Bill Text (PDF)

Washington (September 26, 2023) – Senator Edward J. Markey (D-Mass.), a member of the Senate Health, Education, Labor and Pensions (HELP) Committee, and Senator Alex Padilla (D-Calif.) today introduced the Housing Alignment and Coordination of Critical and Effective Supportive Health Services (ACCESS) Act, legislation to tackle the intersecting crises of homelessness, mental health, and substance use disorder by increasing support for millions of low-income Americans on Medicaid. The bill directs the Secretaries of Health and Human Services (HHS), Housing and Urban Development (HUD), and Treasury Department to issue joint guidance to state Medicaid agencies on how to connect Medicaid beneficiaries to housing-related services and require HHS to conduct a study on the national cost of housing-related services and supports. Senators Richard Blumenthal (D-Conn.) and Cory Booker (D-N.J.) are cosponsors.

In 2022, more than half a million Americans experienced homelessness. Although there are many factors behind housing insecurity, studies show that behavioral health challenges can be both a cause and consequence. Supportive housing works by addressing both homelessness and mental illness together, providing an evidence-based practice that will ensure more people can access wraparound medical and housing services and guaranteeing health care providers are paid a fair wage.

“Housing is a human right, and health care is a human right. Yet, we’ve left far too many without the housing they need to stay healthy or the health care they need to stay housed. We must empower local communities to use every resource Congress gives them to tackle the intersecting health care and housing crises by cutting the red tape and clearing the path forward,” said Senator Markey. “Our legislation ensures that no resources to tackle this crisis are left unutilized – all while ensuring that our community health and housing-related providers make a living wage. I thank Senator Padilla for his partnership in working to build a better future for families across our nation to access affordable housing and supportive services.”

“Far too many people who lack access to the health care they need face housing instability and homelessness. In order to tackle these challenges, we must step up to provide significant federal support for community organizations on the frontlines of the crisis,” said Senator Padilla. “State Medicaid and Housing agencies need direct, cohesive guidance in order to work together to ensure Medicaid recipients receive the housing assistance they need. Our legislation will better integrate care across these agencies, connecting Medicaid beneficiaries with housing support resources and helping put money for housing back in their pockets.”

A copy of the Housing ACCESS Act can be found HERE.

The Housing ACCESS Act is endorsed by A Way Home America, All Home CA, Avalon Housing, Bay Aging, Beacon, Inc., Boston Healthcare for the Homeless, Brooklyn Community Housing & Services, Inc., Camden Coalition, Cardea Health, Central Community Development Corporation, Coalition on Homelessness and Housing in Ohio, Colorado Coalition for the Homeless, Commonwealth Land Trust, Community Oriented Correctional Health Services, The Courtyard, Child Welfare League of America, Citrus Health Network, Community Service Center of Morgan County dba WellSpring, Community Solutions, Continental Management, Cornerstones, Corporation for Supportive Housing, COTS, Downtown Emergency Service Center (DESC), Downtown Women’s Center, ECHO Housing, Englewood CDC, Extended Housing, Father Bill’s & MainSpring, Georgia Supportive Housing Association, Inc., Greater Minnesota Housing Fund, Harrisonburg Redevelopment Housing Authority, Heart of Florida United Way, Help of Southern Nevada, Horizon House, Helping Veterans and Families (HVAF), Housing Action Illinois, Housing Partners of Florida, ICAN Housing, Illinois Supportive Housing Providers Association, Lamb Center, Local Initiatives Support Corporation/National Equity Fund, LTHC Homeless Services, Inc, Lynn Shelter Alliance, Massachusetts Association of Mental Health, Massachusetts Housing & Shelter Alliance (MHSA), National Alliance to End Homelessness, National Coalition for Homeless Veterans, National Council for Mental Wellbeing, National Low Income Housing Coalition, Nevada Homeless Alliance, Nevada Housing Coalition, Northern Virginia Affordable Housing Alliance, Northwest Michigan Supportive Housing, People Assisting the Homeless, Piedmont Housing Alliance, Pine Street Inn, River City Housing, Soldier On, Shiver Center on Poverty Law, Somerville Homeless Coalition, Summit Manor Inc., Supporting Housing Providers Association, Sycamores, Texas Homeless Network, United Way of Massachusetts Bay and Merrimack Valley, VERA Institute of Justice, Veterans Inc., Virginia Housing Alliance, Vitalyst Health Foundation, Vocal Virginia, Volunteers of America Mid-States, Inc., Volunteers of America - Chesapeake & Carolinas, Volunteers of America - Ohio and Indiana, Western Massachusetts Network to End Homelessness, Women’s Lunch Place, Youth Collaboratory, St. John Center, Pathways to Housing PA, Winged Wolf Innovations, Action Housing, The National Homeless Law Center, Project Home, United Way of Greater LA, UPHoldings, Center City Housing Corp, Housing California, Housing Association of Nonprofit Developers (HAND), and Illinois Supportive Housing Providers Association.  

