[Senate Hearing 118-214]
[From the U.S. Government Publishing Office]


                                                        S. Hrg. 118-214


       THE FEDERAL STRATEGIC PLAN TO PREVENT AND END HOMELESSNESS

=======================================================================

                                HEARING

                               BEFORE THE

                            SUBCOMMITTEE ON
           HOUSING, TRANSPORTATION, AND COMMUNITY DEVELOPMENT

                                 OF THE

                              COMMITTEE ON
                   BANKING,HOUSING,AND URBAN AFFAIRS
                          UNITED STATES SENATE

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             FIRST SESSION

                                   ON

    REVIEWING THE UPDATED FEDERAL STRATEGIC PLAN TO PREVENT AND END 
HOMELESSNESS, DISCUSSING RECENT ACTIONS TAKEN BY AGENCIES ON THE ISSUE 
 OF HOMELESSNESS IN AMERICA, AND EXPLORING TOPICS RELATED TO RELEVANT 
                         LEGISLATIVE PROPOSALS
                               __________

                             MARCH 8, 2023
                               __________

  Printed for the use of the Committee on Banking, Housing, and Urban 
                                Affairs
                                
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                Available at: https: //www.govinfo.gov /
                               __________

                    U.S. GOVERNMENT PUBLISHING OFFICE
                    
54-550 PDF                WASHINGTON : 2024   

            COMMITTEE ON BANKING, HOUSING, AND URBAN AFFAIRS

                       SHERROD BROWN, Ohio, Chair

JACK REED, Rhode Island              TIM SCOTT, South Carolina
ROBERT MENENDEZ, New Jersey          MIKE CRAPO, Idaho
JON TESTER, Montana                  MIKE ROUNDS, South Dakota
MARK R. WARNER, Virginia             THOM TILLIS, North Carolina
ELIZABETH WARREN, Massachusetts      JOHN KENNEDY, Louisiana
CHRIS VAN HOLLEN, Maryland           BILL HAGERTY, Tennessee
CATHERINE CORTEZ MASTO, Nevada       CYNTHIA LUMMIS, Wyoming
TINA SMITH, Minnesota                J.D. VANCE, Ohio
KYRSTEN SINEMA, Arizona              KATIE BOYD BRITT, Alabama
RAPHAEL G. WARNOCK, Georgia          KEVIN CRAMER, North Dakota
JOHN FETTERMAN, Pennsylvania         STEVE DAINES, Montana

                     Laura Swanson, Staff Director

               Lila Nieves-Lee, Republican Staff Director

                       Elisha Tuku, Chief Counsel

                  Amber Beck, Republican Chief Counsel

                      Cameron Ricker, Chief Clerk

                      Shelvin Simmons, IT Director

                       Pat Lally, Assistant Clerk

                                 ______

   Subcommittee on Housing, Transportation, and Community Development

                      TINA SMITH, Minnesota, Chair

                CYNTHIA LUMMIS, Wyoming, Ranking Member

JACK REED, Rhode Island              MIKE CRAPO, Idaho
ROBERT MENENDEZ, New Jersey          MIKE ROUNDS, South Dakota
JON TESTER, Montana                  JOHN KENNEDY, Louisiana
CATHERINE CORTEZ MASTO, Nevada       BILL HAGERTY, Tennessee
KYRSTEN SINEMA, Arizona              J.D. VANCE, Ohio
RAPHAEL G. WARNOCK, Georgia          KATIE BOYD BRITT, Alabama
JOHN FETTERMAN, Pennsylvania

                Tim Everett, Subcommittee Staff Director

        Kelsey Pristach, Republican Subcommittee Staff Director

                                  (ii)


                            C O N T E N T S

                              ----------                              

                        WEDNESDAY, MARCH 8, 2023

                                                                   Page

Opening statement of Chair Smith.................................     1
    Prepared statement...........................................    28

Opening statements, comments, or prepared statements of:
Senator Lummis...................................................     3
    Prepared statement...........................................    29

                               WITNESSES

Jeff Olivet, Executive Director, Interagency Council on 
  Homelessness...................................................     4
    Prepared statement...........................................    29
    Responses to written questions of:
        Chair Smith..............................................    42
        Senator Sinema...........................................    44
Richard Cho, Senior Advisor for Housing and Services, Department 
  of Housing and Urban Development...............................     6
    Prepared statement...........................................    36
    Responses to written questions of:
        Chair Smith..............................................    48

                                 (iii)

 
       THE FEDERAL STRATEGIC PLAN TO PREVENT AND END HOMELESSNESS

                              ----------                              


                        WEDNESDAY, MARCH 8, 2023

                               U.S. Senate,
  Committee on Banking, Housing, and Urban Affairs,
    Subcommittee on Housing, Transportation, and Community 
                                               Development,
                                                    Washington, DC.
    The Subcommittee met at 2:30 p.m., in room SD-538, Dirksen 
Senate Office Building, Hon. Tina Smith, Chair of the 
Subcommittee, presiding.

             OPENING STATEMENT OF CHAIR TINA SMITH

    Chair Smith. Well, good afternoon. The Subcommittee on 
Housing, Transportation, and Community Development will come to 
order.
    I am very glad to have Senator Lummis as my new partner and 
Ranking Member on this Subcommittee, and I really look forward 
to working with you over the next 2 years. Both Senator Lummis 
and I are interested and concerned and ready to dig in on 
issues of the shortage of housing, especially in rural 
communities, and the unique challenges that we see on tribal 
lands. And we are both, as we have discovered, focused on 
getting things done, so I am confident that we will be 
successful in finding common ground, and I look forward to the 
work ahead of us.
    And I am also very glad to welcome Senator Fetterman, 
Senator Kennedy, Senator Vance, and Senator Britt to the 
Subcommittee this year.
    So without safe, decent, affordable housing, nothing in 
your life works, and it is nearly impossible to maintain a job 
or go to school or stay healthy. Almost 600,000 Americans 
experience homelessness on any typical night, and of this 
number about 60 percent of those experiencing homelessness are 
sheltered while the other 40 percent are unsheltered.
    Homelessness is a significant challenge in our country and 
we have to acknowledge that it is not getting better. It is 
getting worse. While we made big strides in reducing 
homelessness in the first half of the last decade, we know that 
the number of people experiencing homelessness began to rise 
again around 2016, and the pandemic only exacerbated the 
challenges that individuals and families have faced.
    The backdrop to the issue of homelessness is that our 
Nation is facing an affordable housing crisis. According to 
data published by the National Low Income Housing Coalition, 
not one State in the country has an adequate supply of 
affordable rental housing for the lowest income renters. In 
fact, for the 10.8 million families with extremely low incomes 
in the United States there is a shortage of more than 7 million 
affordable homes, which is very alarming.
    The challenge of funding and keeping a safe, affordable 
place to live is real in every part of the country--urban, 
suburban, and rural--and it affects everyone. However, 
homelessness disproportionately affects some folks more than 
others, including Black and Latino and Native communities. In 
my home State of Minnesota, while Native Americans make up only 
about 1 percent of the adult population, the 2018 statewide 
homeless study found that they make up 12 percent of adults 
experiencing homelessness.
    In December, the U.S. Interagency Council on Homelessness 
published ``All In'', the Federal strategic plan to reduce and 
end homelessness. The plan calls for a 25 percent reduction in 
homelessness by 2025, and lays out a data-backed plan to make 
that happen. This is an aggressive goal but I am glad that we 
are aiming high here.
    We have learned a lot in the last few years about how to 
effectively address homelessness. The American Rescue Plan 
provided 70,000 emergency housing vouchers to rapidly re-house 
individuals at risk of homelessness, especially veterans and 
victims of domestic violence and sexual assault. And just last 
month, Secretary Fudge announced $315 million in awards to 
address unsheltered homelessness and homelessness in rural 
communities, along with thousands of vouchers. This 
coordination of grants and vouchers is critical, and I look 
forward to hearing more about how it can work from our 
witnesses today.
    I am also looking forward to hearing more about how we can 
cut red tape, improve staffing, and make it easier for service 
providers and housing providers to do their jobs instead of 
worrying about administrative paperwork. We heard a number of 
suggestions at the hearing Senator Rounds and I held in this 
Subcommittee last year on this topic, and I hope that we can 
find bipartisan ways to make existing programs work more 
effectively.
    There are several examples of bipartisan efforts in this 
area. Senator Reed and Senator Collins have a bill to 
reauthorize the Interagency Council on Homelessness. Senator 
Coons and Senator Cramer have introduced a bill to expand the 
Housing Choice Voucher Program and eliminate duplicative 
inspection requirements, a bill that both Senator Lummis and I 
have cosponsored in the past. And there are other bipartisan 
efforts to improve the low-income housing tax credit, to 
address veteran homelessness, and more at other committees.
    You know, I often hear from people working on homelessness 
that we know what to do to solve this problem. We just need the 
will to fix it. We have data-driven strategies that have proven 
effective in addressing homelessness in recent years and are 
helping people who have fallen into homelessness. But we must 
also address the housing affordability challenges at all levels 
that are driving people into homelessness in the first place.
    Addressing homelessness and the challenges of housing 
affordability has long been an issue that both Republicans and 
Democrats have been concerned about, so I hope that in this 
hearing we can continue that bipartisan work and look for 
concrete steps that we can take together to address this deep 
challenge with a comprehensive approach, effective, strategies, 
and the resources that we need.
    And with that I recognize Senator Lummis.

