Medicaid enrollment, homeless services, utilities assistance, and housing assistance: what Floridians should know now

If you’re a senior, a caregiver, or a household with limited income in Florida, you can stretch your dollars and improve stability by coordinating three pillars of help: Medicaid coverage, homeless/housing services, and utility assistance. Below is a clear, practical explainer of what these programs are doing nationally right now, how states are connecting health care to housing and nutrition, and how that can translate into concrete steps for you and your family.

Key takeaways upfront
- Medicaid remains the foundation for free or low‑cost health coverage. States are increasingly adding non‑medical supports—like housing navigation, short‑term rent, and medically supportive food—when they are clinically appropriate and targeted to people with high needs. This is happening through “Section 1115” waivers that let states test new benefits addressing health-related social needs (HRSN). See the federal framework from the Centers for Medicare & Medicaid Services (CMS) for details on allowable supports and guardrails, including that HRSN services must be medically appropriate and member‑chosen, and often time‑limited (CMS HRSN framework).
- Some states now cover short‑term rent, medical respite, housing transition services, and food prescriptions under Medicaid for certain enrollees. Washington’s recently approved protocols allow rent or temporary housing support with a combined cap of six months per rolling 12‑month period, plus related items like movers’ fees and storage, for eligible Medicaid members who meet clinical and social risk criteria (CMS approval of Washington HRSN payment methodologies, Jan. 16, 2025; and the state’s approved HRSN services protocol summarized by CMS on Dec. 30, 2024, including the six‑month cap and covered cost types such as landlord-paid utilities bundled into rent when not duplicative of other benefits (CMS letter/protocol attachment)).
- Nutrition supports are also expanding in Medicaid. CMS notes that programs like fruit and vegetable “prescriptions” or protein boxes can be covered for up to six months when medically appropriate, and must supplement—not replace—nutrition programs such as SNAP, WIC, and TANF (CMS HRSN framework).
- For people experiencing homelessness, aligning health coverage, coordinated entry into shelter/rehousing systems, and supportive services is essential. Federal homeless data standards explain how communities use a Homeless Management Information System (HMIS) and coordinated entry to connect people to crisis housing and longer‑term solutions, and how those data inform national policy and the Annual Homeless Assessment Report to Congress (HUD HMIS Data Standards Manual 2024).
- Utility assistance (LIHEAP) income eligibility is guided by federal poverty guidelines (FPG) and state median income (SMI). The U.S. Office of Community Services (OCS) confirms states may use FPG/SMI measures for eligibility; new guidance sets these measures as optional in FY2024 and mandatory in FY2025 (ACF/OCS LIHEAP IM 2024‑02). LIHEAP is administered by the Administration for Children and Families and states submit performance data annually (ACF action transmittals; FY2024 update).

Medicaid today: enrollment, renewals, and new social-support benefits

1) Enrolling or staying enrolled
- States can streamline renewals using “ex parte” reviews—checking existing data sources first to auto‑renew eligible members. For example, California’s approved waiver materials reiterate the use of ex parte strategies through June 30, 2025, including specific approaches when income data sources do not return information (CMS approval letter and monitoring overlay; reaffirmed in the state’s January 2025 approval document (CMS approval)).
- People leaving incarceration: states are implementing “pre‑release” Medicaid processes so benefits can be activated at release. California documents show that Medi‑Cal coverage is suspended (not terminated) during incarceration and is reactivated upon release, with annual redetermination rules tailored to whether the person is the only individual on the case. Counties must notify applicants of eligibility decisions and provide benefits identification cards, with procedures for hearings and redeterminations laid out in policy letters referenced by CMS (CMS CalAIM approval, Oct. 16, 2024).

Why this matters in Florida: while details vary state‑to‑state, these federal approvals show the direction of travel. If you or a family member is due for Medicaid renewal, ask your local Medicaid office or plan whether an ex parte renewal is possible and make sure your address and contact information are current. If you’re being released from jail or prison, ask the facility discharge staff whether they coordinate with the Medicaid agency so your coverage can resume immediately after release, consistent with the federal practices described in recent CMS approvals cited above.

