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.

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

Program Assistant

Location: This position is located in the immediate office of the U.S. Interagency Council On Homelessness (USICH) in Washington, DC.

Start Date/Duration: Immediate; Open until filled. 

Salary: USICH positions are not GS-graded. For comparison purposes only, the responsibility level, duties and salary range are similar to a GS-301-9. Position is in the Excepted Service; Schedule A appointment. This position is full-time and includes federal government benefits.

Description of Responsibilities: 

Working with the Special Assistant (SA), the incumbent serves as an administrative and confidential assistant to the Executive Director (ED), responsible for performing a wide variety of duties that require close association with and full knowledge of the ED’s and other team members’ duties, activities, and interests.

Incumbent is responsible for the ED's appointment calendar with authority for commitments of time, in consultation with the SA and, as necessary, the Senior Policy Director. Reminds ED of commitments and briefs him/her prior to meetings. As a member of the Administrative Team, incumbent screens telephone calls and visitors, responds to questions of a non-policy nature and/or refers callers to appropriate person(s). Leads and/or supports meeting scheduling, set up, note-taking, and follow-up. Recognizes situations when information must be compiled for the ED’s use and gathers needed reference data, highlighting essential items for the ED and team. Assists SA with correspondence addressed to the ED, bringing items of importance or an urgent nature to the SA’s attention. Routes all other correspondence to the appropriate person for action and follow-up as necessary. Prepares non-technical correspondence based upon a thorough knowledge of office needs, policies and practices. May take on special projects that require significant effort to prepare background material or to support critical meetings of direct interest to the ED.

Also independently manages projects, as assigned. Prepares all documents relating to travel for foreign and domestic trips. Performs research on a wide variety of subjects in order to provide ED with various pools of up-to-date information, as directed. Research may entail contact and discussion with high-level personnel at Council member and other government agencies, congressional staff, and the housing industry. Performs other duties, as assigned.

Factor Level Descriptions & Qualifications:

Requires knowledge of mission, strategies, goals and objectives of USICH. Ability to plan, organize, prioritize, and perform work independently with often diverse and competing priorities. High level skill in interpersonal relationships, including the ability to communicate effectively, orally, and in writing with all levels of management and staff including those outside the organization. Requires organizational savvy, both internally and externally, with stakeholders. Ability to handle complex and extensive domestic and foreign travel arrangements. Ability to research and analyze data, and to prepare documents in preparation for meetings, conferences, and for other uses. Ability to oversee and manage preparation for all internal and external commitments of the ED’s team. Knowledge of spelling, punctuation, and business English. Knowledge of standard office record keeping. Knowledge of Microsoft Office products.

The incumbent receives direct supervision from the SA and, when assigned, by the Senior Policy Director. Work is evaluated to ensure that overall objectives have been met.
Guides include verbal instructions, style manuals, correspondence handbooks, and established office procedures, policies and regulations.

The work involves different processes and methods. The incumbent assumes standard responsibilities for prioritizing work, taking initiative to produce routine work products, as well as completion of special projects and assignments.

The purpose of the work performed by the incumbent is to carry out work processes specific to USICH. The work directly affects the accuracy and responsiveness of the DD’s team’s activities and affects the overall accomplishment of the Council’s mission, strategies, goals and objectives.
Personal contacts are generally with the employees of Council, member agencies, other federal, state and local entities, and the general public.

No special physical qualifications are required to perform the work. The work requires the ability to move around the office and carry light items such as office files.

The work is performed in an office setting.

How to Apply: 

Please email a cover letter which includes your availability, your resume and salary history to jobs@usich.gov. Applicant review will begin upon receipt of application materials, and position will be open until filled.

USICH is an Equal Employment Opportunity employer.

You must be a U.S. citizen to be considered for this position.

This position requires successful completion of a background check.

Males born after 12/31/59 - Selective Service Registration required.

This position requires a 1 year probationary period.

All Federal employees are required by PL 104-134 to have Federal payments made by Direct Deposit.

This is a federal government, excepted service (Schedule A) position, open to all candidates with or without prior federal government experience.

Travel and Relocation expenses are not authorized.

This announcement could be used to fill other vacancies.

Full-time position with federal government benefits. The Federal government offers a number of exceptional benefits to its employees including health benefits, life insurance, annual and sick leave, flexible spending accounts, long term care insurance, retirement and thrift savings plan, and family friendly flexibilities.

This position is nonexempt from the Fair Labor Standards Act.

This position is not in a bargaining unit.

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:

Deputy Director

Location: This position is located in the immediate office of the Interagency Council On Homelessness (USICH) in Washington, DC.

Salary: USICH position are not GS-graded. For comparison purposes only, the responsibility level, duties and salary range are similar to a GS-301-15. Position is in the Excepted Service; Schedule A appointment. 

Experience and Qualifications: Advanced degree preferred; college degree minimum. Eight (8) or more years of related work and experience in the areas of housing, homelessness, and other social service sectors.
More specifically, the position calls for an incumbent who demonstrates the following specialized knowledge, skills and experience:

  • Expert level knowledge and mastery of public systems that serve people at risk of and experiencing homelessness. Demonstrated understanding of principles and implementation of practices that apply evidence based and innovative solutions (e.g. housing first model) to homelessness.
  • Expert knowledge of Federal homeless and housing programs along with the governing laws, regulations, methodologies, and/or policies to include technical knowledge of issues surrounding homelessness;
  • Comprehensive understanding of federal and state programs that provide supportive services for persons in housing, public benefits programs, healthcare, employment programs, and programs and services for persons with disabilities;
  • Understanding of strategies and programs that can be employed to serve specific subpopulations; (i.e. chronically homeless, veterans, families with minor children, youth);
  • Involvement with systems reform;
  • Knowledge of USICH’s and its key member agencies’ mission, programs, and legislative history to develop and advise on policies to develop and implement program goals;
  • Knowledge of the Council’s efforts on implementation of the federal strategic plan to prevent and end homelessness;
  • Expert level knowledge and mastery of public systems that serve people at risk of and experiencing homelessness. Demonstrated understanding of principles and implementation of practices that apply evidence based and innovative solutions (e.g. housing first model) to homelessness;
  • Expert knowledge of Federal homeless and housing programs along with the governing laws, regulations, methodologies, and/or policies to include technical knowledge of issues surrounding homelessness;
  • Ability to be responsive to numerous concurrent requests and set priorities;
  • Demonstrated experience convening, facilitating, and coordinating diverse stakeholder groups;
  • Expert knowledge and experience with strategic planning and implementation;
  • Excellent public speaking, briefing, and verbal and written communication skills to articulate positions/policy of vast technical complexity and to represent USICH with various audiences and stakeholder groups;
  • Experience briefing and engaging senior level government officials;
  • Advanced management/supervisory experience.

Description: The incumbent reports directly to the Executive Director, who provides broad policy guidance in terms of Council’s goals and objectives. The incumbent performs duties under the general direction of the Executive Director. The incumbent is expected to exercise professional, independent judgment in carrying out assigned duties and responsibilities and to initiate assignments which assist in implementing the Council’s mandated responsibilities. The incumbent is expected to use originality and creativity in formulating and carrying out work plans; and assume full responsibility for interpretation and application of the findings and development of recommendations for action.

Requires knowledge of mission, strategies, goals and objectives of USICH. Ability to plan, organize, prioritize, and perform work independently with often diverse and competing priorities. Skill in interpersonal relationships, including the ability to communicate effectively, orally, and in writing with all levels of management and staff including those outside the organization. Ability to research and analyze data, and to prepare documents in preparation for meetings, conferences, and for other uses.
Guides for duties performed include verbal instructions, style manuals, handbooks, and established office procedures, policies and regulations.

The work involves different processes and methods. The incumbent assumes standard responsibilities for prioritizing work, taking initiative to produce routine work products, as well as completion of special projects and assignments.

The purpose of the work performed by the incumbent is to carry out work processes specific to USICH. The work directly affects the overall accomplishment of the Council’s mission, strategies, goals and objectives.

Personal contacts are generally with the employees of Council, member agencies, other federal, state and local entities, and the general public.

No special physical qualifications are required to perform the work. The work requires the ability to move around the office and carry light items such as office files.

The work is performed in an office setting.

How to Apply: Please email a cover letter which includes your availability, your resume and salary history to jobs@usich.gov.

Position open until filled.

Position duty station is Washington, DC.

USICH is an Equal Employment Opportunity employer.

You must be a U.S. citizen to be considered for this position.

This position requires a background check; must be able to successfully pass and maintain clearance.

All Federal employees are required by PL 104-134 to have Federal payments made by Direct Deposit.

Male applicants born after December 31, 1959, will be required to certify that they have registered with the Selective Service System, or are exempt from having to do under the Selective Service Law.

This is a federal government, excepted service (Schedule A) position, open to all candidates with or without prior federal government experience.

Position includes a 1 year probationary period in which incumbent can be terminated without case.

Relocation expenses are not authorized.

Full-time position with federal government benefits.

The Federal government offers a number of exceptional benefits to its employees including health benefits, life insurance, annual and sick leave, flexible spending accounts, long term care insurance, retirement and thrift savings plan, and family friendly flexibilities. To find out more click here http://www.usajobs.gov/EI/benefits.asp.

This position is exempt from the Fair Labor Standards Act.

This position is not in a bargaining unit.

President Obama Proposes Historic New Investments to End Homelessness


 

 

Opening Doors is Working:

A Statement from HUD Secretary Shaun Donovan
Chair, United States Interagency Council on Homelessness

 

As Chair of the United States Interagency Council on Homelessness, I’m pleased to announce that President Obama's Fiscal Year 2015 Budget clearly demonstrates the commitment of this Administration to achieve the goals of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness. In a time of difficult budget choices, this Administration continues to make smart investments in proven solutions. Opening Doors is working, and this budget provides historic new investments in programs that prevent and end homelessness.  Overall, the President's Budget requests $5.69 billion in homelessness programs across all Federal agencies, an increase of 12 percent over FY 2014 enacted levels. 

Since the launch of Opening Doors in 2010, with President Obama’s leadership and strong partnerships with States and communities, we’ve reduced family homelessness by eight percent, chronic homelessness by 16 percent, and homelessness among Veterans by an amazing 24 percent. Still, there is much work to be done. The historic new investments proposed in President Obama’s FY 2015 budget would create an even greater opportunity to act together with urgency and focus on what works. 

