Accessing Mainstream Benefits Archive
by Richard Cho
Two new documents released by HHS on October 10 make it clear, once and for all, that the services provided in permanent supportive housing can indeed be covered and financed by Medicaid. These documents include Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants of Permanent Supportive Housing and Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field. Specifically, Medicaid can cover things like case management, services goal setting and services coordination, health care navigation, rehabilitation, skill building around activities of daily living, and other supports that are critical to tenancy. The time is now to seize the opportunity, bring supportive housing to scale, end chronic homelessness, and bend the Medicaid cost curve.
10/31/2014 - Good News from New Orleans: Federal and Community Collaboration Helped Transform This Veteran’s Life
By DaVaughn Phillips
Mr. H. seems like a completely different person from the man I met just a few months ago. He is thriving in his own home, with a stable income to maintain his living expenses and support his family. More importantly, he has regained the strength, motivation, and courage he needed to become self-sufficient and to serve as a positive role model for his children. After three years of working in New Orleans to help people achieve permanent housing, it never ceases to amaze me how rewarding it feels to play a role in such a transformation.
By Laura Green Zeilinger, USICH Executive Director
Whether as a result of a health or economic crisis or fleeing domestic violence, the experience of homelessness is extremely traumatizing for families generally, and can be especially traumatizing for children. We know that there is not a one-size-fits-all solution for every family experiencing a housing crisis. Connecting families to housing interventions and services that are appropriate to their specific needs is an essential part of the actions we identified as critical to meeting the goal of ending homelessness.
By Liz Osborn
Homelessness has many faces. People experiencing homelessness can be old or young, male or female, and can come from any ethnic background. But when one thinks of a person experiencing homelessness in this country, few people picture the face of a child. The fact is, nearly one-quarter of all people experiencing homelessness at a point in time are children, and most of them are very young. In one 2013 Abt Associates study on family homelessness, almost a third of the participating children were two years old or younger, and more than half were under the age of five.
09/10/2014 - How Our Shelter Began Focusing on Permanent Housing, And Started Ending Homelessness for Our Clients.
When I joined the staff of Northern Virginia Family Service (NVSF) as the program manager of the SERVE Shelter in February 2010, I had many things to learn about the 60-bed facility for singles and families located in Manassas, Va., approximately 35 miles southwest of Washington, D.C. Though the beds were filled, it was evident that clients were staying for long periods of time, many up to six months or longer.
In 2012, things started to change. Our shelter went through an expansion to 92 beds, and we had the opportunity to become a Housing First Model. (It seemed fitting that a shelter should focus on housing and that its goal should be to reduce the amount of time that an individual or family experienced homelessness. However, some fairly large barriers stood in our way to implementing this model.
By Debbie Thiele and Katy Miller
This week CSH, in partnership with the Washington Low Income Housing Alliance, published Creating a Medicaid Supportive Housing Services Benefit. In the white paper CSH lays out an easy-to-follow framework for states that want to create a Medicaid benefit to pay for the services in supportive housing. The framework consists of five action steps: 1) Determine benefit eligibility criteria; 2) Define the package of services to be delivered; 3) Align the state Medicaid plan; 4) Establish a financing and reinvestment strategy; and 5) Operationalize the benefit.
08/25/2014 - Hear from Two Community Partners about How They Are Ending Family Homelessness through Our Sept. 10 Webinar
Ending homelessness among families and children is a priority for the nation and for every community. Millions of extremely low-income households do not have access to affordable housing, putting them at-risk of housing instability and the types of crises that can result in homelessness. The challenge is clear: Our most recent data show that 222,197 people in families—an estimated 70,960 households—were experiencing homelessness on a single night in January 2013. In the first three years of implementation of Opening Doors, we have reduced homelessness among families by eight percent.
by Jamie Keene, USICH Communications Intern
Once the city with the highest rate of homelessness in the country, today New Orleans has reduced homelessness to levels that are lower than before the devastation caused by Hurricane Katrina. By overcoming incredible challenges, New Orleans has shown that ending chronic and Veteran homelessness is possible in every American city.
by Eric Grumdahl, USICH Policy Director
Ending youth homelessness means putting a system in place to do so in every community. Here, having a common purpose is a key ingredient. Luckily, at the interface of the child welfare system and the homeless response system, we should agree on a common purpose. The child welfare system wants to see successful transitions to adulthood, which includes all of the outcomes of the framework to end youth homelessness, including stable housing. The homeless response system is certainly eager to close what has been called a pipeline from child welfare to shelter, and to see youth in stable housing instead of outside a shelter door. We should not have to debate our shared purpose.
Where it seems to me that our efforts get stuck is...
