Commitment to Setting Targets, Measuring Results, and Creative Collaboration Sets Chattanooga, Tennessee Apart

Since the release of Chattanooga, Tennessee’s Blueprint to End Homelessness in 2003, and the revamped Blueprint in 2007, the area has been able to make significant gains towards their homelessness goals—both in the number of people they have been able to help initially exit homelessness and the housing retention of those individuals. According to the June 2012 Chattanooga Regional Homeless Coalition’s  Blueprint Analysis, 2,987 people have moved out of homelessness into housing since 2003, 90% of whom have remained housed. The period since the publishing of the 2007 Blueprint has been one of dramatic results, especially for the population in the Chattanooga region experiencing chronic homelessness. From 2007-2011, chronic homelessness declined by 89%, and overall homelessness declined by 48% according to Point In Time data. 

Chattanooga’s leadership and commitment to the smart, strategic allocation of resources that can be used in flexible and innovative ways has allowed them to align their work with the Opening Doors Across America Initiative and has generated real results. Opening Doors Across America encourages communities to move with urgency and take action.  Two of the four elements of this call to action are setting targets and measuring results, and acting strategically with pivotal partners like public housing agencies across the region.  These are two areas where Chattanooga has shown strong leadership. USICH spoke with Mary Simons, Executive Director of the Chattanooga Regional Homeless Coalition, about their work in these areas and how it has helped make progress.

Setting Targets and Measuring Results

To gain a better understanding of the scope of homelessness, Chattanooga’s Regional Homeless Coalition took a close look at who was experiencing homelessness and the types of housing resources they had available.  Together as a Coalition, they set a target for the Blueprint that used the Point in Time (PIT) Count data and added more housing units to account for those who were not experiencing homelessness that night but may experience homelessness at another point in the year. “Once we had PIT data, we were able to see what was needed and who was already involved in programs like the HUD/VA/HHS Collaborative Initiative to End Chronic Homelessness program which began in 2004. When you measure something, everyone wants to get on board with helping to achieve that goal,” noted Ms. Simons. “We used information and strategies from our work with the 50 participants in the Collaborative Initiative to End Chronic Homelessness and previous work with of the Department of Mental Health, and married those strategies and targets with larger federal programs to come up with strategies for all populations.” The Coalition has also benefitted from a longstanding HMIS system, established in 1998. “Even when we only had funds for 50 units, we still noted tenant’s retention rate and also who was entering shelters that we were not able to help at that time. Because we have all of this data, we could see progress from our strategies and were able to estimate the number of housing opportunities we’ll need next year.” 

While there are many targets within the Blueprint, a major sphere of focus is commitment to developing permanent supportive housing and affordable housing. In the 2003 Blueprint, the goal was to create 1400 affordable housing units in 10 years to be used by individuals experiencing homelessness through the provision of rent subsidies, new housing development, and the preservation of affordable housing stock. Between 2003-2007, Chattanooga developed 1620 affordable housing options. The 2007 revision included providing an additional 200 affordable units per year. They also exceeded this goal.  

Acting Strategically – Working with the Public Housing Authority and Supportive Service Providers

Mary Simons spoke of their very successful relationship with Public Housing Authorities in both urban and rural areas as a driver of their success.  It was important to get everyone around the table to discuss all the resources they have and the number of vouchers per program – whether Supportive Housing Program vouchers, Shelter Plus Care vouchers or Housing Choice vouchers. This required federal, state, and local involvement from multiple departments to assess both what resources were available and what resources we needed.  Continued review of successes and ongoing needs of current tenants and people experiencing homelessness during the voucher renewal process helps to determine the level of supportive service provision, financial assistance, and collaboration needed to sustain progress in Chattanooga. Once all parties with resources come together and assess their needs and resources available, the group can work together to determine how best to meet tenant’s needs. 

Mary Simons shared an example of this flexibility: 

We were able to place 50 individuals into housing with services through Collaborative Initiative to End Chronic Homelessness funding in 2003 using Shelter Plus Care Vouchers, and last winter we worked with tenants to reevaluate their needs and see if they needed the same intensity of services. We found this year after working with the case managers that many of the individuals that needed Assertive Community Treatment teams in 2004 were in recovery and were stable at the end of 2011. The individuals we placed through this program (and across all programs) had a very low turnover rate, so the housing authority is very willing to lease to these tenants using any of their voucher programs. We worked with the housing authority to move the folks who were able to remain stable without intense services to the Housing Choice Voucher program. That freed up 44 Shelter Plus Care vouchers that could be used with a supportive services team that is nearby, available as frequently as the tenants may need. Working within the rules of the Housing Authority and the supportive service providers we were able maintain housing for 50 people and get 44 more people off the streets and into housing. 

This example is just one of the many in which all stakeholders in the Blueprint have come together to ensure that the level of intervention is appropriate to the needs of individuals, putting Chattanooga in a position that is best able to maximize resources and achieve their goals. . “Working with all of those who are committed to housing people throughout the region, we’re moving in a much better direction to find what a person really needs and then a voucher or resource to fit their needs.” While the work is not over, Chattanooga has been able to work within and across systems to make progress, engaging both public and private partners. 

Chattanooga has been able to make significant progress by implementing strategies at the core of the Opening Doors Across America Initiative: they aligned their plan with Opening Doors, collaborated with multiple partners, committed to developing targets and measuring their progress, and engaged in creative problem solving to keep momentum going. Using some of the same tools and collaborations, your community can move the needle on ending all types of homelessness as well. 

Learn more about Chattanooga by reading their Blueprint Analysis

Learn more about resources and innovations in Opening Doors Across America

Opening Doors Connecticut

Opening Doors Connecticut

Connecticut recently became the first state in the country to develop a state plan to end homelessness that is fully aligned with our national plan, Opening Doors. USICH discussed the development of Opening Doors Connecticut with Carol Walter, the Executive Director of the Connecticut Coalition to End Homelessness, and staff from the Partnership for Strong Communities.

Benefits of Aligning a State Plan 

Since the effects of homelessness are individual, personal, and local, there can be a tendency for states to expect local communities to do their own planning without providing the comprehensive leadership of a state strategic plan. This misses a great opportunity that can benefit the state, the communities, and people experiencing homelessness in the state. Connecticut has found that a strong state plan aligned with Opening Doors provides a framework for a comprehensive statewide approach to homelessness that helps:

Since the effects of homelessness are individual, personal, and local, there can be a tendency for states to expect local communities to do their own planning without providing the comprehensive leadership of a state strategic plan. This misses a great opportunity that can benefit the state, the communities, and people experiencing homelessness in the state. Connecticut has found that a strong state plan aligned with Opening Doors provides a framework for a comprehensive statewide approach to homelessness that helps:

  • Improve access to interventions for people experiencing housing crises by streamlining collaboration at all levels of government and across jurisdictions. When everyone working on homelessness in the state shares the same goals and speaks with a unified voice, collaboration becomes easier and more effective.
  • Encourage uniform use of best practices. The process to develop the federal plan was thorough and relied on the input of leaders in homeless services from every corner of the country. “The strategies that are in the plan are the best we have as a nation. If these strategies are used uniformly in my state, then I know we are moving toward our goals more effectively. There is no need to reinvent the wheel,” said Carol Walter.
  • Coordinate outcome measures, ensuring all communities are truly measuring progress and that measurements are comparable. In order to use resources wisely, local communities need to be able to assess what programs are working. They cannot do this without using reliable measurements that are comparable with other communities.
  • Access federal resources and ease federal reporting requirements. Walter explained, “All federal homeless programs are coordinated through Opening Doors, it can make life easier as a state or a community when your program dollars are aligned in the same way. This will become especially true when new HEARTH regulations take effect. High performing communities will be eligible for additional resources and it is much easier to be high performing and to demonstrate that performance, if you are using the same measuring stick that the federal government uses.”
  • Save state dollars by reducing the burden on public systems and by increasing efficiency of state distributed resources. People experiencing homelessness - especially people experiencing chronic homelessness - are often high-cost users of public systems. State courts, prisons, and hospitals can reduce the strain on their systems if solutions to homelessness are in place. In addition, states are charged with distributing many resources related to homeless services. To make the most of these resources, states should be putting them into systems that are coordinated and using best practices.

Connecticut's Process of Alignment

In Connecticut, the process of developing the new state plan was spearheaded by a small group of non-profit and advocacy organizations including the Partnership for Stronger Communities, the Connecticut Housing Coalition, the Corporation for Supportive Housing, the Connecticut Aids Resource Coalition, the Connecticut Women’s Education and Legal Fund, and the Connecticut Coalition to End Homelessness. The effort has been guided by the Reaching Home Campaign, supported by the Melville Charitable Trust. Partnership for Strong Communities has provided the staff support needed to move the project forward. This initial small group of organizations realized the importance of a state plan, but they also realized the importance of welcoming many voices to the table.  “Housing loss is intertwined with the issues of income, health, safety, and social and family supports, among others," said Howard Rifkin the Executive Director of Partnership for Stronger Communities. "To develop a state plan that coordinates across these fields and uses the best practices they have to offer, we needed to bring in a broader range of partners that included healthcare systems, workforce development, education, the business community, municipalities and the faith community.”

In order to obtain as much feedback as possible from those working in the field, they identified six topics that were especially relevant to the needs in Connecticut and hosted listening sessions on these topics: housing; health; criminal justice; family, youth, and children; crisis response; and community planning and sustainability. These sessions brought in feedback from many sectors including representatives from state-level agencies (see the table below). An outside observer was tasked with tying all of the feedback together and gaining consensus on a plan aligned with Opening Doors that meets the unique needs of Connecticut.

Ensuring a plan that was implementable was a critical piece of the thought process. “A plan without implementation does not get us closer to our goals, to do the work ahead we kept plan implementation in our sights from the beginning by delineating a structure to guide the implementation,” said Rifkin. Plan implementation is being overseen by a steering committee made up of a broad-based coalition of more than 50 community stakeholders. This steering committee oversees progress from four implementation working groups on retooling crisis response, healthcare and housing stability, economic security, and affordable and supportive housing which guide action on the strategies laid out in Opening Doors Connecticut.

Listening Session Topic
Participating Groups
Housing
Connecticut Housing Coalition, public housing agencies, housing developers, Connecticut Housing and Finance Authority, Department of Economic and Community Development, Partnership for Strong Communities, Governor’s office, Melville Charitable Trust, workforce investment boards, permanent supportive housing providers, legal rights services, Mental Health and Substance Abuse Agency, philanthropy
Health care
hospital staff, behavioral health providers, federally qualified community health centers, health department staff, Mental Health and Substance Abuse Agency, health advocates, AIDS advocates, Department of Public Health, Department of Social Services, state healthcare advocates, Connecticut Women’s Education and Legal Fund, State of Connecticut Child Advocates
Criminal Justice
Department of Corrections, Court Support Services Division, the VA-Connecticut Healthcare System, state budget office, Mental Health and Substance Abuse Agency, Department of Social Services, community service providers, re-entry coordinators, Connecticut Alliance to Benefit Law Enforcement, Central Connecticut State University, philanthropy, Corporation for Supportive Housing, Partnership for Stronger Communities, state legislators
Family, Youth, and Children
children’s advocacy and legal rights groups, Youth Continuum, Youth and Family Services, magnet schools, permanent supportive housing providers, Department of Children and Families, workforce investment boards, Department of Social Services, Mental Health and Substance Abuse Agency, domestic violence advocacy, Department of Education
Crisis Response
permanent supportive housing providers, shelters, social services agencies, Mental Health and Substance Abuse Agency, State Budget Office, National Alliance on Mental Illness, Connecticut Coalition to End Homelessness, Department of Social Services, Partnership for Stronger Communities, United Way of Greater New Haven
 
Community Planning and Sustainability
Community colleges, Connecticut Coalition to End Homelessness, USICH, Mental Health and Substance Abuse Agency, the VA-Connecticut Healthcare System, Department of Economic and Community Development, Department of Social Services, philanthropy, state legislators

 

Five things you can do now to work toward an aligned plan in your state:

1. Determine a lead for the development of a state plan.  Consider state coordinating bodies or organizations that could convene participants around the development of a state plan. Some examples include a state interagency council on homelessness, state coalition on homelessness, state housing agency, and philanthropic organizations.

2. Convene meetings with a broad spectrum of representatives who work day-to-day in homeless services. Get everyone in the same room to talk about what is needed, what the benefits would be, and determine a course of action, that includes concrete steps, accountability for actions, and a timeline.

3. Connect with people experiencing homelessness and who are working on the ground (working case managers, people who run shelters, and others) and discuss the following questions:

  • What do best practices look like on the ground?
  • How do different practices work together?
  • How would we bring them to scale?

4. Don’t reinvent the wheel. Share your own experiences and what you know about how different models work in the real world. Consider solutions that are working in other states, and applicable strategies outlined in Opening Doors. Use the framework of population goals, a clear timeline, and five themes to frame your plan.

5. Be prepared to open your mind.

In relation to this last point, Walter shared this advice for our readers:

Be prepared to open your mind. In order to end homelessness, some things will have to change. Whether that is giving up on a model you have used for a long time or working with partners that you haven’t gotten along with in the past, some uncomfortable changes are inevitable. If you are in a leadership position, make sure others in your organization understand the why behind these sometimes difficult changes. Putting yourself in a silo and immersing yourself in the work of saving people is understandable, but in order to end homelessness and stop just managing it we all need to take a step back and realize where these silos and blinders are holding us back. As an individual or an organization you can begin to do this work and begin to think more openly. As a state you can take leadership and push the whole field toward the use of best practices and a more efficient system.

HUD and National League of Cities announced a new Memorandum of Understanding to help fight against veteran homelessness in cities across the country.

NLC Executive Director signs a historic MOU with HUD Secretary Julián Castro

WASHINGTON - The U.S. Department of Housing and Urban Development (HUD) and National League of Cities (NLC) today announced a new Memorandum of Understanding (MOU) to help fight against veteran homelessness in cities across the country. To date, more than 255 cities, counties and states are pledging to end veteran homelessness in their communities by 2015 using the power of federal, state, local, and non-profit resources.

Speaking at the annual convention of the National League of Cities in Austin, Texas, Secretary Castro announced the new partnership and signed the official MOU with NLC Executive Director, Clarence Anthony.

"Today's partnership sends a loud message that ending homelessness is not a dream," said HUD Secretary Julián Castro. "It's a goal within reach for veterans, for youth, for families and for individuals. It's up to us to make it a reality. Working together we can get it done and give every family a home of dignity."

"We are excited to partner with the Department of Housing and Urban Development on this critical issue facing our veterans," said Clarence Anthony, Executive Director of the National League of Cities. He continued, "Since the beginning of the Mayors Challenge, NLC has worked closely with HUD to engage city leaders. This partnership will expand our efforts to bring a deeper understanding of the resources available to local leaders and assist in creating action plans that will go a long way towards eliminating veteran homelessness."

The MOU calls for HUD and NLC to jointly develop and execute regional forums to raise the awareness and understanding of the benefits of joining the Mayors Challenge to End Veteran Homelessness. Today's announcement is also the latest step in the Mayors Challenge to End Veteran Homelessness announced by First Lady Michelle Obama in June 2014.

The MOU will make available HUD's resources to:

Prioritize the most vulnerable veterans, especially those experiencing chronic homelessness, for permanent supportive housing opportunities;

Coordinate outreach efforts to identify and engage every veteran experiencing homelessness and focus outreach efforts on achieving housing outcomes;

Target rapid rehousing interventions, including those made possible through the Department of Veterans Affairs' Supportive Services for Veteran Families program, toward veterans who need shorter-term rental subsidies and services in order to be reintegrated back into our communities;

Leverage housing and services resources that can help veterans who are ineligible for some of the VA's programs get into stable housing;

Increase early detection and access to preventive services so at-risk veterans remain stably housed; and

Closely monitor progress toward the goal, including the success of programs achieving permanent housing outcomes.

LEARN MORE

National Alliance to End Homelessness Wants Input from Rapid Re-Housing Providers

The National Alliance to End Homelessness published a toolkit, "Rapid Re-Housing Tools," that provides sample materials to assist rapid re-housing providers and rapid re-housing program staff. The organization is asking experienced rapid re-housing providers to submit materials for inclusion in the toolkit. Currently, it includes landlord marketing materials, a housing specialist job description, and materials to help housing provider clients consider their potential housing options and understand leases.

To submit materials for inclusion in the toolkit, please email the Alliance's Center for Capacity Building at thecenter@naeh.org

The National Center on Family Homelessness report that 2.5 million children experience homelessness annually in the U.S.

America's Youngest Outcasts, America's Youngest Outcasts documents the number of children expereincing homelessness in every state, their well-being, their risk for child homelessness, and state level planning and policy efforts. 

Major causes on child homelessness in the U.S. include: (1) the nation's high poverty rate; (2) a lack of affordable housing across the nation; (3) the continuing impacts of the Great Recession; (4) racial disparities; (5) the challenges of single parenting; and (6) the ways in which traumatic experiences, especially domestic violence, precede and prolong homelessness for families.

Effective solutions must combine safe, affordable housing with essential services. Family members should be comprehensively assessed to understand what services they need. Parents may require education, job training, transportation, and childcare, and may also need mental health and parenting supports. All services should incorporate a family-oriented, trauma-informed approach.

To read the full report and find out where your state ranks, please visit www.HomelessChildrenAmerica.org.  

Collective Impact Works

Remarks delivered by Laura Green Zeilinger, USICH Executive Director, at Ballard Spahr’s National Housing Symposium in Washington, DC.

 

Thank you Sharon Geno for the kind introduction and for asking me here today. I’m honored to have the privilege to join this important discussion.

As Executive Director of the United States Interagency Council on Homelessness, I bring greetings from Council Chair, Secretary Tom Perez.

Together, we are responsible for coordinating the federal response to homelessness by creating an interagency platform to maximize the effectiveness of our 19 federal agency partners, sharing best practices, and driving collaborative solutions.

I am here today to deliver a message on behalf of our Administration that we can solve homelessness by working together.

I’ve made a career of trying to tackle complex social problems, first in an international context, then in local government and now at the Federal level, figuring out ways government can work effectively and efficiently for people, the greatest test of which is people with the highest levels of vulnerability.

Through this work I have come to know that homelessness is not an intractable problem; it persists because we choose to let it persist.  But we can choose a different outcome. I’ve seen it... I’ve seen what happens when we choose to work towards a different outcome…a better outcome.

A little more than 4 years ago, when I was working in city government, we held an event to mark the day the 1,000th person (a female Veteran) moved into her apartment in the District’s Housing First initiative.

I ran into Bill, an outstanding outreach worker. Bill said to me,

“I want you to know that I do not have the same job as I used to. It used to be, no one had any reason to really engage with me; they didn’t believe that I had anything real to offer them.  That has changed,” he said. “People have seen others, who have lived outside a very long time, move into housing. They understand now that it is possible for them too.  Now they want to talk with me. It is clear there is a different sense of hope and motivation to begin to access services.”

You see, when you start working towards creating better outcomes for people—people who may have lost hope—they now have a reason to hope, and they do things no one thought possible. They have faith in a better future for themselves.

A few years ago, in an article in Stanford Social Innovation Review, John Kania and Mark Kramer coined the term “collective impact” to describe the success that is possible when key actors from different sectors set a common goal to solve a complex problem, and work in a structured process to pursue mutually reinforcing actions towards that goal, and routinely measure progress against that goal using data, and adjust their efforts. 

They distinguish collective impact from ‘isolated impact’ which is “an approach oriented toward finding and funding a solution embodied within a single organization, combined with the hope that the most effective organizations will grow or replicate to extend their impact more widely.”  They write that there is little evidence that isolated initiatives are the way to solve many of the social problems in today’s complex and interdependent world.

Our work here would fit this description of collective impact: a broad set of stakeholders from the public, private, non-profit, sectors united around and worked towards a common goal of ending homelessness.  The good news is that across the country, communities are beginning to better organize themselves to create collective impact on homelessness.

USICH’s approach to the federal government: coordinating the expertise and efforts of 19 Federal agencies to develop and adopt Opening Doors, the first ever Federal strategic plan to end homelessness. 

It was through the collective impact of our Federal partners that we were able to set the goal of ending homelessness in America, specifically to:

  • Prevent and end homelessness among Veterans in 2015,
  • Finish the job of ending chronic homelessness in 2016,
  • Prevent and end homelessness for families, youth, and children by 2020, and
  • Set a path for ending all types of homelessness.

 

Through a collective impact approach, we are changing the trajectory on homelessness in our nation.

In four years, we have reduced overall homelessness by nearly 10 percent, including a 25% reduction in unsheltered homelessness—meaning fewer and fewer or our neighbors, our families, our Veterans are facing nights on the streets, in cars, in abandoned buildings or other places not meant for human habitation.

  • Homelessness among Veterans down by 33%
  • Chronic Homelessness down 21%
  • Family homelessness down 15%, including 53% drop in unsheltered homelessness among families

Ending homelessness requires a long-term vision, a commitment to policy change, the redirection of resources, new investments in evidence informed practices, and sustained collaborative leadership at the federal, state, and local levels.  Examples of outstanding federal collaboration include the work of HUD and VA to improve the Veterans Affairs Supportive Housing program (HUD-VASH) and to implement Supportive Services for Veteran Families.

VASH pairs a HUD housing voucher with VA health care and services to create supportive housing targeted to vulnerable and chronically homeless Veterans.  VASH has strong bipartisan support and has been the largest new supportive housing investment over the last five years. Since 2008, HUD has awarded 68000 vouchers which have enabled 80000 Veterans to obtain permanent housing.

Supportive Services for Veterans Families was created during the first term of our administration and takes the lessons learned from the Recovery Act’s HPRP to scale for Veterans.  Grant announcements later for rapid re-housing and prevention assistance will total $300million in awards to non-profit organizations and consumer cooperatives.

Our work on solving homelessness among Veterans demonstrates that interagency collaboration, strategic new investment, and the adoption of proven tools points the way for success in other areas.

Another example of how federal agencies have collaborated is our work to accelerate our progress on ending chronic homelessness.  In 2012, however, the Council realized that we were not on track to achieve this goal. We determined that our slow progress was due to four factors:

1) Despite the increase in units, many supportive housing units were not actually targeted to people experiencing chronic homelessness (only 45 percent of the nation's 166,000 supportive housing units were designated for people experiencing chronic homelessness);

2) The expansion of permanent supportive housing was concentrated in the North and East, whereas there were also high needs in the South and West;

3) Our estimates of the need did not adequately account for people experiencing chronic homelessness who cycled in and out of institutional settings; and

4) Congress had failed to act on the repeated requests made by the Administration for resources to increase permanent supportive housing.

In April 2013, the Council developed and adopted a bold interagency strategy to accelerate our progress on ending chronic homelessness. 

We also conducted a careful analysis of the impact of these actions on our goal.  We found that even by fully utilizing every existing resource, we still had a gap of about 37,000 units to achieve the goal. With support from the White House and OMB, this led to the inclusion of a $301 million increase in the President’s FY 2015 Budget to create 37,000 new units of permanent supportive housing.  This request is still being considered by Congress as part of the FY 2015 Omnibus.

Our strategy also focuses on leveraging the opportunities in the Affordable Care Act to finance services that can end homelessness, particularly for people experiencing chronic homelessness.   

 

One of the biggest pieces of legislation supporting our effort to end homelessness was national health reform through the Affordable Care Act.  The ACA is a game changing policy that will improve the lives of low-income families and individuals.

First, it makes possible affordable health coverage to all low-income families and individuals through both the expansion of Medicaid eligibility and health insurance exchanges.  Families burdened by both high rents and high health care costs can get some reprieve.

It also means that low-income families and individuals may be entitled to a comprehensive package of health care services that encompasses not only doctor’s visits and hospital-based care, but also behavioral health care and (depending on the state) case management services.  This is possible because of provisions in the Affordable Care Act that seek to transform what health care means and how it is delivered. It focuses on health and stability, not just on encounters and procedures, and that includes the kind of care and services that low-income families and individuals, including those experiencing homelessness, need. 

The ACA has unleashed a whole set of innovations in health care delivery, and there is an active search for innovative solutions to improving health outcomes while lowering costs.  Those of us in the room know that for many people with complex health conditions, housing is fundamental to improved health and to helping people avoid more expensive forms of care.  We have seen the evidence on permanent supportive housing’s ability to reduce hospitalizations and emergency room visits.  The door has been opened for us to build on this evidence, and firmly establish that affordable housing is a health care intervention and another means of bending the health care cost curve.

Just a few weeks ago HHS released Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants of Permanent Supportive Housing.

We Still Have More Work to Do, National Housing Crisis Poses Significant Challenges

While we have been successful, we know there is much work to be done. That we achieved even these modest reductions is good news, but not cause for much celebration as our work is far from over:

  • More than 578,000 people still experience homelessness on any single night.
  • More than 67,000 families with children are homeless, which includes more than 216,000 people.
  • The U.S. Department of Education also estimates that over the course of a school year more than one million children will lack a stable place to call home.

Infancy is the period of life when a person is at highest risk of living in a homeless shelter in the United States.  Let me say that again because it is so shocking.  The age at which a person is most likely to be found in a homeless shelter in the United States is infancy. 

Rates fall a bit when children are 1-5, although preschool children are still more likely than adults to find themselves in shelter – this fact coupled with what we know about the social determinants of health, hammers home why increasing access to affordable housing and ending homelessness is a critical “strategy for our future”      

Given these numbers, we know we don’t have an easy road ahead.  Our challenges are compounded by a worsening national housing crisis, especially at the lower end of the housing market as the data from NLIHC’s Out of Reach Report and HUD’s Worst Case Housing Needs report shows:

  • For every 100 Extremely Low Income renters, there are only 31 available and affordable units.
  • National research shows that families experiencing homelessness have incomes at or below 40-50 percent of the Federal Poverty Level, which translates to between 14 and 17 percent of AMI
  • For people with disabilities living on SSI, which averages $721 per month in 2014, they can only afford a rent of only $216 per month.  There is not a single county in the U.S. where even a modest efficiency apartment is affordable for this amount.  

It is clear that we cannot end homelessness without addressing the shortage of affordable housing, especially for extremely low-income households and people with disabilities.

On the other hand, it is clear that when we do have investments in affordable housing, we can see the impact it has on homelessness.

Nowhere is that more clear than our work around Veterans experiencing homelessness, where the increased investments have resulted in historic reductions in the number of Veterans experiencing homelessness.  Demonstrating that when we invest, homelessness is a problem that is not too complex to solve.

There is a parallel here to the story I started with about my friend Bill, just as people who had given up hope in themselves started to think differently about what they could do, so too, are leaders, policy makers, and stakeholders throughout our country as we end homelessness among Veterans.

Ending homelessness is not just a good thing to do from a human stand-point; it also makes good fiscal sense.  Many people experiencing chronic homelessness spend their lives cycling through emergency shelters, jails, and hospitals and incur high costs to public systems – sometimes upwards of $50,000 a year. The daily cost of supportive housing for this vulnerable population is a better investment of scarce public resources than the cost of repeated hospital, ER, and detox center admissions. Permanent supportive housing in not only a better public investment, but it results in better health and quality of life for people when they have a home. As HUD Secretary Julian Castro likes to say: ending homelessness works for the common good and the bottom line.

We need to talk about how affordable housing improves health while lowering health care costs, how affordable housing increases public safety and reduces crime and recidivism, how affordable housing creates jobs and improves neighborhoods and property values, how it stabilizes and strengthens families and improves children’s educational outcomes and well-being in life. 

Underlying the ACA was an idea called the “Triple Aim:” that the goal of health reform is:

  • To improve health outcomes
  • To improve the experience of health care, and
  • To lower costs. 

 

Perhaps we need to clarify our own Triple Aim for affordable housing:

  • To improve lives and families,
  • To build neighborhoods, and
  • To create jobs.

 

Preventing and ending homelessness is an ambitious but achievable goal.  It requires equally ambitious collaboration, innovation, investment, data driven and outcome-focused planning, and, above all, an aggressive commitment to getting to the finish line.  Communities across the country are providing examples of this commitment every day.  USICH and our federal partners are weaving together our resources and reforms to ease the journey.  Together, we will continue to make great strides toward our goal of preventing and ending homelessness in America.

Thank you.

Breaking Ground on the John and Jill Ker Conway Residence in DC

Remarks delivered by Laura Green Zeilinger, USICH Executive Director, at the ground breaking of the John and Jill Ker Conway Residence in DC, a 124-unit mixed income apartment building with 60 units of permanent supportive housing for veterans exiting homelessness.

 

I have been looking forward to this day for a long time—as I know all of us have.

Breaking ground today on DC’s first permanent supportive housing residence for Veterans is a testament to the tenacity and resiliency of this town—which I am proud to call my home—and to the many partners who made today possible.

I know…I have been in and around this project since the very beginning, and after several starts and stops, true partnerships emerged to take a hold of it and they haven’t looked back: the District of Columbia, the DC Housing Authority, Community Solutions, A wider Circle, HUD, McCormack Baron Salazar, a braid of public, private, and philanthropic support, and countless others.

It’s because of your efforts that 60 Veterans (all formally, chronically homeless) will show up right here with keys in their hands—ready to make 1005 North Capitol Street home. Right here in view of the Capitol Dome, under which works the very democracy their service fought to defend.  

And while in this democracy of ours there seems to be many things we can’t agree on, ensuring that Veterans have a safe and stable place that is home, thankfully, is not one of them.

This project is a testament to the power of public-private partnerships and faith-based leadership. Most importantly, it’s a testament to the commitment this country has made to every Veteran:  you will have a safe and stable place that IS home. 

The Obama Administration has drawn a line in the sand: no Veteran who has served this country will go without a home in this country. For far too long, being a Veteran meant you were at a higher risk of experiencing homelessness; it’s time to turn that shameful statistic around.  It’s time to end homelessness among Veterans, and we have set a goal to so by the end of 2015.

Since the launch Opening Doors in 2010, the first-ever federal strategic plan to prevent and end homelessness, we have made real progress— reducing homelessness among Veterans by 33 percent, including a 43 percent drop in number of Veterans living in unsheltered situations. In the same time, we’ve also reduced overall homelessness by 10 percent, family homelessness by 15 percent, and chronic homelessness by 21 percent.

Of course, this progress wasn’t done by government working alone.  Not in the least.  This progress has been made by communities all across the country— like DC, where the city has reduced homelessness among veterans by 22 percent.

It’s been made by partners like Community Solutions, who ,with communities, connected more than 105 thousand people experiencing homelessness to permeant housing through their 100,000 Homes Campaign. Over 31 thousand were Veterans.

This progress has been made by commitment of leaders all across this country, including Mayor Gray, who joined the  267 (and counting….) mayors, governors, and county executives in the Mayors Challenge to End Veteran Homelessness.

This progress has been made because we have invested in and implemented evidence-based best practices—like Housing First, permanent supportive housing, and rapid rehousing.  Real solutions that are the foundation of progress and of projects like the John and Jill Ker Conway Residence.

But we have more work to do. And while I’ve been looking forward to this day a long time, I’m looking forward to the day 60 Veterans make this place home so much more; I’m looking forward to the day in the near future  when every community has the leadership, capacity and resources they need to ensure no Veteran has to sleep a single on the streets, and that every Veteran has rapid access to a safe, stable home.  Doing this will show that homelessness is solvable, and is a critical step in the movement to end homelessness for youth, families and all others.  We have never had a Presidential Administration more committed to achieving this.

Which is why I’m honored to introduce Julián Castro, Secretary of the Department of Housing and Urban Development.  Someone who understands how to problem solve at the local level, who knows the needs of communities. Who is committed whole-heartedly this issue; who is determined to ensure communities are places of hope and opportunity for every American, no matter their station in life.  Please welcome, Secretary Julián Castro!

HUD Secretary, USICH Executive Director, and DC Mayor Join Advocates to Break Ground on New Housing for Homeless Veterans

HUD Secretary Julián Castro, USICH Executive Director Laura Green Zeilinger, and DC Mayor Vincent Gray joined advocates and housing
professionals Monday to break ground on the John and Jill Ker Conway Residence, a 124-unit mixed income apartment building. The distinctive building comprises 60 units of permanent supportive housing for veterans exiting homelessness and 64 affordable and low-income units.
It represents an unusual effort to bring top quality architecture and design to housing for low income and homeless populations.
Located on North Capitol St NE between L and K Streets, the project will diversify and contribute to the ongoing revitalization of the booming NoMa area. It is a collaboration between Community Solutions, a national non-profit organization, and McCormack Baron Salazar, Inc., a
leading property development firm.

Last week, the US Department of Housing and Urban Development released the 2014 Homeless Point-in-Time Count, showing that 406 veterans experienced homelessness in Washington, DC on a given night in January of 2014. That number has fallen 22 percent since 2010 due to the committed work of local advocates and government officials. “We have an obligation to ensure that every veteran has a place to call home,” said U.S. Department of Housing and Urban Development Secretary Julián Castro. “In just a few years, we have made incredible progress reducing homelessness among veterans. Today’s opening is the latest step on the path to ending veteran homelessness in Washington, D.C. and across the nation. HUD will continue collaborating with our federal and local partners to ensure that all of the men and women who have served our country have a stable home and an opportunity to succeed.”

 

Read Full Press Release here

Proof Point: The 2014 Point-in-Time Count Shows that Homelessness Is a Solvable Problem

Laura Green Zeilinger, Executive Director of the U.S. Interagency Council on Homelessness, provides an overview of the results of the 2014 Point-in-Time Count of people experiencing homelessness in the United States. With unparalleled community collaboration using Federal strategy since 2010, we've witnessed an overall 10 percent decline in the total homeless population, and of those a 25 percent decline in those who are living unsheltered. Family homelessness is down 15 percent; 53 percent fewer families are living unsheltered. Chronic homelessness is down 21 percent; 14 percent unsheltered. There's been a slight downturn in youth homelessness, but particularly noteworthy are the declines seen among Veterans. Veteran homelessness is down 33 percent, unsheltered down 43 percent. Learn more about the results here.

2014 PIT Report Shows Homelessness in America Continues to Decline

U.S. Housing and Urban Development (HUD) Secretary Julián Castro today announced HUD’s latest estimate of homelessness in the United States, noting a continued general decline and specifically among Veterans and persons living on the street. HUD’s 2014 Annual Homeless Assessment Report to Congress reports that 578,424 persons were experiencing homelessness on a single night in 2014. This represents an overall 10 percent reduction and 25 percent drop in the unsheltered population since 2010, the year the Obama Administration launched Opening Doors, the nation’s first comprehensive strategy to prevent and end homelessness.

HUD’s annual ‘point-in-time’ estimates seek to measure the scope of homelessness on a single night in January. Based on data reported by state and local planning agencies, last January’s one-night estimate reveals a 33 percent drop in homelessness among veterans, including a 43 percent reduction in unsheltered homelessness among veterans, since 2010 and a 10.5 percent decline since last year. State and local communities also reported a 15 percent decline in the number of families with children experiencing homelessness since 2010, as well as a 53 percent reduction among these families who were found be to unsheltered.

Read HUD's press release.

Read The 2014 Annual Homeless Assessment Report to Congress

Read Laura Green Zeilinger's message on 2014 PIT results.

  

  

We Need to be Smarter about how We Understand and Meet the Needs of Youth

Remarks delivered by Laura Green Zeilinger, USICH Executive Director, at the End Youth Homelessness Call to Action Event hosted by the Family and Youth Services Bureau

National Press Club, Washington DC

Wednesday, October 22, 2014

I am so honored to be here today. It’s vitally important that we keep shining the spotlight on youth homelessness; keep the issue front and center.

Ending youth homelessness is a social justice issue.

In each of our cities and towns, every night, there are young people who face the unimaginable risk of exploitation, of abuse, of countless traumas that threaten not only their immediate health and well-being but that can inflict long-term damage.

Everyone, from the federal government, to change agents and like Cyndi Lauper and the True Colors Fund, to every youth provider and school in America—we all have the shared responsibility and the opportunity to be the caring adult who brings young people back to safety, back to stable housing, helping them establish permanent connections, and improve their outcomes in education, employment, and well-being.

Because of the very nature of youth homelessness, what we know about it is limited and improving data on youth is vital. Which is why the release of this new study from HHS is so important to this effort—it adds to our understanding.

We also know that what gets measured gets done, which is why getting to confident estimate of the size of the problem is critical. The federal government, with partners across sectors, is at work now to get the quality of the data to where it needs to be through focused efforts to improve the point-in-time count for youth.

But let me be clear, while better data is critical to solving this problem, there are things we know we can do today, to improve the lives and outcomes of youth experiencing or at-risk of homelessness.

To do so, we need to make some changes. We need to be smarter about how we understand and meet the needs of youth. We need to work together to connect youth with the resources and assistance they need in a meaningful and systematic way.  We can take action today, to identify and use the touch points that we have to more effectively understand and meet the needs of young people—this report gives us that much more to work with.

No single program is the magic pill. No one agency could alone end youth homelessness, but many play a part. When a young person is in crisis, it is not fragmented by government program, it is whole and overwhelming.  Yet when solutions are viewed through the lens of programs, the scope of their interaction is often narrowly defined by whether they’re part of a school, or law enforcement, or juvenile justice, protective services.

So we often find ourselves in a place, where, on some level, many are responsible in-part, but nobody is responsible for the whole, and without a system in place it’s impossible for people to even understand their part.  This has to change, and we are focused on changing this. Programs have to break out of silos and be able to put youth at the center of their work -- that is how we solve complex problems.

At the United States Interagency on Homelessness, we have necessary and extraordinary mission of coordinating among 19 federal agencies, state and local governments and the private and non-profit sectors to prevent and end homelessness.

In 2010, The Obama Administration launched Opening Doors, the first comprehensive federal strategic plan to prevent and end homelessness. In Opening Doors, we set forth bold, measurable goals: end Veteran homelessness in 2015; end chronic homelessness in 2015; end Family homelessness in 2020; and prevent and end youth homelessness in 2020.

Since 2010, we have changed the trajectory of homelessness in this country, and have established a trend line toward ending homelessness across each of our goals.

We know now that homelessness is not an intractable problem; homelessness is a problem we can solve—and a problem we are solving.

In fact, since 2010, we’ve reduced homelessness among Veterans by a third nationwide. We’ve made significant progress ending Veteran homelessness because we knew from years of study and research what interventions worked, and with bipartisan support in Congress, we asked for and received the resources to meet the needs.

With Veteran homelessness as a proof-point, we are making the case for our youth as well.

We have a federal framework to end youth homelessness, where we set a path to progress by improving data and building systems that connect youth the services they need.

This progress was made not by government alone, but in partnership with stakeholders from partners all across the country. We are stronger; we are effective when we work together toward the shared vision that every young person deserves a safe and stable place to call home.

Which is why I am so honored to introduce the next speaker.

She is someone I truly admire.  Her passion and dedication to who she calls ‘her kids” is an inspiration and force that is moving our work with greater urgency and focus.

Too many, she is a Grammy, Emmy and Tony award winning artist, and to thousands of young people and to people who are a part of this effort, she is an unwavering advocate for equality. In 2008, she co-founded the True Colors Fund, which works to end gay, lesbian, bisexual and transgender youth who experience homelessness.

Just a few weeks ago, I heard her speak about choosing a path for the Colors Fund, where she described the two choices for the direction of the organization: one, raise awareness of the issues and share best practices; or two, roll up your sleeves and do the hard work of ending youth homelessness.  She and her amazing team chose the latter.

One thing I appreciate about Cyndi is her emphasis on the importance of learning from young people about what matters, and how to make a difference. I am grateful that we'll get to hear from Jesse, Anthony and Syncere today. To borrow a phrase: "Nothing about us without us"

I’m honored to introduce the one and only, Cyndi Lauper.

SAMHSA Publishes New Brief on Connecting Veterans to Social Security Benefits

connecting veterans to social security disability benefits ending veteran homelessnessThe Substance Abuse and Mental Health Services Administration (SAMHSA) has published a new brief exploring Social Security benefits in the effort to prevent and end Veteran homelessness. Connecting Veterans with mainstream resources, including Social Security Administration (SSA) disability benefits, is a critical step to increasing income stability for Veterans and their families, as well as providing health insurance for those who do not qualify for Department of Veterans Affairs (VA) health care. Veterans may be eligible for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) in conjunction with, or as an alternative to, VA disability compensation. Veterans may also use the Medicaid and Medicare health benefits that come with SSI/SSDI to supplement VA health services.

Read the brief.

Read more about leveraging mainstream resources to prevent and end all forms of homelessness.

We’ve entered a new era of homelessness policy: the era of local problem-solving systems

Remarks delivered by Richard Cho, USICH Senior Policy Director, at the Arizona Coalition to End Homelessness Annual Conference in Phoenix, Arizona.

