[Senate Hearing 114-328]
[From the U.S. Government Publishing Office]
S. Hrg. 114-328
ENDING VETERAN HOMELESSNESS
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED FOURTEENTH CONGRESS
FIRST SESSION
__________
JULY 29, 2015
__________
Printed for the use of the Committee on Veterans' Affairs
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COMMITTEE ON VETERANS' AFFAIRS
Johnny Isakson, Georgia, Chairman
Jerry Moran, Kansas Richard Blumenthal, Connecticut,
John Boozman, Arkansas Ranking Member
Dean Heller, Nevada Patty Murray, Washington
Bill Cassidy, Louisiana Bernard Sanders, (I) Vermont
Mike Rounds, South Dakota Sherrod Brown, Ohio
Thom Tillis, North Carolina Jon Tester, Montana
Dan Sullivan, Alaska Mazie K. Hirono, Hawaii
Joe Manchin III, West Virginia
Tom Bowman, Staff Director
John Kruse, Democratic Staff Director
C O N T E N T S
----------
July 29, 2015
SENATORS
Page
Isakson, Hon. Johnny, Chairman, U.S. Senator from Georgia........ 1
Blumenthal, Hon. Richard, Ranking Member, U.S. Senator from
Connecticut.................................................... 2
Tillis, Hon. Thom, U.S. Senator from North Carolina.............. 16
Manchin, Hon. Joe, U.S. Senator from West Virginia............... 18
Boozman, Hon. John, U.S. Senator from Arkansas................... 20
Sullivan, Hon. Dan, U.S. Senator from Alaska..................... 22
Heller, Hon. Dean, U.S. Senator from Nevada...................... 24
Rounds, Hon. Mike, U.S. Senator from South Dakota................ 26
Cassidy, Hon. Bill, U.S. Senator from Louisiana.................. 28
Murray, Hon. Patty, Chairman, U.S. Senator from Washington....... 30
Hirono, Hon. Mazie, U.S. Senator from Hawaii..................... 32
WITNESSES
Pape, Lisa, Executive Director, Homeless Programs, Veterans
Health Administration, U.S. Department of Veterans Affairs;
accompanied by Dr. Thomas O'Toole, Acting Director, VA National
Center on Homelessness Among Veterans.......................... 4
Prepared statement........................................... 5
Response to request arising during the hearing by:
Hon. Dean Heller........................................... 26
Hon. Mike Rounds........................................... 27
Response to posthearing questions submitted by:
Hon. Johnny Isakson........................................ 34
Hon. Richard Blumenthal.................................... 35
Hon. Sherrod Brown......................................... 40
Ho, Jennifer, Senior Advisor to the Secretary, U.S. Department of
Housing and Urban Development.................................. 8
Prepared statement........................................... 10
Response to request arising during the hearing by Hon. Johnny
Isakson.................................................... 14
Response to posthearing questions submitted by:
Hon. Richard Blumenthal.................................... 42
Hon. Sherrod Brown......................................... 43
Bates, Lisa Tepper, Executive Director, Connecticut Coalition to
End Homelessness............................................... 44
Prepared statement........................................... 46
Response to posthearing questions submitted by Hon. Richard
Blumenthal................................................. 79
Blecker, Michael, Executive Director, Swords to Plowshares....... 47
Prepared statement........................................... 49
Response to posthearing questions submitted by Hon. Richard
Blumenthal................................................. 80
Crone, Baylee, Executive Director, National Coalition for
Homeless Veterans (NCHV)....................................... 57
Prepared statement........................................... 59
Response to posthearing questions submitted by Hon. Richard
Blumenthal................................................. 82
Powers, Edward, Executive Director, HOPE Atlanta................. 66
Prepared statement........................................... 68
Response to posthearing questions submitted by Hon. Richard
Blumenthal................................................. 83
Steele, Jeff, Assistant Legislative Director, The American Legion 69
Prepared statement........................................... 71
Response to posthearing questions submitted by Hon. Richard
Blumenthal................................................. 84
APPENDIX
Gerton, Teresa W., Acting Assistant Secretary for Veterans'
Employment and Training Service, U.S. Department of Labor;
prepared statement............................................. 85
Giraud, Jean-Michel, Executive Director, Friendship Place,
Washington, DC, and Member of the DC Interagency Council on
Homelessness; prepared statement............................... 88
Garcetti, Hon. Eric, Mayor, city of Los Angeles; letter.......... 92
ENDING VETERAN HOMELESSNESS
----------
WEDNESDAY, JULY 29, 2015
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 2:31 p.m., in
room 418, Russell Senate Office Building, Hon. Johnny Isakson,
Chairman of the Committee, presiding.
Present: Senators Isakson, Boozman, Heller, Cassidy,
Rounds, Tillis, Sullivan, Blumenthal, Murray, Brown, Hirono,
and Manchin.
OPENING STATEMENT OF HON. JOHNNY ISAKSON, CHAIRMAN,
U.S. SENATOR FROM GEORGIA
Chairman Isakson. The Senate Veterans' Affairs Committee
will come to order, and we welcome everybody that has come here
today.
Ranking Member Blumenthal and I will make opening
statements. Any member that wishes to issue a statement may do
so at the end of the hearing or may submit one for the record
so we can get right to our witnesses, whom we appreciate being
here today.
But first, I want to take a moment to make note of Joseph
A. Violante, who is here today. Joseph, come on up and stand up
here. You are standing, but, I mean, come forward so everybody
can see you. Joe is retiring from National Legislative Director
of the Disabled American Veterans. He has done an unbelievably
great job for a long period of time.
I reminded him in the anteroom a minute ago, my very first
hearing when Senator Blumenthal and I took over the leadership
of this Committee, you were one of the first people to testify,
and we appreciate your work on behalf of veterans. We
appreciate the fact that you served our country in combat in
Vietnam. We really appreciate the fact that you married a very
beautiful woman who is with you today. Where is she? Stand up,
dear. [Applause.]
Joe, we thank you for your service and appreciate all you
have done for the Marine Corps, all you have done for the
United States of America, and all you have done for this
Committee. Thank you very much.
Mr. Violante. Thank you, Mr. Chairman. I appreciate it very
much. [Applause.]
Chairman Isakson. When I spoke to The American Legion at
the beginning of this year, in January, I made five points
about the five things I wanted our committee to try to
accomplish and work on in terms of the beginning of the new
leadership in this Committee. First and foremost was veterans'
homelessness and second, women's issues in the VA. Today, we
are here to talk about veterans' homelessness in our country.
While it is improving in terms of lessening, it is still a
great problem for many, many veterans coming home. We have two
distinguished panels who will talk about the issue and I am
looking forward to their testimony.
From 2010 to 2014, the number of homeless veterans has
decreased by a third. But when that ends up being 49,933
homeless veterans, that is way too many. There are ways in our
communities that we can meet the needs of these veterans who
are unique in their problems that cause the homelessness in the
first place, as we have learned from the Veterans Courts which
we have established, which are becoming so successful in
helping veterans who have that first-time brush with the law
after they come home, to get them back on the straight and
narrow.
One of the problems with those who are not on the straight
and narrow is the homeless issue, so we are going to talk about
that today, and I know Ms. Ho is going to talk today about the
city of Houston--I read your testimony--and the city of New
Orleans, both of which have substantially and effectively
eliminated veteran homelessness.
We will also hear from the Swords to Plowshares
organization of San Francisco, CA, that has been one of the
Nation's leaders for almost 40 years in providing services to
veterans who are on the streets of our cities, and in that
case, the city of San Francisco. These stories will help us in
setting the priorities we need to set in this Committee to see
to it that veterans' homelessness is a footnote in history, not
a chapter in everyday's history book.
With that said, I will turn it over to Ranking Member
Blumenthal.
STATEMENT OF HON. RICHARD BLUMENTHAL,
RANKING MEMBER, U.S. SENATOR FROM CONNECTICUT
Senator Blumenthal. Thanks, Mr. Chairman, and thank you for
having this hearing today.
In the midst of all the focus on health care and delays in
delivering health services, we should not lose sight of the
importance of homelessness as well as joblessness. The two go
together and, in fact, are related to health care. This hearing
reflects a recognition of the interconnectedness of the
services that we have an obligation to provide to our veterans.
I am very, very pleased and honored that we are joined by
Lisa Tepper Bates, who is Executive Director of the Connecticut
Coalition to End Homelessness. She will be testifying on the
second panel. She has been an extraordinarily steadfast and
effective advocate to end veterans' homelessness. In fact,
Connecticut has been at the forefront of this effort nationally
and I am hopeful that we will have some very exciting and
extraordinary results to announce in the near future.
Under her leadership, the Connecticut Coalition has played
an integral role in a Statewide collaborative effort uniting
different towns, regions, service providers to coordinate the
kinds of help and support that we provide to homeless veterans
and to maximize the potential of the housing and supportive
services Statewide.
With the Connecticut program as a model, I have introduced
a measure called the Veterans Housing Stability Act of 2015
with my colleagues, Senators Brown, Sanders, and Hirono. This
legislation would require VA to take concrete steps to expand
veterans' access to permanent housing. I stress and underscore
permanent housing. It is based on evidence-based solutions that
have resulted in savings in community health care
organizations. They have proven effective in health care
interventions and in providing not just temporary roofs over
veterans' heads, but permanent housing.
The numbers that Chairman Isakson recited before are a
searing indictment of our Nation, the greatest, strongest
nation in the history of the world. Veterans comprise an
estimated 12 percent of the national adult homeless population
overall. One out of ten men and women on the streets today
without a roof over their head is a veteran, having served and
sacrificed for our Nation. The reason that person is homeless
has to do with our failure as a nation to keep faith with those
veterans in other areas, like jobs and health care.
So, the effort today is to seek to address that
interconnected web of issues that are responsible for those
staggering statistics--49,000 veterans who have served in
conflicts ranging from Vietnam to Iraq and Afghanistan and find
themselves on the streets without the help and support they
need.
I want to join the Chairman in recognizing Joe Violante for
his extraordinary service, advancing from Staff Counsel at the
Court of Veterans Appeals all the way to National Legislative
Director at Disabled American Veterans. He has really dedicated
his life to public service and to ensuring that all men and
women who wear the uniform receive the benefits and services
they need and deserve. I want to wish him well, hope that he
will stay in touch, and say to his lovely wife, Debbie, thank
you for your service to our Nation----
Mrs. Violante. Thank you.
Senator Blumenthal [continuing]. And you are going to be
seeing more of Joe, I think. I do not want to say whether that
is a good thing or a bad thing----
[Laughter.]
Senator Blumenthal [continuing]. But I know it is--very
seriously, it is a good thing.
Joe, thank you for your friendship as well as your service
to so many of us who have worked with you. It has been a real
privilege and honor to work with you. Semper Fi and thank you.
Chairman Isakson. It is now my privilege to introduce our
first panel. First, Ms. Lisa Pape, Executive Director, Homeless
Programs, Veterans Health Administration, U.S. Department of
Veterans Affairs; accompanied by Dr. Thomas O'Toole, the Acting
Director of VA National Center on Homelessness Among Veterans;
and Ms. Jennifer Ho, the Senior Advisor to the Secretary of the
U.S. Department of Housing and Urban Development.
I would ask both of you to keep your testimony to 5 minutes
or less if you can. Then we will take questions from all the
members of the panel. We thank you for being here today.
Ms. Pape.
STATEMENT OF LISA PAPE, EXECUTIVE DIRECTOR, VETERANS HEALTH
ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS;
ACCOMPANIED BY THOMAS O'TOOLE, M.D., ACTING DIRECTOR, NATIONAL
CENTER ON HOMELESSNESS AMONG VETERANS
Ms. Pape. Good afternoon, Chairman Isakson, Ranking Member
Blumenthal, and Members of the Committee. I appreciate the
opportunity to discuss the Department of Veterans Affairs
commitment to ending homelessness among veterans.
Today, I am accompanied by Dr. Thomas O'Toole, the Acting
Director of VA's National Center on Homelessness Among
Veterans.
In 2010, VA made a clear organizational priority to prevent
and end veteran homelessness, which is a key objective of the
current administration and leaders throughout our Nation. With
Congress's continuing support and unprecedented Federal and
local partnerships, VA greatly increased access for homeless
and at-risk veterans and their families to permanent supported
housing, to employment, to benefits, and to a full range of
health care, including primary care, specialty care, mental
health care, and substance use disorder care.
VA embarked on this priority using a strategy that
emphasizes housing first and prioritizes access to permanent
supported housing. Housing first means providing access to
permanent supported housing with as few barriers and
restrictions as possible while also providing wrap-around
services to help the most vulnerable veterans sustain housing
and achieve stability.
VA's approach emphasizes rescue for veterans who are
homeless today, sustainment, support, and treatment for
formerly homeless veterans who enter permanent supported
housing to ensure that they are able to maintain it, and
prevention for veterans at risk for homelessness or rapid
connection to permanent housing for those who have fallen into
homelessness. Using this approach, VA identified key elements
essential for success, which include access to high-quality
health care, permanent and sustainable housing, economic
opportunities, and other supportive services.
VA recognizes that no effort to end veteran homelessness
will be effective without comprehensive services for those with
chronic health, mental health, and substance use disorders.
Approximately 71 percent of homeless veterans have a mental
health diagnosis or an addiction disorder, which, if untreated,
can keep them from returning to or sustaining independent
living and gainful employment. Many veterans, but particularly
those who have battled chronic homelessness, need skillful and
repeated attempts to engage them in the care they need.
VA recognizes that no single Federal or State agency or
local organization can end homelessness among veterans. We must
join hands. Together with our partners, VA has helped over
200,000 veterans move from homelessness to permanent housing
since 2009.
My written testimony outlines specific examples of programs
and identifies many of VA's Federal, State, and local partners,
notably the U.S. Interagency Council on Homelessness and the
Department of Housing and Urban Development, who share our
vision of ending veteran homelessness.
VA has maintained close working partnerships with Federal
partners and with State, local, and tribal governments.
Veterans Service Organizations also fill a critical role, as do
community and faith-based organizations, nonprofit providers,
and the business and philanthropic communities. These
partnerships are the linchpin that binds a complex network of
multi-level government programs and community-based services
together. This creates a foundation of direct support,
community by community, tailored to fit the unique needs of
each individual community.
VA has made significant progress and we are now closer to
our goal of ending veteran homelessness than at any point in
our history. Before the priority to end veterans' homelessness
began, the percent of homeless veterans was 63 percent higher
than the percentage of homeless non-veterans. Today, the
percentage of homeless veterans has decreased and is now only
30 percent higher than those of non-veterans.
As VA prepares to mark 5 years of this priority to end
veteran homelessness, we look forward to sustaining the
essential partnerships that have enabled VA and our partners to
significantly reduce veteran homelessness. When veterans become
homeless or even at risk, VA and our partners must have the
capacity to quickly connect them to the help they need to
achieve housing stability.
Sustaining the gains made so far requires continued
investments of financial resources. Failure to provide these
resources will severely jeopardize our ability to sustain our
progress and will put at risk thousands of veterans and their
families in the future. We must ensure that we do not allow
veteran homelessness to return to previous levels.
Mr. Chairman, this concludes my testimony. Dr. O'Toole and
I are prepared to answer any questions the Committee may have.
Thank you.
[The prepared statement of Ms. Pape follows:]
Prepared Statement of Ms. Lisa Pape, Executive Director, Homeless
Programs, Veterans Health Administration, U.S. Department of Veterans
Affairs
Good afternoon Chairman Isakson, Ranking Member Blumenthal, and
Members of the Committee. I appreciate the opportunity to discuss the
Department of Veterans Affairs' (VA) commitment to ending homelessness
among Veterans. I am accompanied today by Dr. Thomas O'Toole, Acting
Director of VA's National Center on Homelessness among Veterans
(NCHAV).
In 2010, VA made it a clear organizational priority to prevent and
end Veteran homelessness which is a key objective of the current
Administration and leaders throughout our Nation. With Congress'
continuing support and unprecedented partnerships with Federal and
local partners, VA has greatly increased access to permanent housing; a
full range of health care including primary care, specialty care and
mental health care; employment; and benefits for homeless and at-risk
Veterans and their families. We are now focusing on sustaining and
continuing the progress VA has made in its efforts to end Veteran
homelessness by ensuring that programs and resources essential to
ending Veteran homelessness are clearly identified and will continue to
be available.
VA embarked on this priority using a comprehensive, evidence-based,
and outcome-driven strategy consistent with the first-ever Federal
strategic plan to prevent and end homelessness, Opening Doors. This
strategy emphasized ``Housing First'' and prioritized access to
permanent housing. Housing First means providing access to permanent
housing with as few barriers and restrictions as possible, while
simultaneously providing wrap around services to assist individuals in
sustaining housing and achieving stability.
VA's approach to ending Veteran homelessness is to emphasize rescue
for Veterans who are homeless today; sustainment, support and treatment
for formerly homeless Veterans who enter permanent housing to ensure
that they are able to maintain it; and prevention for Veterans at risk
of homelessness or rapid connection to permanent housing for those who
have fallen into homelessness.
Using this approach, VA identified key elements of clinical care
and social services that are essential for success. All Veterans must
have access to high-quality health care, permanent and sustainable
housing, and other supportive services.
Since 2010, VA has broadly expanded the array of services and
supports aimed at identifying, interceding with, and rapidly engaging
homeless or at-risk Veterans in housing, clinical care, and social
services, as well as resources aimed at preventing homelessness. VA has
also worked with the U.S. Interagency Council on Homelessness (USICH)
and the Department of Housing and Urban Development (HUD) to develop
and implement criteria for determining whether communities have ended
Veteran homelessness.
housing
Direct connection to permanent housing with appropriate supportive
services ``wrapped around'' the Veteran is the most clinically
effective and cost-efficient way to end homelessness. Strong
interagency collaboration has resulted in housing programs and policies
that have been critical to the advances made so far. They include:
Housing First in the Community (Housing First)
Rapid Re-Housing
Homelessness programs that help Veteran and their families
secure permanent housing such as:
- Housing and Urban Development-Veterans Affairs Supportive
Housing (HUD-VASH); providing permanent supportive housing
opportunities; and
- Supportive Services for Veteran Families (SSVF)--providing
rapid rehousing interventions and homelessness prevention
services.
The Grant Per Diem (GPD) program that uses a community-
based transitional housing model, which includes time-limited
comprehensive support services with the goal of rapidly transitioning
Veterans to stable permanent housing.
- 25 GPD programs are beginning to use the ``transition in
place'' (TIP model), which allows Veterans to remain in their
units after completing GPD participation. The results so far
are promising with 517 operational TIP housing units between
them.
VA's Health Care for Homeless Veterans (HCHV) programs
provide access to healthcare, along with same-day access to safe and
stable temporary housing for:
- Homeless Veterans transitioning from street homelessness;
- Veterans who recently became homeless; and
- Veterans being discharged from institutions.
VBA's Home Loan Guaranty program helps to prevent
homelessness by assisting Veterans who fall behind on mortgage payments
to avoid foreclosure.
sustainability
In addition to stable and affordable housing, economic
opportunities are also essential to maintain housing stability. This
includes access to employment opportunities to support Veterans'
housing needs, improving the quality of their lives, and assisting in
their community reintegration efforts. One resource available to
Veterans is VA's Homeless Veterans Community Employment Services
program. Through this program, each VAMC has been funded to hire a
Community Employment Coordinator (CEC) for homeless Veterans. Each CEC
serves as a liaison to local community providers of employment and
support services, including Department of Labor (DOL) Homeless
Veterans' Reintegration Program grantees and private sector employers.
For Veterans who are eligible, access to VA disability compensation
and pension benefits, and other benefits, are a key component of
financial stability and remaining stably housed over time. Every VA
regional office has either a Homeless Veterans Outreach Coordinator or
Homeless Veterans Claims Coordinator responsible for case management
and expediting the processing of homeless Veterans' claims.
Many Veterans served through SSVF have a disabling condition.
Supplemental Security Income/Social Security Disability Insurance's
(SSI/SSDI) Outreach, Access, and Recovery (SOAR), is a national project
funded by the Department of Health and Human Services' (HHS) Substance
Abuse and Mental Health Services Administration to increase access to
SSI/SSDI benefits. Using the SOAR model, SSVF grantees can help prevent
evictions for disabled Veterans, and connect eligible Veterans to
Social Security benefits, which can be a crucial support for housing
sustainability. Additionally, VA and its partners USICH, HHS, and the
Social Security Administration recently released joint guidance which
includes specific strategies for assisting Veterans experiencing
homelessness to obtain SSI/SSDI benefits.
supportive services
The majority of HUD-VASH participants are experiencing chronic
homelessness and suffer from serious mental illness, substance use
disorders, or chronic medical conditions. VA case managers provide
clinical visits to these Veterans to ensure they remain in housing and
do not become homeless again. VA recently published regulations that
make HCHV services, including Contract Residential Services, available
to all homeless Veterans who are enrolled in or eligible for VA health
care, regardless of whether they have a serious mental illness,
ensuring that VA can immediately engage homeless Veterans and get them
off the street.
outreach
Many Veterans, but particularly those who have battled chronic
homelessness, need skillful and repeated attempts to engage them in the
care they need. A history of incarceration is a powerful predictor and
risk factor for homelessness. Therefore, homelessness and criminal
justice involvement have a reciprocal relationship. As a result,
outreach to justice-involved Veterans is a key part of VA's prevention
strategy. VA conducts homeless outreach at shelters and community
events, and in courts, local jails, and state and Federal prisons. VA
has implemented a clinical reminder to help identify Veterans who are
homeless or at risk of homelessness when they present for care at a VA
outpatient clinic. VA and USICH have also produced an identification
and referral guide to help community-based providers identify Veterans
who are homeless or at risk of homelessness.
access to health care
VA recognizes that no effort to end Veteran homelessness will be
effective without comprehensive services for those with chronic health,
mental health, and substance abuse disorders. Approximately 71 percent
of homeless Veterans have a mental health diagnosis or an addiction
disorder, which, if untreated, can create significant challenges for
returning to or sustaining independent living and gainful employment.
Therefore, VA provides a continuum of outpatient, residential, and
inpatient mental health services across the country.
Since every homeless Veteran is unique, and so are his or her
needs, VA offers services that are responsive to the needs of a diverse
population. Approximately 10 percent of homeless Veterans served in FY
2014 were women. In addition to linking women Veterans to the wide
array of services (some of which are gender-specific), every VA
healthcare system has a designated Women's Healthcare Provider * * *
Homeless and at-risk Veterans in rural areas often face barriers to
services, including a lack of transportation options and limited
housing stock. VA is making significant investments in rural
communities' ability to combat Veteran homelessness, through the SSVF,
HUD-VASH and other homeless programs. VA is also working with HUD's
Office of Native American Programs to allocate HUD-VASH vouchers to
tribal communities.
partnerships
VA recognizes that no single Federal or state agency or local
organization can end homelessness among Veterans. We have maintained
close working partnerships with Federal partners, such as HUD, DOL, the
Department of Defense, HHS, the Small Business Administration (SBA),
the U.S. Interagency Council on Homelessness (USICH), and others, as
well as partnerships with state, local, and tribal governments.
Veterans Service Organizations also fill a critical role, as do
community- and faith-based organizations, non-profit organizations, and
the business community. These partnerships are the lynchpin that binds
an intricate network of multi-level government programs and services
together to create a foundation of direct support community by
community tailored to fit the unique needs of each individual
community.
VA has made significant progress, and we are now closer to our goal
of ending Veteran homelessness than at any point in our history. Since
2010, nearly 230,000 Veterans and their family members have been
permanently housed, rapidly rehoused, or prevented from falling into
homelessness by HUD's targeted housing vouchers and VA's homelessness
programs. As a result of our targeted efforts, we are closing the gap
between homeless Veterans and non-Veterans. Before the priority to end
Veteran homelessness began, the percentage of homeless Veterans was 63%
higher than the percentage of homeless non-Veterans. The percentage of
Veteran homelessness has decreased to be only 30 % higher than for non-
Veterans. So, we are beginning to see that ending Veteran homelessness
is achievable, as cities including Houston and New Orleans, have
announced their achievement of an end to Veteran homelessness. As VA
approaches the five year mark of its priority to end Veteran
homelessness, we look forward to sustaining the essential partnerships
that have enabled VA and our partners to significantly reduce Veteran
homelessness. It will be critical to ensure that once communities meet
the goal of ending Veteran homelessness, they will be able to sustain
it with appropriate systems and resources in place to respond
efficiently and effectively.
conclusion
When Veterans become homeless or even at-risk, VA and its community
partners must have the capacity to quickly connect them to the help
they need to achieve housing stability. Sustaining the gains made so
far requires continued investments of financial resources. Failure to
provide such resources will severely jeopardize our ability to sustain
our progress and will put at risk thousands of Veterans and their
families in the future. We must ensure that we do not allow the levels
of homelessness among Veterans to return to previous levels.
Mr. Chairman, this concludes my testimony. My colleague and I are
prepared to answer any questions you or other Members of the Committee
may have.
Chairman Isakson. Thank you very much for your testimony.
Ms. Ho.
STATEMENT OF JENNIFER HO, SENIOR ADVISOR TO THE SECRETARY, U.S.
DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
Ms. Ho. Chairman Isakson, Ranking Member Blumenthal, and
Members of the Committee, I am Jennifer Ho, Senior Advisor to
HUD Secretary Julian Castro. Thank you for this opportunity to
discuss our collaborative work to eliminate veterans'
homelessness in America.
When we wrote the first Opening Doors: Federal Strategic
Plan to Prevent and End Homelessness, we knew that the
timelines we laid out were aggressive. Ending veterans'
homelessness across the country by the end of 2015 would be a
challenge. We knew that. But, we also knew that in order to
achieve real sustainable success, we needed an ambitious and
measurable goal.
This goal has been crucial to the success achieved thus
far, success that has been achieved in New Orleans and Houston,
both of which have announced that every homeless veteran in
their city who needs help with housing can get it. New Orleans
and Houston prove that although the goal is aggressive, it is
reachable.
We are measuring success by the overall reduction in
homeless veterans over the last 5 years and the system
improvements that have been put into place at the Federal and
local level. HUD, the VA, and the U.S. Interagency Council on
Homelessness are working more collaboratively than ever before.
We meet regularly, share data, use it to drive policy, and we
make decisions together.
The most collaborative of these efforts is HUD-VASH, a
program that combines housing vouchers from HUD with case
management and clinical services provided by the VA to assist
vulnerable veterans and those who are experiencing chronic
homelessness. Since 2008, over 79,000 HUD-VASH vouchers have
been awarded to Public Housing Authorities in each of the 50
States, the District of Columbia, Puerto Rico, and Guam. About
10,000 of those vouchers were awarded since April.
We are also funding joint technical assistance in
communities across the country to eliminate barriers that stand
in the way of meeting the goal. Some of those barriers are
Federal ones. Sometimes our rules and regulations prove
difficult to navigate for communities looking to enact real
systems change, and so when a barrier is at the Federal level,
we are organized to deal with it much more swiftly.
Some of the barriers to ending homelessness among veterans
have not yet been overcome. These barriers stand in the way of
communities meeting the goal, and so we must all work together
to develop solutions.
Perhaps the biggest of those barriers is access to
affordable housing. Once a veteran has a voucher in hand, there
is no guarantee that there will be an affordable unit available
to him or her, particularly in high-cost housing markets. We
need local officials to make it clear that this is a priority.
We need more landlords to step up and become partners in the
work. We need developers to designate some of their units for
homeless veterans. In short, we need more affordable housing.
Another barrier is our inability to serve all veterans
experiencing homelessness, regardless of how or whether they
receive services from the VA. Some veterans do not qualify for
VA benefits. Others choose not to receive treatment from the VA
or are too far away from a VA medical center. They all served
their country.
We must find a way to house every veteran, regardless,
which is why in the President's 2016 budget request we included
vouchers for veterans experiencing homelessness, but who are
not reached by HUD-VASH. While the Senate mark does not include
that specific request, we appreciate how Congress continues to
share our strong commitment to this goal. We recognize Congress
has provided critical funding in prior years for HUD-VASH. But,
if we are truly to end homelessness among veterans, we need to
be able to serve every veteran experiencing homelessness,
including those who are not reached by VA services and those
living in Indian Country. We look forward to working together
with this community to better serve all homeless.
Now is the time to end veterans' homelessness once and for
all. There is momentum building. Over 700 mayors, governors,
and county executives have joined the Mayors' Challenge to End
Veterans Homelessness. In January, New Orleans announced that
it had ended veterans' homelessness. Last month, Houston, the
fourth-largest city in America, announced that it has put a
system in place that can house every homeless veteran who needs
it.
This does not mean that New Orleans or Houston will never
have another veteran that experiences homelessness in their
communities. Instead, it means that they have created a
systematic response to ensure that homelessness among veterans
is rare, brief, and non-recurring. They are serving as models
for other communities who are striving to do the same.
We are taking those models, collaborations, and that
success ending veteran homelessness and applying it to our
broader work ending homelessness for families with children,
for young adults, for everyone.
Mr. Chairman, Members of the Committee, I want to thank you
again for this opportunity to testify on our work ending
veterans' homelessness and I look forward to your questions.
[The prepared statement of Ms. Ho follows:]
Prepared Statement of Jennifer Ho, Senior Advisor on Housing and
Services to Julian Castro, Secretary, U.S. Department of Housing and
Urban Development
Good afternoon Chairman Isakson, Ranking Member Blumenthal, and
Members of the Committee. Thank you for this opportunity to discuss the
progress made by the Department of Housing and Urban Development (HUD),
the Department of Veterans Affairs (VA), the U.S. Interagency Council
on Homelessness (USICH), and our community partners toward eliminating
Veteran homelessness in the United States, along with the challenges
that remain.
Ending Veteran homelessness has been a high priority goal for HUD,
and the entire Administration, since Opening Doors: Federal Strategic
Plan to Prevent and End Homelessness was launched in June 2010. Thanks
to funding from Congress and close collaboration among Federal and
local partners, the Nation has made substantial progress in reducing
Veteran homelessness and creating sustainable Federal and local systems
that quickly respond to homelessness. Our aggressive goal to end
Veteran homelessness by the end of 2015 has been the driving force for
real, measurable, sustainable progress. From 2010 to 2014, there was an
estimated 33 percent drop in the number of Veterans experiencing
homelessness on a single night according to HUD's 2014 Point in Time
count (from just under 75,000 in 2010 to just under 50,000 in 2014).
New Orleans and Houston proved the goal of ending Veteran homelessness
is achievable when they announced this year that they effectively
eliminated Veteran homelessness.
Such great progress would not have been possible without the
investments made by Congress and the authority given to HUD and VA to
collaboratively serve many Veterans with Housing and Urban Development-
Veterans Affairs Supportive Housing (HUD-VASH). In order to fulfill our
commitment to end Veteran homelessness, we must serve all Veterans
experiencing homelessness. Thus, we need support from Congress to fill
in the gaps in current services and to overcome barriers to serving all
Veterans experiencing homelessness.
Specifically, we need the ability to more effectively serve
Veterans not currently reached by HUD-VASH. First, we will need the
special purpose vouchers requested in the 2016 Budget to serve
individuals who served in the Armed Forces but are not currently
eligible for VA Medical Services due to time in service or discharge
status requirements. There are also Veterans in rural areas that are
not close to a VA Medical Center or who are reluctant to use the VA for
services for whom special purpose vouchers would be needed. Finally,
HUD currently has the authority to pilot HUD-VASH funding on Tribal
Lands, but would need the requested special purpose vouchers to expand
voucher assistance in these areas. With more than 700 mayors,
Governors, and local officials signed on to the First Lady's Mayor's
Challenge to End Veteran Homelessness, the level of local commitment to
end Veteran homelessness has never been greater. Now is the time to
capitalize on this momentum by expanding our reach to include all
homeless Veterans, helping communities problem-solve around challenging
housing markets that have very few affordable housing units, and
applying lessons learned from the progress on Veteran homelessness to
all populations experiencing homelessness.
hud-vash
Both VA and HUD administer programs that serve Veterans
experiencing a range of housing issues, from the risk of losing housing
to chronic homelessness over years--or even decades. HUD, VA, and USICH
created an interagency committee called Solving Veteran Homelessness as
One (SVHO) to combat a problem that cannot be solved by one agency
alone. SVHO has dedicated staff members who meet frequently to align
our programs, assess progress, and identify and resolve potential
barriers to success. The greatest source of collaboration between HUD
and VA is HUD-VASH, an essential resource for ending Veteran
homelessness.
The collaboration between HUD, VA, and USICH on the HUD-VASH
program is unprecedented and reaches from the senior leadership at each
Agency to national program staff to local offices on the ground.
However, HUD-VASH is only as successful as the local partnerships
between the VA medical centers (VAMC), Public Housing Authorities
(PHA), and Continuums of Care (CoC). While these local partnerships
often require a new and challenging way of doing business, many
communities have fostered thriving relationships between their VAMCs
and PHAs and closely collaborate with local CoCs. HUD and/or VA staff
is available when communities request or need help to resolve policy
issues or identify solutions regarding procedures or practices that
could be improved.
HUD-VASH provides long-term assistance to the most vulnerable
Veterans experiencing homelessness by combining HUD's Housing Choice
Voucher (HCV) rental assistance with VA's intensive case management and
clinical services. To date, funding for over 79,000 vouchers have been
awarded, and over 90,000 lease-ups have occurred through turnover. We
are currently housing over 57,300 Veteran families through HUD-VASH and
about 4,700 vouchers have been issued but are not yet under lease,
which means a Veteran is searching for a unit. In some areas where the
rental market has a low vacancy rate and rents are high, Veterans are
having difficulty identifying housing options. We are working together
with the VA and USICH to identify and implement strategies to assist
with landlord engagement and to encourage development of more
affordable housing in these areas.
To maximize the impact HUD-VASH resources have on reducing Veteran
homelessness, HUD and VA target HUD-VASH vouchers to the most
vulnerable Veterans. Thus, HUD and VA established a performance target
to use 65 percent of HUD-VASH vouchers for Veterans experiencing
chronic homelessness.\1\ HUD and VA use data on the number of Veterans
experiencing homelessness in communities and data on the performance of
PHAs and VAMCs to distribute vouchers to areas that have the greatest
need and the ability to effectively administer new vouchers. While this
65 percent performance target remains intact, HUD and VA recognize that
there are communities that have successfully housed 100 percent of
those Veterans experiencing chronic homelessness. For those
communities, HUD and VA will consider providing an exception to this
performance target on a case-by-base basis to allow them greater
flexibility to serve other vulnerable Veterans in their community.
---------------------------------------------------------------------------
\1\ Veterans experiencing chronic homelessness live with a
disabling condition and have been continuously homeless for at least
one year or experienced at least four occasions of homelessness in the
last three years.
---------------------------------------------------------------------------
HUD-VASH is critically important for Veterans experiencing chronic
homelessness who typically require long-term housing assistance paired
with supportive services, particularly since they tend to have high
rates of mental health and substance abuse problems that may be
exacerbated by physical illness, injury or trauma. Since HUD-VASH's
combination of HUD housing assistance and VA supportive services can
support Veterans for as long as needed, this type of supportive housing
enables Veterans to live as independently as possible in a place of
their own. Research has repeatedly demonstrated that this permanent
supportive housing not only ends homelessness for people who would
otherwise live for years on our streets and in shelters, but also saves
taxpayer money by interrupting the costly cycle through shelters,
emergency rooms, hospitals, detox centers, and jails.
