TAC created State COVID-19 Response Strategies for the Disability & Homeless Community to help state-level policymakers facilitate a coordinated response that focuses on the needs of people with disabilities and those who are experiencing or at risk of homelessness.
Consolidated for the Affordable Housing, Homelessness, Behavioral Health and Disability Services Sectors
This page last updated: 6/26/20.
Visitors to TAC’s website are typically involved in multiple aspects of meeting the human services and affordable housing needs of individuals and families experiencing disabilities and homelessness. This resource page consolidates important information from the federal government and other sources related to Medicaid, behavioral health and disability services, and housing/homelessness to assist state and local governments and providers in responding to Novel Coronavirus Disease (COVID-19). TAC updates these links and resources regularly as new information becomes available.
Federal Guidance & Resources Related to Medicaid
The Centers for Medicare and Medicaid Services (CMS) is taking several actions in response to COVID-19 aimed at allowing providers, health care facilities, and states more flexibility as they respond to the virus, and has established a Medicaid.gov COVID-19 Resource Page with the most up-to-date information. Selected resources are included below, outlining these regulatory flexibilities and other actions CMS is taking to help health care providers and states respond to and contain COVID-19.
- Emergency Declaration Health Care Providers Fact Sheet
- Fact Sheet on Coverage and Benefits Related to COVID-19 Medicaid and CHIP
- Frequently Asked Questions (FAQs) for State Medicaid and CHIP Agencies (5/5/20)
- Disaster Preparedness Toolkit for State Medicaid Agencies
- Informational Bulletin: Medicaid Managed Care Options in Responding to COVID-19
- COVID-19 Emergency Declaration Blanket Waivers & Flexibilities for Health Care Providers (6/5/20)
- CMS COVID-19 Waivers and Flexibilities Webpage
- The COVID-19 Section 1115 Demonstration Opportunity makes available a number of authorities to assist states in enrolling and covering beneficiaries in Medicaid and to focus agency operations on addressing the COVID-19 pandemic. CMS has also issued a COVID-19 1115 Waiver Demonstration Template that includes specific expenditure authorities and flexibilities for Home and Community-Based Services.
- The Section 1135 Waiver COVID-19 State/Territory Request Template includes a checklist of relevant and commonly requested temporary flexibilities under Section 1135 authorities that are now available.
- 1915(c) Appendix K Template
- Medicaid Disaster State Plan Amendment Template
- CHIP Disaster State Plan Amendment
State Waiver Amendment and Approvals
- Section 1135 Waiver Approvals
- Section 1115 Waiver Approvals
- 1915(c) Appendix K Approvals
- Medicaid Disaster State Plan Amendment (SPA) Approvals
- CHIP State Plan Amendment (SPA) Approvals
Medicaid Telehealth Guidance to States
States have flexibility to cover and support delivery of covered Medicaid services through various telehealth technologies, including live videoconferencing, telephone, email, and remote patient monitoring. CMS has released guidance describing fee-for-service payment options for telehealth within Medicaid to help mitigate COVID-19. Notably, states are not required to submit a State Plan Amendment (SPA) to CMS for the delivery of covered services via telehealth if payments are made in the same way and amount as they would be in a face-to-face setting. If states seek to pay ancillary fees associated with telemedicine, such as equipment and transmission costs, or plan to reimburse for telehealth services differently than for face-to-face services, an SPA may be required to describe the payment rates and methodologies. Telehealth delivery methods that can also be used in response to COVID-19 are outlined in an April 2, 2020 Center for Medicaid & CHIP Services Informational Bulletin on the use of telehealth in Medicaid for rural communities and substance use disorder treatment services as required by the SUPPORT Act. CMS has also released a Medicaid and CHIP Telehealth Toolkit that highlights policy considerations for states to address as they expand the use of telehealth during the COVID-19 pandemic.
Guidance for PACE Organizations
CMS has issued guidance to all Programs of All-Inclusive Care for the Elderly (PACE) Organizations in response to COVID-19. PACE organizations serve older adults who often have serious chronic medical conditions and therefore are at higher risk of serious illness from the virus.