I’m so thrilled to be here with you today here in the beautiful state of Arizona and to be among colleagues and friends who are working to end homelessness.  Thank you to Joan, Mike, and all of the folks at the AZ Coalition to End Homelessness for inviting me to speak with you.

I have a very simple purpose in being here today.  And that is to deliver the message that we can and we will end the tragedy of homelessness in America.  How many of you are already true believers in that statement?  Can I have a show of hands?  Those of you who didn’t raise your hands, let’s talk.

For those of you who did raise your hands, you can count me among you.  And you can count in my boss, Laura Zeilinger, and the small but mighty staff of 20 or so people we have at USICH.  You can also count in Department of Labor Secretary Tom Perez, the current Chair of our 19 agency Council, HHS Secretary Sylvia Mathews Burwell, HUD Secretary Julian Castro, VA Secretary Bob McDonald, and the other Cabinet-level officials who make up our Council.  They are true believers as well.

And you can count in the White House as well.  Some of you may have heard earlier this year First Lady Mrs. Michelle Obama talk about how she believes that we can and must end homelessness, not only for Veterans, but for all adults and children in America. 

And you have a President who is a true believer as well.  The President frequently tells his own team at the White House that that our effort to end homelessness through Opening Doors: the Federal Strategic Plan to Prevent and End Homelessness exemplifies exactly how the Federal government should work in solving big problems:

  • By breaking down silos between Federal departments and resources
  • By using metrics to track and improve our progress and to hold ourselves accountable for the goals and commitments we set, and
  • By working to support those who are doing the real work of ending homelessness—all of you working in your own communities to help people get off the streets and into stable permanent homes and realize their full potential and dreams. 

We have no delusions that the Federal government can solve this problem on our own.  Our job is to support you.  Opening Doors is not just the Federal government’s plan; it is all of our plan.

Earlier this year, we announced that since we began implementing Opening Doors in 2010, the nation has seen a 33 percent reduction in homelessness among Veterans.  We’ve cut it down by a third.  Unsheltered homelessness among Veterans is down by 43 percent.  And of course, since not everyone believes the Federal government, I’m happy to report that Nate Silver’s Five-Thirty-Eight blog had checked the math and they say it’s true. 

Make no mistake.  That reduction is not a Federal government victory.  That is a victory that belongs to every one of you and all communities who have been working to end homelessness. And the victory is not just in terms of the numbers of Veterans sleeping on the streets or in shelters, but about a victory over hearts and minds.

Let me tell you, what you have done here in Phoenix to end chronic homelessness among Veterans has changed everything. It has changed minds around the country that ending homelessness is not a pie-in-the sky dream, but something we can achieve. 

Even if you don’t work directly with Veterans, this victory belongs to you.  All of the solutions we’ve been using to drive a reduction in homelessness among Veterans in the last four years are the same solutions that we’ve been putting into place to end homelessness for all populations—Housing First, permanent supportive housing, rapid re-housing—solutions and technologies that were invented, refined, and implemented over the past decade or more by all of you.  So I want you all to take a moment and picture that downward trend line on homelessness among Veterans in your minds and I want you to reflect on the part you played in that. 

The progress we’ve made on Veterans is our proof-point that ending homelessness is possible for all populations. 

It shows what happens when we collaborate—certainly at the Federal level but also with the State and local levels and with the private and non-profit sectors—to solve problems together. 

It shows what happens when you invest in the right kinds of solutions.  When you take the latest of what we know works to end homelessness, and not only apply it, but also bring these solutions to scale in a rapid timeframe.  Think about it.  We’ve seen a six-fold expansion in permanent supportive housing through the HUD-VASH program in four years.  We’ve seen a fourteen-fold increase in rapid re-housing in five years.  Imagine what we could achieve if we had that kind of scaled investment for all populations?

The progress on Veterans also shows what happens when you take a traditional health care and benefits system (the VA) and charge them to also take responsibility for ensuring that none of their clients becomes or remains homelessness. And that to me is the really exciting thing.  When preventing or responding to homelessness becomes core to the mission of mainstream health care and other public systems, that’s when homelessness will be a thing of the past.

Now it is not lost on me that we are here in Phoenix and that the VA has faced some challenges recently.  Last week, Laura and I had the chance to sit down with VA Secretary McDonald. He told us that while he is fully focused on fixing the access issues at the VA, the work of ending homelessness among Veterans is absolutely one of his top priorities.  In fact, he doesn’t see this work as separate from fixing access issues, but as central to them.  Ending homelessness among Veterans is mission critical to improving access to VA health care and services. 

When I hear statements like these, and as I look across the country at what is happening in communities, it makes me think that we have entered a new era—the next phase—in the evolution of homelessness policy.  That is the era of systems.  Local problem-solving systems.

Those days when the response to homelessness was just about responding to basic needs and managing the symptoms are long behind us.  So are the days when we thought moving people from one step to another in a long series of therapeutic programs. 

We’ve learned that what it takes to end homelessness is first and foremost about housing—permanent housing. And we learned that everyone—no matter how complex their health and behavioral health challenges—can achieve stability in permanent housing.  We learned that it just takes different types and levels of help for people to achieve that stability.  No one is hard-to-house or hard-to-engage.  It’s just that we needed the right tools.  And we needed to make sure that we were putting the right tools to the right problems.

We’re learning now that just operating even great programs is also not enough.  Even the best programs achieving the best outcomes will not end homelessness on their own.  A bunch of isolated virtuosos playing their own beautiful melodies in a room does not a symphony make. 

The communities that are making the greatest progress on ending homelessness are those where those programs are working as a part of a system of programs, where programs working in concert as part of coordinated system that:

  • Rapidly detects and identifies people experiencing or at-risk of homelessness
  • Prevents homelessness wherever possible
  • Quickly connects people to permanent, stable housing with access to appropriate supports,
  • And while stable permanent housing is being secured, people are given access to safe shelter and emergency services. 

The next phase of our work to end homelessness is to build local problem-solving systems for ending homelessness.

Building these systems to end homelessness means taking the Housing First concept from the individual program level, to Housing First as a whole system orientation.  Where a coordinated set of programs is working together, planning together, talking together to rapidly and without barriers or preconditions deliver the right kind of housing and services that help people achieve stability in permanent housing.

Thinking of Housing First as a whole system orientation takes us away from those fights that we used to have.  You know what I’m talking about.  Those fights between whether we need more shelter or housing.  Whether your program or my program should get to apply for Continuum of Care funds.  When a community comes together to work as a single system, those decisions get made together.  And they get made on the basis of outcomes and measure and data.  They get made on the basis of whether or not you are meeting your primary outcomes of connecting people to permanent housing quickly, ensuring that people stay in housing, and people don’t come back to homelessness.

Now the Federal government cannot create local systems for ending homelessness.  That work happens at the community levels and through the efforts of people like you in this room.

Our job is to provide the resources, the tools, and the guidance on how to use those resources and tools to support your efforts.  And to remove the bureaucratic obstacles to using those resources and tools.  

At the Federal level, we are already engaged in the work of supporting the creation of local systems to end homelessness premised on Housing First principles. 

We are doing that for Veterans through the collaboration between USICH, VA and HUD.  With HUD-VASH, SSVF, and other programs both within the VA and outside the VA, the programs are in place.  Our attention must turn to how we can engage all public and private resources and stakeholders to work collaboratively to identify and engage Veterans experiencing homelessness and connect them to these programs.  The VA’s 25 Cities effort is supporting communities to implement coordinated entry systems and housing delivery systems.  I know Phoenix and Tucson are in the house.   They are doing great work through this effort.  We can and must take the lessons of this work beyond the 25 communities.

We are doing it for families.  Earlier this year, we issued a simple blueprint known as Family Connection for how to create the systems we need to end family homelessness.  It talks about investing in and providing tailored interventions like permanent supportive housing, rapid re-housing, and affordable housing.  It talks about coordinated assessment as a way to target those interventions.  It also talks about the use of evidence-based practices that improve educational outcomes and well-being for children, and to strengthen family functioning and parenting. It talks about connecting to mainstream and community-based services.  We are working to leverage mainstream housing and services resources like Housing Choice Vouchers, Multifamily housing, TANF, Community Services and Social Services Block Grants, Head Start, the list goes on.  There are myriad Federal programs that can provide housing and services to families. 

We are building the foundation we need to build systems that can end homelessness for youth—a population that we are still learning more about and learning the different interventions and solutions that they need. 

And we are working on helping communities build the systems to permanently end the costly and tragic cycle of chronic homelessness.

Let me pause for a moment and say that I believe that there has never been a better moment than the present to build the systems that will end chronic homelessness.

The Affordable Care Act gives us the tools that make it possible to ensure that people experiencing chronic homelessness are provided with the wrap-around supportive services in permanent supportive housing that can end their homelessness, improve their health outcomes, and save taxpayer dollars.  In states like Arizona, the expansion of Medicaid coverage means that nearly all individuals experiencing chronic homelessness will be eligible for Medicaid.  And that is great.  But without connection to the right kinds of supports, we know that people experiencing chronic homelessness tend to use emergency rooms, inpatient hospital services, and acute care—and will drive up Medicaid costs.  On the other hand, we know that supportive housing improves health while lowering costs.  By financing the supportive services in supportive housing, Medicaid can help bring supportive housing to scale—at least on the services side of the equation—while achieving their goals of cost containment.

In the same way that we have made ending homelessness a core part of the mission of the VA health care system, we have the opportunity to make supportive housing a standard Medicaid benefit for people with chronic health conditions who experiencing homelessness.  Think of that.  A world in which the mainstream health care system does everything in its power to prevent and end homelessness simply because it knows that doing so will achieve better health and lower costs.

The week before last, HHS released some long-awaited guidance that clarifies and makes a clear statement that the services in permanent supportive housing are services that states can absolutely cover in their Medicaid plans.  And this includes not just the primary care and behavioral health services, but also the critical tenancy, pre-tenancy, and move-in supports that we know make all of the difference for people experiencing homelessness.  The decision on whether and to what degree and how to pay for those services are covered remains with States.  But States have a variety of options whether through things like the 1915i Home and Community Services option, Medicaid Health Homes, through 1115 waivers, or through managed care.  

I firmly believe that we are on the verge of many states fully embracing permanent supportive housing as part of their Medicaid plans and strategies.  And when that happens, we’ll have solved one-half of the equation for how to bring permanent supportive housing to scale.  That leaves the housing side.  We’ve been working with HUD to expand the housing side of PSH through reallocations, through the better targeting of existing units, and through the $40 million permanent supportive housing bonus and other strategies.  However, even with these strategies, we’ve determined that nationally we need another 37,000 units of permanent supportive housing to end chronic homelessness in 2016.  And we are asking Congress to fund a $301 million increase in HUD’s budget to meet that gap.  Thus far, they have not responded to this request, but it is not over.  We need Congress to understand that these resources are critical to ending chronic homelessness, as well as to put taxpayer dollars to better use.  The cost of doing nothing is not nothing.  Ending chronic homelessness is not only the right thing to do, it is also the fiscally smart thing to do.

Meanwhile, we are also working with HUD and SAMHSA to encourage and support community-level efforts to pursue assertive and persistent outreach and in-reach to identify and engage individuals experiencing chronic homelessness who have complex conditions and systematically connect them to permanent supportive housing. 

I know it’s hard to see sometimes what is coming out of Washington.  I can tell you that we are working at a furious pace to provide the guidance, resources, and information you need to build the systems to end homelessness for all.  Whether that is on how to use Medicaid to finance services in supportive housing, how to leverage TANF for rapid re-housing, how to engage PHAs to collaborate on homelessness or make decisions about what CoC-funded programs to reallocate.  And I want to hear from you what other support you need.

Because ultimately, it is you who are doing the hard work of ending homelessness.  It is you who ultimately need to build the systems of response that will signify an end to homelessness.

Whether you are a housing provider, a shelter provider, a behavioral health agency, a case manager, a peer support specialist, an executive director, or a local government official, you must now also think of yourselves as systems designers, systems engineers, and systems participants.  This means realizing the inherent interdependence and interconnectedness of your work.  You are inextricably linked.  That what decisions you make, the actions you take, the way you operate your programs all impact your colleagues and fellow organizations and homelessness overall.  Just like a symphony, if one instrument is out of tune or plays the wrong note, it can sour the whole piece. 

As systems designers, you take on new responsibilities and new challenges.  Those of you grappling with the development of coordinated entry systems know what I mean.  You now face questions about how to create a coordinated and streamlined means of accessing help without creating unnecessary bureaucracy and closing doors.  You now face questions about how to effectively target interventions to the right people, and how to assess people in a way that is uniform and standardized across programs, but do so in a way that is not rigid and robotic, or that overly simplifies the complexity of a person’s needs and strengths. 

You are grappling with what has been called the integration-fragmentation paradox.  That the more integrated a system becomes internally, the more fragmented it tends to become from other systems.  In other words, how do you create a coordinated system for ending homelessness that doesn’t become yet another silo alongside the health care silo, the child welfare silo, the workforce silo and so on? 

As much as we are working to get the response to homelessness to be more coordinated, we must not make the homeless response system another silo.   Let’s remember that homelessness is the result of fragmented systems in the first place.  It results from the failure of multiple systems to adequately address needs of people experiencing homelessness.

The solution to homelessness is not to create yet another silo but to weave together homeless programs seamlessly with mainstream and other public systems.  The solution to homelessness is not to create a separate system and silo, but to weave together homeless programs seamlessly with other public systems to wrap around the needs of people, and not the other way around.

Coordinated entry systems provide a locus for doing just that.  Coordinated entry is a way to bring programs and services and systems to the client.  It is about creating a rapid and streamlined housing and services delivery system to people, tailored to their individual needs and strengths.  It is a way for homeless programs to interface with Medicaid and TANF and behavioral health and corrections and schools and the workforce system and child welfare.   It is not about creating yet another door, yet another place where people must undergo a lengthy assessment, yet more bureaucracy. 

I will be honest with you that a lot is expected of you.  We are expecting you to design your systems to a standard that few other sectors have met.  Certainly the mental health system has not met the standard of creating streamlined access or being not fragmented from other systems.  Certainly the mainstream health care sector has not figured this out.  Child welfare, corrections, housing, education—none of them have gotten all of this right.

What I think you have going for you that sets you apart from other systems and which gives me hope that you/we will get this right is that the response to homelessness has always been a cross-sector partnership.  Aside from a handful of places, there is no single local or state government agency responsible for homelessness.  Instead, the work has always been led by non-profits, working alongside government partners and the private sector.  Those of you working to end homelessness have always collaborated.  Previously out of sheer necessity—because you didn’t have the resources to do it all—and now because you know that is the way to solve the problem.  The work of ending homelessness is, when done right, a case study in collaborative governance. 

That gives me faith.  I have faith that you can build the systems of programs needed to end homelessness. I have faith that you can build those systems in a way that always keeps the people at the center.  I have faith that working together, we can end homelessness, first for Veterans and then for all.  You have the tools and the know-how and we are fighting to give you the resources you need.   Now is the time to prove that ending homelessness is a reality.  Phoenix stuck a big flag in the ground with its work on ending chronic homelessness among Veterans.   

You are one big symphony playing one of the most moving and important pieces of our lifetime.  Your sheet music are your goals.  The notes and measures are your data and metrics.  Your instruments are your programs, your know-how, and your compassion.  It will be a masterpiece.  

Permanent Supportive Housing Bonus in FY 2014 HUD CoC Program: Strategies for Rapid Implementation

In this webinar short, USICH Senior Policy Director Richard Cho provides an overview of the $40 million bonus included in the FY 2014 CoC Program Competition. HUD has set aside this funding to create new dedicated permanent supportive housing to serve people experiencing chronic homelessness.

HHS Releases Two New Reports on Using Medicaid to Cover Services for People in Permanent Supportive Housing

The U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) today released two new reports: Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants of Permanent Supportive Housing (http://aspe.hhs.gov/daltcp/reports/2014/PSHprimer.pdf), and a companion document, Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field (http://aspe.hhs.gov/daltcp/reports/2014/EmergPrac.pdf).

The reports serve as tools for States and communities working to expand services and supports for people in permanent supportive housing.  While they focus on services for people experiencing chronic homelessness, the options highlighted in the Primer can be used by States to increase the role of Medicaid in providing supportive services to any individual who requires supportive services to achieve housing stability and improved health and well-being.

The Affordable Care Act creates unprecedented opportunities for health and behavioral health coverage for people experiencing homelessness. Through both the expansion of Medicaid coverage and new opportunities for care coordination such as through the new Health Home option, all States have the opportunity to increase Medicaid’s role to serve individuals experiencing homelessness. Some States and communities have already led the way in designing innovative Medicaid programs to serve individuals experiencing homelessness and formerly homeless individuals through permanent supportive housing, a proven and cost-effective intervention for ending homelessness, improving health, and lowering public costs.

As the Medicaid program evolves to meet the needs of its beneficiaries, new policy and clarifications of existing policy will be made subsequent to the publication of this Primer. These will be disseminated through State Medicaid Directors’ Letters and through other guidance which will be available on the Centers for Medicare and Medicaid website at cms.hhs.gov.  Stay tuned for fact sheets and briefs from USICH and its partners that will help States, community health centers, supportive housing provider organizations, and organizations serving Veterans understand the options outlined in these documents.

Assets Summit

these are documents for the Partnship Summitt 10/16/14

VA Announces $93 Million Available for SSVF Program

The Department of Veterans Affairs (VA) is announcing the availability of funds for supportive services grants under the Supportive Services for Veteran Families (SSVF) Program. This Notice of Funding Availability (NOFA) contains information concerning the SSVF Program, initial supportive services grant application processes, and the amount of funding available. Awards made for supportive services grants will fund operations beginning approximately March 1, 2015, through February 28, 2018.

The overriding goal for this NOFA is to ensure that appropriate levels of resources are provided to communities with the greatest need to end Veteran homelessness. VA will provide approximately $93 million over a 3-year period for non-renewable grants to eligible entities proposing services for one of 28 priority Continuums of Care. VA has designed this 3-year effort to provide a surge of resources in communities with the highest need. These 28 locations have been selected based on factors that include levels of Veteran homelessness and current unmet service needs.

For more information visit: https://www.federalregister.gov/articles/2014/10/10/2014-24281/funding-availability-under-supportive-services-for-veteran-families-program 

New HUD and VA Funding Will Connect 9,000 Veterans to Permanent Housing

The U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Veterans Affairs (VA) today announced more than $62 million to help more than 9,000 homeless Veterans find permanent supportive housing.  The rental assistance announced today is provided through the HUD-Veterans Affairs Supportive Housing (HUD-VASH) Program, which combines rental assistance from HUD with case management and clinical services provided by VA. See the local impact of the housing assistance announced today.

HUD is awarding $57 million to support 8,276 Tenant-Based Vouchers for rental units in the private market, and $5 million for 730 Project-Based Vouchers (PBV) for existing units or new construction in specific developments. HUD-VASH is an important part of the Obama Administration’s efforts to provide critical housing and services to Veterans experiencing homelessness that also includes HUD’s Continuum of Care program as well as VA’s Supportive Services for Veteran Families (SSVF).

Since 2008, more than 59,000 vouchers have been awarded and over 74,000 homeless veterans have been served through the HUD-VASH program. 

Read the full release.

VA Announces New Grants to Help End Veteran Homelessness, Initiative Targets 70,000 Veterans and Families in High Need Communities

In addition to the $300 million in Supportive Services for Veteran Families (SSVF) program grant awards announced on August 11, 2014 serving 115,000 Veterans and their family members, today Secretary of Veterans Affairs Robert A. McDonald announced the award of $207 million in SSVF grants that will help an additional 70,000 homeless and at-risk Veterans and their families. The grants will be distributed to 82 non-profit agencies and include “surge” funding for 56 high need communities.

During the brief history of this program, VA has helped tens of thousands of Veterans exit homelessness and prevented just as many from becoming homeless. The “surge” funding will enable VA to strategically target resources to high need communities where there are significant numbers of Veterans who are homeless or at-risk of homelessness.

“With the addition of these crucial resources, communities across the country continue a historic drive to prevent and end homelessness among Veterans,” said Laura Green Zeilinger, Executive Director of the U.S. Interagency Council on Homelessness.  “The SSVF program gives Veterans and their families the rapid assistance they need to remain in permanent housing or get back into permanent housing as quickly as possible.”

Read the full release.

HUD FY2014 Continuum of Care Program Competition: Strategies for Continued Success

On September, 19, 2014, USICH hosted a webinar for communities on strategies for continued success in responding to The Notice of Funding Availability (NOFA) for the Fiscal Year (FY) 2014 Funds in the FY 2013 - FY 2014 Continuum of Care (CoC) Program Competition (FY 2014 CoC Program Funding Notice).  

Through this competition, HUD will award $1.83 billion in funds for FY 2014. The FY 2014 CoC Program Funding Notice carries forward and continues the policy priorities outlined in combined FY 2013-FY 2014 CoC Program Competition NOFA, which are focused on accelerating progress on Opening Doors: Federal Strategic Plan to Prevent and End Homelessness.  

This funding Notice includes a number of new important changes and considerations unique to the FY 2014 funding round.  No CoC application is required for this competition; CoCs will only need to include project applications and rankings. In addition, HUD is setting aside approximately $40 million for a funding bonus to create new dedicated permanent supportive housing to serve people experiencing chronic homelessness. Although all CoCs approved in the FY 2014 CoC Registration process may apply, priority will be given to those CoCs that have a high need in relation to chronic homelessness as described in the funding Notice.

Participants in our webinar learned about the results of the FY 2013 competition, the unique aspects of the FY 2014 CoC Program funding competition, the permanent supportive housing bonus to serve people experiencing chronic homelessness, and tips for reallocations and prioritization.

Presenters:

Richard Cho, USICH
Lindsay Knotts, USICH

VA seeks nominations for Advisory Committee on Homeless Veterans members

The Department of Veterans Affairs (VA), Veterans Health Administration (VHA) Homeless Programs, is seeking nominations of qualified candidates to be considered for appointment as a member of the Advisory Committee on Homeless Veterans (herein-after in this section referred to as “the Committee”). In accordance with 38 U.S.C. § 2066, the Committee provides advice to the Secretary, through the Under Secretary for Health, on the provision of benefits and services to homeless Veterans. In providing this advice, the Committee assembles and reviews information relating to the needs of homeless Veterans; provides an ongoing assessment of the effectiveness of the policies, organizational structures, and services of VA in assisting homeless Veterans; and provides ongoing advice on the most appropriate means of providing assistance to homeless Veterans.

Nominations for membership on the Committee must be received no later than 5:00 p.m. E.S.T. on September 30, 2014.

For more information visit:  https://www.federalregister.gov/articles/2014/08/11/2014-18932/solicitation-of-nominations-for-appointment-to-the-advisory-committee-on-homeless-veterans

USICH Internships

Location: 1275 First Street NE, NoMA/Gallaudet, Washington, D.C.; position with National Initiatives Team may be based elsewhere within the Pacific Time Zone

Start Date/Duration: Rolling basis, year round

Salary: $10/Hour

Description of Responsibilities:

The mission of the U.S. Interagency Council on Homelessness (USICH) is to coordinate the Federal response on homelessness and to create a national partnership at every level of government and with the private sector to reduce and end homelessness in the nation while maximizing the effectiveness of the Federal Government in contributing to the end of homelessness. Currently USICH is implementing Opening Doors, the first-ever Federal Strategic Plan to Prevent and End homelessness as the Administration’s response to this important issue. USICH is comprised of 19 Federal agencies and entities and currently chaired by Department of Labor Secretary Thomas Perez.

USICH is seeking interns to support its work on behalf of the nation’s efforts to end homelessness. There are currently multiple intern positions available across the various teams at USICH, including our Policy, National Initiatives, Communications and Executive Office Teams. Assignments may include but are not be limited to:

  • Researching and compiling of information, statistics, studies, etc. on housing related issues;
  • Coordinating activities, meetings, forums and USICH initiatives with Federal, State, local and private stakeholders around the U.S.;
  • Supporting essential administrative assignments related to document and correspondence preparation, answering calls, facilitating webinar and conference calls and responding to general questions of a non-policy nature;
  • Tracking and analyzing appropriations, authorizing and other legislative developments;
  • Data analysis and assessment of resource implications of policy decisions;
  •  Analysis of federal programs, policies, and procedures as they relate to the Federal response to homelessness-related issues;
  • Writing and editing a variety of publications, presentations, technical assistance materials, and other documents related to the work of USICH;
  • Compilation of content for website; website management; and,
  • Special projects, as assigned.
  • Internships at USICH offer exposure to a range of USICH work ranging from key policy decisions to local and State-level implementation of Opening Doors. Work may involve contact with senior personnel at Council member and other government agencies, congressional staff, and the housing industry. 

Experience:

Applicants must be self-starters who are flexible, able to balance multiple competing tasks, work well under tight deadlines, and have excellent organizational skills. Additionally, applicants must have the ability to perform research, think critically, write succinctly, manage multiple deadlines, and work both independently and in a team-based environment. Position requires knowledge of Microsoft Office products and professional English writing and grammar conventions.

Domestic policy knowledge and/or experience, particularly related to housing, homelessness and/or health care, is a plus but not required. Experience with/knowledge of (USICH member) federal agencies’ events process and organizational structures a plus. USICH internships are designed for graduate students; however, high-performing undergraduate students with experience in healthcare, housing, homelessness, public policy and administration and strategic communication are urged to apply. 

How to Apply:

If interested, contact jobs@usich.gov. With your inquiry, please include a cover letter which includes your availability and resume.

Positions open until filled.

USICH is an Equal Employment Opportunity employer. This position requires a background check. Direct Deposit is mandatory. This is a federal government, excepted service (Schedule A) position, open to all candidates with or without prior federal government experience.

Family Connection Webinar: Tailored Interventions and Assistance

Ending homelessness among families and children is a priority for the nation and for every community. Millions of extremely low-income households do not have access to affordable housing, putting them at-risk of housing instability and the types of crises that can result in homelessness. The challenge is clear: Our most recent data show that 222,197 people in families—an estimated 70,960 households—were experiencing homelessness on a single night in January 2013.  In the first three years of implementation of Opening Doors, we have reduced homelessness among families by eight percent.

On September 10, 2014, two community partners, Memphis, TN-based Community Alliance for the Homeless, Inc. and Northern Virginia Family Service, joined USICH and HUD on a webinar to share examples of how they are using a range of resources and program models to better serve families in need of a safe and stable place to call home. Panelists discussed their most effective strategies for helping to lift families out of homelessness, as well as prevention methods that help avert housing crises.

The webinar, “Family Connection: Tailored Interventions and Assistance,” is the second in a series, based around the guidance in the resource, Family Connection: Building Systems to End Homelessness. Click on the webinar materials on the right to download. 

Stay tuned for information about the next Family Connection webinar, and be sure to tweet us at @USICHgov to let us know your most pressing questions about ending family homelessness in your community.

USICH, HUD, and VA Announce 33% Drop in Veteran Homelessness Since 2010

USICH, HUD, and VA released new national estimates today that show Veteran homelessness has declined 33 percent since 2010 and the release of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness. Data from the Point-in-Time count conducted in January 2014 shows that 24,837 fewer Veterans are homeless today than in 2010. This includes a nearly 40 percent drop in the number of unsheltered Veterans sleeping on the street.

 “As a nation, we have proven that homelessness is a problem we can solve,” said USICH Executive Director Laura Green Zeilinger. “Communities all across the country are meeting this costly tragedy with urgency and a focus on helping all Veterans and their families achieve safe and stable housing.”

 The Federal government has provided significant new resources to help communities pursue the goal of ending homelessness among Veterans. Communities that target these resources strategically are making significant progress and can end Veteran homelessness in their communities in 2015. These strategies include Housing First, permanent supportive housing, rapid re-housing, and aligning local goals and strategies with Opening Doors.

 Read the full press release.

VA Announces $300 Million in Grants to Help End Veteran Homelessness

Secretary of Veterans Affairs Robert A. McDonald today announced $300 million in grants that will help approximately 115,000 Veterans and their families who are experiencing homelessness, or are at risk of it. The grants, issued under the Supportive Services for Veteran Families (SSVF) program, will be distributed to 301 community agencies in all 50 states, the District of Columbia, Puerto Rico and the Virgin Islands.

Under the terms of the grants, service providers will offer Veterans and their family members outreach, case management, assistance in obtaining VA benefits, and assistance in receiving other public benefits. Community-based groups can offer temporary financial assistance on behalf of Veterans for rent payments, utility payments, security deposits and moving costs.

Read more.

Partnerships for Opening Doors Summit

   

   

On October 16 2014, a national summit on integrating employment and housing strategies to prevent and end homelessness —Partnerships for Opening Doors —was sponsored and hosted by the Butler Family Fund, the U.S. Department of Labor (DOL), the U.S. Department of Housing and Urban Development (HUD), and the U.S. Interagency Council on Homelessness (USICH). The Summit provided an opportunity for communities, federal government agencies, and national organizations to learn together to identify promising program practices, emerging community practices, and common misconceptions and barriers to using federal funding to support these practices. The Summit identified key activities that DOL can undertake in the near term that could improve access to quality jobs, skills training, and supportive services in the context of employment, training and career pathways for those experiencing homelessness.

Read a writeup on the Summit by USICH Management and Program Analyst Peter Nicewicz. 

See more photos from the Partnerships for Opening Doors Summit.

July 2014 Council Meeting Update

Council Focuses on Leveraging Mainstream Resources, Discusses an Amendment to Opening Doors, and Elects New Leadership

On July 18, 2014, HUD Secretary and Council Chair Shaun Donovan convened Council agencies for the second meeting of 2014.  Council agencies discussed efforts to leverage Federal mainstream resources in the areas of housing, employment, income supports, education, and health care to end homelessness.  The Council also discussed the proposed amendment to Opening Doors and elected new Council leadership.

Shaun Donovan USICH Council Meeting July 18, 2014This was Secretary Donovan’s last Council meeting as HUD Secretary and as Council Chair. Secretary Donovan—now Director of the Office of Management and Budget—reflected on his encounters with homelessness from his childhood in New York City, where he noticed the explosion of homelessness on his morning walks to school, to his volunteer work at a homeless shelter in college, to his internship at the National Coalition for the Homeless. 

“I never could have imagined I would be sitting here at this table with all of you helping lead what I think has been the most comprehensive, smartest, most aggressive campaign against homelessness this country has ever seen,  culminating in a President who is actually willing to say we’re not going to just put a bandage on this problem. We’re going to end it,” said Donovan.

“That’s what’s allowed us to get to a place where we’ve lowered Veteran homelessness by 24 percent in three years, chronic homelessness by 16 percent and made progress in a range of areas with families and children at a time when frankly, given the economic circumstances, you’d expect homelessness to be exploding just like it was when I was kid. How right it feels to have my last day include this meeting.”

Council Leadership Transition

perez burwell USICH Council leadershipAs Director Donovan moves to his new role, the Council elected Secretary of Labor Thomas Perez as Chair and Secretary of Health and Human Services Sylvia Mathews Burwell as Vice Chair. Secretary Perez noted that it was an honor and that Secretary Donovan’s leadership set a high bar for the Council and the nation’s efforts to end homelessness. 

Leveraging Mainstream Resources to End Homelessness

The Council discussed progress and planned actions to increase the degree to which Federal mainstream programs and resources are being brought to bear in efforts to end homelessness—a core tenet of Opening Doors. Ending homelessness with targeted homelessness programs alone is not possible. Federal mainstream resources not specifically targeted to homelessness must also be leveraged.  Whereas the combined set of Federal programs specifically targeted to homelessness total about $5 billion in FY 2014, mainstream programs are significantly larger in scale. 

HUD’s Housing Choice Vouchers, for instance, are funded at more than $19 billion in FY 2014 and TANF is funded at over $16 billion.  Federal spending alone on Medicaid in FY 2014 is projected at almost $300 billion. These programs provide affordable housing and services that are critical to providing pathways out of homelessness.

At its July 18 meeting, the Council reviewed strategies to increase the impact of eight mainstream programs— Housing Choice Vouchers/public housing, HUD multifamily housing, workforce systems, schools and local educational agencies, Medicaid, TANF, Head Start, and Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI).

Richard Cho, USICH Senior Policy Director and Judith DeHaven, Director, Program Support Division, Office of Public and Indian Housing at HUD, presented these strategies to the Council, describing how agencies are using available policy tools to increase access to programs and services for people experiencing homelessness.

“We know that leveraging mainstream programs for homelessness is not simple,” Cho explained, noting that mainstream programs typically have broad mandates and purposes, high levels of state and local discretion in prioritizing resources, and many competing demands. Even with these constraints, federal agencies can encourage state and local systems to use these resources to assist people experiencing homelessness.  Specifically, Federal agencies are pursuing efforts in six categories:

  • Bright spotting” to identify innovative and promising policies and practices that can be replicated widely
  • Issuing guidance to clarify what systems can do to better serve people experiencing homelessness, or creating incentives in funding solicitations and other vehicles
  • Provide clear messaging from agency leadership encouraging mainstream systems to focus on people experiencing homelessness
  • Providing technical assistance and tools to state and local systems on how to modify their programs, adopt new policies and form partnerships to better serve people experiencing homelessness
  • Engaging industry trade groups and associations to champion the issue among their members, disseminate resources and highlight promising practices
  • Partner with national experts to advise and assist with engagement efforts

Council agencies looked to HUD’s work to engage public housing agencies as an example of what federal agencies can do to leverage mainstream resources. DeHaven described how HUD has been able to promote greater access to Housing Choice Vouchers and public housing, increasing new admissions among people experiencing homelessness significantly over a short period of time. DeHaven said constant messaging from senior leadership to HUD staff further reinforced their efforts to promote these strategies.

Building on this example, HUD, the Department of Health and Human Services (HHS), the Department of Labor (DOL), the Department of Education (ED), and the Social Security Administration (SSA) developed related strategies for multifamily housing, Medicaid, workforce systems, schools, Head Start, and income supports. The Council adopted the strategies and will review progress on them in the coming months.

Along with leveraging mainstream resources, using existing targeted homelessness assistance resources more strategically is critical to ending homelessness. Scarce resources must be used strategically and should target people who are the most vulnerable. USICH has created this tool to help communities assess the strategic value of their Continuum of Care (CoC) funding, as well as to help identify mainstream funding alternatives that will allow CoC resources to stretch even farther.

Services in the CoC Program: Assessing Value and Finding Funding Alternatives

Amending Opening Doors

Council agencies discussed also the proposed amendment to Opening Doors.  USICH Executive Director Laura Zeilinger explained that Opening Doors remains the right plan with the right set of strategies. When the plan was launched in 2010, it was presented as a living document, informed by the most current information and evidence on what works.

“Over the past four years of implementation, we have learned much about the role of health care in ending homelessness,” Zeilinger explained. “We also learned about what effective crisis response systems look like and how communities can harness data to end homelessness.” 

In addition, while the nation has made progress on ending chronic homelessness, the lack of Congressional support for needed resources means we will not reach our goal to end chronic homelessness in 2015. “If Congress acts to fund the President’s Fiscal Year 2015 Budget requests for 37,000 new units of permanent supportive housing, we can bring the national inventory of permanent supportive housing to a scale that will end chronic homelessness in 2016 and prevent its recurrence.”  Accordingly, USICH proposes amending the goal to 2016, with the explicit acknowledgment that achieving that goal would be contingent on appropriations. 

USICH is seeking broad stakeholder input into the proposed amendment to Opening Doors. Already, hundreds of stakeholders from across the country have either participated in a community input session or have shared their ideas through an online forum.  We urge you to participate in this process. 

HUD and USICH: Core Principles of Housing First and Rapid Re-Housing Webinar

The U.S. Interagency Council on Homelessness (USICH) and the U.S. Department of Housing and Urban Development (HUD) recently hosted "Core Principles of Housing First and Rapid Re-Housing," a webinar designed for homelessness service providers, communities, and policymakers to understand the core components of the Housing First approach and the Rapid Re-Housing model and how both work together to help end homelessness.

Background

Housing First is a whole-system orientation, and not a "program," that offers permanent, affordable housing as quickly as possible for individuals and families experiencing homelessness, and then provides the supportive services and connections to the community-based supports people need to keep their housing and avoid returning to homelessness. The approach begins with an immediate focus on helping individuals and families get housing. Income, sobriety and/or participation in treatment or other services are not required as a condition for getting housing. All services are voluntary and are not a condition for retaining housing. Housing provides people with a foundation from which they can pursue other goals. Tenants are assisted in developing or improving skills for independent living while they live in permanent housing instead of requiring them to complete a transitional residential program first.

Rapid Re-Housing is the practice of focusing resources on helping families and individuals quickly move out of homelessness and into permanent housing, which is usually housing in the private market. Services to support rapid re-housing include housing search and landlord negotiation, short-term financial and rental assistance, and the delivery of home-based housing stabilization services, as needed. Priority is placed on helping individuals and families move into permanent housing as rapidly as possible and providing services to help them maintain housing. Rapid re-housing has demonstrated effectiveness in reducing homelessness, particularly among families. Rapid re-housing also increases turnover in shelters, which allows them to accommodate more families without increasing capacity.

Both work together to ensure that occurrences of homelessness are rare and brief, help people obtain permanent housing quickly and connect people with the care and support needed to maintain their housing and achieve a better quality of life.

Speakers

Richard Cho, USICH

Ann Oliva, HUD

Lindsay Knotts, USICH

Mayors Challenge Included in President’s Year of Action Progress Report

The President's 2014 Year of Action Progress Report Includes Mayors Challenge to End Veteran Homelessness

After declaring 2014 a "Year of Action," the White House released an updated progress report today detailing the more than 40 actions that the President and his Administration have taken since January to build expand opportunities for Americans — among them being the Mayors Challenge to End Veteran Homelessness announced June 4. The initiative seeks public commitments from local leaders to use federal and community resources to end homelessness among Veterans by the end of 2015. To date, more than 111 governors, mayors and county officials have pledged. Learn more about the Mayors Challenge by clicking here.

Read the President's report

CNCS Will Issue $11 Million through Social Innovation Fund Pay for Success Grants Competition

The Corporation for National & Community Service announced that the 2014 Social Innovation Fund (SIF) Pay for Success (PFS) Grants Competition will provide up to $11.2 million in grants to nonprofit organizations and city and state governments seeking to advance and evaluate emerging models that align payment for social services with verified social outcomes.  The PFS Competition intends to encourage the implementation of PFS projects to enhance the reach and impact of innovative community-based solutions in low-income communities. States and communities are pursuing PFS strategies supporting interventions to address a number of social challenges, from health interventions to chronic homelessness.corporation for national community service

As part of the PFS Competition, each grantee will be awarded between $200,000 and $1,800,000 each year over the three year project period. Every SIF grant dollar must be matched by the grantee with nonfederal dollars and services. Applicants should send a Notice of Intent to Apply by July 15, 2014. Applications are due July 31, 2014 at 5 p.m. EST. 

VA to Award $5 Million in Grants to Aid Veterans with Special Needs Who Are Experiencing Homelessness

The U.S. Department of Veterans Affairs (VA) today announced that it is renewing $5 million in funding available to 25 organizations in 11 states that provide transitional housing and supportive services to Veterans with special needs who are experiencing homelessness. Grant and Per Diem Program (GPD) Special Need Grants allow organizations to continue providing housing and services to Veterans experiencing homelessness, including women, frail elderly, terminally ill, chronically mentally ill and individuals who care for minor dependents.

 “We will continue our work until no Veteran has to sleep on the streets,” said Acting VA Secretary Sloan Gibson. “We have made significant progress toward our goal to end Veterans’ homelessness.  That progress would not have occurred without the important work of GPD Special Need grantees and other local partners.” 

 VA’s Homeless Providers Grant and Per Diem Program provides funds to community agencies that provide services to Veterans experiencing.  The program promotes the development and provision of 

The Notice of Funding Availability for the GPD Special Need is available at www.va.gov/homeless/GPD.ASP. The deadline for submitting proposals will be July 16, 2014.

U.S. Department of Labor Awards $36 Million in Job Training Grants for Veterans Experiencing Homelessness

U.S. Secretary of Labor Thomas E. Perez announced $36,710,368 in grants awarded to 156 organizations to provide job training to more than 12,000 Veterans who are experiencing homelessness. The grants are being awarded under the department's Homeless Veterans' Reintegration Program (HVRP), administered by the Veterans' Employment and Training Service (VETS).

"These job training programs will provide the skills that Veterans require to find and keep a job and secure housing," said Secretary Perez. "The progress made in recent years to reduce Veterans homelessness is encouraging, but it remains our moral duty to do all we can to honor our Veterans with the dignity of a good job and opportunities to build a solid middle-class life for their families."

