Eight states aim to improve homeless services through federal HSPA initiative

April 25, 2024

Maryland and Massachusetts are now poised to expand housing-related services for people with disabilities and older adults who are experiencing or at risk of homelessness, thanks to a newly launched Housing and Services Partnership Accelerator (HSPA).

Altogether, eight states and the District of Columbia were selected by the Department of Housing and Urban Development (HUD) and the Department of Health and Human Services (HHS) to participate in the program. Each state has already been approved for either a Medicaid section 1115 demonstration or section 1915(i) state plan amendment covering housing-related services. The Centers for Medicare and Medicaid Services released its most recent guidance for covering housing-related services through Medicaid authorities in November 2023.

A man wearing a blazer stands near a ramp railing and is addressing a group gathered between parked cars.

Housing leaders tour affordable housing during a CSG East policy summit in Connecticut.

Participating states were also required to assemble a core team from housing and health sectors comprised of at least one member from their state Medicaid agency, and three additional partners from an organization or agency focused on aging, disability, and homelessness. Teams will engage in a year-long collaboration, including needs assessments, peer-to-peer learning sessions, coaching, and meetings with subject matter experts, to study better practices for braiding funding from various sources, designing services and benefits, developing needs-based criteria for services, strategies for service delivery, and improving billing and rate-setting practices.

The District of Columbia aims to achieve a whole-person Medicaid health system by enhancing and expanding the housing services provided to Medicaid-eligible older adults and people with disabilities under its 1915(i) state plan benefit.

Maryland aims to expand its statewide coalition of stakeholders addressing homelessness among Medicaid participants. The state expects to expand its Assistance in Community Integration Services (ACIS) pilot launched in 2017, which focuses on individuals with disabilities and aging populations.

Massachusetts aims to create a map of housing-related services for people experiencing homelessness, and explore how Medicaid funding can support a permanent supportive housing program in the state.


“ We are thrilled that Maryland has the opportunity to learn from our federal partners and states across the country to help us better assist older Medicaid participants to access housing with integrated support services. ”
— Carmel Roques
Secretary, Maryland Department of Aging

HUD released its 2023 Annual Homelessness Assessment Report in December, finding 653,104 people experiencing homelessness, the highest number on record since reporting began in 2007. The report also found that more than 20% of people experiencing homelessness (approximately 138,000) were aged 55 or older. The federal government’s All In strategic plan, led by the U.S. Interagency Council on Homelessness, aims to reduce homelessness by 25% by 2025.

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