Guidance for Pre-Admission Screening and Resident Review (PASRR)
CMS has indicated in its FAQs that PASRR Level 1 and Level 2 evaluations may be conducted remotely rather than face-to-face. PASRR statutory provisions require all applicants to, and residents of, Medicaid-certified nursing facilities to be screened for mental illness and intellectual disability, and to be provided any necessary specialized services while in the nursing facility. Federal regulations do not prohibit PASRR Level 1 and Level 2 evaluations from being conducted by telephone or through another electronic medium. Unless a state has a specific requirement that PASRR Level 2 evaluations be conducted in a face-to-face interview, there is no need to amend language in the state plan. States can also request an 1135 Waiver to temporarily suspend PASRR Level 1 and Level 2 for 30 days.
Families First Coronavirus Response Act (FFCRA) Provisions
Section 6008 of the FFCRA provides a temporary 6.2-percentage-point increase to each qualifying state's and territory’s Federal Medical Assistance Percentages (FMAP) under section 1905(b) of the Social Security Act, effective January 1, 2020 and extending through the end of the calendar quarter in which the COVID-19 public health emergency was declared by the HHS Secretary. Section 6004(a)(3) of the FFCRA adds a new optional Medicaid eligibility group for uninsured individuals allowing for a limited benefit package of services related to testing and diagnosis of COVID-19 during the public health emergency.
- Families First Coronavirus Response Act Increased FMAP FAQs (4/13/20)
- COVID-19 FAQs on implementation of Section 6008 of the FFCRA and Coronavirus Aid, Relief, and Economic Security (CARES) Act (4/13/20)
Other Medicaid Resources
National Association of Medicaid Directors (NAMD)
NAMD has posted a previously delivered webinar on Leading through Emergencies: A Toolkit for Medicaid with information on 1135 Waivers.
Kaiser Family Foundation (KFF)
KFF has created a Medicaid Emergency Authority Tracker summarizing information on approved state Medicaid emergency authorities to address COVID-19. KFF also has created a data tool tracking State Data and Policy Actions to Address the Coronavirus.
Federal Guidance & Resources Related to Behavioral Health
The Substance Abuse and Mental Health Services Administration (SAMHSA) COVID-19 Resources and Information page contains guidance and information to ensure that behavioral health services are uninterrupted during this public health emergency. A sampling of guidance and resources is included below.
- Tips for Social Distancing, Quarantine, and Isolation during an Infectious Disease Outbreak
- SAMHSA Disaster Planning Handbook for Behavioral Health Treatment Programs (Chapter 6 addresses planning for infectious disease pandemics)
- Virtual Recovery Resources
- COVID-19 Information for SAMHSA Discretionary Grant Recipients
- Rural Opioid Technical Assistance Grants
- SAMHSA COVID-19 Funded Grants
- Considerations for the Care and Treatment of Mental and Substance Use Disorders (5/7/20)
- Considerations for Crisis Centers and Clinicians in Managing the Treatment of Alcohol or Benzodiazepine Withdrawal
- Considerations for Outpatient Mental and Substance Use Disorder Treatment Settings
- Interim Considerations for State Psychiatric Hospitals (5/8/20)
SAMHSA has collected guidance documents related to treatment of persons with opioid use disorder (OUD) using telehealth, and to medication-assisted treatment (MAT) during the COVID-19 pandemic:
- Guidance on pharmacotherapy for OUD availability in circumstances in which patients may be exposed to highly contagious infectious agents such as COVID-19
- Opioid Treatment Program (OTP) Guidance – provides increased flexibility in response to COVID-19
- FAQs on the Provision of Methadone and Buprenorphine for the Treatment of Opioid Use Disorder in the COVID-19 Emergency
- Sample Opioid Treatment Program FAQs for states and programs to consider for their individual circumstances
- Use of Telemedicine While Providing MAT
- SAMHSA has also posted links to guidance from the Drug Enforcement Administration allowing flexibility for the use of telemedicine for MAT.
SAMHSA has additionally provided guidance on consent and disclosures for treatment for persons with substance use disorders pertaining to 42 CFR Part 2.
