Washington, DC: Improving VASH Outcomes

Washington, DC: Improving VASH Outcomes

HUD VASH in DC: New Partnerships and Systems Change

PHAs also play a major role in serving homeless Veterans through administration of the HUD-VASH Program, which combines HUD housing choice voucher rental assistance with case management and clinical services provided by VA.   Adrianne Todman, Executive Director of the District of Columbia Housing Authority (DCHA), discussed the VASH  program model used in DC and how it has greatly improved the community’s VASH outcomes. 

Systems Change and Outcome-Based Program Design

Adapting to a Housing First model within the community required significant changes by DCHA and its partners.  Many of these changes were eventually carried over to the VASH program. Todman explained, “WE realized that the processes in place to house Veterans using VASH vouchers were not working very smoothly, and that we needed to reexamine policies and procedures for this part of our system as well.”

Before the shift to the revised procedures, the HUD-VASH program was implemented primarily by two partners:  the local Veterans Affairs Medical Center (VAMC) and DCHA.  According to Todman, there was a long list of steps that had to be checked off before an eligible Veteran could get into his/her own home.  These steps were carried out sequentially in a linear fashion.  “The system was really a process-based system, not an outcome-based system.”

For the most part, the actual steps haven’t changed much.  There are still a lot of things that need to happen to get the keys in the hands of the Veterans, but now there are four partners and they are all working simultaneously on the list of steps.  In addition, the program is now designed to be outcome-based, to track results and adjust if something isn’t working to make sure that they are getting Veterans into housing faster and helping them better.  “Accountability is important to make sure we are using the resources effectively,” explained Todman.

Todman said that the partners had to collectively take a step back and think fundamentally about how the system was working  - as opposed to their individual pieces – and how the steps could be re-sequenced to make things move faster (while still maintaining compliance with program rules).  Under the old process, it took the city between six and eight months to get a Veteran into housing.  Today, it takes between one and two months – a dramatic difference, especially for the Veteran that is living on the street. 

The Partners

As mentioned, there are four key partners involved in the administration of DC’s VASH Program.  DCHA plays a key coordination and training role.  They work with the other partners to make sure everyone understands roles and responsibilities.  They cross-trained DC Department of Human Services (DHS) staff on the applicant paperwork/documentation requirements.  This ensures that DHS staff can help clients compile all necessary documentation prior to their appointment with DCHA.  DCHA also conducts the rent reasonableness determinations and housing inspections on identified units.

DHS is the primary point of contact for the Veterans.  They identify candidates for the program (using a vulnerability index to target the most vulnerable, chronically homeless individuals), and provide the Veterans with case management services.  While the traditional VASH program design utilizes VAMCs to provide both clinical and case management services, the local VAMC and DHS entered into a special inter-governmental agreement.  Instead of providing services directly to the clients, the VAMC provides  funding to DHS to provide those services.  Under this agreement, and with VAMC funding, DHS was able to customize the service delivery model so that services were in line with the community’s existing client-centered Housing First program model.  In turn, the VAMC was able to define the quality and scope of the case management services through the agreement.   

The Community Partnership, the entity that manages DC’s Continuum of Care, uses its relationships with landlords in the city to identify available units and serves as the point of contact for landlords once the Veteran has moved into a unit.  It coordinates with DCHA to complete the rent reasonableness determination and housing inspection.  Veterans are allowed to selects a unit from this pool of pre-approved units, dramatically shortening the length of time spent searching for a unit on the open market.  The Community Partnership also negotiated furniture packages with local vendors so that every Veteran receives a fully finished apartment, as well as the provision of department store gift cards for basic household necessities.

Keys to Success

Close coordination across partners has been essential to success, and communication is the ingredient that drives that coordination.  DHS enlisted the help of the DC Office of the Chief Technology Officer to develop a customized, web-based project management software solution for the purpose of enhanced data sharing.  The system tracks both the identification and approval of housing units, as well as client movement through the process.  As Todman explained, “This was absolutely critical to our success at reducing the timeline to housing.  Each of the four partners could update the system in real time so that there were no paperwork delays as we faxed or mailed forms back and forth.  Having the right technology in place can dramatically improve efficiency.”

In addition, this contractual agreement between the local VAMC and DHS has also been key to DC’s success.  Prior to this arrangement, the area’s VASH allocation covered localities outside of DC, resulting in limited local community focus. Today, the community connects strongly on the issue because the program houses Veterans experiencing homelessness in their own city, in their own neighborhoods. 

For more information, download a comprehensive case study on the D.C. VASH Plus Program.