[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]
MAKING HUD-VASH WORK
FOR ALL VETERAN COMMUNITIES
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HEARING
BEFORE THE
SUBCOMMITTEE ON ECONOMIC OPPORTUNITY
OF THE
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTEENTH CONGRESS
SECOND SESSION
__________
TUESDAY, JANUARY 14, 2020
__________
Serial No. 116-51
__________
Printed for the use of the Committee on Veterans' Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via http://govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
48-956 WASHINGTON : 2022
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COMMITTEE ON VETERANS' AFFAIRS
MARK TAKANO, California, Chairman
JULIA BROWNLEY, California DAVID P. ROE, Tenessee, Ranking
KATHLEEN M. RICE, New York Member
CONOR LAMB, Pennsylvania, Vice- GUS M. BILIRAKIS, Florida
Chairman AUMUA AMATA COLEMAN RADEWAGEN,
MIKE LEVIN, California American Samoa
MAX ROSE, New York MIKE BOST, Illinois
CHRIS PAPPAS, New Hampshire NEAL P. DUNN, Florida
ELAINE G. LURIA, Virginia JACK BERGMAN, Michigan
SUSIE LEE, Nevada JIM BANKS, Indiana
JOE CUNNINGHAM, South Carolina ANDY BARR, Kentucky
GILBERT RAY CISNEROS, JR., DANIEL MEUSER, Pennsylvania
California STEVE WATKINS, Kansas
COLLIN C. PETERSON, Minnesota CHIP ROY, Texas
GREGORIO KILILI CAMACHO SABLAN, W. GREGORY STEUBE, Florida
Northern Mariana Islands
COLIN Z. ALLRED, Texas
LAUREN UNDERWOOD, Illinois
ANTHONY BRINDISI, New York
Ray Kelley, Democratic Staff Director
Jon Towers, Republican Staff Director
SUBCOMMITTEE ON ECONOMIC OPPORTUNITY
MIKE LEVIN, California, Chairman
KATHLEEN M. RICE, New York GUS M. BILIRAKIS, Florida Ranking
ANTHONY BRINDISI, New York Member
CHRIS PAPPAS, New Hampshire JACK BERGMAN, Michigan
ELAINE G. LURIA, Virginia JIM BANKS, Indiana
SUSIE LEE, Nevada ANDY BARR, Kentucky
JOE CUNNINGHAM, South Carolina DANIEL MEUSER, Pennsylvania
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains the
official version. Because electronic submissions are used to prepare
both printed and electronic versions of the hearing record, the process
of converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.
C O N T E N T S
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TUESDAY, JANUARY 14, 2020
Page
OPENING STATEMENTS
Honorable Mike Levin, Chairman................................... 1
Honorable Gus M. Bilirakis, Ranking Member....................... 2
WITNESSES
Mr. Keith Harris, National Director of Clinical Operations, VA
Homeless Program Office, U.S. Department of Veterans Affairs... 4
Mr. Hunter Kurtz, Assistant Secretary of Public and Indian
Housing, U.S. Department of Housing and Urban Development...... 6
Mr. Steve Berg, Vice President for Programs and Policy, National
Alliance to End Homelessness................................... 21
Ms. Kathryn Monet, Chief Executive Officer, National Coalition
for Homeless Veterans.......................................... 23
Mr. Greg Anglea, Chief Executive Officer, Interfaith Community
Services....................................................... 25
Ms. Tamera Kohler, Chief Executive Officer, San Diego's Regional
Task Force on the Homeless..................................... 26
Mr. Gary Cooper, Chairman of the Board of Directors of NAIHC,
Executive Director of the Housing Authority of the Cherokee
Nation......................................................... 28
APPENDIX
Prepared Statement Of Witnesses
Mr. Keith Harris Prepared Statement.............................. 39
Mr. Hunter Kurtz Prepared Statement.............................. 43
Mr. Steve Berg Prepared Statement................................ 46
Ms. Kathryn Monet Prepared Statement............................. 55
Mr. Greg Anglea Prepared Statement............................... 59
Ms. Tamera Kohler Prepared Statement............................. 62
Mr. Gary Cooper Prepared Statement............................... 65
MAKING HUD-VASH WORK
FOR ALL VETERAN COMMUNITIES
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TUESDAY, JANUARY 14, 2020
U.S. House of Representatives
Subcommittee on Economic Opportunity
Committee on Veterans' Affairs
Washington, D.C.
The subcommittee met, pursuant to notice, at 10 o'clock
a.m., in room 210, House Visitors Center, Hon. Mike Levin,
presiding.
Present: Representatives Levin, Brindisi, Pappas, Lee,
Bilirakis, Bergman, Barr.
OPENING STATEMENT OF MIKE LEVIN, CHAIRMAN
Mr. Levin. Good morning.
Without objection, the chair is authorized to call a recess
at any time.
Today's hearing is entitled, ``Making HUD-VASH Work for all
Veteran Communities.''
HUD-VASH is a permanent, supportive housing program jointly
administered by The Department of Housing and Urban Development
and the Department of Veterans Affairs.
This hearing will focus on whether veterans around the
country have equitable access to the housing resources and the
wraparound services provided by HUD-VASH--so critically
important. You know, last week, we talked about making sure
that no veteran goes hungry. This week we will talk about
making sure that no veteran goes without a decent place to call
home.
Specifically, today's hearing will examine access to HUD-
VASH in urban, suburban, rural, and tribal communities, and
work to determine what barriers and bottlenecks exist in
delivering resources to communities of all sizes. This hearing
continues the work the committee conducted during field
hearings in our districts--in the ranking member's district in
Florida and in my district in California--during the summer of
2019. I am sorry that we couldn't quite bring the weather from
California or Florida, but we will have to make do.
One of our subcommittee's goals is to end the veterans'
homelessness epidemic plaguing our country--so critically
important. I have said it before and I will say it again: One
homeless veteran is one too many.
One of the most efficient methods for reducing veterans'
homelessness is to intervene when a veteran is at risk of
homelessness and support them through their period of crisis.
Right now, we are not good enough at identifying at-risk
veterans and connecting them with services before they become
homeless--critically important.
When veterans do slip through the cracks and become
homeless, it is vitally important that our Nation has an
effective method to get them off the street and back into safe
and reliable housing.
Over the years, HUD-VASH has proven to be a highly
effective tool in reducing veterans' homelessness. Since 2010,
the number of veterans experiencing homelessness has declined
by 46 percent and the number of unsheltered veterans had
declined by 53 percent. Without this crucial program, we would
not have seen such a tremendous reduction in veteran
homelessness.
So far, more than 11,000 veterans have found permanent
housing and critically needed support services through the HUD-
VASH program. Each HUD-VASH voucher has increased permanent
support of housing units and decreased the number of homeless
veterans. Despite the effectiveness of this program and the
perpetuation of veteran homelessness, the administration has
not requested additional HUD-VASH vouchers in the last 2 years.
According to the 2019 Point-in-Time count, which counts the
number of homeless individuals on one of the coldest nights in
the year, there were over 37,000 homeless veterans, of which
14,000 were unsheltered.
We must continue investing in HUD-VASH, but we also know
there are some shortcomings to the program and that is why we
are here today. We are here, specifically, to examine how
staffing shortages in VA can lead to increased processing time
before veterans receive their vouchers.
We also want to examine the unique hurdles facing different
communities regarding how HUD-VASH vouchers and supportive
services are distributed. We know that densely populated areas
tend to have higher costs of living and less-affordable housing
stock, which can manifest in veterans struggling to find
suitable housing.
We know that rural areas may not have as many employment
opportunities and adequate public transportation for veterans
to seek and maintain gainful employment.
We know that tribal communities face far are more
regulatory hurdles than any other community.
We have a responsibility to abolish chronic homelessness
for veterans and strengthening the HUD-VASH program is an
important first step.
I look forward to hearing the testimony from our witnesses
on how we can do that.
With that, I now recognize my friend, the Ranking Member,
Gus Bilirakis, for 5 minutes.
OPENING STATEMENT OF GUS M. BILIRAKIS, RANKING MEMBER
Mr. Bilirakis. Thank you, Mr. Chairman.
I appreciate it. Thank you so much for holding this
hearing--a very important hearing. It affects all our
districts. I also want to thank the witnesses for testifying
today.
Mr. Chairman, I thank everyone, again, for joining us today
for the very important hearing of the Subcommittee on Economic
Opportunity--house committee--obviously the subcommittee on
Veterans Affairs on the HUD-VASH program. While homelessness is
an increasing problem in some communities across the country,
and I would say in a vast majority of the communities across
the country, there is no denying that there has been
significant progress made nationwide in reducing homelessness
among veterans.
Since 2010, the number of homeless veterans that you said,
Mr. Chairman, in the United States has declined by nearly half.
The most recent Point-in-Time count shows that veteran
homelessness has dropped by 2 percent since 2018. It is
progress, but there is more work to be done.
Several municipalities have even eliminated veteran
homelessness altogether. While this is good news, as funding
for homeless veterans programs at the VA and the Department of
Labor has reached our record levels, we must--there has been
great funding, but we have got to do more--we must ensure that
we have a true picture of how this money is being spent.
As the chairman mentioned, this hearing is a follow up to
two field hearings that we held on veterans' homelessness
programs; one in North County--San Diego--in the chairman's
district, and one in Pasco County, Florida, in my district.
These field hearings prove to me that while significant
progress has been made, we still have a long way to go to
ensure that none of the estimated 37,000 veterans who were
homeless last year remain living on the street.
It is important to provide veterans with immediate and
rapid housing through the VA's HUD-VASH housing voucher
program; however, I also believe it is even more critical for
the long-term success of these veterans that they also receive
the comprehensive and wraparound services that are a part of
this voucher program, as required by law.
Our goal should always be to help those veterans in need
find meaningful employment that will eventually allow them--no
longer require them government--for them to have government
assistance, because, you know, dignity and pride--veterans are
very proud people, and I do have some other comments off that,
but I will reserve them until later. Without helping homeless
veterans with wraparound services or finding meaningful
employment, we are only providing government-funding housing
and we are failing to set these veterans up for positive, long-
term success.
As we heard in California and in Florida, the lack of
affordable housing, the residents expressing the ``not in my
backyard'' sentiment, substance abuse, and other clinical
factors contribute to homelessness. That is why I am so glad
that we have groups like the National Coalition for Homeless
Veterans (NCHV) here with us today that represent innovative
providers who offer critical wellness and clinical services for
homeless veterans in need.
Like the debate the full committee has been having on
providing services to veterans in crisis who are not connected
to the VA, we should continue to look at innovative programs
that are providing services to veterans who are not necessarily
in the VA system and who are not hampered by government
regulation and barriers to success, and that is so important,
to think outside the box.
Additionally, I am interested to hear from VA, why they are
not providing more widely used--using the authority they have
to contract out the case management positions for HUD-VASH
participants. We will hear from many witnesses today about the
difficulty of hiring and retaining VA case managers in this
program.
It is clear to me that one way around the bureaucratic
hiring process is to contract with local agencies or nonprofits
that already know how to do this work in the first place. I
look forward to discussing that issue with our veterans today
and I am grateful to our witnesses for giving us an opportunity
to hear directly from those on the ground fighting against
veterans' homelessness.
Today, I hope to hear what works, what is not working, and
how we in Congress can help combat this problem. Everyone here
shares the same common goal: To guarantee that those who have
worn the cloth of our great nation never have to worry about
becoming homeless.
Once again, I thank the chairman for holding this hearing
and I will yield back. Thank you.
Mr. Levin. I thank the ranking member. We absolutely share
that goal. It was great to be able to have those hearings in
both of our districts and see the commonality, the important
issues that exist in both places, so I am very grateful.
With that, I would like to introduce our witnesses, and I
am very grateful to you, also. We have got some excellent
experts on the second panel and we will hear from them shortly,
but before that, I look forward to hearing from the important
and appropriate people within the administration who administer
this program.
On the first panel we have got Keith Harris, the national
director of clinical operations at VA's Homeless Program
Office.
Thank you, Dr. Harris, for being here.
I also want to thank HUD for joining us today to discuss
this important topic. From HUD we have Hunter Kurtz, assistant
secretary of Public and Indian Housing.
Thank you Assistant Secretary Kurtz.
Thank you--and as you know, you will have 5 minutes for
your oral statement, but your full written statement will be
added to the record.
With that, Dr. Harris, you are now recognized for 5
minutes.
STATEMENT OF KEITH HARRIS
Dr. Harris. Thank you, sir.
Good morning, Chairman Levin, Ranking Member Bilirakis,
distinguished members of the subcommittee. Thank you for the
opportunity to testify today on the topic of veteran
homelessness and the HUD-VASH program.
VA remains fully committed to the goal of preventing and
ending veteran homelessness and we remain committed to doing
this work, jointly and collaboratively, with our Federal,
State, and local government partners, along with our non-
governmental partners. Several of these are here today; our
close partner, HUD, on this panel with me.
On the second panel, as you noted, the National Alliance to
End Homelessness, the National Coalition for Homeless Veterans
are important national homeless advocates, regular partners to
us in our work. Interfaith Community Services, the Housing
Authority of the Cherokee Nation, and the San Diego Regional
Task Force are important local partners who provide critical
services in their respective communities.
We recognize that ending veteran homelessness is not a
single event in time; rather, it is a deliberate effort made to
achieve the goal and continued follow up efforts to make sure
that progress is sustained. Our goal is a systematic end to
veteran homelessness and we have collectively made significant
progress in this respect, as you both noted.
The most recent Point-in-Time count estimated that on a
single night in January 2019, a little over 37,000 veterans
were experiencing homelessness, a 2-percent reduction from the
prior year.
Since 2010, again, as you both noted, the number of
homeless veterans has declined by nearly half. I think it
should be noted, this dramatic decline of 50 percent for
veterans comes against a backdrop where the general homeless
population has declined 11 percent over the same time period.
It is clear that our approach to ending veteran homelessness is
working.
One of VA's most important resources for ending veteran
homelessness is the HUD-VASH program. HUD-VASH is a
collaborative program between HUD and VA, in which HUD provides
eligible homeless veterans with a Housing Choice rental voucher
and VA provides case management and supportive services.
HUD-VASH is a permanent, supportive housing program which
helps homeless veterans move rapidly into housing without
preconditions, while concurrently providing case management,
supportive services, and treatment so that veterans can gain
housing stability and recover from physical and mental health
problems, substance use disorders, and other issues
contributing to or resulting from homelessness.
The program aims to help veterans and their families gain
stable housing while promoting full recovery, independence, and
self-sufficiency in their communities.
HUD-VASH is a powerful tool in our efforts to end veteran
homelessness and it has, indeed, made a dramatic impact,
particularly, among historically vulnerable homeless
subpopulations; this includes the chronically homeless
veterans, aging veterans, women veterans, all in the standard
HUD-VASH program, Native American veterans in the Tribal HUD-
VASH Program.
Among those acutely vulnerable are chronically homeless
veterans that HUD-VASH has long-targeted. We have seen a 22-
percent decline since 2015. Three-quarters now of Continuums of
Care report 20 or fewer chronically homeless veterans remaining
in their communities, yet so much remains to be done.
With HUD's most recent voucher allocation, there are now
over 100,000 vouchers allocated nationally and over 22,000 of
these are currently unleased. Even after accounting for
veterans in the voucher pipeline and vouchers dedicated to
project-based development, there are still over 14,000 unused
vouchers, nationally. With over 37,000 veterans still homeless
on any given night, this is too much unused vouchers and we are
fully committed to ensuring we maximize the use of this
valuable resource.
I provided explanations and examples in my written
testimony of strategies VA and HUD are adopting to increase
voucher utilization and I am happy to discuss those here today,
as well. One critical strategy is increasing the number of case
managers in HUD-VASH and I want to say here for the record,
that VA recognizes the importance of hiring case managers and
is committed to filling case manager vacancies wherever
possible.
Along with the lack of affordable housing, case management
capacity is unquestionably one of the main rate-limiting
factors in voucher utilization.
As a jointly run program between two Federal agencies, HUD-
VASH receives its funding from two separate appropriations
committees. HUD has received additional money for vouchers
every year since the program's inception in 2008. Using medical
services appropriations, VA has been sufficiently able to keep
its average caseload size at 25 veterans per case manager, but
with HUD's most recent voucher allocation, caseload sizes will
increase.
To this end, we remain grateful for the resources Congress
provides VA to care for veterans; particularly, HUD-VASH
resources which are crucial to ending veteran homelessness. We
pledge to do all we can do ensure these resources are used as
effectively and efficiently as possible.
Thank you for the opportunity to appear before you today to
discuss this invaluable program, and I look forward to your
questions.
[The Prepared Statement Of Keith Harris Appears In The
Appendix]
Mr. Levin. Thank you, Dr. Harris.
Assistant Secretary Kurtz, you are now recognized for 5
minutes.
STATEMENT OF HUNTER KURTZ
Mr. Kurtz. Thank you.
Good morning, Chairman Levin, Ranking Member Bilirakis, and
members of the subcommittee.
It was a pleasure to testify before the Subcommittee on
Economic Opportunity this summer and I look forward to
answering your questions that the subcommittee has today on the
important issue of ending veterans' homelessness and the
efforts by the Department of Housing and Urban Development, as
well as our Federal partners, to accomplish this.
HUD is committed to ending veterans' homelessness by
working collaboratively with our partners and maximizing the
effectiveness of all existing resources. Funding from Congress
and close collaboration at the Federal and local level, that
has pushed the Nation to continue to make progress in
addressing veterans' homelessness, and creating sustainable
Federal and local systems that quickly respond to homelessness.
Together, we have made a measurable impact in reducing the
severity of this issue. Based on the most recent Point-in-Time
count, or PIT count, veterans' homelessness has decreased by
2.1 percent or about 800 veterans last year; additionally, we
are finally able to say that since 2010, veterans' homelessness
has declined by 50 percent. This kind of reduction is historic
and HUD-VASH has been the primary reason for this progress.
HUD-VASH is part of the Housing Choice Voucher or HCV
program in the Office of Public and Indian Housing. The HCV
program currently houses over 2.2 million families nationwide.
HUD-VASH is the only Public Indian Housing (PIH) program
dedicated to homeless veterans; however, many formerly--excuse
me--however, many formerly homeless families, including
veterans' families, are assisted in the regular Housing Choice
Voucher (HCV) and public housing programs.
The HUD-VASH program has been very successful in its
approach to addressing veterans' homelessness. Since 2008, over
170,000 veterans and their families have been moved into
housing with the HUD-VASH voucher. As of October 1st, more than
77,000 veterans and their families are currently housed with a
HUD-VASH voucher.
Every year since 2008, HUD and the VA have collaboratively
awarded new HUD-VASH vouchers based on geographic need and
administrative capacity. In Fiscal Year 2019, HUD and the VA
looked at the HUD-VASH utilization rate of a specific Public
Housing Agency (PHA), when considering the entity for an award.
In total, more than 100,000 HUD-VASH vouchers have been
awarded to more than 600 PHAs between 2008 and 2019. HUD-VASH
can only be used after a PHA receives a referral from its local
Veterans Affairs medical center or a designee. HUD is very
aware that the VA is working to address the health and well-
being of millions of veterans nationwide.
HUD-VASH was originally designed to serve highly acute,
chronically homeless veterans who need intensive case
management. Over the years, the chronically homeless veterans
population has declined, while the number of vouchers has
continued to climb; therefore, HUD is interested in efforts by
the VA to broaden the targeting of HUD-VASH vouchers to other
populations beyond the chronically homeless veterans.
We continue to fulfill our commitment to help tribes with
veterans' homelessness, as well. The Tribal HUD-VASH
Demonstration Program follows the same structure as the regular
HUD-VASH program, providing rental assistance and supportive
services to veterans who are Native Americans and experiencing
homelessness or at risk of homelessness.
As of the end of 2019, approximately 500 Native American
veterans have received case management services under the
Tribal HUD-VASH Program. A great deal of progress has been made
in the way we work together to address veterans' homelessness;
however, we acknowledge there is still a lot of work to be
done.
The HUD-VASH program continues to be a model for
interagency collaboration and one of the best tools that we
have for ending veterans' homelessness. We continue to find
ways to maximize the effectiveness of HUD-VASH, while also
assisting communities in utilizing their available homeless--
sorry--homeless resources.
Thank you for your time and I look forward to your
questions.
[The Prepared Statement Of Hunter Kurtz Appears In The
Appendix]
Mr. Levin. Thank You, Assistant Secretary.
With that, I recognize myself for 5 minutes to begin the
question portion of the hearing.
You know, after field hearings in my district, in the
ranking member's district, in conversations with many of you
and other discussions with experts, some of whom are here in
the audience, it is clear to me that the HUD-VASH program is
working, but that it can be made to work even better.
One of the statistics that really is striking to me, which
you referenced again, the number of unused vouchers--it is a
stunning number. Dr. Harris, in your testimony, you acknowledge
one key reason for this is that 16 percent of VA case
management positions are vacant. I appreciated during your
opening statement, your commitment to filling vacancies
whenever possible, but I want to dig into that a little bit.
What steps are you and VA taking to help address the
staffing limitations, with respect to HUD-VASH case managers?
Dr. Harris. Thank you for the question, Chairman.
A variety of steps are being taken and the first one is
that enterprise-wide, VA H.R. is working to modernize its
hiring efforts and the goal is to reduce the time it takes
through recruitment to onboarding. A big part of that is
consolidating H.R. efforts at the network level and away from
each medical center. Places where we have seen this already
begin have already begun to demonstrate improvements in the
hiring rates and the time it takes. That is a big one for us.
Additionally, we are encouraging, and medical centers are
free to use and are being promoted to use the 3 Rs--the
retention, relocation, et cetera--bonuses, debt reduction. We
are pushing sites to broaden the disciplines in the programs. A
lot of sites have historically hired social workers for this
program to provide the case management, and while that is an
incredibly important case management resource, permanent,
supportive housing can be done by a variety of people and there
is a lot of competition for social workers right now, so
broadening the disciplines will help, as well. As was noted in
opening statements, we also are promoting the use of
contracting as a vehicle to bring in case managers when VA
cannot hire them.
Mr. Levin. I appreciate that, and, you know, obviously, it
is of great importance to us and I hope that we see these
numbers of unused vouchers continue to decrease in the coming
months.
Another reason that I have heard for this underutilization
is the eligibility criteria and, specifically, the exclusion of
many veterans in need. You may be aware that yesterday, the
House, on a broad, bipartisan basis, passed the veteran house
act. I was thrilled to work with my friend, Scott Peters from
San Diego on that legislation. What that would do is expand
eligibility for HUD-VASH to veterans that received an other-
than-honorable discharge.
My question for you is: How many more homeless veterans
could be served if HUD-VASH eligibility were expanded to
include veterans who were not VA healthcare eligible or have
OTH discharges?
Dr. Harris. Thank you for that question, as well.
I want to say, personally, I am very excited about that
bill passing, and in our position within the HUD-VASH program,
we support that, as well. Those ineligible for VA healthcare
remain one of our most important subpopulations that we really
have not been able to reach yet in this program.
We estimate that approximately 15 percent of the parent
homeless veteran population is not eligible for VA healthcare.
We have held that number constant in our modeling for a number
of years. It happens that number is probably going up as we
reduce homelessness among those eligible.
At any given time, 15 percent of those on the streets, we
assume are not eligible and would benefit from this change in
law.
Mr. Levin. You noted in your testimony that VA is working
to broaden the population of homeless veterans it targets.
Could you expand on that.
Dr. Harris. Thank you for that question, as well,
Congressman; yes, I am happy to.
I do want to note that this is--the efforts are very
preliminary, but they are, in fact, designed to address the
very issue we are all focusing on. Today, there are so many
unused vouchers, so many homeless veterans remaining.
The idea here is that we are discussing pilot efforts at
some medical centers--San Diego included, which is represented
here today--to broaden targeting, which would mean,
essentially, assigning HUD-VASH vouchers to those with lower
acuity than in traditionally served by the program; the exact
nature of that still to be determined.
Then the key to these pilot efforts is that case management
would be provided outside of the traditional HUD-VASH program,
so either by other VA staff or in some cases, we are looking at
partnerships outside VA altogether.
Mr. Levin. Thank you.