              STATEMENT OF SENATOR CYNTHIA LUMMIS

    Senator Lummis. Well, thank you, Madam Chair. It is a 
delight to join you on this Subcommittee in this endeavor, and 
I too look forward to tangible results from this bipartisan 
effort. Thank you. And I also want to thank our witnesses for 
being here today.
    Right now many American families are struggling to find 
safe, affordable housing. For some of these families housing 
insecurity is a growing concern. There are many challenges that 
can drive an individual or family to homelessness and make it 
harder to regain housing. The availability of affordable 
housing is part of the problem, but mental health challenges, 
physical disabilities, and struggles with substance use can 
lead to homelessness and make it harder to escape when it 
occurs. These problems cut across demographics.
    As a result, communities in every State right now, 
including my home State of Wyoming, are challenged to help 
those who are homeless or who lack stable housing. Today's 
hearing on the Biden administration's strategic plan to prevent 
and end homelessness provides a good opportunity to talk about 
what has worked and where we can do better.
    ``Housing First'', a centerpiece of the Administration's 
plan, is a policy that places individuals into supportive 
housing without any conditions. Individuals are offered 
supportive services but are not required to use them. The term 
``Housing First'', then, raises an important question. If 
housing comes first, what comes second? Individuals are placed 
into housing and then may choose whether to undertake mental 
health treatment or substance abuse counseling they need to 
live healthy lives, but how many people caught in the cycle of 
addiction or the grips of a severe mental health crisis can 
recognize the help they need at that moment?
    At some point, when ``Housing First'' fails--and it does 
fail for some people--there need to be other paths to help. 
Shuttling vulnerable people between programs without needed 
treatment is not the path to housing independence. It 
perpetuates the problem. I am disheartened at the 
Administration's continued focus on a version of ``Housing 
First'' without the integrated wraparound services some 
individuals and families require to overcome homelessness. As a 
result, we have drifted too far to ``housing only.'' Funded 
does not allow local organizations the flexibility to act on 
what they have seen work in their local community.
    I would also like to see HUD and USICH spend more time on 
the unique needs of rural communities and tribes. These are 
important issues in Wyoming. Homelessness and housing 
instability look different in rural areas and reservations. 
Shelters are rare, and so many people turn to family and 
friends to get through a period of homelessness. As a result, 
homelessness shows up as overcrowding rather than tents on the 
street. But given how HUD conducts its counts of the homeless, 
these individuals and families living with family and friends 
would not be counted. We cannot fix problems when we are unsure 
of how big they are or where they are.
    Homelessness is a challenging issue, one that requires our 
best ideas. I look forward to hearing more from the witnesses 
about specific ideas to reduce red tape and help programs 
better serve vulnerable Americans.
    Thank you, Madam Chair. I yield back.
    Chair Smith. Thank you, Senator Lummis, and I would like to 
welcome Senator Britt to the Subcommittee. We are very glad to 
have you with us today as a Member of this Subcommittee. Thank 
you.
    Senator Britt. Thank you.
    Chair Smith. So I would like to introduce our witnesses 
now. Today we are joined by Jeff Olivet, who is Executive 
Director of the U.S. Interagency Council on Homelessness. Jeff 
has working on issues related to homelessness for more than 25 
years, including as a street outreach worker and case manager.
    And Richard Cho is Senior Advisor for Housing and Services 
at the U.S. Department of Housing and Urban Development. He has 
spent more than 20 years working on housing issues, and 
previously served as Deputy Director of the U.S. Interagency 
Council on Homelessness.
    This hearing is a hybrid format so Senators may join in 
person or by video. For witnesses, you will each have 5 minutes 
for your opening statements. Each of you will have a clock in 
front of you or on your screen, although you are both here so 
no screens, and your full written statement will be made a part 
of the record.
    Mr. Olivet, you are recognized.

