New Hawaii program lets Medicaid pay for housing for houseless persons.
Hawaii Launches New Medicaid Housing Program for Unhoused Individuals
Honolulu, HI – [2025] — Hawaii is taking a major step forward in addressing homelessness by expanding its Medicaid program to support housing stability among people who are homeless or at risk of homelessness. The move aims to tackle one of the root causes of health decline and high medical costs: lack of safe, stable housing.
What’s the Program?
The Medicaid Community Integration Services (CIS) program—administered by the Hawaii Department of Human Services’s Med-QUEST Division—provides both pre-tenancy and tenancy support services for Medicaid beneficiaries. (homelessness.hawaii.gov)
These services are designed to help people who are homeless, at risk of homelessness (for example due to eviction), or transitioning from institutions back into community life—especially if they don’t yet have housing. (homelessness.hawaii.gov)
Who Qualifies?
To be eligible:
- You must be enrolled in QUEST Integration (QI) health insurance through Medicaid. (homelessness.hawaii.gov)
- Be at least 18 years old. (homelessness.hawaii.gov)
- Meet health-needs criteria, such as having a chronic illness, mental health condition, or substance use disorder. (homelessness.hawaii.gov)
- Meet at least one risk criterion (e.g. homelessness, risk of homelessness, or frequent/lengthy institutional stays). (homelessness.hawaii.gov)
What Services Are Covered?
Some of the support services under CIS include:
- Helping members transition into housing
- Coaching on how to maintain good tenant/landlord relationships
- Assistance with paperwork, resolving disputes with landlords, financial literacy, maintaining housing recertification, and crisis planning (homelessness.hawaii.gov)
- Connecting health care coordination with other needed services so members can retain housing and avoid institutionalization. (homelessness.hawaii.gov)
Why It Matters
- Health outcomes: People who are homeless frequently have worse health outcomes; stable housing reduces emergency room visits, avoids crises, and provides a more consistent platform for health services. (Hawaii Public Radio)
- Cost savings: Stable housing can reduce medical costs associated with repeated ER visits, unmanaged chronic illnesses, and institutional care. Hawaii has characterized housing as integral to health care. (Hawaii Public Radio)
- Preventing cycles of homelessness: By offering both pre- and post-housing support, the program helps people stay housed, rather than experiencing repeated bouts of homelessness. (homelessness.hawaii.gov)
Challenges & Considerations
- While CIS provides support services, it doesn’t directly pay rent or build housing stock. The focus is on helping individuals become and remain successful tenants. (homelessness.hawaii.gov)
- Funding, provider capacity, and coordination among landlords, health plans, and social services will be essential to make the program work effectively.
- Outreach is needed so people who are eligible know about the program, and providers are capable of delivering the required services.
What’s Next
Hawaii is one of the states selected to participate in the Housing and Services Partnership Accelerator, a federal initiative designed to help states expand housing-services under Medicaid. (Hawaii Public Radio) This could provide technical assistance and resources to scale up programs like CIS.
Bottom line: Hawaii’s expanding Medicaid housing support is more than just a health policy tweak—it represents a shift in viewing housing as foundational to health. For many people, having stable housing isn’t just a roof—it’s a key tool for better health, stability, and lower public costs.
MAY 2025
As of May 2025, Hawaii is actively pursuing several legislative initiatives to enhance mental health services, with a focus on youth care, culturally responsive practices, and improved infrastructure.