Assistant Secretary Kurtz, I would like to turn to you and
apologize to my colleagues in advance for going a little bit
over my time.
High cost of housing--we certainly know about that in
Southern California. Limited housing stock, that can pose
barriers for use of HUD-VASH.
Assistant Secretary, you suggested that public housing
agencies can strengthen the purchasing power of their vouchers
by increasing payment standards; however, doing so does not
increase the amount that HUD pays a public housing agency per
voucher, so they have to make up the difference.
In order to increase voucher utilization, we need to
improve the accuracy of fair market rents, as is calculated by
the program, and during Fiscal Year 2020 appropriations, I
offered an amendment supporting funding to study alternative
methods for calculating fair market rents in areas with rapidly
rising rents.
When does HUD plan to commence and conclude the study on
this and will you include Southern California communities in
your analysis?
Mr. Kurtz. The fair market rents are managed out of our
Policy and Development Research Office. Is this is something
that the assistant secretary for that office and I have
discussed in the past.
I am not sure what his timeline is for when the study is
going to take place, but we can get back to you on that.
Mr. Levin. That would be great. We will make sure we follow
up with you--I assure you we will follow up on that.
You also stress the--and this is my last question--the
impact of landlord outreach----
Mr. Kurtz. Uh-huh.
Mr. Levin.--in relationships on utilization--we hear this a
lot.
What steps has HUD taken to incentivize are landlords and
developers to participate in HUD-VASH?
Mr. Kurtz. Well, it is not just HUD-VASH; we are looking at
it holistically with our entire HCV program in ways that we can
engage landlords.
We have been doing symposiums--I just spoke a few weeks ago
in Fort Wayne, Indiana, where we held a roundtable with
landlords to try to encourage them and also find out what
issues they are facing to see how we can address.
We have had the task force working on this and I look
forward to continue to working on this issue because it is
beyond HUD-VASH; it is nation--you know, it is with my regular
voucher program, as well, that we continue to face hurdles with
trying to get landlords to engage.
Mr. Levin. Thank you.
I am watching very closely in California. As I think you
are familiar, we discussed new legislation in California on
this topic----
Mr. Kurtz. Uh-huh.
Mr. Levin.--to prohibit people--prohibit landlords from
excluding those who want to use a voucher from being able to
rent an apartment.
Mr. Kurtz. Yes.
Mr. Levin. I appreciate it.
And with that, I will turn to the ranking member for his
questions.
Mr. Bilirakis. Thank you, Mr. Chairman. I appreciate it
very much and you can go as long as you possibly can. I have no
problem, because I am interested in this. As a matter of fact,
I am going to follow up on what you said.
This is not just in San Diego County; it is in Florida
where the amount of the--well, all over the country--I am sure
the general will agree--all over the country, the voucher is
just not enough and they need a kicker. Even in my district in
certain areas that really are not the most-expensive areas of
my district, you know, veterans are having a hard time because
it is not enough and then, also, having a hard time paying the
electricity costs, as well, and that is a wraparound service, I
guess.
We are lucky. We are very fortunate. We have nonprofits
that kick in, but if we could--you know, that study, that
amendment was a good amendment and if we could do something
about that, it would be--because you said, what is it, 14,000
vouchers that are not being used?
Well, part of the reason is because they are not helpful to
veterans in certain areas. That is so very important.
Then the other follow up is would it be helpful if VA was
provided direct hiring authority for these case manager
positions? What is your opinion on that?
Dr. Harris. Thank you for the question, Ranking Member.
VA actually has direct hiring authority now for these--most
of these case manager positions are social workers, licensed
clinical social workers, which are hired into hybrid Title 38
positions. We have the ability to do that now and that is, in
fact, being done in certain medical centers. It is at the
discretion of the local medical center of whether to use it or
not.
Mr. Bilirakis. Okay. Thank you.
The next question is for Dr. Harris: In 2012, Congress
authorized VA to contract out the HUD-VASH case management
services. The most recent report provided to Congress on this
authority found that VA medical centers that used this
authority found contracting out these services--and you touched
on this--they found out that this is very helpful and liked the
improved coordination with the local providers that occurred
with contracted services.
With a significant number of vacancies for the HUD-VASH
case managers nationwide, what could be done to encourage, if
not require, some medical centers to use this authority for--
more often--and, again, you touched on this. If you could
elaborate, I would appreciate it.
Dr. Harris. Sure. Thank you very much for the question, a
very important one.
I wanted to provide you with a couple of numbers.
Nationally, about 5,000 veterans in HUD-VASH now are being
provided case management through contract; that is through 21
contracts nationwide. It is, therefore, about 5 percent of the
vouchers completely allocated, so it is still a pretty small
piece of the program.
Speaking from the program office perspective, we are highly
supportive of contracting as an option. As someone noted
earlier--I apologize, I do not remember who it was--but this--
actually, I think it was you--this is work--contractors know
how to do this work. They have done it for decades. They were
doing it long before VA started doing permanent, supportive
housing.
We are supportive of contracting out where it can be done.
It is not a panacea; the contracting process is laborious. It
takes a long time. It requires a qualified provider in that
community in order to do it.
We have promoted it from the program office. We have
provided as many tools as we can from the D.C. office
nationally. We have a contracting toolkit that is available to
medical centers. We have sample statements of work, performance
work statements, things like that, that will help medical
centers proceed, and we push on medical centers where we see
hiring as a challenge and where we see contracting as an
effective alternative. In the end, it is up to the individual
medical centers to decide this.
You asked the piece about requiring medical centers. We
have actually asked general counsel about that and so far have
been told we cannot actually require it, but we have looked
into that, as well. I think it is a really important strategy.
Mr. Bilirakis. Thank you.
I guess I have time for one more--is that all right?
Mr. Levin. Go ahead.
Mr. Bilirakis. Okay. Thank you.
Dr. Harris, and also Mr. Kurtz, if you will, the committee
has recently heard from a large public housing authority that
one approach to increasing the utilization of resources is to
allow referrals of vouchers to not flow from VA to the public
housing authority, but to allow on a pilot program basis for
the public housing authority to be the conduit for these
vouchers, and then VA comes in, you know, with the wraparound
services.
What is your view on this proposal?
Dr. Harris. Would you like me to----
Mr. Bilirakis. Yes, whoever would like to go first.
Dr. Harris. Thank you, Ranking Member. I am happy to do
that.
I believe you are speaking to one of the pilots that we
have in very early stages of development right now. It has not
begun and, actually, we are all still working out the details.
Since I have been part of those conversations, I can tell
you, personally, I support the idea. There is just a lot of
work still to be figured out.
Mr. Bilirakis. You got to make it work, yes.
Dr. Harris. Yes.
Mr. Bilirakis. I understand.
Dr. Harris. We would be very happy to come brief you or
speak to that or provide additional information for the record,
as we work out the details, but highly supportive of the idea.
Mr. Bilirakis. Very good, thank you.
Mr. Kurtz.
Mr. Kurtz. Again, we are also supportive of this initiative
and, you know, helping the VA in any way we can. Again, Dr.
Harris is sort of the one leading the charge on this
initiative.
Mr. Bilirakis. Very good. Thank you very much.
I yield back, Mr. Chairman.
Mr. Levin. I thank the ranking member, and I would like to
recognize Ms. Lee for 5 minutes.
Ms. Lee. Thank you, Chairman, and thank you, Ranking
Member, for allowing me to ask these questions, and I also
thank both of you for your work on this.
I started my career running a homeless drop-in center, so a
lot of experience in this world. I reached out to some of my
partners just to ask sort of how this is working on the ground.
One of them was Arnold Stalk who runs an organization called
Veterans Village in Nevada; it provides housing and wraparound
services to homeless veterans.
One of the issues that was raised is that during the
housing inspection on part of the VA, landlords are required to
have a full kitchen in order to receive the voucher. It has
been an issue for this organization, in particular, in reaching
its mission, because not all of its units have full kitchens;
they have a hot plate and a microwave, but they have a full
kitchen onsite, as well as a program where they work with
restaurants, the local food bank, and they provide nutritious
USDA-sanctioned meals each and every day.
One of the issues that Arnold Stalk had raised with me is,
because of this requirement, he actually now houses more
veteran or non-veterans, which then takes away from his ability
to meet his mission.
I am happy to report is that in Las Vegas, we have seen a
decrease in homeless veterans, but the most recent point, you
know, data point, is that there is still 559 homeless veterans.
Clearly, just refining this process is something that I hope we
can learn from this hearing.
One of the questions I wanted to ask both of you is, is
having a full kitchen necessary in helping prevent veteran
homelessness?
Mr. Kurtz. We--because HUD-VASH is part of our Housing
Choice Voucher program, we have a set of standards for all
Section 8 vouchers and we are actually in the process of
reviewing all of those standards right now for the physical
inspections through a process--our new process, we are calling
Inspire. This is--it is not actually an issue that I have heard
of before where the voucher--but it makes sense. I am happy to
take a look at that as we continue this effort.
Ms. Lee. Okay. Great.
Dr. Harris. Thank you for the question.
Inspections are, in fact, overseen by Housing Authority, so
I am not going to speak to that piece.
I actually just wanted to let you know we have corresponded
with Mr. Stalk before from our program office and we are happy
to continue to do so.
Ms. Lee. Great. No, absolutely, I would love to continue to
work on this. I think, you know, obviously we want to encourage
innovation. We want to encourage on-the-ground providers to
meet these challenges head on, and anything we can do to work
around--most importantly, making sure that we are getting
veterans off the street and also providing them with the--you
know, nutritious meals, obviously, is important. I appreciate
the ability or the desire to cooperate and work on that.
Another great organization in Nevada is U.S. VETS; again,
they provide transitional and permanent housing.
In conversations with their director, one of the things
that they brought up is when they receive referrals from the
VA, they feel like the referrals for their different programs--
the supportive service for veterans families and then the HUD-
VASH--seem to be inconsistent and sometimes them have two
veterans with almost identical situations and they are being
put into two different programs. They have some concerns about,
basically, the criteria that are being used.
Then they also have concerns with the case management
system, where it currently stands, which I think we have all
addressed here today. They find that veterans who are placed
into the HUD-VASH permanent housing, they come back and ask if
they can go eat at the U.S. VETS mess hall. The staff believes
that there needs to be some efforts to strengthen the
wraparound services through case managers.
One of the questions I have for you, Dr. Harris, is: Has
the VA considered revising its score tool to make referrals to
veterans homeless transitioning programs more uniform?
Dr. Harris. Thank you for that question; it is a very good
one.
We have talked at length, and for several years, about how
to potentially standardize the assessment, screening, and
referral into our program. The direct answer to that question
is, yes, we have.
We have--I have personally spoken with U.S. VETS frequently
and have had these very conversations with them and the piece
you noted about veterans in HUD-VASH coming back for meals is a
really important aspect of this program. This is--we rapidly
move veterans into housing without preconditions, yes, but it
is not a housing-only program.
Ms. Lee. Right.
Dr. Harris. It is incredibly important to do what we can to
help veterans who experience the isolation of suddenly going
from congregate living, or even street living but around other
people, to having their own apartment. It does not surprise me
to hear anecdotes like that, and it is an important part of our
case management to provide veterans the sort of contact and
connections that will help with that.
If I may, one other piece of that, over time, HUD-VASH
early on in its evolution, focused on highly acute, chronically
homeless veterans. The Supportive Services for Veterans
Families program that you mentioned, which U.S. VETS is a
grantee, focused on a group of veterans that was lower acuity
than that. You sort of had HUD-VASH up here and Supportive
Services for Veteran Families (SSVF) down here.
Over time, there is been a certain blending of that, so it
is also not surprising that there might be veterans that are
just above or below that cut, especially in any given
community, and that is because that population of really acute
veterans has diminished quite a bit, in fact, in some
communities. That is a natural piece of the evolution of these
programs, but we want to stay thoughtful about which program
veterans are routed to.
Ms. Lee. Great. Thank you.
Thank you for your willingness to really take on this
issue, especially given--with the local perspective, because,
obviously, that is what it is going to take to make that number
zero.
Thank you very much. I appreciate your work.
Mr. Levin. Thank you, Ms. Lee.
Now, I would like to recognize Mr. Bergman for 5 minutes.
Mr. Bergman. Thank you, Mr. Chairman.
I know we are all here for the same reason; try to figure
out how to mitigate and hopefully eliminate veteran
homelessness, especially chronic homelessness.
Mr. Kurtz, veterans only make up a part of the total
population of the country and a part of the homeless population
of the country. Is there any data out there, let us say by
State, that compares, contrasts the rate of homeless veterans
compared to the general population homeless rate?
Mr. Kurtz. I would assume that there is. I am not sure
what, exactly, the statistics say, but----
Mr. Bergman. Do we know where to find it?
Mr. Kurtz. Yes, we could find it.
Mr. Bergman. Could we find that?
Mr. Kurtz. We may--do you----
Mr. Bergman. I am guessing the VA deals with veterans. You
are not looking at general homelessness; is that correct?
Dr. Harris. Well, thank you for the question.
Ironically, I have the reverse number for you and that is
that veterans made up 8 percent of the general homeless
population in the last PIT count. Historically, that general
veteran population has been 9 percent or above, so this is
actually the first Point-in-Time count that I have seen where
the veteran proportion within----
Mr. Bergman. Can you break that down by State or, I mean,
is it--because, for example, some states are physically,
geographically, smaller. Some states are larger. Some areas, as
in--you know, some of our committee members here live in very
urban areas--my district happens to be very, not only rural,
but remote. For example, we have 8 tribes in our district.
I think it is very important for us, because if we are
trying, and are successful--which we need to be--in solving the
veteran homeless problem, chances are some of the things that
we are going to learn in dealing with veteran homelessness is
going to apply to the general homeless population if we get it
right.
Dr. Harris, you know, in business, you can--if you need a
certain expertise that you do not have today or maybe you have
it, but it is not serving your needs in the business model, you
can either recruit, train from--you know, and make it part of
your company--or you can hire outside, already existing
expertise.
When we talk about contractors versus full-time equivalent
employees, does there exist in the marketplace, individuals or
companies who understand what we are trying to do here and, as
we would say in the military, already a full-up round to, if
you brought them on as a contractor, can start engaging the
veterans or whatever is going to happen in the community right
away.
Dr. Harris. Thank you for the question, Congressman.
Without question, yes, such providers do exist.
Mr. Bergman. Why would we even think, then, if homelessness
is here now, why would we even delay bringing on qualified
contractors, knowing that if we hire our own full-time
equivalents it was going to take a period of time--four months,
6 months, whatever it happens to be--to get that employee up
and on speed, why would--why are not we going out and hiring
contractors right now?
Dr. Harris. Thank you, again, and, again, such an important
question.
The only real reason I can say is that it takes a very long
time to contract, also.
Mr. Bergman. Why does it take so long?
Dr. Harris. I would love to take that for the record and
provide a----
Mr. Bergman. I will tell you what. If there is a place, an
office that the VA has or whomever has--I do not care if it is
here in D.C.--I mean, we went out to Minneapolis to the Debt
Management Center here about 6 months ago to get a brief from
them--I am sure some of my colleagues would travel to that
place that could explain to us in an hour or so what the issues
are with the length of why it takes so long to contract. Thanks
for taking it, you know, for the record.
Mr. Chairman, I would like a follow up on that, because
these are the kinds of, if you will, Congressional Delegations
(CODELs), or whatever you want to call it, that this committee
should be taking to understand what it is that we are trying to
achieve. Because we still struggle with, what is our role as
Congress?
That is--you know, we can be part of a solution here or we
can be exacerbating a problem, and that is--we do not want to
be the latter.
With that--I know we have a second panel, but I guess for
both of you very quickly, from your perspective, do you have
any interaction with or data on how are the tribes across the
country doing with their outreach to eligible veterans?
Because, as we know, as an ethnic group, tribes are the highest
percentage of participation in the military, of any, and proud
service, and, also, they have some unique situations--in a lot
of cases, very positive--that they can control outcomes for
their homeless.
Mr. Kurtz. We are, at the Tribal HUD-VASH Program, are
really excited about the success. We house about 500 veterans,
currently.
There are, as I said, a unique set of issues with outreach
in tribal lands because of the fact that they are rural and
other issues like that. I know the VA has worked--and I guess I
should defer to you on the outreach issue--but, I mean, we are
excited about where we stand with HUD on that Tribal HUD-VASH
Program and hope to expand on it.
Dr. Harris. Thank you, and thank you for the question.
We are equally excited about it and supportive of the
program. You said 500 housed; it is really 500 total, right?
Mr. Kurtz. Yes.
Dr. Harris. It is a little under 400 actually presently
housed in the program, and the reason for that gap is there are
reservations where there is just literally no housing for those
veterans, now, as we mentioned earlier. There is work being
done that VA is a part of, locally, to do that.
In terms of the outreach, our Tribal HUD-VASH case managers
are some of our most dedicated, carrying, culturally competent,
skilled case managers and they scour the reservations and the
lands around it for veterans. It is a very impressive group of
people and very impressive effort.
Mr. Bergman. Okay. I know I am over my time, I would just
like to ask one question for the record--not an answer--but
would it be advisable or possible to expand VA's already
existing SSVF, the Supportive Services for Veterans Families'
Community Grant Program for these veterans? Just, if you would
take that for the record, I would just like a written response
on that.
Mr. Chairman, I yield back.
Mr. Levin. Thank you, Mr. Bergman. I appreciate that.
I would now like to recognize Mr. Pappas for 5 minutes.
Mr. Pappas. Thank you to the Chairman and to the ranking
member for conducting this hearing today, and I thank our panel
for their commitment, one that we all share, of getting to
zero; ensuring that everyone who has worn the uniform of this
country does not have to worry about whether or not they have a
roof over their head at night.
I am curious if we could talk a little bit about rural
homelessness. I know in my State, New Hampshire, we have made
some tremendous progress. Just last year alone, according to
the PIT count, the number of veteran homeless individuals has
decreased by 21 percent, so that is a good step forward. There
is more work to do, however.
I am wondering how much confidence we can have in these
Point-in-Time counts and whether or not you feel that there is
an undercounting of rural homeless veterans.
Mr. Kurtz. From--the PIT count is managed out of an office
that I do not ever see at HUD, but from my understanding, there
is a level of confidence in what the results are, but we are
happy to--I am happy to take your question for the record and
have that office get back to you.
Mr. Pappas. Okay. That would be great to understand a
little bit about, you know, how they might account for what I
think you, Dr. Harris, indicated in your testimony, you know, a
concern that there might be an undercounting of rural homeless
vets.
I know that in 2016, HUD issued 600 vouchers specifically
that were geared toward rural individuals to make sure that
they get into housing. That program, I guess, was scrapped
after the first year because it was underutilized.
I am wondering if you could talk a little bit about how
many of those vouchers were actually used that year and whether
or not there might be another attempt to try to reach out to
that population, specifically.
Dr. Harris. Thank you for the question.
I would like, as a general statement, to take that for the
record and get back to you. I did dig into the rural effort in
preparation for today and did not get hard data on that.
Anecdotally, it is, as you noted, it was actually very
difficult to get those vouchers utilized.
As I noted in my written testimony, homelessness can be
somewhat invisible in rural areas. There is a distinct lack of
both, housing and services, and as it turned out, a lot of the
vouchers, again, anecdotally, people ended up using them in
less-rural areas than they were intended.
I am happy to get a more complete answer to you if you
would like.
Mr. Pappas. That would be helpful.
We reached out to some community partners to understand,
you know, exactly what they are facing on the front lines and
one organization got back to our office--Harbor Homes in New
Hampshire, that provides housing and wraparound services for
veterans and other homeless individuals--and they were curious
about the way that systems communicate, ensuring that there is
good data-sharing across agencies and across systems. They
specifically asked, What is being done to assist with data
sharing between VA's system Homeless Operation Management and
Evaluation System (HOMES) and the HUD data system, Homeless
Management Information System (HMIS)?
I do not know if you have any information for me on that or
would like to get back to me?
Dr. Harris. How much time do you have?
Mr. Pappas. A minute 58.
Dr. Harris. Thank you for that question.
My office has been part of all of those conversations both,
with HUD and internally. HOMES is our data-collection,
information-collection system for homeless veteran programs;
HMIS is HUD's.
There are some deep challenges in getting those systems to
talk to each other. Ours is a single, by-name, national
dataset. HMIS is not; HMIS is parceled out by community. It is
also run by, I think, the last count, 27 different software
platforms, whereas, ours is on a single one. Those challenges
alone make it so you cannot just digitally or on the back end,
make those systems speak to each other.
What we have done, instead, is to everything we can to
allow VA staff to digitally share information on a local basis.
We worked with IT to get an ability to encrypt emails and send
those outside the VA system.
I would like to note that that ability was recently
rescinded; we have lost that and staff are actually back to
faxing things. That is a problem we could even potentially use
assistance with, but, certainly, we are trying to solve
internally. It had to do with updates made to the VA IT
systems.
We have tried to provide staff the ability to digitally
encrypt and protect that information. We have also worked with
the Privacy Office to free up staff with what they can share
about homeless veterans without requiring a signed release.
Homelessness is considered a State of emergency and a
threat to the veteran's health and welfare. It is in the
veteran's best interests to share that information and not wait
for a signed release, a certain subset of information.
Those are some of the things that we have done to allow
information to travel between those two systems.
Mr. Pappas. Well, great. I appreciate your attention and
your responses. I look forward to any further information that
you can provide. Thank you.
I yield back, Mr. Chair.
Mr. Levin. Thank you, Mr. Pappas.
Now, I would like to recognize my friend, Mr. Barr for 5
minutes.
Mr. Barr. Thank you, Mr. Chairman.
Dr. Harris, Mr. Kurtz, thanks for your service; we
appreciate you all being here today and the work that each of
your agencies do to combat veteran homelessness across the
United States.
As I mentioned to this committee before, my hometown of
Lexington, Kentucky, certified an effective end to veteran
homelessness in our area last year, thanks in part, to the HUD-
VASH program and the services offered by each of your agencies.
Obviously, no veteran should go to bed at night without
somewhere to lay their head.
When the program was originally created, the HUD-VASH
program was designed for veterans who were chronically,
mentally ill, or had chronic substance abuse disorders;
however, since 2008, the requirement no longer exists and
veterans can be housed using HUD-VASH, regardless of their
history of criminal behavior or drug abuse.
As with many communities across the country, opioid abuse
is a major issue in my district. In 2017, opioid overdoses in
Kentucky took more lives than car accidents by almost double.
That is why I have been a fierce advocate for transitional
housing for individuals, and particularly veterans, who are
struggling with substance abuse.
Phil Gray, the executive director of St. James place, an
affordable housing facility in Lexington said this, ``We know
that transitional housing, treatment, and helping people get
back into the workforce works. These are the things that people
need to get better.''
While every veteran, regardless of history, deserves to
have a roof over their head at night, I would like to dive into
how the VA and local PHAs determine if HUD-VASH is really the
best program for every veteran; particularly, those with
substance abuse issues.
Dr. Harris, how does the VA determine what program--whether
it is HUD-VASH or grant per diem or SSVF--is best for the
veteran? What information does the VA case manager have at
their disposal before referring the veteran to a particular
program? Then the lasting question if you could answer, if a
veteran is already enrolled in HUD-VASH, would they ever refer
that veteran out of HUD-VASH into a different program that
might meet their needs better?
Dr. Harris. Thank you, sir, for the questions. I may not
have gotten them all--I am going to do my best to get at that.
Mr. Barr. Sure.
Dr. Harris. The first question, I think, was about how it
is determined that veterans are routed to one program or
another.
Mr. Barr. Right. Grant per diem or HUD-VASH or SSVF.
Dr. Harris. Part of that was what kind of information the
clinicians have at their disposal.
Mr. Barr. Right.
Dr. Harris. I will start that in reverse.
The clinicians have a tremendous amount of information at
their disposal, particularly in cases where the veterans have
been enrolled in VA healthcare, have been served by the VA. The
VA medical record is nationwide, so they could have been served
anywhere we have access to that.
The clinicians review all of the extent of the clinical
information in the record in coming to a conclusion about
appropriateness for HUD-VASH, in particular. The way each
individual medical center routes veterans to one or another can
vary by site; it is in large part, dependent upon which
programs are even there. Not every medical center has every
program you listed. Not every medical center has slots in those
programs, if they have them, at any given time. So, part of it
is based on availability.
