In October, MassHealth submitted a Section 1115 Demonstration waiver amendment to the Centers for Medicare and Medicaid Services (CMS) which included, among other things, a request to spend federal money on shelter and other assistance for MassHealth families experiencing homelessness currently in the Emergency Assistance (EA) shelter program. If approved, this would bring significant federal money into the EA shelter system which could be used for shelter costs and supportive health-related services for MassHealth members.

Massachusetts Law Reform Institute, Greater Boston Legal Services, Health Care For All, and the Jewish Alliance for Law and Social Action coordinated a letter where 111 organizations joined to urge CMS to approve this request.

Massachusetts has sheltered eligible pregnant individuals and families with children experiencing homelessness for over 40 years through a unique statewide shelter benefit: Massachusetts’ Emergency Assistance family shelter program (EA shelter). But since the implementation of a waitlist for EA shelter several weeks ago, eligible families are now staying at the airport, in MBTA stations, and outside in freezing weather. There is an urgent need to provide housing assistance to those eligible for shelter, so that their health related social needs can be met.

The Department of Health and Human Services and CMS are committed to addressing health related social needs, such as housing and food insecurity. CMS has already approved waivers to provide housing supports such as housing navigation and benefits assistance, including in Massachusetts, and recently expanded upon the scope of its approvals by authorizing some states to pay for temporary housing as a health related social need.

MassHealth’s request for expenditure authority for temporary housing assistance would both improve health outcomes and reduce health costs. Studies report that in comparison to the general U.S. population, people experiencing homelessness are hospitalized at a rate 4 times higher, are 3-6 times more likely to become ill, and are 3-4 times more likely to die at a younger age.1 The health impacts of homelessness are particularly stark for children.

MassHealth’s request and the letter of support underline the significance of housing as a social determinant of health and demonstrate that Massachusetts’ shelter crisis is also a health crisis.

You can read the full sign-on letter here.