Conferences and Events
It has been almost a month now since the Alliance’s National Conference on Ending Homelessness, and we have been doing our best to make sure that you have access to as much of our conference materials as possible. All the workshop materials that presenters provided to us have been placed on our website here, where they are available for download. We will continue to update the page as we receive materials.
Finally, we have already received numerous requests for the keynote remarks that our CEO and President Nan Roman delivered at the conference, so we thank you for your patience. We have finally published them on our website, and we are including them in this blog post below.
NATIONAL CONFERENCE ON ENDING FAMILY HOMELESSNESS
President and CEO
July 16 2012
Good afternoon and welcome to the 2012 National Alliance on Ending Homelessness. I want to extend our most heartfelt and deep thanks to all of you for being here today. We have over 1400 people in attendance – a record! Most of you are here because you have a burning desire to learn from your colleagues what you can do to improve your own approaches to ending homelessness. You want to know about the most effective practices and the most promising innovations that will work for you. Many of you have traveled far and put a lot of resources into making it here to D.C. for our conference, and we want you to know how deeply we appreciate that. I promise you that the Alliance staff has put tremendous effort into making sure that you have plenty of content here to chew on.
My job today is to tell you what we at the Alliance see as the current lay of the land: where we stand, what has worked, what has not, and what the future holds. I think we are at a pivotal moment on the issue, because things are very difficult now.
It seems that 2008 and 2009 should have been the most difficult years with respect to homelessness, with the huge spikes in unemployment, plummeting family incomes, a massive number of foreclosures, and painful cuts in state and local budgets. Many nonprofits lost big chunks of their budgets, and many households found themselves either on the brink of, or falling into, homelessness. These were, indeed, bad years, but we had some things going for us. We had the Homelessness Prevention and Rapid Rehousing Program (HPRP), and housing costs were going down. And when you have less to work with, you are spurred to innovate, to work harder, to try new things. It may have been a frightening time, but the sense of urgency it inspired was a shot of adrenaline that pushed us forward.
I fear that today is, in some ways, a more dangerous time. We may have arrived at a new status quo. I fear that the sense of urgency has diminished, and that the mood of the nation has taken an alarming turn. Politics have become ugly. Bipartisanship, once seen as something to be aspired to, is now reviled as an indication that one or the other side must have “given in.” Our sense of mutual responsibility is diminishing, perhaps because people are increasingly fearful about their own financial security. Rather than compassion towards people who live in poverty, there is animosity or contempt. There is little acknowledgement that our futures are bound together.
And we still have high unemployment, foreclosures, falling incomes, and budget cuts, although this time those cuts are threatened from the federal government as state and local budgets start to level out. Housing costs are going up, and we are losing HPRP, a program that has done so much to address the problem of homelessness and improve the lives of hundreds of thousands of people.
These are alarming developments, but we are not powerless to affect them. If we believe that a defining value of our nation is the conviction that the most vulnerable people among us should be supported and treated with compassion, we must stand up and say that. If we believe that our nation, which remains the richest nation in the world in spite of its current economic woes, has the capacity to provide children, veterans, people with mental illness – indeed, anyone in need – with food, clothing and a place to call home, we must stand up and say that.
And of course, now is the perfect time. We are in an election cycle. Whatever political party you belong to, now is the time for you to make yourself heard. Now is the time to make sure that people who share your convictions do the same. You are the ones who care the most about poor people and solving their problems. If you do not speak up about it, who will? So make sure to vote; make sure you participate; and, most importantly, make sure that everyone you work with, especially consumers, is registered to vote and participate.
If you want to know how to do that, we have a workshop here that can show you. The Alliance for Justice and the National Coalition for the Homeless both have tables outside where you can get information. Everyone should be registered to vote, and should vote. Your participation will make a difference.