Much larger, referrals to HUD-VASH are for veterans who
need the case management and supportive services that that
program provides.
Mr. Barr. Okay. Let me ask you, if a veteran uses their
HUD-VASH voucher and finds a place to stay, are they required
to accept the wraparound services offered by the VA?
Dr. Harris. Thank you for the question.
The answer is yes; they are required to accept case
management.
Mr. Barr. Okay. This is kind of for both, Mr. Kurtz and
you: Housing First is a policy that has been supporter imposed
on top of HUD-VASH.
Mr. Kurtz, does Housing First frustrate that requirement?
Mr. Kurtz. We do not have a Housing First requirement with
HUD-VASH.
Mr. Barr. Oh.
Mr. Kurtz. There is no--it is--there is not--Housing First
and HUD-VASH are not related.
Mr. Barr. Okay. That is news to me from our oversight on
the financial services committee. I think some of the members
on our committee are under the--they perceive that Housing
First does apply to HUD-VASH.
What you are telling me is that no--there is a
conditionality to HUD-VASH?
Mr. Kurtz. Well, the conditionality is up to the VA.
Mr. Barr. Okay.
Mr. Kurtz. I mean, we are just providing the voucher in
this situation.
Mr. Barr. If you have a veteran that is a recipient of a
HUD-VASH and they decline the wraparound services, the case
management, that is a revocable voucher; is that correct?
Dr. Harris. Thank you for the question.
I want to back up slightly.
Mr. Barr. Okay.
Dr. Harris. HUD-VASH, as a clinical model----
Mr. Barr. Right.
Dr. Harris.--is, in fact, a Housing First model. I think
there may be some misunderstanding to you about exactly what we
mean by Housing First.
I know in HUD's--for instance, it was referenced in regards
to the stock of housing; permanent, supportive housing versus
transitional housing.
That is not what we are talking about in HUD-VASH. We are
talking about a clinical model where veterans will move rapidly
into housing without precondition and then are provided
wraparound services.
They do have to agree to case management to be in HUD-VASH.
Mr. Barr. My time has expired.
I think the case management is critical. I think that is
getting at the underlying issues of homelessness and so I
applaud that feature of the program and appreciate your work
with these veterans. Thank you.
I yield back.
Mr. Levin. I thank the gentleman from Kentucky and
appreciate his comments, as well.
With that, I would like to thank our first panel, and, you
know, if you are available, I would like to ask our friends
from the VA and HUD if they can stay and hear from some of the
experts; we would appreciate that very much. I think it is
important that you hear their perspectives.
With that, I would like to call up our second panel. All
right. Thank you very much. I am excited for this panel, a lot
of experts in the field, including a couple from my neck of the
woods--great to see you.
We first have Steve Berg, vice president of public policy
at the National Alliance to End Homelessness.
Thank you for being here.
Kathryn Monet, the chief executive officer of National
Coalition for Homeless Veterans.
Thank you so much.
Also joining us is Greg Anglea, chief executive officer of
Interfaith Community Services.
I appreciate all the work that you do in North San Diego
County for our veterans and for our community, at large.
Also, Tamera Kohler, chief executive officer of the
Regional Task Force on the Homeless, San Diego.
Thank you so much for all your excellent work in the
community, as well.
Finally, we have Gary Cooper, chairman of the board of the
National American Indian Housing Council and executive director
of the Housing Authority of the Cherokee Nation.
Thank you very much for joining us today.
As you know, you will have 5 minutes for your oral
statement, but your full written statement will be added to the
record.
With that, Mr. Berg, you are now recognized for 5 minutes.
STATEMENT OF STEVE BERG
Mr. Berg. Thank you, Mr. Levin, and other members of the
subcommittee. Steve Berg from the National Alliance to End
Homelessness. We are a national organization that works with
people all over the country on reducing homelessness and
ultimately ending homelessness, and we have made the existence
of homelessness among veterans one of our priorities for many
years now.
Since the beginning of the W. Bush administration, people
who work on homelessness have changed the way we think about
what it is that we are doing. We have changed from running a
bunch of disconnected programs that are trying to do some good
things for some good people to having a systematic approach to
actually solving this problem of homelessness.
During that time, we have focused on getting people into
housing and keeping them into housing, including the range of
supportive services that are necessary to bring that about, and
the results have been strong. Everyone here represents a place
where homelessness over the last decade has declined
substantially. The people who were here before, I was hoping to
have them, but send the message to everyone that homelessness
is going down in this country and it is going down in
communities that have adopted the good practices that people
have put in place.
This has particularly been the case when it comes to
veterans, partly because of the leadership of the Department of
Veterans Affairs, working with HUD in some cases, partly the
committees that deal with this issue in Congress have been very
strong on the issue of homelessness for veterans. We appreciate
that a lot. It continues even in what for many parts of the
country is a difficult time right now in terms of housing
markets and affordability of housing for low-income people, the
numbers on veterans' homelessness continue to get better. I
want to talk about how the HUD-VASH program fits into this
overall strategy of ending homelessness for veterans.
People know, I think, that homeless people are not all the
same, homeless veterans are not all the same, different people
need different levels of support and care, different levels of
permanency. In order to maximize cost-effectiveness in these
programs, which is something people working on homelessness
have to be conscious of--there is not enough money to do
everything for everybody, so we have to be worried about cost-
effectiveness--to do that really requires that we understand
that some people will thrive with a shorter incidence of help
with less supportive services, but there are also other people
who have very severe disabilities and medical conditions.
The intervention known as permanent supportive housing is
what the homeless world has developed in order to do that. It
has gotten fantastic results, been evaluated over and over
again, shown to be effective at getting people who have the
worst kind of problems and have been living on the street the
longest time out of homelessness and into housing. The HUD-VASH
program is the VA program that funds the permanent supportive
housing model for veterans.
As Dr. Harris was saying before, it has historically
targeted veterans with the most severe disabilities. The
success of the program has been such that many of the veterans
with the most severe disabilities aren't homeless anymore. They
are trying to figure out, you know, who is still homeless that
needs this level of intervention, that is an important question
to be asking.
A couple of challenges in the way this program is--a
program like this is always going to run into. I think we have
talked about the case management issues, there are a number of
different issues with that. I think the contracting-out issue
is important. I think it is important to recognize there are
sort of two different functions that case managers have, one is
a medical function, making sure people get the health care they
need, but another is a real estate function: finding landlords
who will rent under a program like this, making sure the
landlords are--their needs are met, as well as the needs of the
veteran are met, and that is a function that needs to be dealt
with and a lot of people in the sort of regular homeless
programs, non-veteran homeless programs are dealing with very
well.
I also want to say that leadership is an important part of
this. Members of Congress can have an important role to play in
their districts to get the medical centers involved, to get
landlords involved, and we are happy to work with anybody who
wants to think about how you can make these programs work
better in your district.
I will leave it at that and any questions I am happy to
answer.
[The Prepared Statement Of Steve Berg Appears In The
Appendix]
Mr. Levin. Thank you, Mr. Berg. I know we are working hard
in my district to do that, I assume the same is true for the
ranking member and for all my colleagues.
With that, I would like to recognize Ms. Monet for 5
minutes.
STATEMENT OF KATHRYN MONET
Ms. Monet. Chairman Levin, Ranking Member Bilirakis, and
distinguished members of the subcommittee, on behalf of NCHV's
board of directors and members across the country, thank you
for the opportunity to testify today.
As of December 2019, we know that 78 communities in three
states have actually achieved the Federal benchmarks and
criteria for ending veteran homelessness, and we have seen that
there has been dramatic decreases in your annual Point-in-Time
Count of veterans experiencing homelessness. Given, though,
that there are still 37,085 veterans experiencing homelessness
on any given night, plus there is this natural ebb and flow of
veterans entering and exiting housing on a day-to-day basis, we
know that we still have much work to do across the Nation.
We know that we have got to look at deep investments in
affordable housing and we have got to pair them with solid
implementation of Housing First-oriented systems in order to
see more progress.
There is a solid body of research pointing to the success
of Housing First and we are clear, all of us, I think, here,
that veterans have earned quick access to permanent housing,
employment services, and any resources that they want in order
to attain housing stability.
In order to get there, though, this requires Housing First-
oriented interventions, incorporating a variety of housing
interventions that include transitional housing options in
communities where the facilities fill gaps in services, where
veterans actively choose to enter into therapeutic and
treatment-oriented environments, or where the housing crisis is
so extreme that permanent housing placements just take too
long.
One of the keys to a Housing First-oriented system is the
HUD-VASH program, which we are here to talk about today. There
is still much unmet need across the country and we know that
HUD's 2019 Annual Homeless Assessment Report (AHAR) indicated
that on any given night over 8,700 veterans had chronic
patterns of homelessness. As such, NCHV calls for increased
investment in the HUD-VASH program to ensure that communities
have sufficient resources for the most vulnerable veterans.
We have a few policy recommendations relating to the
program and I think our first major recommendation is that case
manager funding must keep pace with increases in voucher
funding. We appreciate the ongoing congressional support for
this program, as evidenced by the hearing today and also by the
continual allocations of vouchers that you all have provided
for the program. We think they are great and we think they
should continue; however, the funding appropriated to VA for
case management has not always kept pace with the funding that
is appropriated for vouchers.
The challenging, complicated, most often uncoordinated
appropriations process has an even more profound effect on
interagency programs like HUD-VASH, because the program is
basically relying on two subcommittees to appropriate funds to
two Federal agencies, sort of in collaboration and in
conjunction, right? The status quo right now that we are
operating under has really resulted in unintended consequences
that really lead to an underfunded mandate on VA or, worse, a
mandated reduction in the standard of care for veterans.
There are some real outcomes, right? We are seeing that
this incentive for medical center providers to support their
partnering PHAs requesting more vouchers. We are seeing our
members coming to us, reporting that the medical center has
case managers that are looking really only at the clinical
aspects of case management and not really at housing location,
as Mr. Berg has mentioned, or even at, you know, issues that
focus on housing stability and I guess remaining stable in your
housing.
We are also seeing on the PHA side that the slowdown in
referrals of veterans into the program can affect voucher
allocations more broadly for both veterans and civilians across
communities.
We are hopeful that your leadership can really look at VA
funding increasing and formulaic response to the increases in
number of additional VASH vouchers.
One of the other concerns we have heard is about the
background check and credentialing process for employees of
case management contractors. In certain places where Veteran
Affairs Medical Centers (VAMCs) are contracting with local
service providers the length of the credentialing and
background check process is cumbersome, and can actually affect
staff retention and recruitment. We have talked to a few of
those providers and they have indicated that the 4-to-9-month-
long process that their staff has to go through to I guess
complete the VetPro and Electronic Questionnaire for
Investigations Process (eQIP) procedures make it really
difficult to recruit and retain new staff. We are hopeful that
you can work with VA to streamline or shorten that process, if
possible.
NCHV does support extending HUD-VASH to veterans with Other
Than Honorable (OTH) discharge statuses and we were pleased to
see that your legislation passed yesterday. We do also support
any legislation that would expand eligibility to Guard and
Reserve components that were not federally activated. We will
just hold that out there for you to think about.
The other thing that I really wanted to talk about, though,
was using the voucher program to promote affordable housing
development, because the affordable housing crisis, as we all
know, is really acute in areas of the country where we have got
a high concentration of homeless veterans and communities often
cite the inability to locate housing as one of the single
biggest barriers to utilizing their vouchers. In many
communities, the only way to actually house veterans is to
develop housing by project-basing. We are hopeful that HUD
might consider releasing another round of project-based
vouchers, or perhaps that VA may consider more use of its
Enhanced Use Lease (EUL) program in order to drive down the
cost of affordable housing and bring more housing for veterans
online while, you know, responsibly using its capital asset
portfolio of aging medical centers.
Last, but not least, we do support the housing needs of
Indian Country and we are pleased to see the great progress
that the Tribal HUD-VASH program is making across the country.
We think that is wonderful and support the intent of
legislation that is out there on Tribal HUD-VASH; however, we
do seek some clarifying language to ensure that the expansion
does not remove any vouchers that are already in place or tied
to, I guess, projects that are in the project-based voucher
pipeline.
[The Prepared Statement Of Kathryn Monet Appears In The
Appendix]
Mr. Levin. Thank you, Ms. Monet.
Ms. Monet. Thank you.
Mr. Levin. I appreciate it very much.
I would now to recognize Mr. Anglea for 5 minutes.
STATEMENT OF GREG ANGLEA
Mr. Anglea. Thank you, Chair Levin. Thank you, Ranking
Member Bilirakis. It is a pleasure to be here. I represent a
service provider, boots on the ground, working with the women
and the men who have served our military and find themselves in
times of need and times of crisis.
I am pleased to be here today because our team outlined
three key actions that we were asking for your consideration
and, while I was flying here last night, you did one of them.
You passed H.R. 2398 to expand eligibility for HUD-VASH to
veterans with other-than-honorable discharge. Thank you for
your support of that legislation and thank you for the actions
that you took. It is critical that that be passed into law.
My testimony includes personal stories. I think it is what
I can bring of greatest value here as somebody doing the work.
Our organization works in San Diego County and, to our
knowledge, we are one of the only that sets a goal every year
around how many people we will end and prevent homelessness
for. With the support and partnership of the Federal
Government, we were able to end and prevent homelessness for
more than 2,000 people over the last 18 months, including
nearly 200 veterans. There are many who still need support and
are not eligible for certain resources.
In my testimony, I shared the story of somebody I will call
Mr. Brown. And Mr. Brown is an example of why other-than-
honorable discharge veterans should be entitled to access HUD-
VASH, but also a reflection of--you know, I will reach higher
here--of the need for connection to VA health care benefits.
Mr. Brown was discharged with an other-than-honorable
discharge due to drug use in the military. That came at a time
when he had not yet been diagnosed with a bipolar condition, he
was not yet connected with behavioral health counselors to help
him address the psychotic features that came with that bipolar
condition. He had not yet developed the healthy coping
mechanisms that the counselors he is working with now have
helped him with. He had gone through years of homelessness. He
had not maintained his sobriety during that homelessness as a
result of support he received during a Veterans Grant & Per
Diem transitional housing stay, and the additional services he
connected with afterwards through community-funded supports,
because he is not eligible for VA health care benefits and he
is not eligible to receive the health care offered by the world
class health care system that the VA provides.
He is going to struggle until he is able to access HUD-VASH
to be able to exit our transitional housing program into
permanent housing. His condition is such that he really needs
an ongoing housing subsidy. Whether his condition was the
result of his military service or not is a question, what is
not a question is the amount of veterans who are exiting with
other-than-honorable discharges. The Department of Defense
reports that number at 7700 veterans per year. A Government
Accountability Office report studying more than 60,000
misconduct discharges over a 5-year period--sorry, 90,000,
91,764 discharges over 5 years, found that 62 percent were
diagnosed with a traumatic brain injury or post-traumatic
stress within just 2 years of that discharge.
To not provide these veterans who have served our country,
who are discharged with disabling conditions shortly
thereafter, with access to health care is a mistake that must
be rectified.
I will modify slightly, thanks to your good work, my key
action requested that we not just provide access to HUD-VASH
for other-than-honorable-discharge vets, but that we consider
how they can access the VA health care system.
My second key action requested is to echo the excellent
comments of those who have come before me that support for the
funding of supportive services within HUD-VASH, the staffing,
the case managers, that that be increased commensurate with
other increases, and that also additional--that contracting be
encouraged.
I share the story in my written testimony of somebody who
we call Mr. Jones who only connected with HUD-VASH because he
was able to access outside, non-VA counseling support. Due to
his own issues related to his military service, he is very
hesitant to engage with the VA directly, but in partnership
with our organization we were able to make that connection and
get him housed. Unfortunately, the level of support he receives
through the funded services as the program is currently
constituted we fear are not sufficient and we fear he may
return to homelessness in the future or struggle with
instability.
Increased funding to strengthen those services and
strengthening the partnerships with community providers are
critically needed. Our local VA is leading in that effort and
piloting with a handful of vouchers our organization and
another colleague organization will be linking.
I am over my time. I will be available for questions and
comments. I really appreciate your hard work and your
leadership on these issues.
Thank you.
[The Prepared Statement Of Greg Anglea Appears In The
Appendix]
Mr. Levin. Well, thank you, Mr. Anglea. I am thrilled that
the House got it right this week on your plane ride here,
passing that legislation. You know, we hopefully will do
something else good on your plane ride back, who knows. But
there were only 30 Members of Congress that voted against that
legislation and, if you pay attention around here, that is
pretty good. We just have to keep it up, now we have to make
sure the Senate takes it up.
With that, I would like to recognize Ms. Kohler for her
opening statement.
STATEMENT OF TAMERA KOHLER
Ms. Kohler. Thank you. My voice has kind of given out on me
today, so I will see if it holds.
My name is Tamera Kohler, I am the CEO of the Regional Task
Force in the Homeless; we are the HUD Continuum of Care for San
Diego County. The second-largest county in the State of
California, we have a large geography and a population of 3.4
million people, and about 240,000 of those are veterans.
We are one of over 400 Continuum of Cares across the
Nation. We are designed to promote community-wide commitment to
ending homelessness and working collectively with our partners
to tailor a local homeless response system. Veterans experience
homelessness in every State, but nearly a quarter reside in
California, making the regional task force uniquely positioned
to share data and insight on this issue.
Without question, one of the most impactful and successful
coordinations around ending homelessness is the partnership
between HUD and the VA with the VASH vouchers, but in our
region we are experiencing some bottlenecks and some
challenges. I am going to be very specific in the two areas
that I am going to address. One is the insufficient referrals
to our housing authorities to fully utilize their VASH
vouchers; and, two, the limited eligibility requirements, which
you have taken a major step forward in with the new piece that
you just passed, which is leaving many of our homeless veterans
under-served and without appropriate housing resources.
The insufficient referrals from the VA to our housing
authorities, I collected data in coordination with our largest
housing authority in our region, which is the San Diego Housing
Commission. I am sharing their data and the recommendations of
that data as is current for these hearings.
The San Diego Housing Commission has approximately 354 un-
utilized VASH vouchers, approximately 31 percent of our total
VASH vouchers. The challenges that they identified was through
the VA San Diego health care system were averaging only nine
referrals a month for these VASH vouchers in our Fiscal Year
2019. These VA referrals are insufficient to increase the
utilization rate that we need to keep up with our attrition
rate, which we rarely talk about. Our attrition rate reaches
eight households a month. When we are only getting nine
referrals and our attrition rate is eight a month, we are
struggling to use those VASH vouchers.
We are also concerned about the shortage of VA referrals,
because we have a clear need for permanent housing resources in
the city of San Diego.
In 2019, our regional Point-in-Time Count identified 810
veterans experiencing homelessness. We have a high unsheltered
population in San Diego. We had 427 were sheltered veterans and
338 were unsheltered.
In addition, our regional Coordinated Entry System
Assessment showed in the last 18 months we identified over 840
veterans who are experiencing homelessness and were in need of
housing.
We also did a 6-month review of the homeless veterans
referred for VASH vouchers to the VA through our Coordinated
Entry System through April 2019 through September. We have 192
referrals and, sadly, we had 91 declines, a decline rate of
nearly 50 percent.
Understanding the challenges is a collective effort and it
is important to understand that we worked with the VA to verify
that it was truly a 50-percent decline rate. What the VA and
our data showed that this was solely due to eligibility
requirements, including the prioritization eligibility.
Our partners at the VA, Dr. Robert Smith, said in his
written statement from our hearing in Oceanside in August that
they are supportive of all efforts to increase homeless veteran
HUD-VASH prioritization eligibility.
It is important to recognize, Combat Exposure (CES) does
not have the ability to track the referrals once they go to the
VA through to the housing authorities. Once we have made those
referrals, we are very much in kind of a black box. We work
with our housing authorities to understand the time that lapses
from when we make a referral from Coordinated Entry to when the
VA makes a referral for our housing authorities.
Our housing authorities have stated that this may be due to
staffing of supportive services and the level of care required
by the VA. They say there is a significant gap in time in
referrals from our numbers to what they are actually seeing.
Second, the importance of expanding the limited eligibility for
homeless veterans for VA assistance.
The Housing Commission has been working with our VA
officials and have come up with some priorities that they would
like to see around these: reducing the barriers to expanding
VASH eligibility, eliminating the time-served requirements,
including the veteran discharge under conditions other than
honorable, as Greg talked about, and eliminating the VA health
care eligibility requirements. Also ensuring that we have the
resources needed to maximize our utilization of VASH. We have
heard a lot about that case management.
Another option is using our housing authorities, who are
really skilled at leasing up their VASH vouchers. Where our San
Diego Housing Commission had 31 percent under-utilized VASH
vouchers, they are over 100 percent in their other Housing
Choice vouchers. Using their expertise in helping us lease up
is one of the recommendations.
Will leave that to any questions you may have. Thank you.
[The Prepared Statement Of Tamera Kohler Appears In The
Appendix]
Mr. Levin. Thank you, Ms. Kohler, I appreciate that very
much, and thanks for all your great work in the San Diego
community.
With that, I would like to recognize Mr. Cooper for 5
minutes.
STATEMENT OF GARY COOPER
Mr. Cooper. Good morning. My name is Gary Cooper and I am
the Chairman of the National American Indian Housing Council
and I am a citizen of the Cherokee Nation. I also serve as the
Executive Director for the Housing Authority of the Cherokee
Nation located in Tahlequah, Oklahoma.
I appreciate the opportunity to testify before the
subcommittee today and I would like to thank Chairman Levin,
Ranking Member Bilirakis, and committee members for having this
hearing and for staying engaged on tribal housing issues.
In addition to the comments I will make today, I have
submitted a formal written statement for the record.
The National American Indian Housing Council is comprised
of 289 tribal housing organizations that represent and serve
nearly 500 tribes across the United States. National American
Housing Council (NAIHC) was established in 1974, and our
primary functions are to work with elected Federal officials
here in D.C. and to build capacity among our tribal housing
programs through our training and technical assistance program.
As part of its mission, NAIHC has advocated for and worked with
HUD as it launched the Tribal HUD-VASH Demonstration Program.
I appreciate this committee's focus on supporting and
improving the HUD-VASH program. I am particularly happy that
tribes are now included in these discussions.
As you may know, Native Americans have historically served
in the U.S. Armed Forces at rates higher than any other
demographic. That also means there are a lot of Native American
veterans who need our help once they leave active service. Many
of these veterans return to their home communities in some of
the most rural parts of the country and where they can only
rely on tribal programs for services. However, when HUD-VASH
was first created in 2008, tribes and Native American veterans
were largely left out of the program. The program was operated
through other public housing organizations, but tribes were not
included. This created a gap in service, as many Native
veterans returned to their home communities where many of these
groups were just simply not active in Indian Country.
This exclusion of tribes from the original HUD-VASH program
largely followed the trend to exclude tribes from other Federal
housing programs. Tribes started to receive Native American
Housing Assistance and Self Determination Act (NAHASDA) and the
Indian Housing Block Grant in 1998, and since that time new
Federal housing programs often excluded tribes. Almost as soon
as the block grant started, however, it has not kept pace with
tribal needs or even inflation. Currently, tribes receive only
about 75 percent of inflation-adjusted funding they received in
1998.
I am glad to report that the trend to exclude tribes is
starting to reverse, particular with HUD-VASH. Congress funded
the Tribal HUD-VASH Demonstration Program starting in 2015.
Only 26 tribes have been included in the program and it faced
some obstacles implementing the program. The two biggest
obstacles tribes have faced include finding qualified case
managers within the VA that can work with tribes in their
communities in finding affordable and available housing
options, as Indian Country faces a severe housing shortage.
A 2017 HUD report found that Indian Country as a whole
needs 68,000 new units to overcome overcrowded and substandard
housing in tribal communities. Under current funding, tribes
are largely able to build about 1,000 new units a year, while
the bulk of funding goes to rehab and maintenance of existing
housing stock.
Despite these obstacles, I think that the Tribal HUD-VASH
program is a success and can be more successful. It is a
success because we are now serving hundreds of Native American
veterans who would not have received services otherwise. These
veterans are just a small portion of the Native veterans that
are out there needing services. There are still nearly 550
tribes across the country who are unable to access this
program.