The SAMHSA-funded Center of Excellence for Protected Health Information (CoE-PHI) has released several tools and resources including: Tips to Keep Your Telehealth Visit Private and Federal Guidance for SUD and Mental Health Treatment Providers.
In addition, the National Institute on Drug Abuse (NIDA) has posted COVID-19: Potential Implications for Individuals with Substance Use Disorders.
Other Behavioral Health Resources
National Council for Behavioral Health (NCBH)
NCBH has compiled several resources and tools for addressing the Coronavirus for behavioral health providers, including a guide on Best Practices for Telehealth during COVID-19 Public Health Emergency.
SMI Adviser has compiled a list of resources for clinicians on COVID-19 and Serious Mental Illness.
Housing & Homelessness
Federal Guidance & Resources Related to Housing and Homelessness
The U.S. Department of Housing and Urban Development (HUD) COVID-19 Information and Resources landing page has links to the latest guidance and information to assist homeless service systems, public housing agencies, assisted-housing providers, and other partners as they work together to address this crisis and support vulnerable households at the local level. COVID-19 resources for many HUD programs and cross-cutting requirements are also available on the HUD Exchange. Please see below for links to each HUD program area; many resources are best found through the specific program office.
In the past few weeks, HUD has published resources to help communities ensure that their rehousing strategies are equitable:
- Planning a Housing Surge to Accelerate Rehousing Efforts in Response to COVID-19 (6/4/20)
- Rehousing Activation and Racial Equity (6/4/20)
- Rehousing Activation: Planning and Implementation Tips (6/3/20)
- Untapped Expertise: Strategies for Inclusive Stakeholder Engagement When Developing Your Coordinated Investment Plan (6/3/20)
- Equity-Driven Changes to Coordinated Entry Prioritization (5/26/20)
Homelessness Programs and Funding
HUD has allocated $2.96 billion in Emergency Solutions Grants (ESG) funding to support homeless individuals and those at risk of becoming homeless because of hardships due to COVID-19 such as job loss, wage reduction, or illness. This funding is in addition to $1 billion in ESG grants announced less than a week after President Trump signed the CARES Act. HUD maintains a public spreadsheet of state and territory funding allocations. On the Action and Resource Guide page as well as on the HUD Exchange Disease Risks and Homelessness page, the HUD Office of Special Needs Assistance Programs (SNAPS) provides the latest guidance and information for homeless service systems. SNAPS resources include toolkits for Preventing and Managing the Spread of Infectious Diseases within Shelters and Preventing and Managing the Spread of Infectious Diseases within Encampments, as well as links to CDC guidance specific to homelessness. SNAPS has also issued COVID-19 HMIS Resources, which offers guidance to assist local communities in leveraging the Homeless Management Information System to enhance communication. HUD has developed an information sheet on how the moratorium impacts the ESG and CoC programs. There is also guidance on using HOPWA funds to address the disease and flexibilities for the HOPWA program (5/8/20).
HUD has also recorded a conversation about best practices and strategies for engaging persons with lived experience of homelessness in COVID-19 planning and response.
The U.S. Interagency Council on Homelessness (USICH) has compiled several resources for homeless systems and providers on its Planning and Preparing for COVID-19 web page, including some resources from local jurisdictions as well as a compendium of federal COVID-related resources.
The Federal Emergency Management Agency (FEMA) as a Resource for Temporary Housing
Communities using FEMA funds to assist in addressing COVID-19 challenges may find FEMA's Coronavirus Emergency Best Practices web page useful, as well as recommendations from national advocates for state and local governments on using CARES Act resources to address COVID-related homelessness and housing instability. HUD has also posted recommendations for making FEMA non-congregate requests. With hurricane season arriving, FEMA offers a Preparedness in a Pandemic Exercise Starter Kit (6/1/20), and a webpage with COVID-19 Pandemic Operational Guidance for the 2020 Hurricane Season.
