When it comes to finding a shared housing unit in New Orleans for people with substance abuse issues, there are certain considerations that must be taken into account. A recent study conducted by Dr. Tsai and colleagues on alcohol and drug use disorders among homeless veterans revealed that more than half of the participants had substance use disorders. Despite this, the study found no difference in housing outcomes between participants with or without substance use disorders after six months in the program.
This finding suggests that the Housing First model is an effective way to get people with substance use disorders to access housing. However, once housed, individuals who entered the HUD-VASH program with a history of substance use disorders continued to report problems related to substance use. This raises questions about when and how to incorporate treatment into these programs. Dr. Tsai noted that some doctors suggest interventions to reduce social isolation or help people reintegrate into their communities.
Often, case managers play a key role in trying to help participants rebuild their lives. The VA is considering adapting case management to the needs of its program residents, according to Dr. Tsai. One way to help participants in Housing First programs may be to supplement individual case management with group case management. The groups work together on issues such as obtaining housing vouchers, staying sober, and other measures for reintegration.
This helps combat social isolation among participants. The Housing First model may not be a one-size-fits-all solution for all types of substance use. Two studies, one on substance use and housing stability and the other on stimulant use and housing outcomes, have shown that people who use cocaine do not do as well in housing as those who drink excessive amounts of alcohol. According to studies, many people who use stimulants end up being left homeless. To make Housing First programs as effective as possible, Dr. Tsai recommended that service providers include services designed to keep participants housed and help them reintegrate successfully.
Examples of these effects may include improved medication adherence, reduced avoidable emergency service use and hospital admissions, housing retention, and increased family income. In addition to providing housing for low-income and special-needs populations, supportive housing programs provide services and activities related to housing. In states that have implemented the ACA's Medicaid expansion, millions of low-income adults who were previously uninsured, including homeless adults and others who could live in the community with appropriate supports, now have Medicaid coverage. Federal low-income housing tax credits (LIHTC) and disaster recovery funds under the Community Development Block Grant (CDBG) were used to finance housing. For example, Oregon's 1115 exemption allows state coordinated care organizations, in which most Medicaid beneficiaries are enrolled, to use Medicaid money for “flexible” non-medical services for Medicaid enrollees, which can result in better health at a lower cost, including housing supports. There are several ways to address the housing needs of people with SUDs (Substance Use Disorders), including supportive housing, transitional housing (often referred to as recovery housing), and rental assistance provided after inpatient treatment or during recovery. Providing Medicaid coverage and paying for health and housing related services that would otherwise be funded by housing funds can increase the capacity of housing programs to address these needs. Mercy Maricopa offers a wide range of habitation-related services covered by Medicaid through its housing programs, including housing navigation and case management services, which enrich the assistance available to people with different levels of need.