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Prevention’s Place in a Community System of Response to Homelessness among Veterans VA Homeless Prevention Workshop August 2011.

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Presentation on theme: "Prevention’s Place in a Community System of Response to Homelessness among Veterans VA Homeless Prevention Workshop August 2011."— Presentation transcript:

1 Prevention’s Place in a Community System of Response to Homelessness among Veterans VA Homeless Prevention Workshop August 2011

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 a System of “Flows” 3 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 Homelessness

4 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: 1.The principle of rapidly connecting people to permanent affordable housing without behavioral/clinical preconditions 2.A 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 4

5 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 5

6 Varying Levels of Persistence 6 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)

7 Different Strategies for Different Patterns of Homelessness PatternStrategy Transitionally Homeless  Prevent entry into homelessness in the first place Episodically Homeless  Rapid re-housing  Transitional housing  Permanent supportive housing Chronically Homeless  Permanent supportive housing 7

8 Decreasing Flows In and Increasing Flows Out 8 Homelessness Prevention Permanent Placements into Housing Rapid Re- housing Housing Retention Supports Transitionally Homeless Episodically Homeless Chronically Homeless

9 Ending Homelessness among Veterans Needs Complete “System of Response” 9 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 Program

10 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 10

11 Full Coverage of Range of Needs among Homeless and At-Risk Veterans 11 HOUSING NEEDS SERVICES NEEDS LOWHIGH LOW HOUSING FIRST SUPPORTIVE HOUSING TRANSITIONAL HOUSING RAPID REHOUSING HOMELESSNESS PREVENTION PATIENT- CENTERED HEALTH HOME STANDARD PACKAGE OF VA SERVICES AND BENEFITS OTHER SUPPORTIVE HOUSING

12 Is disabled, has PTSD, and/or has complex behavioral health needs? The Targeting “Decision-Tree” 12 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)

13 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 13

14 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) 14

15 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 assistance May lead to connection to more intensive housing and services interventions 15

16 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 16

17 Opportunities through SSVF

18 Supportive Services for Veteran Families Helps to “complete” a community system of response: –Homelessness prevention –Rapid re-housing Creates 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 system 18

19 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 19

20 Multiple Intercept Points for Outreach and “In-Reach” 20 CourtsJail/PrisonStreetHospitalDetox Alcohol/Drug Treatment Precarious Housing Shelter Psychiatric Hospital Prior Era Veterans Experiencing Chronic Homelessness Homeless Veterans from Prior Conflicts/Era OEF/OIF Veterans Experiencing Homelessness OEF/OIF Veterans At-Risk of Homelessness

21 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 21

22 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 homelessness Expand housing and services options: Increase potential for choice, customization, and matching of needs to models 22

23 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 veterans Pursue systems improvement efforts, such as a VASH Housing Placement Boot Camp 23

24 For More Information Erin Healy, Associate Director, NY erin.healy@csh.org Jonathan Hunter, Managing Dir., Western Region jonathan.hunter@csh.org Richard Cho, Director, Innovations & Research richard.cho@csh.org 24


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