We appreciate how Congress continues to share our strong commitment
to HUD-VASH. We recognize how Congress has continually provided
critical funding in prior years for HUD-VASH vouchers that has enabled
us to have sufficient resources to achieve our goal. But we need to
make sure that assistance is available for all Veterans who need it--
including those not currently reached by the HUD-VASH program, Veterans
living in tribal communities, and Veterans, regardless of discharge
status.
implementing strategies that work
This year, New Orleans and Houston announced that they effectively
eliminated Veteran homelessness, demonstrating that this goal is
achievable when communities have adequate resources, strong local
leadership, and implement the strategies that we know work. These
strategies include using coordinated entry systems that ensure there is
no wrong door for Veterans seeking help; proactive and coordinated
outreach efforts to locate all Veterans in need of assistance; sharing
data across systems to ensure no Veteran falls through the cracks;
implementing community-wide Housing First practices; and collaborating
with the Department of Labor's American Job Centers and their Homeless
Veterans' Reintegration Program grantees, local Workforce Development
Boards, and other stakeholders so Veterans can be quickly connected to
jobs.
The significant announcements in New Orleans and Houston that they
effectively ended Veteran homelessness means that those communities
have created responsive systems that will ensure that when a Veteran
does become homeless, it will be rare, brief, and non-recurring. A
Housing First approach is a key component to ensuring homelessness is
brief and non-recurring. This evidenced-based model provides immediate
access to permanent supportive housing from the streets or shelters
without requirements on service participation. The Housing First model
has been identified as the most successful approach for people who have
been experiencing homelessness for years and have complex disabilities.
While Housing First makes intensive services available, it does not
require residents to undergo psychiatric treatment or have maintained a
period of sobriety to obtain housing, which makes housing more
accessible for Veterans experiencing chronic homelessness. Vulnerable
Veterans can more easily engage in services and address chronic health
conditions, including substance use disorders, once they are housed and
no longer burdened with the chaos and uncertainty of homelessness. HUD
and VA are both committed to following a Housing First approach in HUD-
VASH. In support of the Housing First model, VA issued guidance to VAMC
case managers to not require Veterans to demonstrate sobriety or
receive treatment for underlying addiction or mental health issues as a
precondition for receiving housing assistance. To help target the most
vulnerable Veterans, HUD eliminated all criminal history screening
requirements for HUD-VASH vouchers except for the lifetime ban on sex
offenders.
helping communities meet the goal of ending veteran homelessness
Since the ability of any community to meet the goal of ending
Veteran homelessness depends on the strength of each community's
leadership and successful implementation of proven strategies, HUD and
its Federal partners are committed to working with communities to help
them get there. Because of the critical role that HUD-VASH plays in the
efforts to end Veteran homelessness, a significant amount of technical
assistance and training has been committed to improving the performance
of HUD-VASH.
In addition to the many national and local-level trainings
delivered by HUD and VA staff, both HUD and VA support local partners
on the ground. These initiatives, led by Community Solutions, have
included Boot Camps, the 25 Cities Initiative, and Zero: 2016. Through
these efforts, many communities have achieved large gains in short
periods of time by: getting all key partners to the table and
strengthening local coordination; accelerating HUD-VASH housing
placements; improving targeting of HUD-VASH vouchers to the most
vulnerable Veterans experiencing homelessness; implementing transparent
data and performance management strategies; and developing specific
targets for the number of Veterans to house each month.
These efforts dovetail nicely with other large-scale initiatives
that are helping communities end homelessness, including the Mayor's
Challenge to End Homelessness championed by First Lady Michelle Obama.
This summer, HUD launched Vets@Home, a technical assistance initiative
aimed at helping communities cross the finish line. Vets@Home is
intended to both provide support to communities that have not received
technical assistance through other initiatives and to supplement
existing efforts. Vets@Home will target assistance to where additional
support is needed, and tailor the assistance to each community's needs.
challenges we face in ending veteran homelessness
Despite the unprecedented progress achieved in reducing Veteran
homelessness, communities still face significant barriers. While HUD-
VASH makes housing affordable for Veterans experiencing homelessness,
many HUD-VASH recipients still face a limited supply of affordable
housing, particularly in high-cost markets. Once a Veteran has a
housing voucher in hand, there is no guarantee that there will be
enough affordable housing available in his or her community. While we
can help communities better engage private landlords and incentivize
landlords to prioritize housing Veterans experiencing homelessness,
addressing the shortage of affordable housing requires commitment from
local governments and housing developers to prioritize affordable
housing for this population. The Administration is working with local
actors in areas where this problem is most acute to help incentivize
the availability of affordable housing for Veterans experiencing
homelessness.
We also must continue providing communities with guidance about the
role of transitional housing in efforts to address Veteran
homelessness. While transitional housing may be needed to address the
specific service needs of a Veteran before moving to permanent housing,
some models of transitional housing can lead to longer periods of
homelessness for a Veteran. Much of the country's transitional housing
imposes high barriers to entry, which makes it harder for high-need
Veterans to access transitional housing because it prioritizes
therapeutic goals such as achieving sobriety over permanent housing.
For this reason, HUD, VA, and USICH must continue efforts to transform
existing transitional housing models so that Veterans can access
permanent housing as quickly as possible.
Another barrier is our inability to serve all Veterans experiencing
homelessness regardless of whether they receive other benefits from VA
or whether they live on Tribal lands.
We are excited that Congress authorized a Tribal HUD-VASH
demonstration project for Fiscal Year 2015. This demonstration, for the
first time, gives veterans living on Tribal lands access to targeted
housing assistance and case management. In Fiscal Year 2016 and beyond,
we hope to continue to be able serve Veterans experiencing homelessness
who live on Tribal lands, because our obligation is to all Veterans,
including those who live on Tribal lands.
Similarly, some Veterans do not qualify for VA benefits, while
others choose not to receive treatment from VA, and we must serve them
all. While HUD encourages CoCs to prioritize serving Veterans who do
not access VA services, CoCs lack the resources to meet the needs of
all those Veterans. That is why the President's Fiscal Year 2016 budget
request included $177.5 million for 22,500 vouchers for homeless
families, as well as Veterans who are not currently reached by HUD-
VASH--as well as an increase of $265 million for new permanent
supportive housing for people experiencing chronic homelessness that
could prioritize Veterans who do not receive VA assistance. Many
individuals cannot access VA services because they received a less than
honorable discharge. Therefore, we urge Congress to support the
President's Fiscal Year 2016 budget request for these resources.
conclusion
Mr. Chairman and Members of the Committee, I hope this discussion
has helped inform your understanding of the progress we have made
toward ending Veteran homelessness, and what is needed to achieve our
goal of ending Veteran homelessness and all homelessness in the United
States. Thank you for this opportunity and I look forward to answering
any questions you may have.
Chairman Isakson. Well, thanks to all of you, and I will
begin the questioning by asking you this question, Ms. Ho.
Would you describe for the Committee and the people in the
Committee room what a HUD-VASH voucher is worth.
Ms. Ho. The average cost of the voucher?
Chairman Isakson. Right.
Ms. Ho. Let me just check with Molly for a second. It is
about $8,000 a year of housing assistance. So, it works like a
regular housing choice voucher----
Chairman Isakson. OK.
Ms. Ho [continuing]. Where you get--you pay 30 percent of
your income, and then it pays the difference up to the rent
limit.
Chairman Isakson. So, $8,000 a year would be roughly $650 a
month, is that right? Am I counting right?
Ms. Ho. Your math is much quicker than mine, sir.
Chairman Isakson. It is close. It is probably not right,
but it is close. [Laughter.]
Thank you for being respectful of my old age. [Laughter.]
But, $650 a month will not provide much housing in most of
America's major cities.
Ms. Ho. Sir, this is the average subsidy value of a HUD-
VASH voucher, but the amount of assistance that is paid from
community to community varies----
Chairman Isakson. Right.
Ms. Ho [continuing]. Based on something that we call the
fair market rent, which is a locally determined figure. A fair
market rent in Montana would be different than a fair market
rent in Washington, D.C.
Chairman Isakson. Is that voucher sent to the property
owner, who then offers it to veterans who might be a potential
tenant in the house, or is it sent to veterans, or is it
redeemable by a veteran when they find a house they want to
rent?
Ms. Ho. Thank you for that question, sir, on how it works.
The Public Housing Authority actually has the HUD-VASH
voucher----
Chairman Isakson. Got you.
Ms. Ho [continuing]. So, when the contract is executed
between the veteran and the landlord, the payment of the rent
subsidy is made from the Public Housing Agency to the landlord
directly. Then the veteran would pay 30 percent of their
income. That is all calculated by the Housing Authority.
Chairman Isakson. Did not some cities offer some abandoned
housing from the housing crisis of 2008-2012 and convert it
into housing for the homeless?
Ms. Ho. Sir, that is an excellent question, but I do not
have details on that to report. I could check back with others
at HUD and get back to you.
Response to Request Arising During the Hearing by Hon. Johnny Isakson
to Jennifer Ho, Senior Advisor to the Secretary, U.S. Department of
Housing and Urban Development
Response. The Neighborhood Stabilization Program (NSP) was
established for the purpose of providing emergency assistance to
stabilize communities with high rates of abandoned and foreclosed
homes, and to assist households whose annual incomes are up to 120
percent of the area median income (AMI). NSP funds may be used for
activities which include, but are not limited to:
Establish financing mechanisms for purchase and
redevelopment of foreclosed homes and residential properties;
Purchase and rehabilitate homes and residential properties
abandoned or foreclosed;
Establish land banks for foreclosed homes;
Demolish blighted structures;
Redevelop demolished or vacant properties
If any properties were used to house homeless individuals it most
likely occurred as purchase and rehabilitate homes and residential
properties abandoned or foreclosed. This may well have happened but I
am not aware of specific examples.
Chairman Isakson. Thank you very much.
Ms. Pape, I really appreciate your focus on that 71 percent
that are either drug-related or mental health-related. In your
written testimony, you say, ``Therefore, VA provides a
continuum of outpatient residential and inpatient mental health
services across the country to address that problem.'' What is
that continuum, and what are those services? Are the services
available at the VA hospitals and through the community
contract providers, or what?
Ms. Pape. You know the answer, sir. That is exactly right.
We are able to provide both inpatient residential care, called
domiciliary care, which many of you probably know,
rehabilitation, where a veteran can live up to usually 6
months, usually less, about 4 months, and get the rehab they
need that focuses on substance abuse, PTSD treatment, any
mental health treatment, as well as for communities that do not
have domiciliaries, there is residential contract care that we
also contract for care so that veterans can get what they need.
I will mention there is a huge continuum of mental health
care, inpatient and outpatient, Vet Centers that our veterans
can get connected to, and, of course, any community agency that
joins hands with VA to do mental health or substance abuse
services.
Chairman Isakson. I have been told by advocates for the
homeless that homeless veterans are far different than the
typical homeless person. In fact, they told me if you are going
to find a veteran in need of a house, you do not look to a
wandering street. You go to a public library or other public
facility during the day and they will be there until it closes
at night because they do not want to let anybody know they are
homeless or look that way. Do we do a good job in our mental
health centers of identifying people who might be homeless and
getting them services and getting them help?
Ms. Pape. That is an excellent question. Thank you. Our
veterans are proud, as you know, and not every veteran wants to
step up and say they are homeless because it is so shame-based.
We have instituted a screener both--that is inpatient for us so
that if veterans come to the hospital, there is no wrong door.
We do not ask them, are you homeless. We ask them, are you
having difficulty paying your rent, are you sleeping on someone
else's couch, so that we can start to identify if they are at
risk; are you in jeopardy of losing your job, so we can
identify that. It is really about a no wrong door approach. We
also work with our community partners to ask those same kind of
questions so that we can start looking at the preventative
nature of homeless veterans.
Chairman Isakson. Thank you very much to all of you.
Ranking Member Blumenthal.
Senator Blumenthal. Thank you.
Let me ask you, Ms. Pape, would it be helpful for you to
have a program that increases housing stability and retention
by providing grants to community organizations for after-care
of formerly homeless veterans?
Ms. Pape. We know in order for us to really end
homelessness and sustain homelessness, we need to have the
capacity across the country, community by community, to end
veterans' homelessness. We are always pleased to hear when
folks want to step up and provide permanent supported housing
or additional services that can address the issues of our
homeless veterans.
Senator Blumenthal. Folks in the community. So, that would
be a welcome program for you. That is one of the provisions of
the----
Ms. Pape. Absolutely.
Senator Blumenthal.[continuing]. Veterans Housing Stability
Act of 2015 that I introduced today. Modifying the VA program
so that you could use homes from VBA's foreclosure inventory,
that is to say the homes that are foreclosed, so that nonprofit
agencies could better use them to end homelessness and provide
roofs over heads and even permanent housing. That would be
welcome, would it not?
Ms. Pape. I would need to take the details back and have
our offices work together. That would be under the Veterans
Benefits. But, again, permanent housing for any homeless
veteran is a welcomed addition to our entire continuum.
Senator Blumenthal. So, in theory, you would welcome it,
and you want to see the details----
Ms. Pape. Yes, sir.
Senator Blumenthal [continuing]. And I welcome your
support.
Ms. Pape. Yes, sir.
Senator Blumenthal. In terms of the super-utilizers--let us
use that word to refer to health care clients who need more
intensive case management intervention--would it be helpful to
you to have a program that targeted them among the homeless?
Dr. O'Toole. Senator, if I can answer that. This is a huge
issue and it speaks to the larger process of once we get them
housed, obviously, their care needs to continue, and if we want
to keep them housed, we have to be providing the up-front care.
Homeless veterans, on average, are at least twice, if not more,
complex in their care needs than the general veteran
population.
We have actually instituted a program within the VA using
the homeless registry to actually proactively identify who
those veterans are that are at highest risk for being a super-
utilizer, or most expensive and utilizing the most--highest
levels of care, with reports that go out to the field on a
monthly basis of who those veterans are to field assistance to
support them while they help. We have been able to demonstrate
about a $6.3 million reduction in acute care use with that
group as a part of this initiative.
Much more needs to be done. We would be very, I think,
happy to see any additional support in further developing this
hot spot, or not only for acute care use, but also for risk for
losing their housing and other predictive analytics and
algorithms that we can apply to providing more efficient and
effective care.
Senator Blumenthal. Well, I welcome your support and look
forward to working with you on that provision, as well.
One more among the provisions in this bill, not by any
means exhaustive, the definition of a homeless veteran--why not
conform the definition of homelessness for veterans to the
definition of homelessness for the Department of Housing and
Urban Development so as to include a veteran or veteran's
family who are fleeing domestic or dating violence, sexual
assault, stalking, or other dangerous and even life-threatening
conditions in their current housing situation? Would you favor
that kind of change in the statute?
Ms. Pape. Again, we would want to take those details back,
have discussions with our partners. We would be happy to work
with your office on drilling down on the details of what that
would mean. But, absolutely.
Senator Blumenthal. Well, I hope that you can commit to
work with us on this matter, because I think not only decrying
and describing the problem, but doing something about it is
really what is necessary. Thank you very much, and thank you,
Ms. Ho, as well.
Thank you, Mr. Chairman.
Chairman Isakson. Senator Tillis, followed by Senator
Manchin.
HON. THOM TILLIS, U.S. SENATOR FROM NORTH CAROLINA
Senator Tillis. Thank you, Mr. Chair, and thank you all for
what you do.
The one question I have, and it may be one that each of you
may have a comment on, in North Carolina, I was Speaker down
there before I came up here in January, and we did a lot of
work at the State level on homelessness. We got a CDBG, or
community development block grant, to actually start taking a
facility, a health facility, and converting it to a 150-bed
homeless vets transitional facility. It was a bit of a pain to
get through, though. It was one of these obvious great uses for
the resources. We had a willing State agency. It took us about
a year and a half, almost 2 years to get to the point to where
we are finally at implementing it and should go online fairly
quickly.
What more do we need to do for communities that are forward
thinking, they want to help, VSOs, what more do we need to do
to remove the barriers that would have caused that process to
take so long?
Ms. Ho. I would be happy to take that. Senator Tillis,
thank you for that insightful question. We were at a conference
with 1,800 homeless advocates and service providers and one of
the things that is just so clear to me, this work is not for
the faint of heart, and the bureaucracy of doing the right
thing is incredibly hard. Oftentimes, when you are creating
more supportive housing options, you are trying to figure out
how to weave together 13 different funding streams and tax
credits, and they all work on their own cycles.
It is one of the reasons that we think that the HOME
Program is so important for the creation of more affordable
housing and supportive housing. As you know, in the Senate
markup right now, there is a 93 percent cut to the HOME
Program, and it is the best engine that we have to create more
affordable housing, and it is an incredibly flexible funding
tool that local communities control so that they can use it to
gap fill when they are trying to put together the financing for
supportive housing or for affordable housing.
What we hear from communities all the time is that the
local control and the flexibility associated with the HOME
Program, as well as the fact that it is specifically dedicated
to the creation of more affordable housing opportunities, that
that is a really important tool to have.
Senator Tillis. Something I would like to see from you,
which I was going to ask the other panelists, too, is if you
could go back and identify things that we should rethink that
could be constraints that we placed on you or that you may have
placed on yourself or the interaction with other agencies that
we need to look at modernizing and streamlining so that we can
get a faster rate of solutions to the homelessness problem;
and, I, for one, would like to help.
I would also like to spend some time talking more about the
best practices that are out there. You know, I, for one--
Senator Sullivan is from a very large State with a very large
dispersed rural population. I am in a State that is 50 percent
urban, 50 percent rural. We need different solutions to those
challenges, and I am very interested in hearing about a kind of
national plan and prioritization, if any of you would like to
speak on that.
Dr. O'Toole. Thank you, Senator. I think this is an issue,
as well, that we have been struggling with. I would say that if
we were to look forward 5 years from now in terms of what are
the population groups and what are the dynamics that we need to
be prepared for, there are four population--sub-populations of
veterans at risk for becoming homeless or who are homeless that
we really need to be concentrating our efforts to.
Homeless women, because of the increasing ranks of active
duty who are going to be separated from service. Those men and
women who served in Iraq and Afghanistan, part of the OEF/OIF
era and their return and separation from service and the risks
that they have. We have an increasingly aging and frail
population of homeless and formerly homeless who have had an
accelerated aging process and accelerated needs and complexity
of needs. We also have those veterans that cycle through.
When we start laying into that dynamic, urban homelessness
is very different than rural homelessness and we have to have
that consideration and understanding and appreciation, as well.
We also need to be looking at our programs, really not as
stand-alone, but representing a continuum that can be flexible
and responsive to where the veteran is and what those needs
are.
This is a process that we have been engaging in and, I
think, would welcome a very active role and engagement with you
and others in really trying to map out that strategic thinking
over the next 5 years.
Senator Tillis. Thank you.
Thank you, Mr. Chair.
Chairman Isakson. Thank you, Senator Tillis.
Senator Manchin.
HON. JOE MANCHIN, U.S. SENATOR FROM WEST VIRGINIA
Senator Manchin. Thank you, Mr. Chairman, and thank all of
you for your service and doing the Lord's work, really, trying
to help our veterans.
But, let me just say that in my State of West Virginia,
drug abuse is the number 1 killer. It is prescription drug
abuse. When I first came to the Senate--I happened to be
privileged enough to be Governor of my State, and I did not
realize the amount of unemployment in our veterans' ranks, drug
abuse, and homelessness. I do not know which one follows which.
Do you all have a percentage breakdown of addiction versus
mental impairment? Which is the most?
Dr. O'Toole. A lot depends, of course, on how you want to
define it, but most statistics in this area are putting the
rate of addiction among homeless veterans at a 64 to 65 percent
range. The percentage of homeless veterans who have a mental
illness typically runs about a 45 percent range. Those with two
or more conditions, or those who would have what is considered
a serious persistent mental illness of a higher degree of
severity. It runs about 35 percent; and, chronic disease is
about 65 percent.
Senator Manchin. How often do you all communicate with the
Department of Defense? Basically seeing what you are seeing
after they have given their service to our country and you are
seeing the effects of that service that was commitment. Are
they asking you all, what are you getting on this end and what
we are putting out on this end?
Ms. Pape. We do work with the Department of Defense and
especially during the transition from servicemember to veteran.
Folks know these statistics to make that transition better so
that we can intervene sooner and help prevent some of the deep-
seated issues that may often result as from being a
servicemember. But, some of this addiction and mental illness
is just how people are hard-wired, too. It is not always
because they served in the military.
Senator Manchin. Well, I agree. The thing that we are
fighting is drug addiction here on the private sector, and
there is not a single person sitting in this room who does not
know somebody in their immediate family or extended family that
has not been affected by legal or illegal drugs. It is of
epidemic proportion. None of us here have escaped it.
With that being said, we in the Department of Defense or in
the military are trying to hound it on this side, because we
are looking at, first of all, how it is being dispensed, the
abuses that go on, how they are getting it. In the military, it
seems to be like candy. I mean, we are just giving it for every
reason in the world. I mean, they have problems here, problems
there. We have anxiety. Before you know it, we have got them
hooked before we get them out of the service. Then, we wonder
why the high unemployment rate. They cannot pass a drug test.
Ms. Pape. Right.
Senator Manchin. They cannot pass a drug test. I mean, you
look down into it--the homelessness among addicts, like you
said is 65 percent probably. So, the military is supporting it.
I am saying, if they are speaking to you all and talking to you
all, you have got to tell them what I am getting. When they
have given the service to our country and you are finished with
their service, or they are finished, let me tell you the
product I have got to work with. I think all of us have to be
extremely concerned about this. It is just unbelievable.
I talk to some of these veterans. They cannot transition
back in because of their addiction. They cannot hold a job.
They cannot get retrained. You can spend all the money you want
and if you give them a home, they cannot keep the home unless
you can keep them clean. You have seen that.
Ms. Pape. And employment. It is important to have a way to
sustain----
Senator Manchin. Well, they need a job. We kept saying that
we are trying to reconnect the dots before they leave.
Ms. Pape. Yes.
Senator Manchin. I appreciate the work you are doing. It is
such a mammoth problem that we have. But, if we cannot control
it in the military--and, if the VA, Medicaid, and Medicare
would not be dispensing opiates like M&Ms and we would go,
basically, opiates should not be dispensed unless other
alternative pain relievers have been tried--have you all talked
about that at all. Doctor?
Ms. Pape. I will let Dr. O'Toole answer that.
Senator Manchin. I am sorry.
Dr. O'Toole. No, as a primary care provider who will be
seeing patients in a couple of days in my clinic, this is a
huge issue, and, Senator, I have to just echo everything you
are saying and that it also speaks to a larger issue of how we
manage pain and how we address pain issues in a way that,
obviously, does not keep people suffering, but is effective in
this.
Just to echo and to reinforce your point, the number 1
reason for losing a HUD-VASH voucher from an event-based
process is having a substance abuse-related hospital admission.
Senator Manchin. But, Doctor, dispensing--and I will finish
because my time is up--but dispensing, I cannot believe the
culture that we have today. When I was growing up, you got an
aspirin or something and that was it. We all had pain, I guess,
to a certain extent. We just did not get this kind of relief.
I had a person--my communications director had gone and had
a wisdom tooth pulled. Ninety oxycontin for a wisdom tooth.
Now, you tell me somebody should not be put in jail for that.
This is where we have got to crack down, Doctor. So, I just
hope that you all would push back, and we could do it in the
military.
Dr. O'Toole. I could not agree more.
Senator Manchin. Thank you, sir.
Chairman Isakson. Let me amplify on that for 1 second. You
know, a lot of these homeless veterans with mental health
problems that are coming to you for services are also getting
VA services for their health. Senator Manchin is probably right
on target that they have got some prescriptions being provided
by the VA that are contributing to their homelessness. There
ought to be some vertical reporting back and forth to try and
get that pharmacist or that VA physician or that VA CBOC that
serves that veteran the information that he is now homeless and
on the streets and the biggest contributor is drugs, which they
are the biggest provider of those drugs.
Dr. O'Toole. Absolutely, sir. One of the things we have
developed within the VA is actually a homeless-specific primary
care model that does integrate and coordinate care between the
housing and the veteran's ongoing care needs. I think that the
Senator's point and your point about how essential it is to
manage medication use effectively and judiciously so that we
are not making the problem worse is absolutely spot on and it
is an issue. It is an issue that is not limited to the VA, as
we all know, but it is one that, obviously, this population is
incredibly vulnerable to. And, we do try to work on it. We do
actively address this issue within the clinical context that we
have. VA has launched several initiatives to really try to curb
and redirect away from opiate use to more prudent pain
management approaches, and it is an ongoing battle for all of
us.
Chairman Isakson. Thank you.
Senator Boozman.
HON. JOHN BOOZMAN, U.S. SENATOR FROM ARKANSAS
Senator Boozman. Thank you, Mr. Chairman, and thank you so
much for having this very, very important hearing, and I do
appreciate all of your efforts.
Ms. Pape and Ms. Ho, as the law currently stands, veterans
who receive a housing voucher through the Housing and Urban
Development-Veterans Affairs Supportive Housing, HUD-VASH,
Program are not considered to be homeless because, technically,
they have housing and, thus, they are ineligible to participate
in the Homeless Veterans Reintegration Program, HVRP, which I
understand is a Department of Labor program, but it falls
within Title 38 and is, therefore, within the jurisdiction of
this Committee.
Senator Tester and I have introduced legislation, S. 425,
which reauthorizes HVRP for an additional 5 years and also
clarifies that veterans who participate in the HUD-VASH Program
can still participate in HVRP. It is my firm belief that the
two programs are very complementary. It is difficult for a
veteran to focus on learning the skills needed to find and
maintain employment if they are homeless, and providing housing
without teaching job skills only perpetuates the cycle of
homelessness.
I guess my question is, do VA and HUD support changing the
law to allow veterans participating in HUD-VASH to also
participate in HVRP?
Ms. Ho. Thank you, Senator, for that question. It is a
great question. The way that the different eligibility criteria
between programs works is oftentimes counterproductive to what
we are trying to accomplish in the long run. I would defer to
my colleagues at the Department of Labor on the nuances of the
eligibility, but absolutely, the ability to get employment
assistance to veterans who become housed is critical, both in
terms of their long-term self-sufficiency, but also just their
recovery and well-being. So, anything that we can do to enhance
employment services for veterans once they are housed would be
terrific and HUD would be more than happy to work with you and
our colleagues at the VA and the Department of Labor on the
details of that.
Senator Boozman. Ms. Pape.
Ms. Pape. I would absolutely concur with what Ms. Ho is
saying, and know that targeted programs for homeless veterans
in employment is very necessary, because, remember, our
veterans' average age is about 53 years and they have spent
several years on the streets. They are not used to getting up
and going to a job. Anything that can target homeless for
employment is a good thing for all of us.
Senator Boozman. Yes, it is really kind of crazy. I mean,
it is a catch-22 situation. I mean, you provide them a benefit
where they are in housing for a period of time, and yet they do
not have any benefits to get the skills that they need so that
they can actually maintain their own housing. We really would
appreciate working with you guys.
Ms. Pape, there was a VA OIG report issued in December 2014
about the National Call Center for Homeless Veterans. Let me
give you some of the highlights. In fiscal year 2013, 79,500
homeless veterans contacted the call center. Twenty-seven
percent of callers left messages because counselors were unable
to take the calls. The IG identified 40,500 missed
opportunities, which is a majority, where the call center did
not refer veterans to medical facilities or closed referrals
without verifying that the veterans had received the VA
services that they needed. There was also $267,000 in funding
that was inappropriately spent.
Oftentimes, one of the biggest hurdles to helping a
homeless veteran is getting them to make contact. As you
mentioned and as we have discussed, many of these individuals
are mentally ill or have a variety of problems. How do you call
back somebody who is homeless?
I guess the question is, since the VA OIG report was
issued, can you comment about what is being done to fix the
problem, and can you tell us now what the percentage of
incoming calls are being answered at this point in time.
Ms. Pape. Absolutely, and thank you for the question. Since
the IG report came out, the call center was originally
organized under the Veterans Crisis Line, so the Suicide
Hotline and the Homeless Call Center were organized together.
That call center has been moved out from under the Crisis Line
and moved to our Health Resource Section, where they already
run four other crisis or hotlines, phone lines. They run a
benefits line, a pharmacy line--it is escaping me, another
line--a pharmacy line, and then the Homeless Call Center. That
has improved our ability to respond to calls already.
Senator Boozman. Do we have a percentage of calls that are
actually being answered for homeless people calling in?
Ms. Pape. We do. 95 percent of the calls are being
answered. Instead of an answering machine--they got rid of the
answering machine--they now have a queuing system, so that if
somebody is waiting for a call, it goes to the next available
caller, like all the call lines we have had before. 95 percent
are getting responded to at this point.
Senator Boozman. Good. Thank you very much.
Ms. Pape. Yes.
Senator Boozman. Mr. Chairman, we really need to follow up
on that in the future and kind of hawk that as to what is going
on. Again, I know that you all are working hard in this regard,
and the good thing about that is, you have got all these people
calling in. I mean, we are doing something right along that.
But, it is kind of like the other situation that we have got
with the benefit of some housing and then you lose benefits on
the other. We have simply got to--you know, we have got to
solve the problems that we create by doing some good things,
and sometimes it creates other problems. Thank you very much.
Chairman Isakson. Thank you, Senator Boozman, and I commend
you on your effort on veterans' homelessness, not just at this
hearing, but what you have done the last couple years. I
appreciate it very much.
Senator Sullivan.
HON. DAN SULLIVAN, U.S. SENATOR FROM ALASKA
Senator Sullivan. Thank you, Mr. Chairman, and I want to
thank the panelists for your commitment to a really important
issue that I think all of us want to get behind, and I applaud
the VA for its focus on this.
I think that just the term ``homeless veteran'' is
something that kind of chokes up a lot of us. I think it would
be great if 10-20 years from now to be able to just banish that
term completely because it no longer exists. We will all work
together on that.
I wanted to follow up on the discussion of homeless veteran
women. You know in my State we proudly boast the top number of
veterans per capita of any State in the country, but sadly, we
also have very high levels of domestic violence and sexual
assault in Alaska, some of the highest in the country, as well.
I am wondering, kind of following on a little bit of Senator
Blumenthal's question, to what degree have you seen that our
women veterans homelessness is a result of domestic violence,
and do we need to do something to make sure the definition is
broad enough so these women can avail themselves of these kind
of services if they fall into that definition.
Dr. O'Toole. I am happy to jump in on that. Thank you,
Senator, and I absolutely agree with you. I do not have the
statistics off the top of my head, but domestic violence risk
and fear of domestic violence is a significant factor for women
veterans becoming homeless. The other issue is, obviously, many
of these women, upwards of 30 or 40 percent, have children,
dependent children that they are responsible for. So, it is not
only making sure that the definitions are expanded to make sure
that women can avail of services in the immediacy of needing
them, but also that we have the capacity for caring for their
children, as well, during these crises.
Senator Sullivan. You will take a look at this definition
and make sure that women who fall into that category can avail
themselves of the services?
Ms. Pape. Absolutely. We will, again, work with your office
and our Congressional affairs to provide technical assistance.
Absolutely.
Senator Sullivan. Great. Senator Tillis raised a good point
about kind of the difference between some of the urban
challenges that we have with homelessness and then rural. You
know, for a big State like Alaska, we have a lot of veterans
who live in very remote rural areas. What are you doing in
terms of those kind of challenges with regard to homelessness
in rural communities?
Ms. Ho. Do you want to take that----
Ms. Pape. I will start, but I know my colleagues will have
additional information. As you know, rural homeless is a
challenge, absolutely no doubt. They are often called the
hidden homeless. They are living in campgrounds in the woods,
right, couch-surfing, and you do not find them the same way
that we can find them in urban areas. We have to be really
creative about how we find those homeless rural veterans. We
have the call center, of course, which we try to ensure that
that number is out to all medical centers and our partners in
those areas so that those folks can call into us and we can get
connected.
We also have our SSVF grant, Supportive Services for
Veteran Families, and we are able to target that grant into
rural areas, and I am glad to say that when we started it, it
was in about 48 percent rural areas, and over the last 2 years,
we have grown that so that grant now is available in 68 percent
of rural areas out there, which is very positive. That grant
provides us the opportunity to serve families and then pay
light subsidies, which we cannot do in any other program. If
there is not a resource in the rural area, we can help them pay
for whatever need they may have.
Senator Sullivan. Great. Ms. Ho, do you have a----
Ms. Ho. Yes, Senator, and thank you for that question. I am
a Minnesotan and did this work in rural Minnesota and urban
Minnesota, and while homelessness manifests itself differently
in rural communities than it does in big cities, the causes are
oftentimes the same and the solutions are the same. You know,
the solution is a home.
I think one of the things that--one of the reasons why the
President included in the 2016 budget special purpose vouchers
for veterans that are not tied to HUD-VASH or the VA is that we
want to make sure that no matter where a veteran lives, that we
have the opportunity to have vouchers that are going to meet
those needs.
The other thing that we have done with the HUD-VASH Program
is that we have used the authority that you have given us to
have the HUD-VASH vouchers be immediately portable. Even if
somebody living in a rural community, their closest Public
Housing Authority (PHA) does not have an allocation of HUD-
VASH, as long as they can work with the VA through the
eligibility, they can get a VASH voucher from another PHA that
does and use it in their home community.
It is one of the tools that we have with existing HUD-VASH.
Of course, we also think that getting the special purpose
vouchers for veterans that would not necessarily be tied to the
VA would help us fill in some of the gaps, especially in remote
and rural communities.
Senator Sullivan. Great. Thank you.
Thank you, Mr. Chairman.
Chairman Isakson. Thank you, Senator Sullivan.
Senator Heller.
HON. DEAN HELLER, U.S. SENATOR FROM NEVADA
Senator Heller. Mr. Chairman, thank you for holding this
hearing to examine the issues we have with homeless veterans,
and I want to thank the panel, also, for being here, for your
insight and wisdom on this particular topic.
You know, in this community, we talk a lot about the
failures with the VA health care, VA claims backlog, and,
obviously, improving the management at the VA, but when we look
at how well our Nation is caring for veterans, I think we need
to start by looking at our homeless veterans. Men and women who
have served our country obviously should never be in this
particular position.
I think the VA has been focused on this issue, and frankly,
I think improvements have been made, and I am glad to see that.
But, as long as we have homeless veterans, I think we ought to
be doing everything we possibly can to get them back on their
feet. Frankly, I also do not think it is solely a VA effort. We
have several organizations in our communities back in Nevada
that provide services to help veterans put a roof over their
head and some stability back into their lives. I think Nevada
is lucky in that case to have organizations in both Southern
and Northern Nevada, and for that, they should be commended.
I like the program of VA 25 Cities Initiative. They help
better coordinate with community leaders to address these
veterans' homelessness, and especially in Las Vegas, and in
combination with the effort that you are doing and what these
organizations in the State are doing, we have seen now where
homeless veteran numbers declined by 44 percent in the last
year, and that is very, very commendable. I think that is
great.
My hope is that the VA initiative can be expanded in other
cities, like in Northern Nevada and Reno, where we have about
150 homeless veterans at this point.
But, I also urge this Committee, Mr. Chairman, to consider
legislation I have introduced with Senator Murray for several
Congresses to allow VA-funded shelters to be reimbursed for
care of veterans' dependents.
