Resources and Services to Address the Needs of Homeless Women Veterans The National Center on Homelessness Among Veterans Delivering coordinated, collaborative evidence based solutions to end Veteran Homelessness Resources and Services to Address the Needs of Homeless Women Veterans Stephanie George, LCSW Clinical Project Coordinator The National Center on Homelessness Among Veterans VHA Homeless Programs

5 Year Plan and VA Programs to End Homelessness Secretary's Plan to End Homelessness among Veterans In 2009, Secretary Eric Shinseki announced the Five Year Plan to End Homelessness among Veterans. Seeks to better coordinate our resources, improve collaboration, create new programs, and enhance research and policy to end the indignity of Veteran homelessness. Overview of Homeless Programs Increase in and enhancement of programs and types of services over the years. Homeless Veteran Population This comprehensive plan has already produced results yielding a 12% decrease in the number of homeless Veterans from January 2010 to January 2011.

Homeless Women Veterans Female Veterans are the fastest growing segment of the homeless population Women who are Veterans are at much higher risk of homelessness than male counterparts In FY 2011 there were 198,908 Veterans served, 8.2% were OEF/OIF/OND Veterans, of those 7.7% (15,306) were women Veterans In FY 2012 we see an increase in women Veterans from 7.7% to 8.6% (18,375) Source: Vasquez, S. Homelessness Among Women Veterans PowerPoint presentation; July 2011 National Summit on Women Veterans. http://www.va.gov/WOMENVET/2011Summit/VasquezFINAL.pdf

Homeless Women Veterans and Disabilities VA data indicate that over 40% of VA-identified homeless women Veterans had disabilities and a corresponding disability rating (see note page) Among those, homeless women were more likely than homeless men to have a rating of 50% or higher The most frequent diagnoses among homeless women Veterans with a disability rating were musculoskeletal conditions followed by mental disorders and eating disorders Women Veterans are at risk of homelessness because they have disabling psychological conditions, such as Post-Traumatic Stress Disorder and Major Depressive Disorder, often resulting from experiencing military sexual trauma (MST) Or are single mothers facing challenges with readjustment to civilian life GAO cites “limited VA data.” Source: GAO Report, Dec. 2011 “Homeless Women Veterans: Actions Needed to Ensure Safe and Appropriate Housing” http://www.gao.gov/assets/590/587334.pdf

Homeless Female Veterans Female Veterans are the fastest growing segment of the homeless population Women who are Veterans are at much higher risk of homelessness than male counterparts Women comprise roughly 6% of the 116,000 Veterans that were provided VA Homeless Services in FY2010 Currently, 12% of HUD-VASH recipient Veterans are women Female Veterans are almost 3x (2.7) more likely to be in the homeless population than non-Veteran female population

Homeless Women Veterans and Unemployment The characteristics of homeless women Veterans who reported receiving disability compensation were largely similar to those who did not report compensation. However, a larger percentage were unemployed (86% compared to 71% for those without disability compensation) Source: GAO Report, Dec. 2011 “Homeless Women Veterans: Actions Needed to Ensure Safe and Appropriate Housing” http://www.gao.gov/assets/590/587334.pdf

Veteran Women Face Many Barriers to Employment Job market Economy Child care Transportation Benefits Basic contact information Clothing Stigma Legal issues

Risks Specific to Women Veterans Some women Veterans are at risk of homelessness because they have disabling psychological conditions, such as Post-Traumatic Stress Disorder and Major Depressive Disorder, often resulting from experiencing military sexual trauma Or are single mothers facing challenges with readjustment to civilian life Source: GAO Report, Dec. 2011 “Homeless Women Veterans: Actions Needed to Ensure Safe and Appropriate Housing” http://www.gao.gov/assets/590/587334.pdf*The term “veteran housing” is used in this report to refer exclusively to the housing offered by the GPD and HUD-VASH programs

Possible Barriers to Veteran Housing Homeless women Veterans face barriers when accessing and using Veteran housing,* including: lack of awareness of these programs lack of referrals for temporary housing while awaiting placement in GPD and HUD-VASH housing limited housing for women with children concerns about personal safety Source: GAO Report, Dec. 2011 “Homeless Women Veterans: Actions Needed to Ensure Safe and Appropriate Housing” http://www.gao.gov/assets/590/587334.pdf *The term “Veteran housing” is used in this report to refer exclusively to the housing offered by the GPD and HUD-VASH programs.

