From Policy to Practice: Vermont’s Medicaid PSH Program

In 2022, enhanced federal funding for Home and Community-Based Services in Vermont made it possible to launch a pilot program that used Medicaid funds to provide supportive housing assistance for Vermont residents with complex health and social needs – an important “first” for the state.

Joy Street Consulting was pulled in by The Technical Assistance Collaborative, Inc. (TAC), the consulting firm engaged by the Vermont Agency of Human Services (AHS) to design the program, to help get the project over the finish line. Joy Street took the lead on drafting a clear and comprehensive Provider Manual, a “must-have” for implementation that documented program parameters and requirements in a way that made them as easy as possible for first-time Medicaid provider agencies to operationalize. Joy Street also provided as-needed support for the TAC team’s work to launch a complex new program within a short timeframe and a dynamic stakeholder environment.

The Vermont Medicaid Permanent Supportive Assistance (PSHA) Program went live in April 2025, with five local nonprofit agencies successfully designated as PSHA provider agencies.