Ms. Pape, can you define for me functional zero.
Ms. Pape. Absolutely. Jennifer alluded to some of this in
her testimony. Functional zero, or we call it an effective end
to homelessness, means that communities have the capacity to
serve homeless veterans who are on the streets. It does not
mean, by any means, that a veteran will not become homeless.
People go through hard times. They have housing crisis, health
issues that will cause them to become homeless, but that the
community has a rapid response to that homelessness and can get
them either a house or a safe place to stay and the services
they need.
Senator Heller. Can you give me examples? Can you give me
examples of cities that were formerly not functional zero but
are today?
Ms. Pape. Absolutely. There are two that have stepped
forward, which gives us great inspiration. First, New Orleans,
and what they did was name list everybody. They know every
veteran that is on their streets by name so that they can
continue to work directly with them; and Houston did the same.
Though they may still have veterans kind of out there, they
are connected, know the veteran by name, and are striving
toward getting that veteran as quickly as possible, usually
under 30 days--I think New Orleans is at, like, 25 days at this
point--in a house or a safe place of living very quickly. If
communities can do that, they will well be on their way.
Senator Heller. Have you determined or rated cities? Is
that what you do? I mean, could I find a list of functional
zero cities, and how close, perhaps, cities and communities in
Nevada are?
Ms. Pape. Senator, what we are asking is that communities
come forward to the U.S. Interagency Council on Homelessness,
along with their mayors who have joined into that Mayor's
Challenge. We have several that have stepped up and are nicely
on their way. Phoenix has hit some great milestones. Cleveland
tells me they are on their way. Binghamton, NY, is on their
way. So, we have those who raise their hand and come to us. We
are not out there rating the cities. We are hoping the
communities own it.
Senator Heller. Do you keep a list specifically for women
homelessness, veteran women's homelessness? Is there a
statistic?
Dr. O'Toole. We know and we do track the number of homeless
women who are there. It is roughly 10 to 12 percent. We know
the programs and we have designated programs that are set aside
and specifically dedicated to care for them.
Senator Heller. Is there a hard number?
Dr. O'Toole. I would have to get back to you on that for
the record. There is a figure, but it escapes me right now.
[The information requested during the hearing follows:]
Response to Request Arising During the Hearing by Hon. Dean Heller to
Dr. Thomas O'Toole, Acting Director, VA National Center on Homelessness
Among Veterans, U.S. Department of Veterans Affairs
Response. The number of homeless and at-risk for homelessness
female veterans served by VA last year was 36,763.
Senator Heller. I was just curious. So, you are saying,
what, 10-12 percent of something is----
Ms. Ho. Sir, if I may. The other piece to add to that is
that 14 percent of the HUD-VASH vouchers are going to women
head of households. We have had a real targeted effort----
Senator Heller. There is a targeted outreach effort.
Ms. Ho. That is right, sir.
Senator Heller. What is the uniqueness, the difference
between homeless women versus homeless men?
Ms. Ho. Do you want to speak to that?
Dr. O'Toole. I think one of the primary ones is the issue
of dependent children and, obviously, the needs that extend
beyond the individual to also cover that of the family. The
pathways in, which Senator Sullivan referenced in regard to
domestic violence and instability there, are clearly
significant, as well. Military sexual trauma as a driver for
homelessness is something that our research at the National
Center has identified, as well, as a significant driver.
Senator Heller. Mr. Chairman, my time has run out, but
thank you very much, and again, thanks to the panel for being
here today.
Chairman Isakson. Thank you, Senator Heller.
Senator Rounds.
HON. MIKE ROUNDS, U.S. SENATOR FROM SOUTH DAKOTA
Senator Rounds. Thank you, Mr. Chairman.
I appreciate the VA's mission to end homelessness among
veterans. Recently in South Dakota, I have seen programs like
the Veterans Outreach Center in Sioux Falls get cut, and I am
hoping in the future that may be reconsidered. That particular
decision to cut was with a program in which you had, I believe,
a 1-year contract that in 4 years optioned. You have notified
them that you were taking the option for the fourth year, and
then in the middle of what were some very challenging budget
times, made the decision after notifying them that you were
going to not continue with that last lease.
Of concern to me is not so much that there were hard
decisions made, but, rather, the priority that was placed upon
which programs were being reduced. I am curious, because what
we looked at was about a $3.2 billion shortfall in terms of the
agency, and we are moving money right now under a House bill
coming over with the Chairman and the Ranking Member's
assistance that will help fill that gap or allow the agency to
transfer funds and so forth to take care of those needs.
But, somewhere along the line, the decision was made that
the outreach for the homeless was one of the areas that would
be eliminated. We have got construction projects that are in
some cases a billion dollars over budget. We have got more
demand for services and so forth. I am not so much looking to
criticize the process, but I would like to understand the
process that was used in determining which programs were more
at risk than others and why it was that a VA outreach facility
for the homeless was identified as being one of those areas
which was cut, and what is the possibility of getting it
reinstated for those veterans that were using it on a daily
basis.
Ms. Pape. That is an excellent question; and the details, I
do not have in front of me, although we are happy to take that
back and look into how that process unfolded in your area. I do
know that, and have been told that the level of services was to
remain the same, that they may not be using that space for
outreach, but that there were alternative spaces found in which
veterans could still access their outreach worker. It just was
not at that particular space. But, again, we will take that
back for the record and get you a process----
Senator Rounds. Well, let me ask this. Was the decision,
when the time came to make the cuts in order to get by in case
the transition was not successful with the resources being
moved around, was it decided to divide it up based upon program
by program, with each program bringing or responsible for
sending in cuts? Was it based upon the number of veterans being
served by program? What was the decisionmaking process that
identified that, in this particular case, programs here that we
are talking about today were part of that targeted need for
reductions?
Ms. Pape. That decision was made either at the VISN or
local level. It was not at my program office level, which is
why I do not have those details. We will go back and get that
information for you and make sure that we send it in.
[Responses were not received within the Committee's
timeframe for publication.]
Senator Rounds. The details of this particular decision
were discussed with VISN 23 leadership prior to the decision
being made. No previous discussions occurred with any outside
entity, including my office. But, it would appear, based on the
comments that I received back on my inquiry, that VISN 23 was
advised of them, but was not apparently consulted with them.
Apparently, it is above that local level where these decisions
were being made. Would that be a fair assessment?
Ms. Pape. I just do not know the details enough. I am so
sorry.
Senator Rounds. OK. Let me just finish with this. I have
got one other item, and I am going to run out of time. With
regard to tribal lands, have you had any discussion about
tribal lands were we have got an estimated 2,000 Native
Americans--veterans, warriors--who are homeless today. Do you
have specific programs at all with regard to homeless veterans
who are living on tribal lands in Indian Country?
Ms. Pape. We do. Right now, HUD-VASH does serve about 2
percent of American Indian Native Americans in the HUD-VASH
Program, but HUD was just recently given authority for vouchers
on tribal lands, which we did not have before, and VA is
supporting that effort by providing staff or contracting for
staff. That is good news for all of us.
Jennifer, you may want to add to that.
Ms. Ho. If I may, sir, yes----
Senator Rounds. My time is up, but with the Chairman's
permission.
Chairman Isakson. Permission granted.
Senator Rounds. Thank you.
Ms. Ho. Thank you, sirs. We are very excited about the
authority that was given to us in 2015 to take some of the HUD-
VASH vouchers and use them in tribal designated housing
entities in partnership with the VA. It is going to make that
resource available to veterans who live on reservation land,
tribal land, in a way that it might have been harder for them
to connect to the ones that are out in a Public Housing
Authority.
The other piece that I would just raise is in the
President's 2016 budget, in the special purpose voucher
request, we have both the request for homeless vouchers for
veterans that are not connected directly to the VA. We also
have a second request for tribal vouchers for homelessness
broadly, not only for veterans, who live in Indian Country.
Both would be helpful in terms of reaching this group.
Senator Rounds. Thank you, and we will visit with you later
about that. Thank you very much.
Ms. Ho. Thank you, sir.
Senator Rounds. Thank you, Mr. Chairman.
Chairman Isakson. Thank you, Senator Rounds.
Senator Cassidy.
HON. BILL CASSIDY, U.S. SENATOR FROM LOUISIANA
Senator Cassidy. Thank you, folks. Ms. Pape, I think you
mentioned in your testimony that incarceration is a significant
risk factor for homelessness. There are two ways to read that:
either that most of--the significant number of the veterans who
are homeless have been recently incarcerated; or one who is
incarcerated and about to be released, is at significant risk
for being homeless. Just for clarity, may I ask which it is?
Ms. Pape. It is kind of both. It is if a veteran has a
history of incarceration, they are more likely to become
homeless, and as a veteran is leaving incarceration,
particularly long prison incarcerations, there is also a large
chance that they could become homeless as they have to
transition back into society.
Senator Cassidy. If that is the case and it is long prison
incarceration, not jail incarceration where you are in, you are
out. Now, let me ask, I have done a lot of work in prisons and
there is a high prevalence of mental illness and people with a
history of drug addiction who are incarcerated, probably more
jails than prisons, but still. Can you separate out the
influence of both? Let us face it, if you are mentally ill and
you get out, wherever you are, you are going to have a hard
problem with homelessness.
Ms. Pape. That is right.
Senator Cassidy. But, is incarceration a risk factor
separate from mental illness and addiction?
Ms. Pape. I am looking to the researcher.
Dr. O'Toole. Senator, there is, I think, an independent
effect, and partly, it relates to how well that person is able
to reengage with their community, reengage in the workforce,
that obviously has significant impact on their ability to move
out of poverty and be able to sustain a household or work
independently.
But, I think your observation, though, about the mental
illness and addiction dynamics that are clearly very, very
prevalent with this population also speak to the parallel need
to make sure that in their transition from a prison experience
or jail experience, that they are getting treatment, and that
is really one of the most significant drivers in trying to
eliminate or minimize the risk for homelessness, is getting
that treatment in place in that transition.
Senator Cassidy. For those leaving jails who may have
mental illness or even addiction, do you have any program such
as the Assisted Outpatient Treatment Program that some
communities use, where someone is adjudicated to supervised
treatment? If so, have you seen an effect upon whether the
person becomes homeless once more, whether they are able to
adjust to society?
Ms. Pape. We have a Veterans Justice Outreach Program that
works very closely with Veterans Treatment Courts across the
Nation. Instead of veterans getting incarcerated or even going
to jail, these Veterans Justice Outreach workers work with the
courts----
Senator Cassidy. But, if you have----
Ms. Pape [continuing]. To get veterans into treatment.
Senator Cassidy. Into treatment.
Ms. Pape. Into treatment.
Senator Cassidy. It is an adjudicated--you shall go to
treatment in lieu of going to jail. Do you have data on those
communities that have such programs versus those that do not?
Is it a successful program?
Ms. Pape. It is a successful program, and I want to say it
is around 80 percent of the veterans who participate do not
fall back into homelessness.
Senator Cassidy. Now, do you have a cohort group that you
are looking at that you can compare to and say, listen, in this
group, we do not have it, in this group, we do, and otherwise,
variables are adjusted, and, my gosh, it is 80 percent better?
Dr. O'Toole. We are in the midst of developing some
specific research protocols along that specific line, and so I
do not have any data to cite for you specifically to these
veteran programs, but hope to have that within the next,
probably, six to 9 months, sir.
Senator Cassidy. Now, knowing that you will not have
necessarily a control group, but nonetheless, you are comparing
it to a pretty large population, but you are telling me
comparing it to that large population, do you see beneficial
effect?
Ms. Pape. Absolutely.
Senator Cassidy. On a separate issue, in another committee,
we are working on something related to AOT. If you could,
please, share that data with us--my assistant will give you her
card--we would appreciate that, knowing that it does not have
complete control, but is probably still insightful.
Now, way back when, long before I entered politics, I had a
friend--I will not tell you the whole sordid story, the brother
of an old girlfriend----
[Laughter.]
Senator Cassidy [continuing]. Who had gone to Vietnam,
tragically had become addicted, and he applied for veterans
disability benefits and they said, well, we will only give you
the disability after you go through rehab. He went through
rehab, and it was the best thing that ever happened to him. He
did not need his disability. He became an X-ray tech and et
cetera, et cetera, et cetera, a really a great story.
This was long before I entered politics. I guess my
question is, is there still a program where someone is
screened, and before they can go on to the next step of
whatever there is some dangling carrot. Listen, if you go into
this rehab or you go into this treatment program, you can then
go to this next step, but only until you do so will you go to
the next step. Again, I am just recalling from distantly, but
does that program still exist?
Dr. O'Toole. Sir, one of the things we have done within
homeless programming is adopted a process of housing first,
which tries to remove some of the contingencies to actually be
able to place somebody in housing. Historically, we have worked
within a model where as somebody achieves their sobriety,
achieves their employment, they are able to get the housing
benefits, kind of within an intention-to-treat model. It works
really well for those people who can pass through those
different steps and processes who do well. But, there is a
significant drop-off for those people who do not do well.
We found in the data, both within the VA and outside the
VA, very, very powerful indicators that within a housing first
model, more people are going into drug and alcohol treatment,
more people are succeeding in treatment, and more people are
staying in housing as a result of that, which is a very
positive. It is not to say that it always works all the time,
and it is not to say that there are not individuals who need a
stronger enticement, where drug courts and other inducers can
be very effective in pushing that person to a higher level of
motivation. But, this has been kind of a trend both within the
VA and outside the VA in really trying to create more effective
housing programming.
Senator Cassidy. If you could share that data or at least
point us in the right direction, because, again, you are right,
that has broader relevance outside the VA as well as in.
You have been generous with the time, Mr. Chairman. I
apologize and I yield back.
Chairman Isakson. Thank you, Senator Cassidy.
Senator Murray.
HON. PATTY MURRAY, U.S. SENATOR FROM WASHINGTON
Senator Murray. Mr. Chairman, thank you very much for
having this hearing.
Ms. Pape, last year, the VA put out a new policy that would
exclude veterans who do not meet certain discharge and length
of service requirements from being eligible for homeless
services. The practice that had been followed for decades was
if a veteran's discharge did not say ``dishonorable,'' we could
help them. This was a major reversal, and you will remember it,
that would have put thousands of veterans out on the street. VA
did the right thing in delaying that policy change, but we have
got to fix the problem in the law. That is why I actually
introduced the Homeless Veterans Service Protection Act, to
make sure homeless providers can continue to help those
veterans.
I wanted to ask you, what is the current status of the
General Counsel opinion that will reinstate the limits on
eligibility for homeless services?
Ms. Pape. It is still under review.
Senator Murray. Any timeline?
Ms. Pape. In the recent IG report, they said they would
like to have some kind of response by November.
Senator Murray. OK. Well, without my legislation, if that
policy change is enacted, how many people will the VA no longer
be able to serve, and which agencies actually are going to be
able to absorb the increase in the homeless population?
Ms. Pape. There is an estimate that there is between 15 to
30 percent homeless veterans on the street that are not
eligible for VHA services----
Senator Murray. Under the definition that----
Ms. Pape. Under the definition----
Senator Murray. That is changed?
Ms. Pape. Yes, there is. It will be 15 to 30 percent of
veterans who will not be able to access the programs that they
are accessing right now.
Senator Murray. What will happen to those veterans if----
Ms. Pape. We would rely on our community partners to pick
up and help us serve those veterans.
Senator Murray. They are just supposed to do it because
they are nice, or what? I am very worried about that, Mr.
Chairman, and I will talk with you more about that, but we need
to get this legislation passed or we are going to have a huge
increase in a population that really will not have any
services.
Ms. Pape. We hear from community by community what a tool
they have in the SSVF and the GPD grants to serve this
particular population, because you are right, Senator, there
are not a lot of resources to pick up 15 to 30 percent of the
veterans who may access these kind of services. We are even
hearing from communities how necessary this----
Senator Murray. Well, I am hearing from a lot of
communities out in my State.
VA's budget request for fiscal year 2016 would cut funding
for homeless services by $51 million, almost all of that from
the Grant and Per Diem Program. I still hear frequently from
providers in my State of Washington that there are not enough
HUD-VASH vouchers to meet the demand that they have. VA has
made a lot of good progress on ending veteran homelessness,
according to the 2014 Point in Time Count. There are still
50,000 veterans homeless on a given night. So, there is a
tremendous amount of work to be done before each and every
homeless veteran is actually housed.
With so many of our veterans still in need, does that cut
make any sense to you?
Ms. Pape. With the numbers decreasing, it is important that
we right-size all of our programs and ensure that the right
care is getting to the right people for the right duration of
time. As we move forward and look at the progress we have made,
I just think it is important to strategically decide where the
resources go and where the biggest needs are.
Senator Murray. Well, we know that it often takes several
years for a veteran to become homeless once they leave the
service, so I am really concerned that we are not looking at
the projections coming to us and we are going to see an
increasing number of homeless veterans in the coming years.
Actually, part of that is going to be a growing number of
women, because we are seeing that increase anyway.
As you well know, homeless female veterans and homeless
veterans with children, such as--they need specific things,
like private rooms. You cannot just put them in a dorm. There
is not a lot of capacity out there for homeless women veterans
today. So, tell me, what are your projections for the growth of
homeless veterans and homeless women veterans with children.
Dr. O'Toole. Senator, we actually project four populations
over the next 5 years that raise significant concerns for us
and the need to have a capacity to serve them. Homeless women,
absolutely, and we are seeing an increase, in part reflecting
the larger numbers of active duty women in service.
Senator Murray. Do we have the capacity to serve them?
Dr. O'Toole. We will need to grow that capacity, ma'am.
Senator Murray. But, with budget cuts, how do we grow that
capacity?
Dr. O'Toole. OEF/OIF veterans, I think, is another group
that, again, we see increases to. Our focus for all of these
is, again, on how do we make sure that we are preventing
homeless, rapidly re-housing those individuals who do become
homeless. HUD-VASH serves as a very good vehicle, particularly
for women and women with their children in that capacity there,
and that is an area that we need to make sure continues to grow
and is sustained.
Ms. Pape. We could not agree with you more. In order to
sustain the gains we have made, we--and I said this in my
testimony--we need the continued financial resources to ensure
that we continue to drive those numbers down.
Senator Murray. Thank you, and I am out of time. Thank you,
Mr. Chairman.
Chairman Isakson. Senator Hirono.
HON. MAZIE K. HIRONO, U.S. SENATOR FROM HAWAII
Senator Hirono. Thank you, Mr. Chairman.
First, I would like to recognize the progress that has been
made, and I thank all of you for testifying today.
According to the Point in Time Count, from 2010 to 2014, we
have seen a 33 percent decrease in the number of veterans,
veterans experiencing homelessness nationally, and, of course,
our Secretary has said that he intends to eliminate
homelessness in veterans by the end of this year, and the clock
is ticking. But, I really commend you all for the focus.
While this is encouraging, there are some areas that have
experienced more challenges in addressing this issue. My
homestate in Hawaii has faced some obstacles. From 2010 to
2014, the number of homeless veterans has steadily increased,
from 411 to 593 homeless veterans. I am really concerned about
these trends. In fact, Hawaii has per capita the largest number
of homelessness in the country. The Governor has recently
convened a Homelessness Task Force that includes
representatives from the State, the county, the Federal
Government, the private sector, because this is a growing
concern for the State of Hawaii.
My question to both Ms. Pape and Ms. Ho is: are you
familiar with Hawaii's situation and its increase in homeless
veterans, and could you describe the most prevalent
difficulties in addressing the issue, what coordination efforts
are happening between VA and HUD, State, county, local
officials, and if you are not familiar with Hawaii's situation,
could you provide some best practices that could be applicable
in Hawaii?
Ms. Ho. Senator Hirono, mahalo for that question. I had an
opportunity to be in Hawaii at the end of the year----
Senator Hirono. Anyone who says ``mahalo,'' I know has
familiarity with Hawaii. [Laughter.]
Ms. Ho. My father was born and raised there. When I was in
Hawaii in January, I had a chance to meet Governor Ige and some
of his new team. He also has been to HUD twice. I had a chance
to meet with Mayor Caldwell in Honolulu. I am very excited
about the new task force, very excited about the mayor and the
Governor working together. This is an issue where that type of
local leadership, where you have cities and Governors--I mean,
the control of the Medicaid resource, but also the VA. I think
that would be a perfect partnership if the Hawaii Housing
Authority were also arm-in-arm in all of this.
It seems to me that there are two challenges that are
unique there. One is that, as Dr. O'Toole was saying, a lot of
the progress that we have made has been around housing first,
yet, there are some policymakers and providers there locally
who have been slow to embrace housing first.
The second is just the challenge of adequate supply of
affordable housing. Where we have invested considerably in HUD-
VASH, thanks to the support of this Committee, there are 563
HUD-VASH vouchers in Hawaii, but they are underutilized, in
large part because there are a lot of veterans who have a HUD-
VASH voucher in hand, but they cannot find a landlord to rent.
Secretary McDonald from the VA was recently in Hawaii and
actually did an event----
Senator Hirono. I met with him.
Ms. Ho [continuing]. An event that you were at----
Senator Hirono. Yes.
Ms. Ho [continuing]. To talk about landlord engagement.
That is an area where we have made the investment in the HUD-
VASH vouchers, but we cannot find an affordable place for the
veteran to live.
There is a lot of Hawaii in HUD right now and we are very
interested in supporting you, the rest of the delegation, the
Governor, and the mayor in making sure that everybody is at the
table working in the same direction on the strategies that have
proven to be impactful in other parts of the country.
Ms. Pape. One of the things that we think is helpful is to
engage veteran landlords. They are more likely to rent to a
fellow veteran, and that is some of the focus of Secretary
McDonald as he does these landlord engagements.
Senator Hirono. Have you developed any kind of an outreach
program that we can use to engage the veteran landlords in
Hawaii, because this truly is a growing exigency in Hawaii.
Ms. Ho. Senator, thank you for that question. Working with
the First Lady's office and the Joining Forces effort, we
actually have some one-pager, two-pager landlord engagement
tools. We are also using our platforms at HUD whenever we are
talking to property managers to really encourage this. We could
use everything that you and your colleagues can do to help in
that local engagement. I think that when landlords feel that
same call to duty, that this is a problem that is unacceptable,
it is likely that they will help.
Senator Hirono. Ms. Ho, you have obviously engaged with the
leaders in Hawaii, and I really want to thank you for that. Our
continuing collaboration will be really critical to our
addressing the homelessness in Hawaii in a way that will make a
difference.
Ms. Ho. I look forward to working with you on this, ma'am.
Senator Hirono. Thank you. Thank you, Mr. Chairman.
Chairman Isakson. Thank you, Senator Hirono, and thanks to
each of our panelists. As you can tell from the interest of the
Committee--I think every Member of the Committee but one was
present today and asked questions, which is a testimony to how
much we believe in veterans' homelessness being solved. We want
to reach the goal that Secretary McDonald has set, to end
veterans' homelessness. We appreciate your work very much.
I welcome the second panel to come forward.
Ms. Ho. Thank you very much.
[Pause.]
Response to Posthearing Questions Submitted by Hon. Johnny Isakson to
U.S. Department of Veterans Affairs
Question 1. Should VA not meet its goal of ending veteran
homelessness by the end of 2015, how will the goal be adjusted to
ensure the current momentum behind efforts to reduce and prevent
homelessness continues?
Response. The Department of Veterans Affairs (VA) and our Federal
partners remain focused on driving toward the achievement of the goal,
but know that success ultimately rests upon the ability of communities
to achieve the goal at the local level. As a result of the vision
inspired by this goal, and the focused resources and drive applied
toward achieving it, tremendous progress is being made community by
community, with localities across the country on the path to achieving
this important national priority.
Since the launch of Opening Doors: Federal Strategic Plan to
Prevent and End Homelessness, we have significantly reduced the number
of Veterans and their families experiencing homelessness by connecting
them to permanent housing and supportive services. At the same time,
communities are building enduring systems to ensure that homelessness
among Veterans is prevented whenever possible, and if it cannot be
prevented, it is a rare, brief, and one-time experience.
There is still a lot of work left to do. Ending Veteran
homelessness is not only a Federal goal, it is a national goal.
Federal, state and local Governments, businesses, nonprofits, and
citizens need to push hard in order to meet the goal. We have seen
increased momentum in local communities. Many communities are reporting
dramatic progress, achieving important milestones, and plan to meet the
goal of ending Veteran homelessness before the end of this year. We now
know that the goal is achievable with the right resources and level of
commitment, and if communities implement the most effective strategies.
Federal partners will continue to focus on interagency strategies to
sustain this momentum even if the goal is not fully achieved by the end
of the year.
Question 2. Will VA establish a new timeline for ending veteran
homelessness? If so, what is the new timeline, and how is it
determined?
Response. We know that ending Veteran homelessness is not a one-
time achievement. There is no question it is an ambitious goal--we are
clear-eyed about that--but we believe that with continued Federal,
state, local partnership, we can achieve it in community after
community across the country. Achieving the goal will depend on local
action by communities leveraging all available resources--including
Federal, state, local, and philanthropic--in support of the goal as
well. It will depend on local leadership, particularly through the
Mayor's Challenge. To date, more than 700 local elected leaders have
signed on to take action, including working with local VA leadership to
identify gaps in resources and drive the efforts to fill those gaps. To
ensure we have the most accurate assessment whether we reached the
goal, we need every community to conduct unsheltered counts as part of
their 2016 Point-in-Time (PIT) counts.
We remain committed to fully achieving the goal. However, if at a
later time, it is determined by USICH, VA, and HUD that the goal cannot
be fully achieved, we would consider whether to extend the timeline
through a collaborative interagency process, grounded in analysis of
data.
______
Response to Posthearing Questions Submitted by Hon. Richard Blumenthal
to U.S. Department of Veterans Affairs
Question 1. Many communities are working collaboratively to
address housing instability among veterans and are finding that their
housing and service delivery models need restructuring in order to
better address the needs of veterans in their area, especially as they
get closer to zero. What additional legislative or regulatory changes
would be required in order to provide communities the flexibility to
create an outcome-oriented system that meets their needs and
incentivizes housing stability through permanent housing placements and
income supports to sustain those placements?
Response. The goal of ending Veteran homelessness is not just about
Veterans eligible for VA services, but is inclusive of all who served.
In its Fiscal Year (FY) 2016 Budget submission, VA published numerous
proposals to advance its mission to address the needs of homeless
Veterans. These included proposals to extend numerous expiring
authorities, as well as ideas for new strategies to end and prevent
Veteran homelessness. Additionally, the proposals included broadening
and simplifying eligibility for the Supportive Services for Veteran
Families program; improving the VA Grant and Per Diem (GPD) program to
encompass a transition to permanent housing; and providing VA
assistance for temporary hotel stays in emergency situations.
The GPD program is a major component of VA's continuum of homeless
services. The proposed legislative change would fundamentally transform
the GPD Program by authorizing VA to specifically provide supportive
service grant awards to eligible entities and to convert current
transitional housing stock to permanent housing. VA must poise and
transform the GPD program in order to maintain the progress of the
Ending Veteran Homelessness Initiative and effectively utilize close to
20 years of GPD program capital investment. VA is available to discuss
these proposals with the Committee.
Question 2. As VA continues to decrease homelessness among
veterans, we will be left with a group of veterans who are the hardest
to reach. This group has been on the streets for the longest, has more
complex issues, and frankly may be the hardest to engage. Given the
challenges in engaging this population, how is VA working to find
creative ways to get these veterans the services that they need?
Response. VA agrees with, and appreciates the challenges to the
efforts to end homelessness of all Veterans, some of which are those
Veterans who are chronically homeless, and most difficult to reach and
to engage in care. VA's efforts to date have reflected significant
successes with this subpopulation as reflected in the PIT count-
measured reduction of 43 percent among unsheltered homeless Veterans
since 2010, which is actually higher than the overall reductions noted
among all homeless Veterans. This reduction is largely due to the
implementation of coordinated entry in communities across the country
which has ensured that Veterans that have long histories of
homelessness--including those that are ineligible for VA health
services--are prioritized for assistance. First, in the Department of
Housing and Urban Development- VA Supportive Housing (HUD-VASH), the
adoption of Housing First and targeted priority has resulted in 65-70
percent of vouchers going to chronically homeless Veterans. Similarly,
the ``no wrong door'' strategy for identifying and engaging homeless
Veterans has expanded our ``in reach'' within VA to those Veterans
seeking care through our Clinical Screener and our outreach at Stand
Downs, Health Care for Homeless Veterans (HCHV) Outreach Teams, the
development of Community Resource and Referral Centers (CRRCs), and
with our community partners. This has enhanced VA's capacity and
ability to reach out to and engage these most vulnerable Veterans in
our care and programming. Paralleling this, VA has developed several
initiatives that tailor and enhance care delivery to make sure it is
getting to those Veterans who might not otherwise receive the care and
services needed through traditional channels. Two examples of this are
the Homeless Patient Aligned Care Teams (H-PACT) that provide outreach
and clinical care to homeless Veterans both within VA facilities and in
the community, and Assertive Care Teams (ACT) that reach out to those
Veterans with serious mental illnesses who are resistant to care. VA is
also developing additional housing options for these Veterans that
provide lower threshold, noncontingent housing options, including Safe
Havens and low demand GPD beds. Together, these reflect a comprehensive
strategy that VA hopes and expects will be effective in reaching and
serving this hard-to-reach population. It is something that VA closely
monitors and is continually looking at how it can expand upon and
improve these efforts.
In addition, although not under VA's purview, the Department of
Health and Human Services provides outreach and engages Veterans,
including individuals who are not eligible for VA services. Examples
include 1) serving Veterans in HRSA Health Centers and Health Care for
the Homeless programs; 2) providing outreach, engagement, and referral
to Veterans through the Projects for Assistance in Transition from
Homelessness (PATH) and the Cooperative Agreements to Benefit Homeless
Individuals (CABHI) programs; and 3) increasing access to Medicaid,
including encouraging states to cover supportive services for Veterans
experiencing homelessness.
Question 3. Housing a homeless veteran is important but helping
them earn an income is critical to help maintain housing. Employment
needs to play a more prominent role within VA's existing housing
programs, which includes improving grantee coordination with employment
programs like DOL's Homeless Veterans Reintegration Program, and
others. What guidelines does VA currently enforce to evaluate how well
any of its grantees is connecting homeless veterans with employment and
other sources of income to maintain housing placements?
Response. VA understands the important role employment plays in
Veterans' efforts to maintain permanent housing. There is approximately
one Community Employment Coordinator (CEC) at each VA medical center
and these staff are tasked with:
Working with VA employment services (Compensated Work
Therapy; Vocational Rehabilitation & Employment) and homeless program
staff to identify what employment resources are available and where
there are gaps in order to serve the continuum of homeless and at-risk
Veterans, including chronically homeless Veterans.
Working collaboratively with community partners (outside
of VA) to bring in training and support services not available within
the VA structure to the Veterans.
Engaging employers to develop new job opportunities for
Veterans who have experienced homelessness.
Ensuring ongoing support services are available to
Veterans after they return to work. The CECs are also available to
provide support for the employer in case there are challenges or
adjustment difficulties.
CECs are expected to help align and coordinate existing services
within the community including, but not limited to, Department of Labor
programs, including the Jobs for Veterans State Grants program, which
funds Veterans employment counseling and outreach positions at American
Job Centers.
VA utilizes performance metrics to track the percentage of Veterans
discharged with competitive employment for each of its residential
treatment programs. Currently, 45 percent of Veterans who exit VA
residential treatment programs report employment.
The SSVF program, through its grantees, provides a mix of direct
services and referrals to support efforts to build family income. Where
needed, SSVF grantees can provide up to $1,500 per household for
``expenses associated with gaining or keeping employment, such as
obtaining uniforms, tools, certifications, and licenses'' per 38 CFR
62.34. These efforts have had demonstrable effect. In FY 2014, Veterans
with no income (5,266) and those earning $500 or less monthly (3,631)
at entry still achieved a relatively high rate of success in obtaining
or remaining in permanent housing at exit: 72 percent and 77 percent
for each group, respectively. The median monthly income of Veterans
participating in SSVF increased from entry to exit by 15 percent ($823-
$945). SSVF grantees were highly successful in raising the income of
Veterans who had no income when they entered the program; 1,728 of
these 6,945 Veterans (25 percent) were able to exit the program with an
income source.
Question 4. In March 2014, the National Center on Homelessness
Among Veterans published a white paper detailing a return on investment
analysis of homeless program funding using various modeling
assumptions. The study mentioned that in a previous review of health
care costs for homeless veterans in Baltimore alone, 44 veterans
utilized over $250,000 in care each and two had costs of care that were
above $1.4 million each. Dr. O'Toole mentioned that VA was utilizing
its HOMES registry to identify superutilizers monthly and had realized
$6.3 Million in savings as a result. Please provide additional
information around this initiative, to include:
the duration it has been in operation;
the locations in which it operates;
the number of veterans that have been included on
superutilizer lists;
the number of those veterans who have been engaged; and
the type of additional engagement offered to these
veterans.
Response. The Veterans Health Administration (VHA) Homeless Program
Office ``Hot Spotter'' project was launched in fall 2014. The goal of
the project is to 1) predict which homeless Veterans will utilize
extensive amounts of acute health care services; 2) create a field-
based dashboard that allows teams to identify and target their efforts
toward those individuals; and 3) develop training and intervention
tools that VHA homeless teams can use to effect outcomes. The program
has been implemented nationally and operates out of the 57 H-PACTs
located around the country.
The predictive analytics algorithm for identifying `super
utilizers' uses the Homeless Registry as its platform and has been able
to identify the 10 percent of Veterans who utilize 65-70 percent of all
acute care service use received by the population.
Once a Veteran is identified, the team develops a care plan with
the Veteran which addresses root causes that may be driving their high
usage. This includes expediting housing placement/moving into a safer
environment; facilitating access and engagement in needed clinical
services (substance abuse treatment, mental health care, chronic
disease management); educating the Veteran to more appropriately access
care/navigate the system without going to an emergency room for non-
urgent needs; and/or enhancing their follow-up/case management. Several
trainings and clinical aids have been developed for clinical teams to
use for this.
Over the past 12 months, 6,503 Veterans have been identified
through this process for intervention (approximately 1,500-1,700 per
quarter). Among those Veterans, 70 percent have stabilized their health
care use in the subsequent 3 months and were no longer `super
utilizers'.
Over the past FY, an estimated $25.3 million in hospitalization-
related cost savings were realized, averaging $6.3 million per quarter.
Cost savings estimates were generated comparing the admission and
length of stay rates among homeless Veterans not enrolled in care to
actual rates among the H-PACT `Hot Spotter' cohort with 2013 Medicare
cost/day rates applied to the net difference to reflect systems
savings.
Question 5. Access to complete client data has the power to
accelerate and target efforts around ending veteran homelessness. The
CCEH written testimony for this hearing mentions that data management
systems could be improved upon if VA agencies could participate in the
continuum of care's Homeless Management Information Systems (HMIS) data
tracking systems. Housing providers in other continuums of care have
noted that tracking program eligibility can be a challenge when dealing
with transitory clients who move from continuum to continuum.
Please describe any barriers to VA use of local HMIS
systems and to data exchange between VA's HOMES system and local HMIS
systems.
Please provide copies of any guidance issued to VAMCs and
VA grantees regarding the use of HMIS and HOMES.