Over the past 2 years, the 26 tribes in the demonstration
program have helped about 350 veterans each year, and HUD
estimates that over 600 Native American, including Alaska
Native veterans, have been helped through the program. Native
veterans who were homeless or at risk of homelessness have
received the housing and supportive services they need. Many of
these Native veterans have since exited the program into
permanent solutions, including several who have moved to full
home ownership.
Due to the program's success at the 26 pilot communities,
NAIHC and tribes have been supporting full authorization of the
program. Accordingly, Members of Congress have introduced bills
that would make Tribal HUD-VASH permanent and we support these
efforts. This year, S. 257 and H.R. 2999 are companion bills
that would make the program permanent and provide a mechanism
for all tribes to participate. It also guarantees the
Secretaries of HUD and VA have flexibility to improve the
program and make it as effective as it can be tribal
communities by codifying the flexibility that has been included
in appropriations language in past years.
S. 257 passed under unanimous consent over in the Senate
with full bipartisan support. NAIHC thanks the leadership of
the Senate Indian Affairs Committee and Veterans' Affairs
Committee, all of four which leaders sponsored the bills from
the start. Similarly, in the House, we want to thank
Representative Luian and 11 bipartisan cosponsors of H.R. 2999.
Both versions of the bill are with Financial Services and we
will work with them to move it forward.
With that, I will end my statement, I ran up on time, and I
look forward to answering any questions you have. Thank you
again for focusing on veteran housing issues in Indian Country.
[The Prepared Statement Of Gary Cooper Appears In The
Appendix]
Mr. Levin. Thank you, Mr. Cooper, and I appreciate your
continued advocacy for our Native American veteran community,
and I look forward to working with Mr. Luian and others on that
legislation.
With that, I would like to recognize myself for 5 minutes
for questions, and I thought I would start with Mr. Anglea. I
thank Mr. Anglea and Ms. Kohler for flying all the way from San
Diego and being here. I know from my review of your written
testimony, Mr. Anglea, that you have another anecdote that you
would like to share. You got through two of the three. I wonder
if you could get through the other anecdote, and the other
priority for you and for Interfaith.
Mr. Anglea. Thank you, Congressman Levin, for the
opportunity.
The third key action that I outlined in our testimony is
around veterans who have disabling conditions and struggle to
secure the disability benefits that in our experience they are
entitled to, they are just not able to get through the system
to successfully gather all of their medical records to
demonstrate the level of their health condition disability, to
make that case effectively to the Social Security
Administration, and many of whom, like Mr. Brown as an example
or Mr. Santiago, as he is referred to in my testimony, have
other-than-honorable discharges and therefore do not have
access to the centralized VA health care system to gather those
records easily and, as a result, their health care records are
disparate, spread throughout. If they are experiencing
homelessness, they are in a State of crisis. If they have
mental health conditions, their ability to gather all this
information together and to successfully secure benefits of any
kind are very limited and their rates of denial are very high.
In many cases, north of 75 percent rates of denial.
There is an intervention that is supported by the Substance
Abuse and Mental Health Services Association, Substance Abuse
and Mental Health Services Administration (SAMHSA), called
Supplemental Security Income/Social Security Disability
Benefits Outreach Access and Recovery (SOAR), and it is where
you have a clinician who helps an individual gather their
medical records and apply for disability benefits. They can
secure a sustainable income and, when that happens, they
usually get housed. We are proposing and would like to see a
pilot project focused on veterans with disabling conditions who
are not yet connected to disability benefits to support them to
secure the income that they--we believe and in our experience
they are entitled to.
We will pay for these individuals' care either way. We will
pay in hospitals, emergency departments, with first responders,
in jails, and in shelters, or we can pay by connecting to
health care and dignified housing. A pilot project to help with
disability benefits is, in our experience, an excellent way to
help people in their time of need.
Mr. Levin. Thank you very much for that.
In our first panel, you probably heard, you know, a few
things that HUD-VASH potentially needs to change to improve the
program. One is case management--potentially more money, more
case managers, better hiring criteria--another is the
eligibility criteria. We do have that bill that we have been
talking about regarding the OTH discharges, but there are other
aspects of that as well. The third is the accuracy of fair
market rent calculation. That is a particularly important
consideration in a place like North County San Diego, as an
example.
Going back to eligibility criteria, one area where I have
been stunned to learn some of the statistics is the Coordinated
Entry process and the challenges with that process. I heard
that about half of veterans referred to HUD-VASH through
Coordinated Entry System are denied services due to
eligibility. For both Mr. Anglea and Ms. Kohler, which
eligibility criteria do you think posed the largest hurdles to
connecting veterans with HUD-VASH?
Ms. Kohler. Coordinated Entry struggles in its newness and
the fact that we do not collect a lot of the information right
up front about an individual's disabling conditions. We do not
have the information on their VA medical eligibility, and we
also struggle with, especially if you have a high unsheltered
population, meeting that chronic definition sometimes, having
that documentation.
The 50 percent that we saw declined, 50 percent of those
are 100 percent associated with being ineligible for the VASH
voucher. That may be that they do not meet the VA connection to
health care, it may be that they are other-than-honorably
discharged, it may be that they do not meet the chronic status
and that is something we really need to look at.
One of the things that Greg and I talked about is the fact
that the referrals into CES come from our service providers in
determining that a veteran most likely would be eligible for
VASH. If they know that it is an other-than-honorable
discharge, they do not refer that veteran even into CES for the
VASH vouchers. We know that those numbers are probably under-
represented as well.
It is also challenging with CES because, as Dr. Harris
said, our data systems are not connected. We cannot determine
if there is something else we could collect or more information
we could provide with Coordinated Entry.
We work very closely. Our local VA was an early adopter of
using Coordinated Entry, but a 50 percent decline rate is just
not acceptable. They understand that, we understand it, but
most of it is eligibility of the criteria and the
prioritization. They may not score high enough, they may not
have a length of time homeless, or they may not have the
disabling conditions, which is something we need to look at
when we have unused VASH vouchers sitting in the wings as well.
Mr. Levin. Mr. Anglea, anything to add to that?
Mr. Anglea. Just to highlight that our local VA is piloting
a project with the support of the central VA to award vouchers
to our organization, Interfaith Community Services, and also
vouchers to Veterans Village of San Diego, another organization
serving veterans in San Diego. For our staff, our boots-on-the-
ground social workers to directly connect veterans we are
working with to those vouchers and to get them into housing.
We operate a recuperative care program in San Diego, it is
the only of its kind, in partnership with the VA.
Unfortunately, in the last year, we have not been able to
connect any veterans from that program to HUD-VASH while they
are in the program itself, during the 3-month stay, it takes
longer than that. This will be an intervention to fast-track
that process and to connect veterans who we know will be
successful, we believe will be successful with that
intervention, and it is an example of in a way contracting with
community partners. It does not actually come with any funding,
we will do this with privately funded resources to show that it
works, but it is an example of utilizing partners that are on
the ground and ready to go.
Mr. Levin. Thank you both again for bringing your
perspective from North County San Diego. And if our friend Dr.
Smith from the VA in San Diego is watching, we appreciate all
his hard work as well and his continued partnership to get this
right.
And, with that, I will recognize the ranking member for his
questions.
Mr. Bilirakis. Thank you, Mr. Chairman. I appreciate it.
Thank you, all of you, participating today.
Ms. Kohler, in your written statement you propose an idea
that would allow public housing authorities to be the gateway
to HUD-VASH instead of waiting on VA to provide referrals.
Please tell us more about this proposal and how you believe San
Diego's utilization of the non-VASH vouchers compared to
utilization of VASH vouchers supporting this proposal. This is
really important, so please.
Ms. Kohler. I think this is an important piece that our
housing commission, our housing authority looked into. They are
experts of leasing up the Housing Choice vouchers, most of our
housing authorities are. This is their business, they work with
landlords, they know how to move clients between all of their
various housing resources as well.
As I said in my written statement, and oral as well, our
housing authority is leasing up more than 100 percent of their
Housing Choice vouchers, yet we are under-utilizing 31 percent
of our VASH vouchers.
The ability for a housing authority to not only match those
veterans, especially if they are not eligible for VASH, maybe
to another resource, is just playing to their strengths.
When we talked about using other resources, contracting out
for case management, they have that ability to contract out for
case management as well. It is housing-focused, they know how
to work with the landlords. We could balance that approach and
make sure we have the right level of supportive services, but I
think it is a really innovative way. I think it is housing
authorities stepping up and saying this is our business, we are
good at this, work with us to be able to do that, and the VA
then providing the health care, the supportive services, where
they really focus on their strength as well.
This is something that was proposed from our housing
commission to the VA, I think we are looking at piloting that,
and it could be transformational in the way that we are using
our VASH vouchers.
Mr. Bilirakis. Okay, very good. Thank you for thinking
outside the box, so important.
Again, another question for you, Ms. Kohler. In your
written statement you discuss the increased number of older
homeless veterans. Do you believe this is a factor of an aging
Vietnam/cold war veteran type of population or something else?
What type of additional challenges do older veterans present
compared to younger veterans?
Ms. Kohler. We are seeing a challenge with older veterans,
they need different type of services. As Greg talked about
recuperative care, we need to think about long-term care
housing for them as well.
Veterans--in fact, I will read some of the information--
they have some very complex challenges as they age. They have
age-related needs that pose significant challenges to our
system. Long-term health care issues, independent living
options need to be considered as we are thinking about our
veterans. Not all of our VASH vouchers or project-based units
are really designed for people as they age, so many of them
cannot transition in place.
We also saw a lot of our veterans who are ineligible for
VASH, served with our SSVF, and we saw that age increase from
one in five being in our senior population in 2017 to 2019 it
is one in four. We are seeing a rapid aging and I think it is
associated with those veterans that served in Vietnam and those
other service-oriented processes, and they are really
struggling with just age-related issues. Anyone who works with
the homeless population knows they age rapidly when they are
homeless as well. The early onset of age-related issues with
veterans who have experienced homelessness, we are seeing it at
much younger ages, 55, where someone 70 would be experiencing
those challenges as well.
It is something we need to be planning for, we need to be
mindful of it, and we need to make sure we have the right
services for an aging veteran population.
Mr. Bilirakis. Yes, so you are basically saying ALFs,
assisted living facilities; not nursing homes, but assisted
living facilities, so they can get the proper care.
I had one more question, if I may, Mr. Chairman?
Mr. Levin. Of course.
Mr. Bilirakis. How can the expanded use of project-based
HUD-VASH vouchers help meet the continued problem of affordable
housing in some urban communities? This is a huge problem, we
brought this up.
This question is for Ms. Monet, if you will. Thank you.
Ms. Monet. I think what we have seen is that in some
communities there is just a literal shortage of housing. You
have got veterans wandering around with vouchers, looking for
somewhere to rent. If you have got a project-based site you
know that there are units that will be available, they have got
vouchers tied to them, there is a whole community of, you know,
individuals, and somewhat of a therapeutic milieu for the
veterans. So it really just creates more affordable housing in
areas where you do not have any.
Mr. Bilirakis. Okay, very good.
Thank you, Mr. Chairman. I appreciate it.
Mr. Levin. Thank you, Mr. Ranking Member.
I recognize Mr. Bergman for 5 minutes.
Mr. Bergman. Thank you, and thank you to all here on the
panel for being here. I think I recognize some faces, but maybe
it is because you all travel in the same circles we do when you
are trying all over the country to do the right thing for
people in need.
I am going to make a blanket statement here and just raise
your hand if I am wrong. Okay? That all of you sitting there at
the testimony table have experience with local entities, non-
profits, veterans' groups, faith-based organizations, et
cetera, when it comes to dealing with the issue at hand here
that we are talking about.
Would any of you consider yourselves subject matter
experts--since you have basic understanding--subject matter
experts in the area of understanding that focuses on the
differences between urban, suburban, rural, and remote issues,
you know, that tie into where the veteran population is?
Anybody want to offer yourself up as the subject matter expert
in that arena?
Okay, good. All I want is your business card at the end.
Mr. Berg. Okay, great. I am happy to do it.
Mr. Bergman. There is not a question there, but I wanted to
know, because the point is, you know, we all have areas in
which we know a lot about and, if we are honest, we say there
are areas we do not know much about. The idea--we are all--you
know, all 435 Representatives in the House have different
demographics for where their constituents live and how they
interact with just life. All right?
Mr. Anglea, you went into great detail on the other-than-
honorable discharges. I voted for the bill yesterday because of
my many decades of experience as a commander having to deal
with disciplinary situations, whether it be violation of the
Uniform Code of Military Justice (UCMJ) or whether it be having
to make a decision on the characterize of service of, in my
case, you know, Marines and sailors under my command.
Do you have any data--and this is a really--this is a
detailed question and I don't necessarily expect you to have
the data at this point, but I would like to get the data,
whatever breakdown you have, because some OTH discharges are
handed out because of, let us say, unsatisfactory participation
in the Reserve component. They just--you know, they went
through boot camp, they went through their A school, and then
just decided not to show up at their unit of assignment. The
point is I think one of the reasons--again, I voted for the
bill yesterday--is we need to clarify exactly why an
individual--so the people who are not in the military system
understand why that person got an other-than-honorable. Okay?
Just, you know--again, not to be answered now, but I would
really appreciate any data you have that breaks it out by
service group; it could have been active service, it could have
been Reserve service, it could have been, you know, various
things.
Mr. Cooper, how would the tribe solve the problem of the
shortage of qualified caseworkers that we have acknowledged we
do not--what would the tribes do?
Mr. Cooper. That is a good question. I think that now the
VA has caseworkers in just about--if not every, almost every
one of those tribal communities. It took a little bit of time
to do so. We are talking about, you know, rural America and
remote parts of Alaska and other places.
I like the idea of the housing part starting with the
tribes, but I think as far as the caseworkers on the VA side
goes, I think a lot of it is they have started--they seem to
somewhat figure it out, but there is still an issue there.
I do not know if it is working with tribes and Indian
Health Service to use their caseworkers, if it is expanding it
to require maybe some type of telemedicine part of it, or also,
you know, not requiring--in some cases it is hard to get a
masters of social work person, a licensed social worker to go
out to some of these tribal areas----
Mr. Bergman. Okay.
Mr. Cooper.--plain and simple.
Mr. Bergman. Do you think it would be possible to
literally--for, again, those of us who want to--if the tribes
would be willing to sit down and talk about that? Because if we
can develop a model that is successful for the tribes, who
knows where that model can be applied throughout, you know,
other parts of the country.
With that, Mr. Chairman, I yield back.
Mr. Levin. I thank Mr. Bergman both for his perspective on
these issues, as well as for his support of our legislation
earlier this week, and look forward to working together for a
long time to come on this.
If there are no further questions, we can begin to bring
this hearing to a close. I really want to thank our witnesses
today.
Today's hearing has touched on two of the issues that are
most important to me and to my district, and I would imagine to
many of my colleagues as well, one is improving services for
veterans, the other is reducing homelessness. This particular
program, the HUD-VASH program, touches both. I am encouraged by
a lot of what I have heard today from you, our experts in the
field, as well as from HUD and from the VA.
I thank all of our witnesses again, particularly those
coming from North County San Diego and our district, for
providing their expertise, for the outstanding work that you
continue to do.
We have highlighted that while HUD-VASH is working and we
have demonstrated results that it is working, it can be
improved to work even better by doing some of the things that
we spoke about today. I am very hopeful about this legislation
that we passed earlier this week to expand eligibility to OTH
discharges. I am very hopeful that given the broad, bipartisan
support that that legislation had this week that we can have
them take it up in the Senate. I am hopeful also that our
amendment that we mentioned before will receive consideration
as well.
I hope that, you know, we all agree on this, I believe we
do. It is that simple premise that even one homeless veteran is
one too many. I will continue to work however I can to use this
subcommittee--and I know the ranking member shares this
objective--to use this subcommittee to find bipartisan
solutions to address veteran homelessness and housing issues.
We are going to work on this until we solve the problem.
No one who sacrifices so much to serve our country should
ever have to worry about having a place to live, and I think we
all can agree on that.
With that, all members have 5 legislative days to revise
and extend their remarks and include additional materials.
Without objection, the subcommittee stands adjourned.
[Whereupon, at 11:49 a.m., the subcommittee was adjourned.]
?
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A P P E N D I X
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Prepared Statement of Witnesses
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Prepared Statement of Keith Harris
Good Morning, Chairman Levin, Ranking Member Bilirakis, and
distinguished Members of the Subcommittee. Thank you for the
opportunity to testify today on the topic of Veteran homelessness,
specifically the Department of Housing and Urban Development (HUD)-
Veterans Affairs Supportive Housing (HUD-VASH) Program and the Tribal
HUD-VASH Program.
Introduction
The Department of Veterans Affairs (VA) remains committed to the
goal of preventing and ending Veteran homelessness. We can and will get
there. No one agency or group can end Veteran homelessness alone. The
effort to prevent and end Veteran homelessness is a collaboration
between Federal, State, and local governments and, most importantly,
the local community. VA works with communities to help them develop the
solutions that work best for them and their Veterans.
VA and other Federal, State, and local governments, as well as non-
governmental organizations, recognize that ending Veteran homelessness
is not a single event in time; rather, it is a deliberate effort made
to achieve the goal, and continued follow up efforts to make sure that
progress toward achieving the goal is maintained. Our goal is a
systemic end to Veteran homelessness, which means communities across
the country:
Have identified all Veterans experiencing homelessness;
Can provide shelter immediately to any Veteran
experiencing unsheltered homelessness who wants housing;
Provide service-intensive transitional housing in limited
instances;
Have the capacity to help Veterans swiftly move into
permanent housing; and
Have resources, plans, and systems in place should any
Veteran become homeless or be at risk of homelessness in the future.
The goal is to make sure that every Veteran has permanent,
sustainable housing with access to high-quality health care and other
supportive services and that Veteran homelessness in the future is
prevented whenever possible or is otherwise rare, brief, and
nonrecurring.
State of Veteran Homelessness
Significant progress has been made in preventing and ending Veteran
homelessness. The number of Veterans experiencing homelessness in the
United States declined by nearly half since 2010. The most recent HUD
Point-in-Time (PIT) Count estimated that on a single night in January
2019, 37,085 Veterans were experiencing homelessness; a 2-percent
reduction from the 37,878 reported in January 2018.
Since 2010, more than 800,000 Veterans and their family members
have been permanently housed, rapidly rehoused, or prevented from
falling into homelessness through HUD's targeted housing vouchers and
VA's homelessness programs. In addition to the national snapshot
provided by the 2019 PIT Count, as of December 4, 2019, 81
communities--which includes three States--have effectively ended
Veteran homelessness, based on criteria established by VA, HUD, and the
U.S. Interagency Council on Homelessness. This progress illustrates
what can be achieved when government agencies work with citizens and
community leaders to tailor the delivery of services in a manner that
meets the needs and expectations of the community.
Preventing and Ending Veteran Homelessness Is Possible
To achieve our goal of preventing and ending Veteran homelessness,
we need continued leadership, collaboration, commitment, and a sense of
urgency from communities across the country. No one entity on its own
can prevent and end homelessness among Veterans.
There has been unprecedented support from every branch of
government; State and local leaders; and agencies to provide both the
funding and human resources needed to end Veteran homelessness.
Communities continue to align those resources with the most effective
practices to ensure rapid, safe, and stable housing for Veterans who
need it.
Progress comes when community leaders implement proven practices
that are reducing homelessness among Veterans nationwide and ending it
community by community. Common practices developed and implemented
locally that have achieved an effective end to Veteran homelessness
include:
Identifying all homeless Veterans by name and sharing
those names across systems so that no one is forgotten;
Using and sharing data to find and serve every Veteran
who needs homeless services;
Creating coordinated assessment and entry systems to make
sure there is no wrong door for Veterans seeking help, and coordinating
people and services at every level to create integrated systems of
care;
Setting concrete and aspirational monthly and quarterly
goals and engage the community and associated systems to meet them.
This requires the direct involvement of community leaders and focused
political will and can be used as a benchmark progress against specific
criteria;
Synchronizing programs to coordinate outreach and target
the right type of resource to the right Veteran at the right time;
Making sure outreach and engagement efforts are
coordinated across service providers; law enforcement personnel,
prisons and jails; hospitals; libraries; and job centers to proactively
seek Veterans in need of assistance with housing; and
Focusing on creating connections from homeless services,
housing organizations, and VA medical centers (VAMC) to employment
support services such as those provided by the Department of Labor's
Homeless Veterans Reintegration Program grantees, Workforce Development
Boards, and employers so that Veterans can be quickly connected to
jobs.
HUD-VASH Program
One of VA's most important resources for ending Veteran
homelessness is the HUD-VASH program. HUD-VASH is a collaborative
program between HUD and VA, in which HUD provides eligible homeless
Veterans with a Housing Choice rental voucher, and VA provides case
management and supportive services so that Veterans can gain housing
stability and recover from physical and mental health problems;
substance use disorders; and other issues contributing to or resulting
from homelessness. The program goals are to help Veterans and their
families gain stable housing while promoting full recovery and
independence in their community.
HUD-VASH currently has more than 100,000 vouchers allocated
nationally to Public Housing Authorities (PHA). As of October 31, 2019,
80 percent of these vouchers were leased up, leaving approximately
20,000 vouchers unleased. This unleased number of 20,000 breaks down
further as follows: approximately 2,500 are shelved for project-based
voucher (PBV) development and thus not available for use; over 4,500
are in the hands of Veterans seeking housing; and over 1,300 are
reserved for Veterans recently referred to PHA. This leaves
approximately 11,000 vouchers unleased and available for use. With over
37,000 Veterans still homeless on any given night, 11,000 unused
vouchers are far too many, and VA is dedicated to ensuring we maximize
the utilization of HUD-VASH vouchers and assist as many homeless
Veterans as possible with obtaining and sustaining housing.
There are several key reasons for the current voucher utilization
rate in HUD-VASH. The reasons include: 1) the allocation strategy
employed by VA and HUD over the past few years; 2) market factors,
particularly low vacancy rates and high rents in communities with large
numbers of vouchers; 3) vacancies in VA case management positions; and
4) reductions in the chronically homeless Veteran population.
Allocation Strategy: For many years, vouchers were
allocated to PHAs based on a complex formula that considered multiple
indicators of need and performance and utilization data for the local
PHA and VAMC. This approach fostered a broad distribution of vouchers
where they could be used (e.g., high performers received more
vouchers). In more recent allocations, HUD and VA strategically shifted
this approach and allocated vouchers purely based on need (e.g., those
with the largest numbers of homeless Veterans received more vouchers).
This shift provided enough vouchers were on the ground in high-need
areas in the long term but resulted in surpluses of vouchers in the
short term. To address this problem, HUD established a utilization
threshold that PHAs must meet to be eligible for vouchers. This will
help avoid continuing to push vouchers to communities that already have
a short-term surplus and will help avoid exacerbating the low
utilization rates we see nationally.
Market Factors: A significant obstacle to higher voucher
utilization is a lack of safe and affordable housing for Veterans
holding a HUD-VASH voucher. Rents are skyrocketing in many of the same
cities with the largest number of homeless Veterans and largest number
of vouchers allocated. Veterans holding vouchers in these communities
are finding it very difficult to find housing. To address this problem,
VA and HUD are promoting all strategies that will either increase
housing stock dedicated to Veterans or make the HUD-VASH voucher more
competitive. The primary strategy for increasing housing stock is
through the use of PBVs, where vouchers are tied to units that are
dedicated to HUD-VASH Veterans or make vouchers more competitive by
increasing the payment standard for HUD-VASH vouchers.
