HUD-VASH: The VA Perspective Teresa S. Pittman, LCSW HUD-VASH Program Analyst

Eliminating Veteran Homelessness President Obama and Secretary Shinseki are committed to eliminating homelessness for our nation’s Veterans. Eliminating Veteran homelessness is a very high national priority. VA has developed a comprehensive Five Year Plan to achieve this goal. HUD-VASH is a prominent element of the Five Year Plan.

Program Design The HUD-VASH program was developed to provide case management and supportive services paired with a “Housing Choice” Section 8 voucher to eligible homeless Veterans HUD-VASH case managers work to maintain Veterans recovery and independence HUD-VASH has the opportunity to provide permanent, stable, and safe housing to homeless Veterans

VA Side of HUD-VASH HUD-VASH is a partnership between the VA and HUD and VA case managers and PHAs Both sides need to work together to have good and timely outcomes For VA, case management is the heart of this program VA also needs other community partnerships to successfully implement this program – referrals from community, landlords, assistance with deposits, furniture, etc.

Size &Scope Over 20,000 housing vouchers Almost 600 case managers 10,150 allocated in FY08 10,290 allocated in FY09 Almost 600 case managers 291 case managers funded in FY08 292 additional case managers funded in FY09 283 FY08 Case managers are hired (97%)

Progress on FY08 Allocation 20,295 Veterans have been screened 13,825 Veterans have entered case management 11,970 Veterans have been referred to the PHA 10,707 Veterans have been issued vouchers 6,906 Veterans have been housed as of September 30, 2009

FY 08 Allocation Progress

Priority focus for HUD-VASH Eligibility Priority focus for HUD-VASH Chronically homeless with SMI Homeless Veterans with dependent Children (OEF/OIF)

Eligibility VA determines clinical eligibility PHA determines legal eligibility Meet income requirements Not on lifetime sexual offense registry requirement

Program Requirements VA Health Care Eligible Veteran Homeless (McKinney Act Definition) Needs case management to obtain and sustain independently housed in the community Must agree to participate in the case management portion of the program

Program Requirements Sustained periods of sobriety are not prerequisites for admission to HUD VASH Case managers are to coordinate and collaborate with MH and SUD providers to co-manage the treatment needs of the Veterans HUD VASH is about promoting and sustaining access to treatment and housing and other supports that nourish the Veterans Recovery and enhance their quality of life

VA Case Managers “Community Reintegration Specialist” Evolving to team approach – CM, SUD, Peer Support, Housing Specialist Will network with community advocacy groups, service providers, landlords, and local homeless Continuum(s) of Care

VA Case Management Intensity Target case management Ratio is 35:1 but program needs to match intensity of services with the needs of the veteran. Chronic homeless and families may require more intensive services especially during the engagement & stabilization phase VA moving toward the evidence based Critical Time Intervention case management model

VA Case Manager Functions Promote recovery from homelessness Mental health Substance use Physical health Assist Veteran to obtain treatment or services, as indicated Provide access to benefits & vocational services Assist with housing needs

Vital Functions of Case Management Throughout the case management process: Assessment/ Reassessment Functioning Stability Progress on established goals Developing and revising mutually agreed upon goals and actions to accomplish those targets

Non-HUD-VASH assistance HUD-VASH Flow Chart Connected with other programs and/or services: HCHV, RRTP, GPD, MH, SUD, Inpatient, Community Services, etc. for assistance Referral Outreach to Veterans and Community Referred for Non-HUD-VASH assistance Screening Veteran not eligible for Voucher Admitted Meet With PHA Voucher Issued Case Management Task: “Housing Search” Landlord development Locate suitable housing unit Inspection Lease Move In to housing unit Case Management Task: “Housing Ready” Assessment Housing and Service Plan Referral for concurrent MH, SUD, PCC Income Assistance CWT/ Employment Services VA and SS Benefits Money Management/ Credit Repair PHA Application and Documentation PHA Referral Voucher Returned to PHA Case Management Task: Sustain Housing Recovery in MH, SUD, Physical Health Transition Time Skill Development/ Practice Foster Independence Monitor Stability and Functioning Exit HUD-VASH

