Apple Health and Homes (AHAH) is a multi-agency effort that pairs healthcare services with housing resources for some of our most vulnerable residents. Created under Chapter 216, Laws of 2022 (ESHB 1866), the initiative aligns housing resources (capital financing and rental/operations assistance) with supportive services through the Health Care Authority’s (HCA) Foundational Community Supports (FCS) program. FCS provides supportive housing and supportive employment services designed to enable program participants to lead independent and self-directed lives in their own homes. HCA has contracted with Wellpoint to be the coordinating entity that confirms eligibility for participants in conjunction with local FCS providers across the state.
Commerce’s role is multi-faceted:
- Create the Office of Apple Health and Homes that partners with HCA, other state agencies, and housing and service providers to coordinate a spectrum of practice efforts related to providing permanent supportive housing (PSH).
- Provide capital financing for the rapid acquisition or construction of housing that is, at least in part, dedicated to a subset of individuals enrolled in or eligible for FCS.
- Provide rental and other funding assistance to eligible AHAH housing providers and program participants.
- Provide capacity building and technical assistance to expand and sustain quality PSH.
Capital funding
The 2022 Legislature appropriated $60 million in capital funding to leverage the construction or acquisition of new housing exclusively for AHAH-eligible program participants. These funds will be awarded to non-profit housing providers and community organizations to expand the capacity for permanent supportive housing (PSH) units. At least 10% of these funds will be dedicated to organizations that serve and are substantially governed by individuals disproportionately impacted by homelessness and behavioral health conditions, including black, indigenous, other people of color, lesbian, gay, bisexual, queer, transgender, and other gender-diverse individuals.
Commerce’s Multifamily Housing Unit (MHU) will be conducting the resource allocation process for AHAH capital funds in partnership with the AHAH-PSH Office.
Rental assistance
The AHAH Rental Assistance Program provides project- or tenant-based rental subsidies. The Legislature appropriated funds to provide rental assistance for persons enrolled in the AHAH program. Commerce will pay rent each month on behalf of AHAH program participants deemed eligible for the program. Referrals will be received from Wellpoint, the program’s Coordinating Entity, signaling that the participant has located housing with the assistance of the local FCS Supportive Housing service provider. Prior to payment of rent, landlords will be contacted for confirmation and to gather information necessary to pay rents each month. Commerce is developing a data platform that will track real-time allocations of rent funds to each of the state’s ten behavioral health regions, the amounts spent in each region, and the amount of uncommitted funds in each region.
Technical assistance and capacity building
The AHAH-PSH Office will coordinate resources, technical assistance and capacity-building efforts to help match AHAH-eligible individuals with community support services (also known as supportive housing or tenancy support services), health care, including behavioral health care and long-term care services and stable housing. Commerce, the Health Care Authority (HCA) and the Department of Social and Health Services (DSHS) will work with the Coordinating Entity contracted through HCA (Wellpoint) to ensure seamless integration.
The concept for the AHAH initiative is that lack of housing is a social determinant of health, and individuals with disabling conditions such as medical, behavioral health, and physical impairments may not improve until their housing is stable. Thus, the phrase prescription for housing was coined. However, it is only a concept; no actual prescriptions for housing are being issued.
The AHAH program demonstrates that wrapping housing supports with rent assistance and affordable housing stock for individuals who have been determined as needing a prescription of housing is more effective than the individual navigating the multiple funding sources and limited resources to obtain and maintain their housing. Because FCS is a Medicaid benefit for individuals with a verifiable medical or behavioral health condition who are also at risk for housing instability, including homelessness, FCS is the cornerstone of the AHAH program.
Resources
- AHAH Legislation
- Health Care Authority – Foundational Community Supports (FCS)
- Wellpoint FCS Provider page
- DSHS-ALTSA Supportive Housing
- HCA’s Training and technical assistance calendar
- AHAH Capital Program
- Operations and Maintenance Program (O and M)
- Community Behavioral Health Rental Assistance (CBRA)
- HUD Section 811 Rental Assistance
- Permanent Supportive Housing Advisory Committee