Category Archives: Continuum of Care

Urban Institute Study on the 100,000 Homes Campaign

An Urban Institute study, just out, concludes that “the 100,000 Homes Campaign had a major impact on national efforts to end homelessness.” Researchers noted that communities that participated in the Campaign reported greater reductions in unsheltered, veterans, and chronic homelessness than non-participants.  Over the life of the campaign, the average community saw a 262% increase in the percent of the community’s homeless population housed each month.

This news is great for us locally because we are working toward incorporating best practices that evolved from the campaign, particularly in Hampden County, where we are participating in the follow-up Zero 2016 campaign.

As noted in a Community Solutions blog post, several of the Campaign’s core strategies were associated with greater reductions in homelessness, including:

  • Transparent, monthly tracking and reporting  Communities that publicly tracked the number of people moving into housing each month against predetermined monthly targets on the Campaign’s website saw significantly greater reductions in homelessness than communities that neglected this measurement-based approach.
  • Registry weeks  Communities that completed a registry week, in which community members document every person experiencing homelessness by-name, saw chronic homelessness decline by 26 percent, while those who did not complete registry weeks saw reductions of only one percent.

HUD guidance on prioritizing persons with highest level of need in permanent supportive housing

A message from Ann Oliva, HUD’s Deputy Assistant Secretary for Special Needs:

In a perfect world, there would be enough affordable housing and supportive services to ensure that no one has to experience homelessness. But what do you do when there are not enough resources to achieve that vision? At the local level, this is all too familiar. Every day you are having to make decisions about who to serve when there simply are not enough beds and resources to serve everyone. This is also a dilemma that HUD and its Federal partners have been grappling with in recent years, particularly as appropriated funds become more and more limited. Here at HUD we are working hard to secure additional resources, as reflected in the President’s FY 2016 Budget request, to make sure that communities have the necessary resources to end homelessness locally.

Although the Opening Doors goal of ending chronic homelessness has been pushed back to 2017 we cannot afford to wait for those resources. The most important thing that communities can do to maximize resources is to ensure that all homelessness assistance is prioritized for homeless households with the highest needs. HUD recently published a policy brief on coordinated entry that talked about this more broadly. Today, however, I want to focus on prioritization in permanent supportive housing.

We know that permanent supportive housing is the most intensive solution that HUD has to combat homelessness. Research has consistently found that permanent supportive housing is the most effective solution for people experiencing chronic homelessness. It is not a one-size-fits-all approach and should only be offered to those households that truly need that level of support. Most people experiencing homelessness may need some level of assistance but do not likely need permanent supportive housing. Yet, unless there is a systematic way to prioritize households with the highest needs, this is often not who receives this type of assistance.

For this reason, HUD published the Notice CPD-14-012: Prioritizing Persons Experiencing Chronic Homelessness in Permanent Supportive Housing and Recordkeeping Requirements for Documenting Chronic Homeless Status(Prioritization Notice) in July 2014. The Prioritization Notice established an order of priority for households served in permanent supportive housing and provided uniform recordkeeping requirements for all recipients of CoC Program-funded permanent supportive housing to document the chronically homeless status of program participants. HUD has received significant feedback since publishing the Prioritization Notice and has recently posted Frequently Asked Questions to address the most common questions and concerns.

As you know, the original goal of Opening Doors was to end chronic homelessness by 2015. Progress towards this goal has been slower than we hoped, due in large part to budgetary constraints which have made it necessary to push the goal back two years. While insufficient resources has been a significant challenge, we can also look at our existing stock of permanent supportive housing as reported on the 2014 Housing Inventory Count and see that despite making significant gains on the number of permanent supportive housing available, the overall percentage of those permanent supportive housing beds funded under the CoC Program that are dedicated to serving persons experiencing chronic homelessness is only 30 percent. Far too many CoCs and recipients continue to place people in permanent supportive housing on a first-come-first serve basis, rather than prioritizing those who have the most significant needs. Additionally, where CoCs and providers continue to not fully implement a Housing First approach, unnecessary barriers that screen out those households who need the assistance the most continue to persist.

The overarching intent of the Prioritization Notice is to move CoCs and recipients of CoC Program funding for permanent supportive housing in a direction where chronically homeless persons and other high need households are prioritized for assistance above other eligible households. I also want to be clear—we are not saying prioritize chronically homeless individuals over all other household types. To the extent that a recipient of CoC Program-funded permanent supportive housing is targeting unaccompanied youth, for example, HUD would only expect for the recipient to first serve any unaccompanied youth that met the definition of chronically homeless and if there are not any youth within the CoC that meet that criteria, to then prioritize those unaccompanied youth with the highest needs in accordance with the Prioritization Notice. HUD strongly encourages CoCs to incorporate the process described in the Prioritization Notice into their written standards, making it a requirement of all recipients of all CoC Program-funded permanent supportive housing to use this priority order to fill vacancies.

We will not end chronic homelessness as a nation unless we systematically prioritize persons experiencing chronic homelessness and do so in a manner that ensures persons with the longest histories of homelessness and most severe services needs get housing first. Therefore, the Prioritization Notice establishes two orders of priority—one for beds that are either dedicated or prioritized for persons experiencing chronic homelessness and another for those that are not—both of which aim to prioritize persons with the longest lengths of time homeless and the most severe service needs. Recipients should examine their program design to ensure that it adheres to Housing First principles and that barriers to program entry have been removed to the greatest extent possible.

We recognize that serving people experiencing chronic homelessness and other highly vulnerable populations may require enhanced services that will increase costs, staff training and support needs, and present other challenges for providers. Recipients are encouraged to explore partnering with community resources to meet the needs of their new tenants. New or expanded partnerships with agencies with the expertise and resources to serve this population and a shared goal of stabilizing housing may be essential to ending chronic homelessness in your community.