In this budget, the President continues his unwavering commitment to our nation’s Veterans. With additional investments in the HUD-VA Supportive Housing (HUD-VASH) program, we could ensure that 10,000 Veterans with disabilities will move from homelessness to stable housing. By increasing the Supportive Services for Veteran Families program to $500 million we will make certain that the families who have sacrificed so much for this country will have a safe and stable place to call home. The decreases we have seen in Veteran homelessness are evidence that when Congress works together in a bipartisan manner to fully fund programs that work, we see significant results. If this bipartisanship continues, we will end Veteran homelessness as we know it.

The President’s FY 2015 Budget request includes more than $2.4 billion for HUD Homeless Assistance Grants,$301 million more than in the FY 2014 budget, which will serve a record number of individuals, youth, and families experiencing or at-risk of homelessness through a wide variety of proven solutions like rapid re-housing, permanent supportive housing, and Housing First. We have an incredible opportunity to help vulnerable individuals with disabilities no longer experience chronic homelessness, as well as to continue on our path of ending family and youth homelessness by 2020.

With Opening Doors, we have made solving homelessness the responsibility of the entire Federal government in partnership with state and local community providers. Together, we are changing the trajectory of homelessness and making a real difference in people’s lives. Thank you for your partnership. We hope you will join us in the responsibility of putting these historic new investments to work in your community and achieve the goals of Opening Doors.

Sincerely,

 

 

 

Secretary Shaun Donovan

U.S. Department of Housing and Urban Development

Chair, U.S. Interagency Council on Homelessness

 

 

USICH Details Homeless Programs Requested in the President's FY 2015 Budget


President Obama's Fiscal Year 2015 Budget clearly demonstrates the high priority this Administration has for achieving to the goals of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness. This year’s budget proposal includes more than $5.69 billion for targeted homeless assistance funding, a 12 percent increase over Fiscal Year 2014 appropriations.
 
USICH has developed this fact sheet to serve as an overview of the targeted homeless assistance programs across the Federal government. 

“The President’s Budget includes historic investments to prevent and end homelessness,” said incoming USICH Executive Director Laura Zeilinger. “Together, we have proven that investing in data-driven, evidence-based solutions to homelessness works on a national scale.”


President Obama's Fiscal Year 2015 Budget request reflects a core tenet of Opening Doors, that to end homelessness, we must invest in what works: evidence-based solutions like Housing First, permanent supportive housing, and rapid re-housing. 

Opening Doors calls for the strategic targeting of resources and effective implementation focused on outcomes. The budget request was constructed through a careful analysis of the specific number of housing units needed to achieve an end to Veterans homelessness in 2015, chronic homelessness in 2016, and to achieve an end to family homelessness in 2020, taking into account policy actions by Federal agencies to ensure that existing resources being deployed as efficiently as possible. The President’s FY 2015 Budget Proposal is the fourth budget developed by USICH member agencies since the launch of Opening Doors and includes historic investments, such as: 

Unwavering commitment to ending homelessness among Veterans and their families in 2015. The Budget contains $1.64 billion for Department of Veterans Affairs (VA) programs that prevent or end homelessness among Veterans. This includes an increase of 17.8 percent, or $248 million, over the 2014 level, continuing VA’s steady progress toward ending homelessness among Veterans and their families in 2015. Specifically, $500 million is proposed for VA Supportive Services for Veteran Families program-built on best practices developed across the country. For HUD-VASH program, $321 million for VA case management and $75 million proposed HUD funding for 10,000 additional vouchers.

Historic and strategic investments to implement the HEARTH Act. The budget provides $2.4 billion for Department of Housing and Urban Development’s (HUD) Homeless Assistance Grants, $301 million above the 2014 enacted level. This funding supports new permanent supportive housing units and maintains more than 330,000 HUD-funded beds, which assist persons who experience homelessness nationwide.  These resources enable the Administration to achieve the goal of ending chronic homelessness in 2016 through the creation of 37,000 new permanent supportive housing units, while sustaining and advancing progress in ending homelessness among families and youth. The Administration is working with communities to create coordinated entry systems, and retool existing local programs and policies to create more effective and efficient crisis response systems, while gathering further evidence of which interventions are most effective for specific sub-populations. 

Download The Fact Sheet on Targeted Homelessness Programs 

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, Policy Director

Richard Cho is based in Washington, DC, where he coordinates the interagency priority of ending chronic homelessness by 2015. 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.

Eric Grumdahl, Policy Director

Eric Grumdahl is based in Washington, DC, and works across Federal agencies to help shape policies that address Veteran and youth homelessness. “I am energized by the work USICH, our Federal partners, and our allies across the country are doing right now to end youth homelessness and to enhance our collective capacity to support youth in achieving their goals,” Grumdahl said. He added that “as more communities approach the goal of ending homelessness among Veterans, I look forward to a continuing shift in thinking across the country: a growing recognition, which stretches beyond those of us for whom ending homelessness is our personal mission, that ending all forms of homelessness is within our reach.”

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.

 

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 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. Under her leadership, through national engagement initiatives, 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 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.

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 right, 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

More than a Number: How the Point-in-Time Count Helps End Homelessness

Each year, HUD requires Continuums of Care (CoCs) to count the number of people experiencing homelessness in the geographic area that they serve through the Point-in-Time count (PIT). Conducted by most CoCs during the last ten days in January, the PIT count includes people served in shelter programs every year. In addition, every odd-numbered year, CoCs are responsible for counting people who are unsheltered, mobilizing staff and volunteers who canvas the streets and other settings to identify and enumerate people experiencing homelessness. Data collected during the PIT count is critical to effective planning and performance management toward the goal of ending homelessness for each community and for the nation as a whole. Counting those who are unsheltered ensures that many of the people with the highest needs are taken into account in community planning.  In fact, the benefit of conducting a comprehensive count that includes an unsheltered count is so significant that many communities do so every year, including Boston, Denver, Miami, New Orleans, Orlando, Philadelphia, San Diego, and many others.

Now is the time to get involved. Many CoCs have already begun planning for their next count. Everyone interested in participating in the upcoming 2014 Point-in-Time count should engage the CoC points of contact for their geographic region(s). These can be found on HUD’s OneCPD Resource Exchange. For many communities, the count represents a great opportunity to engage volunteers in local efforts to end homelessness.

The PIT count is also the main data source for measuring progress on the goals of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness. To see PIT count data in action, visit HomelessAnalytics.org, a joint effort of the Departments of Veterans Affairs (VA) and Housing and Urban Development (HUD).Through the PIT count, communities identify important data on the general homeless population and subpopulations, including Veterans, families, chronically homeless individuals, and youth. These counts help us all identify where progress is being made and where redoubling of effort is required, both geographically and for different subpopulations.

Counting Youth Experiencing Homelessness

The number of young people who experience homelessness each year is largely unknown. Often called an "invisible population," young people experiencing homelessness tend to stay with friends, often avoid adult services, and may be reluctant to be identified by authorities, which makes it difficult for communities to include them in their annual PIT counts and to engage them in services. To improve efforts to identify youth during the 2013 PIT count, nine communities, four Federal agencies, and 18 funders launched an initiative called Youth Count!. The Urban Institute conducted a process evaluation of the initiative, identifying promising practices and challenges across the diverse sites and approaches used. How youth are approached and how questions are asked matters. The process evaluation documented the benefits of involving youth in designing and pre-testing the approaches to the counts, and of engaging youth who had experienced homelessness in identifying outreach locations and ways to approach youth successfully. The Federal agencies involved in Youth Count! recently issued a joint statement to encourage CoCs, Runaway and Homeless Youth (RHY) providers, and state and local education liaisons to collaborate around planning and conducting their 2014 Point-in-Time count. The benefits of such collaboration extend beyond the PIT count, and can assist communities as they strive to improve service delivery to youth experiencing homelessness.

Counting Veterans Experiencing Homelessness

Similarly, communities can benefit from proven approaches to identify Veterans among people experiencing homelessness. The Department of Veterans Affairs has recommended better ways to ask people experiencing homelessness about their military service to help assess potential eligibility for VA resources for Veterans experiencing homelessness.

Data about the prevalence of homelessness in each community can help galvanize local responses to accelerating progress on ending homelessness. But the count can be more than just a count, too. The PIT count also provides an opportunity for CoCs to amplify the information they gather with more in-depth surveys of individuals by using tools like the Vulnerability Index and partnerships with a 100,000 Homes Campaign if they are part of a campaign community. Most importantly, communities can work with outreach teams, health care, and service providers to use the count as an opportunity to connect people experiencing homelessness with housing and vital services. A Homeless Registry – a list of people experiencing homelessness, identified by name – has helped many communities connect people experiencing homelessness to housing and services more quickly, by ensuring that those resources are targeted to the most vulnerable populations. In these ways, this year’s count can help reduce next year’s count toward zero.

To join in PIT count efforts, please contact your local CoC.

“In Order to House Everyone, We Must Tear Down Some Walls…”

In this speech delivered at the Georgia Supportive Housing Association annual conference, USICH Policy Director Richard Cho discusses the importance of breaking down silos between sectors and systems to end homelessness.  He discusses how permanent supportive housing embodies the notion of “silo-busting” and creating inter-subjectivity between sectors, and challenges the State of Georgia to create a supportive housing policy for all—people with disabilities under the Olmstead community integration mandate, people experiencing chronic homelessness, and people with chronic health conditions leaving correctional settings.  

Thank you Paul for your introduction, and thanks to the Georgia Supportive Housing Association for inviting me to join your event. Richard Cho

I’m here today representing the United States Interagency Council on Homelessness, and bring greetings from our Executive Director Barbara Poppe, from our Council Chair VA Secretary Eric Shinseki, Council Vice Chair HUD Secretary Shaun Donovan, and the 17 other agencies that comprise our Council.  I want to acknowledge Alvera Crittendon and Mykl Asante from HUD’s Atlanta office and Aileen Bell Hughes from the Department of Justice who are here today.

I’m here to deliver a message today.  And my message to you is, that in order to house everyone, we need to tear down some walls.  Let me repeat that, in order to house everyone, we need to tear down some walls.

Now, you have probably figured out that I am not referring to actual walls or buildings, but rather to the figurative walls that separate our efforts into silos, into isolated and fragmented efforts.  If we want to make sure that everyone in America, especially those who are most vulnerable, have a safe and stable place to call home, we must break down silos and work across sectors, systems, and even the policy and population constructs under which we operate.

This idea of breaking down silos underpins the very premise of USICH.  USICH’s role is not to be the sole Federal department responsible for ending homelessness, but rather, to foster a sense of shared responsibility across the 19 Federal agencies that make up our Council, and build collaborative solutions across department boundaries.

