

That's great, thank you, Martha. Does anybody else want to add anything on home 

modifications or CAPABLE?

Our next question is, my office has a program to make housing both owned and rental more 

physically accessible if the person with a disability is a Medicaid recipient, and/or veteran 

and residing in (unknown term) or Columbia County. I'm not sure who to partner with to 

inform them so we could be more helpful to residents. I am new to working with programs 

as my second job from my office. Thanks for anyone who has time to make suggestions.

Organizations that people can partner with if they help make homes more accessible. I will 

start. I know that the state unit on aging, State Independent Living Council, Centers for 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 21

Independent Living and Area Agencies on Aging, and Aging and Disability Resource Centers 

would all be interested in learning about your organization and the work that you do. They 

often times come in contact with people who are looking to make homes more accessible, 

and could help get you connected to people that would be looking for your knowledge and 

expertise.

We have another question around what is HUD doing to address the fact that many 

landlords won't accept housing choice vouchers and that rents are skyrocketing with 

inflation?

RICHARD S CHO:

I can take that one. We know that there are challenges right now. Some of the data that we 

have shows that rents are spiking all over the country. Some of that is related to the effects 

of the pandemic. And that many communities have voiced to us there are challenges with 

finding available units to lease with vouchers, so we are aware this is universal. 

What seems to be effective at the community level is where housing authorities and other 

service partners are taking advantage of some of the waiver authorities that HUD has 

provided to them, particularly through these new emergency housing vouchers were we 

were able to provide, thanks to the American Rescue Plan, additional admin and service fees 

that come with the vouchers. Many housing authorities are using those to do everything 

from paying for additional housing navigation services so that someone who has been 

issued a voucher can actually find housing, or actually creating landlord incentive programs 

and providing either signing bonuses, I know some communities are creating landlord 

incentive programs where if a landlord has an apartment but knows it won't pass housing 

quality inspections they can provide them with a one-time grant to make repairs and bring 

the apartment back up to meet inspections. It's a creative use to get more units available.

Where you have instances where landlords are saying, I refuse to lease to a voucher holder, 

that is something that in many states is actually, states have passed laws that provide 

source of income protections for people so that a landlord cannot discriminate against 

somebody who has a voucher. There is currently not a federal protection for that, but in 

many cases when those kind of instances happen when they refuse to take a voucher 

holder, there may also be things happening that require looking at whether potential fair 

housing violations have also existed, and certainly if that ends up being a de facto denial of 

somebody who is a protected class, whether that's based on race or disability status or 

familial status, that is something that certainly should be looked at.

What we are finding effective is where housing authorities are partnering with service 

organizations. taking advantage of some of the additional funds that are available, and 

communities are doing interesting and creative things with creating incentives for landlords, 

as well as kind of landlord risk mitigation funds to create an insurance program in case 

anything goes wrong. Lots of creative things happening. I think the best thing I've seen to 

be effective is when you find people who can actually go out and know how to engage 

landlords, explain to them how vouchers work, and also in a recent visit I took, one

community said that when they have Medicaid finance wraparound services, it provides an 

insurance to the landlord that if anything happens there's a number they can call and there 

will be a service provider who can come and help resolve the situation.

LORI GERHARD:

Thank you, Richard. Take you, Richard, Michelle and Martha. I think Richard had mentioned 

earlier about the Housing and Services Resource Center website. You can find other 

federally supported resources on that website along with information about funding 
Expanded Opportunities with Federal Funding for Housing and Services | Transcript 22

opportunities that were mentioned today, and also models and partnerships that were 

mentioned.

You can go to ACL.gov/HousingAndServices/Models.

We really want to hear your impressions of today so we can improve our webinar. We have 

a short feedback form in the chat and we will put the link for the form, if you can take a few 

minutes and fill it out, that would help us continue to make enhancements to make our 

webinars most effective to the audiences that we are providing them for. It will also help us 

understand what your thoughts and ideas are about topics that would be helpful to learn 

more about.

Next week on 15th of March we hope that each of you will return for the next event on state 

community level partnerships to bring together housing and services partnership. We will be 

featuring Washington state and Massachusetts, so please join us. Can you go to the next 

slide.

Hopefully you’ve heard some opportunities that you can act on in the coming weeks. Before 

we close, I want to remind everyone that in the coming days, we will post the recording of 

this webinar. Thank you so much for your participation today, and in the meantime, please 

use the links that staff are putting in the chat to register for the next webinar. 

Visit the HSRC models and partnership page, complete the webinar feedback form, watch 

for our emails when the webinar recording and slides are available. Please email us with any 

questions or additional information that you would like to share at HSRC@ACL.HHS.GOV.

And we go to the next slide. We would like to thank Mission Analytics, USAging and the 

interpreters and our captioners for helping with their roles in this webinar, and we are 

especially grateful for all of you who joined us today and for our federal colleagues and 

speakers. Thank you, and have a good afternoon. This concludes today's webinar.

Acknowledgment

This presentation was supported in part by the U.S. Administration for Community Living 

through a contract with Mission Analytics Group, Inc. (Contract number 

HHSP233201500060I) which subcontracted the work to USAging. The views expressed do 

not necessarily represent the positions or policies of the Administration for Community 

Living / Department of Health and Human Services.