Response. Through close collaboration with HUD, the VHA Homeless
Program Office continues to pursue and support the integration of VA
and community data. To assist and support VA's collaborative efforts
with our community partners, the Homeless Program Office, in
consultation with VHA's Office of Privacy and the Office of Healthcare
Security Requirements, issued national guidance to VA medical centers
(VAMCs) seeking read-only and direct entry access to the Homeless
Management Information Systems. This guidance was provided by VHA to
give VAMCs clear direction for addressing local access requests.
Additionally, VA has developed a report in the Homeless Operations
Management and Evaluation System (HOMES) containing elements consistent
with HMIS data standards to allow for expedited transfer of data
between VA and local Continuum of Care HMIS administrators. Currently,
VAMCs are sharing this data via paper transfer for hand entry into
HMIS. This report will streamline that process and allow the data to be
exported from HOMES, transferred electronically and directly uploaded
to HMIS. VA is currently working with the Office of Healthcare Security
Requirements to identify a mechanism for secure, electronic transfer.
Anticipated deadline for obtaining this guidance is September 20, 2015.
In collaboration with a national a team of Information Technology
Specialists, Information Security Officers and Privacy Officers, VA has
shifted focus from integrating VA and community systems to integrating
data. One significant barrier to integrating our systems is that HMIS
has many different platforms. These various platforms make it
challenging to apply one standard approach for systems integration. VA
is in the early stages of developing a national, bi-directional data
sharing platform incorporating Veteran-level data from both HOMES and
the various HMIS systems. The vision for this shared platform is to
import data from both HOMES and HMIS into a single repository, allowing
direct access to real-time Veteran-level data for both VA and community
partners. This platform is in the early stages of development.
VA is also building the Status Query and Response Exchange System
(SQUARES). SQUARES is a Web-based look up system which will allow HMIS
to check a client's Veteran status in real-time. This system is
currently under development and is expected to be released in
September 2015. The initial version of SQUARES will allow HMIS users to
input an individual and get back one of three responses to the question
whether the individual is a Veteran: yes, no, or unknown. SQUARES will
continue to be improved over the course of FY 2016, resulting in fewer
``unknown'' responses, and will also allow HMIS users to submit batches
of names, rather than only individuals. Online training will be made
available with the release of SQUARES.
Question 6. What actions has VA taken to partner with the
Substance Abuse and Mental Health Services Administration's SSI/SSDI
Outreach, Access, and Recovery (SOAR) Technical Assistance Center (TAC)
to make SOAR training more accessible to its casework staff and to its
grantees, or to publicize the availability of the SOAR TAC's free
online training sessions?
Response. VA has established a collaborative partnership with the
Social Security Administration (SSA); the Health and Human Services-
Substance Abuse and Mental Health Services Administration (HHS-SAMHSA);
the SAMHSA Supplemental Security Income (SSI)/Social Security
Disability Insurance (SSDI) Outreach, Access, and Recovery Technical
Assistance (SOAR TA) Center; and the U.S. Interagency Council on
Homelessness (USICH) to increase access to mainstream benefits for
homeless Veterans and their families. In July 2015, the four Federal
agencies released a tool for communities, organizations, and
practitioners in the field on Key Strategies for Connecting Persons
Experiencing Homelessness to SSI and SSDI Benefits.
VA has taken a proactive approach to removing system barriers
related to VA staff supporting SOAR. VHA Acting Deputy Under Secretary
for Health for Operations Management sent a memorandum to all VHA
leadership and Network Homeless Coordinators encouraging homeless
programs' personnel be trained in and utilize the SOAR program. The
memorandum clarifies the role VHA personnel could play in gathering
medical records and appropriate documentation for the completion of
SSI/SSDI applications.
In February 2015, SSVF included language regarding SOAR in its
Notice of Funding Availability. Accessing VA and mainstream benefits
has always been core SSVF services, but this encourages grantees to
make linkages to existing SOAR programs within their communities and/or
train staff through the online curriculum so that they can directly
practice SOAR. Currently, SSVF grantees in 43 states and the District
of Columbia are involved in SOAR, and 146 grantees have been trained in
SOAR to help Veterans access SSA benefits.
Additionally, SSVF and HUD-VASH serve on the national SOAR TA
Center Expert Panel which meets quarterly to review national SOAR
strategy in the United States for all populations.
Question 7. Domestic violence can negatively impact a veteran's
housing status. In addition to any statutory changes, what changes
would be required for VA's homeless programs to make veterans fleeing
domestic violence eligible for housing assistance? How do VHA homeless
programs collaborate with VHA's Domestic and Intimate Partner Violence
Program?
Response. VHA's Homeless Programs actively collaborate with VHA's
Domestic and Interpersonal Violence Program. A Homeless Programs staff
member served on the VHA Domestic Violence Task Force that was
chartered in 2012, and currently serves as a member of the Domestic
Violence Steering Committee that is charged with overseeing the Plan
for Implementation of the Domestic Violence/Intimate Partner Violence
Assistance Program. In addition to serving on the overall Steering
Committee, the VHA Homeless Programs representative chairs one of the
work groups and participates as an active member of a second work
group.
Recently modified regulations allow SSVF grantees to provide
greater support to those fleeing domestic violence. These changes allow
grantees to provide financial assistance (such as moving costs and
rental assistance) even when the Veteran's household has otherwise
reached the limits of such assistance so that those fleeing domestic
violence are not forced to choose between homelessness and abuse. A
family may qualify for assistance even if the Veteran is the aggressor
or perpetrator of the domestic violence.
______
Response to Posthearing Questions Submitted by Hon. Sherrod Brown to
U.S. Department of Veterans Affairs
Questions for Ms. Pape
Question 1. Homeless Challenges: As the VA continues to make
progress on helping homeless veterans generally; problems in certain
specific subpopulations remain. The rise in numbers of female
servicemembers has corresponded to an increase in the number of
homeless female veterans. This requires that the VA adapt existing
programs traditionally used to serve a largely single, male homeless
veteran population. What is the VA doing to meet the needs specifically
of homeless female veterans? What policies are in place to help both
male and female homeless veterans who seek shelter and have children
with them and thus require special accommodations including unique
access, security measures, and assistance regarding concerns about the
effects of military sexual trauma?
Response. In FY 2014, VA served 36,763 female homeless Veterans,
approximately 10 percent of all homeless Veterans served. The needs of
women Veterans are compounded by the fact that many of them are caring
for dependent children, as well as disproportionately face domestic
violence and military sexual trauma issues. Several of VA's programs
and services are specifically well suited to address these needs,
including SSVF which, in FY 2014, provided assistance to 11,900 women
and over 27,000 children.
More than 200 GPD programs serve homeless female Veterans in some
capacity including 40 that provide women-specific transitional housing
and 38 that can provide housing for women and their dependent children.
The HCHV Program provides funding to support 68 contracted residential
services programs. Of these, 38 programs are dedicated to women, women
with children, or families. These sites work in collaboration with
community partners to provide services to the Veteran's family members.
Currently 12 percent of all HUD-VASH vouchers are allocated to female
Veterans, 49 percent of whom have dependent children.
VA's programs work very closely with clinical staff at the medical
facilities to ensure that female homeless Veterans are getting the care
they need. Female Veterans in the VA health care system are screened
for military sexual trauma, depression, anxiety, Post Traumatic Stress
Disorder and suicide risk. Case managers work closely with the women's
health program coordinators to ensure these Veterans are getting
primary and preventative care and are able to navigate the care system
smoothly and seamlessly.
VA acknowledges that the number of women Veterans at risk, or who
become homeless, is likely to grow over the next several years as more
women leave military service. VA is currently engaged in a strategic
planning process to ensure that it has the capacity and resources in
place to address this need over the next 5 years.
Question 2. Information Sharing: Information sharing between the
VA and its partners in the Federal Government like HUD and our
communities is key. Different criteria and different systems can lead
to inaccuracies. What guidance is provided to local VA facilities and
grantees on participation in HUD's Homeless Management Information
Systems? If there are any barriers to participation, what are they and
how can the Committee work with you to overcome them?
Response. In consultation with VHA's Office of Privacy and the
Office of Healthcare Security Requirements, the VHA Homeless Program
Office issued national guidance on August 7, 2015, for VAMCs seeking
read-only and direct entry access to HMIS. This guidance is intended to
assist and support VA's collaborative efforts with our community
partners, specifically for those participating in coordinated
assessment and entry systems. VA and its partners are coordinating a
synchronized awareness campaign to ensure that this guidance is widely
distributed.
The guidance states that VA staff may obtain read-only and direct
entry access to HMIS as long as the data accessed is being used to
provide needed services and coordinated care to Veterans. VA staff may
enter Veteran data directly into HMIS if the Veteran consents and the
appropriate releases are signed. Additionally, this guidance is
intended to clarify that there are no VA-related security issues
preventing VA staff from accessing HMIS from their workstations.
Question 3. Working with Cities: Because of the VA's targeted
Federal investments and aggressive actions by the VA, HUD, non-profit
partners, and our local communities, it appears that the numbers of our
homeless veterans is declining. Many Ohio cities specifically are
participating in the Mayors Challenge. Is there a feedback mechanism
for participating mayors to register unmet needs for their communities
on this issue? Is there an ongoing engagement to leverage resources, or
is each community left to their own plan?
Response. Federal agencies, along with the White House, have been
convening regular conference calls open to all communities who have
joined the Mayors Challenge to share information on key strategies and
best practices to end Veteran homelessness. These calls have covered
such topics as mayors' role in fostering cross-sector collaboration,
strategies for identifying Veterans experiencing homelessness, and
engaging private landlords. Mayors can also ask questions and request
information and assistance by emailing [email protected].
Regional staff from VA, HUD, and USICH are also available to support
the efforts of Mayors and their partners.
The Web site: http://portal.hud.gov/hudportal/HUD?src=/
program_offices/commplanning/veteran_information/mayors_challenge
provides resources to help communities work strategically to achieve
the goal. Pairing with another city, and using the Mayors Challenge as
an opportunity to learn from one another and spur each other on toward
achieving the goals, has been very successful in the case of Phoenix
and Salt Lake City. HUD, USICH, and VA staff will identify and connect
Mayors with relevant peers for those cities that do not wish to be
paired with another city, but do wish to be connected to other mayors
and communities so that they can share ideas and learn.
Question 4. The 25 Cities initiative includes most of the major
cities on both coasts, as well as throughout the southern half of the
U.S. Given how the homeless veterans population is highly mobile and
Ohio's role as transportation hub for the country, is there any
possibility of adding one of Ohio's major cities to the program in the
near future?
Response. The 25 Cities Initiative was established to help
communities with high concentrations of homeless Veterans to intensify
and integrate their local efforts to end Veteran homelessness. This was
a joint effort by VA, HUD, the USICH and local community partners (city
government, housing authorities, community providers) to identify by
name all of the remaining homeless Veterans in these communities and to
work together to find permanent housing solutions for these Veterans
and chronically homeless individuals.
Unfortunately, the 25 Cities Initiative identified the
participating cities early in its development so it is not possible to
add additional cities at this time. However, every community in the
country was given the opportunity to apply to participate in the Zero:
2016 initiative, a national effort which focuses on similar strategies
as the 25 Cities initiative and which includes technical assistance
funding through HUD to support communities efforts to end veteran
homelessness and chronic homelessness. The Ohio Balance of State (BOS)
Continuum of Care is participating in Zero: 2016. Organizations in Ohio
cities can request other technical assistance from VA, HUD, or other
Federal partners.
Question for Dr. O'Toole
Question 1. At the hearing, you mentioned that there were four
specific subgroups in the homeless veterans population that the VA
predicts will increase over time. Two of them are women veterans and
Operation Iraqi Freedom/ Operation Enduring Freedom veterans. What are
the other two groups?
Response. The National Center for Homelessness Among Veterans is
closely looking at the unique needs of the sub-populations of Veterans
utilizing homeless services. The four homeless/at risk for homelessness
subpopulations that are likely to increase over the next 5 years are:
(1) Female homeless Veterans
(2) Operations Enduring Freedom, Iraqi Freedom and New Dawn
Veterans
(3) Aging/chronically ill Veterans
(4) Veterans at-risk for returning to homelessness
VA is currently engaged in a strategic planning process to ensure
that it has the capacity and resources in place to address these needs.
______
Response to Posthearing Questions Submitted by Hon. Richard Blumenthal
to Jennifer Ho, Senior Advisor to the Secretary, U.S. Department of
Housing and Urban Development
Question 1. Many communities are working collaboratively to address
housing instability among veterans and are finding that their housing
and service delivery models need restructuring in order to better
address the needs of veterans in their area, especially as they get
closer to zero. What additional legislative or regulatory changes would
be required in order to provide communities the flexibility to create
an outcome-oriented system that meets their needs and incentivizes
housing stability through permanent housing placements and income
supports to sustain those placements?
Response. From HUD's perspective, the HUD-VASH program provides a
great deal of flexibility in terms of the vouchers in comparison to the
regular Housing Choice Voucher Program.
Question 2. HUD and the mainstream housing systems have been
transforming transitional housing models in order to improve housing
outcomes for homeless individuals. HUD's written testimony highlights
the need to provide guidance to communities about the role of
transitional housing and the need to examine barriers to entry. Are
there any lessons learned from the transformation of mainstream housing
systems that can be applied within the continuum of veteran housing
providers and services?
Response. HUD has taken many steps in the last few years to push
communities to closely look at their homelessness assistance portfolios
and make changes, as needed. Transitional housing funded under the CoC
Program has dramatically been scaled down in response, in favor of new
permanent housing options (rapid re-housing and permanent supportive
housing).
Question 3. How is HUD determining which communities will receive
additional technical assistance through its Vets@Home initiative?
Response. In July 2015, HUD sent a national listserv message
announcing Vets@Home TA. Any CoC in the Nation could sign up for the TA
by submitting a request through the HUD Exchange at
www.hudexchange.info. CoCs were also targeted for this TA opportunity
based on rates of Veteran homelessness in the 2015 Point-In-Time count.
Following either the request or the acceptance of the Vets@Home TA, HUD
determined whether or not the CoC would receive remote or on-site TA
based upon the 2015 data, with those having higher rates of Veteran
homelessness receiving the more intensive on-site TA.
Question 4. Finding appropriate housing placements for low income
individuals has been a challenge in high cost, low vacancy markets, as
well as housing formerly homeless veterans in these competitive markets
can be even more challenging. What can VA and community partners do to
be more successful at finding veterans permanent housing in these
areas?
Response. HUD recognizes that a great challenge faced by
communities as they work to end Veteran homelessness is lack of
affordable housing. In high cost areas where the market is particularly
tight, even those Veterans with a voucher have a hard time locating an
affordable unit. HUD has taken steps throughout its programs to create
flexibilities wherever possible such as granting waivers to PHAs to
allow for increased subsidies in high cost areas and publishing a
proposed rule on Small Area FMRs that would provide voucher payment
standards that can be higher in high-cost areas and lower in areas with
lower rental costs. HUD's Continuum of Care Program has also published
new guidance allowing CoCs to use rental assistance funds in geographic
areas outside of their respective CoC. Last, the HOME program and the
National Housing Trust Fund both provide opportunities for communities
to develop new affordable housing and we encourage participating
jurisdictions to use funding to develop affordable housing specifically
for persons experiencing homelessness.
With respect to recruitment of landlords, HUD, the VA, USICH and
private non-profit partners have all participated in trainings and
technical assistance on how to recruit landlords. Key techniques
include creation of a 24/7 hotline where landlords can get assistance
if a tenant runs into trouble (the line may or may not get used a lot,
but the reassurance is key), and creation of ``mitigation funds'' to
reassure landlords that they will be paid if there are any damages or
unpaid rent. An example of such a fund is the Portland, Gresham,
Multnomah County's Veteran risk mitigation pool which, in addition to
providing an incentive to landlords, also helps to offset other direct
costs that housing providers often face in tight rental housing
markets.
Question 5. Access to complete client data has the power to
accelerate and target efforts around ending veteran homelessness. The
CCEH written testimony for this hearing mentions that data management
systems could be improved upon if VA agencies could participate in the
continuum of care's Homeless Management Information Systems (HMIS) data
tracking systems. Housing providers in other continuums of care have
noted that tracking program eligibility can be a challenge when dealing
with transitory clients who move from continuum to continuum. How have
HUD grantees addressed eligibility determinations for homeless
individuals who transit between continuums of care?
Response. This continues to be a challenge for CoCs that have a
high volume of homeless individuals who transit between CoCs,
particularly where there is not statewide HMIS implementation, which is
generally the case. That said, this is an issue that HUD and CoCs are
starting to think more about this as they implement coordinated entry
and prioritization, develop by-name-lists, and work to increase overall
data quality. CoCs can explore existing data sharing policies and
develop processes to work across communities to inquire about specific
individuals seeking assistance.
______
Response to Posthearing Questions Submitted by Hon. Sherrod Brown to
Jennifer Ho, Senior Advisor to the Secretary, U.S. Department of
Housing and Urban Development
Question 1. Availability of Affordable Housing: In your testimony,
you mentioned that our Nation's affordable housing shortage is
presenting challenges to addressing homelessness among veterans. Could
you elaborate on the effect that a lack of affordable housing in our
communities is having on efforts to prevent and end homelessness among
veterans and other Americans?
Response. The lack of affordable housing has a two-pronged impact
on efforts to prevent and end homelessness among veterans and other
Americans. First, the lack of affordable housing is a cause of
homelessness for many. When all other options have been exhausted,
veterans and others enter the homelessness response system for
assistance because there are no other options. The second significant
impact is that the lack of affordable housing means that it is more and
more difficult for people to exit homelessness. Even for veterans that
have a HUD-VASH voucher, the opportunity can be lost when a suitable
and affordable unit cannot be found. This results in vouchers being
unused, despite significant need.
Question 2. Federal Investments for FY 2016: You have mentioned
that Federal investments in housing have been a critical component of
the progress we've made on homelessness. Could you talk about the
impact that maintaining sequestration funding levels for appropriated
programs in FY 2016 might have on the Federal Government's investments
in housing?
Response. Fortunately, sequestration funding levels did not
continue in FY 2016. HUD received $60 million in new HUD-VASH vouchers
as well as renewal funds to support vouchers previously allocated and
leased.
Question 3. Barriers to HUD-VASH Voucher Use: You mentioned in your
written testimony how important Federal investments in HUD-VASH
vouchers have been to achieving the goal of ending veterans'
homelessness. But you note that veterans with VASH vouchers sometimes
face difficulty in finding housing to rent with their vouchers. Can you
give us some more background on some of the barriers veterans are
experiencing in using their vouchers?
Response. Challenges include:
(1) Balancing utilization with targeting
- In 2014, 71% of new HUD-VASH voucher holders experience
chronic homelessness
- It can take significantly more time to locate, engage, and
offer housing to Veterans who experience chronic homelessness
- We believe this is a contributing factor to the decrease in
referrals to PHAs and the increase in the amount of time it
takes a PHA to lease-up
(2) Staffing challenges for PHAs
- As a result of the deep cuts to HCV administrative fees
over the last few years, PHAs have reported staffing challenges
(3) Challenges with the housing search process
- Veterans who have spent years living in shelters and on the
streets face unique challenges when searching for a unit to
lease
- Large cities tend to have tight housing markets with very
low vacancy rates and/or a lack of one-bedroom apartments
- Veterans with criminal histories or poor credit scores
often struggle to find landlords willing to rent to them
- Some solutions: PHAs conducting landlord outreach, VAMCs
offering housing search support, and communities hosting
housing fairs
Chairman Isakson. I would like to welcome our second panel
to this hearing on veterans' homelessness, and I am pleased to
introduce our five witnesses.
Lisa Tepper Bates--what a great name--from Connecticut, the
Ranking Member's home State. He has been bragging about you for
a week, so we are glad to have you. [Laughter.]
Michael Blecker, Executive Director of Swords to
Plowshares, which I am anxious to hear the report from him.
Baylee Crone, Executive Director, National Coalition for
Homeless Veterans.
Edward Powers, the Executive Director of HOPE Atlanta, my
home town; we are glad to have you here today, Mr. Powers.
And, Jeff Steele, Assistant Legislative Director of The
American Legion. Welcome. We are glad to have you.
We will start with you, Ms. Bates. Please try to keep your
testimony to 5 minutes.
STATEMENT OF LISA TEPPER BATES, EXECUTIVE DIRECTOR, CONNECTICUT
COALITION TO END HOMELESSNESS
Ms. Bates. Thank you. Good afternoon, Chairman Isakson,
Ranking Member Blumenthal, and distinguished Members of the
Committee. Thank you for inviting me here today to testify on
Connecticut's efforts to end veteran homelessness.
Together with President Obama and Governor of Connecticut
Dannel Malloy, homeless service providers and our colleagues
who serve veterans have proudly embraced the goal of ending
veteran homelessness by the end of 2015. We know this ambitious
goal is achievable in Connecticut and we hope it is achievable
across the Nation.
Our confidence that we can end veteran homelessness in
Connecticut is rooted in the productive cross-sector
collaboration that powers our efforts. Our State team includes
the VA Connecticut health care system, Connecticut's VA-funded
Supportive Services for Veteran Families Programs, the Hartford
office of the Department of Housing and Urban Development, and
our State agency partners, including the Departments of
Housing, Mental Health, and Addiction Services, and Veterans
Affairs. These partners are working in close cooperation with
mainstream homeless providers represented by my organization,
the Connecticut Coalition to End Homelessness.
At the time of our 2015 Point in Time Count, only 80
veterans were found in homeless shelters in Connecticut, and
only nine veterans identified as unsheltered and homeless. A
hundred-and-sixty-one additional veterans were in VA-funded
transitional housing or Grant and Per Diem, GPD, Programs.
I would like to highlight for you some of the most
important aspects of our collaboration that are moving these
numbers of homeless veterans down toward zero.
First, we are knitting together the mainstream homeless and
veteran-specific resources. Veterans experiencing homelessness
may seek assistance at a VA facility and then appear later at a
non-veteran-specific homeless shelter, or vice-versa. It should
not matter where a veteran in need seeks help first. He or she
should have access without delay to the full range of resources
available for veterans to end their homelessness.
We have worked diligently to eliminate gaps between
mainstream providers and VA-funded sources. One good example of
this, a homeless shelter in New London, Connecticut, has an
SSVF Program on-site. As soon as a veteran is identified at the
shelter, the veteran is walked directly to the SSVF offices on-
site to begin the housing process.
At the same time, mainstream providers are working closely
with our state-funded housing resources to ensure that we can
end the homelessness of every veteran, regardless of an
individual's discharge status.
Second, we are bringing together the data. Our approach to
ending veteran homelessness is person-centered, but fueled by
the power of data to accelerate and track our efforts. We have
created a single shared list of veterans in our State
experiencing homelessness by combining information from the
Homeless Management Information System used by mainstream
providers with information collected by the VA. This
information is shared between systems only with full consent of
clients. By pulling together this one shared list, we can
advance efforts to ensure that no veteran in need of housing
assistance disappears between systems. By reporting housing
outcomes against the numbers of veterans indicated as homeless
on the shared list, we are tracking and sharing widely our
progress on a monthly basis.
Third, we are addressing our challenges to reach the goal
and hold our ground. Our VA and HUD partners have worked hard
to push down and reduce the time it takes to lease a housing
unit for a veteran who is then approved for a HUD-VA supportive
housing unit. Due to their good work, lease up time in
Connecticut has dropped from 90 to under 60 days. However, we
have an ongoing challenge with regard to the availability of
rental properties, as you have heard from others today.
To build a system in Connecticut and across the Nation that
allows us to end current veteran homelessness and is poised to
quickly assist future veterans who fall into homelessness, it
is critical that VA resources are allocated as effectively as
possible. You may be aware of the recent research into the
transitional housing model, which suggests that many clients
are best served in a housing first rapid re-housing approach to
resolving homelessness, which may be most effective for clients
and uses scarce resources to best effect. VA Connecticut is
working to help the GPD Programs in our State focus their
efforts on permanent housing planning and shorter lengths of
stay with a target of 60 days or less in our GPD Programs.
No veteran should be without a place to call home. We can
and must end veteran homelessness in our country. With your
support, Connecticut is poised to achieve this goal.
Thank you for the opportunity to testify. I would be glad
to have any questions that you may offer.
[The prepared statement of Ms. Bates follows:]
Prepared Statement of Lisa Tepper Bates, Executive Director,
Connecticut Coalition to End Homelessness
Good morning Chairman Isakson, Ranking Member Blumenthal, and
distinguished Members of the Committee. Thank you for inviting me here
today to testify on Connecticut's efforts to end veteran homelessness.
Together with President Obama and Governor of Connecticut Dannel
Malloy, homeless service providers and our colleagues who serve
veterans have proudly embraced the goal of ending veteran homelessness
by the end of 2015. We know this ambitious goal is achievable in
Connecticut, and we hope it is achievable across the Nation.
Our confidence that we can end veteran homelessness in Connecticut
is rooted in the productive, cross-sector collaboration that powers our
efforts. Our state team includes the VA Connecticut Healthcare System,
Connecticut's VA-funded Supportive Services for Veteran Families (SSVF)
programs, the Hartford office of the Department of Housing and Urban
Development, and our state agency partners--including the Departments
of Housing, Mental Health and Addiction Services, and Veterans Affairs.
These partners are working in close cooperation with mainstream
homeless providers, represented by my organization, the Connecticut
Coalition to End Homelessness.
At the policy level, this group of partners works closely with our
state coordinator of our Opening Doors process to end homelessness
(which mirrors the Federal process of the same name), the Partnership
for Strong Communities, and with colleagues from the CT Heroes'
Project, a campaign to end veteran homelessness efforts in our state.
At the time of our 2015 Point-in-Time count, only 80 veterans were
found in homeless shelters in Connecticut, and only nine veterans
identified as unsheltered and homeless; 161 additional veterans were in
VA-funded transitional housing, or Grant Per Diem (GPD) programs. I
would like to highlight for you some of our most important aspects of
our collaboration that is moving these numbers of homeless veterans
down toward zero.
Knitting together the mainstream homeless and veteran-specific
resources: Veterans experiencing homelessness may seek assistance at a
VA facility and then appear later at a non-veteran specific homeless
shelter, or vice versa. It should not matter where a veteran in need
seeks help first: he or she should have access without delay to the
full range of resources available for veterans to end their
homelessness. We have worked diligently to eliminate gaps between
mainstream homeless providers and VA-funded resources. One good example
of this: a homeless shelter in New London, Connecticut sublets space to
the local SSVF program. As soon as a veteran is identified at the
shelter, that veteran is walked directly to the SSVF office on site to
begin the housing process. At the same time, mainstream providers are
working closely with our state-funded housing resources to ensure that
we can end the homelessness of every veteran--regardless of an
individual's discharge status.
Bringing together the data: Our approach to ending veteran
homelessness is person-centered, but fueled by the power of data to
accelerate and track our efforts. Consistent with national best
practices, we have created a single, shared list of veterans in our
state experiencing homelessness by combining information from the
Homeless Management Information System (HMIS) used by mainstream
providers with information collected by the VA. This information is
shared between systems only with full consent of veteran clients. By
pulling together this one, shared list, we can advance efforts to
ensure that no veteran in need of housing assistance disappears between
systems. By reporting housing outcomes against the numbers of veterans
indicated as homeless on the shared list, we are tracking and sharing
widely our progress on a monthly basis. This system could be improved
still further if it was possible for VA agencies to participate on
HMIS.
Challenges to Reach the Goal, and Hold the Ground: Our VA and HUD
partners have worked hard to push down and reduce the time it takes to
lease a housing unit for a veteran who has been approved for a HUD-VA
Supportive Housing (HUD-VASH) unit. Due to their good work, lease-up
time in Connecticut has dropped from 90 to under 60 days. However, we
have an ongoing challenge with regard to the availability of rental
properties. New Haven, Connecticut--just next door to VA Connecticut--
has held one of the lowest national vacancy rates for rental properties
for some time.
To build a system in Connecticut and across the Nation that allows
us to end current veteran homelessness, and is poised to quickly assist
future veterans who may fall into homelessness, it is critical that VA
resources are allocated as effectively as possible. In the sphere of
non-veteran specific homeless services, there has been considerable
research into the model of housing assistance known as ``transitional
housing,'' similar to the VA's Grant Per Diem (GPD) model. This
research suggests that many clients are best served in a housing-first,
rapid re-housing approach to resolving homelessness, which may be most
effective for clients and in terms of using scarce resources to best
effect.
In Connecticut, our VA Connecticut is working to help GPD programs
focus their efforts on permanent housing planning and shorter lengths
of stay (with a target of 60 days or less) in GPD programs--an
important start in serving veterans as best we can with the resources
we have.
In order to better use the resources currently dedicated to GPD,
Congress needs to make a legislative change to move this program away
from the per diem payment structure to a competitive grant program or
performance-based contract. This would encourage providers to embrace a
more holistic approach to addressing veterans' housing needs while
ensuring the programs are outcome-oriented--that is, focused on
permanent housing placements with shorter lengths of stay, rather than
on bed occupancy. The current per diem payment structure may serve as a
disincentive for providers to move veterans quickly out of the beds, as
a crisis model demands. There are providers who are willing to move to
a short-stay GPD model (so-called ``bridge housing''), but the majority
of GPD programs are not operating in this way. The statutorily defined,
allowable two-year lengths of stay and per diem payment structure
creates a disincentive for this type of program re-orientation, and
instead encourages the continued operation of traditional long-term
transitional housing programs.
In this same vein, it is critical that VA provide overarching
guidance regarding Housing First and on GPD's role in facilitating
rapid exits to permanent housing. VA, non-VA, and veteran services
organizations need to have shared definitions: VA needs to make it
clear that veterans in GPD programs are still considered homeless by
both HUD and the VA, and that those veterans in GPD must have a
permanent housing plan and be in GPD for a very short period, when
possible (60 days or less).
No Veteran should be without a place to call home. We can--we
must--end the homelessness of veterans who have served our country.
With your support, Connecticut is poised to achieve this goal.
closing
Mr. Chairman, thank you for the opportunity to testify before you
today and I welcome any questions you or other Members of the Committee
may have.
Chairman Isakson. Thank you very much.
Mr. Blecker.
STATEMENT OF MICHAEL BLECKER, EXECUTIVE DIRECTOR, SWORDS TO
PLOWSHARES
Mr. Blecker. My name is Michael Blecker. I am the Director
of Swords to Plowshares, and I will resist the temptation to
spend all my time on talking about how great we are and our
history. It is not easy.
So, the first couple pages talked about that. But, I wanted
just to say that we have been around for 40 years. I have been
the Director there since--I have been involved since 1976,
Director since 1982. When we started as a community-based
organization, we provided the crucial things--outreach, jobs,
school. We had a drop-in program. We also had a very unique VA
legal program. We were helping vets get comp and pen, and also
helping veterans with, quote, ``bad paper.'' You have heard
reference to that, about vets who are not eligible because of
administrative separations where they are declared ``other than
honorable.'' So, that was an important issue for us from the
very beginning days.
Let me get right to the VA's program. We presently house
about 476 veterans in various ways, from transition
stabilization beds to permanent supportive housing, and the VA
programs have been crucial for us to allow us to do that.
Initially, the VA's 5-year plan, we were lucky. We were in one
of the 25 Cities Campaign, the Mayor's Challenge, et cetera.
They have talked about that very aggressive approach to
actually create a veterans registry and to try to prioritize
veterans' needs, that is, who is the most vulnerable. Which
chronically homeless vets do we have to address first?
What we have discovered, that in warm weather climates,
like San Francisco, even as we house veterans, there is an
inflow of veterans, right. That is just the reality of what we
are seeing. Maybe the total numbers drop down, but for the warm
weather climates like San Francisco, the number has dropped
down much slower. So, even if we reduce the number, there has
been an inflow of veterans that we have to take account for.
So, whether the functional zero--whatever that is--I am not
sure if it takes in consideration veterans who are moving into
those areas. There is an inflow; do not forget about that. That
is really crucial.
The Grant and Per Diem Program is a really important
program that provides your beds, et cetera, and care for
veterans. The thing to keep in mind is veterans, especially who
are homeless, have greater levels of acuity. They are sicker.
They are older. They are frailer. They have issues with their
primary health care. They have things like diabetes,
neuropathy. They have primary health care issues, respiratory
problems. The years have not been kind to veterans on the
street.
In addition, we have already mentioned about other issues
like PTSD, for the newer veterans, Traumatic Brain Injury, but
also let us not forget depression, anxiety, let us not forget
drug use and substance abuse. You are dealing with very
chronically impaired veterans, especially those who remain
unhoused at the moment, and that is really our population. That
is our mission, to serve those who remain homeless, and the
Grant and Per Diem Program can be very important for that.
However, we need a much more ``do it'' attitude, you know,
an attitude from the VA that can actually get these things
done. For instance, the case management in the Grant and Per
Diem Program is limited to 90 days. There is no reason it
should be limited. You have to have a Grant and Per Diem, and
when people leave that program, there has to be a warm handoff.
You cannot just cutoff case management. That is really crucial.
The other thing is Grant and Per Diem would not even
survive in high-cost areas but for the Special Needs Contract.
The Special Needs Contract is crucial because it augments your
staffing. It also gives you access to VA staffing, especially
nursing care. As I mentioned, there are a lot of primary health
care issues, and if you do not have access to primary health
care professionals, you are not going to be successful serving
that population. So, Special Needs are really crucial.
The Grant and Per Diem rate must be higher. It must be
aligned with what their true costs are. When the program
started, it was $19 a day--$19. That is why there are few
operators in high-cost areas. Now, it has gone up to $43 a day,
but that is still--does that really--does that align with the
true cost? That is what we have to look at. The program--the
rate should be aligned to what your true cost is.
I want to talk a little bit about the VASH Program. If
there is a magic bullet, believe me, it is the VASH permanent
subsidy. That is the magic bullet to relieving homelessness
among veterans. Even in high-cost area, if you have a VASH, if
you have rental subsidy that is permanent, boy, that is so
important. So, we have to keep that VASH Program, those
permanent rental subsidies, we have to keep a way to--if we
want to end homelessness for the 50,000 veterans that remain,
that is going to be crucial. That is the magic bullet.
But, I also say the case management piece of the VA is
where the problem is. The VA case managers, they are not geared
to serving areas where you have--you need 24/7 coverage. You
cannot have banker hours if you are a social worker. Problems
erupt on weekends; they erupt in evenings. You have to have
access to care, crisis care. That is really, really important.
Also, you cannot graduate folks who are in your caseload
because they are doing better. I think a lot of this is
attributed to the VA's difficulty in hiring and keeping social
workers. For every social worker they are hiring, they are
losing certain social workers. There is a real problem with
this shortage of professional social workers within the VA. We
need to address that.
In my final 17 seconds, I will talk about the SSVF Program,
which is another rental subsidy program, but it is a temporary
subsidy, and the key there is to be able to work with your
landlord. You have to have incentives for the landlord. You
have to have staff who is trained to negotiate with landlords.
It is a landlord market, folks, and if you want to use that
program and get vets off the street, you have to create
incentives, because these vets are not ideal tenants. You have
to be able to, you know, just incentivize the landlord.
The final part is the issue with OTH, other than honorable.
I urge you to read my written testimony. It is very nuanced and
it is a very important issue. During the Vietnam War, there are
over 500,000 veterans who ended up with other than honorable
discharges--500,000 that were declared other than honorable.
