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05/29/2015 - Ending Chronic Homelessness in 2017

By Lindsay Knotts

On any given night, we know that nearly 85,000 Americans with disabling health conditions who have experienced homelessness for long periods of time—some for years or decades—can be found sleeping on our streets, in shelters, or other places not meant for human habitation. These men and women experiencing chronic homelessness commonly have a combination of mental health problems, substance use disorders, and medical conditions that worsen over time and too often lead to an early death.

Without connections to the right types of care, people who are experiencing chronic homelessness cycle in and out of hospital emergency departments and inpatient beds, detox programs, jails, prisons, and psychiatric institutions—all at high public expense. Some studies have found that leaving a person to remain chronically homeless costs taxpayers as much as $30,000 to $50,000 per year.

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05/21/2015 - Youth Counts COUNT!

By Coco Auerswald

On Wednesday, April 29, I had the honor of representing our We Count, California! team at two historic events in Washington, DC—a Senate hearing and a White House briefing—both focused on the Administration’s goal of ending youth homelessness by 2020. Across the board, I heard a clear message that youth counts matter.

This day of unprecedented attention to the need to end youth homelessness was inspiring but came with a sober recognition that we have a good way to go to meet our goal. The importance of better data regarding youth—upon which an adequate plan is to be built—was a recurring theme throughout the day. From Senator Dianne Feinstein's remarks to statements by Jennifer Ho of HUD and USICH Executive Director Matthew Doherty, there was a consistent recognition during both events that current counts underestimate the actual scope of youth homelessness.

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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. 

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05/11/2015 - Ending Youth Homelessness

By Luke Tate

No young person should lack a stable and safe home, or be without a caring adult they can count on. Too many of America’s youth have been robbed of that essential foundation — and thanks to the extraordinary work of practitioners and volunteers across the country, we are learning what it takes to reestablish that footing and end youth homelessness nationwide.

In 2012, the U.S. Interagency Council on Homelessness (USICH) issued the Framework to End Youth Homelessness detailing the steps necessary to achieve the goal of ending youth homelessness by 2020, and strategies to improve outcomes for children and youth experiencing homelessness. This framework articulates the need for government, non-profit, civic, and faith community partners to focus together on the overall well-being of youth experiencing homelessness — addressing not just their need for stable housing, but also their educational and employment goals, and the importance of permanent adult connections in their lives.

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05/08/2015 - Harnessing Medicaid to Help Solve Homelessness

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.

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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:

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05/01/2015 - Coordinated Entry System to End Veteran and Chronic Homelessness in Tucson

By Rudy Trinidad 

Sonia Niznik (pictured right, with her Case Manager, Rudy Trinidad) was taking shelter from Arizona’s dry summer heat at a “cooling center” provided by a local church when a team of outreach workers began conducting screenings using the Vulnerability Index-Service Prioritization and Decision Assistance Tool (VI-SPDAT). At the time, Sonia had been without a home for about three years.

Sonia’s interview was part of the first wave of VI-SPDAT assessments conducted for Tucson’s Coordinated Entry pilot. The Coordinated Entry system is designed to prioritize and assist Veterans and chronically homeless individuals based on their level of vulnerability and embraces a “housing first” philosophy, operating with harm reduction principles within the safe environment of a home.

Sonia was the first individual matched with housing under the new system. To date, more than 80 Veterans and chronically homeless individuals have been matched with housing and about 15 clients have been able to move into permanent housing through this system.

I, Rudy Trinidad, a Housing Navigator and Case Manager for the Pasadera Behavioral Network, met Sonia a week and a half after she filled out the VI-SPDAT. When I met her, she had a big smile on her face. She was amazed that she was contacted about permanent supportive housing (PSH) so quickly after completing the survey. I helped her prepare the documentation she needed to qualify for the Pasadera PSH program, which is funded through the Department of Housing and Urban Development (HUD) Continuum of Care. She chose a place in a recovery based living community to help her address her substance use issues, which contributed to the job loss that led to her homelessness. A few weeks later, she had her own fully furnished studio apartment.

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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.

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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.

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04/16/2015 - The Time to Seize Historic Opportunities is Now - A Message from Matthew Doherty, USICH Executive Director

By Matthew Doherty, Executive Director

It is truly an honor to have this opportunity to serve as Executive Director of the U.S. Interagency Council on Homelessness (USICH) and to help carry forward the great work of this agency and of my predecessors. It is also a distinct privilege to work with the fantastic team of staff we have at USICH, both the team working here in DC and our Regional Coordinators working out in the field. Finally, I am humbled by the many sacrifices that my husband, Dean Thorp, is making so that I can step into this role.

USICH’s work is successful because of our strong partnerships with other Federal agencies and their incredibly committed leaders and staff, and because of the collaborative efforts of dedicated people working in states and local communities. Together, we are at a critical point in our efforts to prevent and end homelessness in the United States; we’ve made unprecedented progress and can point to substantial accomplishments under all of the objectives within Opening Doors, but clearly there remains much more work to be done. While we have seen significant reductions in the numbers of people experiencing homelessness documented through the annual Point-in-Time (PIT) count, the fact that the 2014 PIT count identified 578,424 people experiencing the crisis of homelessness, and other data such as from HUD’s Worst Case Housing Needs report, serve as a staunch reminder that housing affordability, housing instability, and homelessness continue to be national challenges—challenges that we must and can successfully address. 

As described in Opening Doors, our focus is on ending homelessness for all populations, and we must seize this historic opportunity to expand housing for every child, youth, family, and individual struggling to achieve stability within our communities.

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