The grants include $9,094,355 in funding for 37 new grantees to help connect Veterans with employers, who will help identify the skills needed for in-demand jobs and careers. They will also provide job placement, career counseling, life skills and money management mentoring, as well as help in finding housing. VETS estimates that these new funds will help approximately 3,000 Veterans.

For more information, including a list of grantees, visit: http://www.dol.gov/opa/media/press/vets/VETS20141224.htm

HUD Provides Additional Funds for nearly 900 Local Homeless Programs across the Country

WASHINGTON – U.S. Housing and Urban Development (HUD) Secretary Shaun Donovan today announced a second round of grants totaling $140 million to nearly 900 local homeless assistance programs across the country (see attached chart). Provided through HUD’s Continuum of Care Program,  the funding announced today will ensure additional permanent and transitional housing renewal projects are able to continue operating in the coming year, providing critically needed housing and support services to those persons and families experiencing homelessness.

Today’s grant announcement includes 436 new local projects aimed at providing permanent supportive housing for persons experiencing chronic homelessness through a Housing First approach and to “rapidly re-house” families with children that are living on the street or in emergency shelters.  View a complete list of all the state and local homeless projects awarded funding.

“Communities all across the country are changing their approach to reducing homelessness and now is not the time to retreat from doing what we know works,” said Donovan.  “Investing in proven strategies such as ‘Rapid Re-housing’ and ‘Housing First’ help to break the cycle of homelessness as we’ve known it in these communities.”

Read the Full Press Release

Learn More about HUD’s FY 2013-2014 CoC Program Competition

Implementing Housing First in Permanent Supportive Housing

implementing housing first in permanent supportive housing

Permanent Supportive Housing is an intervention for people who need housing assistance and supportive services to live with stability and independence in their communities. Many Permanent Supportive Housing programs use a Housing First approach (rapid access to housing with minimal preconditions) to serve people experiencing homelessness. This fact sheet describes the process for incorporating Housing First within a permanent supportive housing program. 

Read Implementing Housing First in Permanent Supportive Housing.

101,628 People Housed in Four Years through 100,000 Homes Campaign

Today on Capitol Hill, the 100,000 Homes Campaign announced it had reached its goal of connecting 100,000 people experiencing homelessness with permanent housing. In fact, the innovative campaign launched four years ago has helped welcome 101,628 people home, including 30,000 Veterans. 100,000 Homes is a movement of New York-based Community Solutions.

"Campaign communities have shown that it is possible to end homelessness quickly and permanently, even for people considered the hardest to help," said 100,000 Homes Campaign Director and former Army Captain Becky Kanis. "This is an urgent national crisis, and we are out of excuses."

Together with local businesses, foundations, government agencies, landlords, outreach workers and service providers, the campaign worked with 238 communities around the country to help find housing for people experiencing chronic homelessness and were medically vulnerable. The campaign estimates it saved taxpayers $1.3 billion that would have otherwise been spent on services like emergency room visits, detox centers, jails and psychiatric interventions.

The campaign announcement gathered partners, including USICH Executive Director Laura Zeilinger, officials from the U.S. Department of Housing and Urban Development, Home Depot Foundation Director Fred Wacker, and former Army Private First Class Alvin Hill, who became the campaign's 100,000th person connected with housing.

"By reaching this milestone, the 100,000 Homes Campaign and communities across the country are providing further proof that ending homelessness is possible," said Zeilinger. "Now is the time to harness the momentum and charge forward with greater urgency, using the evidence-based practices we know work to end homelessness—Housing First, permanent supportive housing, and rapid re-housing."

For more information about the campaign, visit www.100khomes.org and read this fact sheet.

First Lady Launches Mayors Challenge to End Veteran Homelessness

First Lady Michelle Obama Announces Mayors Challenge to End Veteran Homelessness

Watch First Lady Michelle Obama Announce the Mayors Challenge to End Homelessness - June 4, 2014

Click the image above to watch First Lady Michelle Obama announce the Mayors Challenge to End Veteran Homelessness - June 4, 2014.

 

First Lady Michelle Obama, the U.S. Department of Housing and Urban Development (HUD),  U.S. Department of Veterans Affairs (VA), and the U.S. Interagency Council on Homelessness announced today the creation of the Mayors Challenge to End Veteran Homelessness during an event at the White House.  More than 75 mayors and county and state officials across the country pledged they are committed to ending veterans homelessness in their communities by 2015 using the power of federal, local, and non-profit resources.

“With Opening Doors, the first-ever federal strategic plan to prevent and end homelessness, this Administration made ending Veteran homelessness a national priority. The progress we’ve made has put this goal in close reach,” said Laura Zeilinger, Executive Director, U.S. Interagency Council on Homelessness. “Now is the time to act with greater urgency and resolve. We call on every mayor and local leader to convene community partners, focus efforts on outcomes and instill relentless accountability to deliver on this commitment for every single one of our Veterans.”

The Obama Administration has already reduced veterans homelessness by 24 percent since 2010 and ending veterans homelessness by the end of 2015 is within reach, but we must continue to accelerate our progress to reach the ultimate goal.  The successes of ending chronic homelessness among Veterans in Salt Lake City and Phoenix have raised the profile of ending Veteran homelessness and prove that with buy-in from local officials and community partners, ending Veteran homelessness is an achievable goal.

Mrs. Obama and Dr. Jill Biden have led the Joining Forces initiative’s efforts to give our service members and their families the opportunities and support they have earned.  Find out ways you can get involved in local efforts to end Veteran homelessness in your own community.

Read the White House Fact Sheet on the Mayors Challange to End Homelessness

Read the Press Release from HUD.

Read Transcripts of First Lady's Remarks.

The State of Homelessness in America 2014 Released

The State of Homelessness in America 2014 Released

Highlighting across-the-board reductions in homelessness throughout the country, the National Alliance to End Homelessness just released The State of Homelessness in America 2014. The report is the fourth in a series that charts progress toward ending homelessness in the United States. It examines trends in homelessness between 2012 and 2013, studies populations that are at risk of homelessness from 2011 to 2012, reviews changes in the assistance available to people experiencing homelessness, and establishes a baseline from which to measure changes in the homeless assistance system enacted by the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act.

Click here to read the report.

USICH, HUD, ACF and Westat Host Webinar on Ending Family Homelessness

The U.S. Interagency Council on Homelessness (USICH), the U.S. Department of Housing and Urban Development (HUD), the U.S. Department of Health and Human Services Administration on Children and Families (HHS ACF), and Westat hosted the first in a series of webinars addressing response systems to end family homelessness and introduced Family Connection: Building Systems to End Family Homelessness, an interactive resource designed to help communities and stakeholders build and implement an effective housing crisis response system for families.

Click here to access the presentation.

Family Connection: Building Systems to End Family Homelessness

The U.S. Interagency Council on Homelessness (USICH), the U.S. Department of Housing and Urban Development (HUD), the U.S. Department of Health and Human Services Administration on Children and Families (HHS ACF), and Westat hosted the first in a series of webinars addressing response systems to end family homelessness and introduced Family Connection: Building Systems to End Family Homelessness, an interactive resource designed to help communities and stakeholders build and implement an effective housing crisis response system for families.

Background

Ending homelessness for families and children is a priority for the nation and for every community. By providing the right amount of assistance to help families obtain or regain permanent housing as quickly as possible and ensuring access to services to remain stably housed, achieving an end to family homelessness is possible.

Given the current economic realities in most communities, situations in which families experience a crisis and lose their home will likely occur. Recognizing this reality, USICH and Federal partners adopted a vision of an end to family homelessness to mean that no family will be without shelter and homelessness will be a rare and brief occurrence. To achieve an end to family homelessness, we encourage communities to join us to strengthen our local crisis response systems together.

Working together with our partners at the state, local, and federal level to strengthen the local crisis response systems, we will:

  • Ensure that no family is living unsheltered
  • Shorten episodes of family homelessness by providing resources that enable families to safely reenter permanent housing as quickly as possible
  • Link families to the benefits, supports, and community-based services they need to achieve and maintain housing stability
  • Identify and implement effective prevention methods to help families avoid homelessness

Encoding Our Future: HMIS as the Infrastructure for Social Change

Remarks delivered by Eric Grumdahl, Policy Director, at the National Human Services Data Consortium conference, Minneapolis, MN, May 2, 2014.

Eric GrumdahlThank you all for the opportunity to be with you today. I feel like I'm in a room of kindred spirits: people eager to solve complex technical problems in the service of complex social problems. Although I now work in DC, I cut my teeth on HMIS and other data systems right here in Minnesota. I'm probably the geekiest USICH director to address this conference. Thanks for having me.

As many of you probably know, USICH is a small, independent Federal agency responsible for coordinating the Federal response to homelessness across the big 19 agencies on the Council. The Council itself is composed of the heads of those agencies, with HUD Secretary Shaun Donovan serving as our Chair for 2014.

For all of you gathered together today for this conference to help us use data to solve tough social problems, I'm personally grateful for the work you are doing on homelessness and bring the greetings and appreciation of the Obama Administration with me. I know your loved ones, school buddies, and distant relatives may not really understand what you do. "Something to do with data and IT." I want you to know that this Administration does understand what you do. Thank you, for helping to build the infrastructure for social change.

Social change is never easy, is it? Only 10 years ago, the first HMIS data standards were published, and it is easy to forget that before then, most places struggled to have meaningful data to guide homelessness policy, especially locally. Only a decade ago, the data we had was often drawn from studies and research that pointed the way forward but most likely came from somewhere else and so were always prone to the objection that "yeah, but it's not like that here." 

Today, thanks to the infrastructure you build and maintain and enhance and use, most places in our nation have access to readily available, regularly refreshed local data on the magnitude and nature of the problem and the impact of our various interventions and responses. That is critical progress, but as many of you know, that is just the beginning.

Today, I want to reflect on our data about homelessness: how we've used it and how it has shaped our response to the problem; how we need to push ourselves to use it better today; and how are data and practice might evolve together. 

First, how we've used data.

Since the launch of Opening Doors in 2010, we have measured national progress on the goals of the Federal strategic plan to prevent and end homelessness using the annual Point-in-Time count and Annual Homeless Assessment Report data. The story the data tell is compelling, showing unprecedented decreases in homelessness throughout a challenging recession, with progress led by decreases in Veteran and chronic homelessness.

I'm sure most here know the statistics, but they bear repeating: since 2010, Veteran homelessness has decreased by 24 percent. That's one in four. Chronic homelessness has dropped by 16 percent. Unsheltered homelessness across all populations has decreased by 13 percent, with a 30 percent decrease among unsheltered Veterans. How this has happened is a story of courage and dedication and hard work among thousands of people who experienced homelessness and thousands more who supported them. 
It is also a story about our data. 

Let's talk about the linkages between data and investments and impact. The Federal budget is the most powerful vehicle for establishing the Administration's priorities. It is not a wish list: investments proposed in the budget telegraph both what the Administration values but also the confidence that an investment made will have commensurate impact. 

As you can probably imagine, when the Administration develops its budget, there are many, many important and worthy efforts that vie for attention and funding. Every proposal, every detail has to withstand the scrutiny not only of the Administration's best and brightest trying to eke every ounce of impact out of every dollar, it also must be ready for the scrutiny of the taxpayers, the media, advocacy groups, and the Congress itself. To do all of this, it is not enough to be good and important; big investments require strong evidence of impact.

You know that this Administration has committed to ending homelessness. Ending it, not managing it. We know that ending homelessness requires big investments. 

I say all of this because I want to convey the full meaning and weight of this fact: The President's fiscal year 2015 budget proposes the investments needed to end Veteran homelessness in 2015 and to end chronic homelessness in 2016. To end it.

A decade ago, imagining this level of investment may have strained belief. Homelessness is no more worthy or important today than it was then. One of the most important things that has changed is our data. Today, we have a track record to show of investments that have yielded impact. We have a better understanding of the problem than we have ever had. We have an ability to forecast -- that is, to quantify -- the impact of the strategies that will help us reach this bold and ambitious goal. And we have developed new, more effective and cost-efficient approaches to ending homelessness. All of that owes a debt of thanks to the data that we've assembled and that the systems you build collect, manage, and analyze that data.

These benefits of data in the context of the Federal budget also apply locally — perhaps even more so. Data help elected officials and Continuum of Care leaders who want to propose changes or investments in at least two important ways: first, data on impact and effectiveness will help us make sure that these changes are for the better. Using data to guide changes means we are following the evidence, not ideology and not inertia. Second, having strong data provides cover — political or otherwise — to help us be bold in those decisions. We have 20 months until we have committed to end Veteran homelessness. Now is a time for courageous action, not half-measures.   

All of this progress and the role that data have played in it are exciting. Let me pause now and recognize that we have not arrived. We still have a lot of work to do. 

My portfolio at USICH includes our work on Veteran homelessness, youth homelessness, and homelessness among Native Americans. Across those overlapping populations, we see huge differences in terms of access to data. VA has some of the best data available on homelessness, and a national center led by Vince Kane with Dr. Dennis Culhane as the head of research to understand what VA's data say about how to end Veteran homelessness, and how to apply it to practice. 

In contrast, our work on youth homelessness and homelessness among Native Americans routinely confronts the limits of our data, and what we know that we don't know often stymies our most earnest efforts to advance solutions. Again, remember that advocacy for new funding must be grounded in evidence of impact. That's why the Federal framework to end youth homelessness sets out two equally urgent strategies: to improve our data on youth homelessness while at the same time building our capacity to respond. There are many parallels with our work on Native homelessness, but we have much further to go. Wilder Research's partnership with tribal governments to conduct a survey on homelessness on reservations is one of a few bright spots we can point to nationally.

Apart from filling in our knowledge gaps, how else does our data on homelessness need to evolve?

The investments proposed in the budget will only get us to the goal if communities and providers make the hard, ethical decisions needed to use those resources to their greatest effect — to target resources wisely based on people's needs, not just filling vacancies or service slots. To make sure that we are investing in the programs that yield housing outcomes as cost-effectively as possible, not just supporting all the programs we've supported because that is the easy, default thing to do.

We know that ending homelessness, like all social change, is hard. But, for the first time ever, the Federal government has proposed investments that can take us to the goal, with your help. 

We need your help.

Our data are powerful, but too often, in far too many communities, we're not really using that power fully. Helping communities use resources wisely is neither easy nor always popular work. I am here to tell you that it is critical to our success.

How many folks here either offer or use an HMIS system with built-in ways to help communities understand the relative impact of various programs in achieving housing outcomes, in a way that illuminates differences between the people engaged? Labor Secretary Perez recently compared this kind of analysis to competitive diving, where divers' scores are based on both the execution of the dive and the degree of difficulty. To understand the impact of programs, we need to understand both who they engage as well as their effectiveness. HMIS has a critical role to play illuminating both sides of that question. Are we using that capability well?

How many of your systems help service providers identify and engage Veterans and people experiencing chronic homelessness in real time? If you are working in communities that are still taking a first-come, first-serve approach to outreach efforts and in access to critical resources, are they aware of the alternatives? Do they know how other communities are doing it differently, and the impact that targeted engagement and access to resources has on moving the needle? This is happening in places like Salt Lake City and should be happening more broadly. Targeting resources is obviously linked to your work on coordinated assessment, but you do not need to wait for your coordinated assessment system to be fully developed to improve targeting. 

How many systems have links to mainstream data systems, so that data that originated in a school or public assistance department or a hospital or a jail can help you focus on who is being engaged through those systems but doesn't have their housing needs met? The data on who is homeless exist in HMIS, and the data on who uses emergency room frequent exist -- why wouldn't we have those two systems talking to each other? Yes, there are legal hurdles and technical challenges. But it is possible, and we should be doing it.

How many support outreach and engagement in the field? I don't mean "yes, I guess you could load the webpage on a smartphone," I mean really useful mobile features and functionality? There are communities like Houston that are making data available in a street outreach context that not only facilitate connections to housing, but also to other resources like health care coverage. 

Without minimizing the challenges — technical, financial, legal, and otherwise — if we are not doing these things now, what are we waiting for? These are the kind of things data systems are good at and the kinds of problems that people in this room can solve.

By now, I suspect everyone in this room will have read and absorbed the new HUD data standards released yesterday afternoon. Actually, in this room, I think that's possible.

Here's what I hope you see in the evolution of these standards. First, a bold — truly courageous — decision to make the HMIS data standards a tool that serves purposes broader than reporting to HUD. At USICH, we live in this interagency space all the time, and it is wonderful and inspiring to see an agency take something good, something that has had a transformative impact like the HMIS data standards have within HUD's programs and across our efforts to end homelessness, and make them as useful to other agencies as they have been to HUD. Thank you, HUD, especially to the SNAPS team led by Ann Oliva and a special shout out to Karen DeBlasio, who's work on the new data standards makes them what they are. As you probably know, for the past several years, HUD has been working with its partners at HHS and the VA to shape the data standards in a way that reflects the values that their grantees bring to your community. The data standards are better because of their involvement in the process.

This cross-jurisdictional application of HMIS means work in the field can be organized better around people instead of disconnected reporting requirements, to simplify some of the administrative complexity that exists right now and to align our semantic understanding of homelessness across programs. Using HMIS across programs also means that a single data standard can span the expertise of multiple agencies: we are making HMIS smarter on youth homelessness by bringing in the wisdom of HHS's Runaway and Homeless Youth Act grantees; HMIS is better on Veteran homelessness because VA's Supportive Services for Veteran Families (SSVF) grantees use the system. And I don't mean "smarter" just in terms of the data standards -- I also mean that we'll actually have better data about individuals and families experiencing homelessness in the system as well. 

For some of you, the data standards will support work your communities are already doing to address homelessness across populations and funding sources. For others of you, the new standards may lead to growing pains in your community, as additional stakeholders are being brought to the table and being held to the high standards you are setting for your data. I know these transformations can be painful, and I know that your systems don't reprogram themselves overnight. Thank you for the work to create this kind of alignment and to use HMIS as a platform for this kind of evolution. This is tremendously important work. 

The structural changes to the data standards also mean that the data can be more and more useful to practice. They are evolving in a way that support the work that case managers and outreach workers and supportive housing programs do every day. Some of you have heard me talk about the need to shift from a compliance orientation in our use of HMIS to a focus on supporting practice — the actual eligibility determinations and resource allocation decisions that should be informed by all of this data. Again, coordinated assessment already pushes us in this direction. The new data standards take some important steps in this direction structurally in clarifying the stages and frequency of data entry and in helping communities think about HMIS as a community-wide system instead of a siloed reporting database for each specific program. The changes help us understand homelessness locally, by making destination-at-exit a universal data element collected for all programs and tracking homelessness chronicity.

I think these new data standards are important and exciting, and I hope you agree. 

Now I want to turn to the last part of my talk: how do we think about the future? If what we can dream to be today is based on what we know today, what might we dream?
I suspect most of us agree that how we frame homelessness matters. In his dissertation on the importance of framing in the context of social movements, David Wesley said it well: 

Frames have several purposes. They align participants with certain ideologies and beliefs, they challenge existing beliefs, and they create new perceptions of reality. As such, frames are important in the development of social movements that, by definition, seek to challenge the status quo. 

David Wesley, "Social movement heterogeneity in public policy framing: a multi-stakeholder analysis of the Keystone XL pipeline" (2014). Law and Public Policy Dissertations. Paper 16

Frames have several purposes. They align participants with certain ideologies and beliefs, they challenge existing beliefs, and they create new perceptions of reality. As such, frames are important in the development of social movements that, by definition, seek to challenge the status quo.  -David Wesley, "Social movement heterogeneity in public policy framing: a multi-stakeholder analysis of the Keystone XL pipeline" (2014). Law and Public Policy Dissertations. Paper 16.

Data standards are, themselves, a form of framing. They articulate a paradigm — a frame of reference in which we elevate some things as important over others, where we define a scope of options that are anticipated to be possible or at least most probable. We can derive and refine these standards or this paradigm from experience, but experience itself is also mediated. There is no fixed Archimedean point from which to evaluate the merits of each paradigm. Our view is partial, and so is every other view.

So what do we want our view to convey?

As part of the Homelessness to Housing Stability Strategy for the Region of Waterloo in southern Ontario, Canada, the Region of Waterloo Social Service has a language guide that suggests reframing our discussion from focusing on homelessness to focusing on housing stability. Yesterday, you heard Cathy ten Broeke, Minnesota's Director to Prevent and End Homelessness, talk about how in Minnesota, focusing on housing stability has engaged stakeholders in finding options to end homelessness that a focus on homelessness alone may not. In addition to the practical and strategic considerations about this reframing, let's recognize that this also focuses us on the solution, it defines the response in terms of the future we seek.

One of the things I have really appreciated about working for USICH is that my documents are  never edited for brevity when I use person-first language. Person-first language is not about political correctness. It is about conceptual clarity. It is about choosing not to perpetuate the mistaken notion that homelessness is a characteristic of a person, rather than an experience that people survive and that remains fundamentally a social artifact, not a quality of someone's character. It is also about respect. I guess I would rather be known as a person within a bureaucracy than as a bureaucratic person. So, let's challenge ourselves to keep people first in how we frame the problem in our thoughts, in our concepts, and in the words we use.

symbol for disabilityproposed new symbol for disabilitySlate's The Eye design blog recently ran a piece asking the question whether the international symbol of accessibility needed to be redesigned.

These icons provide a powerful example of how the framing of our concepts embeds all kinds of beliefs, assumptions, and ideologies. Comparing these two symbols, ask yourself which wheelchair you would you prefer to use. We cannot avoid our frames being laced with assumptions and beliefs. But we can try to bring those assumptions into view, and my challenge to us all today is that we think hard about the beliefs that we want to hold. 

If an end to homelessness is increasingly in sight, how do we envision the end in the way that we frame the problem today? If we are going to end homelessness, what do our data systems and what does our homelessness response system — or our housing stability system — need to look like as we do?

Thankfully, our work together on homelessness is not the first time a social problem has been solved. Our colleagues in the 

public health world have been here before. The health impact pyramid developed by Dr. Thomas R. Frieden in the American Journal of Public Health suggests the answer, in calling for increasingly population-based responses, to change the context and socioeconomic conditions so that people at risk of homelessness are predisposed to housing outcomes, not bouts of homelessness.

Interestingly, this shift mirrors the same semantic and conceptual shifts we just talked about — moving from focusing on one person's homelessness as the problem, to focusing on the environmental and contextual factors that determine whether risks of homelessness lead to exposure to homelessness.  

 

This table suggests how these concepts from the public health world might apply in the context of housing stability.

But what does this mean for our data systems? A lot, I suspect. Let me call out three key points.

First, if we recognize that context shapes homelessness, how is context part of the story of homelessness that we tell? Do we describe that homelessness exists in a context of unprecedented worst-case housing needs? At a local level, do we quantify the availability of affordable housing alongside our population measures of homelessness? Do we frame homelessness in the context of parallel efforts to improve access to skills and employment? If not, why not? Homelessness Analytics, a collaborative effort of VA and HUD, can help situate data on homelessness in the context of other social indicators. 

Second, as population-based responses to homelessness become more and more essential to taking us across the finish line, how are our efforts — and our data systems — linking to the broad population-based services delivered through our health care and economic assistance systems? If we think about effective prevention, we cannot wait until someone shows up at shelter -- that is too late. So, how are we engaging these mainstream systems to help identify people in danger of becoming homeless to intervene appropriately early and to make those mainstream systems an essential part of the response? This work must happen locally, and our data systems can support it happening well. 

Third, how are we ensuring that those systems are sufficiently sensitive to detect the warning signs of homelessness, to guide those interventions? The know-how for doing so must come from our experience ending homelessness. The best example I'm aware of is the clinical reminder that VA has implemented in every VA medical center in America. Since October 2012, any time a Veteran is engaged for health care services they are asked two questions, the responses to which are strongly correlated with risk of homelessness: 

・    In the past two months, have you been living in stable housing that you own, rent, or stay in as part of a household?
・    If not, are you worried or concerned that in the next two months you may not have stable housing that you own, rent, or stay in as part of a household?

More than 4 million Veterans have been screened to date, and Veterans experiencing homelessness or at risk are referred to appropriate services. Can we imagine a world in which we could say the same about every hospital visit? We need your help — and your data systems — to get there.

Big questions, big opportunities. I think it is a measure of our success to date that they are becoming increasingly relevant ones.

So, in closing, let me say again, thank you for the work you do. Thank you for the progress that has been driven by the data you painstakingly collect, analyze, and improve. We are at an exciting and critical time in the history of our nation's efforts to end homelessness. Thank you for your partnership to make sure that we have the full benefit of the data in your systems and the human stories they tell as we bring about an end to homelessness in this country, and safe and stable housing for all.

Thank you.

Senator Cory Booker to Deliver Keynote at 2014 National Conference on Ending Homelessness

Senator Cory Booker to Deliver Keynote at 2014 National Conference on Ending Homelessness

Cory Booker

The National Alliance to End Homelessness announced today that New Jersey Senator Cory A. Booker will deliver a keynote address on Wednesday, July 30 at the luncheon plenary of the 2014 National Conference on Ending Homelessness. The conference will take place at the Renaissance Washington Hotel from July 29 to 31, 2014. 

New Jersey's first ever African American senator, Senator Booker previously served as mayor of Newark, NJ, during which time he worked with New Jersey's Essex County and the Corporation for Supportive Housing to develop the Essex-Newark Ten Year Plan to End Homelessness. 

The annual conference includes best practices for service delivery, federal agency sessions, and advocacy and public education trainings. The Alliance previously announced that Housing and Urban Development Secretary Shaun Donovan will provide a keynote address on the first day, July 29, of the three-day conference. 

For more information, visit the conference website.

HUD Awards $29 Million To 26 Local HIV-AIDS Housing Programs

HUD announced $29 million in grants to assist more than 1,200 extremely low-income persons and families living with HIV/AIDS annually. This funding will provide these households with a stable living environment, which is essential to accessing healthcare and HIV related services. In addition to housing assistance, these local programs will provide access to the needed supportive services such as life skills, job readiness services and employment training.

The funding announced today is offered through HUD's Housing Opportunities for Persons with AIDS Program (HOPWA) and will renew HUD's support of 26 local programs in 18 states and the U.S. Virgin Islands (see attached chart and individual project descriptions below).

"These grants will give our local partners a vital resource to keep low-income individuals and families living with HIV/AIDS healthy," said Secretary Shaun Donovan. "Having a place to call home can make all the difference to someone who might otherwise be homeless or on the brink of homelessness."

READ THE FULL PRESS RELEASE FROM HUD

Addressing TB Among People Experiencing Homelessness

The U.S. Interagency Council on Homelessness (USICH), the Centers for Disease Control and Prevention (CDC), the National Health Care for the Homeless Council (NHCHC), and the National Tuberculosis Controllers Association (NTCA) hosted a webinar addressing Tuberculosis (TB) among people experiencing homelessness.

Background

Homelessness is a public health issue. TB rates are 10 times higher for people experiencing homelessness than for those with a safe, stable place to call home. In this webinar, presenters describe the work being done at the national and local level to prevent and address TB among people experiencing homelessness and those working with homeless populations. Additionally, staff members from the San Francisco Department of Public Health outline how they have successfully addressed TB and established screening programs, leading to sustained declines in the disease among people experiencing homelessness. The information shared includes lessons learned and recommendations for other homeless providers and health care workers. This webinar is designed to complement the recently released Preventing and Addressing Tuberculosis among People Experiencing Homelessness.

Speakers 

  • Liz Osborn, Management and Program Analyst, U.S. Interagency Council on Homelessness
  • John Lozier, Executive Director, National Health Care for the Homeless Council
  • Donna Wegener, Executive Director, National Tuberculosis Controllers Association
  • Krista Powell, Medical Officer, Centers for Disease Control and Prevention
  • Julie Higashi, TB Controller, San Francisco Department of Public Health
  • Kate Shuton, Shelter Health and Homeless Family Coordinator, San Francisco Department of Public Health

U.S. Federal Interagency Reentry Council Releases Resources For Communities

The Reentry Council recently released a set of “Mythbuster” fact sheets that cover a range of important topics. These fact sheets are designed to clarify existing Federal policies that affect formerly incarcerated individuals and their families in areas such as public housing, employment, parental rights, Medicaid suspension/termination, voting rights, and more.

The Reentry Council supports successful reentry from incarceration by reducing recidivism and victimization, assisting those who return from prison and jail to become productive citizens, and saving taxpayer dollars by lowering the direct and collateral costs of incarceration.

USICH is proud to serve as a member of the Interagency Reentry Council. Stable housing with appropriate supportive services is a key factor in preventing or ending homelessness and reducing recidivism for people coming out of incarceration. 

The Reentry MythBusters are particularly useful for:

  • Prison, jail, probation, community corrections, and parole officials who want to ensure that individuals can access healthcare, behavioral health treatment, and federal benefits, as appropriate, immediately upon release to help stabilize the critical first days and weeks after incarceration. Pre‐release applications and procedures are available for certain federal benefits (veterans, Social Security, food assistance, and student financial aid).
  • Reentry service providers and faith‐based organizations who want to understand the laws and policies related to public housing, employment, VA services, child support options, and parental rights while incarcerated.  
  • Employers and workforce development specialists who are interested in the incentives and protections involved in hiring formerly convicted individuals. The Reentry MythBusters are also helpful to employers who want to better understand the appropriate use of a criminal record in making hiring decisions.   
  • States and local agencies that want to understand, modify, or eliminate certain bans on benefits (TANF, SNAP) for people who have been convicted of drug felonies.  

For those who want to delve deeper, The What Works in Reentry Clearinghouse offers easy access to important research on the effectiveness of a wide variety of reentry programs and practices. It provides a user-friendly, one-stop shop for practitioners and service providers seeking guidance on evidence-based reentry interventions, and serves as a useful resource for researchers and others interested in reentry. 

Effective Community-Based Solutions to Encampments

Ending homelessness is about protecting and furthering human rights. Balancing health, safety, and community impact concerns created by encampments of people experiencing homelessness can be challenging, but there are solutions.

Across the country, many communities are wrestling with how to create solutions for people experiencing homelessness in encampments.  Depending on variables such as terrain, visibility, and accessibility, encampments can take multiple forms, including groups of tents or semi-permanent structures on public or private property. Oftentimes, encampments occur on land which has never been intended for any human habitation. Unfortunately, the first response to encampments often considered by communities and elected officials are ordinances that criminalize certain behaviors, such as panhandling, sitting and/or lying on public sidewalks, and camping.  However, criminalization measures are not real solutions. Real solutions result from strategies and responses that help people living in encampments achieve permanent housing.

As such, USICH believes that encampments also are not a solution to homelessness—as encampments do not provide permanent housing outcomes, nor do encampments best serve those who are experiencing homelessness. Encampments only offer a temporary and reactive response to homelessness. Encampments—regardless of whether or not they are officially sanctioned or publically or privately funded—can distract communities from focusing on the real solution of connecting people experiencing homelessness with safe, stable, permanent housing. Encampments also create risks for their inhabitants related to safety, health, and sanitation. The costs associated with trying to ensure the well-being of people living in encampments can be spent more strategically to create permanent housing and services options for people experiencing homelessness in encampments, which will decrease overall homelessness in a community. 

However, USICH firmly believes that prematurely dispersing people from encampments is not an effective approach to addressing the issue of encampments. Dispersing people from encampments is costly, contributes to distrust and conflict, and is a short-term intervention at best. Many people who live in encampments have nowhere else to go and may be experiencing chronic homelessness and/or be extremely vulnerable due to disability or illness. As described in USICH’s publication Searching out Solutions: Constructive Alternatives to the Criminalization of Homelessness, providing people who live in encampments with access to permanent housing is the solution to encampments.

To help support communities that are seeking to connect people living in encampments to permanent housing, USICH is documenting the strategies and best practices successfully implemented in communities to address the issue of encampments. Below is a sneak peek of the common themes and solutions that will be highlighted in a forthcoming publication, which will serve as guidance to communities working to end homelessness for people living in encampments.

Successful Strategies

Examples of strategies that communities can implement to address successfully the issue of encampments by connecting people to appropriate housing options include:

  • Preparation and Adequate Time for Planning and Implementation: Plans for creating solutions to encampments should ensure that there is adequate time for effective collaboration, outreach, engagement, and the identification of meaningful housing options to occur. Adequate time is essential to achieve the primary objective of meeting the needs of each person and assisting them to end their homelessness.
  • Collaboration: Any plan should include collaboration between a cross-section of public and private agencies, neighbors, and business owners. Any plan should feature strong relationships with a broad range of community service providers and the permanent housing resources that are being targeted to the effort in order to maximize efficiency, align resources, and address any system gaps.
  • Intensive and Persistent Outreach and Engagement: The agencies responsible for collaboratively implementing the plan should have strong outreach experience and demonstrated skills in engaging vulnerable and unsheltered people.
  • Low-Barrier Pathways to Permanent Housing: The plan should include clear, low-barrier pathways to attaining and sustaining permanent housing opportunities and should not include a focus on relocating people to other encampment settings.

Community Examples

Below are examples from three communities that have encountered the challenges that accompany homeless encampments and have responded with effective, people-centered strategies.

  • Between 2010 and 2012, St. Louis, Missouri (population 318,172) was faced with four adjacent riverfront encampments, in which approximately 60-70 people were living. As described in their detailed report Moving Forward: Policies, Plans & Strategies for Ending & Preventing Chronic Homelessness (2012), city partners made great strides in each of the four recommended strategies described above, resulting in housing solutions for all camp residents.
  • In Asheville, North Carolina (population 85,712), homeless service providers, police, and the Department of Transportation are currently working together to create solutions for several small encampments. Police, who participate in Crisis Intervention Training, are involved mostly in the initial stages of the outreach effort but work with other partners to avoid unnecessarily arresting camp residents. Asheville has seen an 82 percent reduction in chronic homelessness, which is largely contributed to the collaborative efforts of these engaged partnerships.
  • Members of the Colorado Springs, Colorado (population 431,834) Police Department collaborated with local service providers to become better informed about the needs of people experiencing homelessness. They worked to improve relationships with providers and their clients, and they became resources for outreach forming Homeless Outreach Teams (H.O.T).  Their model won the 2010 Herman Goldstein award for community policing and inspired the Wichita Police Department in Kansas to follow in their footsteps and devote full-time officers to work with service providers and people experiencing homelessness. (For more information, the USICH Blog piece by Officer Nathan Schwiethale of the Wichita Police Department’s Homeless Outreach Team can be found here.)

These examples illustrate that a comprehensive approach to addressing encampments is the right solution for communities and for the people who experience homelessness in encampments.

For communities that are still struggling with this issue, please continue to share your lessons learned. USICH is eager to learn from communities that are planning, collaborating, and engaging with community stakeholders in order to connect people living in encampments with meaningful housing options.  As USICH prepares a publication on this topic for release later this year, we welcome input and suggestions, case studies, and examples of policies and materials that can help inform and strengthen this planned publication.

Please share your lessons learned with us; contact your USICH Regional Coordinator.

Model Program Profile: St. Leonard’s Ministries

Saint Leonard’s Ministries is a project of the Episcopal Charities of Chicago and provides residential and supportive services for ex-offenders as they transition from incarceration back into society. The program consists of several distinct components:

  • 40 beds of emergency housing at the St. Leonard’s house for men and 18 beds of emergency housing for women at the Grace House for Women. Rooms are either single occupancy or shared. Three meals a day are provided and residents have access to laundry, computers, and other important basic services.
  • 42 beds of second stage housing for men at St. Andrew’s Court.
  • Mental health care, counseling, and substance abuse treatment. All residents receive access to these vital services on site which include relapse prevention strategies.
  • Assistance with accessing benefits, community services, and housing placement.
  • Job training and education provided at the Michael Barlow Center. Formerly incarcerated men and women have the opportunity to study in an adult high school program, take green building maintenance courses, use a computer lab, work with volunteer tutors, train for culinary careers in the onsite training kitchen, and work with an employment placement specialist.

St. Leonard’s hopes to be able to open transitional single room occupancy housing for women in the coming year. The recidivism rate of St Leonard’s residents is 20%, compared to an overall state rate of over 50%.

Advice on the challenges of helping this population and tips for overcoming these challenges from the Executive Director, Bob Dougherty:

The main challenge faced by an organization like St. Leonard’s is one of perception of our work within the community. We know how to help our residents with solutions that work, but the community can often have a “not in my backyard” attitude towards the reentering population that is difficult to overcome. It is important to remind key stakeholders that these interventions work and the population we are talking about deserves a second chance. In many cases they actually deserve the first chance that they never had. Another challenge faced by programs like St. Leonard’s is that funding streams are limited; there are more providers and more need than current funds allow and we are not as effective as we’d like to be.

Two steps for successfully changing outcomes for previously incarcerated individuals:

The first step is pretty simple. We involve ourselves in their lives. At St. Leonard’s we make sure our residents know that we care about them and their success.  Often our residents come to us with a perspective that no one is going to give them a chance so it isn’t even worth trying. We show them that this isn’t true by giving them a chance ourselves.

The second step is to provide the tools they need to be successful. I can’t stress enough that one of these tools is mental health care and substance abuse treatment. Many of our residents have struggled with addiction their entire adult life: they can’t just wake up one morning and decide to no longer be burdened by it. They need help and a partner to work with them as they get through it, including contingency plans if they relapse.  They also need education, job skills, and help accessing benefits.

Tips for other providers on ways to improve a program to help this population:

If you can’t provide all the services you want to, look for organizations in your community who have the resources you need and approach them about a partnership. We have invaluable partnerships with many organizations. A local public high school allows our residents to get high school degrees. We receive clinical help from the Adler School of Psychology and tutors and interns from several nearby universities. Churches and food pantries help us find the food we need to feed our residents. The City of Chicago, the State of Illinois, and the Department of Corrections are all critical to our success as well.

One simple thing to do that we have found really helps is to coordinate with our residents’ parole officers, both before they exit the institution and while they are in our program.

Jail Inreach: Healthcare for the Homeless - Houston

The Jail Inreach program run by Health Care for the Homeless-Houston begins helping Houston’s incarcerated homeless population in the jail itself. Prisoners who have a history of homelessness, mental illness, and/or multiple non-violent incarcerations are referred to Healthcare for the Homeless by the Harris County Jail. Case managers visit with the prisoners up to six or seven times to develop a discharge plan and to build trust. Once an individual is released, a case manager meets them at the gate and helps them through the process of finding housing, qualifying for benefits, and getting continued quality mental health and substance abuse care.

A more than 50% drop in rearrest rates occurred in the population of inmates that were a part of the Jail Inreach Program.

Advice on the challenges of helping this population and tips for overcoming these challenges from the Executive Director, Frances Isbell:

The biggest challenges are the basics. There isn’t enough housing available, notably permanent supportive housing. There also isn’t enough funding available from the state level.  The state government tends to push the issue down to the county level, but counties don’t usually have the same level of resources to address the robust need.  It actually saves the state money by helping these individuals with critical health care and substance abuse therapy as well as housing and benefits support.  These individuals circle in and out of emergency rooms and jail cells, and the best way to stop that cycle is with health care and housing.

Tips for other providers on ways to improve a program to help this population:

The Harris County Jail is a valuable partner in our program. If possible, try to establish a partnership with the local jail in your community as well. The corrections department helps us identify individuals that would be a good fit for our programs and they coordinate daytime releases so that we can have a case manager waiting at the gate.  This pick up is a critical moment for those reentering, as it is very easy for these individuals to go right back to their old neighborhoods and lifestyles. With this coordination, we can get to the individual first and offer them an alternative.

Substance abuse therapy and mental health care are absolutely critical. When prisoners are incarcerated they have access to behavioral health care and medicines that treat mental health disorders, but as soon as they are released that access disappears. In Houston, individuals are not given any extra medication when they leave nor, often, are they given a prescription.  It can take four to six months to schedule an appointment through the public health system; far too long for an individual with a mental health disorder to have no safety net. We are able to solve this problem by walking individuals over to our health clinic (which is four blocks from the jail) as soon as they are released.

Other partners can be helpful to providers as well. Case managers can’t do everything, so they need to be experts at finding the resources to help their clients. For us this means working closely with the county government health systems and the local housing providers. There are also specialty courts that have been very helpful in Houston to limit the incarceration of folks who are not serious criminals but who have other treatable problems like addiction and mental health disorders. These courts include a Homeless Court, a Mental Health Court, a VA court, and a Drug Court. Social workers at these courts also link individuals to services.

Interview with Jeanette Kinard: Holistic Public Defender’s Offices

USICH spoke with Jeanette Kinard the Director of the Mental Health Public Defenders (MHPD) Office in Travis County Texas (County seat of Austin, TX).

In many public defenders offices, lawyers work on a timeline that begins with their clients arrest and ends when the case is dismissed, their client accepts a plea bargain, or the case ends in trial. Holistic public defenders offices work differently. They don’t start with the exclusive goal of defending the client legally in one case. Instead they have the goal of helping the client address the issues that brought them to the court system to begin with. They address the holistic needs of their clients by providing access to case management and services that go beyond legal aid and help the clients achieve long term stability.

