Improving Health, Well Being and Stability Archive
by Paul Gionfriddo
When we see people who are homeless on our streets and in our parks, and take some time to think about them, we might feel pity, sympathy, annoyance, fear, or a host of other emotions.
But we probably never think “that person could be me.”
We just assume that people who are homeless have always lived like that. They’re homeless, their parents were homeless, maybe even their grandparents were homeless. And we assume that they are homeless by choice.
They are not. They are homeless because we have made them so.
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.
by William H. Bentley and Laura Green Zeilinger
Forty years ago, the U.S. government took the bold step of making the landmark Runaway and Homeless Youth Act, or RHYA, the law of the land. RHYA is the only Federal law that highlights the need for and funds critical services for youth experiencing homelessness. In July 2014, Congress introduced the Runaway and Homeless Youth and Trafficking Prevention Act (S.2646), new legislation that, if enacted, would reauthorize and strengthen RHYA. With continued funding for street outreach, basic center and transitional living programs, RYHA provides critical services and support to runaway and homeless youth and plays an important role in the effort end youth homelessness by 2020, a goal set in Opening Doors: Federal Strategic Plan to Prevent and End Homelessness.
09/23/2014 - Stand Up and Be Counted: Better Data Collection on Youth Experiencing Homelessness through the Point-in-Time Count
By Peter Nicewicz, USICH Management and Program Analyst
HUD’s annual Point-in-Time (PIT) count serves as the most consistent year-to-year measure of the number of people experiencing homelessness in America. For this reason, USICH uses the PIT count as our primary measure of our progress in achieving the goals of preventing and ending homelessness set in Opening Doors. The PIT count also provides a reliable estimate of the prevalence of homelessness among three population groups: people experiencing chronic homelessness, Veterans, and families. However, the PIT count has been limited in providing a national estimate for one important Opening Doors population: youth unaccompanied by adults.
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.
09/03/2014 - Two Tennessee Partnerships Create Effective Solutions for Youth Experiencing Homelessness
Early in 2012, the National Association for the Education of Homeless Children and Youth (NAEHCY) contacted advocates and educators in northeast Tennessee to discuss recent increases in youth homelessness in the region. Area school districts were showing stark increases in student homelessness, including jumps of nearly 50 percent in Kingsport City Schools and 36 percent in Johnson City Schools. In addition, the National Runaway Safeline registered calls originating from east Tennessee at nearly twice the rate of calls from urban areas like San Francisco and Seattle.
That was the beginning of two partnerships that are making a difference in ending youth homelessness in the region. Read more.
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.
by Danielle Ferrier and Beatriz McConnie Zapater
There are nearly 6,000 unaccompanied youth in Massachusetts. Experiencing homelessness often prevents motivated, hard-working youth from graduating high school and achieving success. A Journal of Emotional and Behavioral Disorders article shows that without intervention, only about 27 percent of them will graduate high school. Opening Doors, the federal strategic plan to prevent and end homelessness, sets a goal of ending youth homelessness by 2020 by ensuring communities can connect youth with stable housing, permanent connections, education, and employment all while improving youths’ social and emotional well-being.
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...
“In Baltimore,” Adrienne Breidenstine explains, “We have a core group of youth service providers, funders, and government agencies that are committed to The Journey Home, Baltimore’s plan to end homelessness, and the vision that homelessness in Baltimore is rare and brief for children and youth experiencing homelessness. Now is the time for us to harness our community’s energy and commitment to the cause and translate it into action.”
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.
By Jay Melder, USICH Director of Communications and External Affairs
Today, Community Solutions’s 100,000 Homes Campaign announced it has achieved its goal to connect 100,000 people experiencing chronic homelessness to safe, stable housing—101,628 people, to be exact.
At an event on Capitol Hill, former Army Private First Class Alvin Hill, a Veteran from Washington, DC, shared his story of returning home to civilian-life, losing his job and his apartment, and falling into years of homelessness. Mr. Hill remarked that it was “a tragedy that anyone who would put his life on the line for America could return home to sleep on the streets.” In April, Alvin Hill became the 100,000th person to achieve permanent housing through the 100,000 Homes Campaign.
We congratulate Mr. Hill and we congratulate Community Solutions and all of the local and federal partners who have teamed-up to get the job done. This is an incredible milestone.
