3.6 Ending Homelessness for Veterans and Their Families
Speaker: Kim Keaton
In order to reach the federal goal of ending veterans homelessness by 2015, new grants such as Supportive Services for Veterans Families (SSVF) have recently been released. This workshop will look at how these and other programs will be implemented to prevent homelessness and help homeless veterans and their families reconnect to housing in their communities.
Evaluating Philadelphia’s Rapid Re-Housing Impacts on Housing Stability and I...
3.6 Ending Homelessness for Veterans and Their Families
1. Ending Homelessness for
Veterans and Their Families:
Prevention’s Place in a Community System
of Response to Homelessness among
Veterans
NAEH Ending Family and Youth
Homelessness Conference
February 9, 2012
2. Corporation for Supportive
Housing
CSH is a national non-profit organization that
helps communities create permanent housing
with services to prevent and end
homelessness.
CSH advances its mission through advocacy,
expertise, innovation, lending, and
grantmaking.
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3. Understanding Homelessness as
a System of “Flows”
New Entries into Exits from
Homelessness Homelessness
Homelessness
Returns to
Homelessness
Prevalence of Homelessness is a function of rate of “flows in”,
rate of “flows out,” rate of returns to homelessness, and length
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of stay
4. Varying Patterns of
Homelessness
Transitionally Homeless
– Experience homelessness in a single occurrence
lasting only a brief period of time
Episodically Homeless
– Experience homelessness as an “institutional
circuit”, and cycle between jails, hospitals, and
other crisis services along with shelters
Chronically Homeless
– Experience homelessness for long periods, often
as a semi-permanent state
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5. Varying Levels of Persistence
100%
Transitionally Homeless
90%
represent 80%, but use
only 6% of shelter
resources Episodically Homeless
80%
represent 10%, but use
28% of shelter resources
70%
60%
Transitional
50% Episodic
Chronic
40%
30%
Chronically Homeless
20%
represent 10%, but use
66% of shelter resources
10%
Source: Kuhn and
0% Culhane (1998)
5 Cohort Shelter Days Used
6. Different Strategies for Different
Patterns of Homelessness
Pattern Strategy
Transitionally Prevent entry into homelessness in
Homeless the first place
Rapid re-housing
Episodically
Transitional housing
Homeless
Permanent supportive housing
Chronically
Permanent supportive housing
Homeless
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7. Decreasing Flows In and
Increasing Flows Out
Homelessness
Prevention
Transitionally
Homeless
Permanent
Placements into
Rapid Re-
Episodically Housing
housing
Homeless
Chronically
Homeless
Housing Retention
Supports
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8. Ending Homelessness among Veterans
Needs Complete “System of Response”
Supportive
Grant & Per Diem
Services for HUD-VASH
Program
Veteran Families
Enhanced
Patient- Standard VA Permanent “Housing
Homeless Transitional
Rapid Re-
Centered Services Supportive First”
Prevention Housing
Housing
Health Home and Benefits Housing Supportive
Housing
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9. Matching Needs to Interventions
Measure “Needs” along 2 Dimensions:
Housing:
– Current housing/homelessness status
– Duration of homelessness and housing crisis
– Income, employment
Services:
– Behavioral and primary health problems, other
complex service needs
– Independent living skills
– Public system involvement
– Social Supports
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10. A Proposed Housing and
Service Needs Continuum
HOUSING NEEDS
Low Moderate High
Supportive
Low
Standard VA Supportive Services for Services for
Services/Benefits Veteran Families Veteran
Families
Supportive
SERVICE NEEDS
Moderate
Services for
Supportive Services for
VA treatment Veteran
Veteran Families or
services Families or
Grant and Per Diem
Grant and Per
Diem
HUD-VASH/PSH,
High
VA Patient-Centered PACT, Safe
HUD-VASH Haven, or
Health Home
Domiciliary Care
11. Supportive Services for Veteran
Families
Helps to “complete” a community system of
response:
– Homelessness prevention
– Rapid re-housing
Program is very new – applications for new
grantees due on February 15
Most 2011 grantees have only been operating
since September
Grantees are CBOs with access to “front door” of
homeless services system
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12. What is Homeless Prevention?
Provide targeted assistance to people for whom
homelessness would be an inevitability “but for”
receiving help
Assess situation and immediate/underlying
reasons for housing crisis
Counseling/case management to problem-solve
conditions that led to housing crisis and short-
term financial assistance
May lead to connection to more intensive
housing and services interventions
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13. What is Rapid Re-housing?
Best suited to people newly experiencing
homelessness who can maintain housing on their
own with moderate to minimal supports
Combines rental assistance (either short-term or
long-term) and rental start-up costs coupled with
time-limited supportive services
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14. Who is Eligible for SSVF?
Low income vets who are homeless or about to
be homeless
Veterans and their families
– Follows HEARTH guidelines for homelessness
– Household is defined as “all persons as identified
by the Veteran, together present for services and
identify themselves as being part of the same
household”
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15. Key Considerations in
Homelessness Prevention
Must be targeted to clients who are truly at-risk of
homelessness vs. anyone in need
Services plan driven by assessment of situation and
problem solving-orientation
Services plus financial assistance
Connection to appropriate permanent housing and
services options
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16. Design of SSVF
Focus on housing stability with resources and
services designed to produce immediate impact.
Efficient use of resources concentrates efforts on
securing and maintaining housing.
Grant funding weighted towards rapid re-housing.