In Travis County, Texas, a team of two lawyers, two master’s level social workers, and two case workers handle 400 legal cases plus an additional 100 other cases referred to them by other lawyers each year. They work exclusively with clients the court has determined to have a mental illness, many of whom are also experiencing homelessness at the time of arrest. The MHPD team either connects their clients directly to services or works with partners at local organizations to provide medical care, housing assistance, employment services, clothing, and some very basic household needs, and to set up access to Social Security and Veterans’ benefits.

“We don’t have a time limit for working with clients and we don’t have strict rules that clients must adhere to,” said Jeanette Kinard. “We work with the client for as long as they benefit from it. In some cases this means active case management over a few years. And we work with clients in a way that helps them achieve their goals.” In one example, Kinard said that a client who had a severe substance abuse disorder needed to enter rehab, but he wouldn’t do it because in order to complete the inpatient program he would have to give up his dog. The MHPD staff developed a calendar to dog sit for the client while he completed rehab and got sober. “Sometimes we have to be a little creative, the client needed rehab to get healthy, but he also needed his dog. This is just one example where the holistic approach allowed us to meet the client where he was and help him make steps toward stability,” said Kinard.

After five years, it is clear that this program is successful. MHPD clients use fewer justice system dollars after they receive support from MHPD. Trials, bookings, jail bed days, and recidivism are all reduced. Several other counties in Texas have since adopted a similar model and are also seeing results. Communities benefit in three ways: the burden on the justice system (and likely other public systems) is reduced, local residents in need of support are helped to reenter society, and the visibility of homelessness is reduced. 

A note from Jeanette Kinard:

There are different models of holistic public defender’s offices that can work. Our office operates with dedicated mental health lawyers and it has worked very well for us. San Mateo County, California pioneered a model that relies on a centralized office for case management and social services, but contracts out legal services to a qualified list of lawyers who manage their own expenses. This contract based model is something that might work better but achieve similar results for smaller communities as it doesn’t require full time legal staff.

Annual Update 2013

Three years have passed since the U.S. Interagency Council on Homelessness (USICH) launched Opening Doors: Federal Strategic Plan to Prevent and End Homelessness. This update provides the latest data on the number of people experiencing homelessness, an overview of the progress USICH and its partner agencies have made toward the goals set forth in Opening Doors, and information on USICH and member agencies’ activities and accomplishments in the third year of implementation since the release of Opening Doors in June 2010.

Opening Doors has served as a catalyst for significant progress in preventing and ending homelessness in the United States. Opening Doors’ implementation throughout the country continues to grow. The 2013 Point-in-Time (PIT) count reflected a steady and significant decrease in national rates of homelessness since the launch of Opening Doors in 2010. This trend is evidence that, in partnership with communities across the country, the Obama Administration has had a significant impact on the trajectory of homelessness. The progress is particularly remarkable given the economic downturn our country faced and the reality of an economy that has slowly, but steadily been improving. According to HUD’s national PIT estimate, the total number of people identified as experiencing homelessness on a single night decreased by six percent between 2010 and 2013 and four percent between 2012 and 2013. The decrease in persons who are unsheltered was even greater, dropping by 13 percent since 2010 and over 11 percent between 2012 and 2013.

Progress was made across all sub-populations. Perhaps most notably, the country has seen homelessness among Veterans decline by 24 percent since 2010. In addition, the number of people experiencing chronic homelessness declined by 15.7 percent between 2010 and 2013. For the first time in the last five years, the number of families on the street or in homeless programs at a point in time decreased in 2013, as did the number of families experiencing homelessness over the course of a year. Data from HUD’s 2013 PIT indicated that 71,000 families were homeless at a point-in-time in 2013. Longitudinal data from HUD’s AHAR indicate that a larger number—167,000 families—were homeless and sheltered at some point in 2012. Department of Education data, which includes doubled-up households, indicate that more than one million school-age children and their families were homeless at some point during the 2012-2013 school year.

Ending homelessness is possible. However, the country must make adequate investments in effective interventions in order to achieve that goal. Using the tools available (e.g. broad dissemination of information, Federal guidance, technical assistance, and competitive awards) USICH and Council agencies have supported communities’ efforts to implement evidence-based practices and maximize efficiencies wherever possible.

In Phoenix/Maricopa County, Arizona, for example, USICH, HUD, and the VA worked closely with State and local partners to increase focus on collaboration and data-driven decision-making. As a result of a close partnership between VA staff, the Arizona Department of Veterans Services, public housing agencies, and local non-profit and public partners, the community announced that it has ended chronic homelessness among Veterans. The accomplishment will be verified through the 2014 Point-in-Time count.

Understanding that permanent supportive housing is the key solution for chronic homelessness, in Houston, Texas, Federal and local partners designed an initiative to use Federal housing and health care resources to create at least another 1,000 units of permanent supportive housing. Supported by analytic tools provided by USICH and HUD, Federal and local partners in Houston are confident that the additional housing units will contribute towards the goal of ending chronic homelessness in their city.

Opening Doors recognizes that homelessness cannot be solved with targeted homeless programs alone. In the last year, the Council developed toolkits and provided technical assistance and guidance to help communities better leverage the mainstream housing and supports necessary to advance efforts on ending homelessness.

For example, HUD provided public housing agencies (PHAs), as well as owners and operators of HUD-funded multi-family housing programs, with guidance on how to improve access to affordable housing for people experiencing homelessness in their communities. The U.S. Department of Health and Human Services (HHS) issued guidance on how communities can use funds from the Temporary Assistance or Needy Families (TANF) program to provide rapid re-housing to families who are experiencing homelessness. USICH created a database of solutions to further assist communities in their efforts to improve their approaches to ending homelessness. The database includes examples of best practices from around the country, a Housing First Checklist, and a guidebook PHAs can use to increase their efforts to coordinate with local homelessness service providers.

USICH, Council agencies, and communities have been doing everything possible within existing resources to accelerate progress. With sustained support and investment in solutions that work, achieving the goals of Opening Doors is within reach. Failure to invest in solutions is the more costly route. Not only is homelessness destructive and demoralizing for individuals and families, it is also expensive for taxpayers. Too often, people experiencing homelessness become caught in a revolving door between emergency departments, hospitals, and the criminal justice system, resulting in high costs to the public and poor outcomes for the individuals. Research continues to show that this revolving door pattern contributes to the rising cost of Medicaid as well as other costs associated with this system of care. Providing affordable housing and supportive services creates a platform for health and stability for individuals as well as for the community at-large.

Opening Doors has demonstrated that the right strategies are in place to succeed. By relentlessly pursuing the goals in Opening Doors and fully investing in solutions that work, the United States can achieve the vision that no one should be without a safe and stable place to call home.

Read the update

The Appendix to the Annual Update includes information on federal programs that provide assistance to those experiencing or at risk of homelessness, along with information on USICH and member agencies' activities and accomplishments in the last year.

Read the appendix

2014 National RHY Grantees Conference Call for Presenters

The 2014 National RHY Grantees Conference will be held November 11-13 in Phoenix, Arizona.  Over 50 workshop trainings seesions available for workshops addressing pressing issues and cutting-edge practices most helpful to grantees.  The deadline for submitting proposals is May 15, 2014.

Applicationa and more information here

2014 NAEHCY Conference Call for Proposals

The National Association for the Education of Homeless Children and Youth is accepting proposals to present a concurrent session at the 2014 NAEHCY Annual Conference. Download the Request for Proposals (RFP) below and follow the instructions included. Only proposals submitted through NAEHCY's online RFP submission form will be accepted. The link to the online RFP submission form is included in the RFP and Presenter Instructions below. 

Obama Administration Renews Critical Support for nearly 7,100 Local Homelessness Programs across U.S.

HUD Secretary Shaun Donovan today announced nearly $1.6 billion in grants to renew support for 7,100 local homeless housing and service programs across the U.S., Puerto Rico, Guam and the U.S. Virgin Islands (see attached chart).  Provided through HUD’s Continuum of Care Program, the funding announced today will ensure these local projects remain operating in the coming year, providing critically needed housing and support services to those persons and families experiencing homelessness.

“In the face of budget cuts from sequestration, Continuums of Care and grantees were forced to make difficult choices and do as much as possible to advance their local efforts to end homelessness with fewer resources,” said Laura Zeilinger, Executive Director of the U.S. Interagency Council on Homelessness.  “Communities are making the smart choice, investing HUD funds in evidence-based, cost-effective programs.  Now we need help from Congress to fully fund these programs and provide communities with exactly what they need to reach the goals of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness.”

READ THE FULL PRESS RELEASE

Featured Articles

Coordinated Assessment: Putting the Key Pieces in Place

Remarks by Eric Grumdahl at a gathering of community stakeholders focused on ending Veteran and chronic homelessness
Thursday, March 27, 2014

Today, I would like to share what we at USICH see as key components of an effective coordinated assessment system. I will talk about some questions you might be wrestling with, some tactics you can use to make progress, and then review key components of coordinated assessment.

Before coming to Washington, I was responsible for housing and homelessness programs for a metropolitan county, where we were pushing in fits and starts toward a no-wrong-door coordinated assessment system linked to our mainstream systems. I understand that coordinated assessment sounds straightforward, but in practice it can be really challenging.

We suspect that your community is wrestling with some of these critical questions:

  • Is your response effectively reducing how many people experience homelessness?
  • Does it ensure that resources are used well?
  • Does it contain the right mix of interventions?

We know that communities are facing challenges to ensure that the success rate of your response to homelessness is as high as it can be, and that permanent housing is obtained as quickly as possible by everybody served by it. We know that in a resource-constrained environment a central challenge is to make sure that the resources that are available are designed and delivered strategically.

We also know that homelessness-specific resources are not the only game in town, and that indeed we won't end homelessness through targeted programs alone. Communities must engage mainstream resources as much as possible.

So how do we make progress? The key tactics that we've identified among communities making progress include the following:

  • Communities need to use data to focus efforts and drive performance.
  • Mainstream systems and resources need to be engaged completely.
  • Communities have to make hard choices about where interventions and resources are focused and do that in a systemic way, not just a program-specific way.
  • Communities have to be using proven practices. There's a large and growing body of proven practices to end homelessness, like adopting a Housing First approach to reduce barriers to accessing services and focus on interventions on achieving housing outcomes.
  • Finally, we know that the challenge of using the limited resources available is to be wise and strategic about how they should be invested, especially as new opportunities present themselves.

So, how do we create a coordinated assessment system that helps us do these things?

We view coordinated assessment as being about people. Coordinated assessment sounds fancy and clinical, but fundamentally it is about shifting the orientation of our response to homelessness toward identifying the best options for each individual and family experiencing homelessness. It is about structuring the way we use our resources, with shared, explicit criteria, and a common process and a common purpose for how decisions get made.

It is not about simply following the output of a tool, but it does require yielding program-specific decision-making. It's about buying into the benefits of a shared response – for the people served, for the system as a whole, and even for programs themselves – rather than preserving business as usual.

Coordinated assessment puts people – not programs and not tools – at the center of offering the interventions that work best. Offering interventions: we need a system that enables people to choose what intervention best responds to their needs and goals, to have those options informed by helpful assessment and on-the-ground insight and understanding, and to have our entire system oriented to ensure that the smartest choices for people are the choices people make.

Rather than a mysterious black box that spits out matches between people and interventions, consumer choice and practitioner wisdom both have a central place in an effective coordinated assessment system. Policies and practices that screen out the people most in need of an intervention do not.

Here are some of the key components of coordinated assessment:

First, we know that the path from homelessness to housing varies significantly from person to person, from family to family. We would ideally have a system that whatever front door somebody entered, they could quickly be connected to the right resources. That means making sure that there's meaningful coordination between the homeless response system and the intake processes for mainstream systems. Creating those linkages can be challenging, but ultimately mainstream systems have as much to benefit from having an option for the people experiencing or at risk of homelessness that they encounter as people experiencing homelessness and the homeless response system have to benefit from a connection to those mainstream resources.

Next, we know that if we're not connected with the people in need of interventions, it's impossible for coordinated assessment system to make smart connections between people and resources. That means that outreach is essential for a coordinated assessment system to function well.

We also know that these systems have to leverage the local capacities and resources including data systems like your local Homelessness Management Information System and take into account the specific and unique factors in every community, including the physical and political geography, the capacity of partners in your community, and the opportunities unique to your context.

The purpose of coordinated assessment is to make sure that the right access to services is established. This can happen in a variety of ways: access to services can be centralized, a one-stop shop approach; access can be coordinated, leveraging outreach capacity and linking or integrating with mainstream systems. There isn't a single path or option for how best to increase access to services -- how you do that depends a lot on the details of your community. The point here is simply that increased access is central to the purpose.

We also want to be sure we have access to the right stuff. We know that at a systems level, that means making sure that the various types of interventions that are available are all aligned and used strategically where they're most helpful. Again, we have to yield on making decisions about access to resources in isolation in order to get the benefits of a true systems approach and the best use of our limited resources.

Slide 10 provides a schematic view of how some of these pieces fit together. Coordinated assessment is linked with outreach, with a strong assertive outreach linkage to the discharge processes for a variety of mainstream systems. That "in-reach," as it is sometimes called, can be in addition to the other connections to the intake processes for other mainstream resources. These connections, informed by an assessment process with clear criteria to guide the prioritization of access to some services over others, leads to rapid connection to the housing and services that each person served needs and wants.

The push to establish for coordinated assessment systems is enshrined in the HEARTH Act and HUD's regulations for it. Those regulations stipulate the following criteria for a coordinated assessment system:

  • It must cover the entire continuum of care.
  • It must be easily accessible and well-advertised.
  • It must use an assessment tool that is standardized across the whole system.
  • It must be attuned to the local needs and conditions.
  • It must include at least the Continuum of Care and Emergency Solutions Grant programs.

The last point here is really important, because even though the HEARTH Act regulations require that the Continuum of Care and Emergency Solutions Grant programs are in the coordinated assessment system, that is really just a starting point. Many communities are exploring how mainstream systems can also play a part, either as feeders into coordinated assessment, or as additional resources that a coordinated assessment process can access.

VA's vision for a coordinated assessment system reinforces the HEARTH Act requirements: a coordinated assessment system needs to be centralized or coordinated, easily accessible, and use a tool that puts people at the center and is based on established criteria. The purpose, or benefit, is to have a better process for connecting people to services, including better referrals and better coordination between programs, which produces better results for people.

I want to emphasize that coordinated assessment is a process, not a tool. The process serves your community's efforts to end homelessness by bringing into the open, in a more explicit way, how resources are deployed – and should be deployed – to serve the members of your community experiencing homelessness. Tools are an important part of assessment systems, but the tool alone is not sufficient.

So the shift that we are calling for is from thinking about access to programs in isolation, to thinking about options for individuals and families, shifting from "should my program accept this person," to thinking about "which programs offer the best options for this person or family." Another way to think about this is it's having good social work at a systemic level, while maximizing the impact of the resources you have by targeting them intentionally.

We acknowledge that yes, there are challenges with putting a system like this in place. Yes, there are thorny issues about control, discretion, history, and inertia. The point of departure on every community's journey to establish a coordinated assessment system is recognizing the benefits that come from having a system in place, committing to moving toward a systemic response, and to confronting these challenges.

So, what can communities do? Here are some suggestions.

First, you can begin to coordinate the efforts across your community to identify people experiencing homelessness and engage them in services. This coordination provides you with the platform for shared decision-making about access to resources. Often, parallel outreach efforts are not aware of each other’s efforts to engage the same individual, which makes coordinated anything tough.

Outreach also needs to be oriented to achieve housing outcomes. We understand that the purpose of outreach is engagement, and yes, engagement can take time. But the purpose of engagement is housing, and so we must make sure that every engagement attempt has housing as the goal.

Of course, you also need to assess the variety and capacity of programs in your community, to identify and fill critical gaps, and to ensure that there's a range of those options needed for a coordinated assessment system to work well. We can't have a response to homelessness that recognizes that one size does not fit all if we only have one size to offer.                                             

Next, you can begin to engage the programs and interventions in your community about adopting a common way to make decisions. Yes, this can be hard. The Federal government has your back in this work. HUD's regulations and VA's vision require communities to move in this direction. I know many communities have already begun this work, and a few have their systems in place. Learn from each other.

There are also some "must-haves" for your local system. Every community must adopt a Housing First approach, but we also have to make sure that local adoption of Housing First is meaningful —commit  to remove preconditions from each person's access to housing, focus on housing outcomes, and delink service expectations from housing --. It's easy to say your community adopts Housing First. Make sure you're doing it in a meaningful way. VA, HUD, and USICH all have tools to help you.                                                      

Similarly, we need supportive services that don't screen out or alienate the very people who would most benefit from them.

Every community must commit to making careful decisions about how we target the most intensive interventions like permanent supportive housing. In fact, how we should prioritize access for permanent supportive housing can be a case study of how coordinated assessment can work more generally. What we need is to shift from reacting and having a passive role in identifying supportive housing tenants to a more deliberate and intentional engagement of those most in need of that resource and intentionally prioritizing who gets access based on clear and objective measures of need.

In terms of mainstream resources, communities are not alone in trying to identify ways to link mainstream services to your local efforts to end homelessness. HUD has provided some really helpful guidance for public housing authorities and for multifamily housing developments. USICH has released a guidebook focused on partnerships between public housing authorities and other parts of the homeless response system, which can help you in thinking about how to maximize the impact of those partnerships.

In addition to public housing authorities, make sure that you are making connections in your community to your healthcare system, with the workforce development system, and with mainstream income and benefits. These resources are not only critical for each person experiencing homelessness, but also serve as an important front door for people to access care.

Finally, just as coordinated assessment itself is a process, the process of building a coordinated assessment system can yield a lot of benefits. These include creating new partnerships and collaborations, increasing your understanding of how homelessness manifests locally, and most importantly making sure you're using resources wisely to achieve our intended outcomes. As your community moves toward coordinated assessment, you will undoubtedly identify gaps in your system, and the collaboration you create can help you identify options for filling those gaps.

On behalf of USICH and the Obama Administration, thank you for the work that you do and for your commitment to establishing the systems we need in place to achieve our shared goal of ending homelessness.

Thank you.

States See Ending Chronic Homelessness as Important to Medicaid Goals

Evidence that permanent supportive housing improves health and lowers health care costs is spreading.   Just recently, Congressman Paul Ryan’s assessment of Federal anti-poverty efforts, while critical of many Federal programs, noted that supportive housing programs “have been shown to decrease homelessness and reduce costs related to health care and institutionalization.” 

New developments now indicate that this evidence on permanent supportive housing has reached the health care sector as well.  As states and health policymakers seek ways to achieve better health outcomes while containing Medicaid costs, more and more are realizing that ending chronic homelessness through permanent supportive housing should be part of their strategy.  

 

  • Last week, HUD invited Dr. Jeffrey Brenner of the Camden Coalition of Health Care Providers to discuss his groundbreaking “hot spotting” work, through which he found that the highest cost users of health care services in the city of Camden were living in HUD-assisted housing or experiencing significant housing challenges and homelessness. Through this work, he discovered that in order to improve the health of people with complex health needs and lower costs, health care must also address housing and social circumstances. “Many of the patients we identified are the same chronically homeless people you have been working to house,” Dr. Brenner explained. For these individuals, he added, “housing is the best pill.”
  • In their guest blog, Dr. Kelly M. Doran and Dr. Roberta Capp discuss their research that found significant rates of homelessness among emergency department and hospital “super users.” For these individuals, they argue, the traditional tools used by the health care system, like care coordination and patient navigation, will be inadequate to contain costs and achieve better health.  Instead, the authors note that “supportive housing should be considered a critical element of any effort to reduce frequent hospital use for patients who are homeless.” 
  • The National Governors Association (NGA) Center on Best Practices recently launched the Developing State-Level Capacity to Support Super-Utilizers policy academy to improve the State-level response to Medicaid “super-utilizers”—the small subset of beneficiaries that consume a disproportionate share of Medicaid costs. Six states, including Alaska, Colorado, Kentucky, New Mexico, West Virginia, and Wisconsin, along with the territory of Puerto Rico, were selected to participate. At the launch of the policy academy, participating states and national experts recognized how homelessness and housing crises contribute to frequent emergency room visits and hospitalizations. In February, at NGA’s request, HUD and USICH provided a training session to participating state teams on permanent supportive housing.

An End to Chronic Homelessness in 2016

An End to Chronic Homelessness in 2016

HUD Secretary Shaun Donovan and USICH Executive Director Laura Zeilinger discuss Council priorities at a recent meeting.

A Message from Laura Zeilinger, Executive Director of the United States Interagency Council on Homelessness

As the new Executive Director of USICH, many people have asked me what I plan to do in this role. Leading an agency that builds collaboration across Federal, State, and community partners means that the opportunity is not about what I will do, but about what we will do together. The President’s Fiscal Year (FY) 2015 Budget creates an unprecedented opportunity for what we can do together to end chronic homelessness in 2016.

Earlier this month, President Obama released his FY 2015 Budget, in which he calls for historic new resources to end homelessness. These resources support implementation of Opening Doors, positioning us to end homelessness among Veterans in 2015 and sustain and advance programs that serve our families and youth. These historic new resources also include $301 million to create 37,000 new units of permanent supportive housing, finally bringing the national inventory of permanent supportive housing to a scale that will end chronic homelessness and prevent its recurrence. 

While ending chronic homelessness in 2016 is a year later than we had originally planned in Opening Doors, this timeline reflects our ongoing commitment to act with urgency, while adjusting for the fact that the resources requested by the President to increase permanent supportive housing in previous years were not funded by Congress. 

Ending chronic homelessness requires both new resources and strategic local policy changes. We are more successful at securing needed resources when communities are demonstrating that the goal is achievable through strategic action. For example, using Opening Doors as a guide, New Orleans, Phoenix, Salt Lake City, and others have maximized Federal, State, and local resources. They have leveraged commitments from public housing agencies to increase permanent supportive housing, and they are ending chronic homelessness.

We can end chronic homelessness throughout the nation, leveraging new and existing resources, if we can do these five things:

  • Prioritize the most vulnerable and highest need people experiencing chronic homelessness for assistance through permanent supportive housing. 
  • Adopt Housing First community-wide to ensure that people experiencing chronic homelessness can obtain housing without preconditions.

The President’s Budget gives us what we need to achieve our goal through an increase of 37,000 new units of permanent supportive housing, but only after we’ve also increased access to mainstream housing resources like Housing Choice Vouchers and improved targeting of existing permanent supportive housing units to people experiencing chronic homelessness. These are the very same policy priorities that HUD stated in their FY 2013-2014 Continuum of Care Program competition. Federal agencies are working together to provide the resources, guidance, and technical assistance to support communities to bring housing, health, and hope to our most vulnerable citizens. 

Communities have developed and used tools to identify and reach the most vulnerable people experiencing chronic homelessness. Through rigorous program evaluations, they’ve built a body of evidence that shows definitively that ending chronic homelessness is not only the right thing to do for people, but the fiscally smart thing to do for communities and the nation as well. 

Putting a timeline on the goals of Opening Doors allows us to track progress. It is part of what makes the vision that underlies the Plan concrete, not aspirational.

Opening Doors set the goal of ending chronic homelessness in 2015 based on three facts:

  • We already knew what works to end chronic homelessness—permanent supportive housing using a Housing First approach. 
  • We were not starting from scratch. The goal of ending chronic homelessness was one set by the prior Administration in 2002 and backed with bipartisan support. Many communities had already set local goals and plans to end chronic homelessness. 
  • A national inventory of permanent supportive housing already existed; we just needed to expand it. Specific requests were made to Congress to expand this inventory—requests that unfortunately were never appropriated. 

Since the launch of Opening Doors, our understanding of what works has further solidified, and we’ve seen tremendous progress in many parts of the country. With sufficient appropriations, the goal is within reach in 2016—and we are not relenting. 

Some communities are getting there faster—we are counting on these communities to maintain their resolve. Each extra day we take is another day too long for those who continue to suffer the physical and psychological effects of chronic homelessness.

Preventing and Addressing Tuberculosis among People Experiencing Homelessness

Tuberculosis is a serious health concern for people experiencing homelessness and those working with homeless populations. Tuberculosis rates are 10 times higher for people experiencing homelessness. Of the patients involved in Tuberculosis outbreaks investigated by the Centers for Disease Control and Prevention (CDC) in 2010 – 2012, over half did not have a place to call home.

Learn more about Tuberculosis and what service providers can do to decrease risk and exposure to Tuberculosis   

Ending Youth Homelessness: Preliminary Intervention Model Webinar

On March 18, 2014, the U.S. Interagency Council on Homelessness (USICH), in partnership with the U.S. Departments of Health and Human Services (HHS), the U.S. Department of Housing and Urban Development (HUD), the U.S. Department of Labor (DOL), and the U.S. Department of Education’s Technical Assistance Center, the National Center for Homelessness Education (NCHE), hosted the Ending Youth Homelessness: Preliminary Intervention Model Webinar.

Ending youth homelessness requires partnership and coordinated efforts in communities and at every level of government. The Federal Framework to end youth homelessness includes a Preliminary Intervention Model, designed to help communities identify the systems and capacity necessary to meet the needs of all youth experiencing homelessness.

This Model was developed with two, complementary commitments: 1) using the best available scientific evidence from research involving youth experiencing homelessness to guide the contents of the model, and 2) incorporating a risk and protective factors perspective into understanding the diversity of youth experiencing homelessness. The Model targets specific changes in the life of a young person experiencing homelessness that increase the likelihood of getting the youth to positive core outcomes.

Federal Partners:

  • Eric Grumdahl, USICH
  • Caryn Blitz, HHS ACYF
  • Todd Shenk, HUD
  • Lindsay Knotts, USICH
  • Brian Lyght, DOL
  • Diana Bowman, ED’s Technical Assistance Center, NCHE

Community Panelists:

HUD Event Focuses on Homelessness and Health Care

On February 11, the White House hosted a meeting organized by HUD with homelessness and affordable housing stakeholders from across the country to discuss efforts to enroll low-income Americans in health care coverage that is now available because of the Affordable Care Act. Shaun Donovan, the Secretary of the U.S. Department of Housing and Urban Development, urged the participants to do what is right for the individuals and families who live in affordable housing or who face nights without a roof over their head.

“As the President has said, the great challenge of our time is fulfilling the basic American promise that every person should get a fair shot and the opportunity to thrive,” said Secretary Donovan. “That means every American deserves an affordable home in a safe neighborhood. It also means every American deserves access to quality, affordable health care you can depend on because no one should have to choose between paying the rent or paying their medical bills.”

He told the story of a 63-year old woman from Tampa, who had been unable to afford insurance for years, but with the help of a Health Care Navigator, she managed the application process and found that she could get coverage for $35 a month. She wept when she discovered she could get treatment again, Secretary Donovan said.

Mary Wakefield, Administrator of the Health Resources and Services Administration at the Department of Health and Human Services (HHS), discussed new ways that the Affordable Care Act is benefiting low-income households living in Federally assisted housing and people experiencing homelessness.  First, the Affordable Care Act has increased funding for community health centers, which are often the primary source of health care for people living in public housing and other federally assisted housing.  The second way is by funding programs that specifically reach people experiencing homelessness, such as Maternal, Infant, and Early Childhood Home Visiting Program, school-based health centers, and clinics.

Catherine Oakar, Director of Public Health Policy in the Office of Health Reform at HHS helped paint the picture of the full range of coverage benefits available to all income levels, including an explanation of the challenges faced by residents of states who have not yet opted to expand Medicaid.

Jennifer Ho, Senior Advisor for Housing and Services at HUD encouraged attendees to take action to ensure that everyone in their community who wants affordable health care coverage gets covered. She reminded the audience that having access to health care is key in preventing and ending homelessness, increases the likelihood that people can stay in their homes and afford both their health care and their rent or mortgage, and is a move-up strategy for residents of affordable housing.

USICH Policy Director Richard Cho, who presented on a panel at the event said, “The Affordable Care Act was a huge gift to the Federal effort to end homelessness, providing the possibility that nearly all people experiencing homelessness could get access to health coverage and life-saving health care. It holds tremendous promise for the integration of health and housing, where the health care system attends to housing needs and where States can use Medicaid to pay for services that can help support housing stability.”

The first step to realizing this promise, he added, is to ensure that as many people can get covered by Medicaid and health insurance as possible.

At the end of the event, the participants identified a concrete action they could implement in their communities. Those actions included adding intake questions about health care coverage and connecting housing developments with certified application counselors in their community.

For more information about how you can help get your community covered, email housingandservices@hud.gov

Meet the U.S. Interagency Council on Homelessness

Whether working in the nation’s capital or in States and communities across the country, USICH’s team of talented and resourceful professionals are committed to carrying out the Obama Administration’s mission to prevent and end homelessness. As USICH moves through a leadership transition from Barbara Poppe to Laura Zeilinger as the new incoming executive director, we thought a “refresher” on the complement of USICH team would be helpful. Below are short profiles of policy and program staff who work directly with our Federal partner agencies, and State and local leaders.

Laura Green Zeilinger, Executive Director

On March 7, Laura Green Zeilinger stepped up to the role of Executive Director and now leads the implementation of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, an effort that includes the coordination of all Federal homelessness policies among 19 Federal departments and agencies as well as partnerships among State and local communities, non-profits, and the private sector. “Making the policy work that happens in the interagency space on the Federal level meaningful for States and communities is what energizes me most. I’m also excited about working with our partners to bridge what is happening in the field back to the Federal level,” she said. “In the coming months, I’m looking forward to accelerating our interagency work around employment for families and other populations who are experiencing homelessness.” Recently, Zeilinger worked with Federal partners to create Family Connection: Building Systems to End Family Homelessness. USICH will provide more resources and guidance that will help communities operationalize that framework.

Richard Cho, Senior Policy Director

Richard Cho is based in Washington, DC, where he coordinates USICH's Federal policy efforts and the implementation of Opening Doors. One area of his work that will have long-lasting impacts is his effort to promote housing as a health care intervention. “Because of the Affordable Care Act, we are on the verge of having a transformed health care system that is oriented to addressing the needs of the whole person, including housing needs and homelessness,” Cho said. “I firmly believe that when we have a health care system that is able to provide the supports people need to achieve housing stability, homelessness will be a thing of the past.”

Matthew Doherty, Director of National Initiatives

Matthew Doherty is based in San Diego, Calif., and oversees USICH’s work with State and local leaders across the country. Doherty specializes in working with communities to design and implement newly coordinated systems for linking people experiencing homelessness to the housing and services that best fits their needs and best supports their achievement of their goals. “In the coming months, I am especially excited by the opportunity to add another Regional Coordinator to our team, which will enable USICH to deepen our work with states and communities in the Western U.S,” Doherty said.

Jasmine Hayes, Policy Director

jasmine hayes policy director usich

Jasmine Hayes is based in Washington, DC, and works across Federal agencies to help shape policies that address homelessness among families, children and youth, as well as increasing access to employment and education. Jasmine Hayes has devoted much of her career to the field of child welfare, starting as a case-carrying social worker in Child Protective Services where she worked with youth and families who often struggled with unstable housing, periodic homelessness, unemployment and co-occurring disorders. “I have seen firsthand the impact of homelessness on short- and long-term outcomes for children,” said Hayes. “I believe that there are opportunities in child welfare reform to end homelessness among families.”  

Beverley Ebersold, Regional Coordinator

Beverley Ebersold, based in Detroit, Mich., focuses on achieving the goals set forth in Opening Doors by fostering collaboration and partnership among leaders within communities, local, state, and at the Federal level to promote evidence-based best practices, cost-effective use of resources, and peer-to-peer sharing opportunities across the midwest and far reaching to the northwest. “Over the next few months, I am looking forward to traveling to communities in my regions and visiting leaders across the country, to learn local and state dynamics while building, strengthening, and encouraging partnerships to achieve the goal of ending homelessness,” she said.

Katy Miller, Regional Coordinator

Katy Miller is based in Seattle, Washington, and serves as a principal  representative and bridge between the work of the full Council and states and communities. In this role, she is responsible for facilitating the strategic implementation of Opening Doors specifically in Alaska, California, Idaho, Oregon, Nevada, and Washington state. Katy has been working for more than 18 years as an advocate, housing provider, and funder of homeless housing and services. She  played an important role in launching new initiatives and funding resources to help people move out of homelessness into permanent housing, such as the Washington Families Fund, Landlord Liaison Project, Career Connections, and the Client Care Coordination system for targeted recruitment of the most vulnerable and high utilizers of expensive systems into permanent supportive housing.

Robert Pulster, Regional Coordinator

Robert Pulster is based in Boston, Massachusetts, and works with State and local stakeholders in the northeast, south, and central regions to implement evidence-based practices that are proven to be successful. Specifically, he said he is “looking forward to working in communities to advance USICH's vision of Family Connection: Building Systems to End Family Homelessness. We have the opportunity to expand key actions and I am excited to support the tremendous energy and commitments among our partners to set us on a path to prevent and end homelessness among families.”

Amy Sawyer, Regional Coordinator

Amy Sawyer is based in Philadelphia, Pennsylvania, and works with leaders in states on the east coast and southeast to grow momentum and find ways to leverage and target resources in order to reach the goal of ending homelessness across all populations. “Right now, I’m really excited about my work on human rights and finding alternatives to criminalization. I think it is important for our conversations about homelessness to focus on real people and what they are experiencing,” Sawyer said. Stay tuned for blogs, webinars, and conversations about this important issue.  

For the full list of our talented staff, click here

Executive Director Barbara Poppe at the National Alliance to End Homelessness Winter Conference in New Orleans, LA

In this speech, USICH Executive Director Barbara Poppe discusses USICH's accomplishments, the challenges ahead, and where we all need to focus our attention. 

02/19/2014

Opening

Thank you, Nan [Roman], for your kind remarks and your continued excellence in leading the Alliance.

It’s an honor to precede Bryan Samuels, who was such a great partner at ACYF. I’m grateful for his leadership, which was critical for USICH to craft an interagency approach to youth homelessness, create the Youth Framework, and amend the Opening Doors plan to better address the needs of youth and young adults. We’re delighted to continue our partnership in his new role at Chapin Hall.

It’s also great to be among so many friends and allies in the work to address and end homelessness. You inspire and encourage me. Thank you!

One thing I’ve learned is that it is always a good idea to do what Nan suggests. So I’m going to do just that and focus my remarks on:

  • The accomplishments of USICH in this Administration
  • The challenges ahead, and
  • Where we all need to focus our attention

Context of USICH and the Nation:  2009

As President Obama took office, I was very energized and looking forward to the possibilities of a new administration. Despite the difficult time we were experiencing in Columbus – with an escalating number of foreclosures, soaring unemployment, and an uncertain economy – I was still very hopeful that this administration could bring positive change.

I was ecstatic when Shaun Donovan was announced as the HUD Secretary. He was highly regarded and had always been committed to the expansion of affordable housing. He had a great track record of making permanent supportive housing a critical piece of New York City’s work to end chronic homelessness.

When the President and Congress included HPRP in the Recovery Act, I think everyone in this room will agree that we knew this administration was going to mean business when it came to scaling up housing-focused solutions to homelessness.

I was also overjoyed when the HEARTH Act passed Congress after a 10 year battle that was largely advocates fighting amongst ourselves about the definition of homelessness.

The HEARTH Act signaled the promise of being able to work together across constituencies to modernize HUD’s homelessness assistance programs—aligning them with the best practices and innovations that had been developed in communities across the country.

Little did I know in the early days of this administration, that my personal and family life would be changed forever. It’s been quite the ride for someone with no prior government experience. It’s probably a good thing that I didn’t really know what I was getting into.

I joined USICH in November, 2009. Working on a six-month deadline, we sprinted to deliver a high-quality, comprehensive, and inclusive response to the congressional and presidential call for a Federal strategic plan to end homelessness.

2010 – Developing and Launching Opening Doors

Today, as in 2010, USICH is chaired by HUD Secretary Shaun Donovan, and is comprised of 19 federal agencies with the purpose of coordinating the Federal response to homelessness.

Beginning in January 2010, USICH held regional stakeholder meetings, organized Federal working groups focused on specific populations, solicited public comment through an interactive website, and engaged experts from across the country to develop an action plan to solve homelessness for Veterans, adults, families, youth, and children.

All told, over 9,000 people participated in the development of the Plan. The breadth of ideas as well as the clarity and concurrence around key themes was remarkable.

On that historic day in June 2010 when Opening Doors was launched at the White House, I joined four Cabinet Secretaries to announce the first ever comprehensive Federal plan to end homelessness. In my opening remarks, I recalled President Obama who said that “it is simply unacceptable for individuals, children, families, and our nation’s Veterans to be faced with homelessness in this country.”

Onward to Implementation

Immediately following the launch of the Plan we tackled all 52 strategies within the Federal government, across our 19 agencies, and with partners across the country as well.  (Jennifer Ho, now at HUD, and Anthony Love, now with the VA, were both deputy directors at USICH at that time. They are here today and can back me up on that).

We were, and still are, grateful to everyone in this room who has embraced the Plan and who has helped to execute the strategies of Opening Doors at the national, State, and local level.

That day at the White House, I set forth our intentions for execution of the Plan. Today, I ask you to assess whether we have achieved them.

I said then:

  • “We need Federal leadership to highlight goals and timeframes”.
  • “This is not just a Federal issue. To meet these goals, States, local governments, and the private, non-profit, and philanthropic sectors must be part of the solution. “
  • “There is not a one-size-fits-all plan. We recognize the importance of taking into account local conditions when applying this strategy at the local and State levels.”
  • “Local, State, and Federal governments cannot afford to invest in anything but the most evidence-based, cost-effective strategies.”
  • “We recognize that the best ideas to end homelessness are found outside of Washington.”

I hope your reflection is that we have, together, been true to our intentions.

So what’s been the impact?

Over the last three years (since the launch of Opening Doors), overall homelessness is down by six percent, family homelessness by eight percent, chronic homelessness by 16 percent, and homelessness among Veterans by 24 percent. These aren’t just numbers; these represent real people’s lives impacted by your collective action.

But beyond the numbers and the launch of the Plan, what’s been the impact?

To help me prepare a thoughtful response to Nan’s charge, I enlisted help from the collection of committed, talented, and resourceful individuals who are part of today’s USICH team. The first question I posed was “beyond the launch of Opening Doors, what achievement by USICH has proved the most impactful during our administration? Several staff noted the overall shift in how mainstream programs and services are leveraged to create access for people experiencing homelessness, including:

  • HUD’s guidance to and the engagement of PHAs (where ending homelessness is increasingly becoming central rather than peripheral to their work),
  • HHS’ TANF guidance on rapid re-housing,
  • Medicaid as a payer of services in permanent supportive housing, and,
  • HUD’s multifamily housing preference.

And this progress is not isolated to one program; the overall notion that mainstream programs should, and can, have a specialized focus on homelessness has become an accepted truth. Perhaps more internal to the Federal government is how we’ve transformed the way in which agencies work together and with external partners in trusting relationships.

By using participatory leadership practices to guide our work, frame and re-frame problems, and create effective strategies to combatting immediate and long-term issues, agencies are better able to collaborate with each other and consider solutions that before were out of reach. A good example is the newly released shared definition of rapid re- housing designed in a partnership with the Alliance, HUD, VA, and other Federal agencies.

Our mastery of data intelligence has advanced major federal policy shifts that played out at a community level in system change, program re-design, and budget reprioritization. Nowhere is this truer than the implementation of Housing First in the HUD-VASH program. In 2009, utilization rates and the time to lease-up vouchers were unacceptable to HUD, VA, and also to Congress.

Since then, VA has adopted a Housing First approach and joined forces with HUD, USICH, Community Solutions, and the Rapid Results Institute. The results are remarkable. Targeting of VASH to chronically homeless Veterans is up from less than half to nearly 70 percent of all admissions, with vulnerable families and single adults accounting for the balance.

VA medical centers working with PHAs and CoCs have increased utilization and reduced time from homelessness to housing stability.
Congress did its part and fully funded the VASH program in an era when examples of bipartisanship are difficult to point out.
Most impressive, as I noted, the number of Veterans counted as homeless during the annual PIT count has decreased by 24 percent over the last three years.

The second question I posed to my talented team was, “beyond the fiscal uncertainty of the Federal budget, what is the one challenge you worry the most about?”

Here’s what I heard:

  • I worry that success or failure of Opening Doors will be judged solely by whether people will continue to experience homelessness, ever, even if briefly.
  • I worry that the larger accomplishment of transforming homeless services to a crisis response system that prevents homelessness, or rapidly returns people to stable housing, might be lost in the headlines.
  • Another said: I worry that that rapid re-housing will not get traction and will not become institutionalized as standard practice due to ongoing resistance among local policy makers and provider agencies.

