Accessing Mainstream Benefits Archive
By Richard Cho
Five years since the passage of the Affordable Care Act, many of the major objectives of the law are being met; more than 16 million Americans have gained health coverage, bringing the number of people without insurance down to historic lows. Included in the newly insured are approximately six million of the lowest income Americans, who have gained access to public health insurance through Medicaid and the Children’s Health Insurance Program (CHIP). And while the data is limited on the specific number of people experiencing homelessness who have gained coverage, we have numerous reports that enrollment in Medicaid and other types of health insurance among people experiencing homelessness has grown significantly. With so many people now able to access health care coverage, the results are in: the Affordable Care Act is working.
Of course, increasing access to health coverage is only one objective of the law. The other major objective is to shift the focus of health care away from procedures and treatments and towards the overall quality of care and people’s health outcomes. For people who experience homelessness, we know that having stable housing is essential to health. Stable housing not only has direct benefits on health—reducing exposure to high-risk behaviors and the negative effects of life on the streets—but it also creates a platform for better care. Thus, for people experiencing homelessness, the ultimate measure of whether or not the Affordable Care Act is working may be the degree to which it can incentivize the health care system to address housing needs as a foundation for better health.
05/07/2015 - Medicaid is a Game-Changer for Ending Chronic Homelessness, But to Win, We Have to Play
By Richard Cho
It has been proven time and time again that for people experiencing chronic homelessness and suffering from chronic health conditions, the path to improved health begins with stable housing, namely through supportive housing. Supportive housing (also known as ‘permanent supportive housing’) has been shown to improve physical and behavioral health outcomes for people experiencing chronic homelessness, while simultaneously lowering health care costs by decreasing emergency room visits and hospitalizations. In most communities today however, the services that make supportive housing so effective are still funded by a patchwork of public and private sources, or in some cases, are severely under-funded. Fortunately, thanks to the Affordable Care Act we now have the potential to create a more systematic and sustainable way to finance services in supportive housing -- through Medicaid.
The truth is, this isn’t all new. Medicaid has covered these types of supportive housing services for a long time. After all, one of Medicaid’s first authorities allowed states to cover primary care case management. What is new is the Affordable Care Act, which by increasing the coverage of people experiencing homelessness under Medicaid and by shifting the focus of health care on value rather than volume, creates new opportunities to increase the role of Medicaid in covering services in supportive housing. At the same time, Medicaid is a Federal and state program and the decision to cover these services under Medicaid rests with the states. Whether states do so will depend on the degree to which they are made aware of the cost-benefit of helping people access and obtain housing as opposed to cycle in and out of emergency rooms, inpatient hospital beds, shelters, and the streets.
We all have the responsibility of educating states about the cost-effectiveness of supportive housing and the opportunity to cover services in supportive housing under Medicaid. Here are four things you can do to ensure your state includes these services:
By Martha J. Kegel
Three months ago, after a campaign led by Mayor Mitch Landrieu, New Orleans became the first major city to effectively end Veteran homelessness. During an intense six-month campaign, community partners connected every Veteran living on the street or in emergency shelter who would accept housing with an apartment of his or her own, with supportive services scaled to the Veteran’s needs. Now we actively work every day to maintain a “functional zero” in Veteran homelessness by housing any newly homeless Veteran within an average of 30 days.
I firmly believe that every community can and should end Veteran homelessness.
Yes, New Orleans had some advantages. For one thing, the local VA and its partners had already achieved a significant reduction in Veteran homelessness before we started the final drive in June 2014. At that point, we had already driven down the number of Veterans suffering in homelessness from 660 in the January 2011 Point-in-Time (PIT) count to 193 in the March 2014 count. For another, we have a very strong visionary leader in Mayor Mitch Landrieu, who set the bold goal of ending Veteran homelessness a full year before the federal deadline, convened the key players, and recruited active duty military and Veteran groups to help with outreach.
But in other important ways we were at a distinct disadvantage: As of the 2014 PIT count, New Orleans still had one of the highest per capita rates of Veteran homelessness in the nation as compared to our general population of only 379,000 residents. We were also at a disadvantage in resources: Compared to many other cities, we have precious few ways to pay for housing and services other than federal funds. And when pushing ourselves to get to zero, we were confronting the challenge of housing those whom we had always failed to connect to housing before – those Veterans who tended to have the most complex challenges and who for the most part were not eligible for HUD-Veterans Affairs Supportive Housing (HUD-VASH) program.
