Guide to Housing Assistance for Vulnerable Populations

Last updated 4 months ago. Our resources are updated regularly but please keep in mind that links, programs, policies, and contact information do change.

A common question when navigating federal assistance is whether the U.S. Department of Health and Human Services (HHS) offers housing assistance.

HHS does not operate large-scale, direct housing subsidy programs in the way HUD does. However, HHS does fund and administer numerous programs that provide essential housing-related support, typically intertwined with specific health and human service needs.

Understanding HHS’s role requires looking at its core mission: “to enhance the health and well-being of all Americans, by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services.” Fulfilling this mission inherently involves addressing the environmental and social factors that significantly impact health outcomes – and stable housing is paramount among these.

This guide explores the specific ways HHS programs intersect with housing needs, clarifying the types of support available through HHS channels and how they differ from, and sometimes complement, HUD’s initiatives.

Understanding HHS’s Role: Health, Human Services, and Housing Stability

HHS stands as the U.S. government’s principal agency tasked with protecting the health of all Americans and providing essential human services, particularly for the nation’s most vulnerable populations. It oversees a vast array of programs, numbering over 100 and potentially exceeding 300, administered through its various operating divisions.

HHS manages nearly a quarter of all federal outlays and administers more grant funding than all other federal agencies combined. Its responsibilities span critical areas such as Medicare and Medicaid, public health surveillance and initiatives via agencies like the Centers for Disease Control and Prevention (CDC), medical research through the National Institutes of Health (NIH), and a wide range of social services including Head Start, child care assistance, child support enforcement, and programs supporting individuals with disabilities and older adults.

The connection between HHS’s mission and housing stems from the widely recognized concept of Social Determinants of Health (SDOH). These are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Stable, safe, affordable, and accessible housing is consistently identified as a critical SDOH. Conversely, housing instability – encompassing homelessness, frequent moves, living in overcrowded or unsafe conditions, or spending a disproportionate amount of income on housing – is strongly linked to adverse health outcomes. It can exacerbate chronic health conditions, increase the risk of infectious diseases, negatively impact mental health and substance use disorders, and create significant barriers to accessing necessary healthcare and supportive services.

Research supported by HHS and HUD indicates that providing stable housing, particularly when linked with appropriate services, can improve health outcomes and potentially reduce overall healthcare costs, including costs associated with institutional care. HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE) actively conducts research and coordinates departmental responses related to the intersection of housing, homelessness, and health.

This health and human services focus shapes HHS’s approach to housing assistance, distinguishing it from HUD’s primary role. While HUD concentrates on broad housing market issues, affordability mechanisms like vouchers, public housing management, and community development grants, HHS’s housing-related support is generally characterized by being:

Targeted

Aimed at specific populations facing distinct health or human service challenges that contribute to or are exacerbated by housing instability. Examples include runaway and homeless youth, survivors of domestic violence, individuals with serious mental illness (SMI) or substance use disorders (SUD), people with disabilities, and older adults needing supportive services to remain in the community.

Supportive

Often integrates housing assistance (such as emergency shelter, transitional living arrangements, or connections to permanent housing) with essential wrap-around services tailored to the target population’s needs. These services can include healthcare, behavioral health treatment, case management, counseling, life skills training, and employment assistance.

Indirect/Grant-Funded

HHS typically functions as a major grant-making agency. Rather than providing housing subsidies directly to individuals, HHS frequently awards grants to state, local, tribal, and non-profit organizations. These grantees then deliver the direct services, including housing-related support, to eligible individuals and families in their communities.

Several key HHS Operating Divisions are central to these efforts:

• The Administration for Children and Families (ACF) oversees programs for vulnerable children, youth, and families.
• The Substance Abuse and Mental Health Services Administration (SAMHSA) focuses on behavioral health and its connection to homelessness.
• The Health Resources and Services Administration (HRSA) supports healthcare access for underserved populations, including those experiencing homelessness.
• The Administration for Community Living (ACL) works to enable older adults and people with disabilities to live independently in the community.

Observing the structure and focus of these programs reveals a pattern: HHS’s involvement in housing often arises as a response when failures or gaps in other support systems—such as family stability, access to affordable healthcare or behavioral health treatment, or economic opportunity—manifest as housing crises for vulnerable groups.

The department’s programs frequently act as safety nets, providing immediate relief like shelter or linking individuals to stabilizing services after housing instability has become a critical threat to health and well-being. This posture, driven by its core health and human services mandate, contrasts with HUD’s more structural focus on the housing market itself. HHS intervenes when housing instability becomes an unavoidable component of a health or human services problem requiring resolution.

HHS Programs Offering Housing-Related Support

Several HHS agencies administer programs that directly or indirectly address housing needs as part of their broader mission.

Administration for Children and Families (ACF)

ACF programs promote the economic and social well-being of children, families, and communities. This includes well-known initiatives like Temporary Assistance for Needy Families (TANF) and Head Start, as well as targeted programs addressing specific vulnerabilities.

Runaway and Homeless Youth (RHY) Programs (ACF/Family and Youth Services Bureau – FYSB)

Context: Each year, thousands of young people run away, are forced to leave home, or become homeless, placing them at high risk of violence, exploitation, trafficking, substance use, and poor mental and physical health outcomes. The Runaway and Homeless Youth Act (RHYA) provides the legislative foundation for federal support. Estimates suggest hundreds of thousands of youth experience homelessness annually.

