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H2 Systems Integration



Housing is a social determinant of health, and access to health care is essential to ongoing housing stability.

  • People experiencing homelessness face disproportionately high rates of chronic and co-occurring health and behavioral health conditions, which when untreated, undermine their ability to access and maintain stable housing.  

  • Addressing the need for stable housing is essential to helping people maintain health and wellness, as well as to controlling costs that stem from unnecessary emergency room utilization and hospital admissions.  


Recognizing the importance of this intersection, HUD and other federal partners sponsored the Housing and Healthcare Integration (H2) Initiative to support systems change to enhance collaboration between the housing and health care systems to better serve people experiencing homelessness and/or serious health conditions.  



Homebase facilitated intensive 1.5-day action planning sessions in 20 states and communities to design strategies and develop consensus on local action to integrate housing and health care. Diverse representatives from federal, state and local health care, homeless, housing, and other systems attended.  

Assistance provided included:  

  • Pre-Event Planning:  Leadership Team development; agenda design; site-specific research and data gathering; materials development.

  • Action Planning Event:  facilitation; presentations; small group planning support

  • Post-Event Technical Assistance:  Leadership Team support; design and implementation coaching; research and analysis.


  • Leadership Teams and Action Plans incorporated into existing state level structures, such as interagency councils or state plans. Medicaid Directors and other high-level staff participating in implementation.

  • Resources invested in expanding Medicaid enrollment efforts and on streamlining the Medicaid application process.

  • Outstationing of health care staff at homeless programs and co-location of clinics at housing sites.

  • Cross-trainings conducted between the homeless assistance/housing and healthcare systems.

  • Development of common assessment processes for health and homelessness providers.

  • Use of cross-system data matches to identify target populations and document need.

  • Use of Medicaid funding to support housing stability through waivers and state plan amendments.

  • Exploration of other service integration efforts, including discharge planning and recuperative care programs.

Resources and Tools

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