Case management will assist Veteran and family
with employment and benefit resources that will
promote long-term stability.
Program able to address critical barriers to
housing: legal issues, transportation, child care,
family issues.
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17. SSVF – A New “Front Door” to
Homeless Response System
Prevention services replaces shelters as “first stop”
and “gateway” to response system:
– Most obvious place for veterans experiencing or at-risk
of homelessness to seek help on their own (“walk-ins”)
– Central point of coordination for multiple intercept point
outreach/in-reach
– Ideal place for assessing needs/risks and matching/
connection veterans to most appropriate type of help
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18. Multiple Intercept Points for Outreach
and “In-Reach”
Courts
Prior Era Veterans
Psychiatric Experiencing Chronic
Jail/Prison
Hospital
Homelessness
Homeless Veterans from Prior
Shelter Street Conflicts/Era
OEF/OIF Veterans
Experiencing Homelessness
Precarious
Hospital
Housing
OEF/OIF Veterans At-Risk of
Homelessness
Alcohol/Drug
Detox
Treatment
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19. SSVF Completes a System of Response
May be most appropriate intervention for a larger
number of Veterans newly experiencing or on the
brink of homelessness
Allows for re-calibration of VASH, GPD, and
other housing interventions to fully leverage their
strengths to “unclog” homeless system
Supplements and completes the locations and
opportunities for outreach (the “front door” to
system of response)
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20. How SSVF Differs From Other
VA Programs
Remember the goal is Housing Stability and is not
contingent on treatment. A Housing First philosophy
is focus of both the homelessness prevention and
rapid re-housing interventions.
Grantees are community-based organizations
Grantees serve Veterans and their families. Families
can continue to receive services for up to a full year if
the Veteran leaves due to institutionalization, death,
or other causes.
Temporary financial assistance payments may be
provided to third parties on behalf of participants
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21. SSVF Compliments Other VA
and Non-VA Programs
A services “bridge”/enhancement to permanent
supportive housing (e.g. in conjunction with the HUD-
VASH Program).
A stand-alone, short-term, intensive case
management model (e.g. in conjunction with a
program using a critical time intervention model).
A homelessness, eviction, or housing crisis
prevention program (e.g. in conjunction with a
program such as HUD’s HPRP initiative).
In addition to VA supports, SSVF grantees access
universal prevention services, entitlements, and other
available community resources.
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Only a “systems” view allows us to think about how to end homelessness.A systems view allows us to understand how homelessness is really a function of four variables:The rate of people entering the ranks of homelessnessThe rate of people exit the ranks of homelessnessThe rate by which people return to homelessnessThe length of time people stay homeless.Focus of SSVF is to decrease the new entries into homelessness and to provide bridge services and funding to prevent a return to homelessness
It was a systems view that led to research that identified three distinct patterns and types of homelessness:Transitionally homeless – People who experience homelessness just once, only for a short period of time, and leave on their own with no to minimal help and then.Episodically homeless – People who experience homelessness on a repeated basis, usually also involved in many other public systems like jails, hospitals, and other crisis service settings.Chronically homeless – People who become homeless and remain that way for a long (semi-permanent) period of time.
Research by Randall Kuhn and Dennis Culhane found that the majority of homeless experience transitional homelessness and only a small proportion of homeless persons are episodically or chronically homeless. Transitionally homeless represent 80% of the population but only 6% of shelter resourcesEpisodically homeless represent 10% but use 28% of shelter resourcesChronically homeless represent 10% but use 68% of shelter resources
This research taught us that we need differentiated strategies to prevent or end homelessness among these different groups.For the transitionally homeless, we need to prevent their entries into homelessness in the first place or if they become homeless, rapidly connect them back to permanent housing.For the episodically and chronically homeless who have behavioral health challenges like mental health and substance use issues, we need targeted housing and services interventions to help them exit homelessness.
Putting all of these together, we can see how these differentiated strategies can help to reduce homelessness:Homelessness prevention and rapid re-housing for the transitionally homeless to reduce or stop the flow INTO homelessness.Transitional and permanent supportive housing to help increase the flow OUT of homelessness, services to KEEP them out of homelessness.
We need a differentiated response system for ending homelessness among veterans.Previously, however, this was not possible. The only kinds of resources out there were transitional housing (GPD) in addition to the standard set of VAMC services and VA benefits.With VASH, the VA substantially increased permanent supportive housing options.Now with SSVF, we can further complete this system of response adding prevention and rapid re-housing. First program for familiesLastly, we need a patient-centered health or medical home for those veterans with more severe health challenges.
With these new resources, we have the opportunity to create a complete and differentiated system of response for ending veteran homelessness. The next challenge is then to effectively match these different types of help to different types of need. So how to do that?We propose that we need a targeting approach that looks at housing and services as two separate but related dimensions. For housing, we need to look at the level of housing crisis that is being experienced and the duration of that crisis. We need to ask, can the individual or family pay for and maintain housing on their own or do they need financial and services supports to help them keep their housing, and for how long? Are they employable or on fixed income? For services, we need to look at the level of service needs and clinical barriers to successful housing. Do individuals have complex chronic health challenges or more temporary/transient barriers? Do they need help with activities of daily living? Are they involved in multiple different service systems indicating that the clients have more serious challenges? Do they have social and natural supports?
Approximately 1/3 of cases should be prevention
Approximately 2/3 of cases should be rapid rehousing