VA Homeless Prevention Workshop August 2011 Corporation for Supportive Housing CSH is a national nonprofit organization that helps communities create permanent housing with services to prevent and end homelessness ID: 720232
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Prevention’s Place in a Community System of Response to Homelessness among Veterans
VA Homeless Prevention Workshop
August 2011Slide2
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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Understanding Homelessness as a System of “Flows”
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Prevalence of Homelessness is a function of rate of “flows in”, rate of “flows out,” rate of returns to homelessness, and length of stay
New Entries into Homelessness
Exits from Homelessness
Homelessness
Returns to HomelessnessSlide4
A Core Philosophy and Model: “Housing First”
Ending homelessness always begins with a home
All forms of help to end homelessness must first solve the problem of housing
housing first“Housing First” as both a philosophy and a model:The principle of rapidly connecting people to permanent affordable housing without behavioral/clinical preconditionsA model of housing linked to multiple, wrap-around services designed to meet complex needs of people who have been (or are headed to become) homeless for very long periods
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Varying Patterns of Homelessness
Transitionally Homeless
Experience homelessness in a single occurrence lasting only a brief period of time
Episodically HomelessExperience homelessness as an “institutional circuit”, and cycle between jails, hospitals, and other crisis services along with sheltersChronically HomelessExperience homelessness for long periods, often as a semi-permanent state5Slide6
Varying Levels of Persistence
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Chronically Homeless represent 10%, but use 66% of shelter resources
Episodically Homeless represent 10%, but use 28% of shelter resources
Transitionally Homeless represent 80%, but use only 6% of shelter resources
Source: Kuhn and Culhane (1998)Slide7
Different Strategies for Different Patterns of Homelessness
Pattern
Strategy
Transitionally HomelessPrevent entry into homelessness in the first place
Episodically
Homeless
Rapid re-housing
Transitional housing
Permanent supportive housing
Chronically HomelessPermanent
supportive housing7Slide8
Decreasing Flows In and Increasing Flows Out
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Homelessness Prevention
Permanent Placements into Housing
Rapid Re-housing
Housing Retention Supports
Transitionally Homeless
Episodically
Homeless
Chronically
HomelessSlide9
Ending Homelessness among Veterans Needs Complete “System of Response”
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Patient-Centered Health Home
Standard VA Services and Benefits
Rapid Re-Housing
Homeless Prevention
Supportive Services for Veteran Families
Enhanced “Housing First” Supportive Housing
Permanent Supportive
Housing
HUD-VASH
Transitional Housing
Grant & Per Diem ProgramSlide10
Matching Needs to Interventions
Measure “Needs” along 2 Dimensions:
Housing:
Current housing/homelessness statusDuration of homelessness and housing crisisIncome, employmentServices:Behavioral and primary health problems, other complex service needsIndependent living skillsPublic system involvementSocial Supports
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Full Coverage of Range of Needs among Homeless and At-Risk Veterans
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HOUSING NEEDS
SERVICES NEEDS
LOW
HIGH
HIGH
LOW
HOUSING FIRST SUPPORTIVE HOUSING
TRANSITIONAL HOUSING
RAPID REHOUSING
HOMELESSNESS PREVENTION
PATIENT-CENTERED HEALTH HOME
STANDARD PACKAGE OF VA SERVICES AND BENEFITS
OTHER SUPPORTIVE HOUSINGSlide12
Is disabled, has PTSD, and/or has complex behavioral health needs?
The Targeting “Decision-Tree”
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Veterans returning from OEF/OIF
Enhanced Housing First Supportive Housing
Homeless?
Yes.
No.
Is disabled, has PTSD, and/or has complex behavioral health needs?
Is unemployed, non-acute mental health or substance use, or other barriers to self-sufficiency?
Is disabled, has PTSD, and/or has complex behavioral health needs?
Yes.
No.
Rapid Re-Housing
Transitional Housing
Is at-risk of homelessness, precariously or unstably housed?
Yes.
No.
Yes.
No.
Yes.
No.
Permanent Supportive Housing
Yes.
No.
Homelessness Prevention
Patient-Centered Health Home
Standard VA services
Chronically Homeless?
Yes.
No.
Veterans from Prior Conflicts/Eras (e.g. Vietnam)Slide13
Transitional Housing
Best suited for veterans experiencing transitional to episodic homelessness who have moderate service needs and moderate housing needs
With recovery supports and employment services, veterans can become largely self-sufficient
13Slide14
Permanent Supportive Housing
Most effective model for helping chronically (and episodically) homeless veterans permanently exit homelessness
Suited for veterans with high service needs and high housing needs
Primary focus is increase housing stability as foundation for improved health and reduced use of crisis service systems (Housing First approach)
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Homeless Prevention
Provide targeted assistance to people for whom whose 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 assistanceMay lead to connection to more intensive housing and services interventions15Slide16
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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Opportunities through SSVFSlide18
Supportive Services for Veteran Families
Helps to “complete” a community system of response:
Homelessness prevention
Rapid re-housingCreates opportunity for more coordinated approach to outreach (the “front door” to system of response)Allows for re-calibration of VASH, GPD, and other housing interventions to fully leverage their strengths to “unclog” homeless system18Slide19
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-reachIdeal place for assessing needs/risks and matching/ connection veterans to most appropriate type of help19Slide20
Multiple Intercept Points for Outreach and “In-Reach”
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Prior Era Veterans Experiencing Chronic Homelessness
Homeless Veterans from Prior Conflicts/Era
OEF/OIF Veterans Experiencing Homelessness
OEF/OIF Veterans At-Risk of HomelessnessSlide21
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 assistanceConnection to appropriate permanent housing and services options21Slide22
Why Should the VA work with community-based partners?
Not a solo act:
Ending homelessness is beyond the capacity of any one public system and government agency
Don’t reinvent the wheel: CBOs often have decades of experience and existing infrastructure for ending homelessnessExpand housing and services options: Increase potential for choice, customization, and matching of needs to models22Slide23
Steps to Building a Coordinated System of Response
Summits for ending homelessness
– Convene VA and community partners in day-long gathering and knowledge/practice exchange
Cross training for staff – Train housing providers about VA resources and military cultural competency; and train VA staff about housing options and strategies for serving high-needs individuals Build coordinated “front door” by convening outreach providers and institutional settings that encounter homeless and at-risk veteransPursue systems improvement efforts, such as a VASH Housing Placement Boot Camp
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For More Information
Erin Healy, Associate Director, NY
erin.healy@csh.org
Jonathan Hunter, Managing Dir., Western Regionjonathan.hunter@csh.orgRichard Cho, Director, Innovations & Researchrichard.cho@csh.org
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