Vacancies in VA Case Management Positions: VA is required
by statute to ensure that Veterans in HUD-VASH are provided case
management and seen as needed by a case manager. Because HUD-VASH is a
permanent supportive housing program originally designed for
chronically homeless Veterans with acute service needs, VA adopted a
clinical model of 1 case manager for every 25 Veterans in HUD-VASH. It
is not possible to provide intensive case management with caseloads
significantly higher than 25. Of the 4,156 HUD-VASH positions
nationally, 3,497 (84 percent) were filled as of October 31, 2019,
leaving 659 positions vacant. VA aims for a filled rate of 90 percent
staffing, to account for inevitable turnover related to retirements,
changing positions, etc., which would yield an additional 243 case
management positions. If each of these additional positions carried a
caseload of 25 Veterans, HUD-VASH could house over 6,000 additional
Veterans, improving voucher utilization to 88 percent of active
vouchers. VA is employing multiple strategies to address its HUD-VASH
vacancies. VAMCs are continually reminded of the prioritization of
ending Veteran homelessness, and the importance of HUD-VASH positions
in supporting this effort. Where staffing is a long-term challenge, VA
is promoting the use of contracting or other alternative forms of case
management. In the upcoming HUD-VASH voucher allocation from HUD, VA
will require that VAMCs fill current vacancies before requesting any
new positions to support the new vouchers.
Reduction in the Number of Chronically Homeless Veterans
Nationally: HUD-VASH targets chronically homeless Veterans, those who
need the most intensive support in order to obtain and sustain housing.
This approach has been very successful, and the HUD-VASH program has
directly and markedly reduced the population of chronically homeless
Veterans over the past few years. In the early years of HUD-VASH,
chronically homeless Veterans comprised as much as 33 percent of the
homeless Veteran population. As of the most recent PIT count, that
percentage dropped to an estimated 22 percent. In order to fully
utilize the remaining HUD-VASH vouchers, Federal agencies are reviewing
ways to broaden the population of homeless Veterans it targets for HUD-
VASH by targeting specific Veteran subpopulations previously not
targeted.
Tribal HUD-VASH
In Fiscal Year 2015, Congress authorized HUD to set aside funds
from the HUD-VASH program to expand the program into Indian Country. On
March 2, 2016, HUD made $5.9 million in awards to 26 Tribes and
tribally designated housing entities (TDHEs). The amount of the award
was based on the number of housing units requested by the Tribe or
TDHE, the rents established by the Tribe or TDHE, and a flat
administrative fee per housing unit. Tribal HUD-VASH, therefore,
accounts for less than 1 percent of the total HUD-VASH program
nationally.
To ensure that Native American Veterans served by this program
receive case management and supportive services, VA funded one case
manager for each of the 26 Tribes that received grant awards. Given the
unique nature of working with the Tribes and on tribal land, the Tribal
HUD-VASH case manager must develop cultural competence specific to the
Tribe(s) being served. Currently, 23 of these positions are filled,
with three remaining vacant. In all three vacancies, the local VAMC has
a temporary case manager providing Tribal HUD-VASH coverage until these
positions can be permanently filled.
As of October 28, 2019, 387 Native American Veterans are being
assisted under this program. Additionally, 111 Native American Veterans
who previously received housing assistance and case management services
have subsequently exited the program. Of these, 52 have moved into
permanent housing, including 22 who went on to rent their homes without
any public assistance and three who have purchased a home. Moreover,
despite initial delays, all of the grantees have a VA case manager to
provide case management. The Tribal HUD-VASH program is an important
addition to the overall HUD-VASH program, bringing valuable permanent
supportive housing resources to tribal lands.
HUD-VASH Funding
As a jointly run program between two Federal agencies, HUD-VASH
receives its funding from two separate appropriations committees. HUD
has received incremental voucher assistance each year since 2008. Using
the Medical Services appropriations, VA was sufficiently able to keep
its average caseload size at 25 Veterans per case manager for the
100,000 vouchers currently allocated; however, if HUD allocates new
vouchers at the end of the first quarter of Fiscal Year (FY) 2020 as
planned with Fiscal Year 2019 funds, average caseload sizes will
increase to 27 Veterans per case manager without reallocation of funds
internally. The target of 25 Veterans per case manager is considered
high in permanent supportive housing programs. If HUD continues to
allocate new vouchers, VA will require a proportional increase in its
budget for case managers to support those vouchers.
Rural Homelessness
Rural homeless individuals are often referred to as the ``hidden
homeless.'' It is difficult to accurately estimate the size of the
problem of rural homelessness due to its invisibility; the limited
availability in rural areas of services intended to respond to
homelessness; limitations in the definition of homelessness and the
counting methods better suited for use in urban environments; and the
migration of people experiencing housing instability from more to less
rural areas. Rural areas often do not have sufficient resources to
address housing crises, and the rural environment makes it difficult to
implement evidence-based responses, such as rapid rehousing.
Because of the difficulties in accurately estimating the number of
homeless individuals in rural areas, it is generally assumed that the
PIT count underrepresents the need in these areas. This is important,
because homeless resource allocation and distribution is based heavily
on the PIT count. Thus, it is also generally assumed that rural areas
are under-resourced. To address this, in Fiscal Year 2016, HUD
allocated 600 vouchers specifically for rural areas. VA funded 34 case
manager positions to provide supportive services and case management.
It should be noted that 34 Full-time Equivalent to support 600 vouchers
yields an average caseload size of 17 Veterans, which is smaller (i.e.,
more service rich) than the target of 25 in the general program. This
was done to address known challenges in providing case management in
rural areas, such as large geographical catchment areas, lengthy
transportation times, and scarcity of resources. Despite these targeted
vouchers and dedicated rich case management support, these rural
vouchers were significantly underutilized, especially compared to the
general program at the time, which ended Fiscal Year 2016 at over 92
percent vouchers utilized. Fiscal Year 2016 was the only year in which
HUD allocated vouchers specifically to rural areas.
VA remains committed to serving Veterans in all areas, including
those in rural areas, and we will continue to promote strategies and
innovations that will ensure that these Veterans have access to the
housing and services they need.
Conclusion
Across VA, we are committed to providing the high-quality care our
Veterans have earned and deserve. We continue to improve access and
services to meet the needs of Veterans. We are grateful for the
resources Congress provides VA to care for Veterans, particularly HUD-
VASH resources which are crucial to ending Veteran homelessness. We
pledge to do all we can to ensure these resources are used as
effectively and efficiently as possible. Thank you for the opportunity
to appear before you today to discuss this invaluable program.
Prepared Statement of Hunter Kurtz
Introduction
Good afternoon Chairman Levin, Ranking Member Bilirakis and members
of the subcommittee. It was a pleasure to testify before the
Subcommittee on Economic Opportunity this past summer, and I look
forward to updating you on the efforts of the Department of Housing and
Urban Development (HUD) and our Federal partners to end veteran
homelessness across the United States.
HUD is committed to ending veteran homelessness by working
collaboratively with our partners and maximizing the effectiveness of
all existing resources. Thanks to funding from Congress and close
collaboration among Federal and local partners, the Nation has
continued to make progress in addressing veteran homelessness and
creating sustainable Federal and local systems that quickly respond to
homelessness.
I am honored to serve as HUD's Assistant Secretary for Public and
Indian Housing (PIH). The HUD Veterans Affairs Supportive Housing (HUD-
VASH) program, jointly administered by HUD, within PIH, and the
Department of Veterans Affairs (VA), within the Veterans Health
Administration Homeless Program Office, provides homes to veterans who
are homeless or at risk of homelessness. HUD staff, local housing
authorities, Continuums of Care, and local Veterans Affairs Medical
Centers (VAMCs) work in tandem to provide homes and services to
homeless veterans. I can attest that this program has been successful
in providing a home - not just a house - to our Nation's veterans and
their families.
General HUD Homeless Assistance Programs
HUD's Office of Community Planning and Development (CPD) provides
about $2.4 billion annually to communities to help end homelessness.
Funding is primarily used for permanent supportive housing, which
successfully houses people with long histories of homelessness and
significant disabilities. Permanent supportive housing can reduce
hospitalization and emergency room utilization while dramatically
improving the well-being of the people it serves. HUD also provides
funding for rapid re-housing, a cost-effective strategy that helps
people move quickly into housing, provides short-term financial
assistance, and provides supportive services to help the homeless
stabilize in their housing, increase their employment and income, and
connect them to community supports. HUD also supports emergency
shelter, transitional housing, and many other types of assistance
dedicated to ending homelessness.
In 2017, approximately 17,000 homeless veterans were served using
$97 million through HUD's Continuum of Care (CoC) program. Most of that
funding is for permanent supportive housing that houses approximately
10,000 homeless veterans with disabilities. Thousands more homeless
veterans are served with rapid re-housing, emergency shelter, and other
assistance. Additionally, CoCs continue to work closely with VA and
Public Housing Authorities (PHAs) to effectively use HUD-VASH
resources.
Housing and Urban Development - Veterans Affairs Supportive Housing
(HUD-VASH)
HUD-VASH is part of the Housing Choice Voucher (HCV) program in the
Office of Public and Indian Housing. The HCV program currently houses
over 2.3 million families and had an annual budget of more than $20
billion in 2019. HUD-VASH is the only PIH program dedicated to homeless
veterans; however, many formerly homeless families, including veteran
families, are assisted through the regular HCV program.
The HUD-VASH program has been very successful in its approach to
addressing veteran homelessness. The program provides long-term housing
assistance to the most vulnerable veterans experiencing homelessness by
combining HCV rental assistance for homeless veterans with case
management and clinical services provided by VA. VA provides these
services for participating veterans at various locations, including
VAMCs and community-based outreach clinics.
In the HUD-VASH program, the local VA case managers screen and
determine veteran eligibility for the program. These HUD-VASH eligible
veterans are then referred to the partnering PHA to receive their
housing voucher assistance. By agreeing to administer the HUD-VASH
program, the PHA is relinquishing its authority to determine the
eligibility of families in accordance with regular HCV program rules
and PHA policies with two exceptions: PHAs are required to prohibit
admission of any member of the household subject to a lifetime
registration requirement under a State sex offender registration
program and income limits.
A total of $795 million has been appropriated in new HUD-VASH
funding to date. HUD-VASH vouchers are renewed based on actual leasing,
as is the case for the HCV program generally. When a household leaves
the program, their voucher is typically reissued to another eligible
household. Since 2008, over 170,000 veterans and their families have
moved into housing with a HUD-VASH voucher. As of the last day of
Fiscal Year 2019, more than 77,000 veterans and their families were
housed with a HUD-VASH voucher.
HUD-VASH vouchers are specifically targeted to communities based on
geographic need, meaning the size of the eligible population. Every
year since 2008, HUD and VA have collaboratively awarded new HUD-VASH
vouchers based on geographic need and administrative capacity. Using
HUD metrics of how we calculate housing, a total of more than 100,000
HUD-VASH vouchers have been awarded to more than 600 PHAs between 2008
and 2019. In addition to the HUD-VASH vouchers specifically awarded as
project-based voucher (PBV) assistance, PHAs, with the support of their
local VA partners, have the ability to convert any of their existing
HUD-VASH vouchers to PBV.
The Housing Opportunity Through Modernization Act of 2016 (HOTMA)
streamlined this process for PHAs. PHAs can now convert any of their
existing HUD-VASH portfolio without additional approval by HUD, subject
to statutory and regulatory requirements of the PBV program. Because
the landscape of veteran homelessness across the country has changed
since 2008, HUD and VA are working collaboratively to ensure that all
HUD-VASH resources are being used as efficiently and effectively as
possible.
These efforts around HUD-VASH demonstrate HUD's commitment to
optimize the effectiveness of the HUD-VASH program and allow for local
flexibility in addressing the homeless veteran population.
Tribal HUD-VASH
The Tribal HUD-VASH demonstration program provides rental
assistance and supportive services to veterans who are Native American
and experiencing homelessness, or at risk of homelessness, while living
on or near a reservation or other Indian areas. Veterans participating
in this program are provided housing assistance through HUD and
supportive services through VA to foster long-term stability and
prevent a return to homelessness.
The pilot was first authorized in the Consolidated and Further
Continuing Appropriations Act, 2015 (Public Law 113-235, approved
December 16, 2014) and Congress has continued its support in subsequent
years by enacting funds for renewal grants and modest expansion. Thirty
tribes or tribally designated housing entities were invited to
participate in the program based on their level of need and
administrative capacity. Ultimately, 26 of those invited submitted
applications and were awarded grants totaling $5.9 million to fund
approximately 500 units of rental assistance for veterans and their
families, and to fund associated administrative costs. HUD has renewed
these grants annually and will fund additional grants or units of
assistance using funding provided in the Consolidated Appropriations
Act of 2019.
Implementation of the program is overseen by PIH's Office of Native
American Programs (ONAP) and VA is responsible for providing case
management services and referring eligible veterans for housing
assistance. As of the end of 2019, 500 veterans have received case
management service under this program. Additionally, since the
inception of the program, almost 150 additional veterans that were
previously housed under the program subsequently found permanent or
temporary housing or graduated from case management. The program is
producing tangible results, housing Native American veterans and their
families who were living in severely inadequate units - without running
water, heat or electricity - or in overcrowded living conditions.
Continued Collaboration with VA and USICH
HUD has worked closely with VA for many years administering HUD-
VASH. Together, HUD, VA, and the U.S. Interagency Council on
Homelessness (USICH) have implemented a joint decisionmaking structure
known as ``Solving Veterans Homelessness as One'' (SVHO) that assists
in coordinating agency efforts and develops and implements a range of
strategies for preventing and ending veteran homelessness. This
structure allows us to jointly review data on HUD-VASH and other
programs and to coordinate policymaking to ensure our assistance is
integrated and impactful.
This collaboration has also helped us troubleshoot any issues and
improve utilization in the HUD-VASH program, coordinate the
implementation of the Tribal HUD-VASH program, better target available
assistance to those with the highest needs, and ensure all resources
across agencies are prioritized for communities with greater numbers of
veterans experiencing homelessness.
HUD, VA, and USICH have also used the structure of SVHO to work
together to create a set of standards to evaluate whether communities
have ended veteran homelessness. Since 2014, more than 880 mayors, city
and county officials, and Governors have set a goal of ending veteran
homelessness in their communities. As of January 7, 2020, 78
communities and 3 States have achieved the goal.
The agencies also collaborate on the implementation of Coordinated
Entry Systems. Coordinated Entry ensures that a person experiencing
homelessness has simple access to housing and other homelessness
resources. The collaboration between HUD and VA helps to ensure that
veterans have access to all the resources in a community, including VA
dedicated resources, no matter where and how they access assistance.
Technical Assistance for Communities
Because 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 helping communities get there. In
addition to providing funding for homeless assistance, HUD supports
several technical assistance initiatives that have helped reduce
veteran homelessness. The Built for Zero and Vets@Home initiatives help
communities implement best practices and learn from the success of
other communities. Both initiatives were designed with the explicit
goal of helping communities reach the goal of ending veteran
homelessness.
Some best practices have included incorporating HUD-VASH in a
larger coordinated entry system to ensure there are multiple access
points for veterans seeking help, coordinated outreach efforts to
locate all veterans in need of assistance, and better data sharing
across systems to ensure veterans do not fall through the cracks.
HUD has worked with its partners to identify specific strategies
for utilizing HUD-VASH vouchers in high-cost, low-vacancy communities.
These are often the communities with the greatest need. In addition to
converting HUD-VASH to PBV, PHAs have used their flexibility to
increase their payment standard, including the adoption of exception
payment standards, to be competitive in the private market. Another
strategy has been intensive landlord outreach and maintaining landlord
relationships. PHAs have also been able to connect with local service
providers that are able to assist veterans in their housing search.
In an effort to improve the utilization of existing HUD-VASH
resources and ensure maximum impact of new vouchers, in Fiscal Year
2019, HUD instituted a utilization threshold for PHAs to be eligible
for additional HUD-VASH vouchers. HUD set this threshold at 70 percent
current HUD-VASH leasing, with some exceptions.
Results
Each year, communities across the country conduct Point-in-Time
(PIT) counts of people experiencing homelessness. The PIT count, held
at the end of January 2019, includes people living in shelters as well
as people sleeping on sidewalks, in parks, in cars, or in other places
not meant for human habitation. Based on that count, veteran
homelessness decreased by 2.1 percent (793 veterans) in 2019 and has
declined by nearly 50 percent since 2010. This kind of reduction is
historic, and HUD-VASH has been a primary reason for this progress.
A robust body of evidence shows that the combination of permanent
supportive housing, rapid re-housing, and other targeted interventions
can indeed end homelessness. Although there was a 2.7 percent increase
in general homelessness in 2019, that was largely driven by the 16.4
percent increase in one state: California. The trend in the other 49
states shows a significant decrease in homelessness. The long-term
national trend and the results in the many communities that have ended
veteran homelessness show the positive results of a coordinated effort.
Conclusions
A great deal of progress has been made in the way we work together
to address veteran homelessness. However, there is still a lot of work
to be done. The HUD-VASH program continues to be a model for
interagency collaboration and one of the best tools we have for ending
veteran homelessness. We must continue to find ways to maximize the
effectiveness of the HUD-VASH program, while also assisting communities
in utilizing all available homeless assistance resources.
Thank you again for this opportunity to update you on HUD's efforts
to end veteran homelessness.
______
Prepared Statement of Steve Berg
Introduction
Chairman Levin, Ranking Member Bilirakis, and other distinguished
members of the House Veterans' Affairs Subcommittee on Economic
Opportunity, thank you for inviting the National Alliance to End
Homelessness (hereinafter referred to as ``the Alliance'') to testify
at this January 14th hearing entitled ``Making HUD-VASH Work for all
Veteran Communities''. I am Steve Berg, and I am the Alliance's Vice
President for Programs and Policy. The Alliance is a nonpartisan,
evidence-based, and mission-driven organization committed to preventing
and ending homelessness in the United States.
Because of our mission, the Alliance views the veteran homelessness
programs as a vital part of a larger national effort to eliminate
homelessness. The Department of Housing and Urban Development (HUD) is
responsible for the administration of the Continuum of Care (CoC) and
Emergency Solutions Grant (ESG) programs, the two Federal programs that
attempt to address the needs of homeless Americans generally. In Fiscal
Year 2020, more than $2.8 billion will be awarded by HUD through the
CoC and ESG programs to State and local governments as well as
nonprofit organizations. The CoC program, which is the larger of the
two, funds rapid re-housing (RRH), permanent supportive housing (PSH),
and transitional housing (TH); the coordinated entry system; and
initiatives to improve systems, including the Youth Homelessness
Demonstration Program. These programs balance local control with an
insistence on evidence-based practices and results. HUD uses research
and data to establish criteria for the CoC competition based on cost-
effectiveness and performance, while States and localities determine
which evidence-based interventions are most needed, and which entities
in the community should be funded to carry them out. Approximately $290
million will be awarded by HUD in Fiscal Year 2020 through formula
grants to State and local governments for the ESG program, which funds
shelters, RRH, and homelessness prevention (HP).
The Department of Veterans Affairs (VA) is responsible for three
different housing programs designed to assist veterans and their
families with ending their homelessness. The Homeless Providers Grant
and Per Diem (GPD) program will provide $250 million in Fiscal Year
2020 in funding for community-based TH and supportive services. The
Supportive Services for Veterans Families (SSVF) program, which
provides both RRH and HP services, will receive $380 million in funding
for Fiscal Year 20. The three components of RRH, a Housing First
program, are identifying housing, providing short-term rent and move-in
financial assistance, and offering case management and employment
services. The historically well-funded HUD-VASH program, an
interdepartmental collaboration which will receive an additional $40
million from HUD for Fiscal Year 20, provides homeless veterans with
PSH through HUD vouchers as well as VA services to help enrollees find
and sustain permanent housing. PSH, another Housing First program,
combines housing subsidies and support services that are designed to
build independent living and tenancy skills and connect people with
community-based health care, treatment, and employment services. HUD-
VASH is reserved for chronically homeless and highly vulnerable
veterans who have a high level of housing and service needs, such as
those with barriers to employment and self-sufficiency. A demonstration
project to provide HUD vouchers and VA supportive services to homeless
American Indian veterans (Tribal HUD-VASH) will receive an additional
$1 million for Fiscal Year 20.
The Alliance asks members of the Subcommittee to keep two important
points in mind during their efforts to oversee and improve the veteran
homelessness programs:
1. The veteran homelessness programs are widely considered by
providers and academics to be the gold standard in preventing
homelessness and housing people experiencing homelessness.
These programs, which are designed and implemented with proven,
evidence-based practices, are significantly better-resourced
than programs which serve the general homeless population. The
amount of money available for each newly homeless veteran each
year is as much as six times that for each homeless non-
veteran. Moreover, homeless veterans also benefit from their
access to VA's world-class health care system. Finally, because
VA is an integrated health care system, the department can
continuously disseminate and implement best practices across
its far-flung network of medical centers.
This doesn't mean that VA's homelessness programs are above
criticism. Certainly not. If anything, we should hold VA's
dedicated, conscientious, and hard-working managers, health
care professionals, and caseworkers to even higher standards.
But it does mean that non-veteran homelessness services
providers look to VA for inspiration and innovation. Non-VA
providers follow the department's homelessness initiatives--
including newer initiatives like Rapid Resolution and Shallow
Subsidy--with as much interest as the Department's authorizers
and appropriators on Capitol Hill. Consequently, please
understand that what you do and don't do as lawmakers on this
Subcommittee with respect to veteran homelessness programs has
broader implications for homelessness programs generally and
establishes precedents for your congressional colleagues who
set the rules and funding levels for non-veteran homelessness
programs.
2. The veteran homelessness programs are strong because they
enjoy bipartisan support. That's not to say there aren't
reasonable differences of opinion between the two parties, but
there is a bipartisan consensus in support of an evidence-based
approach toward the reduction and even the elimination of
homelessness among veterans, the programs used to achieve those
goals, and adequately resourcing those programs. No lawmaker
blames homeless veterans for their plight, advocates for
criminalization of the conduct of homeless veterans, or insists
we can't adequately resource veteran homelessness programs
until states and localities have reformed their zoning and
housing regulations. Unfortunately, even though non-veteran
homelessness programs are pursuing the same policies and
approaches, albeit with less funding, they do not enjoy the
same level of support. The Alliance commends this Subcommittee
for its bipartisan approach toward veteran homelessness,
putting principle before party, and urges other lawmakers to
learn from the example set by Chairman Levin and Ranking Member
Bilirakis.
I attach to the end of my testimony a chart which illustrates re-
housing capabilities for individuals, families, and veterans. The
Alliance calculates that we could re-house more than three-fifths of
veterans who entered a shelter in 2017, one out of every three families
(which is a significant improvement from one out of every eight
families several years earlier), and less than one-tenth of
individuals. I would be happy to discuss the conservative assumptions
used in the creation of the chart as well as provide the Subcommittee
with an updated version when more recent information becomes available.
Housing First
Integral to the success of the veteran homelessness programs has
been the use of Housing First, an approach which prioritizes quickly
providing permanent housing to people experiencing homelessness, thus
ending their homelessness and serving as a platform from which they can
improve their quality of life. The provision of wrap-around services--
to support housing stability, promote employment, and recovery - is an
integral part of Housing First, and the effectiveness of all these
services depends on the recipients living in stable housing. Housing
First starts with housing, with no preconditions, including those
related to religion, employment, income, absence of criminal record,
and sobriety.
Why should housing (with services) come first? People who
experience homelessness may have a myriad of other challenges,
including a mental health or substance use disorder, limited education
or work skills, scant credit history, or a history of domestic violence
and trauma. Would people experiencing homelessness be better off if we
helped them to deal with other problems they are struggling with first
and only addressed their housing needs later? Housing First, some have
argued, allows people to avoid addressing severe challenges, such as a
substance use disorder, so that people will quickly return to
homelessness.
But this argument is based on a false premise. In fact, services
are part of Housing First interventions. Under Housing First, people
are offered or connected to services that are tailored to the needs of
their households. But those services are not mandated: and people are
not coerced into accepting them because client choice is a fundamental
tenet of Housing First.
Housing First-informed interventions such as PSH and RRH
demonstrate again and again that when people who have experienced
homelessness have help paying for their housing, and when they receive
services tailored to their individual needs, they will escape
homelessness and they will stay housed. Not only are Housing First
interventions effective in ending homelessness, but many and sometimes
all of their cost is offset by reductions in the public spending that
inevitably results from allowing people to remain homeless and reliant
on shelters and other services.
Practitioners experienced with serving long-term homeless adults
know that withholding housing help until people ``get better'' or
change in some way can perversely result in people spending years on
the streets as their health declines. People with severe mental
illnesses cycle frequently between jails, hospitals, shelters, and
streets without ever achieving stable homes. Those that have seen this
heartbreaking cycle, unfortunately still too common given inadequate
resources, understand this fundamental truth: withholding housing
assistance doesn't help people, it hurts them.