Lately there has been a great deal of discussion in homelessness assistance field about new strategies and how we can do things smarter. That’s a discussion we need to have, because the reality is that we are likely going to learn how to do more with less. Already 40 percent of people who are homeless are unsheltered, according to the most recent HUD Annual Homeless Assessment Report to Congress, and the Alliance expects the number of people experiencing homelessness to rise. We issued a report late last year estimating that, based on increases in deep poverty, homelessness might be expected to increase a minimum of 5 percent over the next few years. Because of the fiscal perfect storm that threatens 2013 – the end of the Bush-era tax cuts, the sequestration of federal spending, and the approach of the debt ceiling – we may have fewer federal resources to draw upon in the future.
So the key thing to keep in mind here is that, if we want to keep families and children and youth and vulnerable people off the streets, we are going to have to be smart about it. If we can do something that is equally effective and costs less, we need to do that. And that means change.
Our experience with HPRP has taught us that rapid re-housing linked with services works better and is more cost-effective than interventions like transitional housing. Don’t expect, however, to get more money for rapid re-housing. Instead, we will need to re-allocate funding from other interventions such as transitional housing to rapid re-housing.
We also need to think about effective targeting. Over the past few years, using the permanent housing set aside, HUD-VASH and other permanent supportive housing funding, we have created a lot of permanent supportive housing. Between 2007 and 2011 the nation’s permanent supportive housing inventory increased by 40 percent, or nearly 60,000 units. Chronic homelessness went down, but its decline was not commensurate with that increase in housing inventory.
Chronic homelessness is a complex problem, so there could be several causes for that discrepancy. The one thing we can be certain about, however, is that people experiencing chronic homelessness are not receiving enough of the permanent supportive housing. If we are going to have the impact we want – if we are going to end chronic homelessness – we need to target these units at the most vulnerable people. We need to identify and house the people with the greatest need and the longest spells of homelessness. We have seen, in community after community, that this sort of deep targeting is what brings the numbers down. So we must target the less intensive interventions at the people who are the easiest to serve, and save the most intensive interventions for the people who are the hardest to serve. And we must do this on a community-wide level.
There are two other issues I want to talk to you about today: youth experiencing homelessness, and the crisis system.
While good work has been done on youth homelessness, we are still not where we should be. We still lack crucial information about the size of the population of youth experiencing homelessness; we still lack a definitive typology; we still do not know which interventions work best and for whom. As a result we have not been able to generate the will to go to scale; we have not been able to increase resources appreciably; and we have not made much progress.
At the Alliance, we took a preliminary stab at remedying this by sizing the population and identifying its segments. We used federal survey data and academic typologies. The data are weak, but segments of the population have emerged in our research, and we have arrived at some ideas about how to move forward. Here is what we found.
- A great many youth between 12 and 24 become homeless every year. The number is somewhere around 1.9 million. But the vast majority – 70 percent or 1.3 million – experience homelessness for a relatively short period of time.
- The rest stay homeless longer, but they eventually return home or find housing rather quickly; and those under 18 remain connected to family or school.
- About 80,000 youth have more serious problems, and about half of those have disabilities.
- About 60,000 of these youth are the heads of young families of their own.
Admittedly, this typology is based on less than perfect data, and it does not tell us everything. We still need more research and more data on the population of LGBTQ kids, and on the causes and effects of the sexual exploitation of homeless youth. And the child welfare system still requires our attention: it remains unclear why anyone under 18 is homeless, given that minors are the responsibility of the state child welfare system.
What does this typology tell us? Well, just as in the population of adults experiencing homelessness, the population of youths experiencing homelessness can be divided into two groups: a large group with less intensive needs and a much smaller group with more intensive needs. For the first group, we clearly need a more robust crisis system. These youth may not be homeless for very long, but bad things can happen to them even in a few hours. And for the youth in that group who eventually return home, we need to focus more on family intervention to ensure that their return happens as quickly and safely as possible.
For the second group, where the need is the greatest, we should focus on ending their homelessness by targeting Runaway and Homeless Youth Act resources at them and ramping up housing and services. The number of high-need youth is small, making this a very solvable problem. Nevertheless, youth in this group are often screened out of programs.