For me, personally, I worry that there will be a next generation of homeless youth if we don’t have the courage to make the changes in policies and programs they need, and if we don’t fight for the resources necessary to scale up the interventions specific to the needs of youth.

Finally, I worry that there will continue to be lack of bipartisan political support for a comprehensive national affordable housing policy, and that we won’t stay united to fight for the affordable housing resources we need.

Nan’s third question was, “What advice would you give the audience?”

  • Keep the families, the youth, the Veterans, the single adults and couples at the center of your work. It’s about them. It’s not about you, your agency, or your ego.
  • Look up and see the bigger picture, how can you join with others for better policy and more resources?
  • K.I.S.S. – keep it simple. We won’t win the hearts and minds of the American public, nor our elected leaders, if we can’t tell the simple story of why and how it’s possible to end homelessness.
  • Change is hard. Change requires resilience. Resilience is about dynamic response. Let go of the status quo.
  • YOLO – you only live once so make it count. Don’t bicker over small things, join forces and make a big difference.  And enjoy and support each other along the way.

Onward to the Next Chapter

Yesterday, Laura Zeilinger was announced as the next Executive Director of USICH.

Laura is the epitome of a dedicated and effective public servant. Her commitment to ending homelessness is absolute. And the urgency and focus to which she approaches each day, each task, and each opportunity to expand our work and make a difference in the lives of people who are looking for stability is so powerful you can’t help but follow her.

Laura believes in partnership, collaboration, setting goals, and reaching them. Over the past three years Laura has helped USICH become a better partner, a better collaborator, and a better supporter of our communities and the work of the Council. I am proud of the work we’ve accomplished together.

She, along with the extremely talented USICH staff, is focused on working with you in the right way, on helping you reach your goal to end homelessness in your community and across this nation. She has a high expectation for the work of USICH—and for the work we’ll do together.

Let’s meet that expectation. Let’s make my list of “worries” obsolete by acting together. In the words of my favorite modern prophet Bono, “there is no them –only us”.

Onward! Together, we can make it possible for all of us to have a safe, stable, and affordable place to call home. Let’s end homelessness.

Thank you.

Core Components of Rapid Re-Housing

Rapid Re-Housing

Rapid re-housing is an intervention designed to help individuals and families to quickly exit homelessness and return to permanent housing. Rapid re-housing assistance is offered without preconditions (such as employment, income, absence of criminal record, or sobriety) and the resources and services provided are typically tailored to the unique needs of the household. The core components of a rapid re-housing program are below. While a rapid re-housing program must have all three core components available, it is not required that a single entity provide all three services nor that a household utilize them all. 

Housing Identification 
 

  • Recruit landlords to provide housing opportunities for individuals and families experiencing homelessness. 
  • Address potential barriers to landlord participation such as concern about short term nature of rental assistance and tenant qualifications. 
  • Assist households to find and secure appropriate rental housing. 

Rent and Move-In Assistance (Financial) 
 

  • Provide assistance to cover move-in costs, deposits, and the rental and/or utility assistance (typically six months or less) necessary to allow individuals and families to move immediately out of homelessness and to stabilize in permanent housing. 

Rapid Re-housing Case Management and Services 

  • Help individuals and families experiencing homelessness identify and select among various permanent housing options based on their unique needs, preferences, and financial resources. 
  • Help individuals and families experiencing homelessness address issues that may impede access to housing (such as credit history, arrears, and legal issues). 
  • Help individuals and families negotiate manageable and appropriate lease agreements with landlords. 
  • Make appropriate and time-limited services and supports available to families and individuals to allow them to stabilize quickly in permanent housing.
  • Monitor participants’ housing stability and be available to resolve crises, at a minimum during the time rapid re-housing assistance is provided.
  • Provide or assist the household with connections to resources that help them improve their safety and well-being and achieve their long-term goals. This includes providing or ensuring that the household has access to resources related to benefits, employments and community-based services (if needed/ appropriate) so that they can sustain rent payments independently when rental assistance ends.
  • Ensure that services provided are client-directed, respectful of individuals’ right to self-determination, and voluntary. Unless basic, program- related case management is required by statute or regulation, participation in services should not be required to receive rapid re-housing assistance. 

COUNCIL APPOINTS LAURA ZEILINGER TO USICH EXECUTIVE DIRECTOR POST

WASHINGTON—Today, Housing and Urban Development Secretary Shaun Donovan announced the appointment of Laura Green Zeilinger to the post  of Executive Director of the U.S. Interagency Council on Homelessness (USICH). Secretary Donovan serves as the Chair of USICH.

“Laura Zeilinger’s track record as an innovative local leader with proven success at the national level makes her the ideal person to serve as Executive Director of USICH,” said Donovan. “Her ability to harness data and take a collaborative approach to problem solving is critical to our efforts to end homelessness and achieve the goals of Opening Doors.”

Secretary Donovan and the White House emphasized the Obama Administration’s historic commitment to ending homelessness through investments in proven solutions and partnerships with local communities to share and implement what works to end homelessness.

“We know the power that a strong partnership between the Federal government and local leaders can bring to addressing some of our most challenging issues," said Cecilia Muñoz, Director of the White House Domestic Policy Council. “Laura’s experience bridging Federal policies with what works in communities will strengthen those partnerships and bring valuable leadership as we strive to achieve our goal of ending homelessness.”

Ms. Zeilinger currently serves as the Deputy Director of USICH, where she manages the implementation of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, an effort that includes the coordination of all Federal homelessness policies among 19 Federal departments and agencies, as well as partnerships among State and local communities, non-profits, and the private sector. A hallmark of Ms. Zeilinger’s contributions to the Council has been her success at engaging communities to develop systems of care that ensure individuals, families, youth, and Veterans are able to obtain or regain permanent housing as quickly as possible and access services to remain stably housed.

Ms. Zeilinger is an attorney with a long standing commitment to underserved populations. Before joining USICH in 2011, she served as the Deputy Director for Program Operations at the District of Columbia Department of Human Services (DHS). There, she led the creation of more than 1,000 units of permanent supportive housing as part of the Homeless No More plan. She also designed and implemented the District’s Housing First Initiative which connected 500 individuals and 80 families to housing stability in its first year alone. Prior to her work with DHS, Ms. Zeilinger served as the Mayor’s liaison between DHS and Office of Disability Rights. She has also led international economic development efforts, managing a technical assistance project to reform the pension system in the Republic of Kazakhstan. Ms. Zeilinger is an alumna of Sarah Lawrence College and a graduate of the Washington School of Law at American University. She lives in Washington, D.C. with her husband and two children.

Ms. Zeilinger will assume the post of Executive Director of USICH on March 7, 2014. Current USICH Executive Director Barbara Poppe announced her departure from the Council earlier this month.

Building Systems to End Family Homelessness:  How Virginia Housed 545 Families

Over the past year, a partnership between the Commonwealth of Virginia, the Virginia Coalition to End Homelessness, and the National Alliance to End Homelessness (NAEH) has led the State to increase their use of rapid re-housing, a Family Connection key strategy area.

“If States and communities want to prevent and end family homelessness, they should expand rapid re-housing practices,” says Kay Moshier McDivitt, the Technical Assistance Specialist at NAEH who worked on the initiative.  “In Virginia, it began when former Governor Bob McDonnell issued an Executive Order to create a new housing policy and prioritize homelessness in the Commonwealth of Virginia. When a major decision-maker or funder steps up like this, it really sets the stage for system-wide change.”

NAEH launched seven Learning Collaboratives, which provided an opportunity for organizations involved to look at the housing and services they were providing at the time, determine the changes that needed to be made, and set clear, system-wide goals for improving access to housing among families with children. Between October, 2013 and January, 2014, thirty-one organizations participated in the Rapid Re-Housing Challenge, an ambitious initiative aimed at assisting as many families as possible in obtaining permanent housing within 100 days. But the job wasn’t finished there. Through tailored service provision and short-term financial assistance when needed, participating organizations are working alongside families to ensure that they have the support necessary to maintain housing.

“This initiative was built upon the Housing First approach,” says McDivitt. “This evidence-based practice informs the way that rapid re-housing is provided to families in Virginia who are experiencing homelessness.”

McDivitt also noted that “setting system-wide standards is critical.” Organizations and funders came together to decide what outcomes they needed to bend the needle on family homelessness. Once these system-wide standards were established, a clear path for ending family homelessness was set.

Virginia has also focused heavily on leveraging mainstream resources to pay for rapid re-housing. “They’re beginning to look at how better to leverage TANF at the State level to expand the practice. By shifting existing Federal and State resources to pay for rapid re-housing, the State has been able to reduce family homelessness by 17 percent,” says McDivitt.

The Commonwealth of Virginia has reported that as a result of the Rapid Re-Housing Challenge, five hundred and forty-five families were connected to permanent housing within 100 days. While there is more to be done to strengthen the local crisis response system, Virginia illustrates that, by focusing on key action areas like rapid re-housing and the strategically using resources and evidence-based practices, communities can end family homelessness. 

Working in Partnership to End Homelessness among Families

Today, USICH releases Family Connection: Building Systems to End Family Homelessness, a resource aimed at expanding an effective partnership with communities across the country to prevent and homelessness for families.

In communities throughout the country, people are performing everyday heroics in effort to meet the needs of families. Yet too often, these providers are faced with the painful inability to adequately respond to families seeking homeless services. The interventions they can offer are frequently determined by where there are open beds in a program, if there are open beds at all.  Even [Text Box: An end to family homelessness: no family will be without shelter and homelessness will be a rare and brief occurrence.] when community stakeholders agree on the importance of assessment and linking a family to an intervention best suited to their circumstances, shifting to such an approach might seem impossible —especially while responding to the constant flow of urgent needs.

Family Connection is designed to support communities and stakeholders to build and implement effective housing-crisis response systems for families.  Due to economic realities and the sheer unpredictability of life, there will likely continue to be situations in which families experience a crisis and lose their homes.  Ending family homelessness does not mean that children and their parents will never experience homelessness again.  It does mean that there will be a response system in place that provides shelter to all who need it, while supporting rapid movement into permanent housing.   An end to family homelessness means that no family will be without shelter and homelessness will be a rare and brief occurrence.

Family Connection outlines the Federal vision of an end to homelessness among families, and it identifies key areas of action needed to reach that vision.

  • Developing local coordinated entry systems to address the immediate crisis of homelessness;
  • Tailoring interventions to respond to the specific strengths and needs of adult and child family members;
  • Linking families to mainstream resources; and
  • Furthering application of evidence-based practices like Housing First and Trauma Informed Care in programs and funding decisions. 

Family Connection has resources, tools, and detailed information embedded throughout to support implementation of the policies articulated in the document.  While many resources are available now, USICH with Federal agencies and policy experts are developing additional tools that will continue to be added and linked to the Family Connection page.

As President Obama remarked last month to an audience of more the 250 mayors from around the country, “We want to cooperate and coordinate with you as effectively as we can to make sure that whatever works is getting out there and hitting the streets and actually having an impact on people’s lives.”  When it comes to impacting the lives of families working to secure permanent housing, what works is becoming clearer and clearer.

Since the launch of Opening Doors in 2010, our nation has reduced homelessness among families by eight percent.  We have much more work to do, and USICH and our Federal partners are with you in this endeavor.  We are eager to learn from your experiences and share best practices.

Together, by sharing and doing what works, we can build the local systems necessary to quickly and safely provide families access to permanent housing. We can ensure that no family lives unsheltered, or experiences homelessness as more than a brief occurrence with a clear pathway to safety and stability.  We can help families participate in the benefits, supports, and community-based services they need to achieve and maintain stable housing. We can continue to identify and implement the prevention methods proven to help families avoid homelessness. As partners in this effort, together we can bring an end to homelessness among families and achieve the vision of Opening Doors.

Working in Partnership to End Homelessness among Families

By Laura Zeilinger, USICH Deputy Director

Today, USICH releases Family Connection: Building Systems to End Family Homelessness, a resource aimed at expanding an effective partnership with communities across the country to prevent and end homelessness for families. 

In communities throughout the country, people are performing everyday heroics in an effort to meet the needs of families. Yet too often, these providers are faced with the painful inability to adequately respond to families seeking homeless services. The interventions they can offer are frequently determined by where there are open beds in a program, if there are open beds at all.  Even when community stakeholders agree on the importance of assessment and linking a family to an intervention best suited to their circumstances, shifting to such an approach might seem impossible — especially while responding to the constant flow of urgent needs.

Family Connection is designed to support communities and stakeholders to build and implement effective housing-crisis response systems for families.  Due to economic realities and the sheer unpredictability of life, there will likely continue to be situations in which families experience a crisis and lose their homes.  Ending family homelessness does not mean that children and their parents will never experience homelessness again.  It does mean that there will be a response system in place that provides shelter to all who need it, while supporting rapid movement into permanent housing.   An end to family homelessness means that no family will be without shelter and homelessness will be a rare and brief occurrence.

 

Family Connection outlines the Federal vision of an end to homelessness among families, and it identifies key areas of action needed to reach that vision:

  • Developing local coordinated entry systems to address the immediate crisis of homelessness;
  • Tailoring interventions to respond to the specific strengths and needs of adult and child family members;
  • Linking families to mainstream resources; and
  • Furthering application of evidence-based practices like Housing First and Trauma Informed Care in programs and funding decisions. 

Family Connection has resources, tools, and detailed information embedded throughout to support implementation of the policies articulated in the document.  While many resources are available now, USICH with Federal agencies and policy experts are developing additional tools that will continue to be added and linked to the Family Connection page.

As President Obama remarked last month to an audience of more the 250 mayors from around the country, “We want to cooperate and coordinate with you as effectively as we can to make sure that whatever works is getting out there and hitting the streets and actually having an impact on people’s lives.”  When it comes to impacting the lives of families working to secure permanent housing, what works is becoming clearer and clearer.

Since the launch of Opening Doors in 2010, our nation has reduced homelessness among families by eight percent.  We have much more work to do, and USICH and our Federal partners are with you in this endeavor.  We are eager to learn from your experiences and share best practices.

Together, by sharing and doing what works, we can build the local systems necessary to quickly and safely provide families access to permanent housing. We can ensure that no family lives unsheltered, or experiences homelessness as more than a brief occurrence with a clear pathway to safety and stability.  We can help families participate in the benefits, supports, and community-based services they need to achieve and maintain stable housing. We can continue to identify and implement the prevention methods proven to help families avoid homelessness. As partners in this effort, together we can bring an end to homelessness among families and achieve the vision of Opening Doors.

More on the Role of the Federal Government

At the Federal level, there are a number of important initiatives under way to advance the cause:

  1. The fact that Opening Doors sets a goal for ending family homelessness is itself important. By adopting this goal, the Administration has committed to doing more than managing a problem—it has committed to figuring out a solution.
  2. The Recovery Act investment of $1.5 billion in Homelessness Prevention and Rapid Re-Housing did many things. It was a strong policy statement with real dollars attached that said we need to focus on prevention and rapid re-housing. It also gave communities needed funding during the economic downturn to stem the rising tide of family homelessness. It created a learning opportunity to determine which strategies deployed locally are the most successful in reducing the number of families entering shelter and the length of time they spend there. Today, the Emergency Solutions Grant (ESG), Continuum of Care (CoC), Temporary Assistance for Needy Families (TANF) funds can be used for deploying rapid re-housing activities.
  3. The Federal government has an important role to play in expanding our knowledge of the nature of homelessness and what solutions work.  Four research projects have been commissioned by the federal government that are of note. Three were commissioned by HUD: 1) an evaluations of the Rapid Re-Housing Demonstration Project which preceded HPRP; 2) a review of models communities used for HPRP; and 3) a multi-site controlled comparison of various interventions for families; and one by HHS, looking at how local communities are linking human services to prevent and end homelessness for families. Additionally, HUD published three research studies last year that shed light on the cost of family homelessness, families’ access to mainstream benefits, and the relative cost of different interventions.
  4. There is active collaboration between and among key Federal agencies with a role in family homelessness, including HHS, HUD, DOL, and ED. Agency staff are coordinating to make lasting inroads. Improved federal coordination can help outcomes for families experiencing homelessness.
  5. HUD has been looking at the role its public housing and affordable housing portfolio plays to prevent family homelessness and house homeless families. These resources are administered locally with local decisions about policy and practice. HUD is looking for ways to guide and support local public housing authorities to adopt best practices to use these resources to prevent and end family homelessness.

More on the Role of Local Communities

Communities across our nation are seeing resources decrease while facing continued high levels of family homelessness. Because of these challenges, it is important for communities to take a step back and take a systems level look at how family homelessness is being addressed. It is clear that the only way to make headway ending family homelessness is to make all systems that touch low-income families work in concert to achieve early interventions and to address housing crises when they occur.

Four key strategy areas for Federal, state, and local action to end family homelessness have been identified:

  • Develop a centralized or coordinated entry system with the capacity to assess needs and connect families to targeted prevention assistance where possible and temporary shelter as needed;
  • Ensure tailored interventions and assistance appropriate to the needs of families:
  • Help families connect to the mainstream resources (benefits, employment, and community-based services) needed to sustain housing and achieve stability, and improve linkages to local mainstream systems to more quickly help families gain access to these resources;
  • Develop and build upon evidence-based practices for serving families experiencing and at-risk of experiencing homelessness.

See Family Connection: Building Systems to End Family Homelessness for more information on each strategy area.

USICH, in partnership with Federal agencies, will publish additional resources as more is learned from the field and Federal partners about effective strategies for building systems to end family homelessness.

Families with Children: Population Trends and Characteristics

Families experiencing homelessness are, as a whole, similar to other very low-income families. They face a range of obstacles such as low educational level, sporadic work histories, domestic violence, health conditions, and mental health issues. Despite these broad similarities, some trends are more prevalent in families experiencing homelessness. Recent data from the Department of Housing and Urban Development (HUD) indicates that approximately 80 percent of families experiencing homelessness are headed by a single mother. Additionally, the average age of the mothers is younger than that of low-income mothers in general, and families that experience homelessness, on average, include younger children.

We also know that domestic violence is a common cause or contributing factor to the loss of housing for many families. The occurrence of domestic violence among women experiencing homelessness is reported as over 60 percent. In addition, recent research has identified a strong correlation between childhood adversity and adults in families later experiencing homelessness. 

The 2013 Point-In-Time Count found 222,197 persons in families, an estimated 70,960 households, homeless on a night in January. Since 2010, there were 19,754 fewer people in families experiencing homelessness on a single night. The decline was most prominent among unsheltered people in families, which decreased by nearly 40 percent. However, the number of sheltered people in families has risen slightly since 2010, by less than one percent. In addition, the Department of Education reports that nearly 1,065,794 children were identified as homeless over the course of the 2010-2011 school year by public schools.

The American Recovery and Reinvestment Act of 2009 resulted in targeted interventions to stem the rise in unemployment and strengthen the housing market, and increased investments in affordable housing and homelessness interventions during the peak of the economic crisis.  However, many of the economic factors associated with homelessness, such as poverty, unemployment, and tight rental markets, still remain at elevated levels. 

The current response to family homelessness relies heavily on emergency shelters and transitional housing. According to HUD’s 2012 Housing Inventory Count (HIC), there were a total of 107,815 temporary and permanent housing units available to assist families experiencing homelessness. The number of rapid re-housing program slots for families fell from 11,519 in January 2011 to 6,422 in January 2012, as funding for the Homelessness Prevention and Rapid Re-Housing Program (HPRP) was ending.

 

Affordable housing, including public housing and Housing Choice Vouchers, are also essential resources that can assist families experiencing homelessness. In most cases, these resources are not targeted specifically to such families. For example, HUD reports that approximately one-third of all Public Housing Agencies (PHAs) have a preference for homeless households. But the data on the number of homeless families being served by these and other PHAs is currently limited and the definition of homelessness being used by PHAs varies widely. 

HUD also reports that the approximately 40 PHAs participating in the Moving to Work (MTW) demonstration are doing more specific work targeting families experiencing homelessness, but these numbers are not reflected in current reporting efforts.  On June 10, 2013, HUD published a notice to provide PHAs with a standard definition of homelessness and guidance for collection of data about this priority population.  This step is key to understanding how to prioritize homeless families for these limited resources.

In addition to temporary and permanent housing resources, a range of both targeted and “mainstream” supportive services exist that could help parents and children move out of crisis, achieve stability, and make progress to improve income, education, and well-being. These include Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), child care subsidies, Low Income Heating and Energy Assistance Program (LIHEAP) and Supplemental Security Income and Social Security Disability Insurance (SSI/SSDI) for parents and children with disabilities.

Other mainstream supportive services include education, employment, and training services for parents, early childhood care and learning support for children under six years old, and school access and academic assistance programs for school-age children. Health care services including primary care, mental health and substance abuse treatment, domestic violence counseling and support, and child welfare services are also available mainstream services that can be provided to families experiencing homelessness.

Many of these services are not entitlements and may be oversubscribed or at capacity and have waiting lists for services. Moreover, there is some evidence that families that experience homelessness encounter barriers to accessing “mainstream” supportive services for which they may be eligible. In addition, most “mainstream” supportive services are not directly linked to permanent housing interventions.  

There is also little discernible difference between families who spend an extended period of time in shelters or transitional housing and those that exit more quickly.  Researchers have found that, both families with relatively short shelter stays, classified as “temporary,” and those with much longer stays, classified as “long-stayers,” face challenges similar to low income families as a whole. However, a small number of families, between two and eight percent of those who use shelter are classified as “episodic.”  These families used shelter on average three or more times during the study period, and, were more likely to have had interactions with other systems such as child protective services or behavioral health services.

Families who use transitional housing, with or without an emergency shelter stay, incur costs that are 44 to 48 percent higher than those that use shelter alone. No research to date has demonstrated significantly better outcomes from stays in transitional housing that justify the greater cost. Emerging data from communities surveyed by the National Alliance to End Homelessness indicates that housing outcomes from transitional housing, both at exit and one year later, are not as strong as from rapid re-housing. Transitional housing typically costs many times more than rapid rehousing. The National Alliance to End Homelessness has reported average costs of rapid re-housing for families of approximately $4,100 compared with transitional housing costs of approximately $22,200 per family.

This suggests that there is an opportunity to reduce per family costs and serve more households by designing homelessness assistance to re-house families to permanent housing more quickly.

While data indicates that families experiencing homelessness have even lower incomes, because families experiencing homelessness are similar to other very low-income families and face similar challenges, we know that predicting which families are likely to become homeless is very difficult. However, we also know that, with the right amount of assistance, connection to permanent housing, the strengthening of local crisis response systems, and the strategic use of resources and evidence-based strategies, communities can ensure that homelessness among families with children is a rare and brief occurrence.

Family Connection: Building Systems to End Family Homelessness

Ending homelessness for families and children is a priority for the nation and each community. By providing the right amount of assistance to help families obtain or regain permanent housing as quickly as possible and ensuring access to services to remain stably housed, achieving an end to family homelessness is possible.

Defining an End to Family Homelessness

Given the current economic realities in most communities, situations in which families experience a crisis and lose their home will likely occur. Recognizing this reality, USICH and Federal partners adopted a vision of an end to family homelessness, to mean that no family will be without shelter, and homelessness will be a rare and brief occurrence. To achieve an end to family homelessness, we encourage communities to join us to realize these ends: 

Working together with our partners at the State, local, and Federal level to strengthen the local crisis response systems, we will:

  • Ensure that no families are living unsheltered
  • Shorten episodes of family homelessness by providing resources that enable families to safely reenter permanent housing as quickly as possible,
  • Link families to the benefits, supports, and community-based services they need to achieve and maintain housing stability and
  • Identify and implement effective prevention methods to help families avoid homelessness.

Key Areas of Action

USICH and Federal partners, through a review of research, engagement with communities, and an interagency working group process, identified four key strategy areas for Federal, state, and local action to end family homelessness:

                - Provide rapid re-housing assistance to the majority of families experiencing homelessness

                - Increase access to affordable housing, and help communities target resources and

                - Direct more service-intensive housing interventions to the highest need households

  • Help families connect to the mainstream resources (benefits, employment, and community-based services) needed to sustain housing and achieve stability. Improve linkages to local mainstream systems to help families gain access to these resources more quickly
  • Develop and build upon evidence-based practices for serving families experiencing and at-risk of experiencing homelessness 

USICH and Federal partners are aligned around this approach and committed to supporting communities and stakeholders through the use of interagency messaging, policies, and technical assistance. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Coordinated Entry System

Families experiencing homelessness have varying levels of service needs and strengths. An effective response prevents homelessness or addresses the immediate crisis of homelessness, and then connects families to the most appropriate level and type of assistance based on their strengths and needs. Effective crisis response systems have coordinated access or entry points through which families can seek help, have their needs and strengths assessed, and be connected to appropriate housing and supports. The assessment supports the ability for families to be given access to the best options to address their needs, rather than being evaluated for single programs.

As a result of the assessment process, families can be assisted to maintain or obtain permanent housing while avoiding a shelter stay.  Prevention and diversion assistance may include a combination of financial assistance, mediation, housing location, or other supports.  When the intervention is aimed at helping families stay in their current housing, safety should be a primary consideration.

Temporary shelter with stabilization services provides immediate safety for a family and address immediate crisis needs, including specialized domestic violence shelters and services. Stabilization services may include access to school or early childhood care and learning, benefits, and health services, including substance use and mental health services. Housing placement is the primary objective for temporary shelter.

Safety for Survivors of Domestic Violence – In order for coordinated entry systems to function, providers may need to change their admissions policies to remove barriers to entry that may be embedded in eligibility criteria and accept referrals from the coordinated access point(s). As many families experiencing homelessness are significantly impacted by domestic violence and other trauma, effective entry systems have the training and capacity to engage in a trauma-informed way and identify victims of domestic violence. Successful systems also offer safety planning, advocacy, and access to specialized services that address the safety concerns of individuals fleeing domestic violence and their children. Effective systems are able to assess the needs of children and youth and make effective linkages for appropriate services.

Tailored Interventions and Assistance

Rapid Re-housing helps individuals and families quickly exit homelessness to permanent housing. Rapid re-housing assistance is offered without preconditions (such as employment, income, absence of criminal record, or sobriety) and the resources and services provided are typically tailored to the unique needs of the household. The core components of a rapid re-housing program include housing identification services, financial assistance for rent and move-in, and accompanying case management and supportive services. While a rapid re-housing program has all three core components available, it is not required that a household utilize them all.

Permanent Supportive Housing is long term affordable housing with ongoing services for families with disabilities and high levels of need, such as those who have been repeatedly homeless or high users of other systems of care. Supportive housing that uses a Housing First approach needs to be available at a scale sufficient to serve the households that require this approach to be successful.

Many households can resolve their homelessness without needing either rapid re-housing or permanent supportive housing. Partnerships between homeless service providers, public housing agencies, and other affordable housing providers help expedite quick access to housing.

Transitional Housing programs provide temporary residence combined with intensive services —usually for up to 24 months—for people experiencing homelessness. Transitional housing may currently represent a significant portion of the inventory in many communities. While transitional housing programs may meet the needs of a sub-population of families, it is important to evaluate programs for effectiveness and efficiency at achieving permanent housing outcomes relative to other housing interventions.

Connection to Mainstream Resources

Beyond housing, a range of community-based benefits and supportive services can help parents and children move out of crisis, achieve stability, and improve income, education, and well-being. Given limited resources for homeless specific assistance programs, it is essential that communities develop strategies to improve access to and coordination with mainstream benefits and services. Local mainstream or community service programs can provide comprehensive, wrap-around services for families and children, as needed. More effective coordination between homelessness services, prevention efforts, and mainstream programs is essential. Such a system-level transformation takes a great deal of community-level partnership and engagement.

Evidenced-Based Practices

There is a wealth of evidence and data on practices that improve the efficiency and effectiveness of interventions to support families at achieving and maintaining a permanent housing outcome. Communities can apply this knowledge to their programs and funding decisions to improve outcomes. For example, there is an opportunity for communities to adopt housing first principles, ensure the use of trauma-informed services in every intervention, apply critical time intervention, and connect families with early childhood home visiting and early childhood education programs. Enhancing services for families through the implementation of evidence-based practices can lead to a range of improved outcomes for parents and their children while making scarce resources go further.

Together We Can End Family Homelessness

An end to family homelessness requires partnership across all levels of government and sectors as well as across a range of disciplines. Reaching an end to family homelessness is challenging, but dramatic improvements are achievable with the right amount of assistance, connection to permanent housing, the strengthening of local crisis response systems, and the strategic use of resources and evidence-based strategies. An increase in resources to grow the supply of affordable housing is critical component to this effort.

USICH, in partnership with Federal agencies, will publish additional resources as more is learned from the field and Federal partners about effective strategies for building systems to end family homelessness.

BARBARA POPPE TO STEP DOWN FROM USICH POST

WASHINGTON— After more than four years in office, U.S. Interagency Council on Homelessness (USICH) Executive Director Barbara Poppe today announced that she will step down on March 7, 2014. 

Ms. Poppe, who was appointed USICH Executive Director in October 2009, oversaw the development and launch of Opening Doors, the nation’s first-ever strategic plan to prevent and end homelessness. Opening Doors has led to a reduction of homelessness by six percent overall in the United States, including a 24 percent reduction in homelessness among Veterans, a 16 percent reduction in chronic homelessness, and an eight percent reduction in homelessness among families. During Ms. Poppe’s tenure as Executive Director, four different Cabinet Secretaries—each serving a one-year term—have chaired the Interagency Council on Homelessness: HUD Secretary Shaun Donovan, former DOL Secretary Hilda Solis, HHS Secretary Kathleen Sebelius, and VA Secretary Eric Shinseki. 

During her tenure, and as a result of the American Recovery and Reinvestment Act’s Homelessness Prevention and Rapid Rehousing Program, the Administration was able prevent and end homelessness for over 1.3 million Americans with the one-time HUD funds. The program also drove innovations to community homelessness response systems across the country, creating coordinated and effective systems of care that seek to quickly connect individuals and families experiencing homelessness with permanent housing and supportive services.

“It has been an incredible honor and privilege to work with the dedicated and talented USICH staff, who strive every day to reach the goal of ending homelessness,” said Ms. Poppe. “Over the last four years, we coordinated unprecedented levels of collaboration among federal agencies; we built and strengthened critical partnerships with states and local communities, advocates, businesses, non-profits, and philanthropists; and most importantly, together we’re ending homelessness.”

Ms. Poppe credits the success of Opening Doors to the leadership of President Obama and the Council chairs. “The President has shown at every step his commitment to ending homelessness,” said Ms. Poppe. “Secretary Donovan, Secretary Shinseki, and Secretary Sebelius have literally taken that commitment to the streets—mobilizing efforts and investments toward the strategies we know work to end homelessness.”

“I want to express my deep gratitude to Barbara Poppe for her leadership at USICH and her relentless dedication to ending homelessness,” said Secretary Donovan. “When Barbara joined USICH, this nation was in the midst of a historic recession that was threatening the housing stability of millions of Americans and their families. Despite those challenges and every economic indicator that said homelessness would be on the rise, this nation made real progress toward ending homelessness. Much of our progress is a result of Barbara’s hard work.”

“Barbara’s leadership and coordination of multiple departments and agencies has been critical in our ongoing fight to end homelessness,” said Cecilia Muñoz, Director of the White House Domestic Policy Council. “She has helped prove that we can solve difficult social challenges when the federal government partners with local leaders.”

Prior to joining USICH, Ms. Poppe served as executive director of the Columbus, Ohio-based Community Shelter Board from 1995 to 2009. Community Shelter Board is a nationally recognized non-profit organization that creates collaborations, innovative solutions, and invests in quality programs to end homelessness in Columbus and Franklin County, Ohio.

Secretary Donovan and the White House are working quickly to announce a new Executive Director who we expect to announce in the coming weeks.

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USICH coordinates the federal response to homelessness and creates partnerships at every level of government and with the private sector to reduce and end homelessness in the nation while maximizing the effectiveness of the federal Government in contributing to the end of homelessness. USICH is comprised of the heads and representatives of 19 federal departments and agencies as well as the White House.

HUD, VA & USICH Participate in 2014 DC PIT Count

On the night on January 29, hundreds of volunteers walked the streets of D.C. to take part in the annual Point-in-Time (PIT) count, providing a snapshot of the number of people experiencing homelessness on any given night.

Secretary Shaun Donovan of the Department of Housing and Urban Development, Secretary Eric Shinseki of the Department of Veteran Affairs, and Barbara Poppe, Executive Director of the U.S. Interagency Council on Homelessness, were among the hundreds of dedicated volunteers counting those without a home. From the Secretaries’ speeches before the count to everyone’s participation on the street, this video reveals the immense effort, determination and energy that go into PIT counts across the country.

As Secretary Donovan reminds us, PIT counts are not just about the numbers, but also about every person those numbers represent. “We’re counting, but we are doing more than counting too,” he said. “We’re finding out if somebody is a Veteran, have they served the country at some point? Are we talking about a youth, who may be homeless? And we are trying to find out why.”

This video was posted on the Veteran Affairs blog page. To view the original content, please click here. 

Laura Green Zeilinger

Laura Green Zeilinger is the Executive Director of the United States Interagency Council on Homelessness. Ms. Zeilinger is responsible for the implementation of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, an effort that includes the coordination of Federal homelessness policies among 19 Federal departments and agencies, as well as partnerships with State and local communities, non-profits, and the private sector. Under her leadership, USICH provides technical assistance and supports to communities across the country, building systems of care that ensure individuals, families, youth, and Veterans are able to obtain or regain permanent housing as quickly as possible and access services to remain stably housed.

Ms. Zeilinger is an attorney with a long-standing commitment to underserved populations. She joined USICH in 2011, and prior to her appointment as Executive Director in 2014, she served as Deputy Director. Previously, she served at the District of Columbia Department of Human Services (DHS) as Deputy Director for Program Operations. There, she led the creation of more than 1,000 units of permanent supportive housing as part of the Homeless No More Plan. She designed and implemented the District’s Housing First Initiative, which connected 500 individuals and 80 families to housing stability in its first year alone. Prior to her work with DHS, Ms. Zeilinger served as the Mayor’s liaison to DHS and the Office of Disability Rights. She has also led international economic development efforts, managing a technical assistance project to reform the pension system in the Republic of Kazakhstan. Ms. Zeilinger is an alumna of Sarah Lawrence College and a graduate of the Washington College of Law at American University. She lives in Washington, D.C., with her husband and two children.

Medicaid Home and Community Based Services

On January 16, 2014, the Centers for Medicare & Medicaid Services (CMS) posted in the Federal Register their Final Rule for Medicaid Home and Community Based Services (HCBS). The rule will be effective March 17, 2014. HCBS refers to services that States can cover under Medicaid to help people with disabilities achieve independence and recovery in and around their homes in the community—services like case management, personal care and habilitation (assistance with gaining socialization and independent living skills). USICH identifies HCBS as one of the most promising ways that States can use Medicaid to cover many of the services delivered in permanent supportive housing for people experiencing chronic homelessness.

The regulation clarifies the qualities of settings where individuals can receive HCBS, in essence defining what it means for a setting to be “community based” and preventing its use in institutional settings. Community settings possess qualities like integration in the community and ensure individual rights of privacy, and optimize autonomy and independence. The regulation also outlines additional requirements for settings in which the service provider is also the building owner or operator, requirements like ensuring that tenants have leases, have freedom to furnish and decorate their units, and the ability to have visitors. 

The qualities of HCBS settings outlined in the Final Rule closely match the characteristics and qualities of permanent supportive housing—the cornerstone of the strategy for ending chronic homelessness.  As such, these regulations open the door even further for States to use HCBS to cover services in permanent supportive housing for people with disabilities experiencing homelessness. In addition, the regulations provide States with more flexibility to provide expanded home and community based services and to target services to specific populations. USICH encourages States to consider how HCBS, through the 1915i State plan option, can help create services to end chronic homelessness.

The full text of the final regulation can be found here. CMS also released helpful fact sheets that summarize the regulations.  CMS will be holding informational webinars in the next several weeks.  Questions regarding the final regulation can be submitted to hcbs@cms.hhs.gov. For a hard-copy “primer” providing more general information on Medicaid HCBS, contact Emily.rosenoff@hhs.gov, and provide your name, mailing address, and number of copies requested.  

New Funds to End Veteran Homelessness: What Communities Should Know about the $600 Million SSVF Funding Opportunity

On Tuesday, January 14, 2014, the Department of Veterans Affairs (VA) announced up to $600 million in new funds available for the Supportive Services for Veteran Families (SSVF) program. The Notice of Funding Availability (NOFA) includes up to $300 million in FY 2014 funds and $300 million in FY 2015 funds.

Overview of SSVF

SSVF has been critical to progress on ending Veteran homelessness. The program delivers prevention for Veterans and their families at-risk of homelessness, and rapid re-housing for Veterans and their families experiencing homelessness. These services can include support services like landlord mediation, housing placement support, case management, making connections to benefits, and employment assistance. SSVF providers can also deliver short-term financial assistance, such as rental assistance, funds for damage deposits, paying off past utilities, or helping to resolve debts that impede housing stability for Veterans and their families.

The growth in this program is based on its remarkable success: for Veterans who exited the program in FY 2012, 86 percent had a successful housing outcome, at an average cost of only $2,800 per household. 

VA awards SSVF grants to private nonprofit organizations and consumer cooperatives that assist very low-income Veterans and families. Individual Veterans and Veteran families must have household income at or below 50% of the area median income in their community to be eligible.

The FY 2014-FY 2015 SSVF Funding Opportunity

Existing SSVF programs can apply to renew funding, and new applicants can propose programs to serve very-low income Veterans and their families. Below is a summary of Priority levels, guiding questions for applicants, and CoC considerations for letters of support. 

Overview of Priority Levels

To distribute funding to address the highest levels of need, applications are divided into Priority 1, 2, and 3, based on whether programs are proposing to serve identified high-need communities (Priority 1), submitting renewal applications (Priority 2), or are first-time applicants in other areas (Priority 3).

The table below summarizes the definition, funding availability, and application requirements for Priority 1, 2, and 3 applications:

 

 

 

 

 

 

 

 

 

 

*A list of the 76 high-need CoCs along with the available 3-year funding available for each CoC is found on page 2539 in the NOFA.

** To qualify under Priority 2, a SSVF grantee’s proposed program concept must be substantially the same as the current program concept.

Guiding Questions for Applicants

We recommend that programs carefully review the scoring criteria found in the NOFA and in related Federal Regulations.  Below, we provide an overview of the scoring criteria with the total number of points available in each criterion and some guiding questions to help address each criterion in the application.

Background, experience, qualifications, and past performance (35 points)

  • What kind of experience does the program and partners have in providing services to individuals (and Veterans specifically) experiencing or at-risk of homelessness?
  • What kind of qualifications and experience does the program staff have in supporting Veterans experiencing or at-risk of homelessness?
  • Does the program or partners have experience with Housing First?
  • For programs that have been in existence for some time, what outcomes or measurable results has it achieved? 

Program concept and supportive services plan (25 points)

  • Using data, what is the need of very low-income Veterans in the program’s community?
  • What is the program’s and partners’ plan for finding, screening and assisting program participants (in coordination with other community and VA resources)?
  • Does the plan use models such as Housing First or Critical Time Intervention?
  • What services does the program and partners offer to participants?

Quality assurance and evaluation plan (15 points)

  • Given community need, what outcomes does the program or partners expect to achieve?
  • How will performance be measured?
  • What happens if the program and partners do not achieve the desired outcomes?

Financial capability and plan (15 points)

  • What is the rationale behind the program budget? What assumptions are contained within the budget?
  • How will the program and partners track the use of grant funds and ensure program compliance?

Area and community linkages and relations (10 points)

  • What is the program’s relationship to local services providers and the Continuum of Care?
  • What is the program’s and partners’ relationship with local VA homeless services?

Considerations for Continuums of Care (CoC)

To promote planning and coordination efforts between Veteran programs and the CoC, the NOFA emphasizes  linkages between SSVF programs and the local CoC by requiring Priority 1 applicants (and strongly encouraging Priority 2 and 3 applicants) to obtain a letter of support from its local CoC.

Since CoCs in Priority 1 communities may endorse only up to two applicants, organizations may want to consider applying jointly as partnerships or consortia and describe the structure and relationships of the joint efforts.

To help CoCs provide an endorsement for prospective SSVF applicants, VA has created a Pre-Application Review Template and Tool. Use of the tool template and tool is voluntary, but can be helpful in planning a letter of support for the SSVF applicant.