Overall Goal: To provide immediate shelter, longer-term housing solutions, and comprehensive services to support unaccompanied homeless youth in transitioning to stability and self-sufficiency. Programs utilize a Positive Youth Development (PYD) framework, focusing on youths’ strengths and promoting positive outcomes.

Components: The RHY program offers a range of services through distinct components:

Basic Center Program (BCP):

• Objective: Address the immediate needs of younger homeless youth through crisis intervention, temporary shelter, and counseling, with a goal of family reunification or safe alternative placement.
• Target Population: Runaway and homeless youth under the age of 18.
• Support: Provides up to 21 days of emergency shelter, food, clothing, medical care access, individual, group, and family counseling, crisis intervention, recreation, and aftercare services.
• Access: Services are accessed through local BCP grantees. Locations can be found via the FYSB map linked on the ACF website. The main program page is within the RHY section at https://acf.gov:443/fysb/programs/runaway-homeless-youth.

Transitional Living Program (TLP):

• Objective: Offer stable, longer-term housing and supportive services to help older homeless youth develop skills for independent living.
• Target Population: Homeless youth aged 16 to under 22.
• Support: Provides safe, stable living accommodations for up to 21 months (potentially longer in some cases), basic life skills training (budgeting, housekeeping, etc.), educational support (GED, post-secondary), job attainment services, and mental/physical healthcare access.
• Access: Through local TLP grantees, findable via the FYSB map. The main program page is within the RHY section at https://acf.gov:443/fysb/programs/runaway-homeless-youth.

Maternity Group Homes (MGH) (funded through TLP):

• Objective: Provide specialized support for homeless youth who are pregnant and/or parenting.
• Target Population: Homeless pregnant and/or parenting youth aged 16 to under 22, and their dependent children.
• Support: Offers the services of the TLP plus specific resources like parenting skills education, child development information, and assistance finding reliable child care. Provides child-safe transitional living accommodations.
• Access: Through local TLP/MGH grantees, findable via the FYSB map. The main program page is within the RHY section at https://acf.gov:443/fysb/programs/runaway-homeless-youth.

Street Outreach Program (SOP):

• Objective: Engage youth living on the streets or in unstable situations, build trust, connect them to emergency shelter and other services, and work to prevent sexual abuse and exploitation.
• Target Population: Runaway, homeless, and street youth, particularly those subjected to or at risk of sexual abuse, human trafficking, or exploitation.
• Support: Street-based outreach and education, access to emergency shelter, survival aid (food, clothing, hygiene), treatment and counseling access, crisis intervention, information and referrals, and follow-up support. SOP focuses on connecting youth to housing rather than providing it directly long-term.
• Access: Through local SOP grantees, findable via the FYSB map. The main program page is within the RHY section at https://acf.gov:443/fysb/programs/runaway-homeless-youth.

RHY Support Services: Key national resources include the National Runaway Safeline, offering 24/7 crisis support, information, referrals, and communication services via phone (1-800-RUNAWAY), website (https://www.1800runaway.org), and text (66008), and the Runaway and Homeless Youth Training, Technical Assistance, and Capacity Building Center (RHYTTAC), which supports grantees.

Program Structure Implications: The distinct components of the RHY program—SOP for initial contact, BCP for immediate crisis shelter, and TLP/MGH for longer-term stability—demonstrate an attempt to create a continuum of care designed to meet the diverse needs of youth at different stages of homelessness.

However, this model faces significant challenges. Reports indicate that demand far outstrips available resources, with thousands of youth turned away from BCP and TLP shelters annually due to lack of capacity. While RHY programs serve tens of thousands of youth, this represents only a small fraction of the estimated hundreds of thousands experiencing homelessness each year. This gap suggests that despite the program’s structure, resource limitations prevent many youth from accessing the appropriate RHY service when needed.

Community Services Block Grant (CSBG) (ACF/Office of Community Services – OCS)

Context: CSBG provides flexible funding to states, territories, and tribes to combat poverty at the community level.

Objective: To fund a network of local entities, primarily Community Action Agencies (CAAs), to deliver a wide array of services tailored to local needs identified through community assessments. Over 9 million individuals are served annually by CSBG-funded programs.

Target Population: Individuals and families with low incomes, and low-income communities.

Support (Housing-Related): CSBG funds can be used for various housing-related activities, though specific offerings depend entirely on the local CAA. Potential uses include:

• Direct housing assistance (e.g., rental assistance, security deposit help to prevent eviction or secure housing).
• Utility payment assistance (energy, water).
• Emergency services (e.g., temporary shelter access, food, clothing during a housing crisis).
• Transportation assistance (which supports housing stability by enabling access to jobs/services).
• Support for affordable housing development or home repair programs (less common, but possible).
• In FY23, CSBG eligible entities helped 437,000 individuals avoid eviction or obtain safe affordable housing.

Access: Individuals cannot apply directly to the federal government for CSBG assistance. They must contact their local Community Action Agency or other CSBG-funded eligible entity. A locator tool is available on the OCS website. Official Program Page: https://acf.gov/ocs/programs/csbg. Note the fraud warning: CSBG does not provide direct grants to individuals or charge fees.