When it comes to young homeless families, we need to add developmental programming and family intervention to the general homeless family system, which is where most members of young homeless families receive services.
This typology also has many policy implications. For instance, it shows that we must obtain data faster, and include youth experiencing homelessness in the 2013 point in time count. It also underscores the fact that homeless providers, advocates and researchers still lack a single, definitive management information system for the collection and reporting of outcomes on the size and characteristics of the homeless population, which means that we should merge the Runaway and Homeless Youth Management and Information System (RHYMIS) with the Homeless Management Information System (HMIS). We also should incentivize existing homeless youth providers to serve the highest need kids. We can scale up the family intervention services provided by child welfare, juvenile justice and the Runaway and Homeless Youth (RHY) Act. And we must engage to improve our child welfare and family support programs, because much of the problem of youth homelessness can still be traced back to large holes in this vital safety net.
The problem of youth homelessness will be a big issue for us in the year ahead, and we already have great partners like the National Network for Youth who are committed to making a big push to end youth homelessness.
The other issue that we at the Alliance have been examining is the homeless crisis system: how it should be sized and what it should look like. For many years now the design of the crisis system has largely been neglected, and the idea of emergency shelter as a solution has been demonized, and characterized as inadequate, as a mere “Band-Aid.”
It’s true that the shelters ALONE are not the solution, but it is equally true that the majority of people who become homeless are single, able-bodied adults for whom the interventions of permanent supportive housing and transitional housing are too intensive. As we do with other human service programs, we tend to think of the crisis system in terms of the people who stay there the longest. But in reality, the majority of people who enter emergency shelters quickly move in and then move on. For them shelter is an effective short term solution – as it was designed to be.
For most people, the shelter serves its purpose as a temporary place to stay while they work out whatever kind of housing crisis they are experiencing. Most people do not stay in the system long, and they typically do not come back, or only come back once.
The crisis system also serves a vital sorting function. People enter the system when they need to, but because it is so bare bones and so unpleasant, they have little incentive to stay longer than is absolutely necessary. In this way the system sorts the people with the greatest need, the people who require the most intensive interventions, from the majority of people who are experiencing a crisis that they can handle more or less on their own.
To design a good shelter or crisis system, we must answer the following questions.
- What should it do?
- What should be its overall size?
- What types and number of specialized beds should be available? Most jurisdictions have a good number of beds for single adult men, but have few or none for couples, youth, people with pets, or for people who have active substance abuse issues.
- Who should manage the shelter system, and who should be responsible for determining how many and what kind of beds are needed, and who gets each bed?
- What is the relationship between shelter, detox and rehab, and what should it be?
- What should be the length of stay?
- How should the shelter system link to the back door?
- Do the centralized one-stop-shops and campuses really work? Are they more effective or less effective than a decentralized approach?
- If you want to fix your shelter system, where do you start? What is the first thing to take on, what is next, etc.?
Today we recognize that, if we are to end the problem of homelessness, we must transition from a program-based approach to a systems-based approach. Figuring out what the crisis system should look like is a crucial part of that, because it is sure to remain the front door and the point of assessment for further interventions. Re-tooling this system is absolutely critical, and something we are anxious to explore with you over the next year. But if you thought I would have answers to the questions above – not yet! We do, however, have a few ideas.
We firmly believe that the time a person spends in shelter should be very short. One key goal set by the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act is that no one experience homelessness for a period longer than 30 days. Ideally, people should move through the shelter system fast. The faster people leave, the greater the turnover rate, the fewer the number of beds needed, and the greater the likelihood that the quality of shelters can be addressed, which is important, because right now the quality of shelters must be improved. In many places the standards remain very low.
To accomplish this, shelters should be a place of assessment, and shelter personnel should have a variety of tools to draw upon in order to provide the help people need to move on. More rapid re-housing tools would certainly facilitate this process, and people in the shelter system could be connected to community-based service slots. In short, shelter personnel could probably empower people in the shelter system to accomplish on their own many of the things that transitional housing and other back end interventions currently do for them.
