According to the National Alliance to End Homelessness (NAEH), on any given night in Florida there are approximately 31,000 persons who are homeless. Of this population approximately 27% are families, while 67% are individuals consisting of Veterans, the severely mentally ill, the chronically homeless and those suffering from substance use disorders.
Social factors like housing, food security, and the environment have a significant impact on each individual’s health. As a result, decision-makers are beginning to use the Medicaid program’s flexibility to provide additional supports to keep people healthy.
One such effort is Florida’s recent use of a 1115 Medicaid Waiver to help Floridians with substance use disorders and serious mental illnesses that are homeless or at risk of homelessness.
1115 Medicaid Waivers allow states to explore programming with potentially positive impacts on vulnerable populations within their state. In essence: an experimental and limited expansion of Medicaid services. The experiment must be approved by the Centers for Medicare and Medicaid (CMS).
On March 26, 2019, the Florida State Legislature received approval for the Behavioral Health and Supportive Housing Assistance Pilot (1115 Waiver) from CMS. The state can enroll as many as 42,500 people in this pilot. The experimental program begins July 1, 2019 and ends June 30, 2022.
This programming will only take place in two distinct regions of the state, with annual enrollment limits:
The Behavioral Health and Supportive Housing Assistance Pilot will provide qualifying enrollees with:
Transitional housing services: Services that support a recipient in the preparation for, and transition into, housing.
Tenancy sustaining services: Services that support a recipient in being a successful tenant.
Mobile crisis management: The delivery of immediate de-escalation services for acute maladaptive symptoms and/or behaviors.
Self-help/peer support: Person centered service promoting skills for coping with and managing symptoms while utilizing natural supports (such as family and friends).
The state must follow home and community-based services requirements regarding person-centered planning, conflict of interest, and home and community-based setting requirements. Therefore, this will be no cookie-cutter approach towards this population.