Medicaid housing supports in Hawaiʻi: Community Integration Services (CIS+) explained

Getting help · Published 2026-10-27

Black-and-white photograph of the Queen's Hospital in Honolulu in 1905, a three-story building with long verandas — The Queen's Hospital in Honolulu, 1905. Public domain.

Health insurance and housing used to be separate worlds. In Hawaiʻi they now overlap: the State's Medicaid program, Med-QUEST, can pay for services that help members with serious health needs find a home and keep it. The benefit is called Community Integration Services, recently relaunched as CIS+. It is little known outside the service world, yet it reaches people that homeless programs may never meet.

Where the benefit comes from

Medicaid is a joint federal and state program. States can offer services beyond the federal minimum through "Section 1115" demonstration waivers approved by the Centers for Medicare & Medicaid Services (CMS). On October 31, 2018, CMS approved an amendment to Hawaiʻi's waiver allowing the State to provide Community Integration Services, as recorded in Med-QUEST's quarterly report to CMS. According to the Hawaiʻi Interagency Council on Homelessness, contracted providers on Oʻahu and Hawaiʻi Island began delivering services in early 2022.

The waiver was renewed in 2025. A Med-QUEST implementation memo from July 2026 describes the current benefit as Community Integration Services Plus (CIS+), with the CIS+ and Medical Respite benefits approved from January 8, 2025, through December 31, 2029.

Who qualifies

The Council's 2022 policy brief sets out the basic rule: a member generally needs both a qualifying health need and a housing risk factor.

Community Integration Services eligibility (as described in 2022)
Health need (one of)	Housing risk (one of)
Serious mental illness and/or a substance use need meeting at least ASAM level 2.1	Homeless
Complex physical health need	At risk of eviction
	Transitioning from a long-term care facility to the community

Enrollment is voluntary and coordinated through the member's QUEST Integration health plan. Adults with serious mental illness who receive Community Care Services through the State's specialized behavioral health plan can also be served. Criteria may be refined over time, so the health plan is the authority on current eligibility.

What the services include

Pre-tenancy services

Outreach and navigation to help someone move from homelessness or an institution into housing: applying for benefits, connecting to independent living supports, engaging landlords, preparing applications and planning the move. Med-QUEST expected most of this work to happen where the person already is, including encampments and shelters, as well as in clinics, provider offices or by telehealth.

Tenancy-sustaining services

Help to stay housed once placed: building tenancy skills, completing annual recertifications for subsidized housing, mediating problems with landlords and connecting to crisis services. People who received pre-tenancy help were expected to continue with tenancy services for up to 24 months after moving in, or until they no longer need them.

CIS+ additions

Med-QUEST's 2026 guidance lists outreach, pre-tenancy and tenancy-sustaining support, traditional case management and limited rental and utility assistance as parts of the current benefit. That last item is a change from the original design, which the 2022 brief said did not include paying rent or utilities. The details, such as amounts and time limits, are set by Med-QUEST and the health plans.

Medical respite

A related benefit covers short-term housing for people who need a safe place to recover: before a procedure, during recuperation or after a hospital stay. For someone living outside, being discharged from hospital to a sidewalk can undo the treatment they just received; medical respite is meant to close that gap.

What CIS does not pay for

Capital construction costs.
Direct cash payments to members.
Recreational or leisure services.
Services already paid for by other federal or state sources.
Services to people in public institutions, except as authorized for discharge planning.

Why it matters

About 30% of Hawaiʻi's residents were enrolled in Medicaid when the Council wrote its brief: more than 434,700 people. That makes the health plans a point of contact with far more people at risk of homelessness than any shelter or outreach program. The Council noted that CIS "extends services to a critical population of vulnerable Medicaid members who are at-risk of homelessness, most of whom would not otherwise be known to homeless service providers."

For providers, CIS creates a funding stream that can sit alongside government and private contracts, which is how many Housing First and supportive housing programs now finance part of their case management. The Council also warned that funders must avoid paying twice for the same service and keep services available for people who do not qualify.

How to ask for it

Make sure Medicaid coverage is active. Many people experiencing homelessness qualify but have lapsed coverage. Outreach teams, including the City's CORE program, can help with applications and documents.
Call the health plan. The member services number is on the plan card. Ask for a Community Integration Services (CIS+) assessment or to speak with a care coordinator.
Tell providers about health conditions. Eligibility depends on a qualifying health need. Case managers and doctors can help document it.
Connect it to housing. CIS+ does not create housing units. It works best alongside a referral through coordinated entry, a voucher, or another subsidy.

Questions to ask the health plan

Do I meet the health need and housing risk criteria for CIS+?
Which provider will work with me, and how often will we meet?
Can services start while I am still in a shelter or living outside?
Is any rental or utility assistance available, and on what conditions?
How long will tenancy support continue after I move in?
Who do I call if a problem with my landlord comes up?

Limits to keep in mind

Medicaid can pay for services and, now, some limited assistance, but it cannot solve a shortage of homes. In a market where the median rent in Honolulu is above $2,000 a month (see rent burden in Honolulu), a care coordinator's help finding a unit still depends on there being a unit to find. The benefit also relies on a workforce of trained providers, which takes time to build.

Sources

Hawaiʻi Interagency Council on Homelessness, Expanding Housing Supports through Medicaid Community Integration Services (policy brief, PDF), May 25, 2022.
Med-QUEST Division, CMS quarterly report, FFY 2019 Q1 (PDF).
Med-QUEST Division, CIS+ implementation updated guidelines and medical respite updates (memo QI-2601A, PDF), July 2026.
Med-QUEST Division, Community Integration Services.