By: The 25 Cities Downtown San Diego Design Team
Before he unlocked the door to his studio apartment in September 2014, Ben Jaramillo had been homeless in the downtown area of San Diego for four years. “I was working as a carpenter, and ended up in my van when work fell flat, and then just kind of stayed there out of convenience and convenience turned into necessity and necessity turned into stuck, because of finances,” he said.
Jaramillo described the challenges he experienced while living in his van. “If [my van] breaks down I can’t use it for transportation, and if it gets towed, I’m really jammed up. Then I have to find someplace else to live, which means turning to my friends or a shelter or, push comes to shove, on the street.”
In June, Jaramillo participated in a Vulnerability Index and Service Prioritization Decision Assistance Tool (VI-SPDAT) survey during a 25 Cities Street Outreach week. VI-SPDAT is one tool the San Diego community is using as part of its Coordinated Assessment and Housing Placement (CAHP) System. The following week he was assigned a Housing Navigator, who helped him understand the resources available to him and collect necessary documents for permanent housing. Soon after, he was matched to a Supportive Services for Veteran Families (SSVF) rapid rehousing program through Veterans Community Services, a division of Community Catalysts of California and a partner in the San Diego 25 Cities Effort. The Veterans Community Services SSVF program assisted Ben in finding and staying in permanent housing and provided him with financial assistance to help him pay his rent.
This blog was originally published on the Administration for Children & Families website.
By Marsha Basloe, Senior Advisor for Early Childhood Development
When my son was little, he had a favorite stuffed animal called “elephant.” Elephant went everywhere Benjy went! One of my favorite memories is standing in his bedroom doorway and watching him sleep in his “new big bed” with his arm wrapped around elephant under the covers. This memory was important to me last week as I attended the National Alliance to End Homelessness Family and Youth Conference to present on the Administration for Children and Families’ early childhood efforts to support young children experiencing homelessness.
There were multiple workshops sharing the amazing efforts of programs and communities across the country. Secretary Julian Castro spoke to a large audience about the Department of Housing and Urban Development’s work and HUD’s linking with partners including the Veterans Administration and the Department of Health and Human Services. He said that people need more than just housing; families don’t live in silos and it’s why the collaboration and coordination between HUD, VA and HHS is so important – from the federal level to the local level.
02/25/2015 - Positive Outcomes for Victims of Domestic Violence and Families through Housing First Pilot Program
By Kiley Gosselin
The link between domestic violence and homelessness is well-documented. Regardless of whether survivors seek help through homelessness services, housing assistance, or domestic violence programs, research shows a strong correlation between domestic violence and homelessness. A Department of Justice study found that at least one in four women were homeless as a result of domestic violence and a Massachusetts study found that a staggering 92% of homeless women experienced severe physical or sexual assault at some point in their lives. Often, it is not only the victim, but the children of domestic violence victims that suffer as a result of abuse. Domestic violence is a leading cause of family homelessness in the United States.
The Bill & Melinda Gates Foundation has made ending family homelessness in Washington a focus of their state efforts starting with the launch of the Sound Families Initiative in 2000. The Foundation has helped fund thousands of new housing units for families experiencing homelessness and is investing in approaches that are aligned with the strategies identified by USICH’s Family Connection resource, including coordinated entry and rapid housing.
In 2009, with the financial backing of the Gates Foundation, the Washington State Coalition Against Domestic Violence (WSCADV) launched a five year pilot program testing the success of a survivor-centered, Housing First approach to preventing homelessness for survivors of domestic violence and their families. The pilot worked with 13 existing programs in 13 urban, rural and tribal areas across the state and the findings demonstrate positive outcomes across all sites.
By Diane Kean
The National Conference on Ending Family and Youth Homelessness is underway. We've captured some of the coversations, key moments, and insights. Here are some of the highlights!
By Diane Kean
Tomorrow, the National Alliance to End Homelessness kicks off the National Conference on Ending Family and Youth Homelessness in San Diego, California. The conference provides a forum of learning and sharing for hundreds of policymakers, practitioners, and federal, local and private partners, all working to end family and youth homelessness. Workshops will focus around three learning tracks on Rapid Re-Housing, Youth, and Systems, and cover topics including family intervention, crisis response systems and coordinated entry process. Keynote speakers include Nan Roman, President and CEO of the National Alliance to End Homelessness, Toni Atkins, Speaker of the Assembly, California State Assembly, and Secretary Julián Castro, U.S. Department of Housing and Urban Development.