More Resources

Communities interested in applying can find the NOFA announcement, training, and application information at http://www.va.gov/homeless/ssvf.asp. The NOFA announcement provides detailed information on the funding opportunity, including information on eligibility, application and submission, award review and administration, and contact information. In addition, detailed information regarding application criteria may be found in 38 CFR 62.21–.25.   

Applicants may also be interested in listening to an audio recording or viewing the presentation slides (PDF) webinar on this year’s NOFA hosted by VA. Applicants may also register here for free NOFA training offered in selected cities.

President Lauds Collaborations to End Homelessness

Mayors Prove that Ending Chronic Homelessness Among Veterans is Possible

President Lauds Efforts in Phoenix, Salt Lake City

In last night’s State of the Union address, President Obama highlighted the incredible collaborations happening across all levels of government to end homelessness. 

“And across the country, we’re partnering with mayors, governors and state legislatures on issues from homelessness to marriage equality.”

Last week at a White house reception for more than 300 mayors, the President spoke specifically about the critical role mayors play in the lives of Americans, holding up the achievements of Mayor Ralph Becker of Salt Lake City and Mayor Greg Stanton of Phoenix, Arizona and their communities as proof that progress can be made despite challenges.  

“Everyday mayors are proving that you don’t have to wait for the gridlock to clear in congress in order to make things happen.  Mayor Greg Stanton in Phoenix and Mayor Ralph Becker in Salt Lake City have ended chronic homelessness among Veterans.”

Mayor Becker and Mayor Stanton recently announced that their communities have ended chronic homelessness among Veterans. Innovation, outcome-focused planning, and aggressive commitment combined with strategic investment at the Federal and levels, made it possible to solve what some have considered an intractable problem. Setting an example for the rest of the country, Mayor Becker and Mayor Stanton engaged in a “friendly competition” to see which community would be the first to house Veterans who were experiencing chronic homelessness. The competition, however, is not over. Both mayors have stated that this success is just one step on their way to ending homelessness among all Veterans in their communities.

Last week, four more mayors -- Mayor Chris Coleman of St. Paul, Minn., Mayor Betsy Hodges of Minneapolis, Mayor T.M. Franklin Cownie of Des Moines, Iowa, and Mayor Michael B. Coleman of Columbus, Ohio -- announced their own “friendly competition” to see which can be the first Midwest community to end homelessness among Veterans. 

National Progress and Keeping Promises

Over the past three years, homelessness among Veterans has been reduced by 24 percent, nationally. . Significantly increased Federal investment in programs like HUD-VASH and Supportive Services for Veteran Families, which research shows are effective is frequently cited as a key reason for progress.

“Across the Obama Administration we believe that no Veteran, no man or woman who has served our country, should face homelessness in our country,” said USICH Executive Director Barbara Poppe. “By working with mayors and other leaders across the country it is possible to achieve this vision.”

As the First Lady has said, “We need to uphold the dignity and rights of every veteran. And that starts by keeping up our campaign to end homelessness among veterans.”

Proven Practices Lead to Success

Mayor Becker and Mayor Stanton credit the use of evidence-based practices and community collaborations, in addition to federal investment, as the drivers of their success.  Both note the importance of adopting Housing First practices key to reach this important milestone in their goal to end Veteran homelessness in their communities. Housing First offers individuals and families experiencing homelessness immediate access to permanent affordable or supportive housing without clinical prerequisites like completion of a course of treatment or evidence of sobriety.

In a USA Today piece, Mayor Stanton explained that “navigators” – often peers -- worked one-on-one with Veterans living on the streets to connect them to housing and help them navigate the system to get the financial and other supports necessary to be successful.

Mayor Becker cites the effectiveness of the 100,000 Homes Campaign and the Rapid Results approach as a way to align and leverage community resources to solve chronic Veteran homelessness.

Through smart use of federal resources, leveraging local resources and applying proven strategies, Mayor Becker and Mayor Stanton have demonstrated that ending homelessness is possible. In speaking recently about the importance of ending homelessness among Veterans, Shaun Donovan, Secretary of the U.S. Department of Housing and Urban Development said, “There is no good reason we should allow our fellow Americans to be left out in the cold when we know we have the tools to make a difference in their lives. There is certainly no good reason we should allow our Veterans to remain on the streets.”

To learn more: Check out USICH’s “Housing First Checklist” to assess whether and to what degree your community and programs are employing a Housing First approach.

Native American Homelessness Expert Panel

On September 27, 2012, the Substance Abuse and Mental Health Services Administration (SAMHSA), the U.S. Interagency Council on Homelessness (USICH), and other Federal agencies convened an expert panel on homelessness among American Indians, Alaska Natives, and Native Hawaiians. The purpose of the panel was to inform efforts to end homelessness among American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) populations and to provide recommendations for preventing and ending homelessness among AI/AN/NH people.

The discussion focused on three general themes:

  • What does homelessness look like among American Indians, Alaska Natives, and Native Hawaiians?
  • What strategies are working to prevent homelessness or to help people who become homeless?
  • What could tribal, State, or Federal governments and the field in general take that would be helpful?

The panelists identified a number of successful strategies, including unconditional housing, ensuring access to care, addressing trauma, incorporating Native traditions, fostering community connections, acknowledging racism, and making connections to employment.

Substance Abuse Services

Substance abuse treatment services include participant intake and assessment, outpatient treatment, group and individual counseling and drug testing.

Which HHS programs might be used to provide these services?

Medicaid

Medicaid pays for a broad range of behavioral health services provided by qualified providers to people who are enrolled in Medicaid coverage. Each state must develop a State Medicaid Plan that describes the benefits its program will provide (including what optional services will be covered),  and must have this plan approved by the U.S. Department of Health and Human Services’ (HHS’s) Centers for Medicare and Medicaid Services (CMS).

Federal law and CMS regulations prescribe a core set of benefits that each State must provide. Mandatory benefits include inpatient and outpatient hospital services; nursing facility, rural health clinic, Federally Qualified Health Center (FQHC) services, prenatal and freestanding birth center services; physician, nurse-midwife, and certified pediatric and family nurse practitioner services; home health, family planning, tobacco cessation, laboratory, X-ray services; and early and periodic screening, diagnostic, and treatment (EPSDT) services for children under age 21.

States may decide to cover additional optional services. Optional benefits include clinic services; prescription drugs; rehabilitative services; case management; home and community based services (HCBS) as an alternative to institutionalization; physical, occupational, speech, hearing, and language therapy; diagnostic, screening, and a variety of other services that may be approved by CMS.  States and may limit eligibility for certain additional services to specific groups of people. States may modify their Plan’s coverage of services beyond the federally-mandated core, including changes in provider qualifications, definitions of covered services, target populations, and payment mechanisms for optional benefits.

For both Mandatory and Optional benefits, an individual still must meet “medical necessity” criteria to be eligible for particular covered services. These criteria take into consideration a person’s diagnosis and other factors such as functional impairments.

Who is eligible?

Medicaid is an “entitlement” program, meaning that eligible individuals are entitled to receive covered health, behavioral health, and long-term care services, as defined within the State’s approved Medicaid Plan. The Affordable Care Act expands Medicaid eligibility to persons with incomes under 133% of the Federal Poverty Level (FPL), and allows States to determine eligibility under their Medicaid plans.

How is it financed?

The Medicaid program operates under broad State discretion, and is funded by a combination of State and Federal matching funds.  Each State must develop a State Medicaid Plan that describes the benefits its program will provide.  Many Medicaid benefits, including those most likely to cover behavioral health services delivered in settings such as shelters, drop-in centers, or supportive housing programs, are “optional” benefits, meaning that States can decide if and how to cover these services.  Federal spending on Medicaid is considered a “mandatory” program, meaning that the Federal government matches State spending for all covered services provided to eligible individuals.  This makes Medicaid distinct from other HHS health and supportive services programs, which operate as “discretionary” programs with funding levels that can change from year to year based on actions taken by Congress and the President.

Where do I learn more about the substance abuse services covered under Medicaid?

Where can I find which States have expanded Medicaid?

Medicaid.gov

Substance Abuse Prevention and Treatment Block Grant (SABG)

SAGB is given to States to address their unique behavioral health issues.  There are two main SAMHSA block grants, the Substance Abuse Prevention and Treatment Block Grant (SABG) and the Community Mental Health Services Block Grant (MHBG).  Specifically the Block Grant funds are directed toward four purposes:

  • Fund priority treatment and support services for individuals without insurance or for whom coverage is terminated for short periods of time.
  • Fund those priority treatment and support services not covered by Medicaid, Medicare or private insurance for low income individuals and that demonstrate success in improving outcomes and/or supporting recovery.
  • Fund primary prevention - universal, selective and indicated prevention activities and services for persons not identified as needing treatment.

How is it financed?

States apply for the grant funding through SAMHSA and determine how to spend the funds for prevention, treatment, recovery supports and other services that will supplement services covered by Medicaid, Medicare and private insurance. States fund a network of providers to deliver services, sometimes through a formula funding process.

How does a CoC partner with SABG-funded Agencies?

SABG Grantees

ATR (Access to Recovery)

This SAMHSA program is designed to provide client choice among substance abuse clinical treatment and recovery support service providers, expand access to a comprehensive array of clinical treatment and recovery support options (including faith-based programmatic options), and increase substance abuse treatment capacity, consistent with proven models.  A major goal of the ATR program is to ensure that clients have a genuine, free, and independent choice among a network of eligible providers, using vouchers to access services.  Grantees (State agencies responsible for substance use disorder services or tribal organizations) are encouraged to develop provider networks that offer an array of clinical treatment and recovery support services that can be expected to result in cost-effective, successful outcomes for the largest number of people.

How is it financed?

SAMHSA’s ATR grants provide funding to Single-State Substance Abuse Agencies in the States, territories, and the District of Columbia, tribes and tribal organizations to carry-out voucher programs for substance abuse clinical treatment and recovery support services. ATR grants were offered in 2004, 2007, and 2010.  In the latest round, 30 grants were awarded. The 2010 round is currently in its 4th year of a 4-year grant that ends September 29, 2014.

Where can I find a local ATR provider with which to partner?

ATR Grantees

Health Care for the Homeless Programs and Community Health Centers

Health Care for the Homeless Programs and Community Health Centers deliver primary care and preventive health services as well as oral health services and services to address substance use disorders and mental health.  Some behavioral health services may be delivered directly or through partnerships or referral arrangements with other providers of treatment services. Health Care for the Homeless programs also offer extensive outreach, engagement and case management services, and they often offer transportation and interpretive services, to help people access health care and behavioral health services, as well as assistance with accessing public benefits. Health Care for the Homeless programs are targeted to persons who are homeless and local programs are encouraged to participate in the local CoC planning process.  The first step for any Continuum should be to reach out to any HCH program in its jurisdiction and connect to current services.

How is it financed?

These programs receive grant funding from the Health Resources and Services Administration (HRSA).  In addition, they receive Medicaid reimbursement for some of the services they provide to people who are enrolled in Medicaid.

Where can I find a local HCH provider with which to partner?

Healthcare for the Homeless Grantees

Where can I find a local Community Health Center with which to partner?

Find a Health Center

PATH (Projects for Assistance in Transition from Homelessness)

PATH programs provide services to people who are experiencing mental illness and are experiencing homelessness or risk of homelessness.  PATH eligible services include habilitation and rehabilitation services, case management services, referrals, and housing support services, as well as outreach and a range of other behavioral health services. PATH programs are administered by the State.  State mental health authorities select providers, usually through a competitive process.  PATH providers are encouraged to participate in the local CoC process and all PATH providers are in the process of transitioning data and reporting practices to participate in HMIS

Who is eligible?

Individuals determined to be experiencing serious mental illness or co-occurring serious mental illness and substance abuse disorder; and (2) experiencing homelessness or at imminent risk of homelessness.

How is it financed?

PATH is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). PATH is a formula grant provided to all 50 States, the District of Columbia, and US territories, and allocated to more than 480 local organizations.

Where can I find a local PATH provider with which to partner?

SAMHSA PATH Providers

Cooperative Agreements to Benefit Homeless Individuals (CABHI)

This SAMHSA services program supports infrastructure development at the community and State levels. The major goal of the Cooperative Agreements to Benefit Homeless Individuals program is to ensure that the most vulnerable individuals who are chronically homeless receive access to sustainable permanent housing, treatment, and recovery supports through mainstream funding sources. CABHI funds support three primary types of activities: 1) behavioral health, housing support, and other recovery-oriented services not covered under a State's Medicaid plan; 2) coordination of housing and services for chronically homeless individuals and families at the State and local level which support the implementation and/or enhance the long-term sustainability of integrated community systems that provide permanent housing and supportive services; and 3) efforts to engage and enroll eligible persons who are chronically homeless in Medicaid and other mainstream benefit programs (e.g., SSI/SSDI, TANF, SNAP). 

Who is eligible?

Persons who experience chronic homelessness with substance use disorders or co-occurring substance use and mental disorders.

How is it financed?

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Center for Substance Abuse Treatment (CSAT) and the Center for Mental Health Services (CMHS) provided grant funding to States.

Where can I find CABHI grantees with which to partner?

CABHI Grantees

Which states received CABHI-States funding?

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Center for Substance Abuse Treatment (CSAT), and the Center for Mental Health Services (CMHS) recently modified its Cooperative Agreement to Benefit Homeless Individuals (CABHI), which provided grants directly to entities that provide services, into the ‘CABHI-States’ program focused on building State infrastructure and improving the capacity of State treatment service systems to provide services essential to ending chronic homelessness among people with substance abuse, mental health, and/or co-occurring disorders.

For FY 2013, eligible applicants for CABHI-States are the single State agencies for substance abuse in the District of Columbia (D.C.) and the following States: Arizona, California, Colorado, Florida, Georgia, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Michigan, Nevada, New York, Oregon, Pennsylvania, Texas, and Washington. Services to be created through CABHI-States should include recovery-oriented services not covered under the State’s Medicaid plan including: treatment services; permanent supportive housing; peer supports; CMHS-funded peer navigator(s); assistance with streamlining application processes for mainstream benefits; and more. 

SAMHSA awarded eleven grants for up to $711,818 per year for up to 3 years.   The States that were funded are: Arizona, Georgia, Hawaii, Washington, Louisiana, Illinois, Pennsylvania, Massachusetts, Michigan, Colorado and Nevada. Each CABHI-State grantee will implement its own approach to issuing funding for services. Organizations seeking funding for services should contact the single State agencies who received an award for more information.  

Outreach Services

Outreach services are activities used to engage persons for the purpose of providing immediate support and intervention, as well as identifying potential program participants. Outreach services may include initial assessment; crisis counseling; addressing urgent physical needs, such as providing meals, blankets, clothes, or toiletries; and actively connecting and providing people with information and referrals to homeless and mainstream programs.

Which HHS programs might be used to provide these services?

Health Care for the Homeless Programs and Community Health Centers

In addition to primary care and some behavioral health services, Health Care for the Homeless (HCH) programs provides outreach services to assist difficult-to-reach homeless persons in accessing care, while Community Health Centers provide health services to persons who are underserved and face barriers to accessing health services. Partnership at the State and local level with both Health Care for the Homeless Program and Community Health Centers play a crucial role in ensuring that people experiencing homelessness receive necessary healthcare. Health Care for the Homeless programs are targeted to persons who are homeless and local programs are encouraged to participate in the local CoC planning process.  The first step for any Continuum should be to reach out to any HCH program in its jurisdiction and connect to current services.

Who is eligible?

Individuals and families who are literally homeless as well as those living in hotels or motels, transitional housing, or permanent supportive housing.

How is it financed?

These programs receive grant funding from the Health Resources and Services Administration (HRSA) as well as a grant under Section 330 of the Public Health Service Act, qualifying them as Federally Qualified Health Centers (FQHCs). FQHCs must serve an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program, and have a governing board of directors. In addition, they receive Medicaid reimbursement for some of the services they provide to people who are enrolled in Medicaid.

Where can I find a local HCH provider with which to partner?

Healthcare for the Homeless Providers

Where can I find a local Community Health Center with which to partner?

Find a Health Center

PATH (Projects for Assistance in Transition from Homelessness)

PATH eligible services include outreach, screening and diagnostic services, as well as a range of other behavioral health and case management services.

Who is eligible?

Individuals determined to be experiencing serious mental illness or co-occurring serious mental illness and substance abuse disorder; and (2) experiencing homelessness or at imminent risk of homelessness.

How is it financed?

PATH is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). PATH is a formula grant provided to all 50 States, the District of Columbia, and US territories, and allocated to more than 500 local organizations. PATH programs are administered by the State.  State mental health authorities select providers, usually through a competitive process.  PATH providers are encouraged to participate in the local CoC process and all PATH providers are in the process of transitioning data and reporting practices to participate in HMIS.

Where can I find a local PATH provider with which to partner?

SAMHSA PATH Providers

Community Services Block Grant (CSBG)

CSBG funding is used to provide a broad range of services and activities to reduce poverty. In most cases, CSBG funds are allocated to Community Action Agencies (CAAs).  Contact the local Community Action Agency to identify partnership opportunities and get more information about how local CSBG funds are allocated.

Who is eligible? 

Individuals or families as determined by the Federal poverty guidelines released annually by HHS up to 125 percent of poverty

How is it financed?

CSBG funding is provided as a block grant to States, tribes and territories.  States pass through no less than 90 percent of block grant funds to a network of local entities, primarily Community Action Agencies (CAAs), and some local governments, migrant and seasonal farm worker organizations, that delivery the services in the communities.  CAAs are non-profit agencies created as a network of entities by the Economic Opportunity Act of 1964.  States contract with CAAs to plan, develop, implement, evaluate and provide local services. 

How can I apply for CSBG funding?

2014 CSBG Funding Application

Where can I find local CSBG grantees with which to partner?

CSBG Grantees by State

Community Action Agencies by State and County

Social Services Block Grant (SSBG)

Social Services Block Grant (SSBG) funding supports social services directed towards achieving economic self-sufficiency; preventing or remedying neglect, abuse, or the exploitation of children and adults; preventing or reducing inappropriate institutionalization; and securing referral for institutional care, where appropriate. 

Who is eligible? 

Each State or territory has the flexibility to determine what services (within the broad service categories) will be provided; set the eligibility limits (to low-income households) to receive services; and determine how funds are distributed among various services within the State.

How is it financed?

SSBG funding is allocated to each State or territory to meet the needs of its residents through locally relevant social services, through programs that help people to achieve or maintain economic self-sufficiency to prevent, reduce or eliminate dependency on social services.

How can I apply for SSBG funding?

SSBG Grantees – How to Apply

Where can I find local SSBG grantees with which to partner?

SSBG Grantees by State

For more information, http://www.nhchc.org/resources/clinical/tools-and-support/outreach/ provides resources, guidelines, and info about doing outreach.

Mental Health Services

Mental health services are the direct outpatient treatment of mental health conditions that are provided by licensed professionals. Component services are crisis interventions; counseling; individual, family, or group therapy sessions; the prescription of psychotropic medications or explanations about the use and management of medications; and combinations of therapeutic approaches to address multiple problems.

Which HHS programs might be used to provide these services?

Medicaid

Medicaid pays for a broad range of mental health services provided by qualified providers to people who are enrolled in Medicaid coverage. While Federal law does not include explicit provisions regarding the exact types of mental health services that are available, all State Medicaid programs provide some form of mental health services to enrollees. Each State must develop a State Medicaid Plan that describes the benefits its program will provide, (including what optional services will be covered), and must have this plan approved by the U.S. Department of Health and Human Services’ (HHS’s) Centers for Medicare and Medicaid Services (CMS).

Federal law and CMS regulations prescribe a core set of benefits that each State must provide. Mandatory benefits include inpatient and outpatient hospital services; nursing facility, rural health clinic, Federally Qualified Health Center (FQHC) services, prenatal and freestanding birth center services; physician, nurse-midwife, and certified pediatric and family nurse practitioner services; home health, family planning, tobacco cessation, laboratory, X-ray services; and early and periodic screening, diagnostic, and treatment (EPSDT) services for children under age 21. State plan services, managed carewaivers, and Early Period Screening, Diagnostic and Testing (ESPTD) are all vehicles by which States can support community mental health services in Medicaid.

States may decide to cover additional optional services. Optional benefits include clinic services; prescription drugs; rehabilitative services; case management; home and community based services (HCBS) as an alternative to institutionalization; physical, occupational, speech, hearing, and language therapy; diagnostic, screening, and a variety of other services that may be approved by CMS.  States may limit eligibility for certain additional services to specific groups of people. States may modify their Plan’s coverage of services beyond the federally-mandated core, including changes in provider qualifications, definitions of covered services, target populations, and payment mechanisms for optional benefits.

For both Mandatory and Optional benefits, an individual still must meet “medical necessity” criteria to be eligible for particular covered services. These criteria take into consideration a person’s diagnosis and other factors such as functional impairments.

Who is eligible?

Medicaid is an “entitlement” program, meaning that eligible individuals are entitled to receive covered health, behavioral health, and long-term care services as defined within the State’s approved Medicaid Plan. The Affordable Care Act expands Medicaid eligibility to persons with incomes under 133% of the Federal Poverty Level (FPL), and allows States to determine eligibility under their Medicaid plans.

How is it financed?

The Medicaid program operates under broad State discretion, and is funded by a combination of State and Federal matching funds.  Each State must develop a State Medicaid Plan that describes the benefits its program will provide.  Many Medicaid benefits, including those most likely to cover behavioral health services delivered in settings such as shelters, drop-in centers, or supportive housing programs, are “optional” benefits, meaning that States can decide if and how to cover these services.  Federal spending on Medicaid is considered a “mandatory” program, meaning that the federal government matches State spending for all covered services provided to eligible individuals.  This makes Medicaid distinct from other HHS health and supportive services programs, which operate as “discretionary” programs with funding levels that can change from year to year based on actions taken by Congress and the President.

Where can I learn more about using Medicaid to pay for mental health services?

SAMHSA Community Mental Health Services Block Grant (MHBG)

MHBG is given to States to address their unique behavioral health issues.  There are two main SAMHSA block grants, the Substance Abuse Prevention and Treatment Block Grant (SABG) and the Community Mental Health Services Block Grant (MHBG).  Specifically the Block Grant funds are directed toward four purposes:

  • Fund priority treatment and support services for individuals without insurance or for whom coverage is terminated for short periods of time.
  • Fund those priority treatment and support services not covered by Medicaid, Medicare, or private insurance for low income individuals and that demonstrate success in improving outcomes and/or supporting recovery.
  • Fund primary prevention - universal, selective and indicated prevention activities and services for persons not identified as needing treatment.

Who is eligible?

The target population of the funding is adults and older adults with Serious Mental Illness (SMI) and children with Severe Emotional Disturbances (SED), as defined in the Federal Register.

How is it financed?

States apply for the grant funding through SAMHSA and determine how to spend the funds for prevention, treatment, recovery supports and other services that will supplement services covered by Medicaid, Medicare and private insurance.  States fund a network of providers to deliver services, sometimes through a formula funding process.

Where can I find a local MHBG provider with which to partner?

MHBG Grantees by State

Health Care for the Homeless Programs and Community Health Centers

Health Care for the Homeless Programs and Community Health Centers deliver primary care and preventive health services as well as oral health services and services to address substance use disorders and mental health.  Some behavioral health services may be delivered directly or through partnerships or referral arrangements with other providers of treatment services. Health Care for the Homeless programs also offer extensive outreach, engagement and case management services, and they often offer transportation and interpretive services, to help people access health care and behavioral health services, as well as assistance with accessing public benefits. Health Care for the Homeless programs are targeted to persons who are homeless and local programs are encouraged to participate in the local CoC planning process.  The first step for any Continuum should be to reach out to any HCH program in its jurisdiction and connect to current services.

Who is eligible?

Individuals and families who are literally homeless as well as those living in hotels or motels, transitional housing, or permanent supportive housing.

How is it financed?

These programs receive grant funding from the Health Resources and Services Administration (HRSA) as well as a grant under Section 330 of the Public Health Service Act, qualifying them as Federally Qualified Health Centers (FQHCs). FQHCs must serve an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program, and have a governing board of directors. In addition, they receive Medicaid reimbursement for some of the services they provide to people who are enrolled in Medicaid.

Where can I find a local HCH provider with which to partner?

Healthcare for the Homeless Grantees

Where can I find a local Community Health Center with which to partner?

Find a Health Center

PATH (Projects for Assistance in Transition from Homelessness)

PATH programs provide services to people who are experiencing mental illness and are experiencing homelessness or risk of homelessness.  PATH eligible services include habilitation and rehabilitation services, case management services, referrals, and housing support services, as well as outreach and a range of other behavioral health services. PATH programs are administered by the State.  State mental health authorities select providers, usually through a competitive process.  PATH providers are encouraged to participate in the local CoC process and all PATH providers are in the process of transitioning data and reporting practices to participate in HMIS.”

Who is eligible?

Individuals determined to be experiencing serious mental illness or co-occurring serious mental illness and substance abuse disorder; and (2) experiencing homelessness or is at imminent risk of homelessness.

How is it financed?

PATH is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). PATH is a formula grant provided to all 50 S tates, the District of Columbia, and US Territories, and allocated to more than 480 local organizations.

Where can I find a local PATH provider with which to partner?

SAMHSA’s PATH Programs

Cooperative Agreements to Benefit Homeless Individuals (CABHI)

This SAMHSA services program supports infrastructure development at the community level. The major goal of the Cooperative Agreements to Benefit Homeless Individuals program is to ensure that the most vulnerable individuals who are chronically homeless receive access to sustainable permanent housing, treatment, and recovery supports through mainstream funding sources. CABHI funds support three primary types of activities: 1) behavioral health, housing support, and other recovery-oriented services not covered under a State's Medicaid plan; 2) coordination of housing and services for chronically homeless individuals and families at the State and local level which support the implementation and/or enhance the long-term sustainability of integrated community systems that provide permanent housing and supportive services; and 3) efforts to engage and enroll eligible persons who are chronically homeless in Medicaid and other mainstream benefit programs (e.g., SSI/SSDI, TANF, SNAP). 

Who is eligible?

Persons who experience chronic homelessness with substance use disorders or co-occurring substance use and mental disorders.

How is it financed?

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Center for Substance Abuse Treatment (CSAT), and the Center for Mental Health Services (CMHS) provided grant funding to communities and states.

Where can I find CABHI grantees with which to partner?

CABHI Grantees

Which states received CABHI-States funding?

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Center for Substance Abuse Treatment (CSAT), and the Center for Mental Health Services (CMHS) recently modified its Cooperative Agreement to Benefit Homeless Individuals (CABHI), which provided grants directly to entities that provide services, into the ‘CABHI-States’ program focused on building State infrastructure and improving the capacity of state treatment service systems to provide services essential to ending chronic homelessness among people with substance abuse, mental health, and/or co-occurring disorders.

For FY 2013, eligible applicants for CABHI-States are the single State agencies for substance abuse in the District of Columbia (D.C.) and the following States: Arizona, California, Colorado, Florida, Georgia, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Michigan, Nevada, New York, Oregon, Pennsylvania, Texas, and Washington. Services to be created through CABHI-States should include recovery-oriented services not covered under the State’s Medicaid plan including: treatment services; permanent supportive housing; peer supports; CMHS-funded peer navigator(s); assistance with streamlining application processes for mainstream benefits; and more. 

SAMHSA awarded eleven grants for up to $711,818 per year for up to 3 years.   The States that were funded are: Arizona, Georgia, Hawaii, Washington, Louisiana, Illinois, Pennsylvania, Massachusetts, Michigan, Colorado and Nevada. Each CABHI-State grantee will implement its own approach to issuing funding for services. Organizations seeking funding for services should contact the single State agencies who received an award for more information. 

Other HHS programs

Community Services Block Grant (CSBG)

CSBG funding is used to provide a broad range of services and activities to reduce poverty. Services can include health-related services as well as substance use disorder services.  In most cases, CSBG funds are allocated to Community Action Agencies (CAAs). 

Who is eligible? 

The Federal Poverty Guidelines must be used as the primary criterion in determining income eligibility. In order to receive assistance under any CSBG project involving direct services, an applicant's total household income must not exceed 125% of the poverty level. Household is defined by the Bureau of Census as consisting of all persons who occupy a housing unit (i.e., house or apartment), whether they are related to each other or not. Total household income is based on income at the time of application.

How is it financed?

CSBG funding is provided as a block grant to States, tribes and territories.  States pass through no less than 90 percent of block grant funds to a network of local entities, primarily Community Action Agencies (CAAs), and some local governments, migrant and seasonal farm worker organizations, that delivery the services in the communities.  CAAs are non-profit agencies created as a network of entities by the Economic Opportunity Act of 1964.  States contract with CAAs to plan, develop, implement, evaluate and provide local services. 

Where can I find CSBG grantees with which to partner?

CSBG Grantees by State

Community Action Agencies by State and County

Social Services Block Grant (SSBG)

SSBG funding is allocated to each State or territory to meet the needs of its residents through locally relevant social services, through programs that help people to achieve or maintain economic self-sufficiency to prevent, reduce or eliminate dependency on social services. Services can include health-related services as well as substance use disorder services. 

Who is eligible? 

Each State or territory has the flexibility to determine what services (within the broad service categories) will be provided; set the eligibility limits (to low-income households) to receive services; and determine how funds are distributed among various services within the State.

How is it financed?

SSBG funding is allocated to each State or territory to meet the needs of its residents through locally relevant social services, through programs that help people to achieve or maintain economic self-sufficiency to prevent, reduce or eliminate dependency on social services.

Where can I find SSBG grantees with which to partner?

SSBG Grantees by State

Life Skills Training

The Continuum of Care Program includes life skills training as an eligible supportive service and includes the costs associated with teaching critical life management skills that may never have been learned or have been lost during the course of physical or mental illness, domestic violence, substance abuse, and homelessness. These services must be necessary to assist the program participant to function independently in the community. Component life skills training are the budgeting of resources and money management, household management, conflict management, shopping for food and other needed items, nutrition, the use of public transportation, and parent training.

Which HHS programs might be used to provide these services?

Temporary Assistance for Needy Families (TANF)

TANF funds are used to provide a range of benefits and services to needy families with at least one child or to pregnant women.  In addition to cash assistance, which can help needy families cover basic needs like food, clothing, and shelter, TANF also pays for supportive services which can include life skills services. 

Who is eligible?

Each jurisdiction determines its eligibility criteria for TANF benefits and services.  Many families experiencing homelessness are likely to meet income eligibility requirements for TANF benefits and services. There may be additional requirements, including participation in work activities, associated with eligibility for TANF cash assistance or other TANF benefits. 

How is it financed?

Funding is provided as a block grant to each State, the District of Columbia and the territories of Guam, Puerto Rico and the U.S. Virgin Islands.  These jurisdictions have broad discretion to offer a range of relevant benefits and services. State TANF agencies run a large variety of programs to address and prevent family homelessness, and, at times, form partnerships between the TANF program and other government or private stakeholders.  States have great flexibility in serving needy families, including those who are homeless or at risk of becoming homeless. 

How can services be coordinated with homeless service providers?

TANF agencies, or community-based organizations they contract with, can offer comprehensive approaches that include multiple programs and supports, such as combining a housing benefit with transportation, childcare, and/or job placement services.  TANF agencies can also partner with local homeless providers to coordinate and streamline services delivered across the two service systems.  At the caseworker level, coordination can facilitate the integration of both housing and employment interventions, improving the performance of both service systems and enhancing the outcomes of families.  Co-location of staff can be used to help ensure vulnerable families are connected to the full array of assistance they need to achieve self-sufficiency.  Developing mechanisms to share client-level data can help both systems evaluate their performance in minimizing homelessness, increasing self-sufficiency, refining interventions, and improving the targeting of scarce resources.

For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit

http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

Partnerships

In addition to offering a range of benefits and services, TANF agencies can serve as active partners in State, regional, and local homeless efforts, such as the Continuum of Care.  The expertise of TANF agency leaders can be helpful in ensuring State and local efforts are deploying the full array of available supports to prevent and end family homelessness.  Partnerships can also lead to the identification of strategies that TANF agencies can adopt to minimize homelessness among families receiving assistance. For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit

http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

Medicaid

States have the opportunity to cover personal care and life skills training services under Medicaid. For people who are enrolled in Medicaid, personal care services and life skills training may include assistance not only with Activities of Daily Living (ADLs), but also with personal hygiene, light housework, laundry, meal preparation, transportation, grocery shopping, telephone use, and money and medication management. For persons experiencing homelessness with cognitive impairments, staff providing personal care and life skills training also provide supervision to ensure that tasks are being learned and performed properly.

Who is eligible?

Medicaid is an “entitlement” program, meaning that eligible individuals are entitled to receive covered health, behavioral health, and long-term care services. The Affordable Care Act expands Medicaid eligibility to persons with incomes under 133% of the Federal Poverty Level (FPL), and allows States to determine eligibility under their Medicaid plans. 

How is it financed?

The Medicaid program operates under broad State discretion, and is funded by a combination of State and Federal matching funds.  Each State must develop a State Medicaid Plan that describes the benefits that will be provided.  Many Medicaid benefits, including those most likely to cover case management, are “optional” benefits, meaning that States can decide if and how to cover these services.  Federal spending on Medicaid is considered a “mandatory” program, meaning that the Federal government matches State spending for all covered services provided to eligible individuals.  This makes Medicaid distinct from other HHS health and supportive services programs, which operate as “discretionary” programs with funding levels that can change from year to year based on actions taken by Congress and the President.

How can it be used to address housing needs?

Medicaid is the primary mainstream healthcare benefit that many people experiencing homelessness can access to obtain medical care, and it is a key benefit to help these individuals exit homelessness. There are several existing ways in which Medicaid is used to help people with disabilities exit homelessness and support them in housing, including Targeted Case Management, the Medicaid Rehabilitation Option—which includes Assertive Community Treatment, and Home and Community-Based Services Waivers.

Where can I find which States have expanded Medicaid?

Medicaid.gov

Where should I go to learn more about using Medicaid to pay for life skills training?

Health Care for the Homeless Programs and Community Health Centers

Health Care for the Homeless Programs and Community Health Centers provide primary, behavioral health, and in some cases, dental care to people experiencing homelessness.  An important caveat to consider when cultivating partnerships with these programs is that, if there are Social Workers or other mental health professionals on staff, it is more likely for life skills training to be offered as a part of health care services. Health Care for the Homeless programs are targeted to persons who are homeless and local programs are encouraged to participate in the local CoC planning process.  The first step for any Continuum should be to reach out to any HCH program in its jurisdiction and connect to current services.

Who is eligible?

Individuals and families who are literally homeless as well as those living in hotels or motels, transitional housing, or permanent supportive housing.

How is it financed?

These programs receive grant funding from the Health Resources and Services Administration (HRSA) as well as a grant under Section 330 of the Public Health Service Act, qualifying them as Federally Qualified Health Centers (FQHCs). FQHCs must serve an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program, and have a governing board of directors. In addition, they receive Medicaid reimbursement for some of the services they provide to people who are enrolled in Medicaid.

Where can I find a local HCH provider?

Health Center Homeless Grantees

Where can I find a local Community Health Center?

Find a Health Center

PATH (Projects for Assistance in Transition from Homelessness)

PATH programs provide services to people with mental illness who are experiencing homelessness or at risk of homelessness.  PATH eligible services include habilitation and rehabilitation, case management, referrals, and housing support, as well as outreach and a range of other behavioral health services. Through this variety of eligible services, PATH programs often provide informal life skills training and services. PATH programs are administered by the state.  State mental health authorities select providers, usually through a competitive process.  PATH providers are encouraged to participate in the local CoC process and all PATH providers are in the process of transitioning data and reporting practices to participate in HMIS.”

Who is eligible?

Individuals determined to be experiencing serious mental illness or co-occurring serious mental illness and substance abuse disorder; and (2) experiencing homelessness or at imminent risk of homelessness.

How is it financed?

PATH is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). PATH is a formula grant provided to all 50 states, the District of Columbia, and US Territories, and allocated to more than 480 local organizations.

Where can I find a local PATH provider?

http://pathprogram.samhsa.gov/Path/ListProviders.aspx

Cooperative Agreements to Benefit Homeless Individuals (CABHI)

This SAMHSA services program supports infrastructure development at the community and State levels. The major goal of the Cooperative Agreements to Benefit Homeless Individuals program is to ensure that the most vulnerable individuals who are chronically homeless receive access to sustainable permanent housing, treatment, and recovery supports through mainstream funding sources. CABHI funds support three primary types of activities: 1) behavioral health, housing support, and other recovery-oriented services not covered under a State's Medicaid plan; 2) coordination of housing and services for chronically homeless individuals and families at the State and local level which support the implementation and/or enhance the long-term sustainability of integrated community systems that provide permanent housing and supportive services; and 3) efforts to engage and enroll eligible persons who are chronically homeless in Medicaid and other mainstream benefit programs (e.g., SSI/SSDI, TANF, SNAP). 

Who is eligible?

Persons who experience chronic homelessness with substance use disorders or co-occurring substance use and mental disorders.

How is it financed?

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Center for Substance Abuse Treatment (CSAT) and the Center for Mental Health Services (CMHS) provided grant funding to States.

Where can I find CABHI grantees with which to partner?

CABHI Grantees

Which states received CABHI-States funding?

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Center for Substance Abuse Treatment (CSAT), and the Center for Mental Health Services (CMHS) recently modified its Cooperative Agreement to Benefit Homeless Individuals (CABHI), which provided grants directly to entities that provide services, into the ‘CABHI-States’ program focused on building state infrastructure and improving the capacity of state treatment service systems to provide services essential to ending chronic homelessness among people with substance abuse, mental health, and/or co-occurring disorders.

For FY 2013, eligible applicants for CABHI-States are the single state agencies for substance abuse in the District of Columbia (D.C.) and the following states: Arizona, California, Colorado, Florida, Georgia, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Michigan, Nevada, New York, Oregon, Pennsylvania, Texas, and Washington. Services to be created through CABHI-States should include recovery-oriented services not covered under the state’s Medicaid plan including: treatment services; permanent supportive housing; peer supports; CMHS-funded peer navigator(s); assistance with streamlining application processes for mainstream benefits; and more. 

SAMHSA awarded eleven grants for up to $711,818 per year for up to 3 years.   The States that were funded are: Arizona, Georgia, Hawaii, Washington, Louisiana, Illinois, Pennsylvania, Massachusetts, Michigan, Colorado and Nevada. Each CABHI-State grantee will implement its own approach to issuing funding for services. Organizations seeking funding for services should contact the single state agencies who received an award for more information. 

Other HHS programs

Community Services Block Grant (CSBG)

Funding is used to provide a broad range of services and activities to reduce poverty. In most cases, CSBG funds are allocated to Community Action Agencies (CAAs).  Contact the local Community Action Agency to identify partnership opportunities and get more information about how local CSBG funds are allocated.

Who is eligible? 

The Federal Poverty Guidelines must be used as the primary criterion in determining income eligibility. In order to receive assistance under any CSBG project involving direct services, an applicant's total household income must not exceed 125% of the poverty level. Household is defined by the Bureau of Census as consisting of all persons who occupy a housing unit (i.e., house or apartment), whether they are related to each other or not. Total household income is based on income at the time of application.

How is it financed?

CSBG funding is provided as a block grant to States, tribes and territories.  States pass through no less than 90 percent of block grant funds to a network of local entities, primarily Community Action Agencies (CAAs), and some local governments, migrant and seasonal farm worker organizations, that delivery the services in the communities.  CAAs are non-profit agencies created as a network of entities by the Economic Opportunity Act of 1964.  States contract with CAAs to plan, develop, implement, evaluate and provide local services. 

How can I apply for CSBG funding?

2014 CSBG Funding Application

Where can I find CSBG grantees with which to partner?

Social Services Block Grant (SSBG)

SSBG Funding is allocated to each State or territory to meet the needs of its residents through locally relevant social services, through programs that help people to achieve or maintain economic self-sufficiency to prevent, reduce or eliminate dependency on social services. To locate the State office administering SSBG, please visit the following website: http://www.acf.hhs.gov/programs/ocs/resource/ssbg-state-officials-program-contacts

Who is eligible? 

Each State or territory has the flexibility to determine what services (within the broad service categories) will be provided; set the eligibility limits (to low-income households) to receive services; and determine how funds are distributed among various services within the State.

How is it financed?

SSBG funding is allocated to each State or territory to meet the needs of its residents through locally relevant social services, through programs that help people to achieve or maintain economic self-sufficiency to prevent, reduce or eliminate dependency on social services.

How can I apply for SSBG funding?

SSBG Grantees – Who Can Apply?

Where can I find SSBG grantees with which to partner?

