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CMS Extends Arizona Section 1115 Waiver with Housing Focus

Julie Kozminski
October 25, 2022

The Centers for Medicare & Medicaid Services (CMS) on Oct. 14, 2022, approved an innovative Section 1115 waiver in Arizona, which funds infrastructure to meet health-related social needs (HRSN) with a focus on housing.

The five-year demonstration extension comes after CMS approved waivers in Massachusetts and Oregon that also target unmet HRSN. The agency again applied a new approach to budget neutrality to provide flexibility to advance health equity.

The Housing and Health Opportunities Initiative will provide temporary housing to Medicaid beneficiaries experiencing or at risk of homelessness who have a significant health need — such as a serious mental illness, a high-cost, high-needs chronic health condition, or comorbidities — or are enrolled in long-term care.

The Initiative will provide housing support that includes:

  • rent or temporary housing for up to six months for individuals transitioning out of institutional care or congregate settings, including hospitals;
  • utility costs, including back payments;
  • pre-tenancy and tenancy sustaining services, including eviction prevention; and
  • housing deposits, among others.

CMS also approved the Targeted Investments 2.0 Program, which will offer provider incentives via managed care directed payments for meaningful system transformations, as well as work to improve quality and health equity. Eligible providers include primary care and behavioral health providers, integrated clinics, and justice clinics. Under this program, providers must meet standards for culturally and linguistically appropriate services, use a closed-loop referral system, conduct population health analyses related to HRSN, and implement specialty-specific programs.

Contact Director of Policy Rob Nelb, MPH, at or 202.585.0127 with questions.

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