Instead of requiring people to stabilize before receiving housing,
Housing First interventions focus on helping people to achieve
stability in housing. This is often a prerequisite to other
improvements in their lives. People with the foundation of a home are
in better positions to take advantage of supportive services. They have
the stability with which to engage in a job search. They have the
platform they need to provide care and continuity for their young
children. The safety housing affords allows those who want to address
traumatic experiences with a skilled practitioner to do so at a pace
that is unthreatening and makes sense to them. They have a safe place
to store medication and address their physical and mental health needs.
The absence of housing, on the other hand, makes attaining those
personal goals so much more difficult.
Housing First focuses on providing the housing assistance and the
supportive services that people require to sustain housing and avoid
future homelessness. Study after study demonstrates that housing has
many curative benefits for people experiencing homelessness. It is true
that Housing First does not fulfill every need; people still require
additional supports to attain personal goals and continue to thrive.
But there is one thing that housing clearly does solve: homelessness.
One criticism of Housing First is that it has led to a loss of
temporary beds for people experiencing homelessness. There has been an
increase in the number of emergency shelter beds in the period from
2007 to 2018. Long-term TH beds have declined but they have been
replaced by a much larger increase in permanent housing opportunities
for people who are homeless, based on greater cost-effectiveness and
greater demand, thus leading to long-term decreases in the number of
people homeless, including dramatic decreases for veterans. TH
continues to be available for homeless veterans through the GPD program
in appropriate cases.
During two field hearings, the Chairman and the Ranking Member of
this Subcommittee listened carefully to the concerns of many groups and
individuals who care deeply about veteran homelessness programs, and I
am pleased that their testimonies included much praise of Housing First
and reaffirmed its importance in the success of those programs. Housing
First has enjoyed strong bipartisan support since the Administration of
President George W. Bush--and if the approach is judged on the merits
that should not change. The Alliance urges the Subcommittee to continue
to support Housing First--and, if necessary, aggressively reaffirm its
importance for the veteran homelessness programs.
The Appendix at the end of my testimony summarizes research on the
effectiveness of Housing First.
Point-in-Time Counts
HUD's annual point-in-time (PiT) count is what it is--a snapshot in
time of the sheltered and unsheltered homeless populations based on one
or several days of diligent searching by small armies of experts and
volunteers across the length and breadth of a CoC. A PiT count does not
include everyone who experiences homelessness in a particular year. The
count of the sheltered homeless population is obviously more accurate
than the count of the unsheltered population. A CoC that is
sufficiently funded to employ an aggressive outreach effort throughout
the year is more likely to know where more of the unsheltered
population is during a count. The Alliance believes that for the last
several years communities across the Nation have worked hard to ensure
greater accuracy in the documentation of homelessness. I understand
there are fears that the integrity of the count might be undermined by
schemes to over-count or under-count. However, it is our impression
that too many conscientious people from too many different entities are
involved, many of them governmental, to prevent such conspiracies.
There are concerns about who is to be counted--a family which
spends the night in a car would be counted, while a family which sleeps
in a relative's house (doubled-up) would not. There are other sources
of data, including the Bureau of the Census, to make estimates about
the doubled-up population. However, the PiT count is the only
comprehensive source of data about people sleeping in places not
intended for human habitation.
Conducted over time and in a consistent manner, the counts can be
helpful tools to identify trends, both generally and with respect to
specific subpopulations, and allocate very finite resources,
particularly when used in conjunction with Housing Inventory Counts
(HIC) and other helpful data tracked by HUD's CoC Homeless Management
Information Systems (HMIS).
The nation's affordable housing crisis has created three distinct
populations: the rent-burdened, those several million low-income
households paying a large and unsustainable percentage of their income
toward housing; the unstably housed, often referred to as the doubled-
up, who, according to the Alliance's analysis of the census are more
than 4.4 million people; and the more than one half-million people who
experience homelessness on a particular day. Thanks to the PiT and HIC
counts as well as HUD's HMIS systems, we know far more about the
homeless population than the much larger rent-burdened and doubled-up
populations.
In our view, the biggest flaw of a PiT count is that it doesn't
account for the productivity of homelessness programs. For example,
casual readers might have read HUD's November 12 press release on the
2019 veterans PiT count (``Trump Administration Announces Continued
Decline in Veterans Homelessness--Since last year, 793 more veterans
now have a roof over their heads'') and failed to appreciate how hard
the veterans homelessness programs had to work in order to achieve that
increase. Because of the constant churn--veterans continuing to become
homeless due to the lack of affordable housing or for their own
personal reasons--those programs managed to house tens of thousands of
homeless veterans in 2019, in addition to the 793 for which they were
accorded public credit. In Fiscal Year 2018, for example, I understand
the total number of homeless veterans permanently housed by veteran
homelessness programs was in excess of 50,000--which does not include
family members and dependent children, let alone veterans prevented
from becoming homeless.
There is a similar churn in the non-veteran homelessness programs.
The increase in homelessness in California is much discussed. However,
it is easy to lose sight of the productivity of homelessness programs
in the Golden State. Los Angeles County manages to house 133 homeless
persons per day, a remarkable accomplishment; unfortunately, 150
persons become homeless in Los Angeles County every day. In San
Francisco, for every homeless person housed, three more become
homeless. We should be wary of judging the success or failure of anti-
homelessness efforts entirely on PiT counts. In most instances with bad
PiT counts, if we dig a little deeper, we'll learn that it is not that
the programs aren't working, it is that the programs aren't adequately
resourced to meet extraordinary demands for services, which are largely
caused by the Nation's affordable housing crisis.
The Alliance supports both the effort led by the United States
Interagency Council on Homelessness (USICH) to identify communities
making progress toward ending veteran homelessness through the
establishment of benchmarks developed by USICH, HUD, and VA, as well as
another interagency initiative known as the Mayor's Challenge to End
Veteran Homelessness. Public recognition is a cheap but powerful
incentive for our leaders to show us their best selves and for their
staffs to overcome parochial concerns that might otherwise divide them
and work together to achieve this goal.
Most importantly, both efforts remind us that ending homelessness
is possible, that we do have the right programs in place, and that we
just need to work better together to fund and implement them. When one
looks at the list of the states and localities that have been
determined, consistent with the USICH benchmarks, to have ``ended''
veteran homelessness, it is difficult to generalize about them--because
it's happening in cities, suburbs, and the countryside; it's happening
in all regions--north, south, east, and west; it's happening in red
states and blue states; it's happening in areas with lots of people as
well as less populated areas; and it's happening in wealthy localities
as well as more modest localities. Ultimately, the list shows we can
end homelessness, veteran and otherwise, in all areas of the United
States if our Federal, State, and local leaders make that objective a
higher priority--and in doing so, it is clear from the experiences of
these three states and 78 communities that we won't break the bank.
Prevention
The best way to keep the number of homeless veterans low is to
prevent veterans from becoming homeless in the first place. The
Alliance appreciates the leadership shown by this Subcommittee in
ensuring a successful transition for military personnel to civilian
life, particularly as shown by H.R. 2326, the Mulder Transition
Improvement Act, by enhancing job prospects.
The VA has been justifiably lauded for devising a set of questions
to ask veterans which can help to identify which ones are at risk of
becoming homeless. It would be helpful if a version of those questions
were asked by the Department of Defense of departing personnel prior to
discharge as well as part of a proactive follow up by VA soon after
discharge, rather than wait until a medical center's initial
interaction, in order to identify potential referrals to the veteran
homelessness programs. The Alliance commends the House and Senate
Appropriations Committees for the inclusion of a report requirement in
the Fiscal Year 2020 funding measure for VA that will help us to
understand how much more needs to be done to ensure ``servicemembers
identified through the Transition Assistance program process'' develop
viable post-transition housing plans.
Similarly, it would be helpful if more military personnel received
instruction in basic life lessons prior to discharge. Military service
requires many sacrifices, including a significant loss of personal
autonomy. Financial responsibility, including buying a home or leasing
an apartment, can be daunting and difficult for anyone, let alone
someone for whom housing was largely determined by her or his employer.
The potentially problematic transition out of controlled
environments is also a challenge for non-veteran homelessness programs.
People emerging from incarceration and hospitalization are
disproportionately vulnerable to homelessness for several reasons,
including diminished job prospects, skeptical landlords, inadequate
health care, and lack of family support, in addition to being
unprepared to make basic life decisions.
HUD-VASH: Case Management
The single biggest complaint the Alliance hears about the HUD-VASH
program is the difficulty the VA has in recruiting and retaining
caseworkers. Apparently, caseworkers can find jobs with comparable work
but better pay outside of VA. Too often, we hear, vouchers that might
be used to house chronically homeless veterans are sitting idle because
of a shortage of caseworkers. This is not a problem everywhere, but it
is enough of a problem that it is important to address.
Why should helping chronically homeless veterans be less attractive
than other casework? We need to change this culture so that HUD-VASH
casework is sought after by the very best caseworkers because of the
challenge of the work and the prestige of the clients. Perhaps the VA,
in consultation with its own caseworkers and their union
representatives as well as recognized leaders in social work, should
devise a new pay scale that more adequately compensates this workforce,
endows it with a higher status, and invests it with more prestige.
Other VA positions can receive additional pay if it can be shown there
are recruitment and retention problems--but has the necessary pay
survey been conducted for caseworkers? Are hiring or performance
bonuses appropriate? Should VA caseworkers be made eligible for
performance pay? Does VA's personnel staff need to be specially trained
to expedite at least for caseworkers the infamously lengthy Federal
hiring process? The Alliance commends the House and Senate
Appropriations Committees for the report language included in the
Fiscal Year 2020 funding measure for VA on the department's staffing
for HUD-VASH and the program's management of vouchers.
Until a more robust in-house casework capability can be
established, medical centers should be directed to at least consider
outsourcing HUD-VASH casework and be required to publicly explain why
they failed to do so if vouchers are not being used because of an
absence of Federal caseworkers. Perhaps a little transparency is all
that is needed to induce medical centers to staff up their caseworker
positions.
Finally, HUD-VASH casework should be limited to supporting a
veteran's recoveries from physical and mental illnesses and substance
use disorders in order to allow her or him to live independently in the
affordable permanent housing of her or his choosing. Identifying
landlords who will accept HUD-VASH vouchers, negotiating with those
landlords, and then cultivating them so that they will remain receptive
to the program's enrollees are functions which should be performed by
experienced housing navigators, who are usually locally grown and need
not be Federal employees. Congress and VA should work together to make
housing navigation a regular part of the HUD-VASH program. Allowing VA
caseworkers to focus exclusively on recovery, rather than real estate,
may ultimately allow them to take on more cases and make their work
more rewarding.
HUD-VASH: Cooperative Landlords
Another complaint the Alliance hears about the HUD-VASH program is
the difficulty in getting landlords to accept vouchers. Although there
are obviously outliers, the Alliance believes that landlords are just
as appreciative of the service of our veterans as other Americans and
that they genuinely want to do right by veterans enrolled in HUD-VASH.
Consequently, we favor the use of the carrot, rather than the stick.
Experienced housing navigators who actively seek out and cultivate
cooperative landlords can open up a lot of doors for veterans enrolled
in HUD-VASH. Should VA reward every landlord who houses, say, fifty
HUD-VASH veterans with a commemorative coin? Why not? Such landlords
are private actors doing their part in the promotion of a cherished
public interest. Should congressional lawmakers single out for praise
every year in one of their town hall meetings landlords who
consistently serve HUD-VASH veterans? Why not? Landlords are almost as
much a part of the recovery process for HUD-VASH veterans as VA
caseworkers and HUD vouchers. There are no doubt other ways to earn
goodwill from landlords at minimum expense. Similarly, if landlords
know that the HUD-VASH veterans they are asked to house are being
served by effective caseworkers the more likely they will be to honor
the program.
This could be an area where Members of Congress can play a
leadership role in their local communities. Members of Congress could
work with local Mayors and VA leadership to invite landlords to
participate in the program and thus be accorded public recognition.
If there continues to be problems generating support from landlords
in a particular area, we may need to look more closely at the payment
standard established by the local Public Housing Authority.
Additional Improvements VA Homelessness Programs
Allow HUD-VASH to serve more chronically homeless veterans: The
Alliance thanks the House Veterans Affairs Committee--no doubt because
of the bipartisan leadership shown by the Economic Opportunity
Subcommittee--for being the first congressional panel to mark-up H.R.
2398, legislation introduced by Representative Scott Peters (D-CA) to
allow military personnel who are discharged under the category of
``other-than-honorable'' (OTH) to be eligible for HUD-VASH benefits. We
continue to hear concerns from providers that there are homeless
veterans in their communities who need the more intense treatment
provided by HUD-VASH but who are denied access to that program because
of the status of their discharge. Given that OTH veterans are already
eligible for the GPD and SSVF homelessness programs, H.R. 2398 breaks
no precedents, and the legislation commands the strong support of
homelessness and veteran groups. Enactment of this legislation will
allow a small group of veterans, but one that is disproportionately
vulnerable to chronic homelessness, to enroll in a program that can
actually help them.
Rebuild confidence in HUD-VASH through greater transparency: HUD-
VASH is immensely popular, but it seems just about every congressional
office with whom we consult has its own administrative concerns about
the program, particularly how many vouchers are actually available in
their states and districts. The Alliance does not necessarily share all
of those concerns, but we believe that H.R. 2399, another bill
introduced by Representative Peters, would help to rebuild trust in the
program. HUD-VASH is a fine program, a shining example of how the
Federal Government can help deserving Americans. We have nothing to
fear from learning more about how HUD-VASH works. The Alliance thanks
this Subcommittee for its bipartisan leadership on H.R. 2399.
Target HUD-VASH to chronically homeless veterans: The Alliance
understands that there are homeless veterans enrolled in the program
who aren't actually chronically homeless, and that these veterans might
be more efficiently served by the less expensive SSVF program. In the
non-veteran context, the Alliance encourages providers of services to
those experiencing homelessness to employ ``Moving On'' strategies for
clients in PSH who may no longer need or want the intensive services
offered but continue to need help to maintain their housing. Any
savings generated can be used to serve more homeless veterans.
If a community has housed all or nearly all of the veterans
experiencing chronic homelessness, then additional vouchers should be
targeted at homeless veterans with severe medical conditions that
require intensive treatment (including behavioral health treatment) and
which make employment an unrealistic, short-term goal.
The Alliance does hear concerns about HUD-VASH not covering
important incidental costs, e.g., repair of a car needed for transport
to health care. Co-enrollment in SSVF and HUD-VASH should address most
of those concerns, assuming the former program is sufficiently funded.
Better serve veterans in high-cost areas: The VA is to be commended
for its ambitious Shallow Subsidy pilot program to serve homeless
veterans enrolled in SSVF who live in high cost areas through the
provision of longer housing subsidies. We are concerned about the
adequacy of funding in the program's second year. However, the Alliance
is convinced that this program enjoys strong, bipartisan support, and
that any financing concerns will be satisfactorily addressed by
Congress. Shallow Subsidy is a promising initiative--it's success would
be a very favorable precedent for non-veteran homelessness programs.
Continue to make the veterans homeless programs accessible to
different groups of veterans: This Subcommittee is playing a leading
role in attempting to ensure that the SSVF program continues to serve
the needs of women veterans and their families. Native Americans have
served in the Armed Forces in greater numbers per capita than any other
ethnic group. The Alliance strongly supports Tribal HUD-VASH,
particularly because this program can help to build new housing stock
on reservations with project-based vouchers. Veterans are becoming
older as a group and thus facing greater medical expenses. The Alliance
supports efforts to allow veterans to age in place, which should reduce
costs to VA and promote autonomy for veterans. And under the
appropriate supervision of congressional authorizers and appropriators,
the VA should be encouraged to experiment with its homelessness
programs in order to devise new and better ways to help more veterans.
As mentioned earlier, the advances achieved and the innovations
embraced by VA managers will ultimately redound to the benefit of
homelessness programs generally.
Leadership and Accountability
Finally, I will emphasize the importance of VAMC management in the
exercise of strong leadership in the fight against veteran homelessness
and holding that VAMC management accountable when it fails to exert
such leadership. Notwithstanding variations in the housing market, it
is the Alliance's view that an important factor in making substantial
progress toward a reduction in veteran homelessness in a particular
area is whether the relevant VAMC management has made veteran
homelessness a priority and insisted on allocating finite resources
accordingly. And it is incumbent upon public officials--at the local,
State, and Federal levels of government--as well as veteran and
homelessness groups to hold that VAMC leadership accountable. VAMC's
have immense workloads and limited resources, so it can be all too easy
for local management to give homelessness short shrift. The field
hearings conducted earlier this year by this Subcommittee in the
districts of the Chairman and Ranking Member were master classes in how
to put management in the relevant VAMC's on notice that ending veteran
homelessness must continue to be a top priority.
The Alliance thanks the Subcommittee for consideration of its views
as well as its bipartisan determination to end veteran homelessness.
Appendix: Housing First is a Demonstrated Best Practice
The Pathways to Housing program, one of the early versions of
Housing First, has greatly informed the field of homeless services. Sam
Tsemberis (its founder) first evaluated Pathways in 2000 and continued
to examine its results in subsequent years. The published findings
include:
Pathways to Housing: Supported Housing for Street-
Dwelling Homeless Individuals with Psychiatric Disabilities (2000)
Consumer Preference Programs for Individuals Who Are
Homeless and Have Psychiatric Disabilities: A Drop-In Center and a
Supported Housing Program (2003)
Housing First, Consumer Choice, and Harm Reduction for
Homeless Individuals with a Dual Diagnosis (2004)
Pathways participants in New York City, many of whom had mental
health and/or substance abuse challenges, largely experienced positive
housing outcomes. In the 5-year longitudinal study, 88 percent remained
housed compared to 47 percent of those in the system that required
treatment prior to housing placements.
Encouraged by these results, Canada implemented the housing first
model. It conducted a massive evaluation, encompassing five cities
(Vancouver, Winnipeg, Toronto, Montreal, and Moncton) and over two
thousand participants. After 2 years, 62 percent of the housing first
participants were housed the whole time compared to 31 percent of those
who were required to participate in treatment prior to the receipt of
housing.
In recent years, additional evaluations of housing first were
completed in multiple locations including California and New York City.
These studies have consistently found greater housing stability among
housing first participants:
Association of Housing First Implementation and Key
Outcomes Among Persons with Problematic Substance Use (2014)
Fidelity to the Housing First Model and Variation in
Health Service Use Within Permanent Supportive Housing (2015)
Materials prepared by two relevant executive branch agencies
support these findings.
The United States Interagency Council on Homelessness (USICH), in a
memorandum for local officials, describes Housing First as
``a proven method of ending all types of homelessness and (it)
is the most effective approach to ending chronic homelessness.
Housing First offers individuals and families experiencing
homelessness immediate access to permanent, affordable or
supportive housing. Without clinical prerequisites like
completion of a course of treatment or evidence of sobriety and
with a low-threshold for entry, Housing First yields higher
housing retention rates, lower returns to homelessness, and
significant reductions in the use of crisis service and
institutions...Housing First should be adopted across your
community's entire homelessness response system, including
outreach and emergency shelter, short-term interventions like
rapid re-housing, and longer-term interventions like supportive
housing.''
USICH, Housing First Checklist: Assessing Projects and Systems for a
Housing First Orientation, Updated September 2016, pages 1-2.https://
www.usich.gov/resources/uploads/asset--library/
Housing_First_Checklist_FINAL.pdf
The Department of Housing and Urban Development (HUD) emphasizes the
success of Housing First in treating the most difficult category of
homelessness:
``While the principles of Housing First can be applied to many
interventions and as an overall community approach to
addressing homelessness, permanent supportive housing models
that use a Housing First approach have been proven to be highly
effective for ending homelessness, particularly for people
experiencing chronic homelessness who have higher service
needs. Studies such as HUD's The Applicability of Housing First
Models to Homeless Persons with Serious Mental Illness have
shown that Housing First permanent supportive housing models
result in long-term housing stability, improved physical and
behavioral health outcomes, and reduced use of crisis services
such as emergency departments, hospitals, and jails.''
HUD, Housing First in Permanent Supportive Housing Brief, Published
July 2014, pages 1-2.https://files.hudexchange.info/resources/
documents/Housing-First-Permanent-Supportive-Housing-Brief.pdf
USICH explains the evidence-based rationale behind quickly connecting
those experiencing homelessness with housing and services, i.e.,
Housing First:
``Housing stability is essential for people to address their
challenges and pursue their goals. Housing and income are core
social determinants of personal health, along with the
circumstances under which people are born, grow up, live, work,
age, and access health care. Substantial evidence indicates
that when people--both adults and children alike--experience
homelessness, their prospects for future educational
attainment, employment growth, health stability, and family
preservation are significantly reduced. The lack of a safe and
stable home also results, for some people, in increased use of
crisis services, like shelter, emergency departments, detox
programs, and psychiatric institutions, and greater engagement
with other systems, like child welfare and criminal and
juvenile justice, creating significant, preventable costs for
public programs. To reduce these impacts and end homelessness
as quickly and efficiently as possible, communities are
increasingly focused on using evidence-based practices to
streamline connections to housing opportunities and to provide
people with the appropriate level of services to support their
long-term housing stability. This shift in focus to permanent
housing outcomes, driven by research on effective practices,
has helped reduce homelessness nationwide by 13 percent between
2010 and 2017, according to annual Point-in-Time counts.
``Shifting to Housing First: To improve housing outcomes,
communities are making a fundamental shift to Housing First,
removing as many obstacles and unnecessary requirements as
possible that stand in the way of people's access to permanent
housing . . .''
USICH, The Evidence Behind Approaches that Drive an End to
Homelessness, Published December 2017, page 1. https://www.usich.gov/
resources/uploads/asset_library/evidence-behind-approaches-that-end-
homelessness.pdf
[GRAPHIC] [TIFF OMITTED] T8956.001
______
Prepared Statement of Kathryn Monet
Chairman Levin, Ranking Member Bilirakis, and distinguished Members
of the House Veterans' Affairs Subcommittee on Economic Opportunity.
On behalf of our Board of Directors and Members across the country,
thank you for the opportunity to share the views of the National
Coalition for Homeless Veterans (NCHV) with you. NCHV is the resource
and technical assistance center for a national network of community-
based service providers and local, State and Federal agencies that
provide emergency, transitional, and supportive housing, food, health
services, job training and placement assistance, legal aid and case
management support for thousands of homeless, at-risk, and formerly
homeless veterans each year. We are committed to working with our
network and partners across the country to end homelessness among
veterans.
As of December 2019, 78 communities and three states have achieved
the Federal benchmarks and criteria for ending veteran homelessness.
This is important proof that building systems to end veteran
homelessness nationwide is achievable. We have seen the annual point-
in-time (PIT) count of veterans experiencing homelessness decrease by
nearly 50 percent since 2009. The 2.1 percent decrease between 2018 and
2019, when compared to the 2.7 percent increase in homelessness within
the general population in HUD's 2019 PIT Count, is largely a testament
to the dedication and hard work of local service providers, community
partners, Veterans Affairs Medical Center (VAMC) staff, and the
responsiveness of this committee, its members and dedicated staff with
regard to providing resources and oversight required to scale VA
programs responsibly.
Continued progress comes at a pace that is challenging to maintain,
requiring a dedication to surpassing the status quo. Given the 37,085
veterans experiencing homelessness on any given night according to the
latest PIT count and the ebb and flow of veterans entering and exiting
homelessness, we still have much work to do across the Nation. From
NCHV's perspective, every veteran deserves safe and permanent housing,
whether they are currently experiencing homelessness or are facing
housing-cost burdens that put them at risk of homelessness. We must
enhance and invest in efforts to ensure that homelessness is rare,
brief, and nonrecurring, for veterans and all Americans. Deep
investments in affordable housing must be paired with solid
implementation of housing-first oriented systems and housing-first
interventions in order to see true success. It is NCHV's position that
Housing First should never mean housing only. It is also NCHV's view
that shelter and services alone cannot solve this problem.
