NASHP’s Housing and Health Resources for States

Last updated Oct. 9, 2018

Safe and stable housing is necessary for people to become and stay healthy. States and the federal government have both invested in programs that help low-income and vulnerable populations find housing and access health care and supportive services. However, those programs often remain siloed with health and housing sectors often working independently toward similar goals. These resources highlight how policymakers are breaking down siloes to better deploy their states’ resources through an aligned health and housing agenda. To suggest a resource or share your state’s efforts to integrate health and housing, contact Amy Clary.


How Federal Housing Policy Developments Could Affect State Health and Housing Programs, October 2018. During #NASHPCONF18, Peggy Bailey, director of health integration at the Center on Budget and Policy Priorities, highlighted critical federal affordable housing programs that support state health and housing agency partnerships. In this blog, Bailey provides federal program updates and explains their impact on state efforts to improve health through housing.

States Jumpstart Efforts to Integrate Health and Housing Policies, September 2018. As part of NASHP’s health and housing institute, officials from IL, LA, NY, OR, and TX shared how they work across agency siloes at #NASHPCONF18 to improve health and housing for vulnerable populations.

Strengthening Health and Housing Partnerships through Medicaid to Improve Health Care for Individuals Experiencing Homelessness, July 2017. This brief explores how states have leveraged a range of federal authorities and care models to increase access to housing-related services.

State Health and Housing Programs in the Proposed FY 2018 Federal Budget: Six Housing Programs to Watch, June 2017. This blog post highlights some large federal housing programs and notes how the proposed federal budget for FY2018 could impact them.

Braiding Funds to House Complex Medicaid Beneficiaries: Key Policy Lessons from Louisiana, May 2017. This brief profiles Louisiana’s permanent supportive housing program, which is administered jointly by the state’s Medicaid agency and housing authority.

Improving Health through Housing: Three Tips For State Policymakers, February 2017. This blog post shares three practical tips for state policymakers interested in improving health through housing.

Federal and State Collaboration to Improve Health through Housing, January 2017. This brief shares concrete policy recommendations from a meeting of state and federal health and housing policymakers in December 2016.

State Strategies to Improve Health through Housing Services, March 2016. This chart compiles state strategies to support health through housing services.

State Strategies for Integrating Health Care and Housing for Homeless Individuals and Families, September 2015. Featuring presentations from Oregon, Texas, and CSH, this webinar addressed the financing mechanisms, data infrastructure and strategic partnerships that facilitate the blending of health care and housing funding streams.

Reasonable Accommodations Resources

Illinois Department of Human Rights: Reasonable Accommodations and Modifications: A Guide for Housing Professionals, retrieved Aug. 20, 2018.
This book provides guidance and clarification about accommodations and modifications that must be made in housing for persons with disabilities and their family members.

CSH: Sample Reasonable Accommodation Request Notices and Forms, retrieved Aug. 9, 2018.
This document contains sample notices and accompanying sample forms that can be made available to any tenant requesting a reasonable accommodation.

Intermountain Fair Housing Council’s Guide to Reasonable Accommodation in Housing Under the Fair Housing Act, Retrieved Aug. 9, 2018.

  • This document is a high-level guide to the frequently-asked-questions regarding the reasonable accommodation appeals process.

US Department of Housing and Urban Development’s Reasonable Accommodations Under the Fair Housing Act, retrieved Aug. 9, 2018.

  • A housing provider can deny a request for a reasonable accommodation if the request was not made by or on behalf of a person with a disability, or if:
    • There is no disability-related need for the accommodation;
    • If the request would impose an undue financial and administrative burden on the housing provider; or
    • If it would fundamentally alter the nature of the provider’s operations.
  • When a housing provider refuses a requested accommodation because it is not reasonable, the provider should discuss with the requester whether there is an alternative accommodation that would effectively address the requester’s disability-related needs without a fundamental alteration to the provider’s operations and without imposing an undue financial and administrative burden. 

US Department of Housing and Urban Development’s Procedures for Providing Reasonable Accommodation, retrieved Aug. 9, 2018.

Chapter 10: Denial of Reasonable Accommodation

1. Within three business days, the decision maker must submit a Denial of Request form and submit it to the Disability Program Manager with supporting documentation.
2. The denial notice should explain reasons for denial as well as any alternative accommodations offered that were not agreed to.
3. The written notice must include specific reasons for recommended denial:

• The requested accommodation would not be effective;
• Medical documentation is inadequate to establish that the individual has a disability and/or needs reasonable accommodation;
• The requested accommodation would require the removal of an essential function; or
• The requested accommodation would require the lowering of a performance or production standard.

4. The Disability Program Manager will notify the requesting individual of the recommended denial and next steps.
5. The Reasonable Accommodation Committee will review the request, supporting documentation, and justification for denial. The Committee will vote to determine whether to approve or deny the request in no more than 7 business days from receipt of the request.

Reasonable Accommodation Appeals Cases

US Department of Housing and Urban Development press release: HUD Reaches Agreements with Housing Providers in California, Idaho, and Hawaii Settling Claims of Discrimination Against Individuals with Disabilities, retrieved Aug. 9, 2018.
This HUD press release outlines the outcomes of four recently decided reasonable accommodation cases.

US Department of Housing and Urban Development Press Releases-2018, retrieved Aug. 9, 2018.
This is a US Department of Housing and Urban Development press release archive that includes examples of resolved reasonable accommodation cases.

Dennis Steinman, Reasonable Accommodation in Housing for the Disabled. (Portland, OR: Kell, Alterman & Runstein, LLP.)
This resource considers foundational reasonable accommodation cases on a granular level.

These resources were produced with support from the Robert Wood Johnson Foundation and through a cooperative agreement NASHP holds with the US Health Resources and Services Administration (HRSA). The views expressed here do not necessarily reflect those of the foundation, and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the US government.