New program will provide housing for Washingtonians with complex health needs


Shane Ersland


Staff at the Washington State Department of Commerce are preparing to roll out a program that will develop housing for residents with complex health needs.


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The department created the Apple Health and Homes and Permanent Supportive Housing Unit (AHAH/PSH) following the passage of House Bill 1866 and House Bill 1724 during the 2022 legislative session. AHAH/PSH will provide guidance in the creation of affordable housing for extremely low-income individuals with behavioral health conditions or other disabling conditions.    

AHAH/PSH Managing Director Melodie Pazolt discussed the initiative during a stakeholder meeting on Thursday.

“One of the exciting things about this program is it’s bringing to light the fact that if you have a behavioral health condition or long-term care functioning challenge, trying to adapt to those challenges without a roof over your head is hard to recover from,” Pazolt said. “The idea of being able to fulfill the prescription of housing for a person with those needs is what this program is.”

AHAH/PSH will utilize $60 million in capital funds for the project. It will work with the state Health Care Authority (HCA) and DSHS to meet the housing needs of eligible participants. 

AHAH/PSH will serve a portion of Washingtonians enrolled in HCA’s Foundational Community Supports (FCS) program who have complex health needs and risk factors. FCS is a targeted Medicaid benefit that provides community support services to help individuals obtain and maintain housing and employment.

HCA FCS Supervisor Matt Christie said the project will provide housing as a Medicaid benefit. 

“This is a Medicaid benefit that helps eligible individuals with complex needs,” Christie said. “It’s not available to everyone on Medicaid at this point in time.”

In order to qualify, applicants must be at least 18 years old, enrolled in a medical assistance program, and eligible for community support services, Christie said. They must have been assessed to meet 1 of the following needs: 

  • A mental health need 
  • A substance use disorder need
  • Someone who needs assistance with the activities of daily living
  • A homeless person with chronic health conditions

AHAH/PSH will work with the HCA to identify individuals who are eligible and enrolled in an FCS program who have immediate housing needs. It issued a request for proposals for a pilot program to manage rent assistance subsidies and vouchers totaling $6 million for residents enrolled in FCS. The funds will be used to provide rent assistance at a location identified through an individual’s housing assessment.