The goal of the project is to assist states that have expressed interest in developing Medicaid housing support services initiatives for beneficiaries experiencing, or at risk of, homelessness and provide useful feedback to officials and other stakeholders in the study states (California, Illinois, Maryland and Washington), as well as the Centers for Medicare and Medicaid Services. The researchers will examine the first four states to win approval for Section 1115 demonstration waivers that feature housing support services. Following a review of relevant materials in the four states, as well as interviews with key stakeholders, the researchers will examine: (1) what start-up implementation challenges have states and localities encountered as they have sought to integrate housing into effective care coordination; (2) what strategies have they used to meet these challenges and with what success; (3) given that the pilots in the four states vary in their designs and structures, do certain approaches kindle fewer implementation problems; and (4) what lessons do these cases provide for Medicaid officials interested in pursuing initiatives addressing housing and related social determinants of health. Deliverables will include a project work plan and final narrative and financial reports. The grantee will also produce an issue brief, podcast, slide deck, blogs and e-newsletters, manuscripts for journal publication, and presentations at conferences, as part of the deliverables for this grant.