Recently the Department of Health and Human Services (HHS) published two new documents that provide guidance on how services that are provided in permanent supportive housing can be covered and financed through Medicaid. These documents include Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants of Permanent Supportive Housing andMedicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field. Shortly after the documents were released, the U.S. Interagency Council on Homelessness posted a blog by Richard Cho: Medicaid Can Pay for Services for People in Permanent Supportive Housing. The blog helps to summarize what you can find in these HHS resources and how Medicaid can be used to finance permanent supportive housing for the chronically homeless. I would encourage you to read his message along with the HHS documents because, as Richard states, “We need more Continuums of Care and homeless services providers to learn to speak the language of Medicaid.” HUD expects CoC-Program funded recipients and CoCs to closely examine opportunities to help clients access Medicaid and other mainstream supportive services as quickly as possible. CoC-Program funding should not be used to pay for Medicaid-eligible services for Medicaid-eligible clients.

We believe that ending chronic homelessness is possible but it cannot be done without you. Thank you for all that you do in your community’s efforts to end homelessness.

As always, thank you for your commitment and hard work.

Ann Marie Oliva
Deputy Assistant Secretary for Special Needs

RFPs Available: Springfield ESG program; Hampden-Hampshire-Franklin HOPWA program

The City of Springfield has released Requests for Proposals (RFPs) for the Emergency Solutions Grant (ESG) program and the Housing Opportunities for Persons with AIDs (HOPWA) program. The RFPs and required forms may be accessed below. Applications are due back to the City of Springfield Office of Housing no later than 4 pm on April 16, 2015.

Springfield FY2015 Emergency Solutions Grant (ESG) program:

Hampden-Hampshire-Franklin FY2015-2017 Housing Opportunities for Persons with AIDs (HOPWA) program:

 

 

A Housing System Built for Zero Part Two: Assessment and the Role of By-Name Lists

The second part of a three part post from the Zero 2016 campaign:

A Housing System Built for Zero Part Two: Assessment and the Role of By-Name Lists

Last month, many of the 71 communities participating in Zero:2016 launched their local participation during the federal Point-in-Time (PIT) Count. This annual count of sheltered and unsheltered people experiencing homelessness gathers important data for tracking federal trends, setting policy and allocating national resources – but this anonymous count does have some drawbacks. It does not provide the necessary information that housing and service workers need in order to follow up with people experiencing homelessness in their communities and connect them to housing. That’s why 49 Zero: 2016 communities across the country went the extra mile this year, taking care to meet all federal count standards while also using the PIT count as an opportunity to implement the first of four components of a coordinated assessment and housing placement system: assessment.

Experience has shown us that a community cannot gather the necessary information to house its homeless neighbors solely by counting them anonymously once a year. As New Orleans’ successful drive to end veteran homelessness has shown, a local team must know the names and unique needs of every person on its streets and in its shelters. That’s where assessment comes in. By learning names, documenting stories and understanding the most urgent needs of each of their homeless neighbors, communities can take a critical step toward moving people off the streets and into housing.

In order to collect this by-name information, many communities across the country are selecting, or have already selected, a Common Assessment Tool (CAT).

A CAT is a standard set of questions used by all agencies and organizations in a community that allows the local team to quickly assess people based on their unique circumstances and needs. Additionally, it helps outreach workers and service providers find the best housing match to fit these needs. CAT data creates the foundation of an informed CAHP system, offering a birdseye view of everyone experiencing homelessness in a community and providing a way to connect each person to the most appropriate housing option, in line with research, chronic and veteran status and other local priorities.

If a connection to permanent housing and services is the output of a well functioning CAHP system, then by-name CAT data is the critical input. Without it, it’s hard to connect people to housing in a strategic or comprehensive way.

In order to maximize the impact of a CAT, communities should choose the best tool for their local circumstances and then integrate it into their PIT counts, day-to-day street outreach and service operations. This complete integration allows communities to create a comprehensive, continuously updated, by-name list of all those experiencing homelessness. This list should be stored in a central, HIPAA-compliant database, which then forms the basis of a community’s CAHP system.

A Common Assessment Tool helps community leaders:

  • Know everyone experiencing homelessness by name
  • Understand the history and needs of these people in order to refer them to appropriate housing and services as quickly as possible
  • Create a systematic way to consistently update and track important information on each person experiencing homelessness
  • Improve planning and optimize the allocation of resources based on a clearer breakdown of local homeless populations

While there is no single acceptable CAT – popular choices include the VI-SPDAT and the NAEH Comprehensive Assessment Tool - a community should select a tool that is research informed and that can make effective recommendations across a variety of housing options. These options include permanent supportive housing, rapid re-housing and affordable housing, as well as time limited interventions, including emergency shelter beds, that can be used as a bridge to permanent housing. A community’s CAT should meet several requirements that help guarantee that it will be an effective tool in working to end homelessness.

A strong CAT must:

  • Be available for all subpopulations
  • Be worded in a way that clients can understand and respond to accurately
  • Be able to be implemented by non-clinical staff (such as volunteers)
  • Use a housing first frame to help get people off the streets and into housing as quickly as possible

The use of a CAT is not a one time event, but rather an ongoing process. A successful community should use its CAT to constantly update its by-name list in real time. This information can then be used to help track progress toward zero and to develop and refine a community’s Take Down Target – the total number of homeless veterans and individuals that will need to be housed in order to end veteran homelessness by the end of 2015 and chronic homelessness by the end of 2016.

Next Friday, February 27, is Zero: 2016 Take Down Target Day, when communities will be confirming and committing to their veteran and chronic Take Down Targets. We’ll be using this blog to discuss these Take Down Targets in more detail next week, so be sure to check back soon!