Responding to High Acuity Challenges in Supportive Housing examines the growing complexity of tenant needs driven by behavioral health, substance use, medical frailty, and aging. Drawing from insights shared by communities across the country, this resource defines high acuity, explores the system‑level challenges facing supportive housing providers, and outlines practical strategies to strengthen care. It highlights the need for flexibility, workforce development, intermediate levels of care, and stronger cross‑sector partnerships—underscoring that supportive housing must be augmented, not abandoned, to effectively support people with the highest needs.