Date of Award

January 2022

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Mark Schlesinger

Abstract

The integration of housing and healthcare through the Medicaid managed care system holds significant promise for improving the lives of people experiencing homelessness. This policy brief offers a strategic framework for accomplishing this work. The overall process consists of three phases: (i) strategic vision, (ii) implementation and administrative items, and (iii) housing programs and services. This paper models how this process could be applied to the following groups of people experiencing housing challenges: (i) people living in unsafe and/or unstable housing, (ii) young people experiencing homelessness, and (iii) people experiencing chronic homelessness. This work is rooted in health equity values, cohering with the broader history of Medicaid to facilitate feasible change, and individualizing care to subpopulations. Once the guiding principles are established, this paper zeroes-in on three existing Medicaid practices for change: (i) enrollment, (ii) contractual requirements, and (iii) optional benefits. These items fall under the second phase. This paper does not embark on the third step as this work is best left-up to those with lived experience of housing instability and on-the-ground providers. This brief does not seek to establish all best practices for integrating housing within Medicaid or provide individualized recommendations for all subgroups experiencing homelessness. Instead, it articulates a reasonable entry point for beginning this important work. By positioning the transformative goal of integrating housing supports within Medicaid for success, this policy brief envisions a future where everyone has their housing needs met and brings the world one step closer to realizing that vision.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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