They had no G.I. Bill, no access to care, and it is no surprise
that they became a big part of the homeless population.
That is all I will say for now. Thank you.
[The prepared statement of Mr. Blecker follows:]
Prepared Statement of Michael Blecker, Executive Director,
Swords to Plowshares
introduction
Good afternoon Chairman Isakson and all of the Committee members.
Thank you for holding this hearing and for the concern it demonstrates
regarding homelessness among our Nation's veterans.
My name is Michael Blecker and I am Executive Director of Swords to
Plowshares, a veterans service organization based in San Francisco. I
have been with Swords to Plowshares since 1976 and I am a veteran
myself having served as a combat infantryman in Vietnam. Swords to
Plowshares is in its 40th year of service providing wrap-around care to
veterans in the San Francisco Bay Area. In our dual role as a
community-based service provider and advocacy organization, we are
acknowledged by many, including yourselves, as a national model of
care. I am here before this commission today to discuss the successes
and challenges we have experienced carrying out the mission of VA's
homeless programs throughout the years and today. I am here to
recommend improvements to VA's homeless programs that will better equip
communities like San Francisco and experienced providers like Swords to
Plowshares with the tools they need to prevent and significantly reduce
veteran homelessness.
Swords to Plowshares has been at the forefront of providing
residential services and an array of ancillary support services to
homeless and extremely low-income veterans for 40 years. Our
organization has extensive experience with supportive housing programs
for veterans--including chronically homeless veterans and those with
severe mental illness. We engage in homelessness prevention, permanent
housing placement and other programs that support at-risk and homeless
veterans and their families. Our model of care is based on the
philosophy that the obstacles veterans face--including homelessness,
unemployment and disability--are interrelated and require an integrated
network of support within the community and continuum of care.
Since our inception in 1974, Swords to Plowshares has
helped veterans, including homeless veterans, overcome barriers to
employment and help them translate their skills learned in the military
to civilian careers. Additionally, we have been an operator of the
Department of Labor's Homeless Veterans Reintegration Program since the
1990s.
In 1976, Swords to Plowshares became the first
organization in 32 years to become certified to represent veterans with
disabilities with VA disability claims and military discharge upgrades.
We have successfully helped thousands of veterans--primarily homeless
and low-income veterans--access the VA benefits and medical care they
have rightfully earned, but also turn their lives around. It is a
result of our model in which our benefits advocacy services are nested
within a continuum of care to stabilize at-risk and homeless veterans,
address their basic needs and keep them involved while we help them
through the legal process.
Since 1986, we have operated a Drop-in Center that
provides critical care to help homeless and low-income veterans improve
their health, wellness and long-term stability. The Drop-in Center is
the main point of entry to our continuum of care for many of the
homeless veterans we serve.
Swords to Plowshares has continuously provided needed
services in a housing setting since 1987. Our transitional and
permanent residential programs, combined with a continuum of care, have
provided thousands of homeless veterans with the stability and support
they need to rebuild their lives. We continually expand supportive
housing to meet the needs of veteran families, aging veterans and those
with disabilities. We currently operate four Permanent Supportive
Housing programs and three Transitional/Stabilization Housing Programs
for 476 veterans at any given time.
Transitional & Stabilization Housing: Swords to Plowshares
began its first transitional housing program in San Francisco
in 1987. Initially serving homeless veterans exiting the VA
Medical Center and funded by an HCMI contract, Swords to
Plowshares has been operating an array of successful
transitional housing modalities for homeless veterans since
that time. Currently we provide transitional housing to 130
veterans at a time with nearly 80% achieving successful
outcomes (i.e. moving obtaining permanent housing). This
outcome is 15 percent greater than the national average.
- Since 2004, we have operated a 6-month stabilization program
for veterans with serious mental illness being discharged from
impatient psychiatric settings, providing residential support
for 22 veterans at a time
- Since 2008, we have operated a Special Needs--Chronically
Mentally Ill program at our Treasure Island facility for 20
Chronically Mentally Ill veterans at a time.
- In 2014, we opened a 19-bed Safe Haven program in San
Francisco, serving `treatment resistant' homeless veterans.
Permanent Supportive Housing: As an early adopter of the
Housing First strategies, Swords to Plowshares opened the first
site-based Permanent Supportive Housing program for veterans in
the Nation in 2000. Currently we operate 346 Permanent
Supportive Housing units at four sites. Through these years of
experience as a community-based organization, Swords to
Plowshares fully understands the challenges that veterans with
significant barriers face in obtaining and maintaining housing.
- Since 2012, we have operated 12 units of Permanent
Supportive Housing for veteran families on Treasure Island.
- In 2012, we collaborated with City partners to opens 75
units of Permanent Supportive Housing for homeless veterans
with disabilities at Veterans Commons, a historical site
located at 150 Otis Street in San Francisco.
- In 2014, the San Francisco Mayor's Office of Housing
contracted with us to operate a new Permanent Supportive
Housing site for 130 chronically homeless veterans.
progress achieving the va's 5-year plan:
We know that helping homeless veterans is not a one-size fits all
approach. For more than two decades the only program to meet the needs
of homeless veterans was Grant & Per Diem. But we know that residential
treatment is not the right fit for every veteran. In 2009, when the VA
pledged to end veteran homelessness by 2015 we wondered if it would
ever be possible. Signature programs that were greatly expanded or
newly created for this effort, the HUD-VASH and Support Services for
Veteran Families (SSVF) programs, have helped to make significant
strides and need to continue. HUD-VASH addresses the long-standing need
to house and support chronically homeless veterans while SSVF is
preemptively addressing homelessness instances--that we know from the
experiences of Vietnam veterans--can snowball into long-term struggles
including chronic homelessness.
We have made great progress toward ending veteran homelessness
since the beginning of the five-year plan to end veteran homelessness.
Some cities, particularly those with sufficient affordable housing
stock, are reaching what has been termed as a `functional zero' or
`operational zero' in homeless veterans. Yet many more communities are
not there yet, and many will likely be unable to meet this goal by the
end of this year. Based on our experience, warm weather climates like
San Francisco will never truly get to zero. This is not for a lack of
effort. In San Francisco, unprecedented cooperation between the
nonprofit sector, the City & County, and Federal partners has been
ongoing since 2011. We are seeing significant progress, even with the
highest housing costs and lowest housing stock in the Nation. Following
best practices, we have created a Homeless Veteran Registry, which
prioritizes those with the greatest vulnerability and those at risk of
dying on our streets, for the permanent supportive housing resources
that the City has allocated or created. It is notable that the in-flow
of homeless veterans into San Francisco, indicated by new names being
added to the list, results in two new names of homeless veterans being
added for every three to four veterans that we are able to get housed.
We assume that this is the case in other areas with warmer climates,
scant housing availability, and high ongoing homeless census. To
further illustrate this, San Francisco's January 2015 Point in Time
count indicated a net reduction in homeless veterans to 118 individuals
from the January 2013 count. Our agency alone has permanently housed
many times that number over the 24-month period. However, this process
is two steps forward, one step back.
Each VA homeless program plays an important part of our Nation's
strategy to prevent and end homelessness, but there are challenges that
remain.
grant & per diem
Successes: For more than 20 years, GPD has helped many homeless
veterans gain the stability they need to overcome addiction,
homelessness and gain self-sufficiency. The program allows providers
like Swords to Plowshares to help veterans from further de-compensating
and it gives us the time needed to help them stabilize and to identify
permanent housing options for their future. Before SSVF and HUD VASH
the challenge was how to address permanent housing for those veterans
approaching the maximum length of stay in the program. Thankfully,
those programs have not only significantly reduced the average length
of stay and provided an avenue for program participants to exit to
permanent housing versus continue to be marginally housed or worse.
Additionally, the Special Needs program not only provides a life
line for many severely compromised veterans and those who are the
hardest-to-house, but has also provides a lifeline for nonprofits. The
Special Needs grant provides significantly more funding to cover
staffing needs which is currently inadequate under GPD. The Special
Needs program has provided VA staff on-site to help provide support for
those veterans with the highest level of need.
Challenges: In our experience we have seen a higher level of acuity
and veteran program participants with more severe physical and
psychological conditions. There are more Vietnam-era veterans suffering
from age-related illness and compounded health conditions from years of
homelessness and poverty. Additionally, current-era veterans are often
struggling with multiple disabilities such as Traumatic Brain Injury,
PTSD and other service-connected physical and psychological injuries.
For these reasons, we need adequate services staff on-site to ensure
transitional housing program participants are provided with an
appropriate level of care.
Yet, despite the acuity of GPD and Special Needs program
participants increasing, VA staff coverage on-site has been
increasingly unreliable and inadequate. It is critical to have access
VA staff on-site who can access VA medical records and coordinate care
for the severely compromised veteran residents we serve.
If not for the Special Needs contract, GPD would not provide
adequate funding to cover the costs of service delivery. We would not
be able to serve our veteran clients and have 24-hour staff coverage
which is currently funded under the Special Needs contract.
Additionally, Swords to Plowshares acquired free property to operate
our Transitional Housing Program, which is a major factor that allows
us to operate the program.
Recommendations: The VA should continue funding the GPD and Special
Needs programs and negotiate GPD rates based on actual operating costs
for providers to ensure programs have adequate services staff and
funding to pay for rental or other property and operational costs,
particularly in communities with high rental costs. Additionally, VA
needs to ensure that adequate VA staff are on-site and ensure they fill
vacant positions.
Many veterans exiting GPD programs into permanent housing are doing
so with assistance from the HUD VASH and/or SSVF program. Many of these
veterans need on-going case management services following their exit
from GPD. Rule changes within the SSVF program to allow for a `warm
hand-off' and for ongoing case management to continue as long as they
are needed for the individual veteran would significantly help in
preventing recidivism. However, for those veterans exiting GPD programs
without the support of VA Homeless Programs, flexibility to continue
case management after the veteran has exited would significantly help
in keeping high-need veterans housed. The length of case management
after veterans exit GPD programs should be determined on a case-by-case
basis.
hud vash
Successes: Over recent years, the VASH program has housed tens of
thousands of homeless veterans and the program should continue its
expansion until we have sufficient slots for all chronically homeless
veterans still residing on our streets.
Challenges: While HUD VASH has been successful in housing thousands
of veterans, many of those remaining are the harder to house,
chronically homeless with entrenched mental health, substance abuse,
and physical health challenges. This is the crux of the job left before
us.
In San Francisco and elsewhere where there is a limited stock of
affordable housing and heated rental markets, the only way that we can
house many of those veterans with the highest needs is to do so in
larger, congregate settings, which we need to create. Swords to
Plowshares has been operating this type of congregate permanent
supportive housing program for over 15 years, prior to VASH
availability.
VA medical centers across the country are having difficulty on-
boarding and retaining sufficient numbers of social workers to provide
services to veterans with VASH vouchers. In addition to general VA
staff retention, in these settings that rely on HUD VASH subsidies and
staffing, we have seen that VASH staff have a very difficult time in
providing the needed coverage. These facilities require for the safe
operation of that housing, which include the need to schedule shifts
into the evening and on weekends. Many emergency situations happen
after normal business hours, so staffing patterns need to reflect this
reality. With the VA unable to provide this broad clinical coverage, it
leaves the operators like Swords to Plowshares struggling to meet the
need, and often without any funding to do so. In addition to clinical
staff being available during non-business hours, the VA practice of
`graduating' VASH clients from case management, thereby reducing
staffing levels, is very problematic in these settings. Given the
acuity of veterans living in these communities, as a whole, ongoing on-
site clinical staffing is needed throughout the life of the project. We
have heard identical stories from permanent supportive housing
providers in Los Angeles, Houston, and New York City.
Recommendations: We recommend that VA mandate case management to be
contracted out with the community-based system of care. Community-based
providers delivering the case management portion would save in costs,
improve flexibility with scheduling and other service delivery
components, be better integrated with community-based housing operators
wrap-around services, and leverage the expertise of community
providers.
Future allocations of HUD VASH is critical. We recommend increasing
HUD VASH subsidies in order to sustain our progress housing veterans.
supportive services for veteran families
Successes: The Supportive Services for Veteran Families program is
doing tremendous work helping to shut the front door of veteran
homelessness through Rapid Re-Housing for those recently homeless and
Eviction Prevention for those most at risk of becoming homeless.
Swords to Plowshares has developed the necessary infrastructure
that quickly and efficiently houses veterans. Organizationally, we have
learned from the challenges we faced in the early days of the program
and have established roles, responsibilities and processes that have
been tested and now operate efficiently and effectively. Our community
partnerships are robust and productive.
Challenges: While the SSVF Program has been very successful in
housing veterans, guidelines have changed multiple times since the
inception of the program including mid-year changes which dramatically
impact community providers. Additionally, SSVF limitations regarding
pre-paying rent, providing limited case management and slim allocations
for delivery continue to pose challenges.
In heated rental markets like San Francisco, rent is too expensive
for most veterans to afford. In fact, 45% of homeless veteran
households in San Francisco needed to move out of the county in order
to secure permanent housing that was somewhat affordable. Many of those
veterans who were able to remain in San Francisco, moved into one of
Swords to Plowshares' Permanent Supportive Housing sites, had a housing
subsidy or moved into Single Room Occupancy units within their budget.
The stock of affordable housing is dismally low in the San
Francisco Bay Area. Therefore, it is incumbent upon us to forge lasting
and meaningful relationships with property owners and managers. A
considerable amount of staff time is allocated to finding suitable and
affordable rental units. However, case managers and social workers are
not skilled in real estate and negotiating with landlords. However, we
are typically asking landlords to accept Below Market Rates for a
population that is difficult to house and present certain predictable
risks. In markets such as ours, we need the ability to reduce the
financial risk to property owners. We need continue the current
eviction prevention allowances and enhance rental assistance guidelines
at move-in to incentivize landlords to take on this risk. We also need
to provide some level of financial support when evictions cannot be
prevented.
Recommendations: Funding for the SSVF program must continue beyond
2015 in adequate proportion if we are to maintain the progress that
this Nation has made in reducing veteran homelessness. Otherwise, we
will certainly see the numbers change trajectory and increases in
veteran homelessness will surely re-occur. With the force reduction
currently underway, and the tens of thousands of veterans separating
from the military every year under normal circumstances, the SSVF
program can be the preventative lynch pin needed to assure their
successful transitions to civilian life.
Program flexibility to improve outreach and engagement
with landlords: Many landlords are hesitant to rent to veteran clients,
particularly when many veterans utilizing SSVF have poor credit,
extremely low-income, histories of homelessness, drug and alcohol
abuse, mental illness, incarceration and often evictions. They are not
ideal tenants in many cases and it is incumbent upon service providers
to cultivate relationships with landlords and provide incentives for
them to rent to veterans. For example, paying for up to three months
rent in advance would help to attract more landlords. SSVF staff need
adequate training on engaging with landlords or outside expertise from
a realtor. Community partners operating SSVF need more flexibility to
incentivize landlords to rent to veterans and need funding to hire or
contract with realtors who can broker relationships and negotiate lease
agreements.
Increase funding for Rep Payee services. SSVF provides
funding for staff to provide money management services to clients for
up to 12 months. In addition to extending the 12-month period for those
veterans who need the ongoing service in order to remain housed, many
providers like Swords to Plowshares also provide Representative Payee
services to SSVF clients, despite a lack of dedicated funds to provide
these services which these veterans are mandated to utilize. In fact,
we currently have more veterans enrolled in Representative Payee
services than those enrolled in temporary money management under SSVF.
Increase allocation of Eviction Prevention funds and/or
allow for more flexibility. We have experienced an increase in the
number of requests for Eviction Prevention support. Certainly and
rightly, the focus up to this point has been on Rapid Re-housing more
so than Eviction Prevention. However, the longer-term goal is to ensure
that episodes of homelessness among veterans are infrequent and short-
lived. That means that Eviction Prevention will play a larger role in
sustaining the gains we have made and preventing recidivism. Moving
forward, VA needs to allocate a larger percentage of Eviction
Prevention dollars/enrollments to address homeless prevention among
those who were assisted with Rapid Re-Housing services.
Flexibility for length of case management period: SSVF
currently requires that operators discharge veterans after 90 days.
Support and case management for 90 days is not sufficient for many
veterans--particularly those who have minimal income, long histories of
homelessness, drug and alcohol abuse and mental illness. Limiting the
length of time community-based operators can provide case management
increases the risk for recidivism. The length of case management should
be extended to up to 12 months or as needed for veterans with high
acuity.
Flexibility for use of service dollars: Many homeless
veterans need on-site supportive services in order to remain in
permanent housing, but there are limited Permanent Supportive Housing
sites and units. The California Association of Veteran Service Agencies
championed Prop 41, the California Veterans Housing and Homeless
Prevention Bond Act, to authorize $600 million in bonds to fund
supportive housing for homeless veterans. Prop 41 funds will go a long
way in the physical development of housing units, however, community-
based service providers like Swords to Plowshares need to identify
funding to cover the cost of on-site services staff, as well as
identify housing subsidies for veteran residents. If the VA changed
regulations under the SSVF program to extend the case management period
for those veterans who are at higher risk for recidivism--those
veterans who need to live a supportive housing community--it would go a
long way in covering the operational cost to have services staff on-
site.
In addition to these recommendations, an effective response to the
problem of veteran homelessness will require that we make all VA
homeless programs available to the veterans who need it most. On both
counts, the VA has made great progress but has not yet done all it can
do.
reaching the most vulnerable veterans
The VA has placed some of the most vulnerable veterans beyond its
reach. It has done this by creating eligibility rules that exclude a
large number of former servicemembers, including some who are most at
risk of homelessness. We will not solve the problem of veteran
homelessness until all veterans benefit from the care and support that
they deserve and require.
How servicemembers are excluded from VA services: Not all
servicemembers are eligible for VA care and services. Some are excluded
by rules Congress enacted in 1977 that prohibit the VA from assisting
servicemembers discharged for certain kinds of conduct.\1\ This
includes veterans discharged by General Court-Martial, essentially a
felony-level conviction, and some veterans discharged because of
prolonged periods of unauthorized absence.
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\1\ 38 U.S.C. 5303(a); 38 CFR 3.12(c).
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Others are excluded because of additional rules that the VA created
itself.\2\ The VA's rules presumptively exclude all veterans with a
punitive discharge--those that were discharged by a court-martial--as
well as all veterans who receive non-punitive administrative discharges
for misconduct.\3\ If these veterans correctly apply for an eligibility
review, the VA will evaluate their service according to a series of
criteria that the VA itself created.\4\ If the VA decides that the
veteran failed on of its eligibility tests, then the VA may withhold
housing services, in addition to health care, compensation for
disabilities that arose during service, and low-income pension. In
fact, the VA will not even address that person as a ``veteran.''
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\2\ Most VA benefits are provided only to ``veterans'' and their
spouses or dependents. Congress defined ``veteran'' to include only
those servicemembers who were discharged ``under conditions other than
dishonorable.'' 38 U.S.C. 101(2). Congress did not define what
conditions would count as ``dishonorable.'' Therefore the VA has been
free to make its own standards, 38 CFR 3.12(a, c).
\3\ There are two kinds of punitive discharges, which can only be
issued by courts martial: Dishonorable and Bad Conduct. There are three
kinds of Administrative discharges, which are not issued by courts
martial: Honorable, General Under Honorable Conditions, and Other Than
Honorable (formerly called Undesirable). The VA has decided that it
will treat Honorable and General discharges as presumptively eligible
for ``veteran'' status. However servicemembers with any of the other
characterizations, including the Other Than Honorable characterization
that does not require any court martial, are ineligible unless the VA
includes them based on its individual review. 38 C.F.R 3.12(a).
\4\ 38 CFR 3.12(b, c).
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All of these veterans signed up or were drafted and served at a
time in our history when most people don't do so, and the VA should
withhold care and services only in the most severe cases of truly
dishonorable service. The Congressional rules honor this by
disqualifying eligibility in limited, specific circumstances. Unlike
the rules make by Congress, however, the VA's rules are vague and end
up excluding large numbers of veterans.\5\
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\5\ For servicemembers discharged in FY 2011, about 1,400 are
excluded based on Congressional standards, based on DOD discharge data
and court martial records. However, the VA's presumptive exclusion
criteria exclude 8,686 people discharged that fiscal year. Although
about 4.5% of those people have since been found eligible based on a VA
review, the VA's rules still exclude significantly more people than
required by statute.
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The VA's standards fail to consider several common-sense issues:
Mental health. We know that PTSD, TBI, and other mental
health conditions can lead to behavior problems that look like
misconduct to military commanders: for example, lack of impulse
control, suicidality, or self-medication through drugs or alcohol.\6\
But if this behavior results in misconduct discharge, the VA will only
grant eligibility if the person was fully ``insane'' \7\ or if they
were so impaired that they did not comprehend their own actions.\8\ In
practice, this does not typically address PTSD and TBI, the most common
mental health injuries from service.
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\6\ Milliken CS, Auchterlonie JL, Hoge CW. Longitudinal Assessment
of Mental Health Problems Among Active and Reserve Component Soldiers
Returning From the Iraq War. JAMA. 2007;298(18):2141-2148. doi:10.1001/
jama.298.18.2141; Highfill-McRoy RM, Larson GE, Booth-Kewley S, Garland
CF. Psychiatric diagnoses and punishment for misconduct: the effects of
PTSD in combat-deployed Marines. BMC Psychiatry. 2010 Oct 25;10:88.
doi: 10.1186/1471-244X-10-88. PubMed PMID: 20974004; PubMed Central
PMCID: PMC3020681.
\7\ 38 CFR 3.12(b).
\8\ One of the VA's bases for exclusion is when misconduct was
``willful and persistent.'' 38 CFR 3.12(d)(4). And misconduct was
``willful'' unless the person lacked the mental capacity to make an
intentional act. 38 CFR 3.1(n)(1).
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The length and quality of prior service. The VA's rules
consider the quality of service only if the discipline issue leading to
discharge was a single ``minor'' event.\9\ In that case, the VA has a
very high standard for how good the prior service must be: the VA has
said that even a combat deployment is not inherently ``meritorious''
because that was the basic duty expected of the servicemember.\10\ Its
rules do not consider the duration of prior service.
\9\ One of the bases for inclusion is when misconduct was
``willfull and persistent,'' however the VA will overlook that
misconduct if the misconduct was ``a minor offense'' and service was
``otherwise honest, faithful and meritorious.'' 38 CFR 3.12(d)(4).
\10\ See e.g., Title Redacted by Agency, 03-09 368, Bd. Vet. App.
(June 19, 2009).
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Mitigating factors. The rules do not consider whether
there are family, financial, of other personal circumstances that might
explain the behavior that led to discharge.\11\
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\11\ The Court of Appeals for Veterans Claims has held that the VA
is prohibited from taking these factors into account, because there is
no provision in the regulation permitting it. Winter v. Principi, 4
Vet. App. 29 (1993). Individual adjudicators do sometimes take these
factors into account anyway, on their own initiative.
We routinely see veterans who have served in combat, sometimes on
multiple tours, who have severe mental health problems form service,
and who are turned away from care by the VA because of its
discretionary exclusion rules. The VA has denied eligibility to 78% of
the servicememebrs who it treats as presumptively ineligible and who
applied for benefits. We believe that this is too high. Every one of
them served, and every one of them went to the VA for help. Turning
them away should be done rarely and deliberately.
Who is affected: These rules exclude a large number of veterans.
Since 2001, over 135,000 servicemembers were discharged in a way that
made them presumptively ineligible for VA benefits upon discharge,
according to the VA's eligibility rules.\12\ For those that discharged
recently, approximately 50% had deployed to a contingency operation,
but were ineligible for VA services upon discharge.\13\
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\12\ Servicemembers with Other Than Honorable, Bad Conduct, and
Dishonorable discharges are presumptively ineligible for VA benefits.
38 CFR 3.12(a). Discharge data from Department of Defense FOIA release.
\13\ Deployment and discharge data from Department of Defense FOIA
release.
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The large majority of them--about 85%--were discharged for conduct
that was less severe than the Congressional eligibility rules.\14\ This
means that they may or may not be eligible, depending on how the VA
applies its own criteria. However, the VA has conducted its eligibility
review for only 10% of these servicemembers.\15\ The remaining 90% will
be turned away if they ask the VA for help today, simply because the VA
has not yet completed its eligibility review.
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\14\ Based on FY 2011 data. There were 8,686 misconduct discharges
in FY 2011. In that period, there were 726 discharges by General Court-
Martial. This corresponds to the statutory bar at 38 CFR 3.12(c)(1)
(discharge by General Court-Martial). There were 548 discharges for
Interservice Separation Code 1075, ``AWOL or Desertion.'' This
corresponds to the statutory bars at 38 CFR 3.12(c)(4) (discharge for
desertion) and 38 CFR 3.12(c)(6) (discharge for AWOL more than 180
days). It is overinclusive because the statutory bar includes an
exception for ``compelling circumstances,'' as discussed infra. The
remaining statutory prohibitions are relatively uncommon. Because the
second figure is overinclusive, and because the remaining categories of
prohibition are rare, it is safe to conclude that the total number of
people encompassed by the statutory bars in FY 2011 is approximately
1,274, or 15% of all misconduct discharges. This data was obtained from
the Annual Report of the Code Committee on Military Justice FY 2011 and
from a DOD FOIA response.
\15\ Data provided by VBA analyst.
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These are some of the most vulnerable of all veterans. The same
mental health trauma that may have led to discipline issues in service
will stay with them after service. And because they are turned away
from VA care, those conditions are untreated. This is not speculation:
Marines who deployed to combat and who received a PTSD diagnosis were
seven times more likely to get a misconduct discharge than Marines who
did not have a PTSD diagnosis;\16\ and the suicide rate for veterans
excluded by the VA is twice as high as the suicide rate for other
veterans.\17\ If we needed a red flag, this is it.
---------------------------------------------------------------------------
\16\ Highfill-McRoy RM, Larson GE, Booth-Kewley S, Garland CF.
Psychiatric diagnoses and punishment for misconduct: the effects of
PTSD in combat-deployed Marines. BMC Psychiatry. 2010 Oct 25;10:88.
doi: 10.1186/1471-244X-10-88. PubMed PMID: 20974004; PubMed Central
PMCID: PMC3020681.
\17\ Kang et. Al., Suicide risk among 1.3 million veterans who were
on active duty during the Iraq and Afghanistan wars, Annals of
Epidemiology (Feb, 2015).
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We know where this leads, because we saw the same thing happen to
veterans of prior eras. Vietnam-era veterans who were excluded from VA
care have spent their entire lives dealing with mental health trauma
without VA medical treatment. If they have been too disabled to work,
they got by without income support from the VA. This is unfair and
unwise.
The impact on veteran homelessness: These exclusion rules hit
homeless veterans the hardest. In our housing programs, about 15% of
homeless veterans are excluded from VA services. Informally, other
housing providers and VA personnel report similar numbers. This tells
us two things.
First, it means that veterans excluded from VA services are at
elevated risk of homelessness. Only nine percent of servicememebrs are
presumptively ineligible for VA services,\18\ yet 15% of homeless
veterans are ineligible. This means that veterans excluded from the VA
are about 50% more likely to be homeless. We know some of the reasons
why this happens: their disabilities are not adequately treated, and
they can't receive VA income support if they are too disabled to work.
We shouldn't be surprised that when we turn away veterans in need that
they end up on the street.
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\18\ Discharge data from Department of Defense FOIA release.
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Second, it means that we will not solve the homeless veteran
problem until we include these veterans. That 15% will be the last and
the hardest group to assist. Many are chronically homeless, as they
have lived for decades on their own without heath care or income
support from the VA. Helping them off the street will require all the
resources that the VA can mobilize. We can't afford to be holding back.
What the VA is doing well, and what can be done better: The VA has
long recognized the importance of this part of the homeless veteran
problem. Since the 1990s it has extended its GPD emergency and
transitional housing program to all veterans with administrative
discharges, even if they are not otherwise eligible for VA benefits.
Beginning last year it expanded eligibility to include veterans with
anything but a fully Dishonorable discharge, even if they are not
eligible for other VA benefits. It applies the same policy to its SSVF
Rapid Re-housing program. This is the right thing to do.
However, last month the VA OIG raised questions as to the legality
of this policy and the VA has committed to obtaining a legal
review.\19\ We are very concerned that the VA will limit eligibility
based on that review. This would make it very difficult to meet the
Government's goal of ending veteran homelessness.
---------------------------------------------------------------------------
\19\ Department of Veterans Affairs Office of Inspector General,
``Veterans Health Administration, Audit of the Homeless Providers Grant
and Per Diem Program Management Oversight'' (June 29, 2015) available
at http://www.va.gov/oig/pubs/VAOIG-14-01991-387.pdf.
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Moreover, the VA had never extended this eligibility to its HUD-
VASH program. A permanent solution to veteran homelessness will require
permanent housing options. Homeless veterans will need to have access
to long-term housing, including income support if they are too disabled
to work.
There are two ways to address this. One is for the VA to change its
discretionary eligibility rules. Of the people excluded from VA
services, only about 15% are excluded based on Congressional standards.
The remaining 85% are excluded based on the VA's own rules. It can
change these, and we believe that it should do so.\20\
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\20\ Because Congress has provided the VA with no guidance on how
to define a discharge ``under conditions other than dishonorable,'' the
VA has wide authority under the Administrative Procedure Act to define
this term in its regulations. This includes wide authority to repeal or
modify the definition it has already adopted.
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The second way to address this gap is for Congress to mandate a
change to the VA's rules. Senator Murray has introduced Senate Bill
1731 this term, a bill that would waive the VA's discretionary
exclusion rules for the purposes of GPD program eligibility. We
strongly support this bill. But we will not end veteran homelessness
through the GPD program alone. We will need the preventative resources
of the SSVF program, the long-term resources of the HUD-VASH program,
and the comprehensive health care and disability assistance that only
the VA can provide. This requires that that the VA's exclusion rules be
brought more closely in line with the Congressional rules. If the VA is
unwilling to change its rules on its own, then Congress should rewrite
those rules itself.
closing:
Homelessness became an inescapable byproduct of the Vietnam War and
our failure as a nation and a community to provide strong support.
While Vietnam veterans remain a significant portion of the homeless
veteran population, we have a lingering and constant reminder of how we
failed them. The hard lessons of Vietnam, and perhaps the legacy of
Vietnam veterans, are the homeless fallout and our ability as a nation
to make meaningful strides to end homelessness, for those veterans as
well as our newer generations whose trauma has manifested at a much
quicker pace. Yet it remains that Iraq and Afghanistan veterans, some
home for several years, find their troubles mounting and slip into the
shadows that the veil of homelessness so easily provides.
At the end of the day, we must end up with a system of housing-
related services and supports that will allow each locality to promptly
and effectively address those veterans that are at risk or who become
homeless, thereby ending the phenomena of chronic homelessness. This
system includes adequate Permanent Supportive Housing resources for the
most vulnerable, senior housing supports for the large number of very
low income Vietnam-era veterans aging into the need for senior
services, Transitional and Stabilization housing supports such as the
Grant & Per Diem and Health Care for Homeless Veterans programs, and
maintaining safety net SSVF programs to close that front door to
homeless, which is where the most cost-efficient intervention can be
made.
We were invited to testify based on our expertise and experience in
providing these services. I urge you to listen to those of us who have
been on the front lines of providing services. We are providing the
services needed based on our experience operating within our veteran
community.
Chairman Isakson. Thank you very much for your testimony.
Baylee Crone.
STATEMENT OF BAYLEE CRONE, EXECUTIVE DIRECTOR, NATIONAL
COALITION FOR HOMELESS VETERANS
Ms. Crone. Chairman Isakson, Ranking Member Blumenthal, and
distinguished Members of the Committee, thank you so much for
having me here today. My name is Baylee Crone and I get the
pleasure of being the representative from the National
Coalition for Homeless Veterans.
In this role, I have the opportunity to work with hundreds
of community agencies all across the country that are actively
ending homelessness for thousands of veterans and their family
members every year. The organizations NCHV represents are
transforming the lives of individual veterans and, importantly,
which we have heard a lot about today, they are transforming
the systems that respond to those changing needs.
I am here, in part, to offer thanks for the change which
has already occurred in the lives of tens of thousands of
homeless veterans who used to walk our Nation's streets and
call them home. This change is a testament to your dedication
and hard work and to the dedication of partners within the VA,
HUD, and Department of Labor, and to the commitment of hundreds
of community agencies like those on the panel today.
Veterans are moving off the streets into permanent housing
in higher numbers. They are doing so faster and with more
appropriate interventions than ever before. Our service systems
have improved dramatically. The difference between chance
change and sustained success, between a complicated web of
programs and a coordinated net of service is these integrated
systems.
Although we can see much progress, our work is far from
finished. I am here with the charge, really an urgent plea, to
help us do more, better, and faster to serve veterans who are
homeless and at high risk.
Before national attention focusing on veteran homelessness,
the community we represent stepped in to offer a hand up to all
who wore the uniform. They pulled veterans in and opened that
door to recovery. They screened in to maximize impact and have
done so for over 20 years. With the national spotlight on their
work, this community network has done what you have asked. They
have served more veterans, more efficiently, more effectively,
without screening veterans needing care out of services. They
have continued to serve the hardest to serve.
To promote the stability of this system, we need you to
clarify the intent of Congress in authorizing the GPD Program
that homeless veterans with a discharge status other than
dishonorable be eligible for services through the VA grant
programs, GPD and SSVF. They alone have the expertise and
ability to reach out and engage these veterans. Please help us
to ensure that no veteran is screened out of needed services
because of a legal interpretation that is divorced from the
reality of our daily work and in opposition to the intent of
this body.
We also do need more efficient HUD-VASH case management. To
improve case management, we encourage VA to rapidly increase
the number of HUD-VASH case managers, both through hiring and
through contracting out to community agencies.
To ensure stability for the long-term, client choice cannot
mean hands off. Housing first cannot be housing only.
Maintaining function zero is as critical as getting there in
the first place, and this requires long-term investment to
ensure longevity. If cuts to GPD happen in 2016, current GPD
Programs will either have to pull beds out from under veterans
in need or VA will be forced to reduce per diem rates across
the board to unsustainable levels that would severely restrict
providers' ability to deliver quality services.
Finally, we know that connection to employers and income
enhances long-term housing stability for persons with a history
of homelessness. For veterans who are leaving the streets, this
connection to employment is the difference between
reinstitutionalization and rehabilitation.
The world of work encapsulated by the programs of DOL-VETS
makes the connection between employers seeking laborers, the
untapped unemployed, and the training that binds the two in a
mutually beneficial relationship. Veterans who return to
employment open up limited resources for the next veterans who
need them.
As we make progress, resources need to be redeployed, not
withdrawn. This means that discharge status should not screen
veterans out of GPD and SSVF. HUD-VASH should be effectively
deployed and supported by better case management. GPD and SSVF
must be robustly funded to be a critical component of the rapid
re-housing continuum in every community. We have to better
connect efforts to end homelessness to the world of work, and
we could start with full funding of the HVRP Program.
Veterans will, unfortunately, experience homelessness in
the future, but what matters is how we invest now to ensure
that homelessness is brief, rare, and non-recurring.
I appreciate the opportunity to share these insights that
we hear bubbling up from local communities. We at the National
Coalition for Homeless Veterans and the agencies and veterans
across the country that we represent thank you for your
dedication to serving our Nation's homeless veterans. I am
looking forward to your questions.
