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08/26/2015 - Good News from Philadelphia: Coordinated Services Produce Results

Army Veteran Thomas Green struggled with multiple episodes of homelessness spanning the past 20 years. Thanks to the coordination of multiple VA programs, Mr. Green now has stable housing in the Veterans Multi-Service Center's (VMC) Shelter Plus Care Program.

Learn more about Thomas Green's story and how the VMC, through coordination with other VA programs, is helping connect Veterans to housing in Philadelphia.



08/14/2015 - Project 25: Saving Money While Saving Lives

By Kris Kuntz

Last week my friend Jeanine passed away. She was found unconscious in her apartment. Jeanine suffered from several health complications including a seizure disorder, bouts of depression, and a long history of drinking. The doctors concluded that her body essentially shut down and that nothing could have been done, although it is hard to believe given her athletic 6’2” frame, outgoing personality, and the fact that she walked five miles every day. She was only 52.

I met Jeanine three years ago in the San Diego County women’s jail after her name was brought up among police officers and paramedics as our city’s most frequent user of the ER and jail. I was there to talk with her about a program called Project 25. Started in 2011, Project 25 was conceived of by the United Way of San Diego County with support from CSH. The United Way provided the majority of the funding with the County of San Diego, the City of San Diego and the San Diego Housing Commission playing important roles in both financial support and programming. The idea was simple: target the most costly and frequent users of public resources who were living on the streets of San Diego and, using a Housing First model, provide them with permanent housing and intensive wraparound services. Father Joe's Villages managed the services, oversaw the housing, and collected the data to demonstrate the program’s effectiveness and savings to the community.

The program started with 25 people, grew to 35, and then added Jeanine as the 36th person in the program after officials in the city asked Project 25 to work with her. Like others in the program, Jeanine was initially resistant to the concept. I would like to say that she agreed to participate on our first meeting in jail and things were perfect from there on out, but that’s not the case. We followed her in and out of jail and the ER numerous times before she finally trusted us enough to let us into her life. Once she did, Jeanine was quickly placed into her own apartment and from there the real stabilization began.



06/24/2015 - A Closer Look: Opening Doors, as Amended in 2015 - Spotlight on Medicaid

To accompany the release of Opening Doors, as amended in 2015, we will be taking a closer look at each of the four key updates to the document this week. We’ll be sharing comments from partners, community members, and the USICH staff on how the updates are impacting their daily work, helping to prevent and end homelessness across America, as well as highlight the key changes around the updated topic.

Spotlight on Medicaid

"When launched in 2010, Opening Doors was more than a blueprint for effective Federal, state and local partnerships to end homelessness, it motivated all of us - inside and outside of government - to work harder, together, to address the needs of our most vulnerable people. Five years later, it is just as impactful; a platform on which proven solutions such as supportive housing can expand, and an affirmation that services through Medicaid, coordinated assessment and access, and cooperation among systems must grow too if we are to succeed and tackle homelessness once and for all."  –Deb DeSantis, President/CEO, Corporation for Supportive Housing

The Affordable Care Act creates new opportunities to leverage Medicaid to end homelessness, specifically by financing services that can help people obtain and maintain housing as well as achieve health and well-being. All states now have the opportunity to expand Medicaid eligibility to nearly all individuals under the age of 65 with incomes up to 133 percent of the Federal poverty level. As of May 2015, 30 states including the District of Columbia have acted to expand Medicaid programs, and provide health coverage to millions of adults without dependent children for the first time.  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.



06/22/2015 - Opening Doors, as amended in 2015

Opening Doors, as Amended in 2015

A message from Matthew Doherty, USICH Executive Director

On behalf of the entire team at USICH, the teams at our Federal member agencies, and our many dedicated state and local partners working tirelessly to prevent and end homelessness, I am thrilled to share with you this updated version of Opening Doors, as amended in 2015.  

This document is the culmination of a tremendous amount of work by countless individuals who contributed ideas and information through online forums, in meetings, and by analyzing their agencies’ programs and policies, helping to identify best practices and lessons learned from their years of experience. That collective wisdom has shaped and strengthened this amendment and its focus on objectives and strategies informed by data, research, and results.

The release of this amendment could not be more timely. We have made great strides toward the goals established in Opening Doors, but there remains a large amount of work to be done. Today, on the anniversary of the original publication, we reaffirm our commitment to achieving an end to homelessness in America, with even greater confidence in our collective ability to solve this problem. 