Program Structure Implications: The inherent flexibility of CSBG allows local organizations to respond effectively to specific community needs. However, this same flexibility means that the availability and type of housing assistance funded by CSBG can vary significantly from one CAA to another. Housing aid is an allowable use of funds, not a universally mandated service at a set level. Consequently, individuals seeking help must actively research the specific services offered by their local CAA, unlike more standardized federal aid programs.

Family Violence Prevention and Services Act (FVPSA) Program (ACF/Office of Family Violence Prevention and Services – OFVPS)

Context: FVPSA represents the primary federal funding source specifically dedicated to supporting emergency shelters and related assistance for victims of domestic violence and their children. It acknowledges the strong link between domestic violence, trauma, and homelessness.

Objective: To provide immediate safety through emergency shelter and offer related supportive services to victims and their dependents. The program funds state, territorial, and tribal agencies, as well as domestic violence coalitions.

Target Population: Victims of family violence or domestic violence, and their dependents.

Support: Core support is the provision of safe, emergency shelter. Related assistance includes crisis intervention, counseling, advocacy, emergency transportation, child care, and connections to other resources like legal aid or housing programs. FVPSA also funds national hotlines and resource centers.

Access: Primarily through local FVPSA-funded domestic violence shelters and service providers. The National Domestic Violence Hotline at 1-800-799-SAFE (7233) is a critical 24/7 access point for immediate help and referrals. Official Program Page: https://acf.gov:443/ofvps or https://www.acf.hhs.gov/fvpsa.

Program Structure Implications: FVPSA funding directly targets a specific driver of homelessness – fleeing domestic violence. By prioritizing immediate safety and shelter, the program exemplifies how HHS addresses housing needs that arise directly from acute human services crises. This crisis-response focus aligns with the broader pattern of HHS housing support being linked to specific health and safety issues, rather than addressing general housing affordability.

Affordable Housing and Supportive Services Demonstration (AHSSD) (ACF/OCS)

Context: A newer demonstration program designed to address housing instability exacerbated by the high cost of housing, focusing on renters with low incomes who may be severely cost-burdened.

Objective: To strengthen, expand, and enhance comprehensive, wrap-around supportive services for residents who are already living in affordable housing units owned by participating CAAs or tribes. The goal is to increase residents’ stability, economic mobility, and overall well-being.

Target Population: Individuals and families with low incomes residing in specific affordable housing properties owned by AHSSD grant recipients. This includes populations disproportionately affected by housing instability, such as individuals with disabilities and families with young children.

Eligibility: Federal funding is awarded to CAAs and tribes that received CSBG funding in FY23 and own their own affordable housing units. The residents of these specific housing units are the beneficiaries of the services.

Support: This program does not provide direct housing assistance (like rent subsidies or funding for new construction). Instead, it funds a range of supportive services delivered within the affordable housing setting. Examples include: educational programs (adult literacy, GED, afterschool programs), early childhood education (Head Start, child care), older adult care services, mental health and SUD services, disability support services, self-sufficiency resources (job training, financial literacy), future homeownership resources, transportation assistance, and connections to healthcare.

Program Structure Implications: AHSSD represents an HHS strategy focused on housing retention and improving outcomes for those already housed. It operates on the premise that affordable housing alone may not be sufficient for long-term stability, especially for vulnerable populations. By funding integrated supportive services directly within housing environments, HHS is testing a model aimed at preventing returns to homelessness or instability and promoting overall well-being, demonstrating a move towards embedding human services within housing platforms.

Substance Abuse and Mental Health Services Administration (SAMHSA)

SAMHSA leads federal efforts to advance behavioral health, encompassing both mental health and substance use disorders. SAMHSA explicitly recognizes the strong bidirectional link between these conditions and homelessness, acknowledging that untreated behavioral health issues can contribute to housing instability, while homelessness can exacerbate these conditions. Approximately 30% of people experiencing chronic homelessness have an SMI, and about two-thirds have a primary SUD or other chronic health condition.

Projects for Assistance in Transition from Homelessness (PATH)

Context: A formula grant program addressing the significant overlap between serious mental illness (SMI), co-occurring disorders (COD), and homelessness.

Objective: To fund community-based outreach and services for individuals with SMI or COD who are experiencing homelessness or at imminent risk, connecting them to essential behavioral health treatment and support services that may not be available through mainstream programs. The overarching goal is to reduce or eliminate homelessness for this population.

Target Population: Individuals with SMI or COD who are experiencing homelessness (including unsheltered and sheltered situations) or are at imminent risk of homelessness.

Eligibility: SAMHSA distributes PATH funds via formula grants to states and territories. These entities then award funds, often competitively, to local public or nonprofit organizations (PATH providers). Individuals meeting the target population criteria are eligible to receive services from these local providers.

Support: PATH providers offer a range of services, which can include:

• Outreach and engagement.
• Screening, diagnostic assessment, and treatment for mental health and/or substance use disorders.
• Case management.
• Referrals for primary health care, job training, and educational services.
• Assistance with accessing housing: This involves linking clients to housing resources and potentially providing certain limited housing services as specified in the Public Health Service Act, but PATH funds generally do not pay for rent or housing subsidies directly.

Access: Services are accessed through local PATH providers. Individuals may connect via street outreach, referrals from shelters or other agencies, or self-referral. Official Program Page: https://www.samhsa.gov/communities/homelessness-programs-resources/grants/path.