   STATEMENT OF JEFF OLIVET, EXECUTIVE DIRECTOR, INTERAGENCY 
                    COUNCIL ON HOMELESSNESS

    Mr. Olivet. Good afternoon, Chair Smith, Ranking Member 
Lummis, and distinguished Members of the Subcommittee.
    Homelessness is a life-and-death public health crisis. Tens 
of thousands of people die every year due to the dangerous 
conditions of living without a home. According to the latest 
data, more than 582,000 people experienced homelessness in the 
U.S. on a single night in January 2022, but that is only a 
snapshot in time. We know that over the course of a year, at 
least twice that number--more than 1.2 million people--
experience homelessness in our Nation.
    Two major drivers of this crisis are the lack of affordable 
housing and the failure of wages to keep pace with the high 
cost of housing. By some measures, as many as half of those 
living in shelters and on the street are working, and yet full-
time minimum wage workers cannot afford a modest apartment in 
any county in America. Decades of growing economic inequality 
have left more than half of Americans living paycheck to 
paycheck and one unexpected car repair or medical bill away 
from homelessness.
    In 1970, this Nation had a surplus of 300,000 affordable 
homes, and today, a shortage of millions of units means that 
for every 100 extremely low-income renters, only 37 available 
homes are affordable. Where do we expect the others to live?
    We also know that health and homelessness are inextricably 
linked. Illness, injury, and medical expenses put people at 
risk of homelessness, and homelessness is harmful to people's 
health. People who are homeless face higher rates of mental 
health and substance use disorders, and like many health 
conditions, homelessness is deadly, but it is preventable. 
Every day, roughly 2,500 people exit homelessness in this 
country, yet the same number fall into homelessness. To solve 
this challenge, we must combine effective housing and 
wraparound supports with upstream prevention efforts that keep 
people from losing their homes in the first place.
    While homelessness has increased in recent years, we are 
beginning to see progress. After steady declines in 
homelessness nationally from 2010 to 2016, homelessness began 
to rise again. During the pandemic, however, we were able to 
come together to stem the tide. Between 2020 and 2022, we 
actually flattened the curve. And while unsheltered 
homelessness remains of paramount concern to the Biden-Harris 
administration, along with rural homelessness and tribal 
homelessness, we have seen homelessness drop significantly 
among veterans, families, and youth. And what those successes 
show is that we can make progress even in the most difficult of 
circumstances.
    When the pandemic put millions of people out of work and at 
risk of losing their homes, Congress came together to pass the 
CARES Act, then the American Rescue Plan, amounting to the 
largest investments in ending homelessness at any point in our 
Nation's history. Congress expanded unemployment assistance, 
launched bold initiatives like emergency rental assistance, and 
provided financial support that saved families from starving 
and losing their homes. Together Congress and the President 
prevented what could have been a massive wave of new 
homelessness.
    These investments also ended homelessness for tens of 
thousands of Americans. In just the last year-and-a-half, HUD 
and VA initiatives helped more than 140,000 people move out of 
shelters, off the streets, and into homes. Building on these 
successes, our new Federal strategic plan, ``All In'', aims to 
reduce homelessness 25 percent by 2025, and create a pathway to 
end it for good.
    With the help of Congress and State and local leaders, we 
believe that it is possible to achieve this ambitious goal. The 
plan is founded on an evidence-based, all-hands-on-deck 
approach, and it includes numerous strategies and actions to 
prevent homelessness, urgently address the basic need for 
shelter, and expand housing and support that help people exit 
homelessness.
    Work to implement the plan is already underway. Our team is 
developing implementation work plans and putting the strategies 
into action this year. As we move forward, we will work with 
Congress and our Federal agency partners as well as with people 
who have experienced homelessness, Governors, mayors, 
providers, and others on the front line of this tragedy.
    During my three decades in this work, any progress we have 
made has come when we are united. We all have a role to play. 
Homelessness did not happen overnight, and it will not be 
solved overnight. But with resources, creativity, and unity, I 
believe we can build a country where no one experiences the 
trauma and indignity of homelessness and where everyone has a 
safe place to call home.
    Thank you very much for your time, and I look forward to 
your questions.
    Chair Smith. Thank you very much.
    And now Dr. Cho.

   STATEMENT OF RICHARD CHO, SENIOR ADVISOR FOR HOUSING AND 
     SERVICES, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT

    Mr. Cho. Thank you. Good afternoon, Chair Smith, Ranking 
Member Lummis, Senator Britt, and other Members of the 
Subcommittee. Thank you for allowing me to testify and share 
some of what HUD is doing to address the Nation's homelessness 
crisis.
    In every city, town, rural community, and tribal Nation 
across this country there are people, adults and seniors, 
people with disabilities, youth, families with children who 
lack access to safe and stable housing. No place is immune. But 
every day, in each of those communities, there are also 
people--dedicated policymakers, political leaders, outreach 
workers, and housing and services providers--who are equipping 
people to once again have a safe and stable home.
    At HUD and across the Biden-Harris administration we are 
working hand-in-hand with those leaders to solve this crisis, 
and I would like to take a moment publicly to thank those 
leaders for their commitment to addressing and ultimately 
ending homelessness.
    Regrettably, after 6 straight years of progress, from 2016 
to 2020, homelessness rose both in numbers and in visibility. 
Overall, homelessness rose by 6 percent, unsheltered 
homelessness increased by 28 percent, and chronic homelessness 
increased by 43 percent. But our recent history tells us that 
this does not need to be the end of our story. Homelessness can 
be solved. I know this because it is happening every day across 
communities in this country. I know this because we have cut 
veteran homelessness by 55 percent since 2010. I know this 
because prior to 2016, our Nation as a whole was reducing 
homelessness overall and for nearly all populations.
    Congress deserves the credit for the progress that we have 
made and that we are continuing to make. It was through 
bipartisan 2009 HEARTH Act that Congress started requiring 
communities and HUD, for the first time, to start tracking 
performance outcomes and to achieve those performance outcomes. 
Specifically, are more people exiting homelessness into 
permanent housing? Are lengths of homelessness episodes 
shortening? And are fewer people returning back to homelessness 
once housed? And by creating accountability for those 
performance measures, Congress, HUD, and USICH helped to 
transform our Nation's homelessness response. Through year-
after-year investments, Congress also enacted and scaled 
evidence-based programs to solve homelessness among veterans.
    I will say it again--homelessness can be solved, but to do 
it we must continue to scale the housing and supportive 
services interventions that work, like permanent supportive 
housing, rapid re-housing, and housing vouchers. We must 
continue to keep communities focused and accountable to 
measurable outcomes, and we must continue to mobilize 
partnerships at all levels and across all sectors.
    The record over the last decade illustrates that solving 
homelessness requires Federal leadership, both from Congress 
and the Executive branch, to support what works. It will take 
all of us, Government at all levels and the nonprofit and 
private sector, to work with urgency both to help those 
experiencing homelessness today as well as to prevent others 
from ever becoming homeless.
    Under the leadership of the President, Vice President, and 
Secretary Fudge, HUD has been working to solve homelessness 
with the urgency it requires, and to again move the trajectory 
of homelessness back in the right direction, downward. We are 
doing that by scaling housing and supportive services to meet 
the need. The American Rescue Plan funded 70,000 emergency 
housing vouchers, the first-ever vouchers dedicated to 
addressing homelessness beyond veterans. To date, homelessness 
has been resolved for 47,000 households through those vouchers.
    We are also addressing the national shortage of permanent 
supportive housing through $5 billion in American Rescue Plan 
funding for the Home Investment Partnerships Program, and an 
additional $75 million that we received in fiscal year 2023. 
And working with the Department of Health and Human Services, 
we are working to help communities to leverage HHS programs--
Medicaid, SAMHSA grants, and community health centers--to help 
provide housing-related supportive services.
    We are also directing resources and attention to unmet 
areas of need, especially people in encampments and other 
unsheltered settings, as well as in rural and tribal areas. 
Last June, we issued the first-ever dedicated package of grants 
and vouchers to address unsheltered homelessness and 
homelessness in rural communities. And we are continuing to 
expand tribal communities' access to the housing and 
homelessness resources that we administer.
    We have also been reinvigorating community efforts to work 
with urgency to help connect people experiencing homelessness 
to housing and services. Through our House America initiative, 
we partnered with leaders across 105 communities, across 32 
States, representing over 50 percent of the Nation's 
homelessness population. Those communities collectively re-
housed 100,000 households experiencing homelessness and placed 
40,000 new units of dedicated housing to address homelessness 
into development.
    We also revived a new Federal commitment between HUD, VA, 
and USICH to end veteran homelessness, and in 2022, 40,000 
veterans were moved from homelessness into permanent housing.
    As Mr. Olivet noted, our latest data shows that the 
Administration's early efforts are working with the resources 
and support from Congress. Amid a global pandemic and growing 
challenges in the housing market, we averted a spike in 
homelessness. Homelessness has remained virtually flat in the 
last 2 years. Family homelessness decreased by 6 percent, 
homelessness among unaccompanied youth decreased by 12 percent 
in the last 2 years, and as I mentioned earlier, veteran 
homelessness decreased by 11 percent, the largest drop in 5 
years. Veteran homelessness is now down 55 percent.
    I thank the Subcommittee for its deep concern for this 
national crisis of homelessness, and I will say this again, 
that this crisis is solvable. Senators, we have reduced 
homelessness national before. In fact, two-thirds of 
communities across this country have reduced homelessness since 
2010, and more than half have been continuing to see declines 
in homelessness since 2016. We are continuing to reduce it 
nationally for veterans and families with children, and we can 
reduce it and ultimately end homelessness for all communities 
and for all populations.
    As the President reminds us, there is no problem in America 
that we cannot solve if we work together.
    Thank you for the opportunity to testify, and I welcome 
your questions.
    Chair Smith. Thank you very much. We will now begin a round 
of 5-minute questions from Members, and unless we have any of 
our colleagues on television or on the screen I will go first, 
and then we will go back and forth between the majority and the 
minority.
    Let me just start with this. It is a question for both of 
you. The recently released Federal plan sets the bold but 
achievable goal of reducing homelessness 25 percent by 2025, in 
just a couple of years, and it has been described as an 
aspirational goal but an achievable goal.
    Let me ask both of you, what have we learned from our 
successes in reducing veteran homelessness and youth 
homelessness and family homelessness? What have we learned from 
those successes that we can apply to achieving this goal?
    Mr. Olivet, you can go first.
    Mr. Olivet. I think we have learned quite a few things. One 
is that when we provide resources, we see progress. The things 
that we do not pay attention to, we do not see progress. So the 
bipartisan support of addressing veteran homelessness, for 
example, has really borne fruit over the last decade. That is 
through programs like the HUD-VASH program and supportive 
services for homeless veterans. The same is true with youth. 
The Youth Homelessness Demonstration Project and others have 
shown remarkable success on those areas that we really target 
resources.
    The resources that we are targeting are a combination of 
housing and wraparound supports, and that really is the recipe 
for how to end this, as many of you have noted already.
    I think another thing that we have learned is that it takes 
everybody. The communities that we see really making progress 
are where we have got mayors aligned with county 
administrators, with the nonprofit sector and the faith 
community and the business community in lockstep with what we 
are trying to do with Federal resources. And where we see that 
alignment, we see good things happen.
    Chair Smith. Dr. Cho, would you like to add to that?
    Mr. Cho. Yes, Chairwoman. I would agree with what Mr. 
Olivet already said. You know, working to reduce homelessness 
ultimately is about: can we move more people out of 
homelessness into stable housing quicker than more people fall 
into homelessness, and also can we prevent more people from 
becoming homeless.
    Mr. Olivet already talked about the unity that is needed. I 
think what holds communities up and what sometimes reduces 
their ability to work with speed to connect more households to 
stable housing is often the disagreements that happen at the 
local level about what needs to happen, and those distractions 
often delay a commitment to helping do everything that it takes 
to cut through red tape and assist more individuals and 
families and youth to obtain permanent housing.
    So it is speed, but it is also having the resources on 
hand. Our data shows that for veterans, communities have pretty 
much enough resources to house veterans who become homeless. 
For families, only 1 out of every 3 families with children who 
experience homelessness has an available housing resource 
available at the community level. For individuals it is even 
worse. They often have only one available housing intervention 
for every seven individuals who are experiencing homelessness.
    So we need resources, evidence-based practices scaled to 
meet the need, and we also need to help communities to work 
with urgency and efficiency, and that means also having the 
unity at the local level that prevents them from those 
