Archive for December 15th, 2011

15th December
written by Amanda Benton

Thanks for all your hard work!

The evidence is overwhelming: collectively, we were able to accomplish an incredible amount when it comes to federal homelessness advocacy in the past year.

Chief among these successes is the fact that, despite deep cuts to many programs in both fiscal years (FY) 2011 and 2012, funding for targeted homeless assistance programs held more or less steady – and, in some cases, even increased! In this calendar year, Congress provided $125 million for more than 17,000 new HUD-VASH (HUD – Department of Veterans Affairs Supportive Housing) vouchers. And this doesn’t even count the fact that Congress increased funding for HUD’s McKinney-Vento Homeless Assistance Grants by $36 million in April for FY 2011 in order to get a new program – the Emergency Solutions Grant – off the ground.

These accomplishments are a direct result of the hard work of our partners to educate Members of Congress about homelessness and its solutions over the past year. Moreover, they’re a testament to how much confidence Congress has in your ability to implement effective solutions.

Let’s take a quick look at some of the other highlights of our collective advocacy efforts over the past year:

  • More than 50 local and national news stories about homelessness within just a few weeks after the release of State of Homelessness in America, many of them running after advocates reached out to their local media contacts;
  • A Runaway and Homeless Youth Act (RHYA) letter writing effort that produced about 200 letters to Members of Congress in just one month;
  • Four congressional sign-on letters in support of increasing funding for HUD’s McKinney-Vento programs, and one sign-on letter in support of robust funding for RHYA and Education for Homeless Children and Youth programs; and
  • A record-breaking Capitol Hill Day in July, with more than 360 participants attending over 270 meetings with congressional offices representing 42 states.

And that’s just a sampling of what we did together over the past year! It doesn’t even take into account the literally thousands of letters, calls, and other forms of outreach to Members of Congress about topics as varied as general education, appropriations, and the deficit reduction efforts of the “Super-Committee.”

With recent news about deep cuts to some affordable housing programs within the Department of Housing and Urban Development (HUD) and high risk for further cuts to homeless assistance and affordable housing programs next year, it’s easy to feel as though our advocacy efforts over the past year were not successful. But the truth is these efforts have paid off, with Congress largely protecting funding for homeless assistance programs.

We at the Alliance cannot possibly express how grateful we are for all of your hard work over the past year or how excited we are to build upon this year’s accomplishments in the coming year.

We’ll need to work even harder, but we are confident, given the strength of our partners across the country, that we can outdo ourselves next year. Stay tuned for another blog post at the end of the month on how you can get involved in 2012!

15th December
written by Lisa Stand

Last week, we re-ran an earlier blog post about how expanding Medicaid through the Affordable Care Act (ACA) is critical to ending chronic homelessness. Starting in 2014, the vast majority of vulnerable adults not already on Medicaid will have the opportunity to enroll in a health benefits plan.  We talked about what this means for individuals and their access to care, and what it means for communities, given new opportunities to access Medicaid funding.

Today, we look deeper into the crystal ball to explore what health care reform might mean for mental health and substance abuse treatment.

Behavioral health services, including treatment for substance use disorders, will be part of new Medicaid benefits. Between now and 2014 – and for a long time after – policy officials and advocates will be talking about what those benefits might look like in any given state. What kinds of services will Medicaid pay for? In what kinds of settings, for how long, and by whom? These are key questions that policymakers will gradually answer as implementation proceeds. No matter what, though, it is clear that the ACA is meant to transform behavioral health care delivery, as it transforms the rest of the health care system.

Consider, for instance, that 61 percent of people served under state substance abuse programs have no insurance. Some 87 percent of those uninsured behavioral health consumers will be eligible for Medicaid. So already we can see that Medicaid will play a much bigger role than it has in the past. Many providers of substance abuse treatment do not accept Medicaid now, and will have to decide how they are going to relate to the program in the future.

We also know that the ACA is driving – or attempting to drive – integration of behavioral and physical health care (what is often called “primary care”). Experts speak of “bi-directional” integration, meaning simply that care is client-centered rather than silo-based. So a person needing medical care and behavioral health treatment will be served in a holistic fashion, wherever they access care. There is a double bottom line here – improved access and quality for the consumer; and cost effectiveness in the programs that serve them. To make this work, Medicaid is encouraging the “medical home” concept to coordinate services for people with complex needs like severe mental illness and co-occurring substance or medical conditions.

What does all of this mean when homelessness is in the picture?

- First, it means that Medicaid is moving closer to housing solutions that are proven to be effective. Medicaid does not pay for housing, but it will offer more ways to meet people clinically where they are – for instance, in supportive housing – with more of the services they need.

- Second, communities have an important window of opportunity to make their homelessness assistance programs more effective and realign their funding priorities. Now is the time to build service networks that emphasize service integration, client-centered strategies, and financing that follows the changes in health care financing.

At the Alliance, we are excited to see communities respond to these promising changes that can really improve the lives of vulnerable people who are homeless or at-risk of homelessness. We are studying models and best practices to share in the broader advocacy community. For instance, the Alliance will host a webinar in early January that will highlight the practical aspects of integrating health care with supportive housing. (Register here.)

For a more thorough look at the ACA and behavioral health, check out these materials from the Substance Abuse and Mental Health Services Administration or check out our website.