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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.
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:
04/23/2015 - Federal Partners Move Forward on HMIS Alignment & Integration, Announce MOU on Roles & Responsibilities
The U.S. Department of Housing and Urban Development’s Office of Community Planning and Development, the U.S. Department of Health and Human Services’ Administration for Children and Families and the Substance Abuse and Mental Health Services Administration, and U.S. Department of Veteran Affairs’ Veteran Health Administration have recently announced a Memorandum of Understanding (MOU) that sets forth shared understanding of each agency’s respective roles and responsibilities regarding the use of Homeless Management Information Systems (HMIS).
We know that using data to make smart decisions drives improvement in results. The more effectively we can collect, analyze, share, and coordinate around a common set of data, the more effectively we can inform action to end homelessness. For most communities, Homeless Management Information Systems (HMIS) are the primary data systems to capture information about families, youth, and individuals experiencing homelessness as well as information about the provision of housing and services to homeless individuals and families and persons at risk of homelessness.
HMIS helps us not only understand the impact our programs are having, it helps us better understand who our programs are engaging and how effective that engagement is. Action is underway now at the Federal level to integrate and align HMIS across Federal programs, which will help break down silos between services and programs and improve the effectiveness of our services and programs.
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.
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.
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 Diane Kean
Over the past two weeks, communities across the country have organized thousands of volunteers to conduct the 2015 Point-In-Time (PIT) Count, an opportunity to measure our progress as well as identify people in need—including Veterans—and connect them with a path to permanent housing. As always, Federal partners were on hand to help, including Labor Secretary Thomas Perez, HUD Secretary Julián Castro, OMB Director Shawn Donovan, VA Secretary Robert McDonald and White House Chief of Staff Denis McDonough. The Administration has come out in full force to demonstrate our deep partnership with communities and our unwavering commitment to ending homelessness.
We have compiled just some of the photos, blogs, news articles and captions from PIT Count volunteers at the Departments of Housing and Urban Development, Health and Human Services, Veterans Affairs, and Labor, and USICH and we would like to see more! Share your PIT Count experiences with us using Twitter with the hashtag #PITCount.
By Liz Osborn
For communities across the country, 2014 has been another year of continued progress in the effort to end homelessness. From the 2014 Point in Time (PIT) count data showing a 10 percent decline in overall homelessness since 2010, to 351 mayors, governors, and local officials joining the Mayors Challenge to End Veteran Homelessness, we have gained incredible momentum over the past year. Here are just a few of the events that helped to drive progress in 2014.
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.