distractions.
    Chair Smith. Thank you. I think that the data that you 
cited about how--you know, it is difficult to make progress if 
you have as many people entering into homelessness as you have 
leaving homelessness. And there is this sort of churn or just 
kind of constant processing that is just part of the problem, 
which gets me to the point that the individuals that are 
experiencing homelessness are very diverse, and what is 
happening to them is extremely--you know, you cannot paint it 
all with one picture.
    This gets, I think, as Dr. Cho is raising, the question of 
prevention. What can we do to prevent people from getting into 
that cycle? Would either of you like to just address that 
briefly and specifically? What are one or two things that we 
need to do to make sure that we can stop people feeding into 
the problem of homelessness--entering into, I should say?
    Mr. Olivet. I think you are absolutely right to point this 
out. We have gotten increasingly sophisticated as a Nation 
bailing out the bathtub. We see successes all the time, of 
people exiting homelessness, getting connected with mental 
health care and substance use treatment and jobs and community 
and family. What we have not done is turned off the faucets 
that are flowing into homelessness.
    So when we start thinking about where people are coming 
from, where people are most at risk of becoming homeless, we 
think about young people aging out of foster care, and we think 
about people serving in our military and transitioning to 
civilian life, or people coming out of domestic violence 
situations--these very tough environments. But we are not doing 
a good job at partnering with those systems to make sure that 
we are sharing homelessness prevention as a common goal.
    Chair Smith. Yep. I just want to mention--I am about out of 
time, but I hear over and over again that if you really want to 
get to the bottom of this challenge you have to be working 
hand-in-glove with people who have experienced homelessness 
themselves, folks that have lived experiences, sort of the term 
that is used. But, I mean, it is people who understand what is 
going on.
    Could you just maybe, Dr. Cho, could you just respond to 
that quickly, how important is it to be really building 
strategies and coming up with solutions with folks that have 
actual experience?
    Mr. Cho. I think it is vital and something that we have 
built into a number of programs. We learned it the most through 
the Youth Homelessness Demonstration Program, where it became a 
requirement that young people who had a lived experience with 
homelessness are placed in positions of decision making to help 
design the kind of programs and systems that are needed to 
address homelessness.
    And you learn things from talking to people with lived 
experience that a provider who has never experienced 
homelessness would never have thought of. For example, some 
people do not feel safe in shelters. They feel that they are at 
risk of violence or having their possessions stolen. And if we 
do not understand what the experience of actually being in a 
shelter is like, we will design environments that maybe people 
do not want to come into, and no wonder we see people outside.
    Chair Smith. Thank you. Thank you very much. Senator 
Lummis.
    Senator Lummis. I want to thank both of you for being here 
today.
    Certainly when Congress just does not do a reauthorization 
when it comes up, we just do these continuing resolutions over 
and over, we forget to pay attention. We forget that when all 
else fails, read the directions is always good advice. We do 
not go back and read our own directions, see how a program was 
designed and how it is being applied now, and whether something 
was lost in translation.
    And I am of the opinion that maybe some of those things are 
at play here. So I want to explore that a little bit in my 
questions to you.
    Mr. Olivet, among the tools for action on USICH's website 
there is a ``Housing First'' checklist that is intended to help 
make a basic assessment of whether and to what degree a 
particular housing program is employing a ``Housing First'' 
approach. So if a tenant is unable to abide by the terms of a 
tenancy, every effort is made, according to the website, to 
move them to another housing situation program or project.
    Would you agree that these are principles of ``Housing 
First''?
    Mr. Olivet. Thank you, Ranking Member, for raising the 
issue of ``Housing First'', and sometimes what we see is a 
discrepancy between the directions, as you so rightly said, and 
how things play out in the real world.
    We know that ``Housing First'' does not mean housing only, 
and I was a case manager in this field before we had ``Housing 
First'', and what we were doing was not working very well: 
making people jump through a lot of hoops before they go into 
housing. And so we would see people languishing in shelters and 
in vehicles and on the street with serious mental health issues 
and untreated substance use issues. And what I hear from people 
over and over is that, ``it is incredibly hard to get sober and 
stay sober if I am outside. It is very hard to address my 
mental health if I do not have a stable home to go to.''
    So the whole principle of ``Housing First'' was to get 
people into that stable foundation as quickly as possible and 
provide really good wraparound supports to help them succeed. 
And that works very well for many people, but not everyone, as 
you said.
    Senator Lummis. And so my question is, and my concern is, 
that maybe some of those wraparound services are not actually 
happening, that instead of saying, OK, we are going to give 
them services, and when they are ready we will put them in a 
house. Now we are saying we will provide housing but then not 
requiring these wraparound services that give them the help, 
knowledge, information, and support they need to stay in that 
house.
    Mr. Olivet. I think what we have seen is when those 
services are readily available to people, many, many people 
choose them. And as you said, it does not work for everyone. 
The success rates in ``Housing First'' are as high as 90 
percent. It is an extraordinary success rate. But that also 
means that 1 out of 10 folks are not being served well, and 
they return to homelessness. We need to do a better job 
supporting them.
    Senator Lummis. Should they be required to access those 
services as opposed to leaving it voluntary?
    Mr. Olivet. Voluntary treatment is the thing that's proven 
to work best. When people are forced to do treatment of some 
kind, it is not always as successful, and people do not always 
do as well in that treatment.
    Senator Lummis. OK. Thank you, Dr. Olivet.
    And Dr. Cho, thank you for your 20 years of service in 
housing programs. That is a commitment, and we appreciate your 
years of expertise.
    So in rural areas, as I mentioned, some people just cram 
themselves into housing. It happens a lot on Indian 
reservations. As opposed to being homeless, there are many 
families under one roof. And this has got to be hard, but how 
do we account for those people? They are ``underhoused.''
    Mr. Cho. Thank you, Senator, for that question. We 
recognize that in rural communities and in tribal communities 
in particular, homelessness looks different, and our definition 
of homelessness does include people who are living in 
substandard conditions, who are living in places not meant for 
human habitation. I have been to tribal Nations where I have 
seen some of the conditions that people are living in, severely 
overcrowded. So that is part of the definition.
    And we have been working to increase more resources going 
to rural communities as well as to tribal communities, and with 
additional flexibilities. Resources that we provide to tribal 
communities allows them to adapt the programs to the needs of 
their tribal communities. And for the rural resources that we 
have been providing, we took advantage of the fix that actually 
Congress made so that you can use some of our homeless 
assistance grants to make home repairs and other home 
modifications that are often needed to just make housing 
livable in those rural communities.
    Senator Lummis. My time has expired. Again, thank you both.
    Chair Smith. Thank you very much. Senator Menendez.
    Senator Menendez. Thank you, Madam Chair. Thank you to you 
and the Ranking Member for hosting what I think is a very 
important hearing and topic.
    A key element of combatting homelessness is supportive 
housing or housing paired with supportive services, such as 
treatment for health conditions and substance use disorders. It 
seems to me that these services are critical as they can help 
ensure families are able to stay in their home and provide 
resources to deal with conditions that make it harder to do so.
    So, Mr. Olivet, can you talk to us about the role expanding 
permanent supportive housing plays in the Administration's 
strategic plan to end homelessness?
    Mr. Olivet. Thank you, Senator. One of the pillars of our 
plan is called Housing and Supports, and we deliberately paired 
those two things. We know that housing is essential to end 
homelessness, but housing alone is not always sufficient. And 
depending on people's life experiences and the challenges they 
are facing, people need different degrees of support. I mean, 
all of us do. You think about all of the support that we get, 
from family and friends, from professionals, from therapists, 
from all sorts of social and professional supports. The same is 
true for anyone who has been homeless.
    And so the key is to really tailor and individualize those 
wraparound supports in a way that makes sense for that family, 
for that young person, for that veteran, for that person living 
in a tribal or a rural area. I know it gets harder when you are 
in rural areas in Alabama or Ohio or Wyoming, where there just 
are not that many services, and I think that gets to be the 
real challenge that we all need to wrestle with: How do we 
scale those supports up?
    Senator Menendez. I am glad to hear that access to 
supportive housing is a core element of the plan. We look 
forward to working with you on those services.
