More permanent supportive housing needed to address Washington’s homeless, affordable housing problems


Shane Ersland


The need to build more affordable housing and address homelessness in Washington are crucial initiatives that take center stage in Gov. Jay Inslee’s proposed budget and are high on other lawmakers’ lists. Experts identified some ways to address the issues at the 2023 Washington State of Reform Health Policy Conference.


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Kat Latet, director of health systems innovation at Community Health Plan of Washington (CHPW)—which provides Medicare, Medicaid, and Cascade Select coverage for 300,000 Washingtonians—said housing and other social drivers of health were identified as unmet needs by many customers, according to CHPW’s health assessments.

“When we look at our health risk assessment scores, we’re looking at about 23.3% expressing an unmet need, and you’re looking at a really high amount looking at housing,” Latet said. “CHPW has a community supports program that includes peers, community health workers, health coaches, and housing specialists to work in this space. And one of the biggest areas of need was around housing and shelter supports.”

CHPW is working with its network partners and community-based organizations to determine how to facilitate the integration of health and housing supports, Latet said. 

“We need to make changes at the state and local level to drive some of this work forward,” Latet said. “As we move into the 2023 [legislative] session, CHPW [has] housing as one of [its] policy priorities.”

Melodie Pazolt, managing director of the Office of Apple Health and Homes at the Washington State Department of Commerce, discussed House Bill 1220, which was passed during last year’s legislative session. The bill includes an initiative for the Growth Management Act to project how much new housing the state will need in the next 20 years. 

“They look at the average median income for individuals and that looks at how much people pay in rent,” Pazolt said. “Zero to 30% is the poorest of the poor. That [group has] the highest number of units that are needed in terms of building more affordable housing.”

The state will need to create 116,000 permanent supportive housing units in the next 20 years, Pazolt said. 

The legislation also prohibits discrimination against transitional and permanent supportive housing in certain parts of communities, Pazolt said. Permanent supportive housing incorporates health services wrapped around individuals who have complex needs. 

“It really does effectively reduce complex healthcare costs for people that have behavioral health and healthcare conditions,” Pazolt said. “We’ve got to be able to build and take care of some of our most vulnerable individuals.”

There are various models for providing permanent supportive housing, and it provides subsidized rents for those in need. Therefore, building affordable housing units requires sources of capital to support subsidized rents. 

The Foundational Community Supports (FCS) program offers benefits for supportive housing to Medicaid beneficiaries. Commerce’s Apple Health and Homes program supports FCS, Pazolt said.

“We’re going to try and bring housing, rent assistance, and capital to FCS,” Pazolt said. “We have about $6 million in rent assistance that we’re going to be issuing. We also are issuing capacity grants to help organizations either become FCS providers or partner with FCS providers if they’re housing providers.” 

Derrick Belgarde, executive director of the Chief Seattle Club, said efforts to address homelessness among Native and Black populations must be community driven. He acknowledged that many current efforts are focusing on equity.

“And I’m happy for that but we have a lot of work to do,” Belgarde said. “We have some of the highest acuity intersectionality of substance [and] mental health, people aging out of foster care, incarceration, all those things. We have to invest heavily in mental health and trauma work, and trying to get people to work through that. Housing is just one step to that health. You can’t treat those things without housing. But it pretty much has to be supportive housing.”