[The prepared statement of Ms. Crone follows:]
Prepared Statement of Baylee Crone, Executive Director,
National Coalition for Homeless Veterans
Chairman Isakson, Ranking Member Blumenthal, and distinguished
members of the Senate Committee on Veteran Affairs: Thank you for this
opportunity to speak with you today. As the representative from the
National Coalition for Homeless Veterans, I have the humbling
opportunity to represent hundreds of community agencies across the
country that are actively ending homelessness for thousands of veterans
and their families each year. The organizations NCHV represents are
transforming the lives of individual veterans, and importantly they are
also transforming the systems that respond to the changing needs of
homeless and at risk veterans in every community.
I am here in part to offer praise and thanks for the blessings of
change which have already occurred in the lives of tens of thousands of
homeless veterans who used to walk our Nation's streets and call them
home. This change is a testament to your dedication and hard work, to
the dedication of partners within the Departments of Veterans Affairs
(VA), Housing and Urban Development (HUD), and Labor (DOL), and to the
commitment of the hundreds of community agencies they fund to provide
services. But I also come with a charge, an urgent plea, to help us do
more, better and faster, to serve homeless and at risk veterans.
While much is working to soothe the wound of veteran homelessness,
our work remains unfinished. To make progress toward our mission, we
must see drops in the Point in Time (PIT) count, but that is not the
only aspect of change we must see. We must see immediate engagement of
services when a need arises and rapid response to those on the streets.
We must empower community agencies to meet specific needs of individual
veterans using targeted services through data-driven programs. The
challenges remain daunting, but they are surmountable with close
coordination of complementary programs on the local level. What we hear
from the ground level gives us a better idea of what is working, and
what remains left to be done.
what is working
Across the country, our community organizations and VA partners are
stepping in with a safety net and a hand up to self-sufficiency and
independence. When we look at what is working, we see that more total
veterans are being served, they are being served faster and more
efficiently, and the interventions they are accessing are better able
to meet their needs.
More Veterans Leaving Homelessness
Looking at the 2014 PIT count shows us that on a single night in
January, 49,933 veterans were homeless. This 33 percent decline since
2010 is more than a statistic--it represents a real, measurable,
downward trend in homelessness among veterans.
This measure improves every year. Veteran homelessness dropped 10
percent in one year, representing the steepest decline since veteran
homelessness dropped 12 percent from 2010 to 2011. Homelessness among
unsheltered veterans dropped 14 percent in one year, a greater than 40
percent decline since 2009.
While the PIT count presents a useful benchmark for tracking
progress, it only shows part of the picture of who experiences
homelessness throughout the year and who receives services from VA and
other community programs.
The VA's Supportive Service for Veteran Families (SSVF) program has
served 138,538 veterans since it began, doubling its impact every year.
This program has responded to the expanded need for services across the
country by serving 34 percent of the Nation's homeless veterans in FY
2014. The HUD-VA Supportive Housing (HUD-VASH) program has served over
90,000 veterans since the program's inception, ensuring housing and
services for the most vulnerable, chronically homeless veterans. Over
90 percent have resulted in successful permanent housing. In 2014, GPD
providers served 45,185 unique veterans. Another 45,000 homeless
veterans will receive services in GPD in 2015, providing a critical
connection point between the streets and sustainable housing stability.
Veterans are Served Faster and More Efficiently
Since 2010, major programs ending veteran homelessness are moving
faster to get veterans into housing. The momentum is on the side of
change. For veterans identified by VA grantees, 80 percent moved out of
unsheltered status in an average of 30 days.
Of veterans exiting SSVF who received prevention assistance, 88
percent exited to permanent housing in an average of 84 days. Those
veterans who were homeless stayed in the program only slightly longer,
at 102 days on average. This average continues to decline, with FY 2014
length of stay averaging 91 days, even as the system targets those who
are the most difficult to serve. Resources reach deeper into
communities, with SSVF grantees serving 96 percent of the Nation's
Continuums of Care and 67 percent serving at least one rural area. This
sets in place a coordinated network of service that can serve as a
safety net for retuning servicemembers who find themselves at risk in
the years to come.
Veterans in housing through HUD-VASH, especially those over 55,
reduced their use of costly VA health care by 37 percent. In
communities with DOL-VETS Homeless Veterans Reintegration Program
(HVRP) grantees, homeless veterans are rapidly connected to gainful
employment with a low per-veteran cost of under $3,000, proving
programs can be effective and cost efficient.
Interventions Better Match Veteran Needs
These significant drops and rapid changes are happening as
community organizations and VA medical centers (VAMCs) have improved
outreach and targeted services for those with the most significant
barriers and special populations.
Of those exited from the SSVF program in FY 2014, 80 percent
achieve successful permanent housing. This program is serving those
with high needs and low income, including target populations needing
specific interventions. Fifty-five percent reported having a disabling
condition and four in five had less than 30 percent of AMI when they
came into the program. Fifteen percent were women veterans, and more
than half were over 45 years of age. Importantly, 67 percent of
veterans who exited to permanent housing went to housing with no
subsidy.
The Grant and Per Diem (GPD) program has improved connection to
permanent housing and targeting of special populations. Reaching the
VA's goal of 65 percent permanent housing placements, this program will
continue to adapt to be part of the rapid re-housing continuum through
a focus on bridge housing and transition in place models. Over seven
percent of veterans served through GPD are women, a higher percentage
than VA domiciliary programs or HCHV.
The HUD-VASH program has also improved targeting. Over 11 percent
of HUD-VASH vouchers went to women veterans in FY 2014, and 71 percent
of veterans served were chronically homeless. At the Department of
Labor, refocusing guidance for the Jobs for Veterans State Grants
(JVSG) Disabled Veterans Outreach Program Specialists means that more
veterans who are homeless have direct access to the Nation's large
network of American Job Centers. Implementation of Job-Driven Training
means that employment is informed by the local labor market and
connected to marketable skills to build a career, not just a job.
These numbers show us veterans are moving off the streets into
permanent housing faster, in higher numbers, and with more appropriate
interventions than ever before. However, the measure of our long-term
success is truly the functionality of our service systems. The
difference between chance change and sustained success, between a
complicated web of programs and a coordinated net of service, is
integrated systems. On this front, we have also made progress.
Systems are Changing
For many years, limited resources and an overwhelming challenge
created a structural disconnect between our message and our mission.
Our message was a call for services to help veterans on the streets,
while our mission called for a system that ended homelessness
altogether. Basic human rights and meeting basic needs came first. Now,
having a real end to veteran homelessness on the horizon has both
expanded and consolidated the service system. Our message can stand up
to the charge in our mission. We will end veteran homelessness through
a crisis-response services system that focuses on rapid progression
away from homelessness and toward long-term stability.
As a community, we have developed a services spectrum that matches
the needs of veterans in our care. On one end of the spectrum, veterans
needing housing stability and community connectivity access light-
touch, short-term interventions. Prevention services offered through
SSVF fit these veterans. On the other end, veterans with serious
disabling conditions and chronic homelessness access intensive, longer
term support. Housing subsidies with comprehensive case management from
a multi-disciplinary team of care professionals fit these veterans.
Appropriate interventions are often HUD-VASH or other permanent
supportive housing.
Between these two poles, we find many of the veterans who we will
house in the remainder of 2015. These are the homeless veterans with
moderate to intense service needs, who have challenges identifying
appropriate and affordable housing, and who do not qualify for HUD-
VASH. They fall into a need category built around rapid rehousing.
Serving them requires close coordination of local programs. They need
help and the process to ensure sustained stability progresses along the
spectrum between light-touch and high-intensity interventions. GPD
often provides the bridge back into one's community, especially when it
can follow a transition in place (TIP) model where the intensity of
services fade as the need for those services decreases, resulting in
permanent housing when the veteran can take over responsibility for
that independent housing. SSVF can also factor into this middle section
of the spectrum, providing short-term financial assistance for needed
items like moving costs, security deposits, or child care services so a
veteran can go back to work. HVRP steps into this section, providing a
hand up to gainful employment and income stability to promote housing
stability. We know from our work serving veterans who are homeless that
each one of these programs provides a necessary and unique string in
the fabric of stability. The programs do not duplicate, they
coordinate.
Best Practices are Emerging
We know that Housing First, when done correctly, works. It must
include housing access, access to a broad spectrum of supportive
services, and mandatory case management to be effective. We know that
hosting master lists where we can see every veteran by name helps
communities expedite and target services to those most in need. We know
that including specialists, like Housing Specialists and Peer
Navigators, deepens the impact of every staff member on a team. We know
that a team approach and coordinated case management meetings improve
outcomes.
In many ways, future efforts to end all homeless will benefit from
the challenges and failures we have encountered in our work to end
veteran homelessness, but we are learning what works and doing our best
to magnify that impact in all communities where veterans find
themselves in need. The message is changing from homeless maintenance
to a crisis response system. Some communities are getting there,
proving it can be done. Many more are on target, and able to track
their progress. Others are slightly behind but learning aggressively
and leaning heavily on their community partners.
what still must be done
Although we can see much progress, our work is far from finished.
As a community, we must dedicate ourselves to fostering housing
stability for those who move off the streets, supporting the longevity
of programs to meet future need, and ensuring self-sufficiency through
connection to the world of work.
Fostering Stability
Fostering long-term stability requires that we stabilize the
eligibility requirements for GPD and SSVF and improve both the reach
and case management of the HUD-VASH program.
Before national attention focused in on veteran homelessness, the
community we represent stepped in to offer a hand up to all who wore
the uniform of this country, They pulled veterans in and opened a door
to recovery, irrespective of race, creed, age, period of service,
sexual orientation, gender, or discharge status. They screened in to
maximize impact, and have done so for over 20 years. With a national
spotlight on their work, this community network has done what you have
asked: they've served more veterans, more efficiently and effectively,
without screening out veterans needing care. They have continued to
serve the hardest to serve.
To promote the stability of this system, to let these agencies
continue to do what you've asked them to do, we need you to clarify the
intent of Congress in authorizing the GPD program that homeless
veterans with a discharge status other than dishonorable be eligible
for services through the VA grant programs GPD and SSVF. These programs
have always served these veterans; they alone have the expertise and
ability to reach and engage them. Help us ensure no veteran is screened
out of needed programs because of a legal interpretation divorced from
the reality of our daily work and in opposition to the intent of this
legislative body.
A veteran who moves into a home is only successful if he can remain
stable in that home for the long-term. This means we still need
additional HUD-VASH vouchers. While the President's budget alludes to
national saturation of this resource, national saturation does not mean
local distribution has been perfect. Additionally, these vouchers can
be leveraged to develop new affordable housing in areas of high need
with low vacancy rates. However, some communities with chronically
homeless veterans do not have access to the resource intended to serve
them.
We also need more effective HUD-VASH case management. VAMCs cycle
quickly through VASH case managers who are inexperienced and rarely
stay in the job for more than a few months before leaving for other
opportunities. These chronic vacancies lead to high case loads for the
case managers who remain, leading to burnout and disengagement with the
welfare of veterans they serve. To improve case management, NCHV
encourages VA to rapidly increase the number of HUD-VASH case managers
through contracting out to community agencies and expediting hiring of
permanent VA positions. This case management must provide continuity of
care, be a well-paid job, be filled with candidates qualified through
experience as much as through degrees, and include smaller caseloads so
no veteran is left behind.
To ensure stability for the long term, client choice cannot mean
hands off. Housing First cannot be Housing Only. We need to assess time
in housing but also perceived quality of life as measured through
access to preventive medical care and social connectivity. HUD-VASH is
not re-institutionalization for the sake of cleaner streets, this is
reintegration for the cause of human dignity.
Promoting the Longevity of Service Systems
The evolving landscape of veteran needs demands that the work does
not end, especially for community agencies on the front lines. In rural
areas where aging veterans on fixed incomes are at high risk, our
agencies are there to fix roofs and fill out Medicaid applications. In
urban cities where young veterans move between multiple deployments,
instability is thwarted by job clubs and ``Battle Buddies.'' In towns
and cities across the country where transitioning servicemembers find
themselves jobless, hopeless, and without support, our community
agencies will be there with a hand up for years to come. In the coming
years, over 40,000 veterans will transition back to civilian world
every year. Some of these veterans will be low income and will need our
care and support. The longevity of our impact requires a continued
investment in the community, through and beyond 2015.
Maintaining these local support structures requires long-term
investment in peer-based outreach systems, transition points to bring
veterans off the streets, and landlord liaisons to help open up
affordable housing access. The GPD program provides these critical
elements and much more in local communities across the country.
Unfortunately, the President's budget institutes a premature
disinvestment in resources when they are needed most. If these cuts
happen in 2016, current GPD programs will either have to pull beds out
from under veterans in need, or VA will be forced to reduce per diem
rates to unsustainable levels that would severely restrict providers'
ability to deliver quality services. Flat-lining of the SSVF program's
funding will hamper this program's ability to reach deep into areas of
need in the years to come. Without the needed $500 million investment
for the long term, community agencies will be unable to stymie the wave
of homeless risk surging into communities as servicemembers demobilize.
These organizations are flexible and responsive, but they already do
much with little.
If these cuts happen, an increased demand for care will meet
decreased community referral options. Next year, by VA estimates,
demand for VHA health care services by all veterans will increase by 10
percent and demand for mental health services by homeless veterans will
increase 37 percent. As the numbers accessing VAMC medical care
continue to grow, we will see increased, not decreased, need for local
community referrals for homelessness prevention and rapid re-housing
services. The connection point between the VAMC providing medical care
and the community agencies providing homeless and prevention services
is the safety net that will prevent homelessness after 2015.
Some veterans suffering from Traumatic Brain Injury, military
sexual trauma, and other compounding, disabling conditions will
inevitably fall into homelessness after 2015. Reinstating GPD funding
at 2015 levels and pushing SSVF funding to $500 million ensures brick-
and-mortar bridges out of homelessness. By pushing these reinstated
funds back into the community, VA can fund bridge housing in
communities with a high need for transitional housing or allow for
facility upgrades to meet the safety and security needs of women
veterans, veterans with chronic mental health issues, and aging and
disabled veterans--all rapidly growing populations. Redeploying these
resource to high-need areas and allowing flexibility in program
structure to encourage the creativity systemic to these agencies will
ensure that GPD programs capitalize on expertise in outreach, case
management, and landlord engagement to make homelessness brief and non-
recurring.
In communities that have reached functional zero, social service
workers have not slowed down. Maintaining functional zero is as
critical as getting there in the first place, and it requires long-term
investment to ensure longevity. VA's investment in VA employees and
structures is promising, but the long-term investment in the community
agencies on the front lines is an investment in a promise that has been
fulfilled every day for over 20 years.
Enhancing Self-Sufficiency
Recent research has shown us that connection to employment and
income enhances long-term housing stability for persons with a history
of homelessness. Stability and longevity are tied to self-sufficiency,
and self-sufficiency through employment is the hand up to community
connectivity and purpose. For veterans who are leaving the streets,
this connection to employment is the difference between re-
institutionalization and rehabilitation.
Luckily, we know what works. Veterans who are homeless or at risk
must be connected to the employment system of the Department of Labor.
The Department of Labor is the only agency that utilizes community
agencies to successfully connect homeless veterans to gainful,
competitive employment. Each year, the 153 HVRP grantees work with over
15,000 homeless veterans to connect them to training, employment, and
the supportive services that set them up for long-term self-
sufficiency. Incredibly, this program promises at least a 65 percent
placement rate with a cost per placement under $3,000 per veteran and
is tied directly into the Nation's workforce system through connection
to the American Job Centers (AJCs). Veterans who are homeless,
especially those with disabilities, face considerable personal,
institutional, and relationship barriers to competitive employment. The
HVRP program helps veterans overcome these barriers and succeed in the
competitive labor force.
Unfortunately, this pivotal program is chronically underfunded. If
fully funded to match the surge of other community-based homeless
programs like SSVF, we would open the door to self-sufficiency for tens
of thousands of homeless veterans right now. Addressing unemployment
while addressing homelessness can magnify positive outcomes and address
risk factors precipitating homelessness.
Disabled individuals are often the last hired and the first fired
when the economy expands and contracts, a reality with devastating
consequences for the high percentage of homeless veterans with a
disability. Minority homeless veterans face compounded challenges;
African Americans are overrepresented in both the homeless veteran
population and the ranks of the long-term unemployed. Some homeless
veterans fall out of focus because they have been unemployed for so
long. Too many veterans over 55 are homeless and are statistically
outside of the active labor force due to chronic unemployment.
The world of work encapsulated by the programs of DOL-VETS makes
the connection between employers seeking laborers, the untapped
unemployed, and the training that binds the two in a mutually
beneficial relationship. Veterans who return to employment open up our
limited resources for the next veterans who need them. They become
tomorrow's managers, mentors, and peers. They prevent recidivism into
homelessness. They help decrease incarceration. If we want stable and
long-lasting change for veterans who are homeless or at risk, we must
aggressively open up the world of work. Every person, including
homeless and at risk veterans, including veterans of any age, race,
disability status, or gender deserves an opportunity to seek out self-
sufficiency.
where we go from here
The national decline in veteran homelessness since 2009 is without
precedent. The success we have seen to date, and our future success
relies on the strengths of VA's front lines--the community providers
that fight the daily battle to do more, better and faster. The momentum
is on the side of rapid change, and we are closer than ever to
achieving our mission of effectively ending veteran homelessness.
However, ending veteran homelessness is not a moment; it is a moving
target.
As the number of veterans on the street and in temporary shelter
goes down, we will need to be more, not less, diligent in ensuring that
we provide a hand up to those who remain on the street and find
themselves at high risk. We will end veteran homelessness, but reaching
that benchmark happens when the systems in place are ready and able to
immediately meet a veteran's needs should he fall into homelessness or
be at high risk. As we make progress, resources will need to be
redeployed, not withdrawn.
If we truly want a sustained end to veteran homelessness, we need
to fully utilize all of the resources we have as efficiently as
possible. This means that discharge status should not screen veterans
out of GPD and SSVF. HUD-VASH should be effectively deployed and
supported by better case management services. GPD and SSVF must be
robustly funded to be a critical component of the rapid rehousing
continuum in every community blessed with these vital resources. We
have to better connect efforts to end homelessness to the world of
work, and we can start with full funding of the HVRP program. Given the
flexibility to evolve, these tools will continue to offer a bridge to
stability for tens of thousands of vulnerable veterans moving forward.
Veterans will unfortunately experience homeless in the future; what
matters is how we invest now to make sure homelessness is brief, rare,
and nonrecurring.
S. 1731, the ``Homeless Veterans Services Protection Act of 2015''
Since the creation of the Grant and Per Diem program in 1992, the
homeless veterans' services that the Department of Veteran's Affairs
has provided have not been tied to healthcare eligibility. This
includes the Special Needs grants, and Supportive Services for Veteran
Families programs that were added to the continuum of care in later
years. It has been VA policy for nearly 25 years to serve those most in
need, regardless of their discharge status--as long as the
servicemember was not given a dishonorable discharge. This was the
intent of Congress at the time, and was further based on a 1994 ruling
by the VA's Office of General Counsel.
In 2014, this policy was thrown into confusion during a routine
review of a program handbook, and led to a moratorium, and then
subsequently to a rescission of that moratorium, on serving veterans
with an ``Other Than Honorable'' discharge. This policy is still under
review by the VA. Following a recent Office of the Inspector General
report, it was brought to light that there was still confusion in the
field among GPD providers, and a new legal opinion has been promised by
November of this year.
S. 1731 would maintain the status quo, reaffirm the original intent
of Congress, and protect the eligibility for homeless services of those
veterans with other than Dishonorable discharges who desperately need
assistance. Furthermore, S. 1731 removes the requirement that a veteran
serve in the military for two years in order to be eligible for these
three VA homeless programs, and would direct the VA to properly train
the field on serving these veterans.
Significantly, this legislation would not extend eligibility for
these programs to those who received dishonorable discharges, nor to
those who were discharged following courts-martial. Neither would this
legislation extend any benefits (including healthcare, pensions, or any
other veteran's benefits) to these veterans, other than access to the
GPD, Special Needs, and SSVF programs.
As we reach the end of the Five-Year Plan to End Veteran
Homelessness, it is increasingly important that we retain the ability
to serve homeless veterans with ``Other Than Honorable'' discharges.
Despite the relative infrequency with which veterans receive this
discharge type, those who do receive one make up 15% of the homeless
veteran population across the country. In some urban locales, that
number can be as high as 30% of the area's population of homeless
veterans. The loss of the ability to serve these veterans would
constitute an unnecessary roadblock on our charge to end veteran
homelessness.
This legislation is needed to ensure that we can end veteran
homelessness across the country, it codifies nearly 25 years of best
practices, and it does not change the cost of the VA homeless programs.
NCHV expresses the strongest support for S. 1731, and urges the Senate
to pass this crucial legislation to ensure that we meet our goal.
The ``Veteran Housing Stability Act of 2015''
This bill, while not yet introduced at the time of writing, would
address a number of concerns that face homeless veteran service
providers, either through head-on fixes or through exploratory pilot
programs. These problems include outdated definitions, a lack of
resources to ensure the permanent housing stability of some veterans,
ease of identifying landlords who will rent to formerly homeless
veterans, and heavy administrative burdens to change.
Likewise, the VA faces its own issues as it pushes to end veteran
homelessness. It is saddled with an out dated grant structure that is
resistant to changing circumstances, an impermanent think tank on
veteran homelessness, and a heavy cost burden by certain homeless
veteran ``healthcare super-utilizers.''
Homeless veteran service providers are often faced with
definitional issues that decide who they can and cannot help off the
streets because the McKinney-Vento definition of homelessness was
updated several years ago, without the VA definition being updated
alongside it. As such, veterans fleeing domestic violence are being
turned away from certain programs that are not authorized to help them.
This legislation would update the definition.
Service providers who operate transitional housing are limited in
what they can do for veterans after they leave their facilities by the
method in which VA funds those programs. Because GPD programs are
reimbursed on a per diem system, the VA cannot fund activities called
``follow up case management'' that support the veteran after s/he has
transitioned to permanent housing. This can have an effect on the
success of the veteran, and always hampers the tracking of that
success. This bill would create a grant program to fill this gap.
The VA has provided millions of dollars in grant funds to create
physical spaces where service providers can provide homeless veterans
with transitional housing services. The VA also believes that in some
of these communities, the need for these services is dwindling as we
approach the end of the Five-Year Plan. In all communities, the need
for permanent housing is acute. Therefore, some GPD providers would
like to turn their transitional housing beds into permanent housing for
formerly homeless veterans. However, because of grant obligations and
real estate re-capture provisions they are simply unable to make that
change. This legislation provides a pathway for service providers to
make that change, and continue to serve veterans in need in a new
environment.
The National Center for Homelessness Among Veterans (NCHAV) has
been undeniably critical to the successes that we have seen in the
movement to end veteran homelessness. Working with their academic
partners the NCHAV has been conducting research and using the resulting
data to drive VA policy changes since the Center's inception in 2009.
The National Center ensures that our policies are effective at ending
veteran homelessness, as well as cost-effective; their work helps to
ensure that every dollar spent is used to the fullest, to save veterans
from living on the streets. Currently, the NCHAV is not specifically
authorized and is funded at the discretion of the Secretary of the
Department of Veterans Affairs. This legislation would ensure that this
think tank exists into the future, so that the Federal Government never
allows an epidemic of veteran homelessness to occur, ever again.
One of the other large issues facing the VA today is the heavy
burden of certain homeless veteran ``healthcare super-utilizers.'' This
legislation proposes a pilot program to provide intensive case-
management to these veterans--assisting them with housing stability,
healthcare utilization, and benefits--that is designed to help the VA
lower their overall cost of care. Should it prove effective, this would
benefit not only the VA's bottom line, but the health and quality of
life of many chronically ill homeless veterans.
NCHV strongly supports the Veteran Housing Stability Act, both for
its provisions and for the important issues it brings to the forefront
of discussion. We urge the Senate pass this legislation.
conclusion
A few weeks ago, we celebrated the 25th Anniversary of the passage
of the Americans with Disabilities Act. That pivotal piece of
bipartisan legislation told persons with disabilities you have value in
the workforce, you have a voice in this democracy, and you have a
responsibility to be visible, vocal, and engaged in your community. The
epochal shift of that tide for persons with disabilities was
unprecedented. A social change movement pushed up from local
communities, and national partners were brave enough to act.
Here, 25 years later, we face a different yet comparable
opportunity. Twenty five years from now, will we look back on this year
as the time when we said to the least of these, our Nation's homeless
veterans: you no longer need to hide in the shadows, sleeping in
doorways? Those who served this great national deserve to be part of
her economy and her communities. Will we push ourselves to do what is
right by saying that hidden is not forgotten, housed out of the public
view is not reintegrated, functional zero is not final zero? We must
continue to act with vigilance, with a nearly frantic ferocity and
obsessive dedication to nothing short of perfection.
Thank you for the opportunity to share the insights I have seen
bubbling up from local communities. We at the National Coalition for
Homeless Veterans and the agencies and veterans across the country we
represent thank you for your dedication to bravery and social change
for our Nation's veterans.
Chairman Isakson. Thank you for your testimony, Ms. Crone.
Mr. Powers.
STATEMENT OF EDWARD POWERS, EXECUTIVE DIRECTOR, HOPE ATLANTA
Mr. Powers. Thank you, sir. Let me start by thanking
Senator Isakson for the opportunity to address the Committee
today. As a service provider, CEO, and as a Vietnam veteran, I
am grateful for the SSVF funding that allows HOPE Atlanta to
help my fellow veterans in ways we could not otherwise afford.
Because Georgia has the fifth-highest percentage of
unsheltered homeless veterans in the country, these funds are
incredibly helpful to those of us working with the VA to get
our former warriors stably housed. There are four social
service agencies in the Metro Atlanta area currently receiving
SSVF funds. Of these providers, HOPE Atlanta receives the most
funding, covers the largest geographic area, and services the
most homeless veterans.
Since the SSVF Program began, we have learned a lot and
have had some great successes, but challenges remain. I will
start by telling you about the challenges, some of which can be
fixed with funding. Others are more complicated and time
consuming to fix, even with additional funding.
First, the numbers are large and the solutions are
individual and often complicated. As we implement the program,
HOPE Atlanta faces the following regional challenges: A lack of
affordable housing, a lack of adequate public transportation, a
lack of appropriate employment opportunities that pay a living
wage. For the chronically homeless segment of the veterans'
population, there are the added challenges of PTSD and other
mental health and/or addiction issues.
As we have heard today, by HUD's own estimates, almost
50,000 veterans are at any time homeless in our Nation, and HUD
also estimates that an additional 1.4 million veterans and
their families are considered at risk of homelessness. No SSVF
Program, including HOPE Atlanta, has the resources to address
this potential volume of sustained and long-term demand for our
services without the continued and increased commitment by this
and future administrations in support of veterans and their
families.
Finally, in order to help the VA reach their functional
zero goal by the end of this year, we need an employment
specialist. You have heard about that from others, both on the
first panel and on this panel. We also need to add a staff
person who is trained through the SSI-SSDI Outreach Access and
Recover Program, known as SOAR, to work specifically with our
disabled veterans. SOAR-trained benefits specialists have a far
higher success rate than those without this training, 65
percent versus 27 percent. They also have a significantly
faster decision rate than non-SOAR-trained staff do.
Currently, there is no funding for these positions, and
with more than 2,000 unduplicated calls each year from veterans
in the Atlanta area requesting HOPE's help through the SSVF
Program, there is no way to meet their needs as current funding
stands.
Successes: One-third of HOPE Atlanta's SSVF team are
veterans. They have been great assets to the program and have
fundamentally contributed to our successes.
We are pleased to say that the VA holds regional meetings
and national conference calls to facilitate training and
exchanges for what does work for all SSVF providers. This has
resulted in greater flexibility in providing program services.
In Atlanta, the VA's Community Resource and Referral Center
(CRRC) at Fort McPherson provides a one-stop shop for homeless
veterans. Having staff there 5 days a week has been critical to
our success. Since 2012, 80 percent of the veterans in our SSVF
Program have exited to permanent housing.
Our PATH outreach team, the most successful one in the
metro area, engages and builds relationships with chronically
homeless veterans on the streets and under the bridges and
connects them to housing, medical, and mental health services.
Besides our three full-time staff at the CRRC, HOPE Atlanta has
established and staffed six other office sites to provide SSVF
services to veterans in 15 counties across our region.
We are also pleased to report that we have a strong
relationship with the Atlanta VA, which has reached out to us
for assistance to place homeless veterans with large families,
veterans with serious criminal background problems, etc., and
we have been able to place and case manage them. We have also
been pivotal in doing presentations in the community, making
the community at large aware of the services provided by SSVF.
HOPE Atlanta is part of five of the nine continuum of care
groups in Georgia, which is an asset in assisting the VA in
reaching hard to serve homeless veterans in rural conditions.
SSVF is a program for veterans, and veterans are, after
all, individuals. Let us talk for a moment about a particular
veteran and his family who are in a far different place today
than they were when we first met them.
Joe is a Vietnam-era veteran in his late 50s. He was
injured while serving for 3 years in the Army and received a
medical discharge. After the Army, he got married, raised a
family, and worked many different jobs, never letting the loss
of one job keeping him from finding another, until he was laid
off in 2014 and simply could not find another one. With no
income, he, his wife, and the granddaughter they were raising
lost their home. The three of them lived in their car while Joe
continued to seek employment.
Because of his veteran status, the Department of Labor
referred him to us and things began to turn around. We found an
apartment for the family and provided 5 months of rental
assistance while he continued to look for work every day. He
never gave up, never lost hope, while submitting more than 300
job applications. This sort of rejection takes a toll on a man,
and he persevered, and along with our staff case manager at his
side, he finally was offered a great job with a gas company and
is proudly supporting his family on his own.
It is such stories as Joe's that keep us in the trenches,
helping as many veterans as we can. It is SSVF funding that
supports this important work. Thank you for continuing to
support this program and the U.S. veterans who need us, and
thank you for all you do for people in Georgia, Senator
Isakson.
[The prepared statement of Mr. Powers follows:]
Prepared Statement of Edward Powers, Executive Director, HOPE Atlanta
Let me start by thanking Sen. Isakson for the opportunity to
address the Committee today. As a service provider, CEO, and as a
Vietnam Veteran, I am grateful for the SSVF funding that allows HOPE
Atlanta to help my fellow veterans in ways we could otherwise not
afford. Because Georgia has the 5th highest percentage of unsheltered
homeless veterans in the country, these funds are incredibly helpful to
those of us working with the VA to get our former warriors stably
housed.
There are 4 social service agencies in the Metro Atlanta area
currently receiving SSVF funds. Of these providers, HOPE Atlanta
receives the most funding, covers the largest geographic area and
services the most homeless veterans. Since the SSVF program began, we
have learned a lot and had some great successes, but challenges remain.
I'll start by telling you about the challenges, some of which could
be fixed with more funding while others are more complicated and time
consuming to fix even with more funding.
First, the numbers are large and the solutions are individual and
often complicated. As we implement the program, HOPE Atlanta faces the
following regional challenges:
A lack of affordable housing
A lack of adequate public transportation
A lack of appropriate employment opportunities that pay a
living wage
For the chronically homeless segment of the veteran's population
there are the added challenges of PTSD and other mental health and/or
addiction issues.
Second, according to a report in US News, in 2014 there were 21.8
million veterans in the US. By HUD's own estimates, almost 50,000 at
any one time are homeless in our Nation. HUD estimates that another 1.4
million veterans and their families are considered at risk of
homelessness. No SSVF program, including HOPE Atlanta's, has the
resources to address this potential volume of sustained and long term
demand for our services without the continued and increased commitment
by this and future administrations in support of veterans and their
families.
Finally, in order to help the VA reach their functional zero goal
by the end of this year, HOPE should add an employment specialist. We
can't change the lack of employment opportunities that pay a living
wage, but an employment specialist would help us find some of the jobs
there are and connect the veterans to them. We also need to add an
employee who is trained through the SSI/SSDI Outreach, Access and
Recover Program (SOAR) to work specifically with our disabled veterans.
SOAR trained benefits specialists have a far higher success rate than
those without this training (65% versus 27%). They also have a
significantly faster decision rate than non-SOAR trained staff do. We
can't change the lack of affordable housing but a dedicated SOAR
specialist could help us get more stable SSI/SSDI benefits for our
veterans which would help keep them stably housed.
Currently there is no funding for these positions and with more
than 2000 unduplicated calls each year from veterans requesting HOPE's
help through the SSVF Program, there is no way to meet their needs as
current funding stands.
So much for the challenges. Let's move on to our SSVF Program
successes! One third of HOPE Atlanta's SSVF team are veterans. They
have been great assets and have contributed to our success enormously.
Also contributing to our success:
The VA regional meetings and national conference calls to
facilitate training and exchanges for what's working for all the SSCF
providers that resulted in greater flexibility in providing program
services.
The VA's Community Resource and Referral center at Fort
McPherson (CRRC) which provides a one stop shop for veterans. Having
staff there 5 days a week has been very helpful to our success.
Some specific successes include the following:
Since October 2012 through July 13, 2015, 80% of the
veterans in our SSVF program exited into permanent housing.
HOPE Atlanta's PATH Outreach team, the most successful
PATH team in the Metro region, has reached, engaged and built
relationships with chronically homeless veterans on the streets and
under the bridges and connected them to housing, medical and mental
health services.
Besides our three full time staff at the CRRC located at
Fort McPherson, HOPE Atlanta has established and staffed 6 other sites
to provide SSVF services to veterans in 15 counties across our region.
These have contributed greatly to our success.
I've now regaled you with the challenges and successes of HOPE
Atlanta's SSVF program. What I've focused on has necessarily been a
broad overview. But SSVF is a program for veterans, and veterans are,
of course, individuals. So let's talk for a moment about a particular
veteran and his family who are in a far different place today than they
were when we first met them. This is the sort of story that keeps those
of us at HOPE Atlanta going, day in and day out, working with difficult
clients in difficult situations and wondering if all our hard work
really matters, wondering how much longer we can keep on slogging away
in these particular trenches * * * and then getting up the next day to
do it all over again.
Joe is a Vietnam era veteran in his mid-fifties. He was injured
after serving for three years in the Army and received a medical
discharge. After leaving the Army, he married, raised a family and
worked many different jobs, never letting the loss of one job keep him
from finding another, until he was laid off in 2014 and simply couldn't
find another one. With no income, he and his wife and the granddaughter
they were raising, lost their home. The three of them lived in their
car while Joe continued to seek employment. Because of his veteran
status, the Department of Labor referred him to HOPE Atlanta and things
finally began to turn around. We found an apartment for the family and
provided 5 months of rental assistance while he continued to look for
work every day. He never gave up, never lost hope while submitting more
than 300 applications for work. This sort of rejection takes a toll on
a man, but Joe persevered, with his HOPE Atlanta case manager at his
side, until finally--FINALLY!--he was offered a great job with a gas
company. He's now proudly supporting his family on his own.
It's stories such as Joe's that keep us in the trenches, helping as
many as veterans as we can. It's SSVF funding that supports this
important work. Thank you for continuing to support this program and
the US veterans who need us.
Chairman Isakson. Thank you, Mr. Powers, very much.
Mr. Steele.