VA Homeless Housing Programs: HUD-VASH HUD-VASH-Housing and Urban Development-Veterans Affairs Supportive Housing Program is a collaborative program between HUD and VA in which eligible homeless Veterans receive VA provided case management and supportive services to support stability and recovery from physical and mental health, substance abuse, and functional concerns contributing to or resulting from homelessness. Goals of the program are promote maximal Veteran recovery and independence to sustain permanent housing provided through the voucher. Outcomes of HUD-VASH: 11% of HUD-VASH recipient Veterans are women Women Veterans often have families with children and they are more likely to be offered HUD-VASH vouchers HUD and VA are working together to provide services for over 47,000 homeless Veterans Source: Pape, Lisa. Homelessness Among Women Veterans PowerPoint presentation; September 2012 Emerging Practices in VHA Homeless Programs : Systems and Services ( VA Virtual Conference)

VA Homeless Housing Programs: GPD GPD-Homeless Providers Grant and Per Diem Program allows VA to award grants to community-based agencies to create transitional housing programs and offer per diem payments. The purpose is to develop supportive housing options and services to homeless Veterans to achieve residential stability, increase skill set and level of income. The GPD program offers communities a way to help homeless Veterans with housing and services while assisting VA medical centers by augmenting or supplementing care. Outcomes of GPD: More than 200 Grant Per Diem (GPD) programs have some capacity to serve women Veterans Of the projects that have some capacity to serve women, approximately 40 are women-specific GPD Program has 38 operational projects that have indicated some capacity to serve women with dependent children within their programs. Six projects receive Special Need Grants to provide enhanced services to homeless women Veterans 5% of Veterans in GPD are women Source: Pape, Lisa. Homelessness Among Women Veterans PowerPoint presentation; September 2012 Emerging Practices in VHA Homeless Programs : Systems and Services ( VA Virtual Conference)

VA Homeless Housing Programs DCHV-Domiciliary Care for Homeless Veterans program provides time-limited residential treatment to homeless Veterans with health care and social-vocational deficits. DCHV programs provide homeless Veterans access to medical, psychiatric, and substance use disorder treatment in addition to social and vocational rehabilitation programs. HCHV-Health Care for Homeless Veterans programs reduces homelessness among Veterans by conducting outreach to those who are the most vulnerable and are not currently receiving services and engaging them in treatment and rehabilitative programs. The Contract Residential Treatment Program ensures that Veterans with serious mental health diagnosis can be placed in community-based programs which provide quality housing and services. Outcomes of Emergency Housing: Of the 3,738 Veterans served in Emergency housing in FY 2011 3.7% (138) were women. Source: Pape, Lisa. Homelessness Among Women Veterans PowerPoint presentation; September 2012 Emerging Practices in VHA Homeless Programs : Systems and Services ( VA Virtual Conference)

Homeless Prevention Programs for Veterans: SSVF SSVF-Supportive Services for Veteran Families provides supportive services to very low-income Veterans families in or transitioning to permanent housing. Funds are granted to private non-profit organizations and other community partnerships to provide supportive services and to promote housing stability. Outcomes of SSVF: As of July 2012 SSVF has served 24,652 YTD, exceeding the annual projection of 22,000. Significant impact on Veteran families with 6,047 children assisted. Of 14,896 Veteran participants, 2,179 are women (14.6% of Veterans served). 2,307 Veteran participants are OEF/OIF/OND (15.5% of Veterans served). Source: Pape, Lisa. Homelessness Among Women Veterans PowerPoint presentation; September 2012 Emerging Practices in VHA Homeless Programs : Systems and Services ( VA Virtual Conference)

Homeless Prevention Programs for Veterans: NCCHV NCCHV-VA’s Nat’l Call Center for Homeless Veterans assists homeless Veterans or Veterans at-risk for homelessness with 24/7 access to trained counselors. Veterans, family members, VAMCs, Federal, state, local partners, community agencies, and service providers have access to the call center (1-877-4AID VET). Successful Outcomes of NCCHV: Since March 2010, the call center has received 97,510 calls (end of June 2012) Over 11,000 calls were for/about women and of those: Over 1700 were homeless women Veterans Over 7,600 were at risk of homelessness Source: Pape, Lisa. Homelessness Among Women Veterans PowerPoint presentation; September 2012 Emerging Practices in VHA Homeless Programs : Systems and Services ( VA Virtual Conference)

Homeless Veterans Supported Employment Program (HVSEP) HVSEP-The HVSEP is in the process of hiring 400 homeless or formerly homeless Veterans with disabilities and VA expanded existing training and support for Veterans to acquire the skills necessary to obtain and sustain employment. The HVSEP model is a collaborative effort between the Compensated Work Therapy (CWT) and Homeless Veterans Programs. VA Medical Centers were required to recruit, hire, and train Veterans who are homeless, formerly homeless, or at-risk of homelessness for the VRS positions. Eligibility is minimal: Veteran is eligible for Veterans Health Administration services. Veteran wants immediate competitive employment. Veteran has a sporadic work history (e.g., unable to hold a competitive job longer than three months). Veteran is unable to obtain employment independently.   Source: Pape, Lisa. Homelessness Among Women Veterans PowerPoint presentation; September 2012 Emerging Practices in VHA Homeless Programs : Systems and Services ( VA Virtual Conference)