The thread of breaking down of silos runs through Opening Doors, the Federal strategic plan to end homelessness.  Adopted in 2010, Opening Doors set forth the Administration’s vision that no one should experience homelessness in America, and that no one should be without a safe and stable place to call home.  It lays out the Administration’s goals of ending chronic and Veterans homelessness by 2015 and homelessness among families, children, and youth by 2020.

To achieve these goals, the Federal strategic plan lays out 58 strategies organized around five themes.  And the very first of the five themes is to build collaboration between Federal, State, and local government, across the public, non-profit, and private sector, and between sectors like housing, health, social services, employment, justice and more.

Underlying Opening Doors is the recognition of three fundamental truths about ending homelessness:

1) That homelessness is a problem that is too complex to be the sole responsibility of any one agency, sector or system.

2) That solutions to homelessness—like permanent supportive housing—require the coordination of the housing, health, behavioral health, and other service systems.

3) That the collective knowledge and expertise of multiple agencies, sectors, and systems results in solutions that are better than what any one of those agencies, sectors, and systems could create on their own.

I face these three truths every day in my role as a Policy Director for USICH.  My role and portfolio entails working with HUD on housing policy, working with HHS to encourage states to use Medicaid to help create and finance services that support housing stability, working with the Social Security Administration and SAMHSA to improve access to SSI/SSDI benefits for people experiencing homelessness, and working with the Justice Department to align our efforts to end homelessness with efforts to enforce the community integration mandate under Olmstead and efforts around prison and jail re-entry.

Managing a portfolio that encompasses all of that would seem impossible.  But what makes this mix not only manageable, but fruitful, is that the solutions that emerge when we work across agencies and silos are always better than what any one of us could create or achieve on our own.

That idea is also what makes supportive housing such an effective solution for helping those with the most complex social and health needs achieve stability, dignity, and independence.  What makes supportive housing work is not just that it’s a combination of affordable housing and supportive services.  Those of us who have worked to make supportive housing available over the years know that it’s so much more than just a layering of those two components.  What makes supportive housing work is that it brings together the expertise of the housing and community development sector and the expertise of the social, behavioral health, and health services sectors to help troubleshoot the challenges that its tenants have in achieving that stability, dignity, and independence.

And we are seeing the supportive housing at work all across the country.  In places like Seattle, where supportive housing—using a Housing First approach—has been shown to decrease emergency room and alcohol crisis services use among people experiencing chronic homelessness, translating to a Medicaid savings of 41%.  We see it in New Orleans, where investments in permanent supportive housing made possible because of the Hurricane Katrina relief package, and targeted at the most vulnerable people experiencing chronic homelessness, has enabled the city to achieve an 85% decrease in chronic homelessness since 2010.   New Orleans is now housing people at a rate of two people a day.  I think Atlanta can beat that, right?

Supportive housing is a testament to the power of inter-subjectivity, which is another way of saying that only through the merging and negotiation of multiple vantage points can true solutions be found.

Folks in this room have probably witnessed that inter-subjectivity in action.  When a case manager works with a landlord to prevent eviction by allowing the tenant to pay rent arrears on an installment plan.  That synergy that enables a property manager and services provider to come up with a plan to address the victimization of a tenant by a drug dealer.  It’s inter-subjectivity that enables a supportive services provider to come together with public housing agencies to find creative ways to speed up the time from engagement to housing placement by helping people complete their voucher applications and even conduct apartment inspections.

Supportive housing has been a lever for creating change and inter-subjectivity at the systems-level as well.  Numerous states and municipalities including Georgia have inter-agency councils and funder collaboratives to coordinate funding across the housing, services, and health silos, to engage in multi-year planning with the non-profit and private sectors, to set unit creation goals, and troubleshoot barriers to supportive housing creation and implementation.  At their best, these inter-agency and public-private collaborations bring together the ideas and ingenuity of all of the agencies and organizations that participate.

It’s that inter-subjectivity that makes supportive housing such a powerful, silo-busting tool.  It’s why increasing supportive housing is a key objective of Opening Doors and a centerpiece of our strategy for ending chronic homelessness.  It’s also why supportive housing is a key part of efforts by numerous states including Georgia to comply with the Olmstead community integration mandate for people with disabilities and an increasing part of State and community efforts to ensure that people leaving prisons and jails are able to stay in the community and avoid returns to incarceration.

We need to take that silo-busting inter-subjectivity to the next level and fully realize the potential of supportive housing as a tool for solving all of the complex social problems that affect vulnerable people who need housing and services to achieve stability, dignity and independence.  That means breaking down the silos between our own policy and population constructs to create solutions that work to help all of the vulnerable people for whom those constructs mean little. 

I want to share a story to illustrate this further.

About 14 or so years ago, I was working in the State of Massachusetts on a project to assess the needs of people living with HIV/AIDS who were leaving prisons and jails.  As part of a focus group I had held, one of the participants told the group that he had figured out a solution that could make sure that people like him got the quickest access to affordable housing.  It went something like this: “If you have a serious mental illness, you can get special access to some housing. If you have an AIDS diagnosis, you can also get special access to other types of housing.  If you have both, you win the lottery.”  (Again, these were his words, not mine.)  “If you are in a shelter, you also get a point.  But if you are coming out of jail or prison, all of that gets closed off to you.”

This brief statement has stayed with me over the years. It’s a concise summary of all the problems and challenges that still lie ahead of us. That the ways that we have set up access to housing and services have created a kind of perverse puzzle and contest for people, where people have to struggle to fit into the categories we have set up through our well-intentioned policies.

Access to supportive housing should not be a puzzle or a game show, where people with real needs, disabilities, and life-threatening conditions should be forced to find ways to “game the system.”  Access to supportive housing should be a right and a natural part of an effective response to people with disabilities and chronic health challenges.  Time and time again, we’ve shown that supportive housing is not only the right thing to do, it’s the smarter and fiscally sound thing to do. 

 

This view is reflected in this conference, where the agenda spans topics related to ending homelessness, prison and jail re-entry, and community integration for people with disabilities.  You have gotten this very right in scoping this event and in the kind of cross-sector and cross-population dialogue that is happening over these past two days and in the days that come in the State of Georgia.  And I think it reflects the fact that the State of Georgia is on the verge of being a national innovator in breaking down the silos to create a statewide supportive housing delivery system that works for all.

In so doing, you have a chance to fix a problem that dates back decades.

Chronic homelessness and the institutionalization of people with disabilities are two legacies of what has been a fragmented and inadequate system of care for nearly four decades.  They stem from the failed promise to create a true mental health care system.  They stem from decades of criminal justice policies that have relied on prisons and jails to address social and mental health needs, resulting in the warehousing of thousands of people with mental illness and other disabilities.  They stem from the failure to create a comprehensive affordable housing policy for all, and especially those at the lowest ends of the income spectrum.

We’ve responded to these problems often on the tail end, only once people have reached a state of crisis.  And so emerged the separate policy arenas of our effort to end homelessness, efforts to ensure the right of community integration for people with disabilities under Olmstead, and efforts to address prison and jail re-entry.

We’ve been like the proverbial people in the dark touching an elephant and thinking that we are touching a tree trunk, a snake, or a palm leaf.

But I think the time has come to recognize the elephant, to rejoin these three arenas and create a comprehensive solution to the needs of people with disabilities and chronic health challenges who have in common the need for an affordable place to live, adequate incomes, access to services that can help them achieve maximum independence, and which prevent the over-reliance on the most expensive crisis systems.

When we begin dialogue across these arenas, we realize that although our frameworks and lenses have evolved differently, and our population and eligibility definitions are slightly different, overall we share more in common than not.

We’ve been engaging in that cross-agency dialogue in Washington, between DOJ, HUD, and USICH.  And through that dialogue we have had several insights.

We realize we have a shared population, and perhaps even more than we’ve realized.  Whereas Olmstead encompasses people with disabilities leaving or at-risk of entering institutional/segregated settings, our effort to end homelessness, especially chronic homelessness focuses on people with “disabling conditions.”  And while there are certainly differences between the ADA and HUD definitions of disability, there is more overlap than not.  And while Olmstead focuses on people either at-risk of institutionalization or in institutional settings, we know that many people experiencing chronic homelessness cycle in and out of institutional settings.

We realize that we have shared goals, that is, to maximize affordable housing opportunities, access voluntary supportive services, and support the ability to live independently.

We have shared values of supporting people to be able to have access, choice, be integrated in the community.

And we share a common solution, namely, permanent supportive housing.

Now I know there have been many discussions and concerns around housing models, particularly with regard to single-site supportive housing.  And questions have been raised about whether or not single-site supportive housing is consistent with community integration.

DOJ’s perspective, is that their focus of Olmstead enforcement is on increasing most integrated housing options, and not decreasing or taking down community housing options.  HUD’s guidance makes clear that certain HUD programs (e.g. CoC, Section 811) are statutorily permitted to target people with disabilities.

USICH believes that communities should include a range of PSH models that increase housing opportunities for people experiencing chronic homelessness.   At the same time, we should challenge ourselves to think about who the design of our models is benefiting, and whether the choice of models is for the benefit of tenants or are for the convenience of programs.

Perhaps the question we should be asking is not, is single-site supportive housing a permissible model, but rather, how we are going to create enough permanent supportive housing to meet the needs of all populations—people with disabilities leaving institutional settings, people experiencing chronic homelessness, and the subset of people involved in the justice system who have chronic health and behavioral health challenges?

And how are we going to leverage all available resources and funding, including mainstream housing resources, to increase permanent supportive housing?  We cannot rely on just the targeted homeless programs like the Continuum of Care program to create supportive housing. We need to leverage mainstream resources as well.  Housing Choice Vouchers, Section 8 Project Based Rental Assistance, HOME, low-income housing tax credits, bond financing.

And how do we strike the right balance between our two values of maximizing housing opportunities and access and ensuring community integration?

Neither value should supercede the other.  A housing policy that focuses on increasing housing opportunities at the expense of integration will not meet our goals.  A housing policy that focuses on community integration, but which decreases housing options also does not meet our goals.  We need a housing policy that can achieve both.

The opportunities that come from tearing down the walls, breaking down the silos between homelessness, Olmstead, and prison and jail re-entry are enormous.