STATEMENT OF JEFF STEELE, ASSISTANT LEGISLATIVE DIRECTOR, THE
AMERICAN LEGION
Mr. Steele. Chairman Isakson, Ranking Member Blumenthal,
and distinguished Members of the Committee, on behalf of
Commander Helm and the over two million members of The American
Legion, we thank you and your colleagues for conducting this
hearing and recognizing the importance of dealing with the
struggles of homeless veterans.
At The American Legion's 2009 national convention, then-
Secretary of Veterans Affairs Eric Shinseki laid out one of the
most ambitious aspirational goals in the history of this
Nation's campaigns to care for veterans. Not merely content to
reduce the number of homeless veterans, Secretary Shinseki
called for an end to veterans' homelessness by 2015. Shinseki
told the crowd, quote, ``No one who has served this Nation
should ever find themselves living without care and without
hope.'' Later that year, the Department rolled out an ambitious
5-year plan to end homelessness among veterans.
It is now 2015, the target year, and important strides have
been made. For those numbers to continue to fall, we must
continue on the path VA has set and continue to utilize the
resources of the entire community.
At the Federal level, Congress maintains the power of the
purse and, therefore, is critical to ensuring the success of
the programs they are responsible for funding, such as the
Grant and Per Diem Program, the Supportive Services for Veteran
Families Program, HUD-DASH vouchers, and the Homeless Veterans
Reintegration Program.
With regard to the latter, the Senate also needs to take up
and pass S. 425, the Homeless Veterans Reintegration Programs
Reauthorization Act, the companion bill, which passed in the
House in May. This legislation reauthorizes for five additional
years, through 2020, this critical program within the
Department of Labor's Veterans Employment and Training
Services.
Solving veterans' homelessness is not something the Federal
Government can do alone, though, and we recognize that. The
American Legion has taken a leadership role within local
communities by volunteering, fundraising, and advocating for
programs and funding for homeless veterans. Additionally, The
American Legion provides housing for homeless veterans and
their families in some areas, such as Connecticut and
Pennsylvania.
One of the goals of The American Legion is to help bring
Federal agencies, nonprofit, and faith-based organizations and
other stakeholders to the table to discuss best practices along
with funding opportunities so homeless veterans and their
families can obtain the necessary care and help in order for
them to properly transition from the streets and/or shelters
into gainful employment and/or independent living.
Sometimes, it does not take much. A local shelter for
homeless veterans in Pittsburgh, Pennsylvania, for example,
noted that their entire budget for mattresses each year comes
out of small donations made by the local post of The American
Legion. This is not a large-scale program with hundreds of
thousands of dollars in operating costs, but this is just one
example of how, on a local level, even small donations can make
a tremendous impact. Through thousands of small interactions in
every community across this country, stakeholders can build on
each other's efforts.
VA has done a tremendous job on a national level providing
leadership, but much of the work at the local level will depend
on the interaction of these community partnerships. Due to our
work with homeless veterans and their families, The American
Legion understands that homeless veterans need a sustained,
coordinated effort that provides secure housing, nutritious
meals, essential physical health care, substance abuse after-
care, and mental health counseling, as well as personal
development and empowerment. Veterans also need job assessment,
training, and placement assistance. The American Legion
believes all programs to assist homeless veterans must focus on
helping veterans reach their highest level of self-management.
In conclusion, The American Legion strongly believes that
Congress, VA, and other stakeholders must continue to invest in
the progress that has been made and remove any barriers
remaining to housing for veterans. By helping to provide the
necessary resources, this Nation can finally end this scourge
of veterans' homelessness.
Thank you for the opportunity to testify.
[The prepared statement of Mr. Steele follows:]
Prepared Statement of Jeff Steele, Assistant Director, Legislative
Division, The American Legion
At The American Legion's 2009 National Convention, then Secretary
of Veterans Affairs Eric Shinseki laid out one of the most ambitious
aspirational goals in the history of this Nation's campaign to care for
veterans. Not merely content to reduce the number of homeless veterans,
Secretary Shinseki called for an end to veteran homelessness by 2015,
completely eliminating the scourge. Shinseki told the crowd ``No one
who has served this Nation should ever find themselves living without
care--and without hope.'' By November of that year the Department of
Veterans Affairs had rolled out their ambitious ``Five Year Plan to End
Homelessness Among Veterans.''
In the midst of 2015, the target year, amazing strides have been
made. According to last year's assessment, the numbers have dropped
substantially. On a single night in January 49,933 veterans experienced
homelessness.\1\ That number is nearly 15 percent below the previous
year, and a full 33 percent lower than statistics in 2010, and the
numbers are going to drop lower.
---------------------------------------------------------------------------
\1\ VA 2014 Point-In-Time Count
---------------------------------------------------------------------------
While it remains possible, even probable, that from time to time
there will be veterans who fall in and out of homelessness, a state
where veteran homelessness achieves ``functional zero,'' an equilibrium
state where the number of veterans experiencing homelessness is no
greater than the currently monthly housing placement rate for veterans,
is still possible in the near future, provided we continue on the path
VA has begun, and continue to utilize the resources of the entire
community.
Chairman Isakson, Ranking Member Blumenthal and distinguished
Members of the Committee, on behalf of Commander Helm and over two
million members of The American Legion, we thank you and your
colleagues for conducting this hearing and recognizing the importance
of dealing with the struggles of homeless veterans.
The American Legion believes we can reach functional zero by
continuing the path VA has embarked upon with their Five Year Plan,
ensuring funding levels are not diminished as progress is being made,
and by increasing the work done to build partnerships by all
stakeholders in the community.
va's five year plan
VA developed a five-year plan to assist every homeless veteran
willing to accept services retain or acquire: safe housing; needed
treatment services; opportunities to retain or return to employment;
and benefits assistance. Additionally, VA started a prevention
initiative--the Supportive Services for Veterans and Families (SSVF)
Program, which is designed to help veterans and their families rapidly
exit homelessness, or avoid entering homelessness. SSVF is the only
national, veteran-specific program designed to help at risk veterans
avoid becoming homeless. The SSVF program provides grants to community-
based non-profit organizations and is helping connect very low-income
veterans and their families with services in the community.
This is a critical program because it focuses on ``at risk''
veterans, a cohort ten times the size of the actual homeless veteran
population. This is critical because it has the ability to serve
veterans before they are forced to the streets. The work of SSVF as a
component of VA's Five Year Plan has been highly successful, ensuring
the number of homeless veterans has continued to drop as homeless and
at-risk veterans have been directed to housing solutions.
maintaining the funding
Tremendous progress has been made in reducing the numbers of
homeless veterans, but that progress could be lost if funding is
reduced as the focus fades away from the mission at hand. One of the
most critical tools has been the use of Housing and Urban Development--
Veterans Affairs Supportive Housing (HUD-VASH) vouchers. Through FY
2015, HUD has awarded more than 78,000 HUD-VASH vouchers. Nationwide,
more than 300 Public Housing Authorities (PHAs) have participated in
the program. Recently, Congress created a set-aside pilot program to
encourage HUD-VASH vouchers to be used on tribal lands, thereby filling
an important gap in our service delivery system. It's essential that
funding for these vouchers continue as VA continues its work to get
veterans off the streets. The Grant and Per Diem Program (GPD) provides
``Capital'' and ``Per Diem'' grants and the Capital grants provide up
to 65 percent of the costs to acquire, renovate and construct
facilities for homeless veterans. These grants also see use for
transportation needs, providing community vans and other aids to
outreach functions.
The Homeless Veterans Reintegration Program (HVRP) within the
Department of Labor's Veterans Employment and Training Services (DOL-
VETS) addresses one of the challenges homeless veterans face--finding
and maintaining gainful employment. This program requires relatively
small investment, but potentially provides great dividends, by
increasing the ability of homeless veterans to integrate back into
society and provide meaningful impact in their communities. Although
unemployment has fallen somewhat among veterans in recent years, it
remains a concern. Keeping veterans in meaningful employment is a
critical step toward keeping veterans off the streets.
Congress maintains the power of the purse, and therefore is
critical to ensuring the success of these programs. The American Legion
urges Congress to maintain the funding levels for these critical
programs:
Continue to fund the Grant and Per Diem (GPD) Program at
$250 million and SSVF at no less than $500 million through the maturity
of the five-year plan (FY 2015).\2\
---------------------------------------------------------------------------
\2\ Resolution No. 306 (AUG 2014)
---------------------------------------------------------------------------
Fund $75 million in new HUD-VASH vouchers, while
allocating more project-based vouchers to high concentration cities of
chronically homeless veterans.\3\
---------------------------------------------------------------------------
\3\ Resolution No. 330 (AUG 2014)
---------------------------------------------------------------------------
Fund the Homeless Veterans Reintegration Program (HVRP)
within the Department of Labor's Veterans Employment and Training
Services (DOL-VETS) at the authorized level of $50 million--current
funding at $38 million.\4\
---------------------------------------------------------------------------
\4\ Resolution No. 306 (AUG 2014)
---------------------------------------------------------------------------
build on community partnerships
The American Legion has taken a leadership role within local
communities by volunteering, fundraising, and advocating for programs
and funding for homeless veterans. Additionally, The American Legion
provides housing for homeless veterans and their families in some
areas, such as the Departments of Connecticut and Pennsylvania. One of
the goals of The American Legion is to help bring Federal agencies,
Non-Profit and Faith-Based organizations, and other stakeholders to the
table to discuss best practices, along with funding opportunities, so
homeless veterans and their families can obtain the necessary care and
help in order for them to properly transition from the streets and/or
shelters into gainful employment and/or independent living.
Sometimes, it doesn't take much. A local shelter for homeless
veterans in Pittsburgh, PA noted that their entire budget for
mattresses each year comes out of the small donations made by a local
Post of The American Legion. This is not a large scale program with
hundreds of thousands of dollars in operating costs. This is an example
of how on a local level, even small donations can make a tremendous
impact.
A delivery of $5,000 in clothing and personal items in Shreveport,
LA through The American Legion's Operation Comfort Warrior prompted a
VA Occupational Therapist to note: ``Sometimes our veterans come in and
don't have appropriate clothing to leave the hospital. They now have
access to that appropriate clothing.''
Through thousands of small interactions in every community across
the country, the stakeholders can build on each other's efforts. VA has
done a tremendous job on a national level providing leadership, but
much of the work at the local level will depend on the interaction of
these community partnerships.
Due to our work with homeless veterans and their families, The
American Legion understands that homeless veterans need a sustained
coordinated effort that provides secure housing and nutritious meals;
essential physical healthcare, substance abuse aftercare and mental
health counseling; as well as personal development and empowerment.
Veterans also need job assessment, training and placement assistance.
The American Legion believes all programs to assist homeless veterans
must focus on helping veterans reach their highest level of self-
management.
conclusion
The American Legion strongly believes that Congress, VA and other
stakeholders must continue to invest in the progress that has been made
and remove any remaining barriers to housing for veterans. The VA's
Five-Year Plan to eliminate veteran homelessness by 2015 is roughly
150+ days away. By helping to provide the necessary resources and
changes to reach this obtainable, and worthy, goal, this Nation can
finally end the scourge of veteran homelessness.
The American Legion thanks this Committee for their diligence and
commitment to examining this critical issue facing veterans as they
struggle to access care across the country. Questions concerning this
testimony can be directed to The American Legion Legislative Division.
Chairman Isakson. Thank you very much, Mr. Steele. Thanks
to all of you for your testimony.
Let me start out by thanking Mr. Powers for his kind words.
I appreciate it very much, and your reputation for what you do
in our community precedes you here today and we appreciate it.
I am going to ask you a question in a second.
But, Mr. Blecker and Ms. Crone, both of you made a direct
reference to other than honorable discharges in terms of
eligibility for benefits, VA benefits. I think, Ms. Crone, you
mentioned--maybe Mr. Blecker--that there were half-a-million
veterans who received a less than honorable discharge from the
military during the Vietnam era, is that correct?
Mr. Blecker. That is correct, yes.
Chairman Isakson. What is it you are asking?
Mr. Blecker. Well, the idea is that folks should be
eligible for that kind of health care. The VA actually has the
ability and is given the ability to actually grant--determine
whether someone was dishonorable or not honorable under--it is
kind of confusing. But, if they determine, as Congress said,
that they served other than dishonorable, that is, they were
placed in harm's way and it is not--the dishonorable discharge
is administered through a court-martial proceeding or a
punitive discharge, considered a punitive discharge. In the
middle are other than honorables. They are not necessarily
punitive discharge, but they still--you lose eligibility for VA
health care if you have an other than honorable.
The idea is, especially with this remaining unsheltered
veterans 15 percent as high as 30 percent, that they cannot be
cutoff of that kind of health care, because they are the ones
who are over-represented in the remaining unsheltered veterans.
So, we are saying the VA should make some determinations,
and we outline them in my written testimony. If someone was
deployed or placed in harm's way, if the misconduct was
related, for instance, to stress or trauma, those things should
be considered, because that is what Congress intended. They did
not intend to have those other than honorable be excluded
entirely from benefits. So, the VA is empowered to do that, but
they just do not do that.
Chairman Isakson. Ms. Crone.
Ms. Crone. From the National Coalition for Homeless
Veterans' perspective, it is a slightly different nuance. What
we are asking for is really maintenance of the status quo. For
veterans who have an other than honorable discharge status who
are currently being served by GPD and SSVF Program, those two
programs in particular, there would be the potential for
veterans with an other than honorable discharge status to no
longer be able to access those two resources. We are asking for
maintenance, so veterans with an other than honorable discharge
status would still be able to access GPD and SSVF.
Chairman Isakson. Thank you very much.
Mr. Powers, your explanation of Joe, I have known some real
Joes that had situations exactly like the one you described,
living in an automobile, trying their best to find a job, a
husband and a wife and a child. When they got to you, they came
to you on a Department of Labor referral, is that right?
Mr. Powers. That is correct.
Chairman Isakson. Did they go to the Labor pool offices in
Atlanta? Is that how they were referred to you?
Mr. Powers. They did, absolutely.
Chairman Isakson. What funds did you use? You housed them
for 5 months, got them rental assistance for 5 months, helped
them with their family situation. Was it SSVF funds?
Mr. Powers. Yes, sir, it was.
Chairman Isakson. How much is available to you to do that?
Is it a case-by-case basis?
Mr. Powers. Pretty much a case-by-case basis. We try to
keep an eye on the amount of money that is available throughout
the year and not spend it as quickly as sometimes the
situations call for. But, we were able to, in this case, be
able to stretch them out over a 5-month period to house them
adequately until they were able to move on.
Chairman Isakson. Does Georgia get a certain grant from the
Federal Government on SSVF funds and then the Georgia
Department of Veterans Affairs contracts with people like
yourself to utilize them? Is that how it works?
Mr. Powers. That is correct, Senator.
Chairman Isakson. How are we doing with Pete Wheeler having
just passed away? Are we doing OK?
Mr. Powers. We are doing OK. You know, these are good
dollars and they are dollars that we want to see continuing to
be distributed. We are trying to be good stewards with the
funds that we do have. But, as you have alluded to earlier,
this is not money that is for everyone; you have to have a good
discharge in order to participate, which leaves a significant
number of individuals unable to participate. So, we are
struggling with what to do with those who do not qualify.
Chairman Isakson. When I read your testimony, I think I
remember correctly, and I thought I brought it with me, but I
did not, but I think I remember correctly, you said you were
one of four agencies that use SSVF funds?
Mr. Powers. That is correct, yes.
Chairman Isakson. Who are the other three?
Mr. Powers. Action Ministries, the Decatur Cooperative
Ministries, and PCCI.
Chairman Isakson. Well, thank you very much for all you do,
and thanks to all of you for what you do. Ms. Bates, you are
well represented by Senator Blumenthal, and I am going to turn
it over to him.
Senator Blumenthal. Thank you, Mr. Chairman, and Mr.
Powers, your State is well represented by Senator Isakson, as
well.
Mr. Powers. Absolutely.
Senator Blumenthal. As you know, he is a strong and
steadfast advocate of the causes that you have espoused.
I want to make sure that I understand the point that Ms.
Crone and Mr. Blecker were making about veterans who have
received a less than honorable discharge, not necessarily a
dishonorable discharge, but a less than honorable discharge. I
understand Senator Murray is seeking to correct this legal
issue. But, the point that you are making is that they are
ineligible currently under the law for these kinds of housing
benefits, but that you want--or there may be some question
about eligibility, but you want the VA to continue its present
practice of treating them, in effect, as eligible. Is that
correct, Ms. Crone?
Ms. Crone. I am happy to follow up with your team more on
this----
Senator Blumenthal. Great.
Ms. Crone [continuing]. There is further outline in the
testimony, but in a nutshell--and thank you for the question to
provide that additional clarification--in a nutshell,
currently, and for over 20 years, the Grant and Per Diem
Program and later the SSVF Programs have both been serving that
population. About 18 months or so ago, VA's Office of General
Counsel came to those programs and said, you can no longer
serve those veterans, just with GPD and SSVF. You can no longer
serve those veterans.
Of course, there was quite an uproar, because you are
talking service to 15 to 30 percent of the veterans who they
are trying to help. There was a stay put on that, and my
understanding is that it is currently being discussed within VA
Legal. I am not a lawyer, so we are waiting on their
determination, but my understanding is that the legislation
that was put forward would clarify the intent of Congress that
veterans with other than honorable discharge status would be
able to be served by the SSVF and the Grant and Per Diem
Program. That does not expand to VA health care. We are just
focused on Grant and Per Diem and SSVF.
Senator Blumenthal. I understand, but the same principle,
perhaps, could be applied to VA health care. In fact, the
change in practice that has been adopted by the Department of
Defense at my request, but also as a result of the work of the
Yale Law School Legal Services Clinic and other advocates, has
prompted a review, or at least a different access to review,
among the veterans who have less than honorable discharges.
One of the points that I think is important to follow up
here is whether all of you and other organizations that deal
with veterans are urging those veterans who have less than
honorable discharges to avail themselves of the possibility of
review based on the fact that they may have suffered from Post
Traumatic Stress or Traumatic Brain Injury. They were
undiagnosed then, in fact, unrecognized as a medical condition,
but now are and could be, in effect, diagnosed as the reason,
or one of the contributing reasons, that they received a less
than honorable discharge.
I hope that you will continue to work with my staff on ways
that we can use housing as well as health care as an outreach
mechanism, housing maybe more than health care because many of
them are ineligible for the health care and so they are never
reached by this system.
That is a long-winded way of saying that this issue may be
an opportunity as well as an obstacle. We need to overcome the
obstacle, but it may be an opportunity for us to raise this
issue.
In the short time that I have left, I want to ask Ms.
Tepper Bates, first of all, thanks for the great work that you
are doing. I hope that you will convey my thanks to all of your
team and all who are working in Connecticut on this very, very
important issue and making tremendous progress toward driving
the number of homeless veterans toward zero, which is really a
goal now within sight. As you say, there were 80 homeless
veterans at last count in Connecticut, which is tremendous
progress.
I was very, very interested in the point that you made
about changing the per diem system to, in effect, a more
incentive--a system that removes the incentive to keep people,
but to make sure that the housing and the program is used to
promote different solutions. Maybe you could expand on that a
little bit. I think that is a very, very promising idea.
Ms. Bates. Well, thank you very much for that question. I
can tell you that in Connecticut, where, again, we do have a
substantial stock of these so-called GPD beds, as I noted, we
actually had at the time of our Point in Time Count, double the
number of veterans in those beds as we did in emergency
shelters. Under the definitions of HUD, those are homeless
veterans and, of course, we would like to see as much coherence
as possible between the VA and the HUD definitions of homeless.
The issue that we have tried to address in Connecticut is
the fact that the current GPD structure serves as something,
frankly, of a disincentive to those programs to focus on
quickly exiting veterans out of homelessness to permanent
housing. GPD housing is not permanent, and our goal in ending
homelessness, whether of veterans or others, is to move people
out of homelessness to permanent housing.
In Connecticut, the VA medical center is trying to work
with those programs to squeeze down the amount of time veterans
are homeless in them to 60 days. That is the target. Right now
in Connecticut, veterans in GPD housing are homeless more than
three times that amount in those programs. So, there is a
challenge there, but we are trying to move that direction.
There are legislative changes that could be made, with your
leadership, to look at either introducing a different payment
structure or a competitive grant that would be performance-
based, and that would help incentivize the GPD Programs across
the Nation to look at that real focus on permanent housing and
quickly moving veterans to permanent housing.
Senator Blumenthal. I think that is a very, very promising
idea and I would like to work with you on the legislative
changes and enlist the VA. I notice that Ms. Pape is still with
us. Perhaps we can form a kind of team that will consider that
approach, how much of it can be done administratively and how
much requires legislation, which we can pursue.
Thank you, Mr. Chairman.
Chairman Isakson. Senator Tillis.
Senator Tillis. Thank you, Mr. Chair.
Ms. Crone, I had one question, actually, on terminology,
because I have heard a few things described here. Is ``less
than honorable,'' the appropriate way to--is that how VA refers
to veterans--``less than honorable,'' ``other than
dishonorable,'' I am just trying to get the terminology right.
Ms. Crone. Yes, and we are happy to sit down and walk
through the various discharge statuses with you.
Senator Tillis. Yes. Well, the question I had is I went out
to your Web site. It was very helpful. When we are talking
about a homeless population of 49,000, does that include the
veterans that are in that status, as well?
Mr. Blecker. I believe so, yes.
Ms. Crone. Yes, it is----
Mr. Blecker. Yes. That is among the unsheltered veterans.
Senator Tillis. All of them, OK. And, right now, if they
are determined by the VA to be in this status, OTH, where they
do not receive care, then how many out there right now, based
on the current VA policy, are really not in a position to
receive support?
Ms. Crone. The current VA policy is allowing programs with
GPD and SSVF to serve that population. If the change is made
without the legislative fix being in place, we are talking
between 15 and 30 percent of that 49,000, and my mental math is
pretty bad, so----
Senator Tillis. The reason I was asking that question, I
was assuming it was a significant number. Then, if we do not
make the changes, how can we actually achieve the goal of zero
homeless veterans? So, without that policy change, the goal by
the end of this year is impossible.
Mr. Blecker. I think you could reach that conclusion, yes.
Senator Tillis. OK. Well, it seems to me that time is a-
wastin'. We are in July right now, so we have got to move
pretty quickly if we have any hope of hitting that trajectory.
I probably sound like a broken record on this Committee
already--I have only been here 7 months. The main thing I am
trying to do--I mean, that is clearly something that we can
work with the VA and work with our colleagues in the House and
Senate to try to address. I, for one, think that we should.
The question that I always ask, though, for you all and
what you do--and Mr. Blecker, you made me decide I was going to
ask the question again--is what kinds of things do we need to
do to streamline and make more efficient the relationship
between the VA and organizations like yours to get rid of the
red tape and compress the time between the time a need is
identified and that need is being fulfilled. What general
area--and, by the way, I happen to think that the Secretary and
a number of people in the VA are absolutely committed to it.
Sometimes, we have so many things on our plate that we have to
just be crystal clear in specific interactions that need to be
changed.
Can you give me some insight, if you were to list your top
four or five, or Mr. Blecker, your top ten----
[Laughter.]
Mr. Blecker. Top 35? [Laughter.]
No, they are contained in my recommendations, but I think
in each of those three major initiatives, starting with the
Grant and Per Diem Program, we talked about making those costs
align with the true costs; we talked about extending a warm
hand; and, do not cut off the case management when the vet
still needs it, even if they leave the program.
What I meant about the VA--and they have to sort of take on
the ``can do'' attitude and not think of how the programs
cannot be applied, but how they could be applied. Let us be
creative about it. The SSVF Program is a remarkable investment
in the community, hundreds of millions of dollars.
In California, they passed a bill, a proposition called
Prop 41, that would take $600 million that was in the Farm and
Home Aid Cal Vet Loan and make it available to build vet-
specific housing for formerly homeless vets. But, everyone is
struggling, where are we going to get the service side of it?
Well, the SSVF could provide the services with a few rule
changes. Again, that is being flexible. Why do you not take
this major State investment and provide some of the services
that would allow these programs to function, to operate? That
is an example of how the VA could be creative and flexible with
the programs that they have.
I talk about the VASH Grant and Per Diem. Do more case
management contracting out if you have a partner there. Do not
try to do it yourself and try to have all the FTEs. It is a
real culture, I think, within the VA medical centers that they
are really committed to having as many full-time equivalents,
FTEs, staff, and not look at how you can take that money and
best serve the veteran population. Sometimes, you do not need
all clinical folks. You can hire peer specialists, and that
will go a long way to providing homeless care.
There are creative ways to do these programs working with
their partners.
Senator Tillis. Well, I know that both the Chair and the
Ranking Member have been great advocates for trying to do more
to improve the relationship with the VA and the relationship
with many organizations like yours.
I would sincerely appreciate your giving some thought to a
punch list of things. They could be minor things. They could be
things you already know about. Or, they could be things that
you will run into over the next couple of months as we try to
get to zero homelessness. Please reach out to this Committee
and reach out to my office. Help me find those things that we
can do to remove the impediments so you can continue to do the
great work you are all doing.
Thank you.
Chairman Isakson. I would never accept the accusation that
you are a broken record. In fact, I think, to the contrary, you
hit the nail on the head.
For the benefit of the VA, let me say this to Mr. Blecker
and everyone there. The VA is kind of like a managed care
provider of health insurance. They have 606,500,000 veterans
who are eligible for health care. They have a plethora of
programs that are available. They do not know when those
veterans are going to get sick, get PTSD, get TBI, or whatever.
We appropriate a fixed amount of money to veterans health care.
So, there are times--they are like an insurance company--they
are managing benefits based on how much money they have got
left.
The better the communication between organizations like
yourself and the VA in ways to not only provide benefits, but
also manage the cost of benefits and manage services, will be
extremely helpful. I am convinced that one of the biggest
problems that we have in Washington, and I think it is true
with the entire Federal Government, is we do not have the best
communication we should between ourselves. We are either
governing or providing benefits. There are a lot of times we
are counterproductive because we do not talk to each other as
much.
One of the things we are going to try to do, which Senator
Blumenthal and I have done, is we have gone twice to the VA and
had town hall meetings in the VA with their providers of health
care services just to talk about problems. We want to help and
we want them to be helpful to the veterans; because in the end,
we are all in this for the same reason and that is to provide
those services to veterans.
Your testimony today is very helpful to us to go back and
find those areas where we can work. For example, on the other
than honorable discharge, you have got to really be careful on
that. I mean, on the one hand, you want to make sure you are
providing the benefits. On the other hand, you do not want to
take a veteran who served meritoriously, retired from the
service, is eligible for benefits, and have somebody who did
not leave meritoriously getting benefits out of the pot of
money from which the meritorious service veteran did.
So, you were pointing out that problem. Our communication
about that problem can help us to refine those definitions and
in the end provide a better service to the veterans and,
hopefully, better manage the cost of the VA.
With that said, unless there are other comments anybody
has, I think we stand adjourned, unless you want to say
something.
Senator Blumenthal. Just to thank our witnesses for your
being here today and for your service to our Nation. Thank you.
Chairman Isakson. The Committee is adjourned.
[Whereupon, at 4:41 p.m., the Committee was adjourned.]
------
Response to Posthearing Questions Submitted by Hon. Richard Blumenthal
to Lisa Tepper Bates, Executive Director, Connecticut Coalition to End
Homelessness
Access to complete client data has the power to accelerate and
target efforts around ending veteran homelessness. The CCEH written
testimony for this hearing mentions that data management systems could
be improved upon if VA agencies could participate in the continuum of
care's data tracking systems. Housing providers in other continuums of
care have noted that tracking program eligibility can be a challenge
when dealing with clients who are transitory and move from continuum to
continuum.
Question 1. What challenges manifest at an operational level due
to VA's inability to utilize HMIS?
Response. The entire system of coordinated access to homeless
resources in the state of Connecticut is built around the CT Homeless
Management Information System (HMIS)--the HUD-mandated database used by
all HUD-funded (and most state funded) programs that address
homelessness. This system allows real-time tracking of clients who are
accessing services at CT HMIS participating agencies including
emergency shelters and housing programs specific to homelessness.
In Connecticut, several GPD providers and all SSVF providers are
already participating in HMIS, and use the data in the system to better
inform their outreach and engagement efforts as well as to track their
placements. The VAMC, however, is not currently allowed by internal VA
regulations to access CT HMIS. This hampers the cooperation between the
VAMC and other homeless resources to coordinate, and makes it more
difficult and time-consuming for the non-VA providers to make immediate
referrals to the VA for a veteran experiencing homelessness who
presents at a non-VA facility. Additionally, veterans who may present
at the VA for services but do not qualify for services there may be
eligible for services elsewhere--and cannot now be easily tracked and
referred.
The only recourse that we have at present to create a single,
comprehensive database of veterans experiencing homelessness in
Connecticut is to double-enter veterans experiencing homelessness into
both the VA HOMES system (by the VA) and separately into HMIS (by my
agency, CCEH, and always based on client consent for this data entry).
This is an inefficient use of time and resources, and hinders progress
on referring quickly each veteran experiencing homelessness to the
resources he or she needs; it also complicates the process of tracking
the effectiveness and completeness of our efforts to reach, shelter,
and re-house appropriately each and every veteran in need.
Question 2. What would the optimal data sharing model look like
with regard to tracking information on shared clients between VA and
its Continuum of Care partners?
Response. Optimal data sharing would allow for tracking in the HMIS
system of comprehensive history of each veteran experiencing
homelessness, so that there is a single record of the homeless history,
supports, and housing services in process for each veteran experiencing
homelessness--whether that individual has touched a VA-funded entity or
a non-veteran-specific service provider. A veteran may be in emergency
shelter in a non-veteran-specific facility, but seeking medical
assistance from the VAMC: a comprehensive, shared view of that person's
needs and supports is critical in helping that individual to move from
homeless to housed with the right supports in place. CT-HMIS could be
used as a single, definitive database for tracking all veterans
experiencing homelessness in the State of Connecticut. The CT HMIS
platform is a statewide open data sharing system that allows providers
to easily and responsibly share information to achieve the best
possible outcome for every individual served. We believe this would be
equally helpful to other states' efforts to end veteran homelessness.
______
Response to Posthearing Questions Submitted by Hon. Richard Blumenthal
to Michael Blecker, Executive Director, Swords to Plowshares
Question 1. Swords to Plowshares provides a number of services to
homeless veterans in a high cost, low vacancy housing market. Finding
appropriate housing placements for low income individuals has been a
challenge in these areas, and housing formerly homeless veterans in
these competitive markets can be even more challenging. What can VA and
community partners do to be more successful at finding veterans
permanent housing in these areas?
Response. The VA can contribute to community successes with regard
to finding permanent housing for veterans in challenged rental markets
such as San Francisco first and foremost by continuing to fund the SSVF
program and continuing the expansion of HUD-VASH to ensure we have
sufficient slots for all chronically homeless veterans still living on
our streets. Additionally, VA can apply lessons learned from
experienced community-providers like Swords to Plowshares and make
adjustments to both the SSVF and HUD-VASH programs that will help to
reduce barriers to finding housing for the hardest-to-house veterans in
high cost, low vacancy markets.
hud-vash recommendations
Increase HUD Fair Market Rent standards for HUD-VASH: The City and
County of San Francisco, its Mayor, and the San Francisco Housing
Authority have submitted a waiver request to HUD that would allow
veterans with VASH vouchers to be competitive in the rental market.
Without increases in the amount of funds available per voucher, many
veterans will not be able to find housing with a VASH voucher.
A regional approach is needed: The VA should promote regional
cooperation in the HUD-VASH program, making it easier for veterans with
vouchers issued in high cost areas, such as San Francisco, to readily
seek housing in outlying communities. Existing voucher portability
issues that rest at the Housing Authority (utilization and
administrative payments) and VA Medical Center (acceptance onto
caseloads) level make this very difficult.
Contract out HUD-VASH case management with community-based
providers: VA is having difficulty on-boarding and retaining sufficient
numbers of social workers to provide services to veterans with VASH
vouchers. In addition to general VA staff retention, in congregant
living settings that rely on HUD-VASH subsidies and staffing, we have
seen that VASH staff have a very difficult time in providing the needed
coverage. We recommend that VA mandate case management to be contracted
out with the community-based system of care. Community-based providers
delivering the case management portion would save in costs, improve
flexibility with scheduling and other service delivery components, be
better integrated with community-based housing operators wrap-around
services, and leverage the expertise of community providers.
ssvf recommendations
Program flexibility to improve outreach and engagement with
landlords: Many landlords are hesitant to rent to veteran clients,
particularly when many veterans utilizing SSVF have poor credit,
extremely low-income, histories of homelessness, drug and alcohol
abuse, mental illness, incarceration and often evictions. They are not
ideal tenants in many cases and it is incumbent upon service providers
to cultivate relationships with landlords and provide incentives for
them to rent to veterans. For example, paying for up to three months
rent in advance would help to attract more landlords. SSVF staff need
adequate training on engaging with landlords or outside expertise from
a realtor. Community partners operating SSVF need more flexibility to
incentivize landlords to rent to veterans and need funding to hire or
contract with realtors who can broker relationships and negotiate lease
agreements.
Flexibility for length of case management period: SSVF currently
requires that operators discharge veterans after 90 days. Support and
case management for 90 days is not sufficient for many veterans--
particularly those who have minimal income, long histories of
homelessness, drug and alcohol abuse and mental illness. Limiting the
length of time community-based operators can provide case management
increases the risk for recidivism. The length of case management should
be extended to up to 12 months or as needed for veterans with high
acuity.
Increase funding for Representative Payee services and extend Money
Management period as needed. Providing Rep Payee services to veteran
clients reduces the revolving door. SSVF provides funding for staff to
provide money management services to clients for up to 12 months. In
addition to extending the 12-month period for those veterans who need
the ongoing service in order to remain housed, many providers like
Swords to Plowshares also provide Representative Payee services to SSVF
clients, despite a lack of dedicated funds to provide these services
which these veterans are mandated to utilize. In fact, we currently
have more veterans enrolled in Representative Payee services than those
enrolled in temporary money management under SSVF.
Increase allocation of Eviction Prevention funds and/or allow for
more flexibility. We have experienced an increase in the number of
requests for Eviction Prevention support. Certainly and rightly, the
focus up to this point has been on Rapid Re-housing more so than
Eviction Prevention. However, the longer-term goal is to ensure that
episodes of homelessness among veterans are infrequent and short-lived.
That means that Eviction Prevention will play a larger role in
sustaining the gains we have made and preventing recidivism. Moving
forward, VA needs to allocate a larger percentage of Eviction
Prevention dollars/enrollments to address homeless prevention among
those who were assisted with Rapid Re-Housing services.
The following veteran client story illustrates the value of
allowing flexibility to pre-pay rent and/or offer financial security
incentives to landlords when trying to house veterans with issues
common to those with histories of homelessness--poor credit, criminal
justice involvement, and a lack of rental history:
Mr. Smith (name changed) is a 65 year-old Army veteran with a
credit score in the low/mid 500s, lack of rental history,
multiple items in collections, and a felony record. He lived in
the home of an elderly woman rent free in exchange for caring
for the property while she was in a nursing home. When she
passed away last year, the landlord decided that he wanted to
sell the property. Mr. Smith at that point became homeless and
was ``squatting'' in the building at the time of his enrollment
in the SSVF program. He completed several applications for
market-rate and tax-credit properties. His application was
pulled for a tax-credit apartment building in the East Bay.