Program Structure Implications: PATH clearly illustrates SAMHSA’s strategy of integrating behavioral health treatment with efforts to achieve housing stability. The program functions as a critical bridge, providing the specialized mental health and SUD services often required for individuals with these conditions to successfully obtain and maintain housing, even though PATH itself is not the source of the housing subsidy.

The finding that the proportion of PATH clients who were unsheltered prior to enrollment increased significantly between FY 2019 and FY 2021 (from 39.9% to 49.1%) suggests the program is increasingly reaching individuals with extremely high needs and facing significant barriers, highlighting both the program’s critical role and the growing challenges within the homeless population it serves.

Treatment for Individuals Experiencing Homelessness (TIEH)

Context: A competitive grant program designed to expand access to comprehensive treatment and recovery supports for homeless individuals with significant behavioral health needs.

Objective: To increase access to evidence-based behavioral health treatment (for SMI, SED, COD), peer support, and other recovery-oriented services, while actively assisting individuals in connecting to and sustaining permanent housing. A key expectation is collaboration with homeless services organizations and housing providers, including Public Housing Agencies (PHAs).

Target Population: Individuals, youth, and families experiencing homelessness or imminent risk thereof (e.g., exiting incarceration without housing) who have an SMI, Serious Emotional Disturbance (SED), or COD.

Eligibility: Grants are awarded competitively to states, political subdivisions of states (like counties or cities), federally recognized tribes and tribal organizations, Urban Indian Organizations, and public or private nonprofit entities. Individuals meeting the target population definition receive services from these grantees. Note: Certain previous SAMHSA grantees might be ineligible for specific funding rounds.

Support: TIEH funds support a comprehensive array of activities:

• Integrated mental health and substance use disorder treatment using evidence-based practices.
• Recovery support services, including peer support.
• Case management, including care coordination and service delivery planning across housing transitions.
• Efforts to engage clients and connect them to enrollment resources for health insurance (Medicaid/CHIP) and mainstream benefits crucial for housing stability (e.g., SSI/SSDI, TANF, SNAP).
• Coordination of housing and services: This includes actively collaborating with housing providers and linking clients to HUD’s Coordinated Entry system to facilitate access to sustainable permanent housing.
• Explicit Restriction: TIEH grant funds cannot be used to pay for housing costs like rent or security deposits.

Access: Through organizations that have received TIEH grant awards (e.g., under funding announcements like SM-23-006). Official Program Page: https://www.samhsa.gov/communities/homelessness-programs-resources/tieh-program.

Program Structure Implications: Compared to PATH, TIEH represents a potentially more intensive and integrated model. Its explicit requirement for grantees to coordinate with housing systems like Coordinated Entry signifies a deliberate effort to actively bridge the gap between behavioral health treatment and securing permanent housing. By funding integrated treatment, recovery supports, benefit enrollment assistance, and housing coordination, TIEH embodies a holistic approach aimed not just at treating behavioral health conditions but at proactively facilitating the transition to, and success within, permanent housing for individuals with complex needs.

SSI/SSDI Outreach, Access, and Recovery (SOAR)

Context: A program focused on overcoming a major financial barrier to housing stability for individuals with disabilities.

Objective: To increase access to Social Security Administration (SSA) disability income benefits—Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)—for eligible adults and children who are experiencing or at risk of homelessness and have disabling conditions.

Target Population: Adults (age 18+) and children (under 18) who are experiencing homelessness or are at risk of homelessness (using HUD definitions) and have a serious mental illness, medical impairment, and/or a co-occurring substance use disorder that affects their ability to work.

Eligibility: Individuals must meet the target population criteria. The SOAR program itself operates by training caseworkers within states and communities to assist these individuals.

Support: SOAR does not provide direct housing assistance. Its crucial role is facilitating access to a stable income source (SSI/SSDI) which is often essential for affording and maintaining housing. The program provides specialized training and technical assistance to caseworkers on how to effectively navigate the complex SSA application process for this population, improving the quality and completeness of applications. Successful SOAR applications may also benefit from expedited processing at SSA through the use of a “homeless flag” for those meeting SSA’s specific definition of homelessness.

Access: Individuals access SOAR assistance through SOAR-trained caseworkers located in participating states and communities. The official SOAR website provides resources and information. Official Website: https://soarworks.samhsa.gov/.

Program Structure Implications: The SOAR initiative underscores the critical connection between income security, health/disability status, and housing stability. For many individuals with significant mental or physical health challenges that prevent substantial employment—a population frequently served by SAMHSA programs like PATH and TIEH—accessing disability benefits is a prerequisite to escaping homelessness. By focusing on improving access to SSI/SSDI, SOAR addresses a fundamental economic barrier, acting as an essential enabling service that complements behavioral health treatment and direct housing placement efforts.

Other SAMHSA Initiatives:

Homeless and Housing Resource Center (HHRC): A partnership effort providing training, webinars, and technical assistance resources for health and housing professionals focused on evidence-based practices for serving individuals and families experiencing homelessness with behavioral health conditions.

Recovery Housing: SAMHSA promotes the concept of recovery housing—safe, healthy, peer-supported, substance-free living environments—as a support for individuals in recovery from SUDs. It provides resources and suggested guidelines. This approach is often discussed alongside, and sometimes contrasted with, Housing First models, highlighting different pathways and philosophies within supportive housing.