Here in Georgia, that cross-sector dialogue is taking place, that creative inter-subjectivity is being unleashed, and the silos are being broken down.  Georgia was a participant in SAMHSA Policy Academy on Olmstead, and is now a participant in the Policy Academy on ending chronic homelessness.  Georgia’s a recipient of HUD’s Section 811 Project Rental Assistance Demonstration.  Terrific progress is being made to leverage mainstream affordable housing resources, namely Housing Choice Vouchers, for permanent supportive housing.  There is new energy and enthusiasm behind the state interagency council on homelessness.

The time is now to tear down the walls between our separate efforts and create a unified statewide supportive housing policy and plan focused on addressing the needs of all of the most vulnerable Georgians.  The time is now to bring supportive housing to scale, taking into consideration the right to integration among tenants.  To clarify the overlap in populations through data integration. To leverage mainstream housing resources alongside targeted programs like CoC and Section 811. To fix the front door to supportive housing through assertive and coordinated outreach.  To use targeting approaches that will ensure that the highest need, most chronic, and highest cost people experiencing chronic homelessness will get priority access to housing.  To adopt a Housing First approach that reduces barriers and pre-conditions to entry and helps people obtain housing as quickly as possible.

I, and the US Interagency Council, applaud and support you in this work.

HUD’s FY 2013-2014 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 competition for $1.7 billion in Federal funding for the Continuum of Care (CoC) Program. This year's program competition combines some of the application requirements for FY 2013 and FY 2014 program funding, namely, the CoC Application, which reflects community-wide performance and planning to end homelessness. It also places strong emphasis on using CoC program funding as strategically as possible--given the budget shortfall--to reach the Administration's goals of ending homelessness at set forth in Opening Doors.

This page provides useful resources to help communities achieve success in the CoC program competition.

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

USICH/ NAEH Webinar on the FY 2013-2014 CoC Program Competition- Strategies for Success

CoC Program Competition on HUD's OneCPD

SNAPS Weekly Focus Messages

Messages to Continuum of Care & Ten-Year Plan Leaders from Barbara Poppe, Executive Director of USICH

Message from Richard Cho, USICH Policy Director

Progress in the 2013 PIT sets Stage for NOFA

July 2011 Council Meeting Update

Council Affirms Commitment to Opening Doors

 

Yesterday, Department of Labor Secretary Hilda Solis chaired the second meeting of the U.S. Interagency Council on Homelessness in 2011. The meeting was hosted at the White House and focused on the one-year anniversary of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness.  Secretary Solis was joined by Department of Health and Human Services Secretary and Vice Chair of USICH Kathleen Sebelius, Department of Housing and Urban Development Secretary Shaun Donovan, Domestic Policy Council Director Melody Barnes, and representatives from member agencies. The Council met to review progress and challenges related to implementing Opening Doors, as well as to plan for the second year. Action was taken to affirm the Administration's commitment to the Plan and to send the first annual update on Opening Doors (currently under final review) to Congress.

"Over the last year, there has been unprecedented collaboration from federal agencies with one another, and with state and local governments and nonprofits in our efforts to implement the federal plan," said Secretary Solis. 

Progress in implementing plans locally, in states, and here in the federal government has occurred across the United States. While it is too soon to tell the full impact of the first year of Opening Doors, evidence is emerging that local and state efforts supported by federal targeted and mainstream resources, coupled with partnerships with the private and nonprofit sectors, are making a significant difference. 

"The federal government is laying the groundwork for future successes through better collaboration, better data collection, better use of mainstream resources, and engaging states and local communities in the plan's goals and strategies," said USICH Executive Director Barbara Poppe.  

The annual update will be released shortly and provides an in-depth look at implementation efforts, as well as the latest data about people experiencing homelessness and the federal programs that provide assistance.  At the meeting, the Council discussed some highlights from the first year of Opening Doors: 

  • Smart government requires that resources are aligned to be both efficient and effective. Collaboration is required for alignment.  
  • Agencies within HHS and the VA are working with HUD to coordinate better data collection, analysis and reporting. Good data is essential to measuring what works, what doesn't and what we need to do better.
  • Proven tools to prevent and end homelessness are being adopted. For example, the Department of Veterans Affairs has issued a charge to its medical centers, local providers, and partners to initiate community planning and adopt best practices such as Housing First and Critical Time Intervention.
  • Targeted resources are being used more effectively. The Recovery Act's Homelessness Prevention and Rapid Re-Housing Program (HPRP) has assisted more than 935,000 people. While this is significant, perhaps even more important is the fact that the program paved the way for a fundamental change in the way many communities respond to homelessness, moving from shelter-based interventions to cost effective systems of prevention, diversion, and rapid re-housing.
  • The accessibility of mainstream resources is improving. Affordable Care Act implementation has served as a major focal point in the past year, with HHS playing a catalytic role in helping communities begin to prepare for the opportunities that lie ahead. With careful planning now, the implementation of the Medicaid expansion can significantly increase access to primary and behavioral health care for people experiencing homelessness, and may prevent homelessness for people who will have access to more affordable or fully-subsidized health insurance.
  • State and local communities are increasingly engaged in partnerships to prevent and end homelessness on the local level. One example is the meaningful engagement of USICH and its federal partners with community stakeholders in Los Angeles to increase progress on ending chronic and Veterans homelessness.

Also in attendance were the Department of Veterans Affairs Undersecretary for Health Dr. Robert Petzel, Department of Labor Assistant Secretary for Employment and Training Administration Jane Oates, Corporation for National and Community Service Acting Chief Executive Officer Robert Valasco II, General Services Administration Chief of Staff Michael Robertson, and Department of Justice Senior Counselor for Access to Justice Mark Childress.

September 2011 Council Meeting Update

Cabinet Secretaries Engage with DC Families and Leading Practitioners on Best Practices    

 

On Tuesday, Department of Labor Secretary Hilda Solis chaired the third meeting of the U.S. Interagency Council on Homelessness (USICH) in 2011. The meeting was held atCommunity of Hope's Girard Street Family Shelter in Washington, D.C. It was the first Council meeting under the Obama administration to be held on the site of a homelessness service provider and focused on strategies to end homelessness for families by 2020. Secretary Solis was joined by Veterans Affairs Secretary Shinseki, Health and Human Services Secretary Sebelius, Housing and Urban Development Secretary Donovan, USICH Executive Director Barbara Poppe, and Washington D.C. Mayor Vincent Gray.

At the meeting, Secretary Solis noted, "Today, for the first time, I wanted to bring our Council meeting out into the community to talk to the families we are working so hard to serve." 

During the meeting members of the Council heard from two single parents who have experienced homelessness with their children. Ruth is 22 and has an 18 month old daughter. She has been living doubled up or in shelters since she was 18. Through the program she has been able to gain access to child care, assistance with job training, and support applying to college. She is now employed full-time and enrolled in community college where she is studying childhood education. Ruth will soon enter her own permanent home with the help of the Homeless Prevention and Rapid Re-Housing Program (HPRP). David is a 51-year old single father of two girls both under the age of five. He overcame mistakes that he made as a young man that caused him to spend some time in jail and has now devoted his life to raising his two daughters and making sure they have every opportunity to succeed. In spite of this, he has struggled to find people who will hire him or rent to him because of his criminal record. He spent almost two years living either doubled up with his sister or in a shelter before he came to the Community of Hope. Community of Hope helped him access HPRP resources to find a stable home. He has now lived in his own two-bedroom apartment with his two girls for 18 months and finds temporary work as he can.  

Two leading service providers in the District of Columbia shared their insights into what policies and programs work to help families in need while using resources wisely. The Community of Hope Executive Director Kelly Sweeney McShane and the Executive Director of THC-Housing Families Transforming Lives Polly Donaldson, a DC based service provider for families experiencing homelessness discussed the importance of comprehensive programs that include emphasis on education, employment, and health; the success of rapid-rehousing as a model to help families quickly and efficiently; and the importance of developing more affordable housing.

The meeting concluded with HUD Secretary Donovan announcing the exciting accomplishment that HPRP prevented or ended homelessness for 1 million Americans. He and Secretary Solis then toured the shelter and met additional families that benefited from the programs at the Community of Hope.

For more information about the Administration's efforts to end family homelessness, see our new fact sheet.

July 2012 Council Meeting Update

Council to Discuss New Youth Strategies

 

On June 12th, the U.S. Interagency Council on Homelessness meeting, chaired by HHS Secretary Sebelius,was held and live streamed for public access. This meeting focused on how we together will advance the goal of ending youth homelessness by 2020. Bryan Samuels, the Commissioner of the Administration of Children, Youth, and Families at HHS presented this framework to the Council and to all those viewing via webcast. 

The Council  also gathered leading experts in the field for an interactive discussion. Experts at the meeting included Dana Scott, State Coordinator for Homeless Education for the Colorado Department of Education and Vice President of the National Association for the Education of Homeless Children and Youth; Bob Mecum, Executive Director of Lighthouse Youth Services; and Nan Roman, President and CEO of the National Alliance to End Homelessness. Audience members were able to submit their questions while the Council meetingwas live to both the Secretaries and experts. 

December, 2012 Council Meeting Update

Last Council Meeting of 2012 Focuses on Veterans, the Term Ahead

On December 11, members of all Council agencies, the Director of the White House Domestic Policy Council, and the Associate Director of the Office of Management and Budget met together to recommit to the goals of Opening Doors and to chart a path forward in the second term of the Obama Administration. Leaders gathered at the Department of Veterans Affairs to discuss what's needed in 2013 and beyond, and also elected Department of Veterans Affairs Secretary Eric Shinseki as the new Chair of the Council and Department of Housing and Urban Development Secretary Shaun Donovan as Vice Chair.

The Council was pleased to be joined by Cecilia Munoz, Director of the White House Domestic Policy Council, who shared remarks with the Council on the term ahead, reaching our goals, and the support of the President in this work:  

"These are ambitious goals and we have real measures of progress. The results we've seen in the last year challenge us to build on these gains in an aggressive way...This is the right work to be doing.  This entire Administration is behind this effort; this work is incredibly important. We've got to get this done."

This meeting was foregrounded by the release on December 10 of the most recent HUD Point-in-Time data. This data from 2012 showed a roughly seven percent decrease in both Veterans homelessness and chronic homelessness in just one year. Since 2009, Veterans homelessness has decreased by 17%. While these numbers are encouraging, the Secretaries and USICH Executive Director Barbara Poppe made clear in the remarks and presentation that we must redouble our efforts if we are to meet the ambitious goals of Opening Doors. Speaking to the Veterans goal specifically Secretary Donovan noted that, "Reducing Veterans homelessness by 17 percent [since 2009] is a phenomenal accomplishment. The only reason it doesn't feel like that is because we set such aggressive goals; but if we didn't set such aggressive goals we wouldn't have gotten to that 17 percent." 