These are some of the many things that we, at the Alliance, have been thinking about recently: how to target our resources better, how to retool programs to increase their effectiveness, how to move forward on ending youth homelessness, and how to improve our crisis systems.
Of course, I want to re-emphasize how important it is that we continue to advocate for meeting the needs of poor and homeless people, and how important it is that we make our voices heard. There is a national political debate going on about the role of government, and part of that debate concerns our mutual responsibility for each other and for the least among us. It is easy to feel like a mere observer in this debate. And if all you do is observe, that’s all you’ll be.
As I said earlier, if the people who care the most about this issue don’t speak out, who will? To make your voices heard you do not have to lobby. You do not have to be an expert on all the details of legislation. You just need to be able to express your concerns and those of your community. At present, our voices and our concerns are not being heard. If you speak up, your voice may not have an immediate impact. That’s why we need to keep speaking up, because if we don’t, I can guarantee you that we will not get anything for the people we care about.
Thank you so much for being with us at the National Conference on Ending Homelessness. The conference is going to be terrific, and it is because of all of you. We at the National Alliance to End Homelessness are tremendously grateful, and as always we are deeply honored to be your partners in the effort to end homelessness.
Last week, advocates from across the country participated in Capitol Hill Day 2012 in conjunction with the Alliance’s National Conference on Ending Homelessness in Washington, DC. Hundreds of conference attendees took advantage of the fact that they were in the nation’s capital to meet with their congressional delegations and educate them about homelessness in their communities and the ways in which federal policy can better support local efforts to prevent and end homelessness.
This is the third Capitol Hill Day I have planned in my time at the Alliance, and the level of participation and the dedication of this year’s conference attendees have made it the most impressive by far. Results and “report-backs” from meetings are still trickling in, so it’s too early to announce the full results of Capitol Hill Day 2012. I urge you to keep an eye on this blog next month for a full summary of the event and its immediate impact.
In the meantime, I’d like to highlight some preliminary results that we do have. Advocates attended a record of about 280 congressional meetings – an increase of about 22 percent compared to just two years ago. That’s incredible! And nearly 70 of those were with members of congress.
We are still calculating precisely how many people participated in all of these meetings, but the statistic I am most excited to share is this: participants from a record-breaking 44 states attended congressional meetings. This means that representatives from almost every one of the 47 states represented at the conference went to Capitol Hill last week to educate policymakers on the importance of ending homelessness.
As many of you know, next week will be my last at the Alliance, as my husband and I are moving to Boston so I can pursue a graduate degree. While I’m excited about this new chapter in my life, it is a bittersweet moment. I cannot possibly describe how much I will miss working with all the incredible practitioners, state and local officials, and other stakeholders I have come to know over the past several years.
It has been a true inspiration for me to see the dedication people in this field have to ending homelessness. While not all of the people with whom I have worked would describe themselves as advocates, they have demonstrated an impressive talent for educating policymakers about the role they must play in our efforts to end homelessness.
I will miss working with many of you on a daily basis, but this year’s Capitol Hill Day is just one more piece of evidence of the homeless assistance field’s strength, capacity, and commitment to ensuring that no man, woman, or child experiences homelessness.
We’d like to thank the nearly 1,500 practitioners, public officials and other stakeholders who took time out of their busy schedules to attend our 2012 National Conference on Ending Homelessness. For us in the Alliance, the level of enthusiasm and positivity on display in the plenary sessions and workshops was immensely gratifying. The homeless assistance community has come far, in terms of its overall level of sophistication and focus on implementation in order to get results, and the conference was a great opportunity for people to share what they have learned, as well as for those of us in the community to engage in a discussion about what we still must do to achieve our goals.
In her remarks at the conference’s closing plenary, Alliance CEO Nan Roman touched on a few of the themes that emerged over the course of the three days. I’ll expand on some of those here.
Targeting – The message came through loud and clear: there are a range of interventions to draw upon, but for an intervention to be successful it must be targeted at the right people. Specifically, supportive housing is our most intensive intervention, and it is designed for the most vulnerable population with the most severe disabilities. If such people are screened out in favor of people with fewer challenges, they will live and probably die on the streets.
