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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:
03/12/2015 - After Finals and During Breaks Throughout the Year, Foster Youth Students Face a Much More Difficult Test
This post was originally published on the U.S. Department of Education blog, Homeroom, in December 2014 under the title ‘After Finals, Foster Youth Students Face a Much More Difficult Test’. We have modified some language.
By Annie Blackledge & Johan Uvin
While many college students eagerly await spring break, planning beach getaways or trips home to see family and friends, many homeless and foster care students find themselves scrambling for somewhere to live until classes resume. Many college campuses traditionally close down for breaks. For these vulnerable students their college campus is their home, their community and a primary source of security. While their peers are headed on vacations or home to see family and catch up with old friends, many of these young people are faced with bleak prospects of where to go while school is closed.
These vulnerable youth face the same struggles as other young people trying to maintain good grades, navigating social peer groups, and planning their futures, but they face the additional burdens associated with little to no adult guidance or support. Fortunately, higher education professionals across our nation have begun to tackle the unique issues faced by homeless and foster care students. They are developing comprehensive strategies to address the most persistent barriers these students face; not just during the holiday season, but all year long.
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 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.