In addition to the discussion about what is needed in the second term for all populations, there was a particular focus this meeting on Veteran homelessness. Dr. Dennis Culhane, whose presentation is summarized below, spoke as the Research Director of the VA National Center on Homelessness Among Veterans on the trends in homelessness among Veterans, specific subpopulations to focus intervention on such as Veterans living unsheltered, and how best to reach Veterans who are unsheltered and those not eligible for VA services.

As we look towards 2013, particiapants reaffirmed the urgency with which all Council member agencies need to work. That same urgency and redoubling of efforts must also spur communities across the country, noted Barbara Poppe: "The federal government stand[s] shoulder to shoulder with local communities-supporting their efforts, learning from their practices, and focusing on their success. We cannot solve the problem of homelessness nationally if we don't solve it locally." 

At the Council meeting, VA Research Director Dr. Culhane made a presentation describing the progress made toward ending Veterans homelessness. The 2012 PIT count estimates quantify that progress, with a 17 percent reduction in Veteran homelessness since 2009.  Speaking as the Director of Research for the VA National Center on Homelessness Among Veterans, he illuminated to the Council the way VA has redesigned programs and systems to more accurately assess and assign interventions to Veterans.

He highlighted that the reduction in Veteran homelessness has not occurred uniformly across the country: some communities have reduced Veterans homelessness by 40 percent or more and are on-track to meet the goal, while others are making slower progress. Accelerated progress across all communities is needed to meet the goal of ending homelessness among Veterans by 2015. There are also specific subpopulations that deserve particular attention: unsheltered Veterans and Veterans who are ineligible for VA benefits.

In addition, he shared critical actions needed to continue this progress and ultimately meet the 2015 goal. Some priority actions include:

Increased investments in HUD-VASH and SSVF;
Support for local ownership of the goal, effective resource targeting, and adoption of Housing First approaches; and
A commitment to increase access to mainstream housing and stabilization services, including for Veterans and family members who not eligible for VA benefits.

Finishing the job of ending Veterans homelessness will require continued investment in housing and health programs with practices that promote the right treatment for the right condition for each Veteran's needs and circumstance. Progress can accelerate with the widespread adoption of evidence-based best practices such as Housing First and Critical Time Intervention, resource targeting based on the needs of each Veteran, and collaboration across to provide increased access to mainstream housing, employment, income, and healthcare resources for Veterans.  

USICH Fact Sheet

The United States Interagency Council on Homelessness (USICH) is tasked with coordinating the federal response to homelessness and creating 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.

Here you will find a fact sheet outlining our mission, goals, and strategies to preventing and ending homelessness. 

HUD REPORTS CONTINUED DECLINE IN U.S. HOMELESSNESS SINCE 2010

Donovan calls on Congress to support proven programs to build on progress

WASHINGTON - The U.S. Department of Housing and Urban Development (HUD) today released its latest national estimate of homelessness in the U.S., noting reductions in every major category or subpopulation since 2010, the year the federal government established "Opening Doors," a strategic plan to end homelessness. HUD's 2013 Annual Homeless Assessment Report to Congress finds significant and measureable progress to reduce the scale of long-term or 'chronic' homelessness as well as homelessness experienced by Veterans and families.

HUD's annual 'point-in-time' estimates measure the scope of homelessness on a single night in January of each year. Based on data reported by more than 3,000 cities and counties, last January's one-night estimate reveals a 24 percent drop in homelessness among Veterans and a 16 percent reduction among individuals experiencing long-term or chronic homelessness since 2010. HUD's estimate also found the largest decline in the number of persons in families experiencing homelessness since the Department began measuring homelessness in a standard manner in 2005.

Pointing to the progress made over the past three years, HUD Secretary Shaun Donovan pressed Congress to continue supporting proven programs that are housing and serving persons experiencing homelessness.

"We're making real and significant progress to reduce homelessness in this country and now is not the time to retreat from doing what we know works," said Donovan. "If we're going to end homelessness as we know it, we need a continued bipartisan commitment from Congress to break the cycle trapping our most vulnerable citizens between living in a shelter or a life on the streets. I understand these are tough budget times but these are proven strategies that are making a real difference. We simply can't balance our budget on the backs of those living on the margins."

"We are on the right track in the fight to end homelessness among Veterans. While this trend is encouraging news, we know that there is more work to do," said Secretary of Veterans Affairs Eric K. Shinseki. "As President Obama said, we're not going to rest until every Veteran who has fought for America has a home in America. The results in the latest report are a credit to the effort given by our dedicated staff, and our federal, state, and community partners who are committed to ending Veterans' homelessness."

Barbara J. Poppe, Executive Director of the U.S. Interagency Council on Homelessness, added, "Extraordinary efforts on the part of Federal agencies and our State and community partners have again led to reductions in homelessness, as seen in this year's Point-in-Time count. We are driving toward the goals of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness. This report shows that with strategic investment in evidence-based practices and proven solutions, we can end homelessness in this country."

During one night in late January of 2013, local planner organizations or "Continuums of Care" across the nation conducted a one-night count of their sheltered and unsheltered homeless populations. These one-night 'snapshot' counts are then reported to HUD as part of state and local grant applications. While the data reported to HUD does not directly determine the level of a community's grant funding, these estimates, as well as full-year counts, are crucial in understanding the scope of homelessness and measuring progress in reducing it.

The Obama Administration's strategic plan to end homelessness is called Opening Doors - a roadmap by 19 federal member agencies of the U.S. Interagency Council on Homelessness along with local and state partners in the public and private sectors. The Plan puts the country on a path to end Veterans and chronic homelessness by 2015; and to ending homelessness among children, family, and youth by 2020. The Plan presents strategies building upon the lesson that mainstream housing, health, education, and human service programs must be fully engaged and coordinated to prevent and end homelessness.

The decline in veteran homelessness is largely attributed to the close collaboration between HUD and the U.S. Department of Veterans Affairs on a joint program called HUD-VA Supportive Housing (HUD-VASH). Research demonstrates that for those who have been homeless the longest, often living on our streets for years at a time, permanent supportive housing-housing coupled with supportive services to address mental illness, substance addiction, and other challenges-not only ends homelessness for these vulnerable individuals, but also saves the taxpayer money by interrupting a costly cycle of emergency room visits, detoxes, and even jail terms. Since 2008, a total of 58,250 rental vouchers have been awarded and 43,371 formerly homeless Veterans are currently in homes of their own because of HUD-VASH.

Chronic homelessness among individuals is declining and has done so quite substantially since 2007. This decline is partially attributable to a long-standing push to develop more permanent supportive housing opportunities for those struggling with long-term homelessness who otherwise continually cycle from shelters to the streets.

Key Findings

On a single night in January 2013, local planning agencies or 'Continuums of Care' reported:

  • 610,042 people were homeless representing a 6.1 percent reduction from January 2010. Most homeless persons (64 percent) were individuals while 36 percent of homeless persons were in family households. Nearly two-thirds of people experiencing homelessness (65 percent or 394,698) were living in emergency shelters or transitional housing programs. Meanwhile, 35 percent (or 215,344) of all homeless people were living in unsheltered locations such as under bridges, in cars, or in abandoned buildings.
  • Veteran homelessness fell by 24.2 percent (or 18,480 persons) since January 2010. On a single night in January 2013, 57,849 Veterans were homeless.
  • Chronic homelessness among individuals declined by 15.7 percent (or 17,219 persons) since 2010.
  • Homelessness among individuals declined nearly 4.9 percent (or 20,121 persons) since 2010. Meanwhile, homelessness among persons in family households declined by 8.2 percent (or 19,754 persons) since 2010. This decline is entirely composed of unsheltered people in families.

        

  • Nearly 20 percent of people experiencing homelessness were in either Los Angeles (nine percent of total or 53,798) or New York City (11 percent of total or 64,060). Los Angeles experienced the largest increase among major cities, reporting 11,445 more individuals living in homelessness (or 27 percent) in 2013 compared to 2012. New York City reported 7,388 more persons experiencing homelessness (or 13 percent).

Read more on homeless data reported on a state and community-based level.

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HUD's mission is to create strong, sustainable, inclusive communities and quality affordable homes for all.
HUD is working to strengthen the housing market to bolster the economy and protect consumers; meet the
need for quality affordable rental homes: utilize housing as a platform for improving quality of life; build
inclusive and sustainable communities free from discrimination; and transform the way HUD does business.
More information about HUD and its programs is available on the Internet at www.hud.gov and
http://espanol.hud.gov. You can also follow HUD on twitter @HUDnews, on facebook at
www.facebook.com/HUD, or sign up for news alerts on HUD's News Listserv.

Federal Guidance for Mainstream Programs

Guidance

Below are links to Federal Guidance on resources from mainstream programs.

Department of Education

Department of Health and Human Services (HHS)

Department of Housing and Urban Development (HUD)

Resources and Tools for Leveraging Mainstream Federal Programs to Support Homelessness Efforts

Department of Health and Human Services (HHS)

Department of the Treasury: Office of the Comptroller of the Currency

Creating Permanent Supportive Housing

PHAs are using a variety of strategies and creating a range of PSH program models. The primary approaches include:

Successful partnerships link housing assistance with the services and supports people need to become successful tenants and neighbors.

In addition, some PHAs with Moving to Work designation are using another strategy to create PSH:

USICH Blog

Blog

SUGAR Film

Information about the upcoming film, SUGAR. 

Using Special Purpose Vouchers

Special Purpose Vouchers are distinguished from regular Housing Choice Vouchers in that they have been specifically provided by Congress in separate appropriations and are reserved for specific populations.

  • Only Veterans experiencing homelessness are eligible for HUD-VASH vouchers.
  •  FUP vouchers are for families in need of rental assistance to either prevent or end an out-of-home placement for one or more children, or for youth at least 18 years old and not more than 21 years old who left foster care at age 16 or older and who lack adequate housing.
  •  NED Vouchers are for non-elderly persons or families with disabilities, with a subset of vouchers (Category 2) reserved for people exiting nursing homes or other long-term care institutions.

The success of implementing Special Purpose Vouchers relies on developing strong partnerships with other agencies to pair rental assistance with services. 

Protecting Victims of Domestic Violence

PHAs have the flexibility to implement programs and policies to provide protections to victims of domestic violence, dating violence, sexual assault, and stalking beyond those required by the Violence Against Women Reauthorization Act of 2013 to help ensure that victims of domestic violence do not become homeless as a result of being a victim of domestic violence.