Together, we are proving that homelessness does not have to appear in the pages of American history as a permanent fixture, but as a problem the American people overcame. It is my hope that the release of this amendment to Opening Doors will help move us closer to the lasting solutions that we can and must implement.



06/09/2015 - Housing is Healthcare

This blog was originally published on the Bill and Melinda Gates Foundation blog, Impatient Optimists.

By David Wertheimer

Twenty-five years ago, in the earlier years of the AIDS epidemic, health care and housing providers figured out that without housing, the health of people living with AIDS deteriorated far more rapidly than for those who had stable homes.  AIDS Housing of Washington, now Building Changes, helped coin a critically important phrase that became a game changer in the fight against AIDS: “Housing is healthcare.”

A quarter century later the phrase still rings true, and has expanded meaning in the challenging work of ending homelessness for all people, including families, single adults, youth, and veterans.

The Bill & Melinda Gates Foundation recently hosted more than 100 state and local leaders in ending family homelessness together with health care leaders responsible for implementing the Affordable Care Act (ACA) and Medicaid expansion here in Washington State. As the health care system changes, the opportunities to integrate and improve the delivery of both housing and health services to families recovering from homelessness have the potential to be transformational.

What might this look like in practice? We can now envision and realize the possibilities, thanks to a 5-year, $65 million competitive federal grant for State Innovations in Medicaid secured by the Washington State Health Care Authority. In part, this grant offers the opportunity to think in new and innovative ways about “social determinants of health,” the broad set of conditions in which we live and work, at home and with our families, including the air we breathe and the water we drink, that play a more important role in promoting long-term health than medical interventions.

Health starts where we live, learn, work and play.



05/13/2015 - Public Housing Authorities and Continuums of Care:  Establishing and Maintaining Powerful Teams in the Effort to End Homelessness

By Kiley Gosselin

Although they have long been assisting families and individuals experiencing homelessness, more and more public housing authorities (PHAs) are emerging as heroes in the fight to end homelessness –making housing those experiencing homelessness a formal focus of their efforts, often overcoming regulatory hurdles and limited resources. In many communities from Houston to Asheville, contributions from PHAs are helping to reduce the number of individuals and families experiencing homelessness. Given the scale of PHA resources, even smaller and incremental contributions of vouchers and housing units by PHAs, especially when combined with the resources of Continuums of Care (CoCs), can have a big impact on homelessness.

While some PHAs already have strong partnerships with local CoCs, others are just beginning. HUD and USICH have long promoted the idea that strong CoC and PHA relationships are critical to our efforts to end homelessness across populations. In an effort to assist communities in building these relationships, HUD, in concert with USICH, recently produced a set of two documents. The first, CoC and PHA Collaboration: Strategies for CoCs to Start the Partnership Conversation provides some preliminary strategies and tips for starting or improving the conversation between CoCs and their local PHAs. The second, entitled, The Business Case for Partnering with Public Housing Agencies to Serve People Who Are Homeless is designed to help PHAs and CoCs understand the ways their partnerships can benefit a community’s overall efforts to end homelessness from a business perspective. 



04/23/2015 - The Supportive Housing Opportunities Planner (SHOP) Tool: Setting a Path to End Chronic Homelessness Locally

Permanent Supportive Housing Row HousesBy Lindsay Knotts

Much of my passion for ending homelessness comes from my time on the front-lines where I worked to connect very vulnerable people – adults with disabling conditions who had often spent years without a safe and stable place to call home – to permanent supportive housing. Even in my small city, there were times when units were not available for people who needed them the most. We simply didn’t have enough permanent supportive housing units, and even the units that we had were not always being targeted to people experiencing chronic homelessness. We know that this is too often the case in many communities across the country.

The Obama Administration is committed to ending chronic homelessness nationally in 2017. Achieving this goal nationally is only possible if we achieve it locally. To do so, communities across the country must have enough available permanent supportive housing units to serve people currently experiencing chronic homelessness and to prevent people with disabling conditions from becoming chronically homeless in the future.

A critical first step to achieving our shared goal is to determine the specific combination of strategies needed to increase the availability of permanent supportive housing locally, which really depends on each community’s supply and availability. Some communities with a large supply of permanent supportive housing can make significant progress towards the goal just by improving the targeting of existing units. Most communities will also need to create new supportive housing through both targeted grants and mainstream resources.



03/30/2015 - The New Orleans Model for Ending Veteran Homelessness

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.



03/04/2015 - Early Childhood and HUD Working Together to End Family Homelessness

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.