By Amy Sawyer, USICH Regional Coordinator
Through the 25 Cities initiative spearheaded by the U.S. Department of Veterans Affairs, communities have been invited to convene local leaders eager to build on their successes, identify new strategies, act decisively to strengthen their coordinated response systems and, in the process, end Veteran homelessness. To get started, teams of dedicated individuals are meeting for two-day-long intensive work sessions that drive a sophisticated planning process, resulting in specific action steps that will be carried out in months – not years.
by Laura Green Zeilinger, USICH Executive Director
Yesterday marked the fourth Anniversary of the launch of Opening Doors, the first-ever Federal Strategic Plan to Prevent and End Homelessness. In four years, we have changed the trajectory of homelessness in America. In just the first three years of implementation, Opening Doors led to significant reductions in homelessness, including an eight percent reduction in homelessness among families, a 16 percent reduction in chronic homelessness, and a 24 percent reduction in homelessness among Veterans. And we are hopeful that we will be able announce even greater reductions when the 2014 Point-In-Time Count data are available later this year.
The progress we are making across the nation has proven that Opening Doors is the right plan with the right set of strategies. Opening Doors also provides a foundation and scaffolding upon which we can continue to innovate and refine the solutions that will end homelessness in this country.
This year, we’re considering amending the plan again to include more of what we’ve learned from our progress.
Yesterday, more than 600 providers and stakeholders from across the country joined us for a great discussion about what ending homelessness among families means and what achieving it will require. We were joined by Laura Zeilinger, USICH Executive Director; Ann Oliva, Acting Deputy Assistant Secretary for Special Needs and Director of the Office of Special Needs Assistance Programs at the Department of Housing and Urban Development (HUD CPD/SNAPS); Ali Sutton, Policy Advisor at the Department of Health and Human Services Administration for Children and Families (HHS ACF); and Debra Rog, Associate Director at Westat.
At the end of our discussion, we received a lot of really great questions, many of which we didn’t have time to answer. In this post, we provide responses to two of these questions and will be responding to more of these questions over the next few weeks.
By Richard Cho, USICH Policy Director
President Obama has requested an increase of $301 million in HUD’s Homeless Assistance Grants. At a time of budgetary and fiscal challenges, $301 million sounds like a lot of money. In my view, it’s a small price to pay to achieve an end to chronic homelessness and save the lives of roughly 100,000 people. It’s especially small when compared to the cost of doing nothing, not only in terms of human lives, but also in real taxpayer dollars.
The cost of doing nothing is simply too high.
The expansion of Medicaid coverage under the Affordable Care Act (ACA) will mean that millions of currently uninsured adults will be eligible for coverage, including many formerly homeless individuals residing in supportive housing.
Many states are still opting out or remain undecided about whether to participate in Medicaid expansion. One factor these states might consider in evaluating or re-evaluating their decision to participate is the impact of Medicaid expansion on homelessness in their state. But the benefits don’t stop there. State budgets, hospitals, health care providers, and Americans in general also stand to gain from Medicaid expansion.
07/16/2013 - Ending Family Homelessness: A Message to Continuum of Care & Ten-Year Plan Leaders from Barbara Poppe
Recently, I wrote about the urgency to increase our efforts to end chronic homelessness, suggesting key questions Continuums of Care and Ten Year Plan leaders should ask. Today I want to pose similar questions related to how we address family homelessness. People in families make up nearly 40 percent of the homeless population nationwide. To reach our goal of ending family and child homelessness by the year 2020, we must realign our programs and systems now. As a mother, this quote from Marian Wright Edelman tugs at me: “The future which we hold in trust for our own children will be shaped by our fairness to other people's children.” Shaping better community responses to family homelessness is about shaping our collective future. Thank you for stepping up to the challenge..
06/20/2013 - Ending Chronic Homelessness: A Message to Continuum of Care & Ten-Year Plan Leaders from Barbara Poppe
Not long ago, I sat in the same place that you are sitting, managing the Continuum of Care and leading our community's ten-year plan to end homelessness. You have challenging jobs to do and I know you are balancing many competing issues and priorities. I've been fortunate to visit communities that are making great progress, and to support and work with communities that still struggle. Now I would like to share some reflections on the lessons I've learned from you, my colleagues, in our mission to end homelessness. Thank you for listening and especially for acting.
Today I want to address chronic homelessness, which is the first goal in Opening Doors. We have fewer than 1,000 days to bring the number of people experiencing chronic homelessness to zero; every day and every minute counts. For people living with disabilities and disabling conditions, every day or minute spent on the streets is another day or minute spent struggling to survive. So this message is a call to action. I am reaching out to ask, are we doing everything we can do to end chronic homelessness by 2015? Here are the top-ten questions you and the leaders of your ten-year plan should consider (not likely to be picked up by David Letterman but hopefully useful nonetheless).
Safe Havens have long been a refuge for people with severe and persistent mental illness and other disabilities who also experience episodes homelessness, often for long periods of time. Since 1992, Safe Havens have been part of the Department of Housing and Urban Development’s Supportive Housing Program and will continue to be funded through the new Emergency Solutions Grant program. Designed to offer low-barrier services and supports to the most hard-to-reach people, Safe Havens can provide a sense of stability and security for people who would otherwise be exposed to the life-threatening environment on the streets. Here, people who were formerly disconnected from the community and supports are able to move inside and begin to focus on how they can transition from the streets to permanent, supportive housing. For fifteen years, Safe Place in Tampa, Florida has been offering safe haven to some of that community’s most vulnerable residents. The program is operated by Mental Health, Inc., an agency that works to advocate for and give hope to all people touched by behavioral health and developmental challenges. Recently they’ve begun a new phase in their work as a Safe Haven that partners with the local Veterans Affairs Medical Center (VAMC) to help connect Veterans to this valuable resource.
