The  National Housing Trust Fund (NHTF) program, which is primarily targeted to rental housing for extremely low-income (ELI) households, represents an important opportunity for states to shape the future of our nation’s ELI housing policies, including a robust expansion of integrated permanent supportive housing (PSH) units for the most vulnerable ELI populations. A number of state housing agencies – including Pennsylvania, North Carolina, and Illinois – have successfully pioneered new ELI financing approaches to increase the supply of integrated PSH units. This report documents innovative ELI financing strategies developed by these three states which could be adapted for NHTF capital and operating subsidy funding to begin closing the enormous gap PSH supply. (2015)