II 

118TH CONGRESS 

1ST SESSION S. 2932 

To direct the Secretary of Health and Human Services to provide guidance 

to State Medicaid agencies, public housing agencies, Continuums of Care, 

and housing finance agencies on connecting Medicaid beneficiaries with 

housing-related services and supports under Medicaid and other housing 

resources, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 26 (legislative day, SEPTEMBER 22), 2023 

Mr. MARKEY (for himself, Mr. PADILLA, Mr. BLUMENTHAL, and Mr. BOOKER) introduced the following bill; which was read twice and referred to 

the Committee on Finance 

A BILL 

To direct the Secretary of Health and Human Services to 

provide guidance to State Medicaid agencies, public housing agencies, Continuums of Care, and housing finance 

agencies on connecting Medicaid beneficiaries with housing-related services and supports under Medicaid and 

other housing resources, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Housing Alignment 

3 and Coordination of Critical and Effective Supportive 

4 Health Services Act’’ or the ‘‘Housing ACCESS Act’’. 

5 SEC. 2. GUIDANCE TO STATES ON CONNECTING MEDICAID 

6 BENEFICIARIES WITH HOUSING-RELATED 

7 SERVICES AND SUPPORTS AND OTHER HOUS8 ING RESOURCES. 

9 (a) IN GENERAL.—Not later than 12 months after 

10 the date of enactment of this Act, the Secretary of Health 

11 and Human Services, in consultation with the Secretary 

12 of Housing and Urban Development and the Secretary of 

13 the Treasury, shall issue guidance to State Medicaid agen14 cies, public housing agencies, Continuums of Care, and 

15 housing finance agencies to connect individuals who are 

16 receiving medical assistance under a State Medicaid pro17 gram to Medicaid housing-related services and supports 

18 and other housing resources in an integrated manner. 

19 (b) REQUIRED INFORMATION.—The guidance issued 

20 pursuant to subsection (a) shall include information on— 

21 (1) simplifying health care services for housing 

22 and homelessness service providers and simplifying 

23 housing support services for health care service pro24 viders to understand the respective sectors; 

25 (2) developing a memorandum of understanding 

26 between State Medicaid agencies, public housing 


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1 agencies, Continuums of Care, and housing finance 

2 agencies that— 

3 (A) coordinates housing-related services 

4 and supports provided under a State Medicaid 

5 program with other housing resources by align6 ing— 

7 (i) eligibility criteria; 

8 (ii) eligibility determination processes; 

9 and 

10 (iii) outcome measures, including 

11 housing stability and health outcomes 

12 disaggregated by race; 

13 (B) encourages providers of housing-re14 lated services and supports to seek reimburse15 ment for such services and supports through 

16 the State Medicaid program, including by— 

17 (i) explaining how such providers may 

18 receive such reimbursement; 

19 (ii) helping such providers understand 

20 the eligibility determination process for 

21 housing-related services and supports of22 fered under the State Medicaid program; 

23 and 

24 (iii) providing guidance with respect 

25 to tracking common outcome measures, inVerDate Sep 11 2014 07:04 Sep 27, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2932.IS S2932

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1 cluding housing stability and health out2 comes disaggregated by race; and 

3 (3) existing authorities under which a State 

4 Medicaid program may make Federal funds available 

5 to providers of housing-related services and supports 

6 to build information technology and financial sys7 tems and establish adequate infrastructure and 

8 staffing levels to seek Medicaid reimbursement. 

9 (c) REPORTING.—Not later than 2 years after the 

10 date of enactment of this Act, the Secretary of Health and 

11 Human Services, in consultation with the Secretary of 

12 Housing and Urban Development and the Secretary of the 

13 Treasury, shall submit a report to Congress that in14 cludes— 

15 (1) information on the progress of State Med16 icaid agencies, public housing agencies, Continuums 

17 of Care, and housing finance agencies in aligning eli18 gibility criteria, eligibility determination processes, 

19 and outcome tracking; 

20 (2) information on the adoption by such agen21 cies and Continuums of Care of recommendations 

22 made in the guidance issued pursuant to subsection 

23 (a); and 

24 (3) feedback from States on such guidance and 

25 challenges faced by States in connecting individuals 


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1 receiving medical assistance under a State Medicaid 

2 program with housing-related services and supports 

3 and other housing resources. 

4 (d) DEFINITIONS.—In this section: 

5 (1) CONTINUUM OF CARE.—The term ‘‘Con6 tinuum of Care’’ has the meaning given such term 

7 in section 578.3 of title 24, Code of Federal Regula8 tions. 

9 (2) STATE MEDICAID PROGRAM.—The term 

10 ‘‘State Medicaid program’’ means a State plan for 

11 medical assistance under title XIX of the Social Se12 curity Act (42 U.S.C. 1396 et seq.), and includes 

13 any waiver of such a plan. 

14 SEC. 3. NATIONAL RATE STUDY ON THE COST OF HOUSING15 RELATED SERVICES AND SUPPORTS. 

16 (a) IN GENERAL.—The Secretary of Health and 

17 Human Services (referred to in this section as the ‘‘Sec18 retary’’) shall conduct a national rate study on the cost 

19 of housing-related services and supports to determine ap20 propriate rates for such services and supports that will 

21 allow providers of such services and supports to pay living 

22 wages, reduce staff turnover, and ensure a maximum case 

23 manager-to-client ratio of 1:15 in alignment with the evi24 dence-base for strong supportive housing outcomes. Such 

25 study shall include an analysis of reimbursement rates for 


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1 services provided by certified community behavioral health 

2 clinics (as such term is used in section 223 of the Pro3 tecting Access to Medicare Act of 2014 (42 U.S.C. 1396a 

4 note)) and Federally-qualified health centers (as defined 

5 in section 1905(l)(2)(B) of the Social Security Act (42 

6 U.S.C. 1396d(l)(2)(B))) that promote integrated care, 

7 which may include, but is not limited to, housing-related 

8 supports and services, and serve people with complex con9 ditions. 

10 (b) PUBLICATION.—Not later than 2 years after the 

11 date of enactment of this Act, the Secretary shall publish 

12 the results of the study conducted under this section as 

13 guidance to State Medicaid agencies. 

Æ 


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