2) Medicaid coverage of health-related social needs (HRSN)
CMS’ HRSN framework enables states to cover short‑term, clinically appropriate supports that address upstream needs such as housing and nutrition. Key points:
- Covered domains: housing supports, nutrition supports, and HRSN case management. Transportation to HRSN activities may be allowable in some cases (CMS HRSN framework).
- Medical appropriateness: services must be medically appropriate based on state‑defined clinical and social risk factors, and they must be the member’s choice.
- Nutrition supports: states can cover medically appropriate food supports (e.g., fruit and vegetable prescriptions and/or protein boxes) for up to six months. These must supplement—not supplant—SNAP, WIC, and TANF, with strong coordination across programs (CMS HRSN framework).
- Housing supports: CMS encourages aligning short‑term Medicaid housing aid with existing long‑term rental assistance processes, such as mirroring Housing Choice Voucher program processes where appropriate (CMS HRSN framework).

State examples you can use to ask targeted questions
- Washington: CMS approved the HRSN services protocol and subsequent payment methodologies that include housing transition navigation, rent and temporary housing, and medical respite. Rent/temporary housing is capped at six months per rolling 12‑month period; covered items can include storage fees, movers’ fees, renter’s insurance if required by the lease, and landlord‑paid utilities if part of rent and not duplicating other HRSN utility payments (CMS protocol approval, Dec. 30, 2024; payment methodology approval, Jan. 16, 2025).
- Arizona: reporting by California Healthline describes federal approval of Arizona’s “H2O” initiative to prioritize people who are homeless or at risk of homelessness with mental health conditions and chronic illness, including rent payments up to six months and transitional housing with intensive services (California Healthline coverage).

How to put this to work in Florida right now
- If you are on Medicaid and struggling with housing or food due to medical issues, ask your health plan or case manager if your state covers any HRSN services, and whether you can be screened for eligibility based on clinical and social risk factors. The Washington protocol shows how states operationalize screening tools, care plans, and “closed‑loop” referrals through community hubs and managed care partners (CMS protocol approval for Washington).
- For those with chronic conditions, ask whether a provider‑directed “produce prescription” or medically tailored grocery box is available for a defined time (up to six months in states implementing that option), and how it coordinates with SNAP or WIC so you don’t lose those benefits (CMS HRSN framework).

Homeless services and housing assistance: making coordinated entry work for you

Communities organize homeless services through a Coordinated Entry (CE) system and track support via a Homeless Management Information System (HMIS). Understanding the basics helps you navigate faster:
- Why HMIS matters: standardized “Universal Data Elements” collected at entry (like name, date of birth, veteran status) help match people to the right program types (shelter, transitional housing, Permanent Supportive Housing). Aggregated HMIS data feed the Longitudinal System Analysis and the Annual Homeless Assessment Report (AHAR) to Congress—key tools for directing resources where they’re needed most (HUD HMIS Data Standards Manual 2024).
- Program types to know: emergency shelter (ES), transitional housing (TH), Permanent Supportive Housing (PSH), and other permanent housing dedicated for formerly homeless persons are defined program models in HMIS standards (HUD HMIS Data Standards Manual 2024).

Practical steps when you’re unsheltered or at risk
- Engage intake early. The faster you complete CE screening with a local homeless assistance project, the faster staff can confirm eligibility and prioritize you appropriately within community standards documented in HMIS. Bring any identification or documentation you have; if you lack documents, say so—projects routinely help replace IDs as part of case management, a core service category referenced across HMIS and HRSN guidance (HUD HMIS Data Standards Manual 2024).
- If you are on Medicaid, tell intake staff. States are increasingly using Medicaid to fund short‑term housing navigation, medical respite, or time‑limited rent for specific high‑need members