There is a solid body of research pointing to the success of
Housing First oriented interventions. VA must commit to continued
implementation of Housing First oriented systems to end veteran
homelessness and to implementing them well. Veterans have earned quick
access to permanent housing, employment, services and any resources
they request to attain housing stability. This requires communitywide
partnership to create Housing First oriented systems incorporating a
variety of housing interventions, including adequate transitional
housing options in communities where these facilities fill gaps in
services or where the housing crisis is so extreme that permanent
housing placement takes longer than it should, or where veterans
actively choose therapeutic and treatment oriented environments. We
need to recognize that successful implementation of a Housing First
model also includes access to health and mental health care, and
wraparound services like benefits assistance and employment and
training services to ensure that a placement is indeed sustainable. The
needs of veterans must come first.
HUD-VASH
Homelessness is a multifaceted and complex problem that differs for
each veteran experiencing it. One of the cornerstones of a Housing
First oriented system is the Housing and Urban Development--Veterans
Affairs Supportive Housing or HUD-VASH program, which has allowed VA to
focus resources more efficiently by pairing VA-funded case management
with a HUD-funded Section 8 voucher for the most vulnerable veterans.
We appreciate the commitment Congress has made to investing in the
creation of new HUD-VASH vouchers since 2008. NCHV applauds the
foresight entailed by this consideration, and thanks Congress for these
vouchers on behalf of the over 100,000 veterans who have been and are
currently being housed.
Yet, the simple fact remains that there is still much unmet need
across the country. A recent survey of NCHV members indicated that 86
percent of our respondent communities still had an unmet need for
permanent supportive housing and had a waitlist of veterans for HUD-
VASH. In addition, HUD's 2020 Annual Homelessness Assessment Report
indicated on any given night, over 8,700 veterans experiencing
homelessness had chronic patterns of homelessness. As such, NCHV is
calling for an increased investment in the effective HUD-VASH program
to ensure communities have sufficient resources for the most vulnerable
populations.
The affordable housing crisis in the US is widespread. It is most
acute in urban areas, particularly, in the areas of the country with
the highest concentration of homeless veterans: California, New York,
and Florida. In certain areas of the country with extremely low rental
housing vacancy rates, the ability to locate housing is the single
biggest barrier to housing veterans. For many communities experiencing
this crisis, the only way to find affordable housing in which to place
formerly homeless veterans is to develop it. HUD-VASH vouchers are a
reliable source of operating revenues that enhance a developer's
ability to obtain project financing. Vouchers must be distributed to
areas with the most acute needs and housing authorities should consider
project-basing more frequently, particularly in low-vacancy, high-cost
markets.
NCHV appreciates the ongoing congressional support for the HUD-VASH
program as evidenced by the addition of vouchers in the last several
years. However; the funds appropriated to VA for case management have
not increased in proportion to the increase in vouchers. The
challenging, complicated, and most often uncoordinated appropriations
process has an even more profound effect on interagency programs like
HUD-VASH due to their reliance on two Subcommittees to appropriate
funds to two Federal Agencies. When there is a disconnect in terms of
timing or funding levels, veterans end up paying the price due to
delayed distribution of vouchers and case managers who are stretched
thin. In addition, NCHV is focusing on how to change how HUD-VASH case
management is funded and delivered. Veterans' Affairs Medical Centers
or VAMCs have case managers who focus solely on the clinical aspects of
case management, such as mental health care and medication management,
at the expense of case management that focuses on basic tenets of
housing stability. Successful case management in permanent supportive
housing must address both clinical and housing stability aspects to
adequately support the client, and in too many instances, veterans are
not able to access that standard of care, leaving affordable housing
providers responsible for filling that gap.
NCHV makes the following policy recommendations relating to the
HUD-VASH program:
1. Case managers are the lifeblood of a permanent supportive
housing program like HUD-VASH and we know inadequate supports
can lead to negative exits from a program. VA funding
pertaining to HUD-VASH case management should be increased in
formulaic response to increases in the number of additional
VASH Vouchers each year. This can be achieved either through an
appropriations trigger mechanism, or by redesignating funding
for HUD-VASH case management as mandatory spending, just as
existing vouchers are deemed in the program. The status quo has
resulted in the unintended consequence of an unfunded mandate
placed upon the VA or worse, a mandated reduction in standards
of care provided to those most vulnerable as case managers will
exceed their mandate as the number of vouchers increases and
the number of case managers does not. Further, this creates a
disincentive for VAMC directors to support their partnering
PHA's applications for additional vouchers in their
communities. This is an ongoing issue that has lingered for
several years.
2. In instances where VAMCs are contracting with local service
providers for case management services, the exorbitant duration
of the credentialing and background check process can be
cumbersome and affects staff recruitment and retention. Several
service providers have indicated the four-to nine-month long
process their staff has to go through in order to complete the
VetPro and eQIP background and credentialing procedures make it
difficult to recruit new staff. This also makes retention
challenging, as staff is only able to shadow and learn until
the process is completed and are then provided access to CPRS.
We request that the Committee work with VA to see whether there
are any opportunities to truncate the timeline of this process.
3. Veterans who received an ``Other Than Honorable'' type of
discharge from military service are in practice ruled
ineligible for VA health or other benefits. This is true even
though many studies in recent years have shown that a large
portion of ``Other Than Honorable'' (OTH) discharges are the
result of service members behavioral changes from repeat
deployments or unaddressed Post Traumatic Stress (PTS). The
Department of Defense has acknowledged PTS as a vector to OTH
discharges and has directed review boards for discharge status
upgrades to take it into account. Despite a single-digit
percentage of America's veterans receiving OTH discharges, they
are disproportionately represented, making up 15 percent of the
homeless veteran population nation-wide. In some urban locales
the percentage of OTH veterans among the homelessness
population can rise to nearly 30 percent. NCHV strongly
supports Representative Scott Peters' legislation H.R 2398 that
will expand HUD-VASH eligibility to veterans with ``Other Than
Honorable'' discharges, cited as the ``Veteran Housing
Opportunities and Unemployment Support Extension (Veteran
HOUSE) Act of 2019,'' as well as the Senate's companion bill S.
2061. We have committed as a nation to ending veteran
homelessness - these men and women are veterans, and we must
not leave them behind.
4. HUD should release another round of Project Based Vouchers
to directly address the immediate lack of housing stock due to
the amount of time it takes to plan and develop those projects.
5. The Enhanced Use Lease (EUL) program at VA is a resource for
developers, as land is a significant driver of affordable
housing development costs. VA should consider more use of its
EUL authority to reduce its liabilities for underutilized or
vacant properties while bringing more veteran housing online.
In addition, we recommend the Asset Infrastructure Review
Commission created by the MISSION Act keep the affordable
housing needs of veterans experiencing or at-risk of
homelessness at the forefront by including homeless veteran EUL
initiatives in any Commission Charter.
6. The housing needs of veterans in Indian Country must not be
forgotten in any program that serves veterans experiencing or
at-risk of homelessness. NCHV recommends that Congress do
everything it can to support housing initiatives for Native
American, Alaska Native, and Native Hawaiian veterans,
particularly to create additional Tribal HUD-VASH vouchers.
While we support the intent of legislation introduced in both
Chambers, we are concerned that language in active legislation
would require HUD to shift 5 percent of the HUD-VASH vouchers
already allocated and in use over to Indian Country. Tribal
veterans deserve safe housing, but we are concerned that well-
meaning supporters of this legislation may not have considered
the negative impact of removing vouchers from formerly homeless
veterans who are relying on them for housing stability.
Additional investment in Tribal HUD-VASH should not come at the
expense of veterans using HUD-VASH.
While HUD-VASH remains the lynchpin of proven tried and true, data
driven Housing First methodologies, we would be remiss not to discuss
VA's Grant and Per Diem Program (GPD), given its interconnectedness
with HUD-VASH and its recent changes that create a window of
opportunity for enhancement. GPD plays a key role in providing
transitional housing and making recovery-oriented services available
for those veterans who indicate they would benefit from them.
Successful Program Transitions and Adaptability (Recapture)
Providers in several communities that have made tremendous progress
in ending veteran homelessness have raised concerns to NCHV regarding
barriers to changing their programs that arise from receiving a GPD
Capital Grant in the past. There are certain communities where the
population of veterans experiencing homelessness has decreased such
that there are significant vacancies in local GPD programs. NCHV has
heard from several providers in this situation, who are interested in
transitioning away from operating a GPD grant and into operating
permanent supportive housing, or affordable housing. They have been
told that in order to fulfil both VA real property recapture
requirements and the real property disposition requirements of the
Office of Management and Budget (OMB) including ones found in 38 CFR
61.67 / 2 CFR 200.311 / 38 USC 8136, they would need to pay the
government a percentage of the current market value of their property
to fulfil the requirements of their grants, many of which date back to
the early 1990's. Obviously, real property can appreciate dramatically
over the course of several decades and in some cases these payments are
prohibitively expensive for nonprofit service providers.
It is the view of NCHV that no grantee should face a financial
penalty for their success in achieving housing stability in their
communities. Further, grantees shouldn't be required to embark on a
capital campaign to pay the government in order to adjust their
operations to meet their community's most pressing need. We request
that Congress introduce legislation to waive both VA real property
recapture requirements and OMB real property disposition requirements
for grantees that would like to decrease the number of beds funded by
or leave the GPD program under certain circumstances. These would
include, but not be limited to, making a long-term commitment to
utilizing the property for which the grant was received to serve
homeless or at risk individuals, especially veterans, by offering
affordable permanent housing, permanent supportive housing via project
based vouchers, or other services to address housing instability. NCHV
asks for the committee's leadership on addressing this issue.
Reboot
NCHV has supported the GPD reboot, as it generated several types of
program models service providers can implement as critical parts of a
housing-first oriented system of care for homeless veterans. As
grantees have shifted to utilizing these models, we have heard
consistently that challenges have cropped up, due to the expense of
hiring higher level clinical staff with the appropriate credentials to
operate certain higher-intensity models such as clinical treatment,
hospital to home, and low demand. NCHV suggests that Congress modify
the law such that providers operating these models are eligible to
receive 125 percent of the State home per diem amount. There is
precedent for amending the per diem payment structure to accommodate
the augmented needs of the Special Needs Grant population, and the
higher costs of operating GPD Transition-in-Place beds, thus NCHV urges
Congress to take swift action to make similar changes to ensure
providers can afford to continue operating these models.
Training and Technical Assistance
As with any major change in a large Federal program, sufficient
training of grantees is required to ensure the most optimal outcomes
for veterans. We urge you in Congress to amend 38 USC 2064(a) to
expressly authorize VA to provide technical assistance to grantees on
issues related to operating their grants, national best practices, and
working collaboratively with key partners. We also respectfully request
that the expired authorization of appropriations language in 38 USC
2064(b) be modified to include $2,000,000, annually, in perpetuity for
the training of GPD grantees and contractors through the HCHV program.
Data Collection
Data is a key component of an effective community-based response to
veteran homelessness. HUD has mandated that grantees utilize a Homeless
Management Information Systems (HMIS) to coordinate local efforts to
serve people experiencing homelessness and to collect client-level data
on individuals experiencing and at-risk of homelessness, the services
and housing interventions they utilized, and the services and housing
interventions available in their communities. Data completeness
improves a community's ability to coordinate services and identify and
plan for impending trends in inflow. The SSVF program has mandated its
use for its grantees, and providers have been able to incorporate that
into their annual budgets. The GPD program has not yet mandated its
grantees to do so and many do not. The per diem payment structure does
not allow for those who may be receiving the maximum per diem payment
per bed, to do so without decreasing the standard of service to
veterans in their programs. NCHV recommends that the Committees
consider a legislative change to authorize an appropriation for a
reimbursement of reasonable HMIS user fees for GPD grantees who are
otherwise unable to access HMIS through their SSVF, Continuum of Care,
or other local grants received. The improvement in data quality will
improve community responses to veteran homelessness which in turn will
enhance outcomes and efficiencies. NCHV recommends language alterations
to Title 38 USC Section 2012 in the form of an additional section D
that could read, ``The Secretary may reimburse reasonable sums in
support of efforts to access the Homeless Management Information
Systems or HMIS for grantees that are unable to receive access through
other grant programs or government contracts.'' These changes could
improve programs across the Nation immediately by leveling the field
for smaller service providers.
In Summation
Thank you for the opportunity to submit this testimony for the
record and for your continued interest in ending veteran homelessness.
It is a privilege to work with the House Committee on Veterans' Affairs
to ensure that every veteran facing a housing crisis has access to
safe, decent, and affordable housing paired with the support services
needed to remain stably housed.
______
Prepared Statement of Greg Anglea
Introduction
The introduction of HUD-VASH in 2008, along with additional
housing-focused interventions like Supportive Services for Veteran
Families (SSVF), is directly responsible for the dramatic, nearly 50
percent reduction in Veterans experiencing homelessness over the last
decade, from 76,329 Veterans in 2010 to 37,085 in 2019, per the annual
Point In Time Count.
That's the good news. The bad news is that more than 37,000 men and
women who sacrificed to protect our country are still struggling in
homelessness. They answered the call to service, yet their country is
now failing to help them in their time of crisis. This is unacceptable.
As a Nation, we must do better.
Key Actions Requested to Make HUD-VASH Work for All Veteran
Communities:
1) Pass H.R. 2398 to Expand Eligibility for HUD-VASH to
Military Personnel Discharged with an ``Other than Honorable''
Basis
2) Increase Funding for the Supportive Services within HUD-
VASH, and Encourage Contracting with Local Service Providers
3) Establish Pilot Project to Leverage HUD-VASH with
Sustainable Income for Chronically Homeless, Disabled Veterans
Key Action #1: Pass H.R. 2398 to Expand Eligibility for HUD-VASH to
Military Personnel Discharged with an ``Other than Honorable'' Basis
The HUD-VASH program has been the most instrumental resource in
helping disabled Veterans overcome homelessness in the last decade. But
tragically, there are thousands of Veterans who are not allowed to
access this resource: Veterans with Other than Honorable (OTH)
discharges. This is despite their service to our county, and despite
their disabling conditions, which often stem from their military
service and/or contributed to their OTH discharge.
It is estimated that 10 percent of Veterans experiencing
homelessness have an OTH discharge, excluding them from accessing VA
Healthcare services and excluding them from eligibility for HUD-VASH
Permanent Supportive Housing.
Veterans like ``Mr. Brown.'' Mr. Brown received an OTH discharge
due to drug use. At the time he was in denial about his psychosis and
mental illness. Since his discharge he has been diagnosed as having
bipolar disorder with psychotic features. He has delusions of his
family history and life story. These issues were not diagnosed until
after his OTH discharge.
As a Veteran experiencing homelessness Mr. Brown is eligible for VA
transitional housing through the VA Grant & Per Diem program, which is
how my organization Interfaith Community Services in Escondido,
California met Mr. Brown during his first stay in one of our Veterans
transitional housing programs. While Mr. Brown found stability and
began to address his mental health conditions during that stay, he was
unable to secure housing or stable income. Due to his OTH discharge
status he was not eligible for HUD-VASH, and he ultimately exited to
homelessness.
Through a privately funded grant Interfaith Community Services is
able to provide mental health services for any Veteran regardless of VA
healthcare eligibility. It is through that privately funded resource we
have continued to see and support Mr. Brown even after he was exited
from our VA transitional housing program.
Mr. Brown continued to work with our counsellors over the next 2
years, maintaining sobriety despite being homeless. During that time he
applied for disability benefits but was denied, a common response among
the many disabled, homeless Veterans we serve.
Nine months ago we helped Mr. Brown re-enter our VA transitional
housing program. He actively participates in a substance abuse recovery
group, continues his sobriety, and recently secured part-time
employment as a cook. His path out of homelessness remains doubtful
though, as he is only eligible for SSVF, a short-term rental assistance
program. With his current very-limited income, multiple disabling
conditions, inability to secure disability benefits, and ineligibility
for HUD-VASH, he will struggle to maintain independent living without
the longer-term housing subsidy HUD-VASH would provide.
Sadly, Mr. Brown's story exemplifies a growing group of disabled,
homeless Veterans falling through the gaps, living, and even dying, on
the streets of the country they sacrificed to protect.
Nearly 7 percent of all OEF/OIF/OND Veterans have received OTH
discharges. According to the Department of Defense approximately 7,700
service members are discharged OTH each year. A 2017 Government
Accountability Office Report found that among the 91,764 service
members who received a misconduct separation between 2011 - 2015, 62
percent were diagnosed with Traumatic Brain Injury (TBI) or Post
Traumatic Stress Disorder (PTSD) within 2 years. Of those, 23 percent
received an OTH discharge, making them ineligible for VA healthcare
benefits. That's 12,283 Veterans in just 5 years who have a diagnosed
TBI or PTSD, received an OTH discharge, and are therefore ineligible
for both VA Healthcare benefits and should they ever become homeless,
HUD-VASH.
To be clear we have the proven-effective interventions that have
reduced homelessness nearly 50 percent nationwide, and we have the
resources as a country to extend those interventions to Veterans
homeless today, yet we deliberately and purposefully withhold those
lifeline resources from Veterans who need them. This is unacceptable
and must be changed.
Expand eligibility for HUD-VASH to include ``Other than Honorable''
discharges. Support and pass H.R. 2398.
Key Action #2: Increase Funding for the Supportive Services within
HUD-VASH, and Encourage Contracting with Local Service Providers
In San Diego and in other communities, a lack of supportive
services staff result in under-utilization of HUD-VASH vouchers.
Without the staff to work with individual Veterans to help them secure
housing and then be successful in that housing, HUD-VASH vouchers
cannot be assigned to Veterans in need. Housing vouchers lie dormant
while Veterans meeting HUD-VASH qualifications sleep on our streets.
Interfaith Community Services operates the only VA-funded
Recuperative Care program in San Diego County for Veterans experiencing
homelessness and being discharged from local hospitals. Despite stays
at our Recuperative Care Center of up to 3 months, no Veteran has been
able to qualify for and be matched with a HUD-VASH resource during
their time in program this last year. Local staffing shortfalls
lengthen the approval and matching process, creating wait-lists, and
resulting in a process that takes many months and often more than a
year to connect eligible Veterans in crisis to HUD-VASH.
Furthermore, when Veterans are enrolled in HUD-VASH, the amount of
supportive services provided through VA funding alone is often
insufficient. This is the result of insufficient Federal funding to
local VA Health Centers to provide needed supportive services staff.
A Veteran I will call ``Mr. Jones'' entered our VA transitional
housing program in January 2019. He had already been approved and
enrolled in HUD-VASH, but had yet to secure permanent housing, and
entered our transitional housing with no income and a long history of
mental illness. He was very suspicious of the VA, so he refused to seek
treatment or medication to address those challenges. Thankfully, his
HUD-VASH VA case manager and Interfaith Community Services'
transitional housing case manager communicated regularly to ensure that
the Veteran was taking steps forward toward permanent housing. Mr.
Jones was also willing to engage with our organization's mental health
clinician, because that clinician was outside the VA, to address some
of his paranoia about moving forward with VA support. Because of the
client's mental health challenges he was unable to find employment
while in our program, but his HUD-VASH and Interfaith Community
Services case managers were able to help Mr. Jones move into a new
permanent housing project that opened up in San Diego, where the client
has been living successfully since last June. Mr. Jones still has not
gotten mental health treatment since entering permanent housing, but he
has the support of monthly check-ins from his HUD-VASH VA case manager
and has been able to sustain his housing.
Mr. Jones is a success story today. However it took local service
provider resources contracted by the VA, in partnership with direct VA
resources, to get him to where he is now, safe and no longer homeless.
He would benefit significantly though from an increased level of
support. Once a month check-ins from a VA social worker may be
insufficient long-term.
Increased funding to strengthen the amount of supportive services
offered to HUD-VASH Veterans will further increase long-term success.
Encouraging local VA Health Centers to contract HUD-VASH services with
local, trusted and proven-effective service providers, will further
expand care and deliver services at lower costs to taxpayers.
Key Action # 3: Establish Pilot Project to Leverage HUD-VASH with
Sustainable Income for Chronically Homeless, Disabled Veterans
The following program proposes a regionally coordinated effort to
help disabled Veterans experiencing homelessness to secure the
Supplemental Security Income (SSI) / Social Security Disability
Insurance (SSDI) assistance they are entitled to, expediting a very
complicated application process, improving application approval rates,
and through linkage to HUD-VASH, ending their homelessness.
Interfaith Community Services proposes a pilot project to combine
the proven-effective national SSI/SSDI Outreach, Access and Recovery
(SOAR) program to provide sustainable revenue for disabled Veterans,
with the stable permanent supportive housing offered by HUD-VASH. SOAR
is a best practice supported by the Substance Abuse and Mental Health
Services Administration (SAMHSA). SOAR case managers represent clients
as appointed representatives and waive all monetary fees, communicate
with local Social Security Administration field offices and Disability
Determination Services, collect medical records to help expedite the
decision, and summarize the client's medical records, highlighting the
most important information through a Medical Summary Report, in
cooperation with medical professionals from the partnering federally
Qualified Health Centers.
The target population for SOAR case management support are adults
who are experiencing or at risk of homelessness and have a mental
illness, medical impairment, and/or a co-occurring substance use
disorder. This pilot project would focus on Veterans who meet the above
eligibility criteria. Many Veterans are not eligible for benefits such
as VA pension (due to era of service) or health supports (due to nature
of discharge) and remain homeless when they are no longer able to work.
Interfaith Community Services is currently working with a veteran
we will call ``Mr. Santiago,'' who has an OTH discharge, PTSD,
struggles to maintain employment, and has been homeless for many years.
Mr. Santiago was in our VA transitional housing program three years
ago. He was able to gain a minimum wage job that allowed him to earn
enough to receive temporary rental assistance from the VA (via SSVF),
and exited our program successfully with SSVF support in 2017.
Unfortunately, about a year after his SSVF funding ran out his previous
issues came back to the surface and he ended up homeless again, once
again requiring the services of our transitional housing program. When
Veterans like Mr. Santiago are not eligible for HUD-VASH or VA
healthcare, once their SSVF funding runs out, so does the additional
case management support to assist in emotion management and long-term
planning. It is clear the Mr. Santiago needs ongoing support. The pilot
project we are proposing would help him secure disability benefits to
provide sustainable income, while also coordinating and connecting to
primary care and mental health services. A pilot project to also
combine HUD-VASH housing support would further demonstrate the positive
impact and long-term community savings of safe, stable housing. Without
these resources there is no clear mechanism to provide continuity of
care for Mr. Santiago.
The SOAR framework is proven to increase rates of success for
individuals suffering with multiple disabilities, but in reality there
are no SOAR-trained case managers with availability to help disabled
Veterans who, like Mr. Santiago or Mr. Brown, are significantly
disabled yet unable to secure disability benefits on their own. We
propose and request the testing of a focused pilot project for disabled
Veterans, providing SOAR case managers exclusively for Veterans to
secure entitled disability income, and HUD-VASH to provide housing. We
believe the results will demonstrate cost-savings to tax payers and
most importantly lives saved and enriched for the disabled men and
women who have served our country.
Conclusion and Summary
Launch of HUD-VASH and other housing-focused VA
interventions has reduced Veteran homelessness by nearly 50 percent in
the last decade
Yet more than 37,000 Veterans remain homeless in our
country
Some are not allowed to access the resources, like HUD-
VASH, that have proven effective for others
o Key Action #1: Pass H.R. 2398 and expand access to HUD-VASH
Others need a higher level of supportive services than
HUD-VASH currently provides, and many suffer on waiting lists as a lack
of staffing prevents awarded housing vouchers from being used
o Key Action #2: Increase funding for HUD-VASH supportive
services staff, and encourage local VA Health Centers to
contract with community providers to overcome staffing
shortfalls and help Veterans who are homeless today
Disabled homeless Veterans struggle to obtain the benefit
income they are entitled to
o Key Action #3: Explore the untapped possibilities of
leveraging SOAR disability benefits access with HUD-VASH to
help disabled, chronically homeless Veterans secure sustainable
income and safe, permanent, supportive housing
Thank you for your time today, for inviting me to share our
experiences and expertise helping Veterans overcome homelessness. I
look forward to and offer anything that Interfaith Community Services
or myself can do to help this committee in your work.
