From 2023 to 2025, TAC was contracted by the Vermont Agency of Human Services to provide technical assistance for the development and launch of the Medicaid Supportive Housing Assistance pilot program, approved in the state’s Global Commitment to Health 1115 Demonstration Waiver. TAC assisted with stakeholder engagement to inform program design, tailored to local communities and accessible to people with disabilities; with benefit design and documentation in accordance with federal and 1115 demonstration program requirements; and with housing policy alignment strategy development to maximize supportive housing resources across systems of care by reducing duplication and promoting program alignment to enable an effective and coordinated system for accessing supportive services, rental assistance, and housing options. Our TA included developing a Request for Information for Medicaid housing services, service rate and billing code structures, a Request for Proposals for housing service providers; a detailed provider manual with standardized forms; and a conflict-free case management manual with accompanying oversight tools. TAC also supported the development of reporting measures using Homeless Management Information System (HMIS) data. Following the state’s selection of services providers for the benefit, TAC also delivered targeted training and TA to build their readiness and capacity for best practice delivery and documentation of pre-tenancy and tenancy sustaining services for the state’s target population of Medicaid beneficiaries experiencing or at risk of homelessness.