Permanent Supportive Housing

Permanent Supportive Housing (PSH) is a model that combines low-barrier affordable housing, health care, and supportive services to help individuals and families lead more stable lives. PSH typically targets people who are homeless or otherwise unstably housed, experience multiple barriers to housing, and are unable to maintain housing stability without supportive services. This model has been shown to not only impact housing status, but also result in cost savings to various public service systems, including health care. This page includes resources that address clinical challenges, financial options, and implementation strategies related to PSH.

Technical Assistance and Training Program

The National Health Care for the Homeless Council is partnering with the Corporation for Supportive Housing to support Health Centers that are interested in establishing or expanding services in permanent supportive housing. Technical Assistance and Trainings are available at no cost to Health Centers. To take advantage of this opportunity, please send inquiries to Lauryn Berner at LBerner@nhchc.org.

Upcoming Webinars

  • Understanding Data Elements and Outcome Measures in Health and Housing Partnerships, Thursday, April 27, 2017 at 2pm ET, Register Now!

Archived Webinars

To view past webinars from this Technical Assistance and Training program, visit the CSH Supportive Housing Training Center and search “HRSA”. Topics covered have ranged from care coordination, developing partnerships, and working with MCOs, to data sharing, coordinated assessment, and funding resources.

NHCHC Publications

  • Health Outcomes & Data Measures: A Quick Guide for Health Center & Housing Partnerships, April 2017. This guide, created with the Corporation for Supportive Housing, provides an overview of how health centers and supportive housing providers are tracking and utilizing data to demonstrate progress with the most medically and socially complex patients.
  • Project Profiles. Developed in partnership with the Corporation for Supportive Housing, this series highlights collaborative health and housing initiatives.
    • 10th Decile Project: Los Angeles, CA, September 2015.  The 10th Decile Project brings together health centers, hospitals, and homeless service providers to connect consumers to housing through intensive case management.
    • Integrated Care for the Chronically Homeless: Houston, TX, January 2016. Through their 1115 Medicaid Waiver, the Houston community created an initiative that brings together the Healthcare for the Homeless provider, a social service provider, and a housing provider to form a highly collaborative care team.
    • Frequent Users Systems Engagement (FUSE): Washtenaw County, MI, July 2016. Using a data driven approach, the FUSE initiative connects systems of care to provide housing and services to homeless frequent users of the hospital system.
    • Housing the First 100: Orlando, FL, September 2016. By partnering with various sectors, the Housing the First 100 initiative has creatively funded and housed the most vulnerable individuals in the community through intensive case management and a connection to primary care.
    • Improving Care for Medically Complex Patients: Medical Respite and Supportive Housing, April 2017. Both Yakima Neighborhood Health Services (Yakima, WA) and Circle the City (Phoenix, AZ) meet the needs of vulnerable individuals exiting hospitals by providing Medical Respite care. Their innovative partnerships and care coordination have allowed these communities to demonstrate how medical respite can be an effective bridge to supportive housing.
    • Community Based Supportive Housing Serving Persons with Disabilities at Risk of Institutional Care, April 2017. Long-term services and supports are a critical resource for individuals who have an intellectual, developmental, behavioral, and/or physical disability. Creative partnerships developed in Chicago, IL and Washington, D.C. demonstrate how health centers, behavioral health providers, and housing providers can work together to serve individuals at-risk of institutionalization and support community integration.
  • Comments to the Joint Commission re: Permanent Housing Support Services, August 2015. The Council provided feedback on the Joint Commission’s Proposed Standards for Permanent Housing Support Services, as part of their Behavioral Health Accreditation Program. These comments reflect the Council’s position on health center involvement in Housing First initiatives.
  • Program and Policy Alert: Medicaid Financing for Housing-Related Services, June 2015. This alert, released in partnership with the National Alliance to End Homelessness, the Corporation for Supportive Housing, and the Technical Assistance Collaborative, provides an overview of an Informational Bulletin released by the Centers for Medicare and Medicaid Services (CMS), which discusses how communities can use Medicaid to fund housing-related services.
  • Medicaid & Permanent Supportive Housing: A Quick Guide for Health Centers, April 2015. This fact sheet provides a brief outline of elements discussed in two documents published by the U.S. Department of Health and Human Services, through the Assistant Secretary for Planning and Evaluation.
  • Policy and Practice Brief: Case Studies Illustrating Clinical Challenges in PSH, August 2013. This brief complements our 2011 report, discussing two specific clients and the challenges they present to their care teams. It is intended to further illustrate both the clinical and policy practices that should be considered to maximize the effectiveness of PSH for those clients with more complex needs.
  • Clarification of the 12-Month Rule, HRSA has recently clarified the definition of homelessness in response to language included in the Senate Appropriations Committee Report and confirmed in the Conference Committee Report on the FY2012 Appropriations Act. Read this Policy Advisory from John Lozier, executive director of the National Health Care for the Homeless Council.  Here is the memo from Jim Macrae, Bureau of Primary Health Care at HRSA.
  • Policy and Practice Brief: Clinical Challenges in Permanent Supportive Housing, 2011. This brief highlights issues faced by clinicians providing direct services in the field and makes policy and practice recommendations to help strengthen this growing model of care. The brief is also directed at administrators and policymakers so they may better understand these challenges and work to reduce common barriers.

Additional Resources