Historical Grant Programs (GBHI/SSH/CABHI): Programs like Grants for the Benefit of Homeless Individuals (GBHI), including its Services in Supportive Housing (SSH) component, and Cooperative Agreements to Benefit Homeless Individuals (CABHI) represent earlier iterations of SAMHSA funding focused on integrating behavioral health services, supportive housing, and critical supports for homeless individuals, including veterans and those experiencing chronic homelessness. These programs demonstrate SAMHSA’s long-term commitment to addressing the intersection of behavioral health and homelessness, paving the way for current programs like TIEH.

Health Resources and Services Administration (HRSA)

HRSA works to improve healthcare access and outcomes for populations that are geographically isolated or face economic or medical vulnerability. Its portfolio includes the Health Center Program, health workforce development initiatives, maternal and child health programs, and the Ryan White HIV/AIDS Program.

Health Center Program – Health Care for the Homeless (HCH)

Context: The HCH program operates as a specific funding stream (authorized under Section 330(h) of the Public Health Service Act) within HRSA’s larger Health Center Program. The broader Health Center Program funds nearly 1,400 health centers operating over 15,000 sites nationwide, providing comprehensive primary care services regardless of patients’ ability to pay.

Objective: To provide accessible, high-quality primary and preventive healthcare services specifically tailored to meet the needs of individuals experiencing homelessness.

Target Population: Defined broadly under Section 330(h) to include individuals who lack housing, reside in emergency shelters or transitional housing, or live in permanent supportive housing targeted to homeless populations. Importantly, HCH centers can continue serving individuals for up to 12 months after they move into permanent housing, supporting stability. The definition also includes children and youth at risk of homelessness and homeless veterans. In 2023, HRSA-funded health centers collectively served over 1.4 million patients experiencing homelessness.

Eligibility: Individuals who meet the definition of the target population are eligible to receive services at designated HCH centers. Health centers themselves apply for and receive specific HCH funding or designation under Section 330(h).

Support: HCH centers provide comprehensive primary healthcare services, often integrated, including medical, dental, mental health, and substance use disorder services. They also offer crucial “enabling services” such as outreach, case management, assistance with benefits applications, transportation, and translation, which help patients access and utilize care.

While HCH programs do not directly provide housing or rental assistance, they are a critical source of healthcare within the context of homelessness. Their services are designed to be accessible, often located near shelters or other points of contact for the homeless population. They play a vital role in connecting patients to other necessary resources, potentially including housing services.

Access: Services are accessed directly at HRSA-funded Health Centers that hold an HCH designation. The “Find a Health Center” tool on HRSA’s website is the primary way to locate these facilities: https://findahealthcenter.hrsa.gov/. General information about the Health Center Program is available at https://bphc.hrsa.gov/about-health-center-program.

Program Structure Implications: HCH centers function as vital healthcare safety nets specifically designed for and often embedded within the homeless service system. Homelessness is frequently associated with complex and unaddressed physical and behavioral health issues. HCH centers break down common barriers to care (cost, insurance status, transportation) by offering services regardless of ability to pay and tailoring care to the population’s unique needs.

By addressing health problems directly and providing enabling services, HCH programs improve individual well-being and, consequently, may enhance a person’s capacity to engage with housing programs, maintain employment if possible, and ultimately achieve housing stability. They are a key health component supporting broader homelessness resolution efforts.

Administration for Community Living (ACL)

ACL focuses on maximizing the independence, well-being, and health of older adults and people with disabilities across the lifespan, along with their families and caregivers, strongly promoting the principle of community living.

Supportive Services and Community Living Initiatives

Context: ACL addresses the specific housing and service needs of older adults and people with disabilities. For these populations, lack of access to appropriate supportive services or accessible housing can increase the risk of homelessness or unnecessary institutionalization.

Objective: To promote access to affordable, accessible housing that is linked with necessary home and community-based supportive services (HCBS). This linkage enables individuals to live independently and with dignity in the community, preventing homelessness and costly institutional care.

Target Population: Older adults, people with disabilities (including individuals with traumatic brain injury – TBI), and potentially tribal elders and their caregivers.

Eligibility: Eligibility for specific services is typically determined by state and local programs accessed through ACL’s network partners, often based on age, disability status, income, and functional need level (particularly for Medicaid-funded services).

Support: ACL itself generally does not directly provide housing subsidies or build housing. Instead, it funds and supports state and community networks that connect individuals to resources and coordinate services. Key functions related to housing stability include:

• Information and Referral (I&R): Connecting individuals to local resources through networks like Aging and Disability Resource Centers (ADRCs), Centers for Independent Living (CILs), State Assistive Technology Act Programs, and national resources like the Eldercare Locator (1-800-677-1116) and the Disability Information and Access Line (DIAL) (1-888-677-1199).
• Service Coordination: Linking individuals to a wide range of HCBS necessary to maintain independence at home. These services—often funded through state Medicaid waivers or state plan options—can include personal care assistance, case management, accessible transportation, home-delivered meals, home modifications, and assistive technology.
• Housing Navigation and Transition Support: Assisting individuals in finding suitable accessible housing options or supporting transitions from nursing homes or other institutional settings back into the community. This often involves collaboration with housing agencies.