Here are three things everyone should know about what reaching milestones like this one really means:
05/05/2014 - The Chance to Grow Up to Be Whatever You Want: Expanding Access to Services for Children and Families
By Brock Grosso, HHS, Administration for Children and Families
Recently, I got to experience the intersection of policy and field work first hand when I took a trip to Baltimore with ACF staff members to see the great work being done in Baltimore by Health Care for the Homeless (HCH), an HHS funded health care grantee. HCH is doing everything it can to make sure that every young child who experiences homelessness has the chance to grow up to be whatever they want.
Sparky Harlan, CEO of Bill Wilson Center, talks about the impact of the Center's Family Advocacy Services on preventing homelessness among students while assisting both students and their families.
By Lindsay Knotts, USICH Management and Program Analyst
Our partners at the Departments of Health and Human Services and Education just launched Birth to 5: Watch Me Thrive! – a coordinated, Federal effort to encourage healthy child development, universal developmental and behavioral screening for children, and support for the families and providers who care for them.
Discover how the Wichita Police Department has made an impact in ending homelessness.
10/21/2013 - Leveraging the Affordable Care Act to Solve Homelessness: A Message to CoCs and Ten-Year Plan Leaders
How can we make the best use of the Affordable Care Act to solve homelessness? USICH Executive Director Barbara Poppe poses five questions for communities to consider.
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.
A Message to CoCs and Ten-Year Plan Leaders
From USICH Executive Director, Barbara Poppe
Recently, I wrote about the urgency to increase our efforts to end chronic and family 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 youth homelessness. To reach our goal of ending youth homelessness by the year 2020, we must realign our programs and systems now.
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).
USICH Launches the Solutions Database
The big news of the week around USICH is the launch of our Solutions Database - an online resource hub of evidence-based practices, promising practices, and model programs from around the country that work in ending homelessness. We profile model programs from around the country successful at implementing practices like coordinated entry, targeting of permanent supportive housing, and outreach. Check out the 50+ profiles now! Explore the Solutions Database
Coverage of Potential Local Impacts of Sequestration
With budgets at all levels of government impacted by sequestration, local media has started to cover stories of organizations that will experience a drastic change in their work. As mentioned by HUD Secretary Donovan and echoed by federal leaders working with low-income populations, sequestration has severe impacts on our work to prevent and end homelessness in America.
In Indiana, they anticipate that sequestration will create big gaps in funding that will place Public Housing Authorities and housing vouchers at stake.
“We are expecting this will mean that public housing authorities will end up reducing the number of households they serve because there won’t be sufficient funding for all the vouchers currently in use…”
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.
11/20/2012 - Keeping the Momentum for Ending Youth Homelessness: Reflections from Indianapolis and Beyond
Last week, the Family Youth Services Bureau of HHS’s Administration on Children, Youth, and Families hosted two days of training and workshops on addressing youth homelessness at the National Runaway and Homeless Youth Grantee Conference. More than 550 participants from around the country met in Indianapolis to share knowledge and learn from others as we work together to end youth homelessness by 2020.
The Runaway and Homeless Youth (RHY) provider community has thoroughly embraced the Opening Doors goal to end youth homelessness by 2020. The goal was mentioned throughout conference workshops, it was written in conference materials, and in the hallways of the hotel I heard this goal in discussions among providers, administrators, and policy professionals. It is inspiring to see the resounding commitment and enthusiasm for this ambitious goal has spread outside of Washington, DC and into communities throughout the country.
Given the momentum we have gained from Opening Doors and the USICH Framework to End Youth Homelessness, the RHY conference was ripe with opportunity to build more commitment and enthusiasm for the work ahead. The USICH Framework to End Youth Homelessness held a prominent spot on the conference agenda at a luncheon keynote session. Jennifer Ho provided an energetic keynote address about ending youth homelessness. She discussed two complementary strategies—getting better data on youth and building service capacity—included in the Youth Framework and explained why these strategies are important to our goal of ending youth homelessness.
Valley of the Sun United Way has come a long way in four years. Together, with partners in the public, private, and nonprofit sectors, we have set ambitious yet achievable goals and have made progress towards the one big goal: ending homelessness in the Maricopa County region. By taking a look at our milestones and key actions throughout the past four years, we identified strategies that have worked for us, and we believe can work for other United Ways or community-wide partnerships across the country.
Take a look.