______
Prepared Statement of Tamera Kohler
Introduction
My name is Tamera Kohler, I am the Chief Executive Officer of the
Regional Task Force in the Homeless (RTFH) for the San Diego area. On
behalf of our Board of Directors and members, I thank you for the
opportunity to share our views with you this morning. The Regional Task
Force on the Homeless is the Housing and Urban Development (HUD)
Continuum of Care (CoC) for San Diego County, the second-largest county
in the State of California. We have a large geographic area and
population, for context the population in San Diego County is nearly
3.5 Million, a population larger than 22 of the states in the Nation.
We are one of over 400+ CoC across this Nation designed to promote
a community-wide commitment to the goal of ending homelessness; provide
funding for efforts by nonprofit providers, and State and local
governments to quickly rehouse homeless individuals and families while
minimizing the trauma and dislocation caused to homeless individuals,
families, and communities by homelessness; promote access to and effect
utilization of mainstream programs by homeless individuals and
families; and optimize self-sufficiency among individuals and families
experiencing homelessness.
We work collectively with our funding partners, such as the
Veterans Administration (VA) and local housing authorities to tailor a
local homeless crisis response system through data-driven planning,
purposeful collaboration, targeted aligned resources and coordination
of efforts while providing guidance and technical assistance around
proven evidence-based practices and emerging promising practices to
effectively and efficiently use resources to address and alleviate
homelessness. This includes all efforts undertaken with local, State
and federally funded agencies, faith-based organizations, non-profit
organizations, health organizations, and others. These programs provide
outreach, prevention, diversion, emergency shelter, transitional
housing, short term rental assistance, housing subsidies and permanent
supportive housing along with food, health services, employment
services, connection to social services, legal aid and case management
support for thousands of homeless in our region, both sheltered and
unsheltered, those at-risk, and formerly homeless each year.
I appreciate the opportunity to focus on Veteran homelessness in
this statement. Specifically, to examine access to HUD-VASH in urban,
suburban, rural, and tribal communities and work to determine where
bottlenecks exist in delivering resources in communities of all sizes.
What we know about veteran homelessness nationally:
In 2018 Point-In-Time (PIT) estimates no less than 73,878 veterans
are experiencing homelessness on any given night, with 38 percent
unsheltered.
What we know about veteran homelessness in California:
California accounted for just under 30 percent of all veterans
experiencing homelessness in the United States (29 percent or 10,836
veterans) and half of all unsheltered veterans (7,214 veterans)
according to 2018 PIT estimates.
With these numbers in mind, I will focus my statement and testimony
on two areas around where bottlenecks tend to be present to access HUD-
VASH vouchers in our communities; referrals from VA to Housing
Authorities and limited eligibility for homeless veterans for VA
assistance with HUD-VASH.
Focus: Insufficient referrals from the VA to Housing Authorities
Without question one of the most impactful and successful
coordinated efforts to address homelessness has been the partnership
between HUD and VA in the VASH voucher programs. This single dedicated
resource has reduced the numbers of veterans significantly with nearly
a 50 percent reduction since 2009. In our region we are experiencing a
significant challenge with insufficient referrals to fully utilize the
VASH programs.
In coordination with our largest Housing Authority in the Region,
San Diego Housing Commission (SDHC), I am sharing the following data
SDHC prepared and their recommendations as of the date of this hearing.
SDHC is strongly focused on this issue, holding discussions with both
regional and Federal leaders at the VA as well as State and Federal
legislators.
SDHC has approximately 354 unutilized VASH vouchers, approximately
31 percent of their total VASH allocation of 1,117 vouchers. Challenges
in our jurisdiction include:
The U.S. Department of Veterans Affairs (VA) San Diego
Healthcare system averaged nine referrals per month to SDHC for VASH
vouchers in Fiscal Year 2019 (July 1, 2018 - June 30, 2019). These VA
referrals are insufficient to increase the utilization rate or keep up
with the attrition rate, which averaged eight households per month in
Fiscal Year 2019.
SDHC is concerned about this shortage of VA referrals because of
the clear need for permanent housing resources in the city of San
Diego:
The 2019 regional Point-in-Time Count identified 810
veterans experiencing homelessness--472 sheltered and 338 unsheltered.
In addition, regional Coordinated Entry System (CES) assessments in the
past 18 months identified 840 veterans experiencing homelessness in
need of housing.
Currently, as the need for these resources remains, VASH vouchers
go unutilized because of few referrals to the program. A 6-month review
of homeless veterans referred for VASH voucher to the VA through CES
managed by the RTFH shows from April -September 2019, 192 referrals
were made to the VA with 91 declines or a decline rate of 50 percent.
This data was verified by our partners at VA with over 50 percent of
those declines solely due to VA eligibility requirements, including
prioritization eligibility. The CES does not have the ability to track
the referrals from the VA to the Housing Authorities (HA) such as SDHC.
There is a gap in the time and number of referrals from CES
referral acceptance to assignment for referral to the HA for VASH. The
HA have cited this may be due to staffing of supportive services and
level of care required by the VA.
Focus: Limited eligibility for homeless veterans for VA assistance with
HUD-VASH
With a high concentration of homelessness among military veterans
locally, San Diego has a more significant need to identify housing
solutions for veterans experiencing homelessness than other
communities.
SDHC has recommended the following actions to Federal VA Leadership
for SDHC to maximize the utilization and impact of VASH vouchers to
provide housing for veterans experiencing homelessness in the city of
San Diego:
1. Reduce barriers to ending a veteran's homelessness by
expanding VASH eligibility:
-Eliminate the time-served requirement.
-Include veterans discharged under conditions other-
than-honorable, but not dishonorable, in the
eligibility criteria.
-Eliminate VA healthcare eligibility requirement.
2. To ensure needed resources are available to maximize VASH
utilization, outsource Case Management:
-VA outsource case management, including referrals.
-Permit SDHC to administer and contract out supportive
services from community-based organizations.
Organizations would make referrals for VASH (in
coordination with Regional CES data, Supportive
Services for Veteran Families (SSVF) providers, and
outreach teams) and provide services.
3. Allow SDHC to use VASH vouchers to provide housing for
veterans experiencing homelessness, regardless of the
supportive services they receive.
-SDHC's voucher utilization rate for non-VASH vouchers
exceeds 100 percent.
-SDHC voucher households obtain housing within 60 days,
on average.
-SDHC's Landlord Engagement and Assistance Program
(LEAP) and other initiatives create additional
opportunities to identify housing for veterans with
VASH vouchers.
-The average turnover rate of 60-80 households per
month among all SDHC voucher households will enable
SDHC to accommodate all of the referrals it receives
from the VA for VASH vouchers.
The underutilization of VASH vouchers was specifically cited as an
area for immediate consideration in the City of San Diego Community
Action Plan on Homelessness, approved unanimously by the San Diego City
Council on October 14, 2019. (On behalf of the city of San Diego, SDHC
contracted with the Corporation for Supportive Housing to develop this
plan).
This Community Action Plan on Homelessness further identified that
with more efficient use of veteran's resources, specifically VASH
vouchers, ending veteran homelessness in San Diego is an attainable
goal within reach in the next 3 years. SDHC, the city of San Diego and
the Regional Task Force on the Homeless seek the support of the VA to
achieve this goal.
Our partner at the VA, Dr. Robert Smith, Director of VA San Diego
Healthcare System Veteran Health Administration (VHA) stated in his
written statement for the August 2019 field hearing that they support
all efforts to increase Homeless Veteran HUD-VASH prioritization
eligibility.
Additional factors in San Diego County suburban and rural areas-
Housing affordability/tight rental market:
With rents rising much faster than wages, the burden of affording
rent is looming larger and larger for many veterans, especially those
that are aging and on fixed incomes, and, in some cases becoming
insurmountable. According to the Zillow Group Consumer Housing Trends
Report 2018, 8 out of 10 renters or 79 percent of renters who moved in
the last 12 months experienced an increase in their monthly rent before
moving to a new place. Over two-thirds (67 percent) said that hike was
a factor in pushing them out the door and into another rental.
Nearly a third (30 percent) of households nationwide, representing
roughly 73 million adults, report they're struggling or just getting by
financially. Most extremely low-income Americans spend greater than 50
percent of their income on rent. Increasingly, major metro areas are
becoming out of reach for those who aren't earning more than minimum
wage, and this is becoming increasingly true even in markets that have
historically been more affordable. This is especially difficult for
those on fixed incomes. A majority of renters (79 percent) report
living with others. This is very true in the high cost tight rental
market in San Diego County.
As an example, according to the National Low-Income Housing
Coalition, San Diegans need an income of nearly $30 an hour to afford a
1 bedroom unit at 30 percent of their income. San Diego County's
average rent hit an all-time high in September of $1,960 a month, as
reported from MarketPointe Realty Advisors. The lowest vacancy rate in
the county in September was 1.5 percent for apartments costing $1,200
to $1,299 a month. These are traditionally the units veterans are
looking to lease with vouchers.
In our regions Point-in-Time count survey the question was asked,
what do you need to end your homelessness? 60 percent stated a rental
subsidy or financial assistance. Increases in rent, tight rental
markets and limited housing stock all contribute to the difficulty
finding adequate and affordable housing and our Homeless Management
Information System (HMIS) data shows higher than the national average
returns to homelessness after housing assistance due to unaffordable
rent without assistance.
This high cost, tight rental market makes it extremely difficult
for veterans with vouchers to find rental units. In this type of market
conditions there is a need to assist veteran in navigating the market
and working with landlords.
Aging homeless veteran population:
Older Veterans are expected to be a majority of the population of
Veterans who experience or are at risk of homelessness in the coming
years. As members of this group get older, they are likely to have
increasingly complex and age-related needs. Among participants in the
VA's transitional housing programs, a significantly greater proportion
of Veterans age 55 or older have serious medical problems, compared to
younger Veterans, making them especially vulnerable to experiencing
negative consequences related to homelessness.
Homeless veterans are not just aging, their needs are vastly
different than younger veterans. With the greater numbers of Elderly
Homeless Veteran come significantly different challenges than our
system has been designed to serve. Long term healthcare issues and
independent living options will become greater challenges and housing
options more limited. Attention to this emerging urgent need is needed
by both the VA and HA as well as the HUD CoC Homeless system. This
again speaks to efforts to increase Homeless Veteran HUD-VASH
prioritization eligibility and consideration of level of supports
outside of current models.
Data from the RTFH Homeless Management Information System (HMIS)
for the San Diego CoC shows significant increases in our population
over the age of 62 in just 2 years. In the 1st quarter of 2017, 1 in 5
or 20 percent of veterans were 62 or older, 2 years later in the 1st
quarter of 2019, 1 in 4 or 26 percent of veterans are now 62 or older.
Additionally, during this same timeframe in 2017, 12 percent of
those served with SSVF Rapid Rehousing were 62 or older, in 2019 it has
increased to 18 percent. We need more permanent housing resources and
options for elderly homeless veterans who are currently being served by
short term SSVF.
Focus: Building on Success
A significant measure of success has been achieved through the
impactful partnership between HUD and the VA in the VASH voucher
programs. To address the underutilization of our VASH programs, RTFH
supports the Expanding Access options of H.R. 2398. This proposed
legislation will allow additional vulnerable chronically homeless
Veterans to receive much needed HUD-VASH vouchers and case management.
As our regional VA office noted that in expanding eligibility, VA and
HUD will need to coordinate to ensure responsible program
implementation in order to maintain continued quality of care and
success of the HUD-VASH program. RTFH also supports H.R. 2399
transparency in HUD-VASH.
Focus: Data-driven decisions
Despite these areas of success, we are missing critical information
on the characteristics and needs of Veterans who experience unsheltered
homelessness to better tailor and target strategies and resources. We
need greater data collected by outreach on the unsheltered population.
We need to better understand the risk factors for returns to
homelessness among Veterans being served by the HUD-VASH and SSVF
programs and more data on the numbers of Veterans experiencing
homelessness who have dishonorable discharges or are otherwise not
eligible for VHA health care services.
Conclusion
Thank you to the committee for inviting me to again speak on this
issue. I will restate my conclusion from my previous statement in
August 2019. Nowhere is the struggled more real than here in California
as those experiencing homelessness tonight are more likely to be
unsheltered than sheltered or housed. We must acknowledge there are
continuing and growing serious issues and major challenges in this work
and it will take our best efforts, collectively and individually to dig
deeper, to stretch our understanding, and test our assumptions, and be
bold in our determination and decisions. We must not be afraid to act,
to learn, analysis and coordinate at the system level not only as
individual programs or funding sources but as leaders too. We need to
be nimble and act with urgency to address local homeless issues and
scale up proven practices that the data shows are effective. We must
fully utilize all of the resources we have as efficiently and as
collaboratively as possible. We ask this committee to continue to work
to increase access to these dedicated resources to serve veterans so
their homelessness may be rare, brief and nonrecurring. We need to
return dignity to our citizens and communities, and remove the
demoralizing effects homelessness has on communities that struggle to
meet the needs of its most vulnerable citizens and veterans.
______
Prepared Statement of Gary Cooper
Good Afternoon. My name is Gary Cooper, and I am the Chairman of
the Board of Directors of the National American Indian Housing Council.
I am a citizen of the Cherokee Nation, and I currently serve as the
Executive Director of the Housing Authority of the Cherokee Nation. I
would like to thank Chairman Levin, Ranking Member Bilirakis and all
committee members for having this hearing today and for including
tribes in this discussion regarding the HUD-Veteran Affairs Supportive
Housing (HUD-VASH) program.
The NAIHC is comprised of 289 voting members that represent 496
tribes and tribally designated housing entities across the United
States. The NAIHC was established in 1974 to advocate on behalf of
tribal housing programs and now NAIHC also provides vital training and
technical assistance to increase the managerial and administrative
capacity of tribal housing programs.
Background on the National American Indian Housing Council
The NAIHC was founded in 1974 and for over four decades has
provided invaluable Training and Technical Assistance (T&TA) to all
tribes and tribal housing entities; provided information to Congress
regarding the issues and challenges that tribes face in their housing,
infrastructure, and community development efforts; and worked with key
Federal agencies to ensure their programs' effectiveness in native
communities. Overall, NAIHC's primary mission is to promote and support
American Indians, Alaska Natives and Native Hawaiians in their self-
determined goal to provide culturally relevant and quality affordable
housing for Native people.
The membership of NAIHC is comprised of 289 members representing
496 \1\ tribes and tribal housing organizations. NAIHC's membership
includes tribes and tribally designated housing entities throughout the
United States, including Alaska and Hawaii. Every member of this
Committee serves constituents that are members of NAIHC, either
directly through tribes located in your Districts, or generally through
the United States government-to-government relationship with all tribes
within the United States. NAIHC's members are deeply appreciative of
your work to improve the lives of veterans throughout the Country. As
many of you know, Native Americans have historically served in the
United States Armed Forces at the highest rate of any other
demographic.
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\1\ There are 573 federally recognized Indian tribes and Alaska
Native villages in the United States, all of which are eligible for
membership in NAIHC. Other NAIHC members include state-recognized
tribes eligible for housing assistance under the 1937 Housing Act and
that were subsequently grandfathered in under the Native American
Housing Assistance and Self-Determination Act of 1996, and the
Department of Hawaiian Home Lands, the State agency that administers
the Native Hawaiian Housing Block Grant program.
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Profile of Indian Country
There are 573 federally recognized Indian tribes in the United
States. Despite progress over the last few decades, many tribal
communities continue to suffer from some of the highest unemployment
and poverty rates in the United States. Historically, Native Americans
in the United States have also experienced higher rates of substandard
housing and overcrowded homes than other demographics.
The U.S. Census Bureau reported in the 2017 American Community
Survey that American Indians and Alaska Natives were almost twice as
likely to live in poverty as the rest of the population--25.4 percent
compared with 13.4 percent. The median income for an American Indian
Alaska Native household is 30 percent less than the national average
($40,315 versus $57,652).
In addition, overcrowding, substandard housing, and homelessness
are far more common in Native American communities. In January 2017,
the Department of Housing and Urban Development (HUD) published an
updated housing needs assessment for tribal communities. According to
the assessment, 5.6 percent of homes on Native American lands lacked
complete plumbing and 6.6 percent lacked complete kitchens. These are
nearly four times than the national average, which saw rates of 1.3
percent and 1.7 percent, respectively. The assessment found that 12
percent of tribal homes lacked sufficient heating.
The assessment also highlighted the issue of overcrowded homes in
Indian Country, finding that 15.9 percent of tribal homes were
overcrowded, compared to only 2.2 percent of homes nationally. The
assessment concluded that to alleviate the substandard and overcrowded
homes in Indian Country, 68,000 new units need to be built.
Since the Native American Housing Assistance and Self-Determination
Act (NAHASDA) was enacted in 1996, tribes have built over 37,000 new
units according to HUD. However, as the IHBG appropriations have
remained level for a number of years, inflation has diminished the
purchasing power of those dollars, and new unit construction has
diminished as tribes focus their efforts on unit rehabilitation. While
averaging over 2,400 new unit construction between Fiscal Year 202007
and 2010, new unit construction has dropped in recent years with only
2,000 new units between 2011 and 2014, and HUD estimating less than
1,000 new units in future years as tribes maintain existing housing
stock.
Tribal HUD-VASH
HUD-VASH was first established in 2008 to better help homeless
veterans by combining HUD rental assistance to homeless veterans with
case management and supportive clinical services provided through the
VA. While Native American veterans were generally eligible for the HUD-
VASH program, they could only receive HUD-VASH assistance through
public housing agencies (PHA), as tribes and tribally designated
housing entities (TDHE) were not eligible to receive HUD-VASH funding
or vouchers directly. This left a gap in service to many Native
American veterans, as many Native Americans often look first to their
tribe for needed services and would not necessarily be aware to, or may
be reluctant to, request services from PHAs. An additional gap existed
as many PHAs do not necessarily serve individuals living within a
tribe's reservation or service area, as those individuals would
primarily be served by the tribe or its tribally designated housing
entity (TDHE).
To address this gap, tribal leaders and tribal housing
professionals advocated for an expansion of the HUD-VASH program to
include funding to tribes. Congress eventually responded by creating a
demonstration Tribal HUD-VASH program with a $4 million set aside from
Fiscal Year 202015 appropriations. HUD and the VA announced the
establishment of the demonstration program in January 2015. After some
consultation with tribes, HUD invited 30 tribes to participate in the
demonstration program, and in March 2016, 26 tribes were awarded
initial tribal HUD-VASH grants.
The participating tribes have had varying levels of success with
their implementation of the HUD-VASH program. End of Fiscal Year
reports from 2018 and 2019 show that the 26 tribes in the demonstration
have held steady at serving approximately 350 veterans each year.
Measuring success has often included looking at the percentage of
housed veterans against the total level of funding appropriated. When
the total number of veterans expected to be served is shown as 500,
that level of success seems low at 69 percent. However, in 2018, HUD
and the VA were measuring the number of housed veterans against the
lower number of ``active allocations'' based on the decreased
appropriation for that year, and the percentage shows a better success
rate of 92 percent.
Further, any attempt to reduce funding to Tribal HUD-VASH or deem
the program unsuccessful based on these year end numbers overlooks two
important facts. First, there are over 550 other federally and state-
recognized tribes that could serve veterans in their communities if
given access to the program. Second, many, if not all, of the 350
veterans served annually by the participating tribes would not have
received these services if not for the Tribal HUD-VASH program.
Success can also be seen in the number of veterans housed upon exit
from the program. While data seems to be differ, one report provided by
the VA at the February 2019 NAIHC Legislative Conference showed that 45
of 56 veterans (80 percent) who exited the program prior to 2/11/2019
were housed on exit, either with permanent, temporary, or in a
treatment setting. Finally, while the year-end reports show tribes
holding steady with the total number of veterans housed through the
Program, it does not necessarily capture the full total number of
veterans that program has served over time. For instance, the Cherokee
Nation has served over 40 veterans in total since the demonstration
program began, while the year-end reports only ever show the number of
veterans actively being served at the time of the report.
One of the initial barriers was the lack of case managers from the
VA that were able to serve individuals in tribal communities. Many of
the tribal communities participating in the demonstration program are
rural and do not have nearby access to VA hospitals or clinics. This
has improved, through a combination of relaxing the qualifications
required to be a case manager within the tribal HUD-VASH program and
including tribes in the process to identify and hire qualified case
managers.
A second common obstacle is the severe shortage of housing options
available within the tribal communities. This issue is not specific to
HUD-VASH housing needs, as a 2017 HUD report found that tribal
communities together require 68,000 new units to replace substandard
and/or overcrowded homes. Tribes that have been the most successful in
utilizing the HUD-VASH funding have found housing options outside the
reservation or away from tribal communities. Nearly all tribes own and
manage their own housing stock, but often these are fully utilized
through a tribe's regular low-income rental assistance program with
many having extensive wait-lists.
Additionally, many tribally owned housing units that could be used
for HUD-VASH recipients also contribute to the formula that determines
the tribe's level of assistance through the Indian Housing Block Grant.
HUD has made the determination that a tribe must remove the unit from
its formula count if it applies the HUD-VASH subsidy to that unit. This
creates a disincentive to the Tribe on both an administrative and
funding level. While HUD has maintained that a tribe could place the
unit back into its formula count once the HUD-VASH subsidy is removed
from the unit, many tribes are reluctant to go through the
administrative steps to do so. HUD-VASH funding was also seen as a
mechanism to provide additional resources to tribes to specifically
help a subset of their members but doing so using existing tribally
owned units essentially negates the HUD-VASH funding as a net positive
resource.
Other barriers reported by tribes include finding eligible veterans
(particularly those able to travel distances needed for case
management), changes in TDHE staff and expertise, lack of privately
owned rental stock available to tribal veterans, and a lack of
resources for ancillary housing needs, such as transportation,
furniture, supplies etc.
One key difference that may need to be addressed moving forward is
how funding for veterans in the program is treated year to year. In the
larger HUD-VASH program, veterans added to the program each year are
often re-characterized or added in the next year to a PHA's allocation
of funding for normal tenant-based vouchers. In essence, each Fiscal
Year Congress is adding appropriations for new HUD-VASH vouchers that
can serve newly identified veterans in need. In the tribal context,
annual appropriations for tribal HUD-VASH must continue to serve the
same veterans in the program each year, as new funds are not added to a
tribe or TDHE's overall funding level similar to a PHAs increased
voucher funding.
S. 257 & H.R. 2999 , the Tribal HUD-VASH Act of 2019
NAIHC supports the bills that have been introduced this Congress to
improve and expand the Tribal HUD-VASH program. S. 257 has already
passed the Senate this Congress, and we urge all members of the House
to support and pass the bill so it can be enacted. H.R. 2999 is a
bipartisan companion bill, and currently both are pending with the
House Financial Services Committee.
The bill would codify and make permanent the Tribal HUD-VASH
program within the larger HUD-VASH program and ensure funding for the
program. The bill would make all tribes and their tribal housing
programs eligible for the HUD-VASH program, which to date has remained
limited to the original 26 recipients. The bill would also call on the
Indian Health Service to assist the program as requested by the HUD or
VA. Primarily, the bill is intended to give the Secretaries of HUD and
the VA the flexibility to make further improvements to the program to
overcome the obstacles the tribes and agencies have identified.
The flexibility provided to the agencies by the bill would allow
the VA and HUD to address the two primary concerns that NAIHC has heard
regarding HUD-VASH implementation: the lack of case managers the VA can
identify willing or able to work in tribal areas, and the restrictions
placed on certain tribal housing units by HUD that make them ineligible
for VASH vouchers. Many communities have housing shortages and limiting
the housing stock that can be used in the tribal HUD-VASH program
forces some of the participating tribes to house their tribal veterans
in nearby urban areas, rather than the tribal community as intended by
the program.
NAIHC wants to thank the Members of Congress who have introduced,
sponsored and supported the HUD-VASH program and legislation. After
passing the Senate in the 115th Congress, the Tribal HUD-VASH Act was
nearly passed by the House but was pulled from the suspension calendar
just prior to the end of the year. Being passed by the Senate and
initially placed on the suspension calendar shows the level of
bipartisan support the Tribal HUD-VASH program and bill enjoy. NAIHC is
hopeful that the bill, having been passed by the Senate again, can
finally be passed by the full House this Congress and enacted into law.
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