USICH is looking forward to attending and participating in the conference. Below is a list of the workshops where USICH staff will be presenting or moderating sessions during the conference.
By Jasmine Hayes
In September 2014, William H. Bentley, Associate Commissioner of the Family & Youth Services Bureau and former USICH Executive Director Laura Zeilinger, highlighted the impact of Runaway and Homeless Youth Act-funded programs for youth experiencing homelessness. These services – street outreach, basic center and transitional living (including maternity group homes) programs – are critical to meet the immediate needs of some of our most vulnerable young people.
We know there are different ways that information is captured across Federal programs about the extent and scope of youth at risk of or experiencing homelessness. We also know that youth can experience homelessness in many ways including being unsheltered or living on the street, doubled-up or couch surfing, and this is impacted by complicated issues including poverty, abuse, violence, trauma, and discrimination based on gender identity and sexual orientation. As communities increase their capacity to capture information on youth, our understanding of the prevalence and characteristics of youth homelessness is improving and helping to shape strategies that respond to the diverse needs of young people.
By Jill Fox, Virginia Coalition to End Homelessness & Matt Leslie, Department of Veterans Services
Most great stories have a beginning, middle, and end. When it comes to the story of Virginia’s efforts to end Veteran homelessness, we started with the end in mind – a vision of a Virginia where Veteran homelessness, when it does occur, is rare, brief, and non-recurring.
The Beginning – Defining the Challenge, Getting Organized!
In the summer of 2013, the Virginia Department of Veteran Services and Virginia Coalition to End Homelessness partnered with the VA VISN Network Coordinator, Jeff Doyle, and local leaders in communities to hold a statewide Veteran homeless summit. This event marked the beginning of increased collaborations among federal, state and community partners. We believed that ending Veteran homelessness in Virginia was not an impossible task.
The goal of our effort was supported by the Governor’s Coordinating Council on Homelessness, which includes representatives across state agencies that play a role in addressing homelessness as well as local providers, nonprofits, and other community leaders. Our focus was to unify mainstream and Veteran specific housing and services while continuing to shift to housing first statewide. The success of this endeavor relied on leveraging existing partnerships with the US Department of Veterans Affairs (VA) and the Department of Housing And Urban Development (HUD) that the Virginia Department of Veteran Services (DVS) had nurtured. Along with federal agencies, DVS built on partnerships with VA Medical Centers (VAMCs), SSVF providers, and the VASH programs. Also paramount were the relationships that the Virginia Coalition to End Homelessness (VCEH) has with local Continuums of Care (CoCs), including nonprofit housing and homeless providers, local jurisdictions, and other mainstream providers involved with local homelessness planning.
By Mary Owens
On January 23, the White House hosted over 240 mayors during the U.S. Conference of Mayors (USCM) Winter Meeting. During the event, mayors took part in a breakout session with Administration officials including Veteran Affairs Secretary Robert McDonald, Assistant to the President & Deputy Chief of Staff for Implementation Kristie Canegallo, Special Assistant to the President Luke Tate, and USICH Interim Executive Director Matthew Doherty, to discuss ensuring access to quality, affordable health care for all Americans and ending Veteran homelessness. The breakout session also provided an opportunity for New Orleans Mayor Mitch Landrieu to discuss best practices on how mayors can accomplish the goal of ending Veteran homelessness. Through the Mayor’s Challenge to End Veterans Homelessness, local leaders across the country are ending Veteran homelessness in their communities. Mayor Landrieu was one of the first Mayors to sign on to the Mayors Challenge and on January 7, 2015, New Orleans became the first major U.S. city to achieve the goal.
By Peter Nicewicz
We often say at USICH that to end homelessness nationally, we must end homelessness locally. To help communities optimize their current resources to accelerate progress towards ending Veteran homelessness, we have identified ten essential strategies for communities to increase leadership, collaboration and coordination among programs serving Veterans experiencing homelessness, and promote rapid access to permanent housing for all Veterans. Each strategy is accompanied by resources to help community leaders and stakeholders understand how to implement these strategies more effectively.
