Housing as Health Care

Housing as Health Care




The time is right for New York to make a commitment to ending the AIDS epidemic because of three factors:

  • Medicaid Redesign
  • Affordable Care Act (ACA)
  • Delivery System Reform Incentive Payment (DSRIP)

Medicaid Redesign

Immediately upon entering office, New York Governor Andrew Cuomo created a team dedicated to redesigning the Medicaid program. Previously, the system performed poorly and was extremely expensive, draining county and tax dollars. The Governor designed an effective Medicaid Redesign Team (MRT) and instituted measures to ensure that Medicaid costs remained manageable for the State, reduced the county share of Medicaid expenditures, and improved health outcomes for Medicaid recipients. More information about the redesign can be found on the MRT website.

An essential component of Medicaid Redesign has been institution of a global cap. All Medicaid expenditures must stay under the global cap or the Commissioner of Health has the authority to make targeted cuts to stay under the global cap. This can include cutting services or cutting Medicaid reimbursements to providers.

Staying under the global cap has another benefit: Medicaid savings are reinvested in programs that have a proven track record of improving health outcomes. For example, within the last two years $230 million in Medicaid savings has been invested in housing for people with chronic conditions.

Affordable Care Act (ACA)

New York immediately seized upon the opportunities presented by the Affordable Care Act (ACA) to bring additional Medicaid money into the State. Between Medicaid and the exchanges created under the ACA, every single person in New York State now has access to health insurance, except undocumented immigrants.

Delivery System Reform Incentive Payment (DSRIP)

For people with chronic conditions, the population with the most significant Medicaid expenditures each year, a number of innovative programs have been implemented. Through our Medicaid waiver New York is receiving roughly $8 billion from the federal government. $6.5 billion of this funding will be delivered through the Delivery System Reform Incentive Payment (DSRIP) program to Performing Provider Systems (PPS) that are being developed across the State. To identify the PPS in your region, please see the DSRIP website.

DSRIP providers for a new payment system for people living with chronic conditions in New York as we move towards outcome-based Medicaid reimbursement. A health care provider will now be reimbursed based upon their patients meeting health targets rather than reimbursed per visit with each patient.


The HIV/AIDS community for years has supported the implementation of a designated single point of entry in each social services district for people living with HIV and AIDS to access benefits. This would include enhanced rental assistance, transportation assistance and nutritional assistance.

New York City already provides enhanced rental, transportation and nutritional assistance through the HIV/AIDS Services Administration. However, these programs are only available to people living with AIDS. Advocates would like to see the program expanded to include everyone who is HIV-positive.

Additionally, advocates want these benefits made available to people living with HIV/AIDS statewide. We believe that each social services district should have at least one staff person trained on the benefits available to people with HIV/AIDS to make it easier to access services statewide.

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