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01/23/2013 - Aligning Assets Towards the Goal: A Blog from VA’s Tom O’Toole on the Homeless Patient Aligned Care Teams (HPACT)
The adage, “It takes a village” has been applied to lot of different efforts over the years to the point of over-use. However, when it comes to ending homelessness among Veterans by 2015, there is probably no better descriptor for what is needed and what is being done. Last year, as part of this effort, the Department of Veterans Affairs (VA) launched an ambitious pilot project to develop Homeless Patient Aligned Care Teams (H-PACT) to provide comprehensive, wrap-around primary care coupled with homeless programming to help Veterans make the transition out of homelessness and to help keep them housed. This joint effort between the Office of Homeless Programs and Office of Primary Care Services funded 32 sites around the country located in a variety of settings, including Community Resource and Referral Centers (easy access community- based centers), VA outpatient clinics (community-based outpatient clinics) and within VA Medical Centers. These are sites where we see homeless Veterans struggling to subsist, where they often find themselves cycling through the system dealing with the consequences of their homelessness in emergency departments and hospital wards, and where we have the resources in place to make a difference.
We released a newsletter this week covering the 2013 PIT Count, staffing changes at USICH, and a reflection on the Boston PIT Count that Executive Director Barbara Poppe attended in December.
In addition to the newsletter, we shared various news items through Facebook and Twitter. Here are a few of them:
News from across the country
A 5-year study of individuals in Boston’s Health Care for the Homeless program shows that drug overdoses, rather than AIDS, is now the leading cause of death among program participants. As noted in the article, this represents a reversal of the trend from 15 years ago, and mirrors the rise in drug-related deaths among the larger population. This type of study is important to advance our understanding of the prevalence of drug abuse in order to better allocate resources and services to meet the increase in need. The study will be published next month, but you can read about it here right now.
More than 350 volunteers left Boston City Hall on the crisp, cold early winter night to fan out across the city streets and conduct the annual homeless census—a 33-year tradition. USICH Regional Coordinator Bob Pulster and I were part of the team lead by Boston Emergency Shelter Commission Director Jim Greene. Under the directive of Boston Mayor Thomas M. Menino, Jim had emphasized that the volunteers participating in the count had a primary goal to assist and help those who were unsheltered. We were charged to help them connect to immediate resources like shelter, health care, food, blankets, and clothing. Counting alone would not be sufficient -- we also were to engage and outreach. If someone needed help, we were to wait with that person until one of the outreach vans arrived and a good connection was made. Our job was to make sure the linkage actually happened.
I observed Jim and another volunteer interact with two women, one in her 50s, the other in her early 20s and pregnant. Among the volunteers on Mayor Menino’s team was Dr. Paula Johnson, a noted primary care physician, the head of the Connors Center for Women’s Health at Brigham and Women’s Hospital, and board chair of the Boston Public Health Commission. Jim beckoned Dr. Johnson over, and she spoke softly, and more privately, with the young woman about her pregnancy, homelessness and related risks. The rest of the group stood back to give them some space and a level of privacy. When Dr. Johnson urged the young woman to consider accepting a ride to shelter, she wavered, asking for time to think it over. Greene assured her that an outreach van would be back to check in with her during the night.
Making Everyone Count: Gearing Up for the 2013 PIT Count
Every year, during the last ten days in January, HUD requires Continuums of Care (CoCs) to count the number of people experiencing homelessness in the geographic area that they serve through the Point-in-Time Count (PIT). In this year’s Point-in-Time Count, HUD is emphasizing the importance of including homeless youth, and has modified data collection methodology by age group to better gather data on youth. Cyndi Lauper and her foundation, The True Colors Fund, teamed up with HUD to create this public service announcement (PSA) promoting participation in this year’s PIT Count. Take a look at this PSA along with FAQs about the PIT Count.
This week HUD released a promotional poster for all Continuums of Care as well as further supplementary guidance on requirements for counting youth and strategies. Access it here. To obtain more information about a local PIT count in your community contact your local CoC.
Recently, I accompanied the VA Greater Los Angeles’ (VA GLA) new Assertive Community Treatment (ACT) team, to observe their work in Hollywood, California. I wanted to see the team in action, tackling issues on the ground level. Ending Veteran homelessness in Los Angeles cuts across three of my top priorities as Executive Director of USICH: ending Veteran homelessness, ending chronic homelessness, and reducing all homelessness in Los Angeles.