Meanwhile, we have been working on the Federal level to assist communities as they work to reduce the number of Veterans experiencing homelessness and build the systems to prevent its recurrence. Below is a highlight of some of the Federal efforts aimed at helping communities develop and optimize their systems of connecting Veterans experiencing homelessness to permanent housing and the appropriate services and resources Veterans need to have a safe and stable place to call home.
By 25 Cities
The U.S. Department of Veterans Affairs (VA), in partnership with the U.S. Department of Housing and Urban Development (HUD) and the U.S. Interagency Council on Homelessness (USICH), launched the 25 Cities Effort in March 2014. The 25 Cities Effort is a key Federal strategy through which 25 communities, including Washington, DC, are receiving technical assistance and are mobilizing local planning efforts and partnerships to create effective systems for aligning housing and services interventions through coordinated systems to end homelessness. Led by VA, in partnership with HUD and USICH, the aim of this effort is to assist 25 communities in accelerating and aligning their existing efforts toward the creation of coordinated assessment and entry systems, laying the foundation for ending all homelessness in these communities.
Many Veterans echo the sentiment that their military experience helped them develop important skills that they now apply in their civilian lives.
Today, a year after getting permanent housing and getting out of homelessness, Michael Horton – a Marine Corps Veteran and the Director of Business Development for the National Association of Concerned Veterans (NACV) – is passionate about helping other Veterans who encounter challenges in transitioning to civilian life. “If it wasn’t for my service I can’t imagine where I would be, and now that I am where I’m at and understanding the challenge not only for me but for other Veterans, [helping Veterans] is my passion and purpose,” he said. “That’s why I’m working with NACV now.”
Erica Myrtle-Holmes, Horton’s case manager at the Washington, DC VA Community Resource and Referral Center (CRRC), recalled that Horton demonstrated this passion long before he transitioned out of homelessness. “He was very helpful with new Veterans who were coming in [to the CRRC] that were newly homeless,” she said. “He really took them under his wing.”
A message from USICH Interim Executive Director Matthew Doherty
This week, President Obama put forward a 2016 Budget that again demonstrates his Administration’s deep commitment to ending homelessness. As Interim Executive Director of the U.S. Interagency Council on Homelessness, I am pleased to share that this Budget calls for the investments needed to end chronic homelessness in 2017, make significant progress toward ending homelessness among families, children and youth in 2020, and sustain efforts to end Veteran homelessness in 2015. In his Budget, the President calls for nearly $5.5 billion in targeted homelessness assistance. In addition to targeted homelessness assistance, the Budget also includes key investments to mainstream programs needed to end homelessness, such as 67,000 new Housing Choice Vouchers to support low-income households, including families experiencing homelessness; survivors of domestic and dating violence; families with children in foster care; youth aging out of foster care; and Veterans experiencing homelessness, regardless of their discharge status.
By Matthew Doherty, Kelly King Horne and Libby Boyce
All across the country, communities are developing coordinated entry systems to streamline and facilitate access to appropriate housing and services for families and individuals experiencing homelessness. In the Greater Richmond area of Virginia and in Los Angeles County, California—like in other places—efforts to bring these systems online are in full swing.
Let’s hear from Richmond and Los Angeles County, who presented at the December 2014 full Council meeting regarding their local efforts to implement coordinated assessment, their successes, their lessons learned, and the challenges that they continue to tackle.
By Matthew Doherty
Many readers have likely heard about the great progress being made toward ending homelessness in Salt Lake and Utah. Earlier this fall, I had the privilege of joining more than 475 people for the 11th Annual Utah Homeless Summit organized by Utah Department of Workforce Services’ Housing and Community Development Division. The Summit also coincided with the release of Utah’s 2014 Comprehensive Report on Homelessness prepared by the State Community Services Office. The report describes the remarkable progress Utah has made under its ten-year plan to end both chronic and Veteran homelessness by the end of 2015, documenting that “Chronic homelessness has declined 72 percent since 2005 and chronic homelessness among Veterans has reached an effective zero.” Such progress should help convince skeptics that making progress on homelessness can be a reality in communities all across the country. Summit participants spent the day both celebrating Utah’s progress and engaging in dialogue to ensure that progress is sustained.
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.