Sponsor-Basing Vouchers

Generally, rental assistance administered by PHAs is assigned either to the tenant (“tenant-based”) or to a specific housing unit or building (“project-based”). In a “sponsor-based” program, an organization that works with people in the community (the “sponsor”) holds the housing voucher and is able to lease a unit from the landlord on behalf of the tenant in order to help facilitate access to housing.  The organization holding the voucher also delivers or facilitates access to supportive services that help the household achieve stability.

Project-Basing Vouchers

One approach to creating PSH is for a PHA to dedicate some Housing Choice Vouchers (HCV) and use them as project-based vouchers (PBVs) in a supportive housing development project. Many PHAs have found the PBV strategy, when paired with services provided by a community partner, is a particularly effective model for creating expanded housing opportunities for people with disabilities who are experiencing homelessness, particularly those with long histories of homelessness or significant challenges to housing stability.

Moving Up Strategies

When people have the opportunity to move from permanent supportive housing (PSH) into another stable housing opportunity, such turnover creates availability in existing PSH to that can be used to serve persons experiencing chronic homelessness.    These approaches, when done in a purposeful way, are referred to as “moving up” or “moving on” initiatives.

Modifying Tenant Screening and Eligibility Policies

Incarceration and homelessness are highly interrelated, as difficulties in reintegrating into the community increase the risk of homelessness for released prisoners, and homelessness increases the risk for re-incarceration.  Sometimes people come in contact with the criminal justice system because of behaviors related to the symptoms of untreated mental illness or other disabling conditions.  However, contrary to common assumptions, a person’s criminal background does not predict whether that person will succeed of fail at staying housed. 

 

HUD has provided encouragement to PHAs, including this letter the Secretary of HUD sent to all PHA Executive Directors, to review their policies related to criminal history and consider more flexible, reasonable admissions policies that balance safety concerns with the importance of providing individuals a second chance at improving their lives and becoming productive citizens.

 

Helping People Experiencing Homelessness Use Housing Vouchers

Once issued a housing voucher, people who don’t already have a place to live may have difficulty using that voucher within the local rental market.

People who are experiencing homelessness may find it challenging to find available rental units that meet program standards, and which are managed by landlords who are willing to accept tenants with housing vouchers.  This can be especially challenging if they have health and behavioral health conditions, poor credit, histories of contact with the criminal justice system, or prior evictions.

With some extra help, vulnerable people can successfully use vouchers to obtain housing and exit homelessness. For example, some PHAs and their service-provider organization partners have worked together to streamlined the housing search process and provided assistance to make it easier for people who are experiencing homelessness to use their vouchers. 

Eviction Prevention Strategies

PHA assisted households, who are typically extremely low-income and often have disabilities, are particularly vulnerable to homelessness if they are evicted. Additionally, when PHAs terminate assistance, such households not only lose affordable housing but may also become ineligible to return to public housing or receive other types of housing assistance in the future.

 PHAs can balance enforcement of rules and responsible property management with efforts to prevent homelessness by partnering with service providers to help ensure that vulnerable households are provided with the support they need to successfully maintain housing.

PHAs have considerable discretion in determining their policies regarding evictions from public housing and the termination of assistance for tenants who participate in the Housing Choice Voucher Program.

Establish Waitlist Preferences

All PHAs have significant flexibility in establishing procedures and priorities for waiting lists and tenant selection, within the overall framework provided by federal law.

Each PHA is required to establish an Annual Plan that describes the PHA’s approach to meeting local housing needs among low- and very low-income people. The PHA Plan describes eligibility for housing assistance and tenant screening and selection criteria. 

Additional Resources

For more information on how PHAs can help end homelessness, visit the following resources

USICH Blogs on PHAs and Homelessness

Funders Collaborative

By participating in funder collaboratives, PHAs can significantly increase the impact of their resources and programs, by connecting housing assistance to other investments in affordable housing and funding and the delivery of the services often needed by people experiencing homelessness.

Frequently a single public agency does not control funding that can be used for all of the elements or costs of strategies that are needed to prevent and end homelessness. Nonprofit providers of housing and services must go separately to dozens of funders, and they often need to secure funds from a multitude of funding sources to launch new programs or complete supportive housing projects. 

A funder collaborative links critical funding resources to achieve a common set of goals and may disburse those funds on the basis of a single, streamlined application process. 

Partnering with Schools

Schools play important roles in the lives of children and their families, and in creating strong and healthy communities. 

Schools and Local Education Agencies (LEAs) also have obligations to identify and provide some assistance to students who are experiencing homelessness.  Such assistance includes transportation to allow students to continue to attend the same school even if they are staying in shelters or in other arrangements that may be far from where they were living when they enrolled in school.

HUD also strongly encourages collaboration among homeless assistance programs and schools, and requires that each project that receives HUD funding through the Continuum of Care must appropriately coordinate with schools and community agencies to enroll children and youth in school, and to ensure that the children and youth receive all required and necessary educational services.

Partnering with Health Centers

Community Health Centers and Health Care for the Homeless (HCH) Programs receive federal grants from the Health Resources and Services Administration (HRSA), which is part of the US Department of Health and Human Services (HHS).  These health centers and HCH programs also receive Medicaid reimbursement as Federally Qualified Health Centers .  They provide comprehensive primary care services to low-income people in underserved communities, and many health centers often also provide some behavioral health and dental services.

Housing Stabilization and Case Management

Housing stabilization supports and case management services can help people who have experienced homelessness become successful tenants and achieve housing stability.  PHAs can partner with service providers to deliver supports to households that have been experiencing homelessness prior to receiving housing assistance. 

Housing stabilization supports are usually time-limited, and services are most intensive at the point when families and individuals exit homelessness and move into permanent housing.  Services are often delivered in the participant’s home and in the community, and focus on helping people improve their housing-related skills.  Housing stabilization services also help people establish or strengthen their connections to community services and other resources, including facilitating the use of informal or “natural” support from family members, friends, faith communities, and others.

Application Assistance

The process for applying for and receiving housing assistance administered by PHAs can be challenging for any applicant household, but is even harder to navigate for individuals and families experiencing homelessness.

Depending upon the specific types of housing assistance and PHA policies regarding waiting list preferences, the application process can involve submitting forms and documentation, showing up for interviews and scheduled appointments, and waiting for weeks, months, or even years before an eligible household receives assistance. 

Move-In Assistance

When families and individuals experience homelessness, they often do not have funds for security deposits, utility hook-ups, or the household goods and furniture they need to settle into a home when they get housing assistance. 

Such expenses are not covered by many of the primary publicly-funded subsidy programs, but private support for such needs can help the public programs to operate more efficiently and to house people more quickly. In some cases, households exiting homelessness may be moving into a neighborhood where they do not have friends or family connections.

PHA partnerships with faith-based and community organizations can help provide people with the items that are essential to furnishing an apartment or house, and they may offer additional informal support that would help an individual or family to feel welcomed into their new home and community.

Social Security Administration Clarification of Identification Requirements

The Social Security Administration (SSA) has made some recent changes to its identification requirements for individuals seeking a printout of their Social Security Number (SSN) as discussed in this letter.  USICH and SSA have received many questions and concerns regarding the impact of these new requirements of people experiencing homelessness, because of their difficulty obtaining forms of photo identification.  In response to these questions, SSA has provided the following clarification of its requirements: 

  • The identification requirements and interview techniques used to verify identity for Social Security Disability Insurance and Supplemental Security Income benefits have not changed and are not affected by the requirements for the SSN printout.
     
  • Beginning in June 2013 Social Security enhanced its identification requirements for individuals seeking an SSN Printout.  These requirements now mirror the requirements to obtain a replacement Social Security card.
     
  • Social Security does have other procedures in place to assist individuals who do not have acceptable proof of identification for obtaining an SSN printout or replacement Social Security card.
     
  • Acceptable documents to show proof of identity include, but are not limited to:

o   Unexpired Driver’s License

o   Unexpired State Identification Card

o   Valid and Unexpired U.S. Passport/Passport Card

o   U.S. military identification card

o   Current U.S. lawful alien document and an unexpired foreign passport

o   Certificate of Naturalization

o   Certificate of U. S. Citizenship

o   Certified copy of medical records (clinic, doctor, or hospital) or letter providing extract data from medical records showing the applicant’s name and date of birth or age

o   Health insurance or Medicaid card showing the applicant’s name and either a photograph of the person or the person’s date of birth

o   School identity card or certified school record or transcript showing the applicant’s name and either a photograph of the person or his/her date of birth

o   Life insurance policy showing the age or date of birth

  • If an individual does not have the necessary documentation to obtain a replacement Social Security card or SSN printout, the individual may request a computer extract of his/her Social Security Number Application with the SSN provided.  This is referred to as a copy of the Numident record, and a fee of $16 is charged for the request.  These requests are mailed to a central location, and it may take up to 60 days to receive a reply.
     
  • Employers can use Social Security Number Verification Serviceand Department of Homeland Security’s eVerifyService to verify an SSN or employment eligibility.
     
  • Private or government agencies can use Social Security’sConsent-Based SSN Verification Service. 

As a reminder, please remember that the Social Security card, not the SSN printout, is SSA's official verification of the SSN assigned to the individual named on the card. 

For any additional questions, please visit http://ssa.gov/pgm/reach.htm to find out how to contact SSA directly.  

Medicaid Expansion: Your Guide for Engaging People Experiencing Homelessness

Medicaid Expansion: Your Guide for Engaging People Experiencing Homelessness

The Affordable Care Act, and the expansion of Medicaid in particular, will provide States with greater tools to prevent and end homelessness. Beginning on January 1, 2014, states will be required to eliminate traditional barriers to insurance enrollment and have the choice to expand Medicaid to cover the vast majority of individuals experiencing homelessness in America.  As a result, people experiencing homelessness will have health coverage and greater access to a more comprehensive package of health services that can help them achieve health and housing stability.  For more information on how Medicaid can fund supportive services, click here.

In states that are participating in Medicaid expansion, people experiencing homelessness will be able to enroll in Medicaid beginning on October 1, 2013, with coverage starting on January 1, 2014. A new streamlined application process will make applying for Medicaid easier, including an online process and fewer paperwork requirements.  Even with these improvements, many people experiencing homelessness will need special outreach, education, and assistance with enrolling in Medicaid.   Providers of services to people experiencing homelessness can overcome the challenges and barriers to Medicaid enrollment with these tips and talking points.