Olmstead – The Olmstead case reminded us that large programs devoted solely to housing people with severe mental illness are seldom the best way to serve people, and often are not what people in such programs would choose for themselves if they had more reasonable options. In some cases, such programs actually violate civil rights laws. This challenges people who run housing programs for people with disabilities to consider when it might be appropriate to develop mixed-use projects.
Rapid Re-housing – Somebody once said that the only people who believe in rapid re-housing are everyone who’s ever tried it. Now that virtually every sizeable community around the country has tried it, thanks to HPRP, there is a consensus that it’s the right model for moving most people who are experiencing homelessness into housing. With HPRP winding down soon, much of the talk at the conference was about how to maintain funding for rapid re-housing programs. Fortunately, new HUD regulations make it easy for communities to use Continuum of Care and ESG funds for this purpose, and many communities have also identified other funding sources for rapid re-housing.
Youth and youth counts – The homeless assistance community has begun developing a range of ideas about a more systemic approach to ending youth homelessness. A double track of workshops about youth homelessness, as well as increasing collaboration with the federal Administration for Children, Youth and Families and organizations like the National Network for Youth, focused on advancing these ideas. When the January 2013 point-in-time counts roll around, expect a stronger push for a more accurate count of youth experiencing homelessness.
Veterans’ money and leadership – During the conference, VA announced the awards for about $100 million in grants for the Supportive Services for Veteran Families program, which funds community-based organizations that run rapid re-housing and emergency homelessness prevention programs for veterans and their families. This announcement drew attention to the fact that VA now has a full array of programs to address homelessness, and that those programs are on their way to being funded at the scale necessary to end homelessness among veterans.
The struggle over other federal money – It’s clear that federal money for HUD programs has been harder to come by in the past two years, and that this will continue to be the case. Many communities are increasingly turning to the large antipoverty entitlement programs – TANF, SNAP, SSI, and Medicaid, for example – where federal funding has not been cut, while programs for veterans, which are less threatened by budget cuts, must serve as examples of what can be accomplished with the proper funding. Homeless assistance practitioners are also turning to more efficient models like rapid re-housing, which require less money per household. And they are making sure that their representatives in congress, who determine the funding levels, know about the good that their programs do.
Medicaid – The prospect of funding most services and treatment for chronically homeless people through Medicaid appears closer to reality that anyone would have thought possible only a few years ago. The Affordable Care Act will allow states to expand eligibility in 2014, and the majority of states will opt to do so. A lot of work behind the scenes has already gone into ensuring that the right kinds of services will be funded by Medicaid, but it will take new partnerships, particularly at the state level, to make the most of these new opportunities.
Progress – Perhaps the most rewarding part of the conference for us in the Alliance was seeing the resolve of advocates, in the face of enormous obstacles put up by the economy and the political system, to try new options, discard methods that are less effective, and work smarter and more efficiently to develop programs that, for thousands of people, mean the difference between housing and homelessness.
We at the Alliance are getting increasingly excited for tomorrow, July 18 – the official Capitol Hill Day 2012! Capitol Hill Day is held every year in conjunction with our National Conference on Ending Homelessness. This year, conference participants from an astounding – and record-breaking! 44 states will head up to Capitol Hill to meet with their senators, representatives, and their staff members. They are scheduled to attend upwards of 250 meetings.
We’ve been extremely busy! Conference participants have been stopping by the Advocacy Information Table at the conference to pick up Capitol Hill Day Packets that contain information on each of the official Capitol Hill Day policy priorities. Advocates will then educate members of congress and their staff about the great work being done in their communities to solve homelessness, and explain the impact of these policy issues on their efforts.
If you’re unable to attend the conference, please keep an eye on this blog next month for a full report of the success of this year’s Capitol Hill Day. In the meantime, you can always check out last year’s report and get involved in the Alliance’s advocacy efforts by checking out our ongoing campaigns.
