II 118th CONGRESS 1st Session S. 2932 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. Short title This Act may be cited as the Housing Alignment and Coordination of Critical and Effective Supportive Health Services Act or the Housing ACCESS Act . 2. Guidance to States on connecting Medicaid beneficiaries with housing-related services and supports and other housing resources (a) In general Not later than 12 months after the date of enactment of this Act, the Secretary of Health and Human Services, in consultation with the Secretary of Housing and Urban Development and the Secretary of the Treasury, shall issue guidance to State Medicaid agencies, public housing agencies, Continuums of Care, and housing finance agencies to connect individuals who are receiving medical assistance under a State Medicaid program to Medicaid housing-related services and supports and other housing resources in an integrated manner. (b) Required information The guidance issued pursuant to subsection (a) shall include information on— (1) simplifying health care services for housing and homelessness service providers and simplifying housing support services for health care service providers to understand the respective sectors; (2) developing a memorandum of understanding between State Medicaid agencies, public housing agencies, Continuums of Care, and housing finance agencies that— (A) coordinates housing-related services and supports provided under a State Medicaid program with other housing resources by aligning— (i) eligibility criteria; (ii) eligibility determination processes; and (iii) outcome measures, including housing stability and health outcomes disaggregated by race; (B) encourages providers of housing-related services and supports to seek reimbursement for such services and supports through the State Medicaid program, including by— (i) explaining how such providers may receive such reimbursement; (ii) helping such providers understand the eligibility determination process for housing-related services and supports offered under the State Medicaid program; and (iii) providing guidance with respect to tracking common outcome measures, including housing stability and health outcomes disaggregated by race; and (3) existing authorities under which a State Medicaid program may make Federal funds available to providers of housing-related services and supports to build information technology and financial systems and establish adequate infrastructure and staffing levels to seek Medicaid reimbursement. (c) Reporting Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services, in consultation with the Secretary of Housing and Urban Development and the Secretary of the Treasury, shall submit a report to Congress that includes— (1) information on the progress of State Medicaid agencies, public housing agencies, Continuums of Care, and housing finance agencies in aligning eligibility criteria, eligibility determination processes, and outcome tracking; (2) information on the adoption by such agencies and Continuums of Care of recommendations made in the guidance issued pursuant to subsection (a); and (3) feedback from States on such guidance and challenges faced by States in connecting individuals receiving medical assistance under a State Medicaid program with housing-related services and supports and other housing resources. (d) Definitions In this section: (1) Continuum of Care The term Continuum of Care has the meaning given such term in section 578.3 of title 24, Code of Federal Regulations. (2) State Medicaid program The term State Medicaid program means a State plan for medical assistance under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ), and includes any waiver of such a plan. 3. National rate study on the cost of housing-related services and supports (a) In general The Secretary of Health and Human Services (referred to in this section as the Secretary ) shall conduct a national rate study on the cost of housing-related services and supports to determine appropriate rates for such services and supports that will allow providers of such services and supports to pay living wages, reduce staff turnover, and ensure a maximum case manager-to-client ratio of 1:15 in alignment with the evidence-base for strong supportive housing outcomes. Such study shall include an analysis of reimbursement rates for services provided by certified community behavioral health clinics (as such term is used in section 223 of the Protecting Access to Medicare Act of 2014 ( 42 U.S.C. 1396a note)) and Federally-qualified health centers (as defined in section 1905(l)(2)(B) of the Social Security Act ( 42 U.S.C. 1396d(l)(2)(B) )) that promote integrated care, which may include, but is not limited to, housing-related supports and services, and serve people with complex conditions. (b) Publication Not later than 2 years after the date of enactment of this Act, the Secretary shall publish the results of the study conducted under this section as guidance to State Medicaid agencies.