Key Legislative Developments in Hawaii Mental Health Services
1. Senate Bill 1442 (SB1442): Modernizing Youth Mental Health Services
SB1442 aims to revamp Hawaii’s child and adolescent mental health system—the first comprehensive update in 50 years. The bill mandates the Department of Health’s Child and Adolescent Mental Health Division (CAMHD) to establish family guidance centers across counties, offering a spectrum of services including prevention, early identification, screening, diagnosis, treatment, and rehabilitation. Importantly, the provision of these services is contingent upon the availability of federal or state funding, addressing concerns about potential litigation due to unfunded mandates. The legislation also requires CAMHD to submit a statewide mental health services plan every five years, starting in 2027, with public hearings in each county to ensure community involvement .(Honolulu Star-Advertiser)
2. Senate Bill 623 (SB623): Addressing Native Hawaiian Mental Health Disparities
Recognizing the unique mental health challenges faced by Native Hawaiians, SB623 proposes the inclusion of members with expertise in Native Hawaiian concepts of well-being, culturally grounded mental health methodologies, or traditional healing practices in the State Council on Mental Health. The bill also mandates annual training for council members on topics related to Native Hawaiian healing and health, aiming to foster culturally responsive policies and programs .(LegiScan)
3. Senate Bill 787 (SB787) and House Bill 112 (HB112): Establishing a Statewide Mental Health Warm Line
Both SB787 and HB112 focus on creating a free, statewide mental health warm line operated by the Department of Health. This initiative is designed to provide immediate mental health support to residents, serving as a preventive measure to address mental health issues before they escalate .(FastDemocracy, FastDemocracy)
4. House Bill 854 (HB854): Enhancing Mental Health Record-Keeping in Correctional Facilities
HB854 addresses critical challenges in mental health record-keeping within Hawaii’s correctional facilities. The bill allocates $500,000 annually for the 2025–2027 fiscal biennium to the Department of Corrections and Rehabilitation for procuring a new electronic health record system. This move follows reports of significant issues with the existing system, which hindered access to essential medical records .(BillTrack50)
5. Senate Bill 1042 (SB1042): Pilot Program for Emerging Mental Health Therapies
SB1042 proposes a two-year pilot program under the Department of Human Services to explore emerging and breakthrough mental health therapies. The bill includes the establishment of a special fund and appropriates necessary funds for the program’s implementation .(trackbill.com)
These legislative efforts reflect Hawaii’s commitment to improving mental health services through modernization, cultural sensitivity, and enhanced infrastructure. By addressing systemic issues and prioritizing community involvement, the state aims to provide more effective and accessible mental health care for its residents.(BillTrack50)
As of May 2025, Hawaii’s Community Integration Services (CIS) program continues to play a pivotal role in addressing the intersection of housing and healthcare for Medicaid beneficiaries. Administered by the Hawaii Department of Human Services’ Med-QUEST Division, CIS provides pre-tenancy and tenancy support services aimed at assisting Medicaid members in securing and maintaining stable housing, thereby improving health outcomes and reducing homelessness .(OHHS)
Funding and Program Developments
In January 2025, the Centers for Medicare & Medicaid Services (CMS) approved a five-year extension of Hawaii’s QUEST Integration Section 1115 Demonstration, effective through December 31, 2029. This extension encompasses continued support for housing-related services under the CIS program, aligning with CMS’s framework for addressing health-related social needs (HRSN) . The approved services include:(GovDelivery)
- Pre-tenancy services
- Tenancy and sustaining services
- One-time transition and moving costs (excluding rent)
- Utility assistance
- Medically necessary home remediations
- Home/environmental accessibility modifications(Medicaid)
These services are designed to support Medicaid enrollees at risk of homelessness or those experiencing homelessness, with the goal of promoting recovery, wellness, and self-advocacy within the community .(Medicaid)
Medicaid Billing and Reimbursement Considerations
While the CIS program’s integration into the QUEST Integration Demonstration provides a structured framework for funding, healthcare providers in Hawaii have expressed concerns regarding delays in supplemental Medicaid payments. As of May 2025, Hawaii’s private hospitals are awaiting approximately $240 million in funds, which were anticipated earlier in the year. These delays are attributed to increased scrutiny and a surge in applications for state-directed payments at the federal level, leading to financial strain on healthcare facilities .(WSJ)
Legislative Initiatives
In response to the need for enhanced support of home- and community-based services (HCBS), Hawaii’s legislature introduced Senate Bill 715 in 2025. This bill proposes appropriating funds to the Department of Human Services to achieve full funding status for Medicaid HCBS, including estimated payment increases. The legislation emphasizes maximizing federal matching funds and exploring all available funding sources before utilizing state general revenues .(LegiScan)
These developments underscore Hawaii’s commitment to integrating housing support within its Medicaid program, recognizing the critical role stable housing plays in overall health and well-being.(OHHS)
As of May 2025, Hawaii has implemented significant updates regarding the medical billing and reimbursement for long-acting injectable antipsychotics (LAIAs) under its Medicaid program.(OUP Academic)
Enhanced Reimbursement for LAIA Administration
Effective November 1, 2023, the Hawaii Medicaid program increased the administration fee for LAIAs to $200 when administered in community settings. This adjustment aims to incentivize providers to offer these services outside traditional clinical environments, thereby improving access for patients with serious mental illnesses. Eligible providers include physicians, pharmacies, and other qualified healthcare professionals. (MedQuest Hawaii)
Alignment with Medicare Fee Schedule
In 2025, Hawaii’s Medicaid program updated its professional fee schedule to align with 100% of the Medicare rates. This alignment ensures consistency in reimbursement and supports providers in delivering cost-effective care. (MedQuest Hawaii)
Billing Codes and Documentation
Providers administering LAIAs should utilize the appropriate Healthcare Common Procedure Coding System (HCPCS) codes and ensure accurate documentation to facilitate reimbursement. Staying informed about any changes to billing codes is crucial for compliance and optimal reimbursement. (Medicare)
For the most current information on billing codes, reimbursement rates, and provider requirements, healthcare professionals are encouraged to consult the Hawaii Medicaid Provider Memos and the Med-QUEST Division.