Learn how your organization can help

Providers of services to people experiencing homelessness are ideally positioned to provide information and assistance around Medicaid and health insurance options.  This can range from general outreach and education, to “navigation” around the Medicaid application process, to being designated as an authorized representative on a Medicaid application.  Many organizations, including Health Care for the Homeless providers, are already helping people experiencing homelessness to enroll, and some are receiving Federal grants to provide this assistance. If you organization is not already involved, the first step is to learn what roles you can play. Visit the Centers for Medicare & Medicaid Services’ marketplace website to learn what roles you can play and how to get training.

 

Think outside-the-box for outreach

Innovative methods of outreach in many settings allow practitioners to reach a broader population and to give immediate enrollment assistance to people experiencing homelessness. If it is not already, make health insurance education and outreach a part of your street outreach efforts.  Reach and help people with enrollment in creative ways and in a variety of settings, including advertising help or setting up a table at a food pantry or soup kitchen and reaching out to people, or establishing a designated time and place in emergency shelters or other settings frequented by people experiencing homelessness with a “Got Insurance?” sign or other phrase designed to initiate conversations.

Technology will allow enrollment activities in most areas to be completed using table computers or other portable devices that can be taken into encampments and other street locations where applications can be initiated.  This approach does not require the individual to enter a service location in order to initiate benefits, and may help build greater trust and willingness to seek services at a later date.

Enact education tools and coordinate with other forums for education, so people know about options and care plans ahead of time.

Group power

Holding group discussions with clients at service locations can help distribute information about health insurance and stimulate peer support and encouragement to sign up for benefits. Larger group settings might also be less intimidating for some clients who are unsure of what questions to ask and give them an opportunity to learn from others.  Asking consumers who are already insured to describe how health insurance has benefited them can bolster confidence in the enrollment process. 

Spend time one on one

As a complement to groups, initiating one-on-one time with clients helps people to feel empowered to ask questions they may not have wanted to ask in front of others.   Conversations about income and health status are inherently personal, so creating a private space for this will help raise trust and confidence.  Take the time to help clients understand how health insurance works, the benefits of Medicaid enrollment, what’s needed to apply, key dates in the process, and who to contact for more information.   Make space for both appointments and walk-in availability to make it easier for clients to access this conversation.

If at first you don’t succeed…

While many people will sign up immediately, it occasionally takes a couple of encounters before clients are willing to apply for Medicaid.  For some individuals, it may take weeks or even months before they are willing to engage in conversations before a successful enrollment can take place.  It is important to build a relationship and establish trust first and understand people’s needs and barriers.  If people have not previously been engaged or if an outreach worker is new to the client, it can take three or more contacts before they might be ready to apply and perhaps even more than that for those who are extremely vulnerable (due to mental illness or other factors).

Talking point:  “It’s okay if you don’t want to enroll today, but can I give you information on where to go if you change your mind, or we can talk more about it the next time.” (Then direct to main site or clinic where there may be multiple people able to help with Medicaid enrollment efforts.)

Don’t “sell” Medicaid, sell what Medicaid offers

Start by finding out what services clients want or need, and then discuss how enrolling in Medicaid can help.  Explain that Medicaid coverage gives access to a wide range of services, including those that the clients say they need and want.  In some states, having Medicaid coverage might also increase a client’s ability to obtain permanent housing.

Mention that there are a wide range of benefits—coverage for specialty care is a big selling point.

Talking Point: “Did you know that enrolling in Obamacare could provide you with services you don’t currently have insurance coverage for?”

Talking point:  “I know you’ve wanted to see a podiatrist about your feet—Medicaid can help us get you an appointment to see someone.”

Talking Point:  “You’ve mentioned having problems filling your prescriptions because you don’t have the money, so this program can help make that more affordable for you.”

Discuss what’s new, and what’s not new

Some clients may not be familiar with Medicaid, may know it by another name, or may have been denied in the past.  Clients should know that there have been some changes to Medicaid, and that things might differ from their past experience. If clients believe they are ineligible, ask them to explain why. Explain about the concept of health insurance and how eligibility for Medicaid has changed.  At the same time, explain how some things are the same.  If a client has insurance currently, their coverage will not be affected. 

Talking Point: “It used to be that people were only eligible for Medicaid if they had kids, were on disability benefits, or were elderly.  That has changed in our state.  Now most adults are eligible as long as they earn less than $15,282 a year for a single individual, or $32,499 for a family of four.”

Talking Point: “Have you heard of Medicaid <or state name for program> or tried to apply before?”

Explain that applying has never been easier

With online enrollment through the marketplaces, it has never been easier to apply for Medicaid. For example, now people can enroll without paperwork and without needing a permanent home address. The marketplaces will simplify the process by making the application shorter and reducing the amount of information needed. 

If a client has ever applied for benefits locally in the past, they might not even have to provide any additional information.

Clients can check their status online and they can ask a service provider to be an authorized representative and/or to receive their mail if they don’t have a home address. 

Providers can walk clients through the entire process; explain that they won’t have to interact with multiple agencies. People will be more likely to sign up immediately if the staff member has the application available right there and can walk through it with them.  This is especially helpful if the client doesn’t have to go to multiple places and can stay with just one person or agency to do everything at once.

Talking Point: “In the past, applying for benefits could be really complicated and time consuming. There have been changes that make the process for Medicaid much easier and we can probably do it all right now.  I can help you through the entire process and you won’t have to go anywhere else.”

Skip the alphabet soup, use familiar language

Health insurance can be confusing and full of jargon. To make it more manageable, discuss what clients already know.  For example, in California people are familiar with Medi-Cal and know if they are not eligible. Clients may not have heard of the ‘Affordable Care Act’, but may have heard of ‘Obamacare.’

Common Concerns

Many practitioners have already heard concerns from clients, some common ones include:

Clients often have questions about eligibility and fear not having coverage or being mistakenly being disenrolled. 

Clients who are currently covered want to make sure they can continue to receive care from their primary care provider.

Many patients have a fear of copays. Currently arrangements with pharmacies might be affected by the Affordable Care Act changes. 

Help offset the cost of copays by:

  • Health centers should have sliding fee scales that go to $0 and can cover prescription copays and/or use the 340B program to further reduce costs to the client.
  • Setting up a “patient services account” to assist people who can’t afford copays.
  • Trying to encourage people with income to cover their own copays to the extent possible.

Patients are very interested in full dental coverage and other services that aren’t provided through Medicaid.  They still enroll but it is often something people voice as a need. Learn more about essential health benefits standards here.

 

Information is power

Supplying clients with as much information as possible can help them make informed, confident decisions, but at the same time, don’t overwhelm them if they are not ready for it.  “Meet the client where they are.”

Let clients know that Medicaid is an entitlement—they can get covered if their incomes qualify them.  

Talking Point: “Getting covered by Medicaid is now something that you are entitled to simply due to your income.  It’s not something you jump through hoops to earn anymore.” 

It is important to communicate who is eligible for what services now.

Thoroughly review opportunities for careand inform clients that they will have more options.

Some Health Care for the Homeless providers find that explaining how services are funded and discussing the fact that enrolling in Medicaid allows staff to provide even more services to others empowers clients to understand they are part of an effort to help the greater community.  This can be one way to encourage them to enroll. 

Talking Point: “When clients enroll in Medicaid, it helps the health center get paid for the help we provide, and that allows us to serve even more people who need help.” 

Enroll to engage in care

Some people will already be engaged in services, or will need to engage in services, before they are willing to enroll in Medicaid.  However, others will find the enrollment process as a step toward service engagement.  Use your judgment about what will work best, but the ultimate goal is to engage clients in the health care services they need to improve their health.  Knowing about additional services available at your location (e.g., identification documents, other benefits, health services, case management, housing or employment assistance, etc.) may help to keep clients engaged.

Don’t just sign people up. Discuss next steps and let them know what will happen afterwards, when they have coverage, and facilitate that next step.

Treat every encounter with clients as an opportunity to engage them around their health education and insurance options.

Talking Point: “I’m glad I was able to help you apply for Medicaid.  Would you like to hear about other ways we can help you, such as seeing a doctor or applying for permanent housing?”

Have information available to take away

A combination of electronic and paper records can be very effective. Accompany one-on-one meetings or group discussions with handouts they can take with them to provide clients with additional information, telephone numbers, and basic information that reinforces the health education messages.   Make sure handouts are written in clear and concise language that will be understood by those with more limited reading proficiency and/or those with limited English skills.

 

 

 

 

 

 

 

 

“Medicaid Expansion: Your Guide for Engaging People Experiencing Homelessness” is a joint publication of USICH and NHCHC. This publication was made possible in part by grant number U30CS09746 from the Health Resources and Services Administration, Bureau of Primary Health Care. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA.

 

 

Solving for Services: New Medicaid Opportunities to Pay for the “Support” in Permanent Supportive Housing

Solving for Services: New Medicaid Opportunities to Pay for the “Support” in Permanent Supportive Housing

Solving for Services: New Medicaid Opportunities to Pay for the “Support” in Permanent Supportive Housing

As much as a flexible “do whatever it takes” approach to case management and supportive services is essential to permanent supportive housing’s success for people experiencing chronic homelessness, it are also very difficult to finance. Providers have often had to patch together multiple streams of public and private funds—each with different eligibility and coverage rules—in order to provide the “support” in supportive housing. Funding these services often feels like solving a complex mathematical equation, where providers have to solve for multiple variables at once. 

Through changes under the Affordable Care Act, providers may finally have found a solution to that equation: Medicaid.  With states having the choice to expand Medicaid eligibility, more people experiencing chronic homelessness may be eligible for Medicaid. At the same time, the Affordable Care Act is shifting the focus of Medicaid to “whole person” health needs rather than just medical and physical health needs. This means that states will have incentives to pay for things like case management and behavioral health services under Medicaid, alongside hospital stays, doctor’s visits, and prescription drugs. 