CHALENG Survey Results: Understanding the Needs of Veteran Women Since 1993, VA has collaborated with local communities across the United States on Project CHALENG for Veterans. The vision of CHALENG is to bring together homeless and formerly homeless Veterans, providers, advocates, local officials, and other concerned citizens to identify the needs of homeless Veterans and then work to meet those needs through planning and cooperative action.

Overview of early data from the 2011 report NUMBER OF RETURNED SURVEYS: 17,953 VETERANS: 11,446 705 (7%) FEMALE VETERANS 9,885 (93%)MALE VETERANS 856 No Gender indicated COMMUNITY PARTNERS: 4,376 VA STAFF: 2,131

Age of Veteran CHALENG Participants Homeless Veterans (n=11,241)* Male Veterans (n=9,794) Female Veterans (n=692) Less than 25 1% 3% 25-34 5% 4% 14% 35-44 11% 10% 20% 45-54 41% 55-64 37% 39% 65+ 2% *205 participants did not indicate their age. **Sample of male and female Veterans do not add up to total because of respondents who did not indicate age or gender.

Race/Ethnicity of Veteran CHALENG Participants Homeless Veterans (n=11,168)** Male Veterans (n=9,732) Female Veterans (n=697) AHAR (2010) African American 41% 40% 42% 35% American Indian/ Alaskan Native 2% 3% Asian/ Pacific Islander <1% Hispanic 5% 6% White 48% 44% 52% Other 4% ** 278 participants did not indicate their ethnicity **Sample of male and female Veterans does not add up to total because of respondents who did not indicate ethnicity or gender.

Veteran CHALENG Participants: Chronicity Chronically Homeless indicators Homeless Veterans (n=11,318)* Male Veterans (n=9,838) Female Veterans (n=701) Homeless a year or more AND/OR experienced four episodes of homelessness in the past three years. 59% 60% 45% *Does not include 128 homeless Veterans that did not complete one of the two chronically homeless questions. **Sample of male and female Veterans does not add up to total because of respondents who did not indicate time homeless or gender.

Housing Situation of Veteran CHALENG Participants Where homeless Veteran CHALENG Participant was living at time of Survey Homeless Veterans (n=10,853)* Male Veterans** (n=9,440) Female Veterans** (n=667) Literally Homeless (on streets, in shelter, car) 23% 20% In VA DCHV 17% 12% In VA GPD or other Transitional housing program 32% 33% 21% In Permanent Housing (including Section 8 Housing) 28% 27% 48% *Does not include 593 homeless Veterans who indicated no housing status. **Sample of male and female Veterans does not add up to total because of respondents who did not indicate housing status or gender.

Highest Unmet Needs of Veteran CHALENG Participants Rank All Veterans Male Female 1 Financial assistance to prevent eviction/foreclosure Housing for registered sex offenders 2 Dental care 3 Legal assistance to prevent eviction/foreclosure 4 Child care 5 Welfare payments 6 Legal assistance for child support issues Legal assistance for outstanding warrants/fines 7 Goods (furniture, housewares) for new apartment Credit counseling 8 Move-in assistance (rent and utility security deposits) Family reconciliation assistance 9 10 Discharge upgrade

Highest Unmet Needs by Housing Situation Rank Veterans Literally Homeless (shelter, street, or environment unfit habitation) (n=2,458) Veterans in Transitional Housing (VA Grant and Per Diem and Domiciliary) (n=5,319) Veterans in Permanent Housing (including HUD-VASH) (n=3,076) 1 Long-term, permanent housing Financial assistance to prevent eviction/foreclosure Dental care 2 Move-in assistance (rent and utility security deposits) Legal assistance to prevent eviction/foreclosure Housing for registered sex offenders 3 Goods (furniture, housewares) for new apartment Child care Legal assistance for outstanding warrants/fines 4 Legal assistance for child support issues 5 6 7 Welfare payments 8 Credit counseling Family reconciliation assistance 9 Legal assistance to help restore a driver's license 10

VA Needs Your Help View the CHALENG Survey report and the breakdown of your VISN. http://www.va.gov/HOMELESS/chaleng.asp

Questions or Comments Stephanie George, LCSW National Center on Homelessness among Veterans Stephanie.george@va.gov