Access: Individuals typically access these supports by contacting their local Area Agency on Aging (AAA), ADRC, or CIL. National locators like the Eldercare Locator (https://eldercare.acl.gov) and DIAL help find these local entry points. ACL’s housing-related resources are often centralized through the Housing and Services Resource Center website: https://acl.gov/HousingAndServices.

Program Structure Implications: ACL’s contribution to housing stability highlights that for many older adults and people with disabilities, effective “housing assistance” is less about the physical structure or subsidy and more about ensuring access to the critical supportive services that make independent community living feasible and sustainable. ACL plays a key role in building and supporting the service infrastructure, often leveraging Medicaid HCBS funding streams, to prevent institutionalization and homelessness for these populations.

Overview Table of Key HHS Programs

The following table summarizes key HHS programs discussed above that offer housing-related support, providing a quick reference for comparison.

Bridging Health and Housing: HHS and HUD Collaborations

Recognizing that the complex challenges faced by many vulnerable Americans require solutions that span traditional agency boundaries, HHS and HUD have increasingly engaged in formal collaborations. The fundamental rationale for this partnership is clear: many individuals, particularly older adults, people with disabilities, and those experiencing homelessness with complex health needs, require both affordable, accessible housing (HUD’s primary focus) and tailored health and supportive services (HHS’s primary focus) to achieve long-term stability, live independently in the community, and avoid costly institutionalization or returns to homelessness.

Historically siloed housing and service systems often create barriers, preventing individuals from accessing the integrated support they need. Recent federal initiatives aim explicitly at dismantling these silos and fostering better coordination of resources and programs.

Housing and Services Resource Center (HSRC)

Establishment and Scope: Launched in December 2021, the HSRC (https://acl.gov/HousingAndServices) embodies this collaborative spirit. It is a joint effort between HHS and HUD, designed to serve as a centralized hub for information and technical assistance. Within HHS, the initiative is led by the Administration for Community Living (ACL) and includes participation from the Centers for Medicare & Medicaid Services (CMS), SAMHSA, ASPE, ACF, CDC, and HRSA. Other federal partners like the Department of Agriculture’s Rural Development agency, Labor, Justice, Energy, and Veterans Affairs also participate.

Purpose and Function: The HSRC aims to improve access to both affordable, accessible housing and the critical supportive services that enable community living. It seeks to facilitate stronger state and local partnerships between housing entities (like Public Housing Authorities) and health and human service systems (including Medicaid, aging and disability networks, behavioral health agencies, and homeless service providers). A key goal is to help communities effectively leverage available resources, including new funding streams made available through legislation like the American Rescue Plan.

Resources: The HSRC website consolidates—often for the first time—a wide range of federal resources, guidance, and tools related to both housing and supportive services. It offers information organized by focus areas (e.g., accessible housing, homelessness, supportive services, fair housing, transitions from institutions, tribal housing), along with practical tools such as data and reports, directories of relevant agencies and programs, information on funding opportunities, program models and best practices, toolkits, and training materials.

The Center also hosts webinars, facilitates peer learning, and supports initiatives like learning collaboratives to promote cross-sector understanding and action. While primarily aimed at professionals and system administrators across the housing and service sectors, the resources can also inform advocates and individuals seeking to understand available options.

Other Key Joint Initiatives

Beyond the HSRC, several other initiatives highlight the HHS-HUD partnership:

Section 811 Project Rental Assistance (PRA) Coordination: HUD’s Section 811 PRA program provides funding to state housing agencies to create project-based rental assistance for extremely low-income persons with disabilities. A crucial element of this program is the required partnership with state health and human service/Medicaid agencies (supported by HHS/CMS) to ensure that residents are linked to appropriate long-term services and supports (LTSS) necessary for community living. States often target these resources to specific populations, such as individuals transitioning from institutions under CMS’s Money Follows the Person (MFP) initiative. This represents a direct braiding of HUD rental subsidies with HHS-supported services.

Housing and Services Partnership Accelerator (HSPA): Launched in late 2023, the HSPA is a joint HHS/HUD technical assistance initiative designed to help selected states develop or expand innovative housing-related supports and services for Medicaid-eligible individuals with disabilities and older adults experiencing or at risk of homelessness. It focuses on helping states leverage Medicaid flexibilities (like Section 1115 demonstrations or 1915(i) State Plan Amendments) to cover services that promote housing stability. The Accelerator brings together state teams (including Medicaid, housing, aging/disability agencies) for intensive learning and coaching to improve cross-system collaboration.

Money Follows the Person (MFP) Rebalancing Demonstration: While primarily a CMS (HHS) program providing enhanced funding for Medicaid HCBS to help individuals transition from institutions to the community, successful transitions heavily rely on securing appropriate housing, necessitating close coordination with HUD programs and local housing resources.

Targeted Guidance and Technical Assistance: HHS and HUD frequently collaborate on issuing joint guidance documents, webinars, and technical assistance resources. Examples include guidance on using Medicaid to pay for specific housing-related services, best practices for coordinating ACF’s Runaway and Homeless Youth programs with HUD’s Youth Homelessness Demonstration Program, and joint efforts to improve access to HUD’s Foster Youth to Independence (FYI) housing vouchers for youth aging out of foster care.

