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3.6 Ending Homelessness for Veterans and Their Families
The document discusses strategies to prevent and end homelessness among veterans and their families, emphasizing the need for a comprehensive response system. It outlines various patterns of homelessness and the appropriate interventions for each, including prevention, rapid re-housing, and supportive services. The Supportive Services for Veteran Families (SSVF) program is highlighted as a new approach that facilitates housing stability and connects veterans to necessary resources.
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. 2
- 3. Understanding Homelessness as aSystem 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 3 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 4
- 5. Varying Levels ofPersistence 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 forDifferent 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 6
- 7. Decreasing Flows Inand Increasing Flows Out Homelessness Prevention Transitionally Homeless Permanent Placements into Rapid Re- Episodically Housing housing Homeless Chronically Homeless Housing Retention Supports 7
- 8. Ending Homelessness amongVeterans 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 8
- 9. Matching Needs toInterventions 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 9
- 10. A Proposed Housingand 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 forVeteran 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 11
- 12. What is HomelessPrevention? 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 12
- 13. What is RapidRe-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 13
- 14. Who is Eligiblefor 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” 14
- 15. Key Considerations in HomelessnessPrevention 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 15
- 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. 16
- 17. SSVF – ANew “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 17
- 18. Multiple Intercept Pointsfor 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 18
- 19. SSVF Completes aSystem 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) 19
- 20. How SSVF DiffersFrom 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 20
- 21. SSVF Compliments OtherVA 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. 21
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Editor's Notes
- #4 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
- #5 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.
- #6 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
- #7 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.
- #8 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.
- #9 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.
- #10 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?
- #13 Approximately 1/3 of cases should be prevention
- #14 Approximately 2/3 of cases should be rapid rehousing