But if you ARE at the conference, we hope you plan to participate in Capitol Hill Day 2012! It couldn’t be any easier. Your state captains have been busy scheduling meetings. They just need YOU to participate! Stop by the Advocacy Information Table to get more information on how to get involved.
This year will be a year of change for the Department of Housing and Urban Development (HUD) and, by extension, for advocates and people working on behalf of people experiencing homelessness, said HUD’s acting assistant secretary for the Office of Community Planning and Development, Mark Johnston.
Speaking at the opening plenary session of the 2012 National Conference on Ending Homelessness on Monday, July 16, Assistant Secretary Johnston addressed what is perhaps the most significant piece of news circulating the conference, the release on Saturday, July 15 of the Continuum of Care interim regulations under the HEARTH Act.
Assistant Secretary Johnston reminded the nearly 1,500 practitioners, public officials, and advocates at the conference that the new regulations will alter how communities manage and distribute resources in the future, but will also provide communities with important tools that have the potential to strengthen prevention and rapid re-housing efforts.
He noted that the HEARTH was signed into law in 2009, the same year as the Recovery Act, which created the Homelessness Prevention and Rapid Re-Housing Program (HPRP). Developing and implementing both policy initiatives have been a challenge for his agency, he said, but doing so has taught HUD officials a great deal about homelessness prevention and rapid re-housing.
“In retrospect, it was great timing,” he added.
HUD officials have incorporated lessons learned from the implementation of HPRP into their regulations for the HEARTH act.
But Assistant Secretary Johnston also acknowledged the difficult fiscal environment in which agencies and advocates must operate. The funding for HUD’s McKinney-Vento Homeless Assistance Grants, which had been growing year after year, he noted, has flattened out over the last several years.
“Funding…at federal, state and local levels is getting very, very tight, forcing us to become even more efficient and even more strategic,” he told the audience.
Assistant Secretary Johnston said he expects another HEARTH Act regulation for the Rural Housing Stability Program to be released sometime in the coming weeks.
In his remarks, Assistant Secretary Johnston also praised the interagency collaboration between HUD and the Department of Veterans Affairs (VA) in the implementation of HUD – VA Supportive Housing (HUD-VASH) vouchers, which he said has helped put the nation on track to meeting the goal of ending veteran homelessness by 2015.
Between 2009 and 2011, veteran homelessness decreased by 11 percent. Assistant Secretary Johnson noted the decline in veteran homelessness in recent years is “stunning,” particularly considering the economic situation.
“I worked for the VA for many, many years, and I can attest that we’ve had the strongest relationship in the last two to three years than we’ve ever had before,” he said.
Last week, the Senate Appropriations Committee announced its funding levels for key programs serving low-income and homeless people within the Departments of Health and Human Services (HHS), Labor, and Education (yes, it’s quite a big bill!). To cut to the chase, many of the programs on which the Alliance works and on which people experiencing homelessness rely, including SAMHSA Homeless Services, Runaway and Homeless Youth Act (RHYA) programs, Projects for Assistance in Transition from Homelessness (PATH), and the Education for Homeless Children and Youth (EHCY) program, along with many other programs, would receive the same amount of funding in fiscal year (FY) 2013 under the Senate’s proposal as they do in FY 2012.
Many of these programs, – especially RHYA programs – have seen several years of flat funding in a row – despite increased need, despite a bad economy that continues to fare poorly month after month, and despite the program’s target population: our nation’s most vulnerable young people.
In recognition that flat funding is not enough, the Alliance has made RHYA and SAMHSA two of its top priorities for Capitol Hill Day this year. We are hoping to bring these two issues, and a handful of others, to the forefront of congressional offices’ minds and educate as many Members of Congress as possible on the importance of these key programs. We’ve got loads of materials to help participants prepare, and our State Captains are in the process of setting meetings up with key Members (in the House and Senate). But in order to make the biggest impact, we need you!!