    Let me turn to another issue. HUD's most recent Annual 
Homelessness Assessment Report, or AHAR, shows that the number 
of individuals experiencing chronic homelessness has continued 
to increase, even as the overall number of people experiencing 
homelessness has mostly leveled off.
    Dr. Cho, what factors are driving the increase in chronic 
homelessness specifically, and what additional steps can we 
take to moderate the trend of rising chronic homelessness.
    Mr. Cho. Yeah, thank you so much for raising that, Senator, 
and I think you actually answered that in your first question, 
which is we have seen a significant decrease in the production 
of new permanent supportive housing, which is the best tool we 
have to address chronic homelessness. People experiencing 
chronic homelessness are people who have experienced 
homelessness long term and who have a disabling condition, 
whether it is mental illness, addiction, or chronic medical 
conditions, often all co-occurring at the same time. And 
permanent supportive housing is the intervention that provides 
that, wraparound supports along with affordable housing.
    From 2010 to 2016, our Nation added 104,000 new units of 
permanent supportive housing to the national inventory. From 
2016 to 2020, we only added 32,000 in that 4-year period. So 
the rate of new permanent supportive housing production cut to 
less than half of what it was in the prior 6-year period. We 
need to get back to doing that.
    HUD is using resources from the American Rescue Plan as 
well as resources provided through appropriations to help 
communities provide the capital and operating, and well as 
supportive services to create more permanent supportive 
housing. Through our Continuum of Care program we actually fund 
about $240 million of those funds actually goes to pay for 
supportive services in permanent supportive housing settings.
    Senator Menendez. I appreciate that answer. You know, AHAR 
2022 detailed demographic data for the overall population of 
persons experiencing homelessness, but it does not have data 
for this population of persons experiencing chronic 
homelessness. Given the struggle these individuals face, 
whether it is that affordable housing shortage you just spoke 
about or whatever, I think it is critical that we understand 
more about them.
    Can you commit that you will work on obtaining this data 
and making it public?
    Mr. Cho. Yes, Senator. We actually do collect that in the 
second part of our AHAR reports, which tracks the number of 
people who use our homelessness assistance programs. The latest 
data on that, part 2 of our AHAR report, covers 2019 and 2020, 
and in that report we do have demographics on people who are 
experiencing chronic homelessness, including their age----
    Senator Menendez. OK. And that is made public?
    Mr. Cho. Yes, it is, Senator.
    Senator Menendez. All right. So I will have to look at 
that.
    Finally, I worry that Congress met the challenge of the 
pandemic with a historic response from the eviction moratorium 
to emergency housing rental assistance to housing counseling, 
and the list goes on. That response was overwhelmingly 
successful in keeping people in their homes throughout the 
pandemic. However, these programs are expiring, and I worry 
that if we see a weakening of our core Federal housing programs 
what we are going to see is an increase in the homelessness 
situation that people will face.
    How can we ensure that the expiration of COVID-era housing 
programs do not contribute to rising homelessness?
    Mr. Cho. Senator, I think the answer is that we need 
continued investments through our regular appropriations for 
the permanent supportive housing, rapid re-housing, and more 
housing vouchers. In the President's budget will be released 
soon, and that will provide at least what the Administration is 
seeking with regard to housing resources.
    We have learned a lot through the pandemic era programs, in 
particular the Emergency Housing Voucher program, which is the 
first-ever voucher program dedicated to homelessness 
specifically. And we have seen that be incredibly successful 
and popular. Housing authorities across the country have 
partnered with homeless continuums of care, and that 
partnership has proven to be wildly successful in ensuring that 
these vouchers are reaching the households that need this the 
most. And we expect to see the impact of those resources when 
we release the results of the 2023 Point-in-Time Count later 
this year.
    Senator Menendez. We look forward to seeing the President's 
budget.
    Thank you, Madam Chair.
    Chair Smith. Thank you very much.
    Senator Vance, welcome to the Subcommittee, and it is now 
your time.
    Senator Vance. Great. Thank you. Thanks to the Chair and 
the Ranking Member, and thanks to both of you for being here.
    Mr. Olivet, I wanted to just use my time to investigate and 
talk a little bit about the ``Housing First'' approach to this 
particular problem. And I want to read something from the ``All 
In'' plan, in the prefatory letter, and I just want to unpack 
this a little bit.
    So you write in that letter, ``The United States of America 
can end homelessness by fixing public services and systems, not 
by blaming the individuals and families who have been left 
behind by failed policies and economic exclusion.''
    Now I certainly agree that we all have to recognize that we 
are all a product of our circumstances in different ways, and 
you do not want to blame people for being down on their luck. 
But I also worry that the approach of seeing people, even 
people who are very significantly suffering, as pure victims 
sort of robs them of agency, and if you rob people of agency, 
the compassion that you have for them is not the compassion for 
a human being. It is compassion for an animal, instead of a 
human being who makes decisions, who is influenced by their 
environment, certainly.
    And I think that a lot of the ``Housing First'' approach 
does precisely that. It sees people as pure victims instead of 
actors who, yeah, sometimes have very tragic things happen to 
them, but also can do things in the face of that tragedy to 
rise above it.
    I am curious sort of how you think about this. And you are 
dealing with people who had very, very tough lives, often 
cases, childhood trauma, drug addiction, the whole gamut of it. 
How do you not slip into treating them as pure agency-less 
victims? How do you treat them as human beings? Because when I 
read this letter I worry that you are not taking that approach.
    Mr. Olivet. Thank you, Senator, for asking a tough 
question. I start with a fundamental belief that we are all 
equal as human beings. We are all deeply flawed and beautiful 
and wonderful and powerful and broken, all at the same time. 
That is true regardless of housing status.
    I have known many people who have experienced mental 
illness and addiction who never become homeless, and I have 
known a lot of people who are homeless who have never 
experienced mental illness or addiction----
    Senator Vance. Sure.
    Mr. Olivet. ----and it overlaps a lot. And you rightly 
mentioned the prevalence of childhood trauma, physical and 
sexual abuse, that scars people for decades to come for their 
entire lives.
    But I also believe that recovery is possible, and I believe 
that very, very deeply. And what I have seen around ``Housing 
First''--and I said this earlier--I was in this field in the 
mid '90s when we were not doing ``Housing First'', and we set 
up a lot of requirements for people before they could move into 
housing. What I saw in those approaches was dehumanizing and 
disempowering.
    What I see when we can get people the stable foundation of 
housing is that they can live into their best selves, and 
without such a foundation, it is nearly impossible to do that. 
It is impossible for people to rebuild their lives without the 
safety of a door they can lock, without the safety of their own 
bathroom, without their own kitchen that they can prepare their 
meals in.
    And so I actually see ``Housing First'' as fundamentally 
humane and empowering and very much treating the person as an 
agent of their own future.
    Senator Vance. I appreciate that. I think that is very 
important. It is one of the things that I think often right and 
left talk past each other on these issues because obviously, 
again, we are subjects of our circumstances. We are also 
individual human beings with free will. And I do worry that 
sometimes the antipoverty lingo on the left very often glosses 
over that fact, even though certainly we have, on my side, our 
own problems.
    I want to just talk about the evidence basis of the 
``Housing First'' policy. I recognize I am short on time, but 
let me try to get this out quickly.
    The first time I ever visited San Francisco, California, I 
thought it was one of the most beautiful cities that I had ever 
seen. And when you go to San Francisco now, when you go to the 
Tenderloin, or you go further south and you go to Los Angeles, 
you go to Skid Row, what you see is a community that feels 
like, and, in fact, if you look at the violent crime rates, are 
approaching something like a Third World country. I mean, just 
unbelievably catastrophic. Chronic homelessness. All the 
addiction, the abuse, the violence that comes along with that. 
And yet California, since 2016, has supported the ``Housing 
First'' approach to ending homelessness, even as chronic 
homelessness has gotten way worse in the State of California.
    One worry that I have is that the evidence clearly shows, 
over the past 6 or 7 years, that that approach has not worked. 
We should be looking for alternative approaches, and yet I 
worry that what we are talking about in this proposal is to 
take the California approach and take it nationwide.
    Mr. Olivet. I think there is a great evidence base that 
``Housing First'' works for people. It works 75 to 90 percent 
of the time, and there are randomized controlled trials over 20 
years that show that to be the case. In fact, there are very 
few other interventions in the homelessness arena that have 
this degree of evidence.
    Senator Vance. But why is California gotten so much worse 