On June 17, both the FHA and the FHFA announced two-month extensions of their foreclosure and eviction moratorium through August 31, 2020, affecting homeowners with FHA-insured or Freddie Mac or Fannie Mae single-family mortgages. The Office of Affordable Housing Programs in HUD’s Office of Community Planning and Development posted a sample flyer (6/9/20) for tenants and a sample letter to owners (6/9/20).
Housing Choice Voucher Programs and Funding
The Public and Indian Housing (PIH) COVID-19 page provides guidance for public housing agencies. PIH has issued waivers for the Public Housing, Housing Choice Voucher, Indian Housing Block Grant and Indian CDBG programs (4/10/20), and COVID-19 FAQs for Public Housing Agencies (5/29/20) are updated regularly. PIH has also issued FAQs on eviction moratoriums as these apply to PHA programs. See CARES Act Eviction Moratorium Q&A for Public Housing Agencies (4/21/20).
Multifamily Housing Programs and Funding
The Multifamily Housing COVID-19 resource page provides guidance for HUD-assisted housing providers, service coordinators, and tenants of Section 202, Section 811, and other multifamily housing programs. These include regularly updated Multifamily Q&A for COVID-19 (5/21/20); COVID-19 Guidance for Residents (4/28/20); and a recently issued Notice on electronic signatures (5/26/20). Multifamily has also issued guidance to assist property managers and service coordinators in addressing tenants’ food needs.
Rural Housing Programs and Funding
The US Department of Agriculture (USDA) provides COVID-19 rural housing-related resources including a comprehensive resource guide. Also see Rural Housing Updates from the Housing Assistance Council (HAC).
Community Development Block Grant Funding
HUD's Office of Community Planning and Development (CPD) has published CPD Program Formula Allocations and CARES Act Supplemental Funding for FY 2020, listing CARES Act allocations for Continuum of Care (CoC), Emergency Solutions Grant (ESG), and Housing Opportunities for People with AIDS (HOPWA) funding, as well as a Memorandum (3/31/20) explaining the availability of waivers for these programs to prevent the spread of COVID-19 and to facilitate assistance to eligible communities and households economically impacted by COVID-19. CPD has issued COVID FAQs for the Youth Homelessness Demonstration Program and a Quick Guide to CDBG Eligible Activities to Support Infectious Disease Response (3/19/20). More recently, CPD has published general HOME program waivers and waivers specific to using HOME funds for Tenant Based Rental Assistance (TBRA) as well as an initial set of waivers for the Community Development Block Grant (CDBG) program. Check out the HUD CPD web page for new waiver authority issued May 22, 2020.
Information for Tenants
HUD's Multifamily Office issued COVID information for tenants (5/24/20) and posted it in multiple languages on the Fair Housing and Equal Opportunity webpage. HUD’s PIH Tenant Flyer on the Eviction Moratorium has been translated into 20 languages.
- CDC Fact Sheet for Youth Experiencing Homelessness
- National Alliance on Mental Illness (NAMI) COVID-19 Resource & Information Guide
- Plain Language Information on COVID-19
- National Domestic Violence Hotline – Staying Safe during COVID-19
Information for Property Managers and Service Coordinators
The organizations listed below provide COVID-19 information that property managers and service coordinators may find useful.
- Stewards of Affordable Housing – Resources for Front Line Staff and Residents
- Leading Age – Collection of Resources for Affordable Housing Providers
- Leading Age – Visitor Guidance for HUD-Assisted Communities
- COVID-19 and Permanent Supportive Housing resources
COVID-related fair housing resources are available from the National Housing Law Project and the National Fair Housing Alliance. The Federal Emergency Management Agency (FEMA) has also published Ensuring Civil Rights during the COVID-19 Response.
Other Housing and Homelessness Resources
"Framework for an Equitable COVID-19 Homelessness Response has been released by a new partnership among several national organizations and leaders dedicated to helping communities navigate their response to COVID-19 with a racial justice and equity lens. Several HUD technical assistance providers have collaborated to launch a new disaster response website for communities seeking to address and prevent homelessness.