The proliferation and expansion of these formal collaborations signal a significant evolution in federal strategy. There is clear recognition at the federal level that tackling complex, cross-cutting issues like chronic homelessness, the institutional bias in long-term care, and poor health outcomes among vulnerable housed populations requires moving beyond traditional agency silos.

These initiatives aim to integrate funding streams, service delivery models, and data systems to create more seamless support networks. However, the emphasis on state-level implementation in many key initiatives (like HSPA, Section 811 PRA partnerships, and Medicaid waivers) means that the practical impact of this federal integration strategy ultimately depends heavily on the capacity, resources, and policy choices made at the state level. This could potentially lead to variations in the availability and effectiveness of integrated housing and service supports across different states and localities.

Finding and Accessing HHS-Related Housing Support

Navigating the landscape of HHS programs for housing-related assistance presents a challenge: unlike applying for a HUD voucher, there is no single, centralized HHS “housing application.” Access is program-specific and often depends on an individual’s particular circumstances (e.g., age, health status, income, location) and the availability of services through local grantees. Finding the right door requires proactive searching and often involves connecting with intermediary organizations or using specialized locators.

Key Starting Points for Information:

• HHS Website: Provides general overviews of HHS programs and services. Sections dedicated to Social Services and Homelessness may contain links to relevant programs and operating divisions.
• Housing and Services Resource Center (HSRC): As described previously, this joint HHS-HUD site serves as a central repository for resources, guidance, and tools related to integrated housing and services, particularly useful for understanding cross-system efforts.
• FindSupport.gov: An HHS portal focused on locating mental health and substance use disorder treatment and support, which may lead to relevant SAMHSA-funded programs (like PATH or TIEH) that offer housing coordination.
• 2-1-1: Calling 2-1-1 from most locations connects individuals to trained community resource specialists. These specialists can provide information and referrals to a wide range of local health and human services, often including emergency shelter, housing assistance programs, utility assistance, and food banks. It serves as a valuable first point of contact for navigating local resources.

Program-Specific Locators and Access Points:

• ACF Runaway and Homeless Youth (RHY) Programs: To find local Basic Centers (emergency shelter), Transitional Living Programs, or Street Outreach Programs, use the FYSB grantee map or locator links available on the ACF RHY program pages (https://acf.gov:443/fysb/programs/runaway-homeless-youth). The National Runaway Safeline (see below) is also a primary access point.
• HRSA Health Centers (including HCH): Use the official “Find a Health Center” tool (https://findahealthcenter.hrsa.gov/) to locate nearby HRSA-funded health centers. This tool allows searching for centers providing specific services or serving specific populations, including those designated as Health Care for the Homeless.
• SAMHSA Treatment Locator: FindTreatment.gov is SAMHSA’s confidential and anonymous resource for persons seeking treatment for mental and substance use disorders. While it doesn’t specifically list PATH or TIEH programs, it can help locate behavioral health providers who may participate in or provide referrals to these programs.

Key National Hotlines:

• National Runaway Safeline: Provides 24/7 crisis support, information, and referrals for youth considering running away or experiencing homelessness. Call 1-800-RUNAWAY (1-800-786-2929), Text 66008, or visit https://www.1800runaway.org.
• National Domestic Violence Hotline: Offers 24/7 confidential support, crisis intervention, safety planning, and referrals for victims of domestic violence. Call 1-800-799-SAFE (7233) or visit https://www.thehotline.org.
• Other potentially relevant national lines include:
  • National Human Trafficking Hotline: 1-888-373-7888 / Text 233733
  • 988 Suicide & Crisis Lifeline: Call or text 988
  • National Maternal Mental Health Hotline: Call or text 1-833-852-6262

Connecting with Local Providers and Agencies:

Given the decentralized nature of many HHS programs, connecting with local organizations is often essential:

• Community Action Agencies (CAAs): For assistance potentially funded by the Community Services Block Grant (CSBG), contact your local CAA. Find yours through the locator on the OCS website (https://acf.gov/ocs/programs/csbg).
• Local Mental Health Authorities (LMHAs) / Local Behavioral Health Authorities (LBHAs): These county or regional agencies are often the entry point for publicly funded mental health and SUD services and may provide referrals to SAMHSA-funded programs like PATH or TIEH. Contact information can usually be found on county or state health department websites.
• Aging and Disability Resource Centers (ADRCs) / Centers for Independent Living (CILs) / Area Agencies on Aging (AAAs): These organizations form the core of the local aging and disability network. They provide information, counseling, and access to supportive services, including assistance related to housing options and community living supports for older adults and people with disabilities. Use the Eldercare Locator (https://eldercare.acl.gov) or DIAL (1-888-677-1199) to find local contacts.
• Continuums of Care (CoCs): These are local or regional planning bodies that coordinate housing and services funding for homeless individuals and families, primarily using HUD funding but often partnering with HHS-funded providers. Individuals typically access CoC resources through designated “coordinated entry” points in their community, often accessed via 2-1-1 or local shelters/outreach teams.

The process of finding HHS-related housing support necessitates a more proactive and potentially complex search compared to accessing centralized federal programs. Individuals often need to navigate through intermediary organizations, use specific program locators, or contact local agencies to determine eligibility and service availability.

This places a significant burden on the person seeking assistance, particularly those already in crisis. Consequently, easily accessible, knowledgeable referral services like 2-1-1, national hotlines, ADRCs, and well-informed local providers are vital components in effectively connecting people to the HHS supports that may be available to them.