VA Case Manager Basics Provide case management services in: VA setting Veteran’s home Community settings Group settings Face to face meetings at least weekly Stop code 522 Group meetings count as face to face Telephone contacts Stop code 530

Exit from Case Management Veterans ready to exit from case management will have: Developed skills Achieved sustained recovery from clinical symptoms Demonstrated ability to live independently Stage transition – fewer visits, longer time between visits Communicate with PHA at all stages

Exiting from HUD-VASH Why Veteran may be exiting HUD-VASH: Veteran no longer needs case management or voucher Veteran refuses to participate in case management Veteran is incarcerated Veteran loses voucher due to PHA rule violation Veteran evicted from housing unit All reasonable efforts will be made to assist Veteran to keep the Veteran involved in the Program, unless program not needed

Community Partnerships PHAs HUD – Field Offices/ National Office Landlords Homeless Service Providers Veteran Service Organizations Law Enforcement/ Justice System Faith Based Organizations Local Homeless Continuum of Care Community at large

FY 2010 HUD-VASH Dashboard Must be accurate - shared with HUD and Congress Monitored by the year of the award (FY 08 and FY 09) Four primary sections: Hiring status information (internal to VA) Cumulative implementation of the program Current number of Veterans with vouchers and number of Veterans housed

DASHBOARD VISN Site identification information Voucher awards Site Name Site Code Number of Awarded Vouchers FTEE 2 ALBANY 528A8   FY 09 Total 70 3 W NEW YORK HCS (Buffalo) 528 CANANDAIGUA (Rochester) 528GE CANANDAIGUA 528A5 35 1 SYRACUSE 528A7 SYRACUSE (Rome) 528GM FY 09 VISN Total 245 8 VISN Site identification information Voucher awards Case manager allocations

FY 09 Dashboard Status Current Hiring Status Start Date ??/??/?? Dev Functional Statement Awaiting HR On Hold Posted Posted and closed Recruiting Screening Applicants Interviewing Selection Made Pending HR Approval Position Offered Credentialing Target Start Date Filled Recently vacated Current Hiring Status Start Date ??/??/?? Target Start Date  11/15/09 Interviewing   Recruiting  Posted and Closed Awaiting HR 

DASHBOARD Cumulative Data Automatic Calculations for: Pink = Performance Monitor Purple = Performance Measure VISN Totals Cumulative Veteran Involvement in HUD- VASH Program (FY 2009 vouchers) Veterans Screened for HUD-VASH Program Veterans Entering HUD- VASH Case Management HUD-VASH Veterans Referred to Local Public Housing Authority (PHAs) HUD- VASH Veterans Issued Voucher from PHAs Veterans Housed in HUD-VASH Performance Monitor: % of Vouchers Issued Performance Measure % Housed Returned Vouchers   0%

DASHBOARD Current Data Automatic Calculations for: Current Status Current Vouchers in Use Actual % Issued Number of Veterans Housed   0% 0.0% Current Data Automatic Calculations for: Current Vouchers in Use Percentages VISN Totals

HUD-VASH Outcome Goals End homelessness for Veterans through permanent supportive housing Veterans will sustain housing and will: Remain stable and in Recovery (Improved quality of life) Learn and use new skills and strategies Participate in cultural and social activities Be good tenants Engage in healthy practices Make thoughtful and appropriate decisions Gain independence

HUD-VASH Low Barrier Access Maintain Hope for Veterans VHA Handbook 1162.05 Internet http://www1.va.gov/vhapublications/ Intranet http://vaww1.va.gov/vhapublications/ Sharepoint: http://vaww.national.cmop.va.gov/MentalHealth/HUDVASH/Forms/AllItems.aspx

Contact Information Please contact me if you have questions or want to discuss specific program concerns: Teresa Pittman VA Central Office 810 Vermont Ave. NW Washington, D.C. 20420 202-461-7308 Teresa.Pittman@va.gov