So what can providers of permanent supportive housing do to tap Medicaid as a way to pay for the services in permanent supportive housing?  Four emerging and exciting trends offer some ideas:

  • Permanent supportive housing is becoming a part of new health care delivery models for people with chronic conditions Chances are that efforts are already underway in your state to develop innovative health care delivery models for people with chronic conditions like serious mental illness.  Through innovations like Accountable Care Organizations (ACOs) and Health Homes, partnerships are forming between health care and social services providers to provide wrap-around care to improve overall health and wellness, rather than focus just on medical procedures and visits.  In places like Oregon and Illinois, permanent supportive housing are being made a part of the package of care provided as part of ACO and Health Homes.
  • Medicaid managed care benefits covering supportive housing services – More and more states are moving towards enrolling Medicaid beneficiaries in managed care, in which states contract with selected managed care organizations (MCOs) and provide them with a fixed or “capitated” amount of funds to address enrollees’ health needs. In places like Massachusetts, Minneapolis, and Pittsburgh, managed care organizations have realized that for their enrollees experiencing chronic homelessness, housing is a key to success. These MCOs are partnering with permanent supportive housing providers to provide housing for these enrollees, and in exchange, paying for some or all of their supportive services. (See the blog by Mike Nardone on supportive housing and managed care partnerships.)
  • States are adopting and covering supportive housing services in their Medicaid plans – States like Louisiana and New York are making permanent supportive housing for people experiencing chronic homelessness a central part of their state Medicaid policies and health reform efforts. Health policymakers and Medicaid officials in both states recognize the value of permanent supportive housing in improving health and lowering costs. 
  • Efforts focused on Medicaid “super-utilizers” are seeing the importance of linking care management to housing- More and more states and counties are looking to permanent supportive housing as part of their strategies to address the health and social needs of “super-utilizers”—the small subset of Medicaid enrollees whose frequent use of hospitals and emergency rooms drive up overall health care spending.  Housing’s role in reducing health care costs was included in the Center for Medicare and Medicaid Services’ (CMS) recent information bulletin on “super-utilizers” and is being discussed as part of the National Governors Association’s Developing State-Level Capacity to Support Super-Utilizers policy academy.

US Labor Department awards nearly $24 million in Pay for Success grants

New York and Massachusetts awarded grants to improve employment outcomes for formerly incarcerated individuals

WASHINGTON — The U.S. Department of Labor today announced nearly $24 million in Workforce Innovation Fund grants to pilot the Pay for Success program, a new model of financing social service programs to help federal, state and local governments ensure that public funds only go to programs that achieve positive, measurable outcomes. Under this model, independent investors provide the financial capital to cover the operating costs for the programs, and the Department of Labor disburses funds when and if those programs demonstrate that they have achieved the targeted outcomes.

Two grants were awarded: one to the New York Department of Labor in the amount of $12,000,000 and the other to the Massachusetts Executive Office of Labor and Workforce Development in the amount of $11,670,000. These grants will support programming that aims to increase employment and reduce recidivism among formerly incarcerated individuals.

"The Pay for Success model is a promising strategy for expanding effective programs while ensuring maximum return on taxpayer dollars," said Secretary of Labor Thomas E. Perez. "At a time when all levels of government are experiencing cutbacks, Pay for Success offers a new approach to strategically leverage resources to provide essential services for vulnerable populations through programs with measurable success rates."

The grants announced today represent amounts of committed funds, which the department will release in installments based on whether the grant outcomes were met. Both grantees are expected to employ rigorous evaluation methods in gauging the results of their respective programs, and the findings will be reviewed by independent validators at the end of grant performance period.

The robust evaluation component incorporated in Pay for Success projects will also help to: 1) the expand the body of knowledge about the intervention strategies being tested, 2) demonstrate the feasibility and viability of this funding model and 3) use taxpayer dollars wisely by shifting the investment risk to private investors and releasing funding based on results.

The original solicitation for Pay for Success grant applications announced that $20 million would be awarded. Because of the quality of applications received, the department elected to fully fund the top two grant applicants’ projects using funds from fiscal years 2012 and 2013.

To access more information about the Workforce Innovation Fund, the Pay for Success model, and related tools and resources, please visit our Workforce Innovation Fund Web sites at: http://www.doleta.gov/workforce_innovation andhttp://innovation.workforce3one.org/#5.

HUD Webinar: Overview of PIH Notice 2013-15

Overview of PIH Notice 2013-15: Guidance on Housing Individuals and Families Experiencing Homelessness Through the Public Housing and Housing Choice Voucher Programs Webinar 

This a joint webinar between CPD and PIH to provide an overview of the PIH Notice, the types of strategies PHAs can implement to participate in local efforts to end homelessness, how PHAs can coordinate with CoCs and providers, and how this supports the goals of the Federal Strategic Plan to End Homelessness.

Presenters:Ryan Jones (HUD), Amaris Rodriguez (HUD), Danielle Bastarache (HUD).

HUD Webinar: CoC 101 for PHAs

This webinar, recorded on August 26, 2013, is a joint webinar between CPD and PIH to provide an overview of the basics about CoCs and the CoC Program for PHAs.

Presenters: Marcy Thompson (HUD) & Irene Pijuan (CSH)

HUD Webinar: PHA 101 for CoCs

This is a joint webinar between CPD and PIH to provide an overview of the basics about PHAs and the programs administered by HUD’s PIH.

The Affordable Care Act’s Role in Preventing and Ending Homelessness

What is the Affordable Care Act? 

On March 23, 2010, President Obama signed the Affordable Care Act into law. The Affordable Care Act expands access to affordable health care to all Americans, gives consumers new rights and protections that make coverage fairer and easier to understand, improves the quality of health care, strengthens public health infrastructure, and lowers health care costs. 

How does the Affordable Care Act benefit people experiencing homelessness? 

People experiencing homelessness often have complex health challenges that both contribute to, and are exacerbated by, homelessness.  They generally have limited access to health care because they are often unemployed, lacking employer-sponsored insurance, and living in poverty. As a result, many people who are homeless have had to rely on emergency room visits and uncompensated hospital care, resulting in poor health outcomes, higher mortality risks, and higher public costs. 

The Affordable Care Act benefits people experiencing homelessness in three ways:

1)      It makes health insurance more accessible and affordable (through the development of Health Insurance Marketplaces offering private insurance plans as well as expanded Medicaid eligibility);

2)      It ensures coverage of a broader set of health services including preventive, wellness, and behavioral health care; and

3)      It encourages health care delivery to focus on quality and health outcomes, including addressing “whole person” health needs and partnering with community-based organizations.

What types of health insurance options are available to people experiencing homelessness? 

Medicaid* – Medicaid is the health insurance option for most people experiencing homelessness, given their extremely low-incomes. Previously, most people only qualified for Medicaid if they were disabled, pregnant, parents, or children. The Affordable Care Act gives states the option to expand Medicaid coverage to all eligible people whose earnings are less than 133 percent of the Federal Poverty Level, regardless of their disability or family status.In 2013, that equals an individual annual income of $15,282, and $32,499 for a family of four

Private Health Insurance – Through the new Health Insurance Marketplace (also known as exchanges) people can compare and buy affordable private health insurance. Families earning between 100 and 400 percent of the Federal Poverty Level may qualify for tax credits that can help offset the cost of health insurance.

Visit HealthCare.gov to find out what health insurance options are available.

 

How do I know if my state is participating in Medicaid expansion?

Following the Supreme Court ruling in 2012, the choice to expand Medicaid eligibility is left to states. To find out if you are eligible for Medicaid in your state, visit this site.

How can people experiencing homelessness apply for Medicaid and other health insurance? 

Starting October 1, 2013, people will be able to apply for Medicaid and all other health insurance through the online Health Insurance Marketplace, by phone through a toll-free call center with help available in 150 languages (1-800-318-2596; TTY: 1-855-889-4325), and through local enrollment sites.  With the new streamlined application process, applying for Medicaid and other types of insurance will be easier than ever and the new online application makes it possible to track your application. 

What if my state is not participating in Medicaid expansion? 

Even in states that do not participate in expansion, people experiencing homelessness may be eligible for Medicaid under one of the following categories: pregnant women, senior citizens, parents, children, and people with disabilities. Organizations that serve people experiencing homelessness who have disabilities can continue to assist with applications for Supplemental Security Income (SSI) or Social Security Disability Income (SSDI)  benefits, which usually confers Medicaid eligibility. Training and information on SSI and SSDI is available through the SOAR TA Center

People who do not meet the eligibility requirements for Medicaid will be unable to access that coverage in states that do not expand Medicaid eligibility. And people who are unemployed or too poor to afford private insurance will have few options for health insurance.  

How can people experiencing homelessness get assistance with enrolling in Medicaid and other types of health insurance? 

Over 1,100 community health centers across the country (including Health Care for the Homeless grantees) have received funds to provide in-person assistance for individuals to apply for Medicaid and other forms of insurance, including Marketplace coverage.  In addition, the Center for Medicare & Medicaid Services awarded 105 grants to navigators who can help people prepare applications for Medicaid and health insurance through the Marketplace.  Organizations serving people experiencing homelessness may also apply to become certified application counselor organizations to help people understand and enroll in coverage.

What services does Medicaid cover?  How can enrollment in Medicaid increase access to these services? 

Each state’s Medicaid program is different and while certain services are required by all state Medicaid programs, many states provide Medicaid beneficiaries with additional services. For individuals and families in the Medicaid expansion population, ten sets of benefits and services, known as benchmark benefits, must be covered. The benchmark benefits include traditional health and medical services such as primary care appointments, diagnostic tests, hospital visits, and surgical procedures. It also includes services that are very important to people experiencing homelessness such as behavioral health services, mental health treatment, substance abuse treatment, prescription drugs, preventive and wellness services, and rehabilitative services.  

In addition, states can choose to cover services like case management, care coordination, and home- and community-based services in their state Medicaid plans. Many of the services in the essential health benefits package and optional services match the set of services provided in permanent supportive housing.  More information on how Medicaid can finance services in permanent supportive housing can be found here.

FOR MORE INFORMATION, VISIT HEALTHCARE.GOV

* The Affordable Care Act uses modified adjusted gross income (MAGI) to determine eligibility for Medicaid or premium credits.  MAGI calculation includes a standard 5 percent earned income disregard, effectively making Medicaid eligible to people at 138 percent of the Federal Poverty Level.

Referrals

To make their strategies of implementing housing assistance programs targeted to people experiencing homelessness successful and efficient, PHAs must have processes for consistently receiving applications from eligible households and those processes will be strongest if based upon partnerships between PHAs and organizations that serve people experiencing homelessness.

By establishing a regular referral process, partnering organizations can help create a pipeline of qualified applicants so PHAs can effectively target assistance to homeless households without sacrificing utilization rates or lease-up times.

Otherwise PHAs, which face financial pressures to make sure their resources are utilized, may be reluctant to implement programs targeted to homeless people who are most in need of housing assistance.

Even those PHAs most committed to the mission of ending homelessness will have their efforts strengthened through community partnerships.

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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.

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