Unaccompanied Youth and the 2013 Point in Time Count
Communities are now beginning to think about their January 2013 Point in Time Count, especially as it relates to unaccompanied youth. For the first time as part of the new Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act guidelines, unaccompanied youth will be counted in the Point-in- Time count in every community across the country. To kick off this process, The National Alliance to End Homelessness will host a webinar on including Youth in the “Point-In-Time” (P.I.T.) Count on Thursday, October 4 from 1:30-3:00PM (EST).
Also discussing both the full Point in Time count as well as the upcoming Housing Inventory Count, HUD is putting on a webinar on Tuesday, October 2 from 3:30-4:30 EDT. This will cover all the new requirements for communities conducting these counts, which includes information on ensuring more youth are counted in January 2013.
The biggest event of this week was our quarterly Council meeting, which was held on Wednesday at the Department of Housing and Urban Development (HUD). The focus of this meeting was on the ways states and communities can best use mainstream resources, like school programs, public housing resources, and Temporary Assistance for Needy Families (TANF), woven with targeted homelessness resources to make progress. USICH Chair and Department of Health and Human Services Secretary Kathleen Sebelius was joined by HUD Secretary Shaun Donovan, Director of the Corporation for National and Community Service Wendy Spencer, Luke Tate from the Domestic Policy Council, and key representatives from 18 member agencies.
Starting in 2014, the Affordable Care Act allows states to expand Medicaid to most people earning at or below 133% of the federal poverty level (FPL), which is about $14,856 a year for an individual and $25,390 for a family of three in 2012. (To their credit, some states have gone ahead and expanded early.) This provision helps unify the current “categories” of Medicaid, where very low income children, pregnant women, adults who can prove a permanent disability, and parents in some states are eligible for Medicaid, but those without a proven disability or dependent children are not—creating a significant disparity in access to care among those at the lowest income levels. A recent Urban Institute analysis found 15 million uninsured adults will now be eligible for Medicaid, which would allow them access to the health care services needed in order to treat and manage chronic illnesses, prevent new health conditions from developing, and protect against financial ruin due to inability to pay medical bills.
What We're Talking About is a weekly column from USICH Communications on the topics and issues in the news and on our minds. Topics range from international and national conferences, news from around the country, innovative work to highlight, and more. We look forward to catching you up news you may have missed and connect you to articles and resources.
USICH released a general newsletter this week which compiled news from federal agencies, national partners, and cities revamping their approach to homelessness. If you missed it, you can check it out here.
A Reminder of the Needs of Veterans Two Years After End of Combat Operations in Iraq
Today marks the two year anniversary of combat missions in Iraq, a milestone to be sure, but one that must remind the country of the needs of Veterans of that conflict as well as Veterans of previous wars. In Yuma, Arizona, the allocation of the city’s first HUD-VASH vouchers will enable Veterans in that community to have stable housing and access to coordinated supportive services for their recovery. The HUD-VASH program continues to expand to both more communities and to more Veterans because of its ability to stabilize vulnerable Veterans in the long-term.
08/13/2012 - A Unique Permanent Supportive Housing Plan and Using Medicaid to Make it Happen: My time in Louisiana
I spent August 8, 9, and 10 in Louisiana with Don Moulds, the Acting Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services. Don is also Secretary Sebelius’ point person for USICH. We went to talk with people operating and overseeing the Louisiana Permanent Supportive Housing project. For those who aren’t familiar with this incredible project, you can find more information from the Corporation for Supportive Housing, which highlighted this state-wide project as part of their Focus on Health Care Series in February 2012. If you don’t have time to listen to the webinar now, here’s the short version: after the hurricanes in 2005 and 2006, the state, advocates, and community providers worked together to figure out how to help people with one-time federal recovery investments. What has emerged is a unique model to use these new resources for housing and supportive services to provide permanent supportive housing across the region. Federal investments included Community Development Block Grant funds, Shelter Plus Care and Section 8 Housing Choice Vouchers.
When USICH released Opening Doors in June 2010, the Affordable Care Act had passed in March, just three months earlier. The second anniversary of Opening Doors occurred the same time that the Supreme Court delivered its ruling on the Affordable Care Act (ACA). Since the law was largely upheld, many of the provisions that will help us prevent and end homelessness are still in place. The provision giving states greater choice around Medicaid expansion, however, means that some of the original promise of the ACA in the fight against homelessness will be, in some parts of the country, up in the air, at least for a while.
Remaining provisions of the law that will prove helpful for populations experiencing homelessness are the expansion of affordable insurance coverage through state health insurance exchanges and the expansion of community health centers. Better access to affordable insurance that covers people with pre-existing conditions and does not limit coverage when you get sick can act as homelessness prevention for many.