States are responding to a series of overlapping public health crises, including increased homelessness and housing instability, increased morbidity and mortality due to substance use disorders, and over-reliance on corrections and institutional care in the absence of robust community-based solutions for complex behavioral health and social support needs. State policymakers are key players in shaping the policy ecosystem toward aligned federal, state, and local resources needed to implement effective programs. At NASHP’s 2024 Annual Health Policy Conference, Ohio, Michigan, and Illinois shared how they are implementing such strategies, tailored to the needs of individuals with substance use disorder, individuals reentering the community from incarceration, and transition-age youth.
Ohio’s Recovery Housing Program
Ohio’s Recovery Housing Program relies on close collaboration among various state and local agencies to improve housing stability for individuals with substance use disorder. Recovery residences are substance-free living environments that support individuals who are recovering from addiction. The Recovery Housing Program is administered by the Ohio Department of Mental Health and Addiction Services (MHA) in partnership with the state affiliate of the National Alliance for Recovery Residences, the Ohio Department of Development, and local Alcohol, Drug Addiction, and Mental Health (ADAMH) boards. MHA also supports an array of housing programs, including permanent supportive housing, transitional housing, and residential care facilities for adult mental health group homes. In recent years, Ohio has established recovery housing quality standards and gained a better understanding of the resources and needs across the state. In 2014, the state established Ohio Recovery Housing, a state affiliate of the National Alliance for Recovery Residences, to oversee certification of recovery homes across the state. In 2022, MHA began requiring recovery housing operators to meet national quality standards and collect outcomes data as a condition of receiving state funds. House Bill 33, signed by Governor Mike DeWine in July 2023 updated the definition of recovery housing, gave MHA the authority to monitor recovery housing residences, and created a registry for recovery homes, among other provisions designed to increase quality.
The Ohio Recovery Housing Program is funded through a combination of state general funds, the federal Recovery Housing Program authorized under the SUPPORT Act, and state opioid settlement (SOS) funds. State bond dollars contribute to capital funding for new construction, renovation, and acquisition of recovery housing and must have a 50 percent match, which can be made up of federal and local resources. SUPPORT Act funds are allocated to the Ohio Department of Development, which partners with MHA to channel the funds into up to two years of rental assistance for individuals in recovery housing.
Ohio leverages a network of 50 regional ADAMH boards that oversee and administer various behavioral health programs across the state. These boards receive capital funds from the state and contract with a wide range of providers for prevention, treatment, and recovery support for their community members. MHA provides these local boards with technical assistance to advance braiding of funding streams for housing supports. The boards also use a Landlord Incentive Fund, which provides up to $2,000 to incentivize landlords to accept tenants from the recovery housing program, particularly targeting those who were formerly incarcerated.
Michigan’s Housing Reentry Program
Michigan’s state prison system has a reentry program designed to support individuals transitioning from incarceration to the community that is funded through an annual appropriation in the state budget. The program provides temporary housing and comprehensive support to reduce recidivism and assist individuals with reintegration into the community. The Michigan Department of Corrections (DOC) manages the reentry housing program, using state general funds to support transitional housing combined with wraparound supports for individuals on parole. The program rents out homes where parolees can stay temporarily while working with housing specialists to develop long-term housing plans. The state employs 10 regional contractors who are responsible for working with parolees to secure permanent housing and providing other supportive services such as assistance applying for benefits. As a result of this program, over the past 20 years, Michigan has seen state prison recidivism rates drop from 45 percent to 22 percent.
In addition to the state-funded reentry housing and supportive services for parolees, the Michigan Housing Development Authority dedicates a pool of housing choice vouchers specifically for individuals exiting incarceration who will have the most difficulty maintaining housing, while the DOC provides necessary wraparound services such as connections with job training, social services, counseling, and health services. This cross-sector partnership has led to 96 percent of voucher recipients maintaining housing stability over the past three years.
Illinois’ Youth Homelessness Programs
Illinois has a longstanding program to address homelessness among youth. This initiative highlights the importance of collaboration between child welfare systems and housing authorities to provide long-term support for families and young adults transitioning out of foster care.
The Illinois Department of Children and Family Services (DCFS) supports coordination with housing assistance programs, working closely with public housing authorities (PHAs) — who administer the Family Unification Program (FUP) and the Foster Youth to Independence (FYI) vouchers — and homeless Continuums of Care. DCFS maintains a full-time employee dedicated to working with PHAs to administer these vouchers to youths and families. DCFS has also supported the Youth Housing Assistance Program since 2001, which provides both financial assistance and other support to youth referred to FUP and FYI, including with a voucher application, life skills education, and employment support services for individuals up to age 27. DCFS uses federal Chafee Foster Care Program funds in the state, which support youth and young adults in, or formerly in, foster care through their transition to adulthood. The state has a waiver from the federal Children’s Bureau to provide Chafee funds for individuals up to age 23.
Conclusion
The state programs from Ohio, Michigan, and Illinois exemplify the critical role of partnerships among various agencies in integrating funding and services to effectively address homelessness and housing instability in target populations. NASHP will continue to support states in their efforts to address homelessness. For more information about NASHP’s Health and Housing work, please visit our Health and Housing Resource Center. For more information on NASHP’s work supporting individuals exiting incarceration
Acknowledgments
NASHP thanks the state officials from Ohio, Michigan, and Illinois who provided thoughtful review of this blog.