Los Angeles County Makes a Smart Move for Ex-Offenders
As noted in the most recent USICH newsletter, the importance of connecting ex-offenders to safe, stable housing is a key element in successful reentry. In a few months, Los Angeles County Housing Authority, will allow ex-offenders on parole or probation who are also experiencing homelessness to be eligible for vouchers under the long-running homeless set-aside. This move will enable access to the nearly 22,000 vouchers for ex-offenders who are experiencing homelessness – a large group of individuals in Los Angeles County and individuals who face many barriers to housing stability.
Interested in reentry issues like this one? Take a look at our newsletter
Lessons from Rapid Results Bootcamp Success
The work of the Rapid Results Bootcamps continues to create a buzz among communities involved in the bootcamps as well as national leaders in innovative solutions to complex problems. The Harvard Business Review posted a blog this week about the underlying principles of how the bootcamps work, their success, and what other corporate and social organizations can learn from this effort. The authors highlight the concepts of mobilizing an ecosystem, having a common goal, and harnessing the power of peer pressure and support as lessons to be drawn from this work.
Last week another bootcamp was held in Denver, this time with participation from six communities. Look for a blog post from one of the USICH National Programs team on this event soon!
Photo courtesy of 100,000 Homes
"Big systems change requires big systems to change."
That's what the Chief Medical Officer for Health Share of Oregon told me was the approach to change that the new Coordinated Care Organization, created out of the State of Oregon's health reform plan, needed to take. I had a chance to meet leaders in this effort when I travelled to Portland September 19. One change that was visible was who was at the table. Big hospital systems are pairing up with nonprofits that have been delivering care on the streets and at community clinics, hoping to learn from the work that organizations like Central City Concern have been doing for years. One of the premises of health homes and accountable care organizations, called Coordinated Care Organizations in Oregon, is that the only way to achieve the "triple aim" of health reform that is, better care, better health, and lower costs, is to change the whole approach to patient care. That can start with big systems like hospitals and their data about who has multiple hospital admissions or many trips to the emergency room. And it also has to start with actual patient care.
08/06/2012 - The Siemer Institute on Family Stability: Maintaining Housing Stability to Ensure Academic Success
One of the most detrimental trends affecting a student’s ability to succeed in the classroom happens outside of school walls. When parents or guardians are struggling to make ends meet financially or shifting housing locations due to work, the children involved are often forced to move from one school to another and then another and so on. This constant mobility is disruptive, making it difficult for a child to feel connected to a school, to make connections with new friends, to be accepted socially, but most importantly, to stay on target academically. The Siemer Institute for Family Stability (SIFS) headquartered at the United Way of Central Ohio is responding to the challenge.
What We're Talking About is a new 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.
This week the International AIDS Conference was in Washington, DC for the first time in 22 years, shining a spotlight on HIV/AIDS both in America and around the world. For us at USICH, this conference also pointed to the topic of housing instability and homelessness among those with HIV/AIDS in America. There are more than 1 million people in the United States currently living with HIV/AIDS, and for those with low incomes or experiencing homelessness, managing the disease is complicated and expensive...
For those who ask me to describe the face of family homelessness, I often recommend they start by looking into a mirror.
Whether from an act of nature or recession-era unemployment and mortgage foreclosures – even the more fortunate among us could find ourselves homeless tomorrow. Although a host of different factors can catapult a family into crisis, we know some families are more at risk than others. More than 80% of homeless families are headed by single parents, and more than 80% of these parents are women. Most have young children. Families of color are at disproportional risk. These characteristics suggest poverty is, of course, at the root of family homelessness – single mothers, particularly those with limited educations and skills – find themselves at the bottom of the economic ladder, often not able to keep their families housed with the income generated by one wage earner working minimum wage.
However, poverty and the lack of sufficient financial capital is only one of the roots of homelessness.
According to America’s Youngest Outcasts 2010, a report by The National Center on Family Homelessness, more than 1.6 million, or one in 45 children in America, experience homelessness each year. Family homelessness is increasing in all parts of the country and families represent an ever growing sub-set of the overall homeless population.
Most homeless families have experienced extreme poverty and violence, have been unstably housed, and have limited education and work histories. Service providers can better serve homeless families and help mitigate the devastating impact of homelessness by implementing ten basic principles of care. Does your organization implement these principles when serving homeless children and families?