If you’re planning on coming to the National Conference on Ending Homelessness (in less than a month’s time!), join us as we make sure that Congress knows the impact of these programs and hears loud and clear from all of you that flat funding is not enough! We are working extra hard this year to ensure that youth providers play a big role in Capitol Hill Day, so get involved! Reach out to us or your State Captains to find out how we can work together to ensure that these programs are not forgotten!
Today, June 12, at 1:30 p.m. ET, the U.S. Interagency Council on Homelessness (USHICH) meeting, chaired by Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, will be streamed live online. Today’s meeting will feature a presentation by the U.S. Department of of Health and Human Services (HHS that will announce a new framework to advance the goal of ending youth homelessness by 2020.
The Alliance’s own Nan Roman will be on a panel of experts who will participate in a discussion immediately following the presentation of the new framework. The other experts on the panel will be Dana Scott, State Coordinator for Homeless Education for the Colorado Department of Education and Vice President of the National Association for the Education of Homeless Children and Youth; and Bob Mecum, Executive Director of Lighthouse Youth Services.
Check back here at the Alliance’s blog this afternoon to read more about the presentation and the Alliance’s response.
Leaders and innovators in supportive housing convened in Chicago last week for a multi-faceted look at integrating housing and health care. The Leadership Forum, sponsored by the Corporation for Supportive Housing, was also the occasion for the release of a “business case” for states to tap Medicaid to pay for key services in permanent supportive housing. The presenters at the day-long conference and the paper on the business case speak to recent innovations with health care and supportive housing — demonstrating what’s possible under the Affordable Care Act, and what’s actually happening in communities where state government and homeless providers are proactive.
Two stand-out ACA provisions enable homeless advocates to persuade state policymakers that supportive housing is a worthwhile Medicaid investment.
- First, the “health home” benefit can be a good vehicle for funding care management and service coordination, services that make supportive housing viable as a strategy to end chronic homelessness. As the Forum audience heard, a Medicaid health home is a unique concept that has to be understood in a health policy context. But once that context is understood, it is easier to bring relevant data and analysis to Medicaid decision-makers. The business case illustrates that if Medicaid pays appropriately for care management via this new benefit, states can expand their service capacity in supportive housing. That’s because Medicaid allows the state to access federal funding to pay a portion of what the state would otherwise have to pay all by itself for a given number of supportive housing units.
- Second, when Medicaid expands in 2014, states will have new responsibilities to care for very vulnerable people who currently lack coverage and tend to incur very high public costs, especially in hospital emergency rooms. They tend to have severe behavioral and physical health conditions, often co-occurring. And they tend to have unstable housing histories. This is not news to homeless advocates. However, the expanded Medicaid role creates an opportunity to talk to state decision-makers about the value of Housing First for clinical outcomes and managing health care costs.
This is all promising for systems of care addressing chronic homelessness. Safety net systems may always be somewhat fragmented financially, but in any case they need to be integrated and high-performing for the vulnerable people who rely on them. Of course, more needs to be done to finish the job of ending chronic homelessness, and Medicaid in supportive housing is not the answer by itself. As the business case also points out, new strategies should also consider “new processes and/or technologies to identify high-cost, chronically ill clients who could most benefit from supportive housing.” Those who are now experiencing chronic homelessness should be a priority.
The Medicaid proposition for ending chronic homelessness requires advocates to be active in statewide arenas – with Medicaid administrators, of course; but also with their partners – such as mental health directors, hospital systems, and even managed care organizations that deliver on Medicaid contracts. Advocating statewide is the theme of an Alliance pre-conference session on July 16, immediately preceding the start of the National Conference on Ending Homelessness. “Opening Medicaid Doors: State Strategies to Support Homeless Assistance for Vulnerable Populations” is co-sponsored by the U.S. Interagency Council on Homelessness. The half-day program will examine several key facets of how to make Medicaid a stronger partner in programs that house and stabilize people who have been chronically homeless. Space is limited and pre-registration is highly recommended. RSVP at firstname.lastname@example.org.
Image courtesy of donbuciak.