SSBG Grantees by State

Health Services

Health services are direct outpatient treatment of medical conditions when provided by licensed medical professionals. This may include providing an analysis or assessment of an individual’s health problems and the development of a treatment plan; assisting individuals to understand their health needs; providing directly or assisting individuals to obtain and utilize appropriate medical treatment; preventative medical care and health maintenance services, including in-home health services and emergency medical services; provision of appropriate medication; providing follow-up services; and preventative and non-cosmetic dental care.

Which HHS programs might be used to provide these services?

Medicaid

Medicaid pays for a broad range of health care services provided by qualified providers to people who are enrolled in Medicaid coverage. Each State must develop a State Medicaid Plan that describes the benefits its program will provide (including what optional services will be covered), and must have this plan approved by the U.S. Department of Health and Human Services’ (HHS’s) Centers for Medicare and Medicaid Services (CMS).

Federal law and CMS regulations prescribe a core set of benefits that each state must provide. Mandatory benefits include inpatient and outpatient hospital services; nursing facility, rural health clinic, Federally Qualified Health Center (FQHC) services, prenatal and freestanding birth center services; physician, nurse-midwife, and certified pediatric and family nurse practitioner services; home health, family planning, tobacco cessation, laboratory, X-ray services; and early and periodic screening, diagnostic, and treatment (EPSDT) services for children under age 21.

States may decide to cover additional optional services. Optional benefits include clinic services; prescription drugs; rehabilitative services; case management; home and community based services (HCBS) as an alternative to institutionalization; physical, occupational, speech, hearing, and language therapy; diagnostic, screening, and a variety of other services that may be approved by CMS.  States and may limit eligibility for certain additional services to specific groups of people. States may modify their Plan’s coverage of services beyond the federally-mandated core, including changes in provider qualifications, definitions of covered services, target populations, and payment mechanisms for optional benefits.

For both Mandatory and Optional benefits, an individual still must meet “medical necessity” criteria to be eligible for particular covered services. These criteria take into consideration a person’s diagnosis and other factors such as functional impairments.

Who is eligible?

Medicaid is an “entitlement” program, meaning that eligible individuals are entitled to receive covered health, behavioral health, and long-term care services, as defined within the State’s approved Medicaid Plan.  The Affordable Care Act gives States the choice to expand Medicaid eligibility to persons with incomes under 133% of the Federal Poverty Level (FPL), and allows States to determine eligibility under their Medicaid plans.

How is it financed?

The Medicaid program operates under broad State discretion, and is funded by a combination of State and Federal matching funds.  Each State must develop a State Medicaid Plan that describes the benefits its program will provide.  Many Medicaid benefits, including those most likely to cover behavioral health services delivered in settings such as shelters, drop-in centers, or supportive housing programs, are “optional” benefits, meaning that States can decide if and how to cover these services.  Federal spending on Medicaid is considered a “mandatory” program, meaning that the Federal government matches State spending for all covered services provided to eligible individuals.  This makes Medicaid distinct from other HHS health and supportive services programs, which operate as “discretionary” programs with funding levels that can change from year to year based on actions taken by Congress and the President.

Where do I go to assist persons experiencing homelessness to enroll in healthcare?

Medicaid.gov

Where can I find which States have expanded Medicaid?

Medicaid.gov

Where do I learn more about the healthcare services available for persons experiencing homelessness?

Health Care for the Homeless Programs and Community Health Centers

Health Care for the Homeless Programs and Community Health Centers provide primary, behavioral health, and in some cases, dental care to people experiencing homelessness.  Health Care for the Homeless programs are targeted to persons who are homeless and local programs are encouraged to participate in the local CoC planning process.  The first step for any Continuum should be to reach out to any HCH program in its jurisdiction and connect to current services

Who is eligible?

Individuals and families who are literally homeless as well as those living in hotels or motels, transitional housing, or permanent supportive housing

How is it financed?

These programs receive grant funding from the Health Resources and Services Administration (HRSA) as well as a grant under Section 330 of the Public Health Service Act, qualifying them as Federally Qualified Health Centers (FQHCs). FQHCs must serve an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program, and have a governing board of directors. In addition, they receive Medicaid reimbursement for some of the services they provide to people who are enrolled in Medicaid.

Where can I find a local HCH provider?

Health Center Homeless Grantees

Where can I find a local Community Health Center?

Find a Health Center

PATH (Projects for Assistance in Transition from Homelessness)

PATH programs provide services to people with mental illness who are experiencing homelessness or at risk of homelessness.  PATH eligible services include habilitation and rehabilitation, case management, referrals, and housing support, as well as outreach and a range of other behavioral health services.  Case management and other services funded by PATH is typically provided to people who are currently or at-risk of homelessness as opposed to people who are formerly homeless and living in permanent housing. PATH programs are administered by the State.  State mental health authorities select providers, usually through a competitive process.  PATH providers are encouraged to participate in the local CoC process and all PATH providers are in the process of transitioning data and reporting practices to participate in HMIS.”

Who is eligible?

Individuals determined to be experiencing serious mental illness or co-occurring serious mental illness and substance abuse disorder; and (2) experiencing homelessness or at imminent risk of homelessness.

How is it financed?

PATH is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). PATH is a formula grant provided to all 50 States, the District of Columbia, and US Territories, and allocated to more than 480 local organizations.

Where can I find a local PATH provider with which to partner?

SAMHSA’s PATH Providers

Employment Assistance Services

Employment assistance services may include classroom, online and/or computer instruction, on-the-job instruction, services that assist individuals in securing employment, acquiring learning skills, and/or increasing earning potential. Learning skills include those skills that can be used to secure and retain a job, including the acquisition of vocational licenses and/or certificates.

Which HHS programs might be used to provide these services?

Temporary Assistance for Needy Families (TANF)

TANF funds are used to provide a range of employment services and work supports, as well as cash benefits, to needy families with at least one child (or to pregnant women).  TANF funds may also be used to promote job preparation and work. TANF provides assistance to needy families in the form of cash benefits, subsidized employment or transitional jobs, education, job training, job placement, child care or other work supports, and other services that help people acquire and maintain jobs.

Who is eligible?

Each jurisdiction determines its eligibility criteria for TANF benefits and services.  Many families experiencing homelessness are likely to meet income eligibility requirements for TANF services. There may be additional requirements, including participation in work activities, associated with eligibility for TANF cash assistance or other TANF benefits. 

How is it financed?

Funding is provided as a block grant to each State, the District of Columbia, as well as the territories of Guam, Puerto Rico, and the U.S. Virgin Islands.  These jurisdictions have broad discretion to offer a range of relevant benefits and services.

How can services be coordinated with homeless service providers?

TANF agencies, or community-based organizations they contract with, can offer comprehensive approaches that include multiple programs and supports, such as combining a housing benefit with transportation, childcare, and/or job placement services.  TANF agencies can also partner with local homeless providers to coordinate and streamline services delivered across the two service systems.  At the caseworker level, coordination can facilitate the integration of both housing and employment interventions, improving the performance of both service systems and enhancing the outcomes of families.  Co-location of staff can be used to help ensure vulnerable families are connected to the full array of assistance they need to achieve self-sufficiency.  Developing mechanisms to share client-level data can help both systems evaluate their performance in minimizing homelessness, increasing self-sufficiency, refining interventions, and improving the targeting of scarce resources.

For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit

http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01

How can it be used to provide employment services?

A range of employment-specific services are allowable as general supportive services, including but not limited to education, job training, job placement and subsidized employment services. The role of employment in reducing homelessness is critical.  Homeless families and individuals require sustainable employment to pay for housing.  When families have sustainable employment, they become less dependent on services such as rental assistance.  This, in turn, makes scarce agency resources available to other program areas, and may allow agencies to provide rental assistance to a greater number of homeless families and individuals.

For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit

http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

State homeless service agencies have demonstrated a variety of strategies and structures for implementing employment services into their work. Whether an agency partners with its State and/or local TANF agency and Workforce Investment Board for employment services, or provides in-house, specialized employment services aimed at meeting the specific needs of their clients, an integrative, collaborative approach to employment and housing services empowers clients to attain social and economic self-sufficiency and independence.  Improving coordination between the provision of housing and employment services can help each system achieve interrelated goals.  Permanent housing provides a stable platform that allows parents to achieve their employment goals and increase self-sufficiency.  Successful connection to employment increases a family’s income and promotes a family’s overall housing stability.

Partnerships

In addition to offering a range of benefits and services, TANF agencies can serve as active partners in State, regional, and local homeless efforts, such as the Continuum of Care.  The expertise of TANF agency leaders can be helpful in ensuring State and local efforts are deploying the full array of available supports to prevent and end family homelessness.  Partnerships can also lead to the identification of strategies that TANF agencies can adopt to minimize homelessness among families receiving assistance. For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit

http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

Other HHS programs

Community Services Block Grant (CSBG)

Funding is used to provide a broad range of services and activities to reduce poverty. In most cases, CSBG funds are allocated to Community Action Agencies (CAAs).  Contact the local Community Action Agency to identify partnership opportunities and get more information about how local CSBG funds are allocated.

Who is eligible? 

The Federal Poverty Guidelines must be used as the primary criterion in determining income eligibility. In order to receive assistance under any CSBG project involving direct services, an applicant's total household income must not exceed 125% of the poverty level. Household is defined by the Bureau of Census as consisting of all persons who occupy a housing unit (i.e., house or apartment), whether they are related to each other or not. Total household income is based on income at the time of application.

How is it financed?

CSBG funding is provided as a block grant to States, tribes and territories.  States pass through no less than 90 percent of block grant funds to a network of local entities, primarily Community Action Agencies (CAAs), and some local governments, migrant and seasonal farm worker organizations, that delivery the services in the communities.  CAAs are non-profit agencies created as a network of entities by the Economic Opportunity Act of 1964.  States contract with CAAs to plan, develop, implement, evaluate and provide local services. 

Where can I find CSBG grantees with which to partner?

Social Services Block Grant (SSBG)

SSBG Funding is allocated to each State or territory to meet the needs of its residents through locally relevant social services, through programs that help people to achieve or maintain economic self-sufficiency to prevent, reduce or eliminate dependency on social services.

Who is eligible? 

Each State or territory has the flexibility to determine what services (within the broad service categories) will be provided; set the eligibility limits (to low-income households) to receive services; and determine how funds are distributed among various services within the State.

How is it financed?

SSBG funding is allocated to each State or territory to meet the needs of its residents through locally relevant social services, through programs that help people to achieve or maintain economic self-sufficiency to prevent, reduce or eliminate dependency on social services.

Where can I find SSBG grantees with which to partner?

SSBG Grantees by State

Communities Engaged to End Youth Homelessness

Communities across the country are using the Federal framework to develop systemic and client-level responses to end youth homelessness.  The headline article in this issue discusses efforts in Seattle/King County, Washington and Cleveland, Ohio, recently shared with the Council. Many other communities across the country are also taking steps to end youth homelessness, and using the Framework to guide their efforts.

The Framework focuses on two key strategies: getting to better data and building capacity for better service delivery. These strategies serve as the foundation for our efforts to achieve four core outcomes for youth: stable housing, education/employment, well-being, and permanent connections. 

On the data strategy, several communities are using experience from Youth Count 2013! and the subsequent report from the Urban Institute that highlighted promising practices from the study sites, communities are planning their 2014 Point-in-Time (PIT) counts to achieve more confident estimates of youth homelessness in their community. 

  • In Massachusetts, the State Interagency Council is leading an effort across all Continuum of Care (CoC) regions to implement a common methodology using best practices and a shared survey tool to gain a more accurate understanding of the scale, profile, and needs of unaccompanied youth. 
  • In California, a grant from the California Wellness Foundation to the California Homeless Youth Project in collaboration with the University of California Berkeley will fund capacity building efforts to better count homeless youth across the state.
  • In Minnesota, new funds appropriated by the State legislature for its Homeless Youth Act are being awarded in grants to organizations focused on ending youth homelessness. In another initiative, several Twin Cities metro youth-serving organizations are testing data sharing strategies as a first step in a coordinated assessment approach for youth. The goal of this effort is to ensure that youth do not “start over” each time they seek service from one of these organizations.
  •  In Houston, Texas, the Coalition for the Homeless has partnered with One Voice Texas, a statewide policy organization to assemble a work group for the 2014 Count that includes broad representation from the Runaway and Homeless Youth lead agency, Texas Homeless Education Office, CoC youth providers, juvenile corrections, academia, foster care system, and youth advocates.  As an additional strategy, a researcher from the University of Houston will facilitate focus groups to plan for ongoing research using targeted sampling. Based on the findings, One Voice Texas will advance policy and program initiatives at the state level. 

Youth Count 2013! study sites also surveyed youth as part of their PIT Count. In New York City, unaccompanied youth were encouraged to visit drop-in centers where volunteers administered a 27-question survey.  The December 2013 Report prepared by Darrick Hamilton and Lance Freeman for the New York City Coalition on the Continuum of Care offers significant insight into the housing status of surveyed youth based on their demographic profiles.  One finding documented that disconnected youth – those not enrolled in school or working – were more likely to have stayed outdoors, in a subway station, or in another more vulnerable location than their peers enrolled in school or employed who were more likely to have stayed with a friend or relative.

In Connecticut, Yale University’s Dr. Derrick M. Gordon released Invisible No More, the state’s first report at a Legislative Forum in December 2013.  Dr. Gordon interviewed 98 young people as well as key informant and focus group interviews.  The study found that youth often are not connected to services, and populations within the youth who are most vulnerable are LGBT, trafficked, and/or have involvement with the juvenile justice or child welfare systems.  The Study made a number of recommendations including the creation of a planning task force to develop strategies to address housing insecurity for young people.

There has been forward movement on efforts to address youth homelessness all across the country.  By using the Federal framework to get to better data and to build coordinated service capacity we will continue to make progress toward our goal to ensure that all youth have a place to call home.

Early Childhood Development Services

Early childhood development services may include establishing and operating a child care center, providing child-care vouchers for children of families experiencing homelessness, as well as the provision of meals, snacks, and comprehensive and coordinated developmental activities. Children must be under the age of 13, unless they are disabled. Children with disabilities must be under the age of 18, and CCDF Lead Agencies have the option of serving disabled children up to age 19, but it is not required.

Which HHS programs might be used to provide these services?

Head Start and Early Head Start (HS/EHS)

HS/EHS is a child-focused, multi-generational program that promotes the school readiness of children ages birth to five from low-income families by enhancing their cognitive, social, and emotional development. HS/EHS programs provide children and families with services related to nutrition, developmental, medical, and dental screenings, immunizations, mental health and social services referrals, family engagement, and in some cases transportation.

Who is eligible?

The children of families who are experiencing homelessness are categorically eligible for HS/EHS and are identified and prioritized for enrollment. The children of families experiencing homelessness can apply, enroll and attend while required documents are collected in a reasonable time frame.  Contact should be made with local HS/EHS programs to learn about space availability and waiting lists.

How is it financed?

Head Start grants are awarded from the Federal Office of Head Start (OHS) to local programs including public or private non-profit organizations. Community-based and faith-based organizations or for-profit agencies within a community that wish to compete for funding, are also eligible to apply for Head Start funding. 

Where can I find a local Head Start or Early Head Start program with which to partner?

Find a Head Start Office

Temporary Assistance for Needy Families (TANF)

TANF can be used to provide a range of employment services and work supports, as well as cash benefits, to needy families with at least one child (or to pregnant women).  TANF funds may be used to pay for child care and other services and supports that help parents participate in training and get and keep jobs.

Who is eligible?

Each jurisdiction determines its eligibility criteria for TANF benefits and services.  Many families experiencing homelessness are likely to meet income eligibility requirements for TANF benefits and services. There may be additional requirements, including participation in work activities, associated with eligibility for TANF cash assistance or other TANF benefits. 

How is it financed?

Funding is provided as a block grant to each state, the District of Columbia and the territories of Guam, Puerto Rico and the U.S. Virgin Islands.  These jurisdictions have broad discretion to offer a range of relevant benefits and services. TANF agencies run a large variety of programs to address and prevent family homelessness, and, at times, form partnerships between the TANF program and other government or private stakeholders.  States have great flexibility in serving needy families, including those who are homeless or at risk of becoming homeless. 

How can services be coordinated with homeless service providers?

TANF agencies, or community-based organizations they contract with, can offer comprehensive approaches that include multiple programs and supports, such as combining a housing benefit with transportation, childcare, and/or job placement services.  TANF agencies can also partner with local homeless providers to coordinate and streamline services delivered across the two service systems.  At the caseworker level, coordination can facilitate the integration of both housing and employment interventions, improving the performance of both service systems and enhancing the outcomes of families.  Co-location of staff can be used to help ensure vulnerable families are connected to the full array of assistance they need to achieve self-sufficiency.  Developing mechanisms to share client-level data can help both systems evaluate their performance in minimizing homelessness, increasing self-sufficiency, refining interventions, and improving the targeting of scarce resources.

For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

How can it be used to address housing needs?

Federal TANF and Maintenance of Effort (MOE) funds may be used to address the housing-related needs of families who are homeless or precariously housed, consistent with TANF rules on providing benefits and services to needy or eligible families.  Families do not have to be receiving TANF cash assistance in order to qualify for housing services, although those receiving a cash grant may use TANF assistance to pay for housing.  States may adjust cash benefit levels in relation to housing costs and/or provide a housing supplement to cash assistance grants.  Along with providing ongoing basic assistance, a TANF program can provide an array of non-recurrent, short-term benefits and services.  In order to fall under this category, these must be designed to extend no longer than four months and must address a specific crisis situation rather than meet ongoing needs. Also, TANF funds can be used in coordination with HUD’s targeted homeless assistance grants programs – the Continuum of Care (CoC) program and the Emergency Solutions Grants (ESG) program – to maximize the impact of both resources.  For example, TANF could be used to pay for rental assistance while ESG is used to pay for supportive services to help a family remain housed. 

For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit

http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

Partnerships

In addition to offering a range of benefits and services, TANF agencies can serve as active partners in State, regional, and local homeless efforts, such as the Continuum of Care.  The expertise of TANF agency leaders can be helpful in ensuring state and local efforts are deploying the full array of available supports to prevent and end family homelessness.  Partnerships can also lead to the identification of strategies that TANF agencies can adopt to minimize homelessness among families receiving assistance.  

For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

Child Care and Development Fund (CCDF)

The Child Care and Development Fund (CCDF) is a multibillion-dollar federal and state partnership that promotes family economic self-sufficiency and helps children succeed in school and life through affordable, high-quality early care and afterschool programs.  Subsidized child care services are available to eligible families through certificates (vouchers), or grants and contracts with providers.

Who is eligible?

Children (age birth through 12) in vulnerable families are eligible for CCDF.  States also have the option of extending eligibility to children under age 19 who are physically or mentally incapable of caring for him/herself, or under court supervision.  While CCDF does not require prioritization of homeless families, States have the flexibility to broaden their eligibility policies to include homeless children and families and are encouraged to do so.

How is it financed?

CCDF is a block grant to States, territories, and tribes.  Additionally, States provide matching funds and may transfer TANF funds to CCDF.

Where can I find a local CCDF grantee with which to partner?

CCDF Tribal Grantees by State

Other HHS Programs

Community Services Block Grant (CSBG)

Community Services Block Grant (CSBG) funds may be used to provide a broad range of services and activities to reduce poverty, revitalize low-income communities, and empower low-income families and individuals in rural and urban areas to become fully self-sufficient.  Grantees are required to conduct community needs assessments and develop community action plans to address local needs, including services and activities related to employment, education, better use of available income, housing, nutrition, emergency services and/or health. In most cases, CSBG funds are allocated to Community Action Agencies (CAAs). 

Who is eligible? 

The Federal Poverty Guidelines must be used as the primary criterion in determining income eligibility. In order to receive assistance under any CSBG project involving direct services, an applicant's total household income must not exceed 125% of the poverty level. Household is defined by the Bureau of Census as consisting of all persons who occupy a housing unit (i.e., house or apartment), whether they are related to each other or not. Total household income is based on income at the time of application.

How is it financed?

CSBG funding is provided as a block grant to States, tribes and territories.  States pass through no less than 90 percent of block grant funds to a network of local entities, primarily Community Action Agencies (CAAs), and some local governments, migrant and seasonal farm worker organizations, that delivery the services in the communities.  CAAs are non-profit agencies created as a network of entities by the Economic Opportunity Act of 1964.  States contract with CAAs to plan, develop, implement, evaluate and provide local services.  Contact the local Community Action Agency to identify partnership opportunities and to receive more information about how local CSBG funds are allocated.  To locate the local agency, please visit http://www.communityactionpartnership.com/index.php?option=com_spreadsheets&view=search&spreadsheet=cap&Itemid=188.

Where can I find local CSBG grantees with which to partner?

Social Services Block Grant (SSBG)

Social Services Block Grant (SSBG) funding supports social services directed towards achieving economic self-sufficiency; preventing or remedying neglect, abuse, or the exploitation of children and adults; preventing or reducing inappropriate institutionalization; and securing referral for institutional care, where appropriate. 

Who is eligible? 

Each State or territory has the flexibility to determine what services (within the broad service categories) will be provided; set the eligibility limits (to low-income households) to receive services; and determine how funds are distributed among various services within the State.

How is it financed?

SSBG funding is allocated to each State or territory to meet the needs of its residents through locally relevant social services, through programs that help people to achieve or maintain economic self-sufficiency to prevent, reduce or eliminate dependency on social services. To locate the State office administering SSBG, please visit: http://www.acf.hhs.gov/programs/ocs/resource/ssbg-state-officials-program-contacts

 Where can I find SSBG grantees with which to partner?

SSBG Grantees by State

For more information

The Administration for Children and Families has developed several resources to encourage the use of child care and education programs to serve children experiencing homelessness. http://www.acf.hhs.gov/programs/ecd/expanding-early-care-and-education-for-homeless-children

These resources may be used to support work at the State or community level on early childhood systems and services, or help to encourage a Head Start program or early childhood program to ensure that these young children are prioritized for services that support their learning and development.

Visit the links below for helpful information about serving children experiencing homelessness in HHS child care programs:

•        Letter from the Administration of Children and Families, the Office of Head Start, and the Office of Child Care

•        Policies and Procedures to Increase Access to ECE Services for Homeless Children and Families

•        Strategies for Increasing ECE Services for Homeless Children

•        Early Childhood and Family Homelessness Resource List

Case Management

Case Management includes assessing, arranging, and coordinating the delivery of individualized services to meet the needs of program participants. Such services may include counseling, developing, securing, and coordinating services; accessing resources through the centralized or coordinated assessment system; obtaining Federal, State, and local benefits; monitoring and evaluating program participant progress; providing information and referrals to other providers; providing ongoing risk assessment and safety planning with victims of domestic violence, dating violence, sexual assault, and stalking; and developing an individualized housing and service plan, including planning a path to permanent housing stability.

Which HHS programs might be used to provide these services?

Temporary Assistance for Needy Families (TANF)

TANF funds are used to provide a range of benefits and services to low-income families with at least one child or to pregnant women.  In addition to cash assistance, which can help low-income families cover basic needs like food, clothing, and shelter, TANF can also pay for supportive services which can include case management and housing search and placement services. 

Who is eligible to receive services?

Each jurisdiction determines its eligibility criteria for TANF benefits and services.  Many families experiencing homelessness are likely to meet income eligibility requirements for TANF benefits and services. There may be additional requirements, including participation in work activities, associated with eligibility for TANF cash assistance or other TANF benefits. 

How is it financed?

Funding is provided as a block grant to each state, the District of Columbia and the territories of Guam, Puerto Rico, and the U.S. Virgin Islands.  These jurisdictions have broad discretion to offer a range of relevant benefits and services. State TANF agencies run a large variety of programs to address and prevent family homelessness, and, at times, form partnerships between the TANF program and other government or private stakeholders.  States have great flexibility in serving low-income families, including those who are homeless or at risk of becoming homeless. 

How can services be coordinated with homeless service providers?

TANF agencies, or community-based organizations they contract with, can offer comprehensive approaches that include multiple programs and supports, such as combining a housing benefit with transportation, childcare, and/or job placement services.  TANF agencies can also partner with local homeless providers to coordinate and streamline services delivered across the two service systems.  At the caseworker level, coordination can facilitate the integration of both housing and employment interventions, improving the performance of both service systems and enhancing the outcomes of families.  Co-location of staff can be used to help ensure vulnerable families are connected to the full array of assistance they need to achieve self-sufficiency.  Developing mechanisms to share client-level data can help both systems evaluate their performance in minimizing homelessness, increasing self-sufficiency, refining interventions, and improving the targeting of scarce resources. For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

How can it be used to address housing needs?

Federal TANF and Maintenance of Effort (MOE) funds may be used to address the housing-related needs of families who are homeless or precariously housed, consistent with TANF rules on providing benefits and services to needy or eligible families.  Families do not have to be receiving TANF cash assistance in order to qualify for housing services, although those receiving a cash grant may use TANF assistance to pay for housing.  States may adjust cash benefit levels in relation to housing costs and/or provide a housing supplement to cash assistance grants.  Along with providing ongoing basic assistance, a TANF program can provide an array of non-recurrent, short-term benefits and services.  In order to fall under this category, these must be designed to extend no longer than four months and must address a specific crisis situation rather than meet ongoing needs. Also, TANF funds can be used in coordination with HUD’s targeted homeless assistance grants programs – the Continuum of Care (CoC) program and the Emergency Solutions Grants (ESG) program – to maximize the impact of both resources.  For example, TANF could be used to pay for rental assistance while ESG is used to pay for supportive services to help a family remain housed. For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit

http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

Partnerships

In addition to offering a range of benefits and services, TANF agencies can serve as active partners in statewide, regional, and local homeless efforts, such as the Continuum of Care.  The expertise of TANF agency leaders can be helpful in ensuring state and local efforts are deploying the full array of available supports to prevent and end family homelessness.  Partnerships can also lead to the identification of strategies that TANF agencies can adopt to minimize homelessness among families receiving assistance.  For more information on the TANF-ACF-IM-2013-01 (Use of TANF Funds to Serve Homeless Families and Families at Risk of Experiencing Homelessness), visit

http://www.acf.hhs.gov/programs/ofa/resource/tanf-acf-im-2013-01.

Medicaid

Under Medicaid regulations, case management services are defined as services available that assist individuals “in gaining access to needed medical, social, educational, and other services.”  There are several ways Medicaid can cover case management services, which can be defined as a rehabilitative service, targeted case management (TCM) services for specific beneficiary groups, a home and community-based service (HCBS) for a person with a disability as part of the services provided by a health home, or as an administrative function of the Medicaid program or a Medicaid managed care plan.  For each of these approaches, a state Medicaid program establishes “medical necessity” criteria, which takes into consideration a person’s diagnosis and functional impairments to determine eligibility for specific services. 

Who is eligible?

Medicaid is an “entitlement” program, meaning that eligible individuals are entitled to receive covered health, behavioral health, and long-term care services. The Affordable Care Act gives states the choice to expand Medicaid eligibility to persons with incomes under 133% of the Federal Poverty Level (FPL), and allows States to determine eligibility under their Medicaid plans.

How is it financed?

The Medicaid program operates under broad state discretion, and is funded by a combination of state and federal matching funds.  Each state must develop a State Medicaid Plan that describes the benefits that will be provided.  Many Medicaid benefits, including those most likely to cover case management, are “optional” benefits, meaning that states can decide if and how to cover these services.  Federal spending on Medicaid is considered a “mandatory” program, meaning that the federal government matches state spending for all covered services provided to eligible individuals.  This makes Medicaid distinct from other HHS health and supportive services programs, which operate as “discretionary” programs with funding levels that can change from year to year based on actions taken by Congress and the President.

How can it be used to address housing needs?

Medicaid is the primary mainstream healthcare benefit that many people experiencing homelessness can access to obtain medical care, and it is a key benefit to help these individuals exit homelessness. There are several existing ways in which Medicaid is used to help people with disabilities exit homelessness and support them in housing, including Federally Qualified Health Centers, Targeted Case Management, the Medicaid Rehabilitation Option—which includes Assertive Community Treatment, and Home and Community-Based Services Waivers.

Where can I learn more about using Medicaid to pay for case management?

Where can I find which States have expanded Medicaid?

Medicaid.gov

Health Care for the Homeless Programs and Community Health Centers

In addition to primary care and some behavioral health services, Health Care for the Homeless Programs and Community Health Centers provide case management services and assistance with accessing public benefits and housing to patients and recipients of health care services.  The focus of case management services is usually helping to ensure that people have access to primary care. Partnership at the State and local level with both Health Care for the Homeless Programs and Community Health Centers play a crucial role in ensuring that people experiencing homelessness receive necessary case management services associated with maintaining healthcare. Health Care for the Homeless programs are targeted to persons who are homeless and local programs are encouraged to participate in the local CoC planning process.  The first step for any Continuum should be to reach out to any HCH program in its jurisdiction and connect to current services

Who is eligible?

Individuals and families who are literally homeless as well as those living in hotels or motels, transitional housing, or permanent supportive housing.

How are they financed?

These programs receive grant funding from the Health Resources and Services Administration (HRSA) as well as a grant under Section 330 of the Public Health Service Act, qualifying them as Federally Qualified Health Centers (FQHCs). FQHCs must serve an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program, and have a governing board of directors. In addition, they receive Medicaid reimbursement for some of the services they provide to people who are enrolled in Medicaid.

Where can I find a local HCH provider with which to partner?

Health Care for the Homeless Grantees

Where can I find a local Community Health Center with which to partner?

Find a Health Center

PATH (Projects for Assistance in Transition from Homelessness)

PATH programs provide services to people with mental illness who are experiencing homelessness or at risk of homelessness.  PATH eligible services include habilitation and rehabilitation, case management, referrals, and housing support, as well as outreach and a range of other behavioral health services.  Case management and other services funded by PATH are typically provided to people who are currently or at-risk of homelessness as opposed to people who are formerly homeless and living in permanent housing. PATH programs are administered by the state.  State mental health authorities select providers, usually through a competitive process.  PATH providers are encouraged to participate in the local CoC process and all PATH providers are in the process of transitioning data and reporting practices to participate in HMIS.

Who is eligible?

Individuals determined to be experiencing serious mental illness or co-occurring serious mental illness and substance abuse disorder; and (2) experiencing homelessness or is at imminent risk of homelessness.

How is it financed?

PATH is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). PATH is a formula grant provided to all 50 states, the District of Columbia, and US Territories, and awarded to more than 480 local organizations

Where can I find a local PATH provider with which to partner?

SAMHSA’s PATH Providers

Community Services Block Grant (CSBG)

Community Services Block Grant (CSBG) funds may be used to provide a broad range of services and activities to reduce poverty, revitalize low-income communities, and empower low-income families and individuals in rural and urban areas to become fully self-sufficient.  Grantees are required to conduct community needs assessments and develop community action plans to address local needs, including services and activities related to employment, education, better use of available income, housing, nutrition, emergency services and/or health. In most cases, CSBG funds are allocated to Community Action Agencies (CAAs). 

Who is eligible? 

The Federal Poverty Guidelines must be used as the primary criterion in determining income eligibility. In order to receive assistance under any CSBG project involving direct services, an applicant's total household income must not exceed 125% of the poverty level. Household is defined by the Bureau of Census as consisting of all persons who occupy a housing unit (i.e., house or apartment), whether they are related to each other or not. Total household income is based on income at the time of application.

How is it financed?

CSBG funding is provided as a block grant to States, Tribes and Territories.  States pass through no less than 90 percent of block grant funds to a network of local entities, primarily Community Action Agencies (CAAs), and some local governments, migrant and seasonal farm worker organizations, that delivery the services in the communities.  CAAs are non-profit agencies created as a network of entities by the Economic Opportunity Act of 1964.  States contract with CAAs to plan, develop, implement, evaluate and provide local services. 

How can I apply for CSBG funding?

2014 Application for CSBG Funds

Where can I find local CSBG grantees with which to partner?

Social Services Block Grant (SSBG)

Social Services Block Grant (SSBG) funding supports social services directed towards achieving economic self-sufficiency; preventing or remedying neglect, abuse, or the exploitation of children and adults; preventing or reducing inappropriate institutionalization; and securing referral for institutional care, where appropriate. 

Who is eligible? 

Each State or Territory has the flexibility to determine what services (within the broad service categories) will be provided; set the eligibility limits (to low-income households) to receive services; and determine how funds are distributed among various services within the State.

How is it financed?

SSBG funding is allocated to each State or Territory to meet the needs of its residents through locally relevant social services, through programs that help people to achieve or maintain economic self-sufficiency to prevent, reduce or eliminate dependency on social services.

How can I apply for SSBG funding?

SSBG Grantees – Who Can Apply?

Where can I find local SSBG grantees with which to partner?

SSBG Grantees by State

Cooperative Agreements to Benefit Homeless Individuals (CABHI)

This SAMHSA services program supports infrastructure development at the community and state levels. The major goal of the Cooperative Agreements to Benefit Homeless Individuals program is to ensure that the most vulnerable individuals who are chronically homeless receive access to sustainable permanent housing, treatment, and recovery supports through mainstream funding sources. CABHI funds support three primary types of activities: 1) behavioral health, housing support, and other recovery-oriented services not covered under a State's Medicaid plan; 2) coordination of housing and services for chronically homeless individuals and families at the State and local level which support the implementation and/or enhance the long-term sustainability of integrated community systems that provide permanent housing and supportive services; and 3) efforts to engage and enroll eligible persons who are chronically homeless in Medicaid and other mainstream benefit programs (e.g., SSI/SSDI, TANF, SNAP). 

Who is eligible?

Persons who experience chronic homelessness with substance use disorders or co-occurring substance use and mental disorders.

How is it financed?

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Center for Substance Abuse Treatment (CSAT) and the Center for Mental Health Services (CMHS) provided grant funding to states.

Where can I find CABHI grantees with which to partner?

CABHI Grantees

Which states received CABHI-States funding?

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Center for Substance Abuse Treatment (CSAT), and the Center for Mental Health Services (CMHS) recently modified its Cooperative Agreement to Benefit Homeless Individuals (CABHI), which provided grants directly to entities that provide services, into the ‘CABHI-States’ program focused on building state infrastructure and improving the capacity of state treatment service systems to provide services essential to ending chronic homelessness among people with substance abuse, mental health, and/or co-occurring disorders.

For FY 2013, eligible applicants for CABHI-States are the single state agencies for substance abuse in the District of Columbia (D.C.) and the following states: Arizona, California, Colorado, Florida, Georgia, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Michigan, Nevada, New York, Oregon, Pennsylvania, Texas, and Washington. Services to be created through CABHI-States should include recovery-oriented services not covered under the state’s Medicaid plan including: treatment services; permanent supportive housing; peer supports; CMHS-funded peer navigator(s); assistance with streamlining application processes for mainstream benefits; and more. 

SAMHSA awarded eleven grants for up to $711,818 per year for up to 3 years.   The states that were funded are: Arizona, Georgia, Hawaii, Washington, Louisiana, Illinois, Pennsylvania, Massachusetts, Michigan, Colorado and Nevada. Each CABHI-State grantee will implement its own approach to issuing funding for services. Organizations seeking funding for services should contact the single state agencies who received an award for more information. 

January 9, 2014 Council Meeting

Council Focuses on Youth Homelessness, Elects New Chair and Vice Chair for 2014

Last week, the U.S. Interagency Council on Homelessness elected Shaun Donovan, the Secretary of the Department of Housing and Urban Development, as its Chair for 2014, transitioning from Veterans Affairs Secretary Eric K. Shinseki. After assuming the gavel, Secretary Donovan praised the Secretary’s Shinseki’s leadership on the Council.

“I'll never forget the very first meeting that we had together, which was on this issue,” said Secretary Donovan . “I left that meeting thinking this is a man on a mission and I was right. Thank you for the inspiration that you provided to all of us, and to me personally. I know you are going to be just as focused on ending homelessness in the next three years and that gives me some comfort. I look forward to continuing to partner with you in the year to come and beyond.”

The Council also elected Tom Perez, the Secretary of the Department of Labor, as Vice Chair for 2014. The Council meeting was attended by Assistant to the President and Director of the Domestic Policy Council, Cecilia Muñoz; HHS Administration for Children and Families Acting Assistant Secretary, Mark Greenberg; and representatives from all 19 Federal agencies that are members of the Council. In addition to electing its officers for 2014, the Council discussed progress on Opening Doors goals based on the results from the 2013 Point-in-Time Count, and community-level efforts to end youth homelessness.

Progress on Opening Doors Goals and the 2013 Point-in-Time Count Data

Mark Johnston, HUD’s Deputy Assistant Secretary for Special Needs of the Office of Community Planning and Development, provided the Council with an overview of results from the last Point-In-Time (PIT) count, which were released in November, 2013. He shared that on a single night in January 2013, there were 610,042 people experiencing homelessness in the nation. He also provided an overview of progress on the Opening Doors population goals for Veterans, people experiencing chronic homelessness, families, and youth.

Cecilia Munoz commented that the downward trend across all populations is the result of relentless focus  on the task.  “I regularly bring this work out as an example of the government setting high marks and meeting them because we know how to end homelessness,” Ms. Munoz said. “We can do what many people think is impossible. But it’s not impossible and we have the metrics to show for it.”

Ending Youth Homelessness: Perspectives from the Field

The Council also had the opportunity to hear from experts in two communities about how they have been using USICH’s Framework to End Youth Homelessness.

Leslie Strnisha, Vice President for the Sisters of Charity Foundation in Cleveland, Ohio, discussed her organization’s participation in YouthCount!, a public-private partnership to find and count young people experiencing homelessness. They found 129 young people experiencing homelessness in Cleveland. Strnisha explained that her foundation has focused on helping non-profits and other organizations improve their practices so that they can better serve young people who are experiencing homelessness. Some of the most effective and innovative best practices they’ve funded include:  

  • Providing emergency safe places for those youth who are newly homeless, and for victims of human trafficking
  • Permanent supportive housing, scattered and single site models for those with the highest risk factors
  • More intensive transition coaching for those aging out of the foster care system
  • And providing a flexible pool of funding to support youth without a safety net

USICH’s youth framework has and will guide the community’s work, Strnisha said.

“We really applaud this Council for supplying a framework to assist communities in their local planning,” she said. “We know that our community's vulnerable youth belong to all of us and we believe it will take all of us to plan for and carry out this work.”

Megan Gibbard, the Homeless Youth and Young Adult Project Manager with the King County Committee to End Homelessness, provided an overview of her community’s systematic approach to end youth homelessness. Their work starts with a data strategy, which aims to improve multiple efforts to collect and use data to inform their work. Based on the local data, the community selected four goals, including reducing the disproportionate representation of lesbian, gay, bisexual, transgender, and questioning youth and youth of color, and reducing young people’s return to homelessness.

“Preventing an ending to youth and young adult homelessness has emerged as a King County regional priority,” Gibbard said. “We are strengthening and coordinating our capacity to act effectively”

Highlights of King County’s work so far include the collaborative review of data, simple screening at every front door for every young person, a shared, common direction, more than 4 million dollars of new resources from public and private funders, and a deep community commitment to get youth and young adults off the street.

Following the presentations was a robust discussion about the work being done in Cleveland and King County. Learn more about the panelists and these community efforts by reading the expert briefs prepared for the Council by the panelists with Katie Hong from the Raikes Foundation. The Council remains dedicated to preventing and ending youth homelessness, and all forms of homelessness, as established in Opening Doors.

CoC Services Categories with Possible HHS Program Alternatives

CoC Services Categories with Possible HHS Program Alternatives

Of the seventeen (17) categories of services that are eligible to receive CoC Program funds, there are eight (8) categories in particular that have a higher likelihood of also being eligible for an HHS program or services funding stream.  These include:

Funding for Services at the U.S. Department of Health and Human Services

There are thirteen (13) programs that are administered at the Federal level by the U.S. Department of Health and Human Services that may serve as alternative funding sources for the eight (8) categories of CoC services above.  These include:

The below table identifies which of these thirteen (13) programs may be a potential alternative to one of the CoC eligible services categories:

Assessing Strategic Value of CoC Program-Funded Supportive Services

As part of their community planning and preparations for the application submission, Continuums of Care (CoCs) have an important opportunity to assess whether they are using their CoC program funding in the most strategic way possible to advance local goals of ending homelessness.

Such an assessment can:

  1. Identify projects or project costs for reconsideration that do not contribute directly to a community’s ability to end homelessness.
  2. Reveal project costs within the CoC inventory that could be funded through alternative (non-CoC) sources, thereby allowing the potential to ‘free up’ a portion of funding that could in turn be shifted to housing.

The potential for identifying non-CoC funding alternatives may be greatest for project costs related to supportive services. Therefore, a key starting point for this strategic assessment is to examine the grants funded under the CoC Program that are currently used to pay for supportive service costs. For more information on the importance of assessing the strategic value of CoC Program-funded supportive services, visit HUD’s SNAPS Weekly Focus: Leveraging Mainstream Services Funding.