if this works so well?
    Mr. Olivet. We see people still falling into homelessness. 
If you look at the housing market--and you talked about San 
Francisco, you talked about Skid Row in Los Angeles--cities 
where the cost of housing is significantly higher than the rest 
of the Nation. I was in San Diego recently, and their vacancy 
rate is 1.4 percent. There are no units. And so even if you 
have a voucher, you cannot go get an apartment.
    We see elderly people falling into homelessness for the 
first time because they simply cannot afford the rent. The rent 
goes up ,and their income, or Social Security, stays fixed.
    If we look at ``Housing First'', the intervention that is 
actually working to help people move out of homelessness, and 
say, ``But we still have homelessness, so `Housing First' must 
be a failure,'' it is a misinterpretation of what is actually 
going on. ``Housing First'' is working at an individual level. 
It is not working at a population level, for two reasons: One, 
we have not scaled it up to meet the need, and two, we have not 
turned off the faucets that are flowing into and creating 
homelessness.
    Senator Vance. I am out of time. Thank you.
    Chair Smith. Thank you, Senator Vance. And I want to just 
note that I appreciate--I am not making a left or right 
comment. I am just noting that sometimes the language that we 
use to describe people who are experiencing homelessness can be 
dehumanizing. And we always talked about people as being 
victims or being vulnerable, but sometimes that seems to 
suggest that they do not, as you say, have agency and that they 
are not human beings with lots of assets. And so I wanted to 
just acknowledge that I heard what you were saying there.
    Senator Vance. Thank you.
    Chair Smith. Colleagues, I believe I understand that 
Senator Sinema is on her way, but while we are waiting for 
Senator Sinema I defer to Senator Britt.
    Senator Britt. Thank you so much, Madam Chair. To both of 
you, thank you for bringing this important issue before this 
Subcommittee. I appreciate getting to be a part of the 
conversation and therefore, hopefully getting to be a part of 
the solution. So thank you.
    Gentlemen, thank you for being here today. Mr. Olivet, Roll 
Tide.
    Mr. Olivet. Roll Tide.
    Senator Britt. I wanted to tell you both I appreciate your 
testimony, reading them and looking through it. Obviously, 
homelessness is something experienced by a wide variety of 
people and a range of circumstances across our great Nation.
    Would you agree obviously individuals that experience 
homelessness--I think I have heard you say it but just to make 
sure we are on the same page--it is adults, children, veterans, 
families. People from all walks of life can find themselves in 
this position.
    Mr. Olivet. Absolutely, and I think no two stories are the 
same. People have their own pathways into and out of 
homelessness. And if you just start breaking down the data, 
there are huge numbers of families who are experiencing 
homelessness, and even though we are making progress in that 
area, we can do more. The same is true for single adults.
    I talked about elderly Americans. Older Americans are one 
of the fastest-growing groups of people experiencing 
homelessness.
    So we have to look subpopulation by subpopulation at what 
really works.
    Senator Britt. Right. And so on that note--and Dr. Cho, I 
would love for you to jump in here as well--you know, obviously 
these vast circumstances that are different and people's 
stories, how are we tailoring the services needed for each of 
these different families or people or individuals or children 
that come in front of you all?
    Mr. Cho. Senator, that is actually a great question and 
something that HUD and actually Congress, through the HEARTH 
Act, began requiring communities to do. You know, prior to 
2009, most communities' homeless services looked like a loose 
collection of uncoordinated programs, each maintaining their 
own waiting list. Following the HEARTH Act in 2010, communities 
just started developing coordinated systems so that we could 
actually do a better job of assessing their needs and matching 
them to the right level of assistance.
    Some people just need short-term rental assistance and 
housing navigation. Others need permanent supportive housing, 
intensive case management coupled with long-term, indefinite 
rental assistance. Others just need a little bit of financial 
assistance and a point in the right direction. And I think our 
ability to reduce homelessness is, can we use the resources 
that we have smartly to match people to the right level of 
assistance, relative to their needs and strengths.
    Senator Britt. So as we are doing that you kind of talked 
about sometimes the hang-up in local communities. I believe you 
kind of referenced that. What are we doing to partner with 
State and local communities, one? What are we doing to partner 
with nonprofits and charities and religious organizations that 
want to be a part of the solution?
    Mr. Olivet. Senator, our team has senior regional advisors 
around the country who work with Governors and their teams, 
with mayors and their teams, as well as with the local 
nonprofit sector, faith community, and business community, 
because we believe that you need all levels of Government and 
the private sector working together. So we are actively 
fostering those partnerships and trying to support best 
practices.
    Senator Britt. Is there any impediment in current practice 
that keeps those faith-based communities from getting to be a 
part of helping in this?
    Mr. Cho. I do not see any impediment, Senator. We see lots 
of faith-based organizations who participate in efforts to end 
homelessness. I have learned a lot over the years working with 
faith-based organizations who provide supportive housing and 
other housing and services.
    I think another thing that Mr. Olivet and I have in common, 
in addition to working on homelessness for a long time, is that 
we are both--I believe we were both children of clergy.
    Mr. Olivet. I am not a child of the clergy but I have known 
a lot in my life.
    [Laughter.]
    Mr. Cho. OK. So, you know, our work in homelessness is 
rooted in the faith community and they have always been a 
critical part of the homelessness services.
    Senator Britt. So from both of your perspectives we have a 
good working relationship across the board there.
    Mr. Olivet. It is community-by-community. In some areas, 
there is very good alignment between how public funding is 
working and how faith-based service providers or faith 
community members themselves are working, and in other places 
there is a lot of dissention and disagreement. And I think it 
is critical that those things are aligned. Otherwise, you just 
get a lot of finger-pointing.
    Senator Britt. Yeah, I appreciated your comments earlier 
about needing to align so that we can work together to make it 
happen.
    And I know I am almost out of time, so I will just jump 
ahead a little bit. But the National Alliance to End 
Homelessness calculated that in 2021, the U.S. Federal 
Government enacted over $51 billion in funding for selected 
homelessness and housing programs. And as we kind of look at 
that I wanted to just talk specifically about something that my 
colleagues have already brought up, and that is mental health 
and substance abuse. Seventy-five percent of chronically 
homeless suffer from mental illness, and 75 percent have 
substance abuse problems. And we know, obviously, that overlaps 
the majority of that chronic homelessness.
    So would you agree that in addition to putting a roof over 
their head, as we have discussed, that it is imperative that 
these people are given the resources and begin the process of 
being able to deal with the issues that have created the 
homelessness in the first place?
    Mr. Olivet. Absolutely.
    Senator Britt. Thank you.
    Mr. Cho. Senator, I 100 percent agree, and we recently have 
developed additional tools, working the Substance Abuse and 
Mental Health Services Administration, on how to tailor 
recovery supports while people are moving into stable housing.
    Senator Britt. And one question--I have 19 seconds----
    Chair Smith. Take another 30.
    Senator Britt. Thank you so much, Madam Chair. How long, on 
average, would someone who is homeless find themselves in this 
one-roof program or ``Housing First'' program, being there?
    Mr. Cho. I think it varies by person. Again, ``Housing 
First'' is not one single program model. It is different types 
of assistance. So again, some people only need 6 months, 3 
months, sometimes 9 months of rental assistance. Other people 
who have been homeless for many, many years may need longer-
term housing supports, and ``Housing First'' can last 
indefinitely until they no longer need that level of rental 
assistance.
    Senator Britt. So there are some people that are there 
indefinitely. Do those people ever have a moment where they 
shift into, well, now it is time for you to start utilizing the 
resources in front of you so that you can get back on your 
feet?
    Mr. Cho. Absolutely, Senator. We see lots of people 
graduating from permanent supportive housing either moving into 
housing without services or, you know, rental assistance 
without services, or even just moving into independent. There 
have been examples of people experiencing homelessness who have 
gone from homelessness to permanent supportive housing all the 
way to home ownership. It can really vary, just as the pathways 
into homelessness varies.
    Senator Britt. Well, thank you so much. I believe we have 
to not only help people but then give them the tools to help 
themselves. So thank you so much. I appreciate it.
    Thank you, Madam Chair.
    Chair Smith. Thank you, Senator Britt.
    We now have, joining us virtually, Senator Sinema.
    Senator Sinema. Thank you, Madam Chair, and thank you to 
our witnesses for being here today.
    You know, housing is one of the biggest issues I hear about 
in Arizona. Whether you are trying to rent or trying to own, 
the cost of housing in Arizona is outpacing wages, not just in 
Phoenix but also in Tucson, Flagstaff, and throughout the Verde 