There are a lot of changes that are happening or about to happen as a result of the HEARTH Act, and we’ll be spending a lot of time at the conference explaining the changes and their implications. Here’s a rundown of the planned content related to implementation of the HEARTH Act.
There are a few workshops where you can expect to learn about specific aspects of the HEARTH Act. Before the conference begins, there’s a pre-conference session where you can ask HUD officials questions about the HEARTH Act and HUD programs (it’s not on the published agenda yet, but it will be soon). There are also conference sessions providing an overview of how the HEARTH Act changes and HUD programs fit together (1.13), rural homelessness (3.13), the new ESG program (4.13), the new CoC program (5.12), and Continuum of Care leadership (6.10).
We also have several workshops about using the changes made by the HEARTH Act to improve homeless assistance, including sessions on coordinated assessment (2.6), overseeing homeless assistance (2.7), retooling programs (3.7), measuring and improving community-wide outcomes (4.7), and reallocating resources (5.7). We’ve put together a one page HEARTH Act Conference Track.
As with all of our conferences, the main goal is to share ideas about how to best prevent and end homelessness. The HEARTH Act provides a lot of new tools to help do that, and so you’ll hear HEARTH Act changes discussed throughout.
Monday, July 16, 2012
Pre-Conference Session – 10:00 a.m. – 12:00 p.m.
[Session with HUD officials to discuss the HEARTH Act and HUD Homeless Assistance Programs: title and description forthcoming]
Workshops I – 2:00 p.m. – 4:00 p.m.
1.13 [Overview of the HEARTH Act and Changes to HUD Programs: title and description forthcoming]
Workshops II – 4:30 p.m. – 6:00 p.m.
2.6 Coordinated Assessment
2.7 Getting the Most Out of Your System: Overseeing Homeless Assistance
Tuesday, July 17, 2012
Workshops III – 9:00 a.m. – 10:30 a.m.
3.7 Retooling Your Transitional Housing Program
3.13 Beyond the City Limits: Ending Homelessness in Rural and Tribal Areas
Workshops IV – 1:00 p.m. – 2:30 p.m.
4.7 Measuring and Improving System Outcomes
4.13 Implementing the HEARTH Act: The New Emergency Solutions Grant Program
Workshops V – 2:45 p.m. – 4:15 p.m.
5.7 Shifting Gears: Community Planning to Re-Allocate Resources to Support New Strategies
5.12 Implementing the HEARTH Act: The New Continuum of Care Program
Wednesday, July 18, 2012
Workshops VI – 9:15 a.m. – 10:45 a.m.
6.10 Effective Continuum of Care Leadership: Examples and Strategies
Last week, the Office of Planning, Research, and Evaluation (OPRE) in the Administration for Children and Families (ACF) in the U.S. Department of Health and Human Services hosted the 15th Annual Welfare Research and Evaluation Conference in Washington, DC. This conference provides welfare and poverty researchers, state and local administrators, practitioners, and Federal officials to meet and discuss research, programs, and policies that impact welfare and related programs.
This year, the conference featured tracks on TANF, education and the labor market, child and youth well-being, fatherhood, evaluation of social programs, and alleviating poverty and strengthening the safety net. While a number of the sessions at the conference had implications for homeless families, individuals, and youth, there was a session specifically dedicated to the role that TANF and other human services programs play in ending family homelessness.
The session was moderator by the Alliance’s own Sharon McDonald, Director of Families and Youth, and featured:
- Dennis Culhane of the University of Pennsylvania who provided an overview of his widely accepted typology of homeless families and discussed the important role that short- and medium-term rent assistance in ending homelessness for a large proportion of homeless families;
- Frank Cirillo of the Mercer County Board of Social Services in New Jersey who discussed the successful efforts in Mercer County to fund rapid re-housing for families using TANF funds; and
- Alvaro Cortes from Abt Associates who provided a broad overview of findings from a study that looked at how communities are linking housing supports with social services.
A detailed agenda of the conference is available and electronic copies of powerpoint presentations from the above workshop as well as from other workshops from the conference are available upon request via email.