Health Care and Housing (H2) Initiative Action Planning Sessions

HomeBase has been spearheading a U.S. Department of Housing and Urban Development-sponsored initiative to help states and communities integrate subsidized housing, homeless assistance and health care services on a systems level in order to better serve vulnerable individuals with multiple needs.

H2 Initiative

The Housing – Healthcare Integration (H2) Initiative is a technical assistance effort sponsored by the U.S. Department of Housing and Urban Development (HUD) in collaboration with the U.S. Interagency Council on Homelessness (USICH) and the U.S. Department of Health and Human Services (HHS) to assist communities and states in undertaking the systems changes needed to enhance integration of the subsidized housing and health care systems. The goal of this effort is to better meet the needs of people experiencing homelessness and those who are low income and living with HIV/AIDS by maximizing their care coverage and increasing their access to comprehensive health care and supportive services coordinated with housing.

Action Planning Sessions

The cornerstone of the H2 Initiative is 2-day community-focused action planning sessions, designed and facilitated by HomeBase. These sessions bring together subject matter experts, representatives from CoC and ESG programs, HIV/AIDS providers and networks, local and state healthcare agencies, HUD and HHS regional and field offices, and other interested parties to engage in cross-system knowledge exchange and develop strategies to for the systems changes needed to enhance integration and collaboration between housing and healthcare providers.

From December 2014 through May 2016, action planning sessions have been successfully carried out in 20 states and communities across the country. Sessions involved 102 Continuums of Care and over 1200 stakeholders.

Key Features of the Action Planning Sessions

  • Community-focused planning process, led by HomeBase, to create a list of key stakeholders and pertinent agenda topics to address
  • Participation by key stakeholders from all levels of the Homeless Assistance and Health Care systems, including:
    • agency and program staff, from front-line workers to Executive Directors;
    • public housing authorities;
    • city, county, and state-level government, including representatives from health and human services, health and welfare, behavioral health, corrections and criminal justice, housing finance authorities, and other agencies and departments;
    • Federal Agency representation, including HUD, HHS’s Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA), USICH, and the Centers for Medicare and Medicaid Services (CMS);
    • managed care organizations, federally qualified health centers, hospitals, clinics, and other health care service providers;
    • funders; and
    • other interested parties.
  • Data-based profiles of the populations at the intersection of HUD-assisted housing and health care assistance, assessing their affordable housing and health care needs, services currently being provided, and the current payment sources for those services.
  • Knowledge exchange across the homeless assistance and health care systems, including:
    • baseline knowledge of how each system operates;
    • opportunities for connection and integration; and
    • case studies and best practices being explored in the host state as well as around the country.
  • Subject matter experts and experienced, effective facilitators working with diverse group of participants, focused on eliciting actionable strategies to address the specific needs of the community.
  • Tailored to local resources, with sessions held in states that have expanded Medicaid coverage to low-income single adults as well as states that have not.

Action Planning Session Outcomes

  • Action plans developed or in process. Plans outline strategies for integrating housing and health care services and improving access and outcomes for the target population, set priorities, name responsible parties and establish timelines.
  • Leadership Teams in place to oversee action plan implementation.
  • Connections made between people and agencies serving the same populations.
  • Increased knowledge of resources in the state, on both the housing and health care side, and how to help programs, organizations, and clients access those resources.
  • Increased knowledge of Medicaid and other potential funding sources to tap, both within and outside of the state.

Lessons Learned To Date

  • Incorporate H2 Leadership Team and plan elements into existing state level structures, such as interagency councils or state plans.
  • Create work groups to focus on discrete plan sections or strategies.
  • Leverage large ongoing efforts, such as emerging Coordinated Assessment/Entry systems, by prioritizing H2 implementation efforts linked to strategies that complement those efforts.
  • Conduct frequent user data matches across systems (e.g. homeless assistance, criminal justice, health care) to demonstrate the need for collaboration and identify the most vulnerable individuals.
  • Compare existing State Medicaid plan covered services with those most needed by people experiencing homelessness and target Medicaid enrollment to people who need/use those services. Conduct HMIS-Medicaid data match to identify gaps.
  • In Medicaid managed care states, focus partnership building and data match proposals on managed care organizations.