Step 1. Take inventory of all CoC Program-funded grants that pay for supportive services

This inventory should include all of the CoC Program-funded grant programs that include a supportive services budget line item in the grant agreement. This includes Supportive Services Only (SSO) projects where supportive services are provided to homeless individuals and families not residing in housing operated by the grant recipient, as well as Permanent Housing (PH) and Transitional Housing (TH) projects where supportive service funds are funded through the CoC Program to pay for supportive services for participants in a housing program. 

CoCs may choose to start by considering the projects that are eligible for renewal in the upcoming CoC Program competition or conduct longer-range planning for programs up for renewal in the next few years.

CoCs can create a list or table of all grants in their inventory that pay for supportive services using CoC Program funds. The table (see example below) should, at a minimum, include the name of the project, name of the recipient, the component, the total grant amount, the amount of funds that pay for supportive services, and the year the most recent grant was awarded:

 

 

 

 

 

 

 

 

Step 2.  Assess strategic value of supportive services

Once CoCs have compiled the inventory of SSO grants and grants with services costs, they can conduct a review of these grants to assess their strategic value. For each of the grants in this list, CoCs can ask the following three questions:

  • Are the supportive services essential to exiting people from homelessness to permanent housing as quickly as possible or to support their long-term stability in permanent housing? 
  • Are the supportive services serving the highest need people experiencing homelessness?
  • Are the supportive services performing with the highest quality, meeting or exceeding program quality standards, if established, and implementing evidence-based practices?

If the answer to any of these questions is ‘NO,’ the services may not be the most strategic use of CoC program funds.  CoCs should strongly consider reducing funds for these services, either in whole or in part, and reallocating those funds to either a new permanent supportive housing or rapid re-housing program.

If the answer to all three questions is “YES”, the services may be of high strategic value in ending homelessness.  At the same time, given the limited availability of CoC program funds and the lack of alternative sources that create permanent housing specific to people experiencing homelessness, CoCs are encouraged to determine if there are other ways to finance or provide these services to free up more funds for housing.

Step 3: Determine likelihood of services being provided through alternate source of funds or partnerships

CoCs should then consider the following set of questions:

How great is the potential for alternative (non-CoC program) sources of funds which can pay for some or all of the supportive services? Are there partnerships with other services providers who are funded by non-CoC program funds who can provide these services instead? To identify possible alternatives within HHS programs to pay for these services or deliver them through partnerships with existing HHS-funded services providers, please see CoC Services Categories with Possible HHS Program Alternatives.

If the answer to either of these questions is ‘YES,’ CoCs may be able to leverage these alternative non-CoC program sources or enter into partnerships with existing services providers to offset and therefore free up CoC-funds to create more permanent housing.  Doing so will increase the total pool of resources for homelessness programs and create more permanent housing. 

Step 4: Determine strategic approach based upon assessment

Depending upon the degree to which there are alternative sources or partnerships that can provide these services, CoCs should determine the most appropriate strategy:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 5. Seek non-CoC program services or enter into services partnerships

Where it is determined that a non-CoC program funding source or partnership with an existing services provider is available, CoCs and project recipients should refer the information provided on the HHS programs page to find more information about how the each funding source can be accessed.  CoCs should make sure that all of its project recipients are informed about the mainstream funding options that may be available.

Services in the CoC Program: Assessing Value and Finding Funding Alternatives

Many communities use funding from HUD’s Continuum of Care (CoC) Program to pay for supportive services for people experiencing homelessness.  These services can be provided to people currently experiencing homelessness who are residing on the streets, in shelters, or transitional housing or to people receiving services as part of permanent housing models, such as permanent supportive housing or rapid re-housing programs. 

Using CoC Program funds to pay for these services is permitted.  In fact, the CoC Program interim rule defines 17 categories of supportive services that are eligible costs under the CoC Program.  At the same time, using CoC Program funding to pay for supportive service costs may not always be the most strategic way to use these funds. This is for two primary reasons:

The CoC Program remains one of the only Federal programs that can fund permanent housing specifically for people experiencing homelessness. As evidence shows that permanent housing models, such as permanent supportive housing and rapid re-housing are the most effective interventions for ending homelessness, CoCs and project recipients should use CoC Program funds to pay for the costs associated with providing housing which are not funded through other sources.

Many services that are essential to ending homelessness may also be financed through mainstream programs, including programs administered or overseen by the U.S. Department of Health and Human Services (HHS). 

This tool is intended to help CoCs and recipients of CoC Program funding make strategic decisions regarding the use of CoC Program funds for supportive services. This tool can help CoCs: 

  • Make assessments about whether or not services are contributing to efforts to end homelessness.
  • Learn which types of CoC Program-eligible supportive services are most likely to have mainstream HHS-funded programs as an alternative source.

VA Offers $600 Million in Funding to Support Services for Homeless Veteran Families

The Department of Veterans Affairs (VA) has announced the availability of up to approximately $600 million in grants for non-profit organizations and consumer cooperatives that serve very low-income Veteran families occupying permanent housing through the Supportive Services for Veteran Families (SSVF) program. 

“Those who have served our Nation should never find themselves on the streets, living without hope,” said Secretary of Veterans Affairs Eric K. Shinseki. “These grants play a critical role in addressing Veteran homelessness by assisting our vital partners at the local level in their efforts. We are making good progress towards our goal to end Veterans’ homelessness, but we still have work to do.” 

The SSVF program is designed to assist very low-income Veteran families who are homeless or at imminent risk of becoming homeless. The program employs a housing first model, an approach which centers on providing homeless Veterans with permanent housing quickly and then providing VA health care, benefits and services as needed. 

Required services include outreach, case management, assistance in obtaining VA benefits, and providing or coordinating efforts to obtain needed entitlements and other community services.  Grantees secure a broad range of other services for participants, including legal assistance; credit counseling; housing counseling; assisting participants in understanding leases, securing utilities, and coordinating moving arrangements; providing representative payee services concerning rent and utilities when needed; and serving as an advocate for the Veteran when mediating with property owners on issues related to locating or retaining housing.  Grantees also offer temporary financial assistance that provides short-term assistance with rent, moving expenses, security and utility deposits, child care, transportation, utility costs, and emergency expenses. 

VA announced the availability of funds today through a Notice of Funding Availability (NOFA) via the Federal Register.  VA is offering $300 million in FY 2014 funds and $300 million in FY 2015 funds, subject to available appropriations.   VA will make award decisions based on a national competition.

In FY 2013, VA awarded approximately $300 million in SSVF grants for operations beginning in FY 2014.  VA is focusing up to $300 million in surge funding on 76 high priority continuums of care in an unprecedented effort to end Veterans’ homelessness in these communities.  In FY 2013, funding from the SSVF program served over 39,000 Veterans and over 62,000 participants (i.e., Veterans and their family members). 

In November, VA and the Department of Housing and Urban Development (HUD) announced the results of the 2013 Point-in-Time Estimates of Homelessness, which was prepared by HUD.  The report estimated there were 57,849 homeless Veterans on a single night in January in the United States, an eight percent decline since 2012 and a 24 percent decline since 2010.

The SSVF program is authorized by 38 U.S.C. 2044.  VA implements the program by regulations in 38 CFR part 62.  More information about the program can be found at www.va.gov/homeless/ssvf.asp.

Progress Reflected in the 2013 PIT Sets Stage for NOFA : What Communities Need to Understand about the Application Process for the CoC Program Competition

On Friday, November 22, 2013, HUD released the Notice of Funding Availability (NOFA) for the Continuum of Care Program Competition, launching the annual competition for $1.7 billion in Federal funding for the Continuum of Care (CoC) Program. HUD has also made some important changes in this year’s competition. HUD has made these changes in an effort to sustain and accelerate the progress our nation has made in ending homelessness, as reflected in last week’s release of the 2013 Annual Homelessness Assessment Report to Congress. The 2013 Point-in-Time count data reflects an overall downward trend in homelessness and shows that with strategic investment in proven strategies, we can achieve the vision set forth in Opening Doors, that everyone should have a safe and stable place to call home.

The FY 2013-FY 2014 CoC Program Competition NOFA encourages communities to further adopt and implement the proven programs and practices that will increase this downward trend.

Looking at the 2013 PIT Results in Context

The 2013 Point-in-Time (PIT) count shows a steady and significant decrease in national rates of homelessness since the launch Opening Doors. This trend is evidence that, in partnership with communities across the country, the Obama Administration has significantly impacted the trajectory on homelessness.  The progress is particularly remarkable given the economic downturn our country faced and the reality of an economy that has slowly, but steadily been improving.

Communities have made progress in difficult times by doing more of what works, through policy changes, shifting resources, and leveraging new funding opportunities.

For example, Veteran homelessness has decreased by 24 percent since 2010.  Bipartisan congressional support for increased targeted investments in programs like HUD-VASH and SSVF have been critical.  Communities are taking proven practices like Housing First to scale in the way they implement these programs. The results are stark: between January, 2012 and January, 2013 there was a 16 percent reduction in the number of Veterans living on the streets. This is the deepest reduction in unsheltered Veteran homelessness our nation has experienced to date.

The number of individuals experiencing chronic homelessness has decreased by 16 percent since 2010, due to the expansion of permanent supportive housing serving this population. Permanent supportive housing is a proven and cost-effective solution that helps people gain housing stability and become healthier. In addition, communities achieve lower costs by decreasing the need for crisis services like emergency rooms and jails.

We need bi-partisan congressional support to increase funds for HUD’s homeless programs so that communities can create enough permanent supportive housing to end the costly tragedy of chronic homelessness.

The 2013 point-in-time count shows a decrease in national rates of homelessness among families of 8 percent since 2010.

The downward trend in homelessness overall is evidence that the collaborative effort of Federal Agencies with State and local governments and private and non-profit partners is creating meaningful results for people experiencing homelessness. We have much more work to do, and we will only continue on a path to end the crisis of homelessness if we are willing to invest in solutions.

At the same time, the current Federal budget situation presents significant challenges. Due to flat funding from Congress and sequestration, HUD’s FY 2013 funds for the CoC program have been cut by five percent. The Obama Administration is fighting hard to increase funding for programs that serve people experiencing homelessness. In the meantime, it is more important than ever that we use the resources we have to create the biggest impact on homelessness. Communities that demonstrate that every dollar will be spent in the most strategic way possible will be in the best position to make the case for needed resources. This year’s NOFA application, more than ever, requires communities to show this strategic investment.  

What communities should be thinking about in approaching the FY 2013-FY 2014 CoC Program Competition

This year’s competition is for a smaller amount of funding than has been available in years past, with little hope for restoration of funds due to continuing budget cuts. Although the partial government shut-down delayed the NOFA release, HUD is allowing communities a longer response time to support these critical planning decisions.

USICH will provide more information in the coming weeks. In the meantime, we wanted to highlight three aspects of in this year’s competition that are of particular importance: timing, policy priorities, and tiering and project selection.

1.Timing

For the first time, HUD is asking CoCs to submit a combined “Continuum of Care Application”—the portion of the application that reflects community-wide performance and planning—for the FY2013 and FY2014 competitions. This streamlines the application process for FY2014, reduces some of the time and paperwork burden for CoCs, and enables HUD to get FY2014 funds in the hands of communities and programs on faster timetable.

The CoC Application to be submitted in FY2013 should reflect a CoC’s planning and performance for both FY2013 and FY2014. The score CoCs receive in the FY 2013 application will apply to the FY2014 funding awards.  Consequently, the FY2013 application is where CoCs need to demonstrate that they are putting in place the key policies and practices that are essential to ending homelessness.

For the current NOFA, CoCs will have to submit a CoC application, along with project applications and priority lists for FY2013 funds.  When HUD releases the FY2014 NOFA, communities will need to submit project applications and priority lists for FY2014 funds, but not a CoC Application. At this time, the amount of funds in the FY2014 is not known.

The FY 2013/FY 2014 CoC Program Competition opened on November 22, 2013 and will close on February 3, 2014.  HUD then anticipates opening the FY2014 competition for project applications much earlier in the year, making it possible to announce 2014 funds by around the end of the fiscal year, which ends on September 30, 2014. 

2. Policy Priorities

This year’s NOFA places even stronger emphasis on system-wide implementation of the policies and practices that are critical to ending homelessness. HUD and USICH have provided specific communication to the field in advance of the NOFA to support local understanding of key policy priorities.

It is critical that CoCs carefully review the policy priorities and scoring criteria in the FY 2013-FY 2014 CoC Program Competition NOFA, as there are significant changes aimed at encouraging CoCs to adopt and implement specific policy priorities and best practice models. Some of the highlights of the scoring criteria in the FY 2013-FY 2014 CoC Program Competition NOFA include:

Ensuring that CoCs strategically allocate resources to evidence-backed and high-performing programs
Ending chronic homelessness through new and reallocated permanent supportive housing projects that serve people experiencing chronic homelessness, and which adopt a Housing First approach
Ending family homelessness through new reallocated Rapid Re-housing projects for families experiencing homelessness
Reallocating or reducing Transitional Housing Grants and Supportive Services Only Grants
Prioritizing households most in need
Maximizing the use of funding from mainstream services
Serving Veterans and youth who are experiencing homelessness   

3. Tiering, and Project Selection Priorities in Light of Funding Decreases

Due to flat funding levels and budget cuts under sequestration, there is insufficient FY 2013 funding available for all existing renewal projects. Therefore, in FY 2013 CoCs will once again rank projects into two funding tiers. The amount available in Tier 1 represents a CoC’s Annual Renewal Demand (or the total sum of all renewal projects eligible for renewal in FY 2013) minus a five percent cut. Projects ranked in Tier 1 are considered relatively safe, while projects in Tier 2 are at risk.

CoCs that receive higher scores on the FY 2013/FY 2014 CoC Application will be in the strongest position for having some of their Tier 2 projects funded in the order of priority outlined under the selection criteria in the NOFA.  It is important to understand that while in FY 2012, CoCs were asked to plan for cuts, HUD was able to reduce the level of cuts through carryover and recaptured funds; HUD does not anticipate that this will happen in FY 2013.

Given these unfortunate cuts, HUD is asking communities to ensure that CoC resources are used in the most strategic way possible. This mean prioritizing funding for programs and infrastructure that are essential to helping people experiencing homelessness obtain permanent housing as quickly as possible and with appropriate levels of services to support housing stability. One way to approach this if for communities to leverage mainstream resources—like Housing Choice Vouchers, Medicaid, TANF, and more—to supplement CoC funds.

HUD will select projects based on project type using the selection priorities outlined in the FY 2013-FY 2014 CoC Program Competition NOFA. HUD will follow this order to select projects for funding in both Tier 1 and Tier 2.  HUD will select lower ranked projects from the CoC Priority Listing above projects ranked higher by the CoC, consistent with these selection priorities. Above all other types of projects in each tier, HUD will prioritize the renewal permanent housing projects and new reallocated permanent housing, namely permanent supportive housing and Rapid Re-housing. This means that should HUD be able to fund any projects within Tier 2, it will first fund all renewal and reallocated permanent housing by CoC score before moving to the next project type in the selection criteria.

In the coming weeks, USICH will be holding a webinar to advise CoCs on how they can be as strategic as possible in responding to the FY2013-FY 2014 CoC Program Competition. In addition, USICH will be releasing a tool that will help CoCs identify mainstream funding and programs that can serve as alternatives for CoC-funded services, and assess the strategic value of CoC-funded services.

CoCs and project applicants can also find additional resources related to the FY 2013-FY 2014 CoC Program Competition on HUD’s OneCPD Resource Exchange FY 2013 Continuum of Care (CoC) Program NOFA: CoC Program Competition page.

CoCs that submit applications that demonstrate alignment with these policy priorities will receive higher scores and will therefore have a greater likelihood of having a portion of their Tier 2 projects awarded in FY 2013 and FY 2014 in the order of priority established in the NOFA at Section VII.B.b.

Improving Access to Health Care: Some Key Protections and Rights

While the United Nations’ Universal Declaration of Human Rights includes the universal right to health care, in the United States, health care is seldom discussed in that context. There are, however, key protections under U.S. law and through Federal policy that can be used as tools in the work to prevent and end homelessness through improved access to health care.

Through the Emergency Medical Treatment and Labor Act (EMTALA) of 1986, Americans have the right to receive emergency health care services regardless of their ability to pay. EMTALA ensures the right of all Americans to receive emergency care and imposes specific obligations on hospitals and health care providers to provide that care. This guaranteed access to emergency medical care has been critical to survival for many people experiencing homelessness who have not historically had health coverage or the ability to pay for care.

Access to emergency health care is not access to full and complete health care. For too many people, including those experiencing homelessness, health care entails just one emergency room visit after another without addressing underlying health needs or improving people’s overall health status. Meanwhile, the costs to hospitals and the public increase with repeat emergency room visits. 

The Affordable Care Act of 2010 takes important steps to improving access to more comprehensive health care for most Americans. It expands access to health insurance coverage both by creating private insurance marketplaces and providing States with the option to expand Medicaid coverage to all persons earning at or below 133 percent of the Federal Poverty Level. 

State choice to expand Medicaid coverage under the Affordable Care Act is groundbreaking for millions of low-income Americans and for the effort to prevent and end homelessness. The U.S. Department of Health and Human Services estimates that 1.46 million people have been determined eligible to enroll in Medicaid since October 1, 2013.

“The Affordable Care Act is a vast improvement for millions of people who are homeless or at risk of homelessness,” says John Lozier, Executive Director for the National Health Care for the Homeless Council (NHCHC).

In addition, the Affordable Care Act includes new health coverage rights and protections, making strides to further ensure access to health care in the United States. These include protections against being denied health insurance coverage based on pre-existing conditions, the right to choose any doctor or provider from within one’s health plan network, the right of young adults under 26 years old to be covered under their parent’s plan, and the right to appeal decisions made by private health plan.

Adequate coverage of mental health services is critical to many people experiencing homelessness.  The Affordable Care Act achieves this in part by ensuring that mental health services are covered both by private insurers and by State Medicaid plans. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act fixes the historic disparity in payment for mental health services compared with medical care. 

Passed in 2008, this legislation requires health insurers to pay for mental health or substance abuse care at a comparable rate to payments for physical health care. As a result, insurance companies can no longer arbitrarily limit the number of days patients can spend in the hospital. They are also not allowed to assign higher co-payments or deductibles for persons needing mental health services than they would generally apply to medical services.

Just last month the Federal government issued its final guidance on the Mental Health Parity and Addiction Equity Act, increasing parity between mental health, substance abuse treatment and medical benefits for group and individual health plans, and ensuring that the law will be adequately enforced. These regulations create transparency in benefits and represent a big step forward for patients in guaranteeing that health plans adhere to parity.

“There is no justification for a health plan to impose restrictions on mental illness,” said Andrew Sperling, Director of Federal Legislative Advocacy at the National Alliance of Mental Illness (NAMI).  “Schizophrenia and other psychological disorders are just as devastating to families as diabetes and other medical illnesses.”

Now, “insurance providers must simply cover mental health on the same terms and conditions as any other medical disorder,” said Sperling.

EMTALA, the Affordable Care Act, and the Mental Health and Substance Use Disorder Parity Act all take steps towards access to comprehensive healthcare. Health care availability and quality still varies greatly depending on where people live, and much more work is needed to create a true health care system focused on whole person needs rather than what has been described as a “sick care” system focused on treating illnesses.

As the Federal government, States, the health care industry, and the private sector are now working together to implement the Affordable Care Act, it is possible to envision a day when people with even the most complex and chronic conditions will have access to a full and complete package of health care services regardless of their ability to pay.

To learn more about how the Affordable Care Act, Medicaid expansion, and mental health parity can help end homelessness, please visit the USICH Affordable Care Act page. 

Rights for People Experiencing Homelessness

Each year on December 10th, the world celebrates the anniversary of the United Nations’ Universal Declaration of Human Rights by observing Human Rights Day. While much attention is focused internationally on human rights, there are many to be recognized and celebrated here in the United States. And while many people do not think about the rights they enjoy on a regular basis, when you need them most they will be there for you. For people who are homelessness or close to it, the rights afforded to them can be a lifeline to pulling themselves out of a housing crisis. At USICH, we strive to promote opportunities for communities and providers to utilize a human rights approach to homelessness. Liberties, such as the right to keep your family together, be protected under the Violence Against Women Act (VAWA), go to school, obtain Supplemental and Nutritional Food Assistance (SNAP), vote, and receive mail go a long way towards ending or preventing homelessness. Guaranteeing these and other rights to everyone, including those at risk of or experiencing homelessness, gives people the tools they need to reach their highest potential.

The Right to Family

Staying together has not always been guaranteed for families experiencing homelessness. They are sometimes forced to separate, making a difficult situation even more challenging. The National Law Center on Homelessness and Poverty outlines the issue in its publication Cruel, Inhuman, and Degrading: Homelessness in the United States under the International Covenant on Civil and Political Rights, stating: “families with adult males are more likely to be excluded than individuals with records of child abuse; one study found that 40 percent of family shelters exclude families because of the presence of adolescent males. Thus, families have a choice of either forgoing shelter all together, or separating fathers and teenage males from other relatives. These separations may last a long time, since families stay in shelters for an average of nearly 6 months.”

While separation may sometimes occur, the right to family is protected under both international and Federal law. According to Article 23 of the International Covenant on Civil and Political Rights, societies owe protection to the family because it is “the natural and fundamental group unit of society.” The US government also protects the right of families experiencing homelessness to stay together, prohibiting family separation in shelters with the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009. After the passage of the HEARTH Act, the Department of Housing and Urban Development (HUD) now prohibits the involuntary separation of families on the basis of a child’s age, which prevents federally funded family shelters from excluding teenage males and causing family separations. The HEARTH statute and regulations do not extend to homeless shelters that do not receive Federal funding, but the Federal government, through HUD and USICH, encourages all shelters, transitional housing, and permanent housing to not deny assistance to children based on age in order to prevent involuntary family separations. 

Family separation can also occur outside of shelters, when parents and children are separated by court order as a result of child and family services agencies’ findings. Although this may be appropriate in some instances for the safety of the child, research indicates that, when possible, keeping families together is generally better for children, parents, and the community. To that end, the Administration on Children, Youth and Families (ACYF) recommends providing families with intervention services and support – including housing – in order to keep children with their families in a safer, healthier, more stable home when possible.

The Violence Against Women Act (VAWA)

According to the National Network to End Domestic Violence, approximately 63 percent of women experiencing homelessness are survivors of domestic or sexual violence. Unfortunately, domestic violence and homelessness go hand in hand.

The National Coalition for the Homeless (NCH) notes, “When a woman decides to leave an abusive relationship, she often has nowhere to go … many women and their children are forced to choose between abuse at home and life on the streets.”

In order to help families experiencing a housing crisis due to domestic and/or sexual violence, the US government passed VAWA in 1994. The law provides housing protections for adults who have experienced domestic violence. Specifically, it protects individuals applying for or living in federally subsidized housing from being discriminated against due to the fact that they have experienced domestic violence. On the heels of the legislation’s reauthorization last March, HUD issued a notice providing information on how the reauthorization will apply to HUD programs, and the  National Housing Law Project (NHLP) published a comprehensive manual for advocates titled "Maintaining Safe and Stable Housing for Domestic Violence Survivors: A Manual for Attorneys and Advocates."

States have individually built off VAWA to expand protections. Common State laws include allowing courts to remove the perpetrator of domestic violence from a home regardless of who the legal owner is, protecting the identity of the survivor by making it illegal for a landlord to disclose confidential information without a court order, and providing housing and relocation assistance to survivors and families who are homeless because of their experience with domestic or sexual violence.

While the law goes a long way towards protecting the rights of people experiencing violence, some advocates believe the legislation should be updated to reflect rights afforded by many States. As the National Law Center on Homelessness and Poverty states, “the new VAWA provides the best support system to survivors of domestic violence that we have seen up to this date, and even more women will feel they can return to normalcy. That isn’t enough though. Although VAWA was passed, the re-authorization … does not provide the specific protections that State laws do.”

The Right to Education

Children and youth experiencing homelessness face a wide variety of barriers to schooling, resulting in the need for legislation that protects their right to education. During a housing crisis, parents and guardians often move children to emergency housing without taking school needs into account. Enrollment requirements, coupled with high mobility, lack of transportation and school supplies, poor health, fatigue, and hunger create challenges for children in families and unaccompanied youth who wish to attend school.  

In the US, every child experiencing homelessness—defined by the Department of Education (ED) as a child or youth who lacks a fixed, regular and adequate nighttime residence—has access to the same public education as any other student. McKinney-Vento, the primary legislation aimed at educating children and youth in homeless situations, provides a broad mandate for all school districts to remove barriers to enrollment and retention, and requires that districts assign a homeless liaison to link with students in a housing crisis. The law also allows students to stay in their original school if they are forced to move out of the district as a result of homelessness, provides transportation to and from school, gives students the right to enroll in school right away even if all of their paperwork is not available, and provides all students with the right to equal access to school services.  

The Right to Be Free from Hunger

Hunger, poverty and homelessness are inextricably linked. In order to combat hunger in the U.S. and support those emerging from homelessness, the Department of Agriculture implements the Supplemental Nutrition Assistance Program (SNAP) to help low-income households pay for food. SNAP’s Food and Nutrition Service works with State agencies, nutrition educators, and neighborhood and faith-based organizations to ensure that those eligible for SNAP have the information needed to apply for the program and can access nutrition assistance.

People experiencing homelessness have the same rights under SNAP as everyone else. In order to ensure that everyone is able to receive the food they need, applicants cannot be denied SNAP based on the fact that they do not have a permanent address. Additionally, SNAP can be used to purchase food at a variety of locations, including grocery stores, restaurants, and even soup kitchens or shelters. Finally, youth experiencing homelessness have the right to apply for SNAP without taking parents’ income into account.

The Right to Vote

While many think of the right to vote as universal in the United States, it is not specifically granted by the Constitution. Whether or not people experiencing homelessness can vote depends on individual State laws. Typically, people can vote as long as they meet their State's requirements. Some States make special provisions for people experiencing homelessness, such as allowing them to use a courthouse address to register to vote. Unfortunately, it is becoming more difficult for people experiencing homelessness to vote as laws in many States are making the act contingent upon proof of identification, citizenship, or residency.

Since 1992, the National Coalition for the Homeless (NCH) has worked to guarantee all citizens the right to vote by coordinating civic participation programs through their "You Don't Need a Home to Vote" project.

"It's critically important for people who are experiencing homelessness to make their voices heard on Election Day,” said NCH Executive Director Jerry Jones. “More than practically any other group, they are being failed by current policies. We have to ensure their right to the ballot box."

The Right to General Mail Delivery

The ability to receive mail can improve an individual’s ability to maintain important correspondence that can impact personal stability, such as applying for jobs or services and benefits including SNAP, Medicaid, and Social Security. In the U.S., the absence of a home address does not preclude a person from receiving mail.  The United States Postal Service (USPS) provides delivery to people experiencing homelessness through General Delivery service. General Delivery service is available at designated post offices. Individual pieces of General Delivery mail can be held for up to 30 days. 

Homelessness Should Not Limit Access to Civil and Human Rights

All of these rights can offer a step up to someone experiencing homelessness. But while people experiencing homelessness are afforded the same rights as other citizens of the United States, including the right to family, the right to be protected from domestic and sexual violence, the right to an education, the right to be free from hunger, the right to vote, and the right to receive mail, they still can have their rights violated as a result of their housing situation. Discrimination against Veterans, families, youth, children and people experiencing chronic homelessness occurs on a daily basis, and these protections are necessary to make sure that all men and women, regardless of whether they have a home, are treated equally under the law. 

How HUD Protects Rights to Housing

The United States has had a long and complicated history when it comes to the right to housing. In 1944, President Franklin Roosevelt recognized the right of “a decent home” for every American family, regardless of “station, race, or creed” in what has come to be known as the Second Bill of Rights. By acknowledging that millions of Americans were not able to realize their right to housing, FDR helped to spark a national and international dialogue and future legislation.

In 1948, the United Nations’ Universal Declaration of Human Rights stated that, among other things, “everyone has the right to an adequate standard of living … including the right to housing.” Soon after, The Housing Act of 1949 established the national goal of “a decent home and a suitable living environment for every American family.”

Since then, many laws and regulations have passed that have been specifically designed to help every American citizen realize his or her right to housing. Perhaps most notably is the Fair Housing Act of 1968 which, as amended, ”prohibits discrimination in the sale, rental, and financing of dwellings, and in other housing-related transactions, based on race, color, national origin, religion, sex, familial status (including children under the age of 18 living with parents or legal custodians, pregnant women, and people securing custody of children under the age of 18), and disability.”

Community planners and services providers who are committed to ending homelessness can use the Department of Housing and Urban Development (HUD) statutes and regulations to help families and individuals sustain and access housing. These are important tools to help prevent and end homelessness in every community.

HUD in Action 

As the nation’s lead housing agency, HUD has the responsibility of making the Federal goal of decent housing and suitable living environments for all a reality. This is not to say it is the government’s job to build a house for each of its citizens, rather, it is the government’s responsibility to create the best conditions through policy, legislation, and enforcement so that all residents are able to enjoy their full rights. 

As described in the National Law Center on Homelessness and Poverty’s 2011 report “Simply Unacceptable: Homelessness and the Human Right to Housing in the United States,” such efforts can include “devoting resources to public housing and vouchers, creating incentives for private development of affordable housing such as inclusionary zoning or the Low Income Housing Tax Credit, through market regulation such as rent control, through legal due process protections from eviction or foreclosure, ensuring habitable conditions through housing codes and inspections, or by other means.”

Other means include enforcing the Fair Housing Laws and Presidential Executive Orders that ensure housing right protections for millions of Americans. This includes Section 504 of the Rehabilitation Act of 1973, and Title II of the Americans with Disabilities Act of 1990, which both prohibit discrimination on the basis of disability in reference to housing.

Through the Office of Fair Housing and Equal Opportunity (FHEO), HUD “administers and enforces federal laws and establishes policies that make sure all Americans have equal access to the housing of their choice.” Some of the methods the FHEO uses, which may be of significant use to State or local practitioners, are the Fair Housing Initiatives Program (FHIP) and the Fair Housing Assistance Program (FHAP), both designed to assist those who believe they have been victims of housing discrimination by investigating claims. Through these programs, HUD provides funding incentives to government and non-government entities to help enforce fair housing laws, thereby increasing access to housing for protected classes of Americans. 

HUD also maintains the Fair Housing Accessibility FIRST initiative, providing information, resources, support, and technical assistance in the planning of housing that complies with fair housing laws. This initiative is a useful resource for housing developers to help ensure low-barrier access to housing is implemented from the very early stages of planning.

Finally, HUD requires local governments and States that receive funding for housing to participate in Affirmatively Furthering Fair Housing (AFFH), thereby increasing access to housing for Americans. A new rule proposed this year would boost State and local governments’ assessment of fair housing by improving access to tools necessary for data collection. 

Above and Beyond 

As demonstrated above, HUD works to make sure existing laws and policies are enforced to ensure equal access to housing. In order to provide even greater access to fair housing, HUD has taken steps to improve the experience of Americans seeking housing who are not covered by Federal laws.

For many Americans seeking housing, especially those who are homeless and/or dependent on housing vouchers and alternative sources of income such as social security or disability, discrimination is a major challenge to accessing housing.

Currently 12 states and the District of Columbia have source of income anti-discrimination laws. In 2010, HUD began requiring general funding grant applicants to comply with State and local source of income anti-discrimination laws. As Secretary Donovan stated in a HUD press release, “A family’s source of income should never be used as a basis to discriminate against them.”

HUD has also expressed its commitment to ensure equal access within HUD-funded programs for lesbian, gay, bisexual, or transgender (LGBT) people. In 2012, HUD issued a new regulation called the Equal Access to Housing in HUD Programs Regardless of Sexual Orientation or Gender Identity, commonly called the LGBT Equal Access Rule. By instituting this rule, HUD is serving as a model for equal access to housing for all communities.

Furthermore, HUD’s Office of Policy Development and Research recently published results from the first large scale study on housing discrimination toward same-sex couples, showing that discrimination toward gays and lesbians is occurring and is a significant barrier to housing. Currently, only sixteen States and the District of Columbia protect individuals from housing discrimination based on gender expression, and 21 States and D.C. protect individuals from housing discrimination based on sexual orientation.

By committing to help further the housing rights of LGBT Americans, HUD is ensuring that many LGBT people experiencing homelessness (for example, the 29% of San Francisco’s 2013 homeless population who identify as LGBT) can end their homelessness without being discriminated against.

The international human right to housing means more than protecting people from discrimination; it means ensuring that all Americans have appropriate levels of housing assistance. 

Thus, the next frontier for the right to housing movement could be protecting the right to affordable housing. Fair housing laws have achieved the goal of providing the right to nondiscrimination on the basis of race, age, sex, and creed. Moving forward, a comprehensive affordable housing policy would continue progress on protecting the right to affordability and quality. Achievement of that goal would dramatically and significantly contribute to an end to homelessness for all in America.

Opening Doors to Innovation: Building Strong Connections to Rapidly House Veterans

On December 4, 2013, USICH and the National Coalition for Homeless on Veterans (NCHV) hosted an informational webinar focused on how providers serving Veterans experiencing or at risk of homelessness can build strong local connections between VA and Continuum of Care (CoC) resources and rapidly connect homeless Veterans to permanent housing.

Coordinated, collaborative, and community-based actions that rapidly connect Veterans to permanent housing, healthcare, jobs, and other supportive services are essential to achieve our collective goal of ending Veteran homelessness by 2015.

Speakers

  • Barbara Poppe, Executive Director, U.S. Interagency Council on Homelessness
  • Baylee Crone, Vice President of Operations and Programs, National Coalition for Homeless Veterans
  • John Kuhn, National Director, Supportive Services for Veteran Families, U.S. Department of Veterans Affairs
  • Eric Grumdahl, Policy Director, U.S. Interagency Council on Homelessness
  • Gerald Eckert, Social Services Manager, The Salvation Army, Greater Houston Area Command, Houston, TX
  • Jamie Ebaugh, Director of Supportive Housing, Southwest Counseling, Detroit, MI

Tell us what you thought about the webinar. Complete this short survey and let us know more about what is helpful for you and your work to end homelessness.

Additional resources

SSVF Resources

CoC Resources

Coordinated Assessment Resources

 Examples of Prioritization Tools

Human Rights and Alternatives to Criminalization

Alternatives to Criminalization

The U.S. Interagency Council on Homelessness is dedicated to promoting opportunities for States and communities to assemble the tools and partnerships needed to implement a human rights approach to ending homelessness. To that end, USICH and the Department of Justice (DOJ), with support from the Department of Housing and Urban Development (HUD), held a summit in December, 2010 to explore constructive alternatives to the criminalization of homelessness. As a result of that summit, USICH released a report focused on effective alternatives to criminalization called Searching Out Solutions.

Searching out Solutions offers communities ways to address alternatives to criminalization by providing three key solutions, examples of specific strategies and interventions, and examples of successful implementation of these solutions in communities across the country. 

  • The creation of comprehensive and seamless systems of care: In an effort to address gaps in service delivery, supported by communitywide planning, many local organizations partner to coordinate housing and services, creating systems of care. These systems of care enable long-term reductions in street homelessness and connect individuals with benefits and services that improve housing stability.
  • Collaboration between law enforcement, behavioral health, and social service providers: Collaboration between service providers and law enforcement regarding outreach to individuals and specialized crisis intervention training can limit the number of arrests for non-violent offenses. This partnership can also help link individuals experiencing homelessness with the system of care and permanent, supportive housing.
  • Alternative justice system strategies: Strategies that provide alternatives to prosecution and incarceration and offer reentry planning for individuals show an increase in the likelihood that people will connect to permanent housing and employment. This solution includes the use of specialty courts, citation dismissal programs, holistic public defenders offices, and reentry programs.

Human Rights

The right to have basic human needs met are among the most fundamental of human rights and are the core of our moral argument that homelessness should be ended. Here are three key benefits of addressing homelessness from a human rights perspective:

  1. Housing is a human necessity, and remembering that keeps stakeholders focused on helping people who experience homelessness achieve permanent housing, rather than on services that—may be well-intentioned but—do not ultimately help people exit homelessness into housing stability. Permanent housing is the primary solution to preventing and ending homelessness and the overarching strategy of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness.
  2. Human rights put people first. Good strategies start from understanding the unique needs of individuals, families, youth, and Veterans. A human rights approach keeps people and their needs at the forefront of our work.
  3. Homelessness has a human cost. Yes, ending homelessness is cost-effective for the taxpayer (doing nothing can actually costs taxpayers more money). But dollars are not the only cost of homelessness; humans experience homelessness at a horrific expense to the health and well-being of themselves and their communities. When we make the case that safe and stable housing is a human right, our cause is strengthened. We can tap into the passions, relationships, and experiences that cut across sectors--and budget sheets--to create new partnerships and solutions.

Above all else, we’ve learned that person-centered community engagement must be a centerpiece in any effort to end homelessness. Whether engaged as people who have experienced homelessness, outreach workers, law enforcement, volunteers, funders, service providers, business leaders, or members of a faith group, when the larger community is informed and working together, people get connected to safe, stable housing. This type of collaboration can make a difference for communities as they address challenges with encampments, homelessness, people experiencing crisis, and develop a thriving downtown that welcomes everyone.

Since Searching Out Solutions was released, USICH has convened conversations with community and Federal partners to further discover and encourage effective solutions to enhance human rights and eliminate the criminalization of homelessness. More information is available in the menu below. Finding alternatives to criminalization is a tough job and it is important to learn from community successes. We want to hear from you when your community is implementing creative and effective alternatives that end homelessness and save lives.

Fact Sheets

​Research and Reports

​Programs & Projects

Features

Medicaid Enrollment: A Frontline Guide for People Experiencing Homelessness

Staff members from the USICH and NHCHC describe the work being done at the national level to enroll people experiencing homelessness in Medicaid, and frontline workers from Boston Health Care for the Homeless and Heartland Health Outreach in Chicago outline how they have already been implementing these practices.  The information they share includes lessons learned and recommendations for other enrollment workers new to Medicaid expansion. View this webinar and learn how these skills can aid in enhancing your community's Medicaid enrollment efforts. This webinar is designed to complement the recently released Medicaid Enrollment: Your Guide for Engaging People Experiencing Homelessness.

Speakers: 

  • Liz Osborn, Management and Program Analyst, U.S. Interagency Council on Homelessness
  • Barbara DiPietro, Director of Policy, National Health Care for the Homeless Council
  • Julie Jones, Boston Health Care for the Homeless, Boston, Massachusetts
  • Julie Nelson, Associate Director of Outreach, Benefits, and Entitlements, Heartland Health Outreach, Chicago, Illinois
  • Sheena Ward, Senior Benefits and Entitlements Specialist, Heartland Health Outreach, Chicago, Illinois

Tell us what you thought about the webinar. Complete this short survey and let us know more about what is helpful for you and your work to end homelessness.

HUD’s FY2013-FY2014 Continuum of Care Competition - Strategies for Success Webinar

USICH held a webinar for communities on strategies to succeed in this year’s HUD Continuum of Care program competition.  In this year’s competition, HUD has made some important changes to the competition and NOFA—changes which will continue and accelerate progress on ending homelessness.  This includes a requirement to complete a CoC Application that covers two years of CoC strategic planning and performance, new policy priorities and criteria, and new project selection priorities.  Through the current Notice of Funding Availability (NOFA), HUD will award $1.7 billion in funds for FY2013.  HUD will subsequently issue a streamlined NOFA to award its FY2014 funds in calendar year 2014.  Listen to our webinar to learn more about these changes, to get more information on the policy priorities sought through the NOFA, and to hear tips and strategies for completing a successful application. 

Presenters

  • Lindsay Knotts, USICH
  • Richard Cho, USICH
  • Norm Suchar, National Alliance to End Homelessness

View the USICH resource page for the FY 2013-2014 CoC Program Competition

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The Solutions Database is a living resource hub. USICH is continuing to identify programs and practices that will be added to the database in the future. Profiles reflect the most accurate information available at the time the profile was written, but things can change. If you feel something in the database is in error, if you have a resource for us to add to a current solution or if you would like to recommend a solution to us as we move forward updating the database, please contact USICH Communications.

Featured Solutions:

Critical Time Intervention (CTI)

Critical Time Intervention (CTI) is a structured, nine-month intervention that provides support to people during and after a transition to community living from shelter, hospital, or other institutional setting, with the primary goal of preventing a return to homelessness and other adverse outcomes.…

Whatcom Homeless Service Center

The Whatcom Homeless Service Center in Bellingham, Washington, provides centralized, coordinated entry to community housing and service programs targeted to people experiencing or at risk of homelessness. Through formal partnerships with 20 community providers throughout the county, it coordinates a…