National Alliance to End Homelessness (NAEH)
NAEH has compiled key resources to assist homeless systems and providers in responding to COVID-19 from federal, state, and local partners, including examples of local homeless shelter and street outreach guidance. Working with the Center on Budget and Policy Priorities, NAEH has updated its Racial Equity Network Toolkit, which now includes functions to collect COVID-19-specific data.
National Council of State Housing Agencies (NCSHA)
The NCSHA COVID-19 Resources and Updates page contains information, guidelines, and notices published by state Housing Finance Agencies (HFAs), federal agencies, and state governments.
National Health Care for the Homeless Council (NHCHC)
NHCHC has created a Coronavirus resources section on its website dedicated to the response to COVID-19 by health care providers who work with people experiencing homelessness. This collection includes COVID-19 Information for Homeless Shelters and Homeless Service Providers.
National Housing Law Project
The National Housing Law Project has put together resources on Protecting Renter and Homeowner Rights during our National Health Crisis for attorneys, advocates, policymakers.
National Low Income Housing Coalition (NLIHC)
NLIHC's Coronavirus and Housing/Homelessness page summarizes the federal response and related advocacy efforts, as well as state and city actions related to housing and homelessness. NLIHC and the Consortium for Citizens with Disabilities have published a fact sheet on how COVID-19 impacts people with disabilities in congregate settings. NLIHC also maintains a list of state and local emergency rental assistance programs.
National Network for Youth (NN4Y)
NN4Y has created a COVID-19 Resources for Youth Homelessness Providers webpage.
Federal Guidance & Resources Related to Veterans
The U.S. Department of Veteran’s Affairs (VA) has posted several resources to its Supportive Services for Veteran Families (SSVF) program web page, including Consolidated Guidance (05/21/20); SSVF COVID-19 FAQs (5/7/20); and "Additional SSVF Resources Available During COVID-19 Crisis," among others.
Other Veteran-Related Resources
National Coalition for Homeless Veterans (NCHV)
The NCHV COVID-19 Resource Page has been established to assist in preparing and responding to COVID-19 for Veterans experiencing homelessness.
Other Health & Disability-Related Information
Federal Guidance & Resources Related to Health & Disabilities
Centers for Disease Control and Prevention (CDC)
The CDC has compiled a number of COVID-19 preparedness and response resources for the health care sector (see Housing & Homelessness section of this resource page for CDC guidance specific to homelessness). Some specific helpful resources include:
- Steps Healthcare Facilities Can Take Now to Prepare for Coronavirus Disease (COVID-19)
- Interim Guidance for Preventing the Spread of COVID-19 in Retirement Communities and Independent Living Facilities
- Interim Environmental Cleaning and Disinfection Recommendations for U.S. Community Facilities with Suspected/Confirmed Coronavirus Disease 2019 (COVID-19)
The CDC has also issued guidance for a variety of Home and Community-Based Servcies (HCBS) providers and stakeholders regarding the impact of COVID-19:
- Guidance for Direct Service Providers
- Guidance for Group Homes for Individuals with Disabilities
- Guidance for Direct Service Providers, Caregivers, Parents, and People with Developmental and Behavioral Disorders
- People with Developmental and Behavioral Disorders
National Institutes of Health (NIH)
Interim Guidance for COVID-19 and Persons with HIV for health care providers and persons living with HIV.
Social Security Administration (SSA)
SSA has established a Social Security and Coronavirus update page to provide information about operational changes during the COVID-19 pandemic.
U.S. Department of Health and Human Services (HHS)
Office of Civil Rights bulletin to ensure non-discrimination for medical treatment decisions and compliance with the Americans with Disabilities Act.
U.S. Department of the Treasury
The Treasury has updated its FAQs on the Coronavirus Relief Fund for State, Territorial, Local, and Tribal Governments established in the CARES Act. (5/28/20)
Other Veteran-Related Resources
American Network of Community Options & Resources (ANCOR)
National Association of State Directors of Developmental Disabilities Services (NASDDDS)
NASDDDS COVID-19 Library of Topical Resources for States contains a series of topical briefs immediately relevant to state intellectual and developmental disability (I/DD) systems as they coordinate responses to COVID-19.