Swords' staff went to Mr. Smith's appointment with the Property
Manager to qualify him for a studio unit. Because he is 100%
service-connected with the VA, he qualified for the income
requirements. When they ran his credit report, however, it
generated a denial of his application. Mr. Smith had brought a
friend with him that had offered to co-sign for his lease if
necessary. At that point, the Mr. Smith's friend and a case
manager from Swords to Plowshares stepped in offering to co-
sign (his part) and double the deposit (SSVF). The Property
Manager agreed to approve his application on the condition of a
double deposit. They deemed that a co-signer was not necessary
since he had enough income to cover 2.5x the monthly rental
price. Mr. Smith will move-in to his new apartment on 9/1/15.
The following veteran client story illustrates the need not only
for experienced community-based providers to provide case management
directly to HUD-VASH recipients, but also the need for flexibility
regarding the length of time SSVF grantees are permitted to provide
money management services:
Mr. Johnson, a Vietnam era veteran with a monthly income of
$1,920 monthly via VA benefits and Social Security was facing
eviction due to being behind on his portion of rent for
multiple months in a row and was in danger of losing his HUD-
VASH voucher. Swords to Plowshares' housing placement
specialist negotiated with Mr. Johnson's landlord over a period
of a few weeks and was able to keep him housed after agreeing
to pay for the overdue water bill and help with Mr. Johnson's
stability. Swords staff were able to convince the landlord that
using Swords to Plowshares' money management program would help
Mr. Johnson stay in his unit and help the landlord avoid costs
associated with an eviction. Money management is 100%
responsible for keeping Mr. Johnson housed. Mr. Johnson is
still in money management and is learning how to live within
his means, however, staff are confident that the landlord will
not keep Mr. Johnson as a tenant once he is no longer enrolled
in money management.
______
Response to Posthearing Questions Submitted by Hon. Richard Blumenthal
to Baylee Crone, Executive Director and Joshua L. Stewart, Director of
Policy, National Coalition for Homeless Veterans
Question 1. What more can be done to improve coordination between
HUD and VA during the voucher allocation process in order to make the
hiring or contracting process move more quickly?
Response. NCHV does not believe that the challenges with the HUD-
VASH program are a result of a lack of coordination efforts between HUD
and VA. Both departments have made history with their excellent cross-
departmental efforts to integrate data for improved targeting of
chronically homeless veterans, maintain continuous communications on
several levels within both agencies to improve voucher distribution,
and support service for the hardest to serve on the local level. NCHV
applauds them for that work. In fact, if anything NCHV believes that
the two departments should continue and expand on their current joint
efforts and joint area of focus. For instance, HUD-VASH should continue
to be targeted to the chronically homeless population. As we near the
end of the Five-Year-Plan, this population continues to be the hardest
to serve, and the population with the highest acuity of need. Targeting
through tested data analytics currently in use by the departments have
proven to be sufficient to the task, and additional vouchers should be
targeted to the areas with the highest remaining need. The main point
relating to HUD-VASH in our written testimony, that of contracting
case-management, is an internal VA issue and not part of the HUD--VA
relationship. While VA hiring efforts have improved, the agency's
contracting process continues to be slow, convoluted, and burdensome to
qualified agencies.
Question 2. Beyond staffing improvements, are there other
improvements VA might consider to ensure HUD-VASH participants are
receiving high-quality case management in this program?
Response. While we focused on the need for contracting of HUD-VASH
case management as a high priority in our written testimony, other non-
staffing oriented adjustments should be addressed immediately. One of
these adjustments is ensuring veterans leased up through HUD-VASH can
access HVRP to promote a return to the world of work. Currently, being
leased up in an apartment through the HUD-VASH program makes a veteran
ineligible for the crucial employment training and job placement
offered through the Department of Labor's HVRP. The benefits of co-
enrollment to the veteran are manifold. Divisions of case management
duties between employment (HVRP) and supportive service (SSVF) adds
depth to the quality of care; employed veterans in HUD-VASH obtain
better community connectivity and support. Employment increases the
income of the veteran (lessening the cost of the HUD-VASH voucher), and
employment increases the successful graduation rate of veterans out of
the HUD-VASH program, thereby freeing the voucher up for the next
veteran in need. This fix would be accomplished by a bill currently
before the Senate, S. 425, the ``Homeless Veterans' Reintegration
Program Reauthorization Act of 2015.''
Other improvements to the case-management for veterans could be
achieved by a recapture and re-deployment of unused or turned-over HUD-
VASH vouchers into project-based vouchers (PBV) for areas with high
need and saturated rental markets. Vouchers should not be taken from
communities with demonstrated need, but need shifts over time. PBV's
would stimulate the creation of new affordable housing in which to
place high-need veterans. Benefits of this model include 24/7, on-site
case management to ensure stability and safety. This is critically
important especially for programs implementing the low-barrier Housing
First model. High impact, high frequency case management is an
excellent way to improve care. This model is tailor made for project-
based vouchers.
Question 3. Are there specific parameters VA should consider when
determining to provide case management in-house or by contract?
Response. VA's recent work on speeding hiring has been laudable,
and has directly impacted the wellbeing of homeless veterans across the
country. NCHV would however urge VA to mirror this momentum in the area
of contracting. The same focus on urgency and streamlining has been
absent from the contracting process. Both of these areas should receive
focus and a sense of urgency. VA should be firing on all cylinders to
get to the goal of ending veteran homelessness. The procurement process
should be encouraged as a way to speed hiring and bring expertise in
house and streamlined as a process itself to increase the speed of
these agreements.
A focus on contracting would allow VA to leverage the considerable
network of qualified community agencies. Veteran service providers
across the country are experts on the Housing First model, educated on
it in theory and practitioners of it in their daily work. In places
where this same pre-existing expertise does not exist in a VAMC, local
service providers are ready to step in and take on the case management
responsibilities. These agencies have long-standing relationships with
landlords, and are connected to other community agencies to ensure
wrap-around services and continuity of care. Importantly, in rural
areas, these local expert agencies can fill a case management gap when
the VAMC housing HUD-VASH case managers are far away.
Time with the veteran is irreplaceable. In rural areas where
distances between veterans and the VAMC may be large, the time
necessary for the counselor to travel between VAMC and housing sites
can be burdensome. Local providers can provide far more effective and
efficient case management by taking some of that travel burden off of
VAMC staff. To this end, geographic distance covered by VAMC case
managers should be a factor in the awarding of contracts to homeless
veteran service providers. The caseload ratio of VA HUD-VASH case
managers to veterans is of perennial concern. One of the most important
things we can do to ensure high-quality case management is to keep
caseloads of individual counselors' reasonably low. Especially in surge
communities where there exists high lease-up pressures to keep pace
with local planning, contracted case management to established
community agencies can cut down on the case management ratio for
individual case managers. This is a critical short-term strategy, and a
smart long-term one to allow VA to capitalize on the dedicated local
resources it has available.''
______
Response to Posthearing Questions Submitted by Hon. Richard Blumenthal
to Edward Powers, Executive Director, HOPE Atlanta
Question 1. Many communities are working collaboratively to
address housing instability among veterans and are finding that their
housing and service delivery models need to be restructured in order to
better address the needs of veterans in their area, especially as they
get closer to zero. What additional legislative or regulatory changes
would be required in order to give communities more flexibility to
create an outcome-oriented system that meets their needs and
incentivizes housing stability through permanent housing placements and
income supports to sustain those placements?
Response. HOPE Atlanta suggests the following to address the
challenges of housing homeless veterans:
A. Offer tax credits to landlords who rent to veterans.
B. Give preference to veterans in local HUD funded programs and
projects.
C. Help Public Housing Authorities develop, and then adhere to,
uniform policies. Currently policies vary from one housing authority to
another, with some being far more restrictive than others.
D. Offer the SSVF/HUD VASH program to veterans who were less than
honorably discharged from their service. They are the ones who are the
most in need.
E. Create a fast track for VA benefits such as SOAR with SSI/SSDI.
Homeless veterans should be a top priority in the VA's disability
screening process.
F. Create funding for SSVF Housing Specialists who act as advocates
for the veterans in the program. They also interact with local
landlords to educate them on veterans in the area and their housing
needs.
Question 2. HOPE Atlanta's testimony highlighted the benefits of
having their staff complete SSI/SSDI Outreach, Access, and Recovery
(SOAR) training to improve the likelihood of, and speed at which
veterans obtain social security benefits. What actions has VA taken to
promote, to its grantees, free online training courses through the
Substance Abuse and Mental Health Services Administration's SOAR
Technical Assistance Center that might increase the availability of
income supports to veterans eligible for those benefits?
Response.
A. The VA promotes SOAR as a best practice and has recently
collaborated with the US Interagency Council on Homelessness and other
Federal organizations to create a report that outlines key strategies
for connecting people experiencing homelessness to SSI/SSDI. Here's the
link for the report: http://usich.gov/usich--resources/key-strategies-
for-connecting-people-experiencing-homelessness-to-ssi-ssdi. The
primary issue, however, isn't access to training, but the lack of
dedicated staff time to implement SOAR once SSVF staff receive the
training. There is a need for dedicated SOAR staff to be a part of the
SSVF grants. As the VA reaches functional zero, more SSVF staff could
be trained if needed to do SOAR. HOPE Atlanta is taking the first steps
to change an SSVF outreach worker position to a SSVF SOAR position. We
are only able to do this, however, because of overlapping outreach
services provided by the agency.
B. The State of Georgia's Dept. of Behavioral Health and
Developmental Disabilities (DBHDD) is placing a SOAR worker in the
regional Community Resources and Referral Center (CRRC) two days a week
to assist veterans in obtaining SSI/SSDI through SOAR. This appears to
be a collaboration between the VA and the State of Georgia. We find
this to be a very positive step.
______
Response to Posthearing Questions Submitted by Hon. Richard Blumenthal
to Jeff Steele, Assistant Legislative Director, The American Legion
Question 1. The Legion is not only a strong advocate for veterans
across the country, but also a direct service provider to homeless
veterans in the State of Connecticut. The 18-bed facility built by Post
15 in Jewett City, CT operates at capacity for the majority of the
year. It is critical that veterans service organizations take a hands-
on role in ending veteran homelessness across the country. What can VA
and others do to engage more mainstream VSO groups to play a more
significant role in this arena?
Response. VA and other stakeholders can reach out to the VSO
community to explain their plans to combat (and ultimately end) veteran
homelessness in their catchment area as well as provide opportunities
for them to engage in meetings/activities/events that deal with
assisting homeless veterans and their families. In addition, VA can
reach out to the VSO community to create opportunities to participate
in their conferences, state conventions or important meetings to
discuss challenges and `best practices' in helping at-risk and homeless
veterans. There are many dots to connect in order to assist a homeless
veteran from the street to transitional and/or permanent housing. If
VSOs understood these steps--it would be easier for these organizations
to find the best way to assist and/or unite with other local resources
to bring about the necessary changes for this vulnerable demographic.
VSOs are distinctly associated to the veteran community all across
the country--which can lead them to being a tremendous resource for
such a meaningful endeavor of ending veteran homelessness. Listed below
are some activities and/or functions that the VSO community can
potentially provide:
Assistance with disability claims, discharge review and VA
benefits
Job Fairs & Resume/Interviewing Workshops--hosted by
Legion Posts
Networking--employment and training opportunities with the
public and private sectors
Fundraising--rental assistance, utilities, moving costs,
etc.
Welcome Kits--for those veterans who are moving in
apartments with HUD-VASH vouchers
Volunteer--at VA medical centers, Community Service
Providers and Food Banks
Advocacy--Both State and Federal Level
Grantee for transitional and/or permanent housing
A P P E N D I X
----------
Prepared Statement of Teresa W. Gerton, Acting Assistant Secretary For
Veterans' Employment and Training Service, U.S. Department of Labor
introduction
Chairman Isakson, Ranking Member Blumenthal, and distinguished
Members of the Committee, thank you for the opportunity to provide a
statement for today's hearing on veterans' homelessness. I commend you
all for your tireless efforts to ensure that America fulfills its
obligations to our current servicemembers, veterans, and their
families. The Department of Labor (DOL, or The Department) also works
hard every day to ensure all veterans are prepared to meet their
employment objectives.
Secretary Perez and I believe that one of the most important ways
to prevent and end veteran homelessness is through a good job. However,
employment is not the only factor in overcoming homelessness among
veterans. Long-term stability requires a coordinated level of care
between many Federal partners, including the Departments of Veteran
Affairs (VA) and the Department of Housing and Urban Development (HUD),
state and local organizations, non-profits, and the private sector to
ensure veterans are successful in overcoming the myriad of challenges
to homelessness. To that end, the Department is committed to helping
the Administration meet its goal of ending homelessness among veterans
in 2015, as guided by Opening Doors: The Federal Strategic Plan to
Prevent and End Homelessness. In leading this effort, the U.S.
Interagency Council on Homelessness (USICH) has generated powerful
national partnerships at every level to work toward ending homelessness
across the Nation. Currently, Secretary Perez serves as the Council
Chair.
Through these interagency efforts and many others, the
Administration has achieved historic progress. According to the HUD's
2014 Annual Homeless Assessment Report to Congress, homelessness among
veterans has declined by 33 percent from January 2010 to January 2014.
Yet, on a single night in January 2014, there were still 49,933
homeless veterans. That is why the Department looks forward to working
with the Committee in providing these brave men and women who serve our
Nation with the employment support, assistance and opportunities they
need and deserve to succeed in the civilian workforce.
We also note that our partnerships throughout DOL extend VETS'
ability to achieve its mission, and bring all of DOL's resources to
bear for America's veterans, separating servicemembers, and their
families. VETS' mission is focused on four key areas: (1) preparing
veterans for meaningful careers; (2) providing them with employment
resources and expertise; (3) protecting their employment rights; and,
(4) promoting their employment and related training opportunities to
employers across the country.
VETS administers the Homeless Veterans' Reintegration Program
(HVRP) to help homeless veterans reenter the labor force. The agency
provides grants to state and local Workforce Investment Boards, tribal
governments and organizations, public agencies, for-profit/commercial
entities, and non-profit organizations to administer services to assist
in reintegrating homeless veterans into meaningful employment and to
stimulate the development of effective service delivery systems that
will address the complex problems facing homeless veterans. The HVRP
program succeeds, not only because of the hard work and local
connections of our grantees, but also because of the collaborative
efforts of our government partners at the Federal and State levels.
These efforts help ensure that homeless veterans receive a robust,
comprehensive network of support.
HVRP's client-centric, hands-on approach has helped place thousands
of previously-homeless veterans, some of whom were chronically
homeless, on a path to self-sufficiency. Historically, the Department
also has utilized HVRP funding for other grants designed to address
difficult-to-serve subpopulations of homeless veterans: the Homeless
Female Veterans and Veterans with Families Program (HFVVWF) and the
Incarcerated Veterans' Transition Program (IVTP). In addition, the
Department supports ``Stand Down'' events (described below) and
technical assistance grants.
hvrp
HVRP is one of the few nationwide Federal programs focusing
exclusively on helping homeless veterans to reintegrate into the
workforce. HVRP is employment-focused; each participant receives
customized services to address his or her specific barriers to
employment. Services may include, but are not limited to, occupational,
classroom, and on-the-job training, as well as job search, placement
assistance, and post-placement follow-up services. Grantees under this
program are competitively selected for a one-year award, with up to two
additional option years, contingent on the availability of
appropriations and grantees' compliance with the terms of their grant.
Grants like HVRP have helped homeless veterans like Edwin Sostre, a
Marine veteran, in Pittsburgh, PA. Edwin moved to Pittsburgh after
obtaining employment in 2010 but was laid off shortly after. He tried
to make it on his own for about a year but had no local support kinship
networks and ultimately found himself homeless. In 2011, Edwin and his
two sons enrolled with one of VETS' HVRP grantees, Veterans Leadership
Program of Western Pennsylvania (VLP), which he found out about at a
Stand Down event.
Through VLP, counselors worked with Edwin to help him obtain
housing, and then helped him acquire employment as a security guard at
the Monroeville Mall while he also attended the Community College of
Allegheny County. Edwin completed the HVRP program, but still kept in
touch with his Case Manager. Edwin graduated from the Community College
in May 2015 and will start at VLP as a HVRP Career Advisor/Case Manager
on August 3, 2015. Edwin now wants to give back to those who were so
helpful to him and to his fellow veterans who can see in his
accomplishments a path to their own success.
the homeless female veterans and veterans with families program
HFVVWF are competitive grants that specifically target the
subpopulation of homeless female veterans and veterans with families
who are ``at risk'' of becoming homeless. As noted in HUD's 2014 Annual
Homeless Assessment Report to Congress, homeless women veterans
accounted for 10 percent of the overall homeless veteran population.
The program provides direct services through a case management approach
that leverages Federal, state, and local resources. Eligible veterans
and their families are connected with appropriate employment and life
skills support to ensure a successful integration into the workforce.
the incarcerated veterans' transition program grants
The IVTP was last awarded in FY 2010; those grants continued up
through September 30, 2013, after which funds were not appropriated for
the program. IVTP grants were designed to support incarcerated veterans
who are at risk of homelessness by providing referral and career
counseling services, job training, placement assistance and other
services. For PY 2012, IVTP grantees enrolled 1,408 participants and
had a placement rate of 63.4 percent with an average hourly wage of
$10.69 at placement. Funds have been made available for IVTP grants for
FY 2015, and the 2015 Consolidated and Further Continuing
Appropriations Act expanded the definition of the veterans eligible to
participate in the IVTP program. Veterans eligible to participate in
IVTP include veterans who are at risk of homelessness and are either
residents of penal institutions, residents of institutions providing
long-term care for mental illness, or were recently released from
incarceration.
stand down and technical assistance grants
Through HVRP, the Department also supports ``Stand Down'' events.
These events, typically held over one to three days in local
communities, provide an array of social services to homeless veterans.
Stand Down organizers partner with Federal and state agencies, local
businesses and social services providers to offer critical services,
including temporary shelter, meals, clothing, hygiene care, medical
examinations, immunizations, state identification cards, veteran
benefit counseling, training program information, employment services,
and referral to other supportive services.
A portion of the HVRP funding is used for the National Veterans
Technical Assistance Center (NVTAC). The NVTAC provides a broad range
of technical assistance on veterans' homelessness programs and grant
applications to: existing and potential HVRP, HFVVWF, and Stand Down
grantees; interested employers; Veterans Service Organizations; and,
Federal, state, and local agency partners.
program performance
In Program Year (PY) 2013, DOL received in appropriations
$36,187,711 for HVRP. With these resources, DOL funded 35 new HVRP
grants, 90 option-year HVRP grant extensions, 22 HFVVWF grants, 14 IVTP
grants, and 90 Stand Down grants.
In FY 2014, the HVRP programs received an appropriation of
$38,109,000 with which the Department awarded 37 new HVRP grants, 101
option year HVRP grants, 18 HFVVWF grants, and 66 Stand Down grants.
These grantees are expected to provide services to 17,000 homeless
veterans, with an estimated placement rate of over 60 percent, at an
estimated cost per participant of $2,200. In addition, to support
grantees and disseminate best practices, the Department awarded two
technical assistance Cooperative Agreements.
In June 2015, Secretary Perez announced the awarding of more than
$35 million in grants to provide an estimated 16,000 veterans with
services through over 150 new and option year HVRP grantees, 12 HFVVWF
grantees, and estimates 70 or more Stand Down grants.
HVRP grant recipients, including HFVVWF and IVTP, are measured
against four performance outcomes outlined in our policy guidance. The
performance outcomes are: (1) Number of Enrollments; (2) Number of
participants placed in unsubsidized employment; (3) Placement Rate; and
(4) Cost per Placement. DOL staff members work closely with grantees to
help them succeed and to achieve their goals for all four performance
outcomes. HVRP grant recipients also report on the average earnings for
individuals who retain employment.
Table 1. HVRP Participant Statistics, PYs 2012-2013*
------------------------------------------------------------------------
Performance Outcomes PY 2012 PY 2013
------------------------------------------------------------------------
Participants Enrolled......................... 17,480 16,133
Placed Into Employment........................ 11,317 10,226
Average Cost Per Participant.................. $1,985.95 $1,903.28
Average Hourly Wage at Placement.............. $11.22 $11.50
------------------------------------------------------------------------
* As reported in the Veterans' Employment and Training Service
Operations and Program Activity Report (VOPAR) System, HVRP Program
Status Report, including HFVVWF but not IVTP data.
jobs for veterans state grants (jvsg)
In addition to HVRP, DOL awards Jobs for Veterans State grants
(JVSG) as a formula grant to each state and territory to support two
types of staff positions in the AJC network: Disabled Veterans'
Outreach Program (DVOP) specialists and Local Veterans' Employment
Representatives (LVER). DVOP and LVER staff support HVRP grantees by
helping grantees achieve employment goals through case management,
direct employer contact, job development, and follow-up services.
DVOP specialists provide intensive services targeted at meeting the
employment needs of disabled veterans and other veterans with
significant barriers to employment, including homeless veterans. In
addition, DVOP specialists often refer veterans who experience
homelessness to other AJC services, such as the Workforce Investment
Act of 1998 (WIA) Adult and Dislocated Workers services and training.
AJCs provided JVSG-funded services to 17,734 homeless veterans in PY
2013. LVER staff conduct outreach to employers and engage in advocacy
efforts with local businesses to increase employment opportunities for
veterans, and encourage the hiring of veterans, including homeless
veterans.
The transition from WIA to the Workforce Innovation and Opportunity
Act (WIOA) provides an extraordinary opportunity to improve job and
career options for our Nation's jobseekers and workers, including
veterans, through an integrated, job driven public workforce system
that links diverse talent to businesses. While retaining the network of
DVOP specialists at AJCs, WIOA strengthens accountability and
transparency of outcomes for core programs, including establishing
common performance indicators across these programs. The Department is
considering the adoption of these new common performance indicators for
JVSG and other VETS-administered programs, so that we will know with
even greater detail the outcomes of our investments in veterans'
employment and related programs.
s. 425--homeless veterans' reintegration programs reauthorization act
of 2015
The House passed H.R. 474, the ``Homeless Veterans' Reintegration
Programs Reauthorization Act of 2015,'' which would reauthorize HVRP
through 2020. The Department is also aware of a similar Senate Bill,
S. 425, which mirrors H.R. 474 expanding the eligibility for services
under HVRP, to include not only homeless veterans, but also veterans
participating in VA- supported housing programs for which certain
rental assistance is provided and veterans who are transitioning from
being incarcerated, as well as the addition of Native Americans who are
veterans and receiving assistance under the Native American Housing
Assistance and Self Determination Act of 1996.
The Department supports the extension of the HVRP authorization to
2020. The Department looks forward to working with the Committee to
provide technical information pertaining to S. 425 as necessary.
As mentioned, H.R. 474 would expand eligible participants under
HVRP to veterans currently receiving housing assistance under the HUD-
Veterans Affairs Supportive Housing (VASH) program and Native American
veterans participating in the Native American Housing Assistance
program who are otherwise not eligible for HVRP services. Under current
legislative authority, approximately 78,000 veterans who participate in
the HUD-VASH program annually are ineligible for HVRP's services
because they are not, technically, homeless. The Department believes
housing programs, such as HUD-VASH, are critical to the rehabilitation
and success of homeless veterans because the availability of housing
and health services improves their job readiness and employability.
Similar to H.R. 474, under S. 425, veterans who are transitioning
from incarceration would also be eligible for HVRP's services. For
veterans, having an arrest record is a major barrier to employment and
can lead to homelessness. VETS believes it is critical to begin
delivering employment support prior to their release in order to better
prepare them to secure civilian employment.
While the Department supports the goals of this legislation, these
changes would mean a substantial increase in the eligible population.
To accommodate these changes within existing funding, VETS would need
to write the HVRP grant solicitations to establish service priorities
for the program to reach those with the greatest needs and avoid
duplication.
conclusion
We at the Department of Labor remain committed to the
Administration's goal of ending veteran homelessness, and we look
forward to working with the Committee to ensure the continued success
of our efforts. Chairman Isakson, Ranking Member Blumenthal, and
distinguished Members of the Committee, this concludes my written
statement. Thank you again for the opportunity to submit a statement
for the record.
______
Prepared Statement of Jean-Michel Giraud, Executive Director,
Friendship Place, Washington, DC, and Member of the DC Interagency
Council on Homelessness
Chairman Isakson, Ranking Member Blumenthal, and Members of the
Committee, as executive director of a community-based nonprofit
organization that partners with the Department of Veterans Affairs, I
thank you for inviting me to present our perspective on progress toward
VA's goal of ending veteran homelessness by the end of 2015.
Founded in 1991 by a grassroots coalition of businesses,
congregations and concerned community members, Friendship Place is a
leader in Washington, DC, in developing and implementing innovative
solutions to homelessness that have demonstrable results and a lasting
impact. Our customized, person-focused programs include street
outreach, drop-in, free medical and psychiatric services, job
placement, case management, transitional shelter, rapid rehousing,
homelessness prevention, permanent supportive housing for families and
individuals, specialized services for homeless youth and young adults,
and rapid rehousing and homelessness prevention for veterans and their
families. In 2014, we helped 2,000 people; in 2015, we will help more
than 2,500.
In October 2014, The Community Partnership for the Prevention of
Homelessness (the agency responsible for coordinating DC's homeless
services Continuum of Care) presented its 25th Anniversary Award ``for
extraordinary service to homeless single adults'' to Friendship Place.
We accomplish our mission--to empower individuals and families
experiencing or at risk of homelessness to rebuild their lives with the
involvement of the community--with the help of more than 300
volunteers, who contribute 20,000 hours of service a year, and the
support of 26 neighboring congregations, several of which partner with
us to provide shelter or housing.
Friendship Place has participated in the DC VA Medical Center's
annual January Stand Down, Winterhaven, since 2010. Since October 2011,
we have been providing homelessness prevention and rapid rehousing
services under VA's Supportive Services for Veteran Families program
(SSVF). With our $2 million SSVF contract this year, we are serving
veteran households in the District of Columbia and eight surrounding
counties in Maryland and Virginia. In April 2015, we received an
additional $3 million dollar SSVF surge grant to be used over the next
three years for households in DC alone.
We call our SSVF program ``Veterans First.'' Based on the
successful outcomes of Veterans First, VA has twice awarded Mentor
Status to Friendship Place--in 2014 and 2015. In addition, within our
grant, VA is funding a staff position dedicated to providing training
and technical assistance to providers in our SSVF region.
In June 2014, Friendship Place launched Families First, a pilot
project for veteran families in Prince George's County, Maryland, who
need more support than SSVF can provide. With funding from the Maryland
Department of Housing and Community Development and the Freddie Mac
Foundation, Families First will serve 40 to 45 veteran families over
three years. The goal of the program is to end both homelessness and
poverty for the participating families. Case management places a
special focus on increasing income through education, job placement,
and benefits. Eligible families must have at least one dependent child
and be below 50 percent of the Area Median Income. They are provided
intensive case management for six months with possible re-certification
for up to three years.
The Director of our Veterans Services Division and I are both
members of the 25 Cities--a joint initiative of VA, the Department of
Housing and Urban Development (HUD), the U.S. Interagency Council on
Homelessness (USICH), Community Solutions, and the Rapid Results
Institute--whose aim is to achieve VA's goal of ending veteran
homelessness nationwide by the end of 2015 through implementing
Coordinated Entry. Friendship Place has assumed a leadership role in
implementing Coordinated Entry for DC through Veterans NOW, the 25
Cities Initiative, and Zero:2016.
Based on our five years of experience working closely with both the
DC VA Medical Center and VA's National Center on Homelessness among
Veterans, we would like to present our perspective in four areas
concerning Federal efforts to end veteran homelessness: (1) the SSVF
program, (2) the joint VA-Department of Housing and Urban Development
Supportive Housing Program (HUD-VASH), (3) character-of-discharge
issues, and (4) VA's Homeless Providers Grant and Per Diem Program.
1) SSVF
In the most recently completed fiscal year (2014) of our provision
of SSVF services in DC and eight surrounding counties in Maryland and
Virginia:
Our Veterans First program served 415 veteran households--
89 percent of them with Extremely Low household incomes (less than 30
percent of the Area Median Income)
We exited 267 households, representing 461 individuals
(including 147 children).
425 of the 461 individuals who exited the program in FY
2014 (92 percent) graduated to stable permanent housing.
The average length of time from intake to exit was just
under three months (88 days) for homelessness prevention and just over
three months (104 days) for rapid rehousing.
In other words, 425 people who would have remained or become
homeless but for our intervention are now safely housed and rebuilding
their lives. The average cost per household served is less than
$5,000--a small price to pay for stability for an entire household.
With the additional surge funding, we now have the capacity to
serve 550 households a year.
We know that the program is effective. The annual Point-in-Time
enumeration reveals that the overall number of homeless individuals
dropped by 2 percent in the Metro area from 2011 to 2015, while the
number of homeless veterans dropped by 19 percent.
We would like to draw your attention to key features of the SSVF
program that, from our perspective as a community provider, make it
successful:
It is based on nationally recognized best practices,
including the Housing First service model.
It is empowering. In the words of one of our Veterans
First graduates, the program is a ``hand up,'' not a ``hand out.'' The
service model recognizes that the individual or family is resilient and
can rebuild quickly with the right kind of help.
It is individualized and participant-centered. SSVF does
not dictate that we deliver services in a cookie-cutter manner but
gives us flexibility to provide exactly what each particular household
needs--no more and no less--to transition rapidly into stable housing.
Clinically, the program is backed by CARF, the national
gold standard for rehabilitation services.
SSVF is flexible, allowing us as the service provider to
adapt services to the local community and allowing veterans to transfer
agencies and even regions.
As a community-based organization, we can leverage
additional resources--volunteer support, private donations, and in-kind
contributions--to enhance the assistance we are able to provide.
More than anything, the success of the SSVF program is due to the
outstanding expertise of the national VA leadership and their unfailing
commitment to working collaboratively with their local grantees,
including Friendship Place, to continually refine and improve the
service model so as to ensure that we are achieving the desired results
as effectively and efficiently as possible. We would like, in
particular, to recognize the contributions of Mr. Vincent Kane, former
Director of the National Center on Homelessness among Veterans (now
Special Assistant to VA Secretary Robert McDonald); Mr. John Kuhn,
National Director of VA Homeless Prevention Services; Mr. Dennis
Culhane, Director of Research; and Ms. Adrienne Melendez, who is the
Regional Coordinator for SSVF for our region.
We applaud this VA team for providing excellent training (monthly
webinars, regional meetings, SSVF universities), for fostering
collaborative relationships among SSVF providers (coordinating regional
meetings in which we can share our best practices), and for soliciting
and being responsive to our feedback.
We regret that there have recently been travel restrictions placed
on the SSVF regional coordinators. We believe that SSVF providers need
the hands-on technical support of their regional coordinators if
communities nationwide are to reach the goal of functional zero by the
end of this year. We strongly urge the immediate lifting of these
travel restrictions.
Here in DC, we have moved quickly to establish and fully implement
a system of Coordinated Entry, which has increased the effective
utilization of resources by reserving HUD VASH for the most vulnerable
veterans while assigning to SSVF those who need only temporary help to
become stably housed.
2) HUD-VASH
The success of SSVF provides ample evidence that VA can make
effective use of community-based organizations to get results in its
efforts to end veteran homelessness. To improve outcomes in the HUD
VASH program, we recommend that VA (1) increase the use of community
organizations for the provision of the program's case management
services, and (2) streamline the process for awarding contracts to
community organizations.
The advantages of contracting out case management services for HUD
VASH are many:
Community providers can have smaller caseloads and,
therefore, more intensive case management. In Housing First programs,
the larger the caseload, the less likely it is that those served will
achieve long-term housing stability; smaller caseloads produce higher
housing retention rates. Programs with low retention rates are more
costly to the taxpayer in the long run, because participants who return
to the streets then seek out other services elsewhere.
Community providers have maximum flexibility to provide
culturally competent services adapted to local needs and conditions.
Successfully linking program participants to community
resources is key to the success of any Housing First program, and
community providers are more familiar with and connected to resources
in the local community.
Separating the funding source and the service provider
allows for better checks and balances; the funding source can more
objectively evaluate programs that are run by an outside provider.
Unfortunately, some veterans are uncomfortable seeking
services at VA because of negative experiences they may have had in the
past.
Friendship Place has been providing Housing First services under a
contract with the DC Department of Human Services since 2008, with an
annual housing retention rate that consistently tops 98 percent. Our
Housing First Director and I would be happy to meet with any interested
Congressional or VA staff to provide greater detail on what makes our
Housing First program successful and how a community-based model could
be implemented by VA for HUD VASH.
3) Character-of-Discharge Issues
Friendship Place urges passage of the ``Homeless Veterans Services
Protection Act of 2015'' (S. 1731), which will guarantee that homeless
veterans with Other Than Honorable discharges have access to all VA
services for homeless veterans, including GPD and SSVF (excluding
veterans who received dishonorable discharges or were discharged
following courts-martial).
Veterans with other than honorable discharges make up 15 percent of
the Nation's homeless veteran population and are among the most
vulnerable of all the veterans that seek the help of our SSVF program.
Eddie is a typical example; he was nearing completion of his enlistment
with a record of exemplary service when his squad was attacked in
Afghanistan and he was one of only a few survivors. He began self-
medicating his PTSD, and ended up being discharged under other-than-
honorable conditions.
If SSVF eligibility were limited to only those veterans that are
eligible for VA health care, veterans like Eddie would be left out in
the cold. Fortunately, we were able to get him legal assistance and
walk him through the process of upgrading his discharge status, so that
he is now VHA-eligible and can receive the help he needs and deserves.
As we reach the end of the Five-Year Plan to End Veteran
Homelessness, it is increasingly important that we retain the ability
to serve homeless veterans with Other Than Honorable discharges.
4) GPD
We believe that VA's Grant and Per Diem program would be more
effective with greater flexibility in its regulations and with
implementation of the following changes:
The VA should address structural issues in GPD in order to
move veterans through the program and into stable permanent housing
more quickly. The current slow pace of rotations through GPD is a
costly waste of VA resources for addressing homelessness.
To ensure the provision of high-quality services that are
in line with best practices, VA should establish the same high level of
technical support for GPD providers that SSVF providers enjoy.
summary
We are excited and energized by VA's impressive progress toward
ending veteran homelessness and are honored to partner in this
admirable--and much-needed--work.
We believe that the following recommendations, if implemented,
could expedite the success of VA's efforts:
1. Extend the authorization of appropriations for the highly
successful SSVF program and lift travel restrictions on the SSVF's
regional coordinators.
2. Increase the contracting out of HUD VASH case management
services to community providers and streamline the process for awarding
HUD VASH contracts.
3. Ensure that homeless veterans with Other Than Honorable
discharges are eligible for VA's homeless services by passing the
``Homeless Veterans Services Protection Act of 2015'' (S. 1731).
4. Institute changes in GPD that will result in a more timely
rotation of veterans through the program.
These recommendations not only are aligned with best practices in
the field of homeless services, but would, we believe, make VA's entire
system of services for homeless and at-risk veterans and their families
both more cost-effective and more humane.
Thank you for the opportunity to participate in this important
discussion.
______
Letter from Eric Garcetti, Mayor, City of Los Angeles
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