Should Medicaid pay for supportive housing for homeless persons? After describing current limits on how states can use Medicaid funds to support housing, this article considers whether justice requires treating Medicaid recipients residing in nursing homes and Medicaid recipients needing supportive housing similarly.
See A.Donley and J.Wright, “The Health of the Homeless,”Sociology Compass12, no. 1 (2018), available at <http://onlinelibrary.wiley.com/doi/10.1111/soc4.12550/full> (last visited July 6, 2018); J.Hodgeet al., “Homelessness and the Public's Health: Legal Responses,”Journal of Law, Medicine & Ethics45, no. S1 (2017): 28-32.
4.
M.Sandel and M.Desmond, “Investing in Housing for Health Improves Both Mission and Margin,”JAMA318, no. 23 (2017): 2291-2292.
5.
M.H.Katz, “Homelessness — Challenges and Progress,”JAMA318, no. 23 (2017): 2293-2294.
J.Feder, “The Missing Piece: Medicare, Medicaid and Long-Term Care,” in A.B.Cohenet al., eds., Medicare and Medicaid at 50 (New York: Oxford University Press, 2015): at 253; S.Watson, “From Almshouses to Nursing Homes and Community Care: Lessons from Medicaid's History,”Georgia State University Law Review26, no. 3 (2010): 937-969.
R.Lieber, “The Ethics of Adjusting Your Assets to Qualify for Medicaid,”New York Times, July21, 2017.
15.
LTSS provide assistance with activities of daily living and instrumental activities of daily living for persons requiring those services as a result of a disability, chronic health condition, or aging. E.Reaves and M.B.Musumeci, Medicaid and Long-Term Services and Supports: A Primer, Kaiser Family Foundation (December2015), available at <https://www.kff.org/medicaid/report/medicaid-and-long-term-services-and-supports-a-primer/> (last visited July 6, 2018).
L.Hermer, “Rationalizing Home and Community-Based Services Under Medicaid,”St. Louis University Journal of Health Law & Policy8, no. 1 (2014): 61-88, at 78.
18.
S.Rosenbaum, “Using the Courts to Shape Medicaid Policy: Olmstead v. L.C. by Zimring and Its Community Integration Legacy,”Journal of Health Politics, Policy and Law41, no. 4 (2016): 585-597.
In 2015, more than 640,000 people with disabilities were on waiting lists for waiver-funded HCBS, and they spent more than two years on average on those lists. T.Nget al., Medicaid Home and Community-Based Services Programs: 2013 Data Update, Kaiser Family Foundation (October2016), available at <https://www.kff.org/medicaid/report/medicaid-home-and-community-based-services-programs-2013-data-update/> (last visited July 6, 2018).
24.
M.Crossley, “Community Integration of People with Disabilities: Can Olmstead Protect against Retrenchment?”Laws22, no. 6 (2017), available at <http://www.mdpi.com/2075-471X/6/4/22> (last visited July 6, 2018).
25.
Rosenbaum, supra note 18, at 592.
26.
See Centers for Medicaid and Medicaid Services, supra note 21.
27.
Paradise and Ross, supra note 22.
28.
See M.H.Katz, “Housing as a Remedy for Chronic Homelessness,”JAMA313, no. 9 (2015): 901-902 (contrasting housing first approach with “continuum of care” approach).
29.
See Paradise and Ross, supra note 22.
30.
Id.
31.
B.J.Wrightet al., “Formerly Homeless People Had Lower Overall Health Care Expenditures after Moving into Supportive Housing,”Health Affairs35, no. 1 (2016): 20-27. In the second year of participants' residence in supportive housing, Medicaid expenditures increased slightly year-to-year, but remained lower than when they were homeless.
32.
Id.
33.
“Health Policy Brief: Medicaid and Permanent Supportive Housing,”Health Affairs Health Policy Brief, October4, 2016, available at <https://www.healthaffairs.org/do/10.1377/hpb20161014.734003/full/> (last visited July 6, 2018); Paradise and Ross, supra note 22.
“Health Policy Brief: Medicaid and Permanent Supportive Housing,”supra note 33 (characterizing the evidence as “promising but not conclusive”).
36.
S.G.Kerteszet al., “Permanent Supportive Housing for Homeless People — Reframing the Debate,”New England Journal of Medicine375, no. 22 (2016): 2115-2117.
37.
“Health Policy Brief: Medicaid and Permanent Supportive Housing,”supra note 33.
Y.Alcindor, “Patients Prescribed Shelter and Medication Are Wary of Trump Cuts,”New York Times, April10, 2017 (describing projects).
44.
Butler et al, supra note 1.
45.
N.Bagley, “Are Medicaid Work Requirements Legal?”JAMA319, no. 8 (2018): 763-764.
46.
See Medicaid.gov, Institutional Long-Term Care, available at <https://www.medicaid.gov/medicaid/ltss/institutional/index.html> (last visited July 6, 2018) (“Medicaid covers certain inpatient, comprehensive services as institutional benefits. … The comprehensive care includes room and board. … The comprehensive service is billed and reimbursed as a single bundled payment.”).
National Law Center on Homelessness & Poverty, Housing not Handcuffs: Ending the Criminalization of Homelessness in U.S. Cities (2016), available at <https://www.nlchp.org/documents/Housing-Not-Handcuffs> (last visited July 6, 2018).