A Look at Program Effectiveness (Where Data Permits)

Assessing the effectiveness of HHS’s housing-related programs involves examining available evaluation data and research findings. HHS, particularly through ASPE, invests in policy research and program evaluation to understand impacts and inform future directions. Operating divisions like ACF and SAMHSA also conduct or commission evaluations of their specific programs.

However, measuring the success of these programs, especially in terms of broad goals like “ending homelessness,” is inherently complex. HHS programs are often targeted to specific, highly vulnerable populations with complex needs. Their impact can be influenced by numerous external factors (e.g., local housing market conditions, economic climate, availability of complementary services).

Furthermore, data collection can be challenging with mobile populations. As a result, evaluations frequently focus on program outputs (e.g., number of people served, services delivered) and measurable participant outcomes (e.g., housing status at program exit, connection to services, changes in well-being indicators) rather than population-level homelessness reduction rates.

Specific Program Findings (Highlights):

ACF Runaway and Homeless Youth (RHY) Programs:

• Outputs: RHY programs collectively serve tens of thousands of youth each year through emergency shelters (BCP), transitional housing (TLP/MGH), and street outreach (SOP). The National Runaway Safeline handles a large volume of calls and contacts, providing crucial immediate support.
• Outcomes: The Transitional Living Program Youth Outcomes Study (TLP YOS) found that a majority (78%) of youth participants exited the program to a permanent housing situation, indicating success in achieving stable housing exits for many. Employment rates among TLP youth were higher during program participation compared to before entry (62% vs. 52%), though employment often remained unstable, and average earnings were low (around $9,000 annually if continuously employed).
• Reports to Congress have noted RHY program success in assisting youth with safe/stable housing, education (GED attainment), and employment seeking, although improvements in social and emotional well-being were less consistently demonstrated. Evaluations also highlight challenges, including difficulties serving specific subpopulations like LGBTQ or trafficked youth effectively, and significant capacity limitations meaning programs cannot meet the full demand for services. The COVID-19 pandemic also demonstrably impacted youth housing, employment, and education experiences while in TLP.
• Evaluation Resources: Key sources include the TLP YOS reports from OPRE (https://www.acf.hhs.gov/opre/project/transitional-living-program-evaluation-studies-2014-2023), resources from RHYTTAC (https://www.rhyttac.net/program-evaluation), and official Reports to Congress on the RHY program.

SAMHSA Projects for Assistance in Transition from Homelessness (PATH) Program:

• Outputs: The PATH program reaches a substantial number of individuals experiencing homelessness and serious mental illness annually, with outreach contacts exceeding 100,000 and enrollments typically ranging from 50,000 to over 65,000 per year in recent reporting periods.
• Outcomes: Triennial process evaluations consistently find that PATH programs provide appropriate and necessary services, including outreach, case management, behavioral health treatment linkages, and assistance connecting clients to housing resources. A high percentage of state PATH coordinators surveyed in the 2020 evaluation (73%) believed the program had a positive effect on moving clients toward permanent housing. The program effectively targets individuals with SMI/COD, including a large and growing proportion residing in unsheltered situations prior to enrollment. Strong collaboration with local Continuums of Care (CoCs) is reported by the vast majority of PATH grantees, indicating integration with the broader homeless service system.
• Evaluation Resources: Official SAMHSA PATH Triennial Process Evaluation Reports (available on SAMHSA’s data website, e.g., reports covering 2016-18 and 2019-21), and evaluation summaries from organizations like the Human Services Research Institute (HSRI).

HHS-HUD Support and Services at Home (SASH) Evaluation: Jointly sponsored evaluation of Vermont’s SASH program, which integrates care coordination and supportive services within affordable housing properties for seniors and individuals with disabilities, found it to be a promising model for improving care coordination and potentially health outcomes for residents.

General ASPE Research: ASPE continually produces research reports, issue briefs, and environmental scans on various facets of homelessness and housing instability, examining specific subpopulations (e.g., older adults, families, youth exiting foster care, individuals with OUD), health conditions among homeless populations, the role of service integration, and challenges like reentry from incarceration. This body of work helps inform HHS policy and program development.

Based on the available evidence, HHS programs that incorporate housing-related support appear to achieve positive outcomes for many of the individuals they serve, particularly in terms of facilitating exits to stable housing and connecting participants with needed health and human services. These programs effectively target specific vulnerable populations facing complex challenges at the intersection of health and housing.

However, the evaluations also reveal systemic limitations. Funding levels, particularly for programs like RHY, often fall short of the documented need, restricting program reach and capacity. The increasing severity of challenges faced by clients, such as the rise in unsheltered homelessness among PATH participants, points to intensifying needs that may strain program resources.

Furthermore, achieving long-term stability, especially economic self-sufficiency through stable employment and adequate earnings, remains a significant hurdle for participants in programs like TLP. A consistent theme emerging across diverse HHS programs (PATH, TIEH, AHSSD, ACL initiatives) and related evaluations (SASH) is the critical importance of integrating housing assistance with tailored, often intensive, supportive services. This suggests that for the vulnerable populations HHS primarily serves, simply providing housing may be insufficient; success often hinges on the availability and coordination of ongoing health, behavioral health, and social supports.

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