1. Health Care for Homeless Veterans Programs (HCHV)
Eileen Devine, LCSW
National Director, Health Care for Homeless Veterans
June 1, 2017

2. History Lesson on HCHV and VA Homeless Programs
Core Mission: Outreach to Homeless Veterans
1987 Homeless Chronically Mentally Ill (HCMI) Program, a 6-month pilot project established by Public Law (Pub. L.) 100-6, introduced.
1992 VHA Grant & Per Diem Program introduced.
1994 HCMI renamed HCHV.
2008 Congress funds 10,000 HUD-VASH vouchers.
2015 Public Law H.R was enacted which modified HCHV authority to allow expanded services to Veterans who do not have a SMI diagnosis.

3. Components of the HCHV Program
HCHV Outreach and Homeless Case Management (HCM)
HCHV Permanent Supportive Housing Case Management (PSH)
Contracted Residential Services (CRS)
Low Demand Safe Havens (LDSH)
Community Resource and Referral Centers (CRRC)
Stand Downs
Lead for VA’s participation in coordinated entry at the VACO level

4. HCHV Case Management
The HCHV Case Management Model consists of two different types of case management:
Homeless Case Management (HCM) is initiated through outreach with the focus on providing access to housing resources and monitoring of Veteran involvement with appropriate VA and community-based providers throughout the continuum of services. Homeless Case Management is generally short-term in duration.
Permanent Supportive Housing (PSH) Case Management is initiated through VA and/or community partner referrals. PSH Case Management ensures Veterans have access to clinical and social support services necessary to maintain independent housing. PSH Case Management is typically long-term in duration and is not meant for Veterans that are served in the HUD-VASH program.

5. Contract Residential Services
Targets and prioritizes homeless Veterans transitioning from literal street homelessness, Veterans being discharged from institutions, including who recently became homeless and require safe and stable living arrangements while they seek permanent housing.
Emphasis is placed on referral and placement in permanent housing or longer term residential programs utilizing VA and/or community resources. Lengths of stay in CERS typically range from 30 to 90 days with the option to extend based on clinical need.
NOTE: CRS programs represent a consolidation of existing HCHV contract residential programs, previously designated as either residential treatment (RT) or emergency housing (EH). Since varying levels of supportive services have been present in both, as noted above, this consolidation reflects the range and flexibility of these services as currently constituted.

6. Low Demand Safe Havens
Low Demand Safe Havens (LDSH) are 24-hour staffed transitional residences with private or semi-private accommodations, that target the population of hard-to-reach, chronically homeless Veterans with mental illness and/or substance use problems who require a low-demand environment.
The low-demand or non-intrusive environment is designed to re-establish trust and motivate the homeless Veteran to seek needed treatment services and transitional and permanent housing options.
Lengths of stay in LDSH programs are typically 6 months with the option to extend based on clinical need.
Four model development projects introduced through VA’s National Center on Homelessness among Veterans in July 2010; then expanded to 15 additional sites.

7. HCHV Contract Residential Programs – Then and NowFY
Available beds
Available beds (LDSH)
Totals
HCHV Fiscal Support
Veterans Served
Exits to Permanent Housing
2009
859
2,847
959
2010
1602
4,140
1278
2011
2304 60
2364
8,129
2613
2012
3265
134
3399
$47,892,963.00
11,496
3863
2013
3598
3732
$74,449,284.00
13,525
4747
2014
3688
373
4061
$74,549,848.00
15,739
6626
2015
3785
460
4245
$97,123,971.00
16,723
7655
2016
3706
440
4146
$97,584,055.00
17,326
7830

8. Community Resource and Referral Centers
CRRCs are a collaborative effort of VA, the community, service providers, and agency partners.
The primary goal of the CRRC is to provide rapid and comprehensive homeless services to Veterans who are experiencing homelessness in a “one-stop” environment with the lowest barriers to services possible.
The CRRCs are located in 30 strategically selected communities to provide both a refuge from the streets and a central location to engage homeless Veterans in services.
CRRCs have been modeled after research that indicates: the creation of provider networks impacts housing gains; service integration leads to improved outcomes; non-restrictive approaches support client engagement and retention in services.

9. Stand Downs
1-3 day events held by community agencies in partnership with VA.
Range of services may include: food, shelter, clothing, health screenings, dental services, legal services, VA and Social Security benefits counseling. In addition, referrals to a variety of other services including medical, mental health and substance abuse treatment, as well as information on housing and employment resources.
HCHV staff often serve as the local VA facility Point of Contact (POC) for these events.
POCs assist in coordinating the involvement of other VA staff members and outlining their roles in supporting Stand Downs.

10. VA Medical Center’s role in CES
Development of Guidance for VAMCs
Areas of Key Focus:
Data sharing
Case Conferencing and BNL Participation
BoS and Rural CoC participation
Internal VA Operations
Participation on CoC Boards

11. HCHV Then & Now Program 2008 2016 HCHV funded FTE 335 620
HCHV Outreach (# Veterans Served)
70,870
157,061
CRS Beds
832
4,146
CRS Program (# Veterans Served)
1,600
17,326
Safe Havens (# programs) 22
Safe Havens (# Veterans served)
1,609
CRRCs (# sites) 30
Stand Downs
157
353

12. Discussion
Comments or Questions?