“CSH applauds Senator Markey for introducing the Housing ACCESS Act, which we see as a game-changer for supportive housing, an evidence-based model that promotes independence and thriving for individuals with disabilities and complex behavioral and physical health conditions. The Housing ACCESS Act would strategically align Medicaid housing-related services with federal housing resources to streamline the coordination of programs, supports, and resources for Medicaid beneficiaries experiencing long-term homelessness. The Housing ACCESS Act's straightforward approach will significantly improve the effective use of existing resources and ultimately reduce homelessness and unnecessary institutionalization,” said Deborah De Santis, President and CEO of the Corporation for Supportive Housing.

“Aligning housing assistance and supportive housing services doesn’t require new policies or new programs, but it does require Senator Markey’s Housing ACCESS Act. Communities across the nation would benefit greatly from the Senator’s legislation: it will reduce not only the number of people experiencing chronic homelessness, but the significant cost burdens on health care, the criminal legal system, and other vital community resources. Reducing chronic homelessness helps people who need help the most. The Housing ACCESS Act would allow for much-needed alignment of resources among providers who serve people experiencing homelessness. Streamlining these partnerships is absolutely critical to addressing our current homelessness and affordable housing crisis,” said Ann Oliva, Chief Executive Officer of the National Alliance to End Homelessness.

“We’re grateful to Senator Markey for proposing legislation that would help connect more frontline service providers to Medicaid reimbursements, a critical source of funding. We’ve found — and countless studies have shown — that housing stability leads to better health outcomes for our most vulnerable neighbors, reducing their reliance on emergency services, such as ER visits and shelter stays, and leading to lower public costs,” said John Yazwinski, President and CEO of Father Bill’s & MainSpring.

“Since its founding nearly 40 years ago, the Boston Health Care for the Homeless Program has provided medical and behavioral health care to thousands of adults and youth experiencing the trauma of homelessness. During that time, our staff have witnessed the profoundly positive effect that stable housing can have on a person’s physical and mental health. But our experience has also shown that simply providing someone with the keys to an apartment without the necessary supports is often not enough. Over half of chronically homeless people lose their housing within four years of being housed, primarily due to lack of support, often leading to catastrophic health consequences. Supportive housing is a critically important intervention to help this vulnerable population, and BHCHP enthusiastically endorses the Housing ACCESS Act, which will reduce barriers to this needed service for people with Medicaid,” said Peter Smith, MD, Medical Director of Boston Health Care for the Homeless Program.

“We appreciate Senator Markey who understands solving homelessness involves more than just houses, it involves healthcare as well. Having HUD work with HHS, sharing information, is an extension of what we in the field have found to be effective; housing + healthcare,” said Lyndia Downie, President and Executive Director of Pine Street Inn.

“The Housing ACESS Act will help ensure that low-income individuals and families have the critical support they need to achieve housing stability and independence - Brooklyn Community Housing & Services enthusiastically supports this Act!” said Jeff Nemetsky, Chief Executive Officer of Brooklyn Community Housing & Services, Inc.

During National Recovery Month, Senators Markey, Padilla, and Tim Kaine (D-Va.) wrote a letter to the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Department of Housing and Urban Development (HUD) calling for the implementation of a pilot program to provide mental health, substance use, and other supportive services for people experiencing homelessness, at risk of becoming homeless, or living in HUD-assisted housing.