Pictured L-R: Veteran client, Janell Perez, Barbara Poppe
The ACT team is part of the VA’s Housing First demonstration project. The team provides case management support to Los Angeles County Supervisor Zev Yaroslovsky’s Project 60. Project 60 (a replication of Project 50) is an innovative partnership between VA GLA, community based non-profit organizations, and the Supervisor’s deputy, Flora Gil-Krisiloff. Project 60 uses HUD-VASH vouchers from the Housing Authority of the City Los Angeles (HACLA) in order to get chronically homeless and vulnerable Veterans into permanent supportive housing with access to comprehensive, wrap-around services. Supervisor Yaroslovsky provided county funding to support the efforts of the non-profit partners, including Ocean Park Community Center (Santa Monica), Step Up on Second (Hollywood), St. Joseph Center (Venice), and San Fernando Valley Community Mental Health Center (Van Nuys).The Hilton Foundation, working through the Corporation for Supportive Housing brought together financial assistance to help with move-in costs. Project 60 also collaborates with Hollywood’s Vulnerability Registry as part of the 100,000 Homes Campaign (an initiative of Community Solutions). HACLA has been a strong partner in this effort as well working to streamline the application and inspection processes and working closely with VA GLA to prioritize Veterans who are chronically homeless.
As we close out 2012, it is important to look at the accomplishments of the past year and point to ways we must focus our work in the year (and years) ahead. The release of the 2012 Point in Time (PIT) data just a few weeks ago provides the nation with an opportunity to reflect and improve on the work ahead.
As a nation, despite the economic downturn and our continuing recovery, we made progress toward preventing and ending homelessness overall. The 2012 PIT count provides the most recent available data on progress toward the goals of Opening Doors: to end chronic homelessness and homelessness among Veterans by 2015; to end homelessness for families, youth, and children by 2020; and to set a path toward ending all forms of homelessness. According to the 2012 PIT count, through interagency collaboration, strategic investment, and the adoption of proven tools, we have made particular progress in reducing the number of Veterans experiencing homelessness—witnessing a 17 percent reduction since 2009.
Social Media Wrap up
Today is National Homeless Persons’ Memorial Day. Each year since 1990, on or near the first day of winter and the longest night of the year, National Coalition for the Homeless (NCH), National Consumer Advisory Board (NCAB), and the National Health Care for the Homeless Council (NHCHC) has co-sponsored National Homeless Persons’ Memorial Day to bring attention to the tragedy of homelessness and to remember our homeless friends who have paid the ultimate price. Events will occur all over the country.
I recently participated in an Organisation for Economic Co-operation and Development (OECD) consultation on the topic of Integrated Services and Housing Consultation.
Participants came from across Europe, Australia, New Zealand, Japan, Canada, and the US.
US participants included:
Dennis Culhane University of Pennsylvania
Deborah Desantis Corporation for Supportive Housing
Richard Frank Harvard University
Jennifer Harwood U.S. Department of State
Donald Moulds U.S. Department of Health and Human Services
Debra Rog WESTAT
Nan Roman National Alliance to End Homelessness
Robyn Stone Leading Age
Roseanne Haggerty Community Solutions
David Wertheimer Bill & Melinda Gates Foundation
While homelessness wasn't the sole focus, a substantial part of the two day meeting focused on research, policy, and practices related to homelessness. In addition to those issues, there was discussion around the importance of the integration of services and housing for the aging population, those with mental health and substance abuse disorders, and families with children.
Today, we released the latest USICH newsletter coveringthe December Council meeting that took place this past Tuesday at the Department of Veterans Affairs, the Department of Housing & Urban Development’s 2012 PIT Count release, our Youth Count! Initiative, HEARTH resources, and 2013 PIT guidance and resources.
In addition to our newsletter, we put out quite a few resources and information through our social media this week. Here are a few of them.
HUD releases 2012 PIT Count Estimates
On Monday, HUD released the 2012 Point-in-Time (PIT) Count estimates of homelessness. The numbers show that homelessness remained steady this past year, but the numbers also document a 7% decrease in Veterans and chronic homelessness.
The 2013 Point-in-Time (PIT) Count at the end of January is an important time for communities across the country to collect the most accurate data on those of all ages experiencing homelessness in America. Accurately collecting data and using it to drive performace is a critical component to a community's progress in their plans to end homelessness. Below is a message from HUD on the 2013 PIT Count:
via HUD's OneCPD
As we get closer to the 2013 Point-in-Time (PIT) count HUD wanted to inform communities that we are reaching out to several Federal partners and other organizations to encourage greater coordination and involvement. HUD is encouraging volunteers to contact their CoC Primary Contacts to learn how to assist with the PIT and other opportunities in their communities. CoCs should take the time to ensure that their contact information on HUD’s Homelessness Resource Exchange (HRE) is current. If the CoC contact information needs to be updated, please submit a Virtual Help Desk question on the HRE to make the appropriate change. HUD asks that each CoC prepare ahead of time to know how to utilize the services of volunteers.