Valley. The cost of housing in Arizona has a direct nexus with 
the rise in homelessness in our State.
    That is why, in February, I convened two events with 
leading housing stakeholders in Phoenix, one around 
homelessness and services and another around housing supply and 
affordability. First we toured Yuma, the largest shelter 
services provider in Maricopa County, and saw how their 
innovative model provides childcare and workforce development 
alongside shelter services, ensuring that the tools to get back 
on your feet are accessible to the people that need them.
    Then we brought together industry stakeholders and 
affordability advocates to assess the market in Arizona, 
identify supply chain and regulatory challenges that are 
holding capital investment back, and craft solutions to these 
challenges.
    At each of these events I was honored to be joined by Joan 
Serviss, a deeply respected Arizona leader on housing in 
Arizona, who was recently appointed by Governor Hobbs to lead 
the Arizona Department of Housing.
    What I learned at these events reaffirms my understanding 
of the problem. We have a supply shortage in Arizona, and in 
order to make housing more affordable and accessible for 
Arizonans we need to build more of it. Specifically, we need to 
build the types of homes and apartments that everyday Arizonan 
families can afford. And that is why I have cosponsored 
legislation to expand the low-income housing tax credit and why 
I support additional investment in the Housing Trust Fund and 
Home Investment Partnerships Program.
    According to the Arizona Department of Housing, the State 
needs about 250,000 more affordable units to meet demand, to 
improve housing affordability in a generally sustainable 
manner. We need solutions outside of merely increasing demand-
side subsidies without increasing the overall supply of 
available housing.
    In October of 2022, members of my staff toured Prescott's 
Fort Whipple, alongside veterans groups, affordable housing 
developers, VA officials, and saw the need for affordable 
permanent housing in Arizona for veterans experiencing 
homelessness. Following that tour and discussion with local 
leaders, I raised the issue directly with HUD, and then HUD 
encouraged the Department to 84 HUD-VASH vouchers needed to 
move forward with Fort Whipple's veterans housing project.
    I have heard from Arizonans with rental assistance vouchers 
that they have been unable to use them, partially because of 
the lack of available rental units. However, project-based 
vouchers are a tool on the other side of the ledger that can 
help spur the development of affordable housing units like Fort 
Whipple.
    Can both of you speak to ways that Congress can strengthen 
project-based subsidy programs in order to increase the 
creation of affordable housing units, and specifically, what 
are some recommendations outside of just increasing funding or 
the overall number of project-based vouchers?
    Mr. Cho. Senator, this is Richard Cho. I can respond to 
that question. Thank you for raising that.
    I agree 100 percent that project-based vouchers is an 
incredible tool to be able to add not only housing access but 
also housing units. We have talked about how it is difficult to 
be able to find housing, even when people do have vouchers. 
That said, communities are finding housing but it is a lot of 
work to try to find landlords and vacant units. Project-based 
vouchers is an incredible tool.
    One of the things that could be done is to review the 
statutory cap that exists on our voucher programs, where public 
housing agencies that administer those vouchers can only 
project base up to 30 percent of their housing vouchers. Many 
communities have already reached their cap on project-based 
vouchers, and some of those communities are the very ones that 
are seeing the lowest vacancy rates and so actually need more 
project-based voucher assistance.
    So a simple thing that can be done, again, without new 
resources is just providing waivers and flexibility to allow 
communities to go above that 30 percent project-based cap.
    Mr. Olivet. And Senator, I will just add that I was in 
Arizona recently, and I would agree with you that your State is 
lucky to have Joan Serviss running the Housing Department. I 
met recently with Governor Hobbs and much of her new Cabinet, 
as well as with the mayors of Phoenix, Tucson, and Nogales, as 
we toured around rural areas as well as the cities. And I know 
the affordable housing crisis that you are facing in your 
State, and we have seen homelessness in Phoenix and Maricopa 
County increase by almost 30 percent in the last couple of 
years. So the situation is certainly dire.
    I was also very heartened to hear Mayor Romero in Phoenix 
talk about using large shipping containers to create housing. 
That is a creative approach that we have seen used with great 
success in Los Angeles and other places. It is also important 
to note that the Balance of State in Arizona is one of the 
recipients of HUD's recent first-of-its-kind rural and 
unsheltered funding, and so it will be really interesting to 
see how that funding plays out in rural areas as well.
    Senator Sinema. Thank you. Chair, I have additional 
questions but I see my time has expired so I will submit them.
    Chair Smith. Thank you very much, Senator Sinema. Thank you 
for joining us.
    Colleagues, it is possible that I might have another 
colleague or two come, though I am not sure. I am going to ask 
another couple of questions, but Senator Lummis, I would like 
to defer to you and have you go next, if you have another 
question or two next.
    Senator Lummis. Madam Chair, this is your Subcommittee. You 
go right ahead.
    [Laughter.]
    Chair Smith. Well, I like to go back and forth.
    Senator Lummis. Thank you. Thank you.
    Chair Smith. All right. Well, I will ask my questions and 
then see if either Senator Lummis or Senator Britt would like 
to ask any others.
    Last year when we heard from stakeholders who were working 
in the field kind of on what we could do, we heard a variety of 
ideas for how we can cut red tape and improve the functioning 
of our policy response. And these ideas included, for example, 
switching to a 2-year application cycle from a 1-year 
application cycle. Senator Britt, you were talking about local, 
on-the-ground nonprofits or faith-based organizations that are 
trying to run a program, and every year they are having to 
reapply. That was one idea that we heard.
    We also just heard about the importance of having resources 
for staffing so that frontline workers that are often barely 
staying out of a condition of homelessness themselves because 
they are paid so little, you know, increasing resources for 
staff would make a really huge difference, especially for those 
frontline staff. Incorporating some of the flexibilities that 
we did use during the pandemic incorporating those 
flexibilities into programming going forward.
    I am wondering if either of you would like to comment on 
those ideas for how we can make these programs work better.
    Mr. Cho. Yes, Chairwoman, I can answer both of those 
questions. I think the idea of making the Continuum of Care a 
2-year renewal cycle would be, I think, pivotal to helping free 
up the capacity at the local level to focus on what works, 
which is to actually figure out how to help more people exit 
homelessness.
    The Continuum of Care right now is an annual cycle. The 
process of applying for annual grants is--let me just put it in 
context. There are 386 continuums of care. They all 
collectively administer about 7,000 separate grant agreements, 
and they have to apply for those 7,000 grant programs every 
year, on an annual cycle. And so that is just a huge 
administrative burden that communities face. So the very people 
that are trying to do the work of actually addressing 
homelessness are often tied up in an application process that 
takes many, many months. So shifting to a 2-year cycle would be 
game-changing for those communities.
    I think, second--I am sorry. I forgot your other question, 
Senator.
    Chair Smith. It had to do with boosting pay for frontline 
staff that are struggling to make ends meet themselves.
    Mr. Cho. That is right. Thank you so much for that. That is 
critical, and we have encouraged communities to increase pay of 
frontline workers through our Homeless Continuum of Care 
funding. The challenge is because it is funded at a fixed 
level, on an annual basis, communities have to make the choice 
about whether they are going to actually reduce the amount of 
rental assistance they are providing. Are they going to serve 
fewer people in order to raise wages of the frontline workers?
    And so it is a difficult kind of tradeoff, and I think the 
only way that can be really done is to increase funding for the 
Continuum of Care program so that we can both add more housing 
capacity to serve people while also increasing the pay of the 
frontline workers who are trying to help those vulnerable 
individuals and families obtain housing.
    Chair Smith. Thank you.
    Mr. Olivet. On the workforce front, it is a crisis. Even 
before the pandemic we saw 50 percent turnover rates in the 
homeless services workforce, and this is a workforce that is 
doing very hard work for very low pay. Something like 25 
percent of those working in the programs--outreach workers, 
case managers--have been homeless themselves. So we have a lot 
of lived experience in that workforce, which is beneficial for 
improving the system, but we are not supporting them very well, 
and that is despite wonderful nonprofits out there trying to do 
this work.
    The other thing that we are seeing is philanthropy 
sometimes stepping in to help close that gap, which is a 
wonderful thing, but when philanthropic dollars are going to 
supporting the workforce, then that money is not being used for 
housing, for treatment, or for other things. It is a really 
delicate balance.
    The challenge has only gotten worse because the pandemic 
required people to do even more. These were emergency workers. 
They were showing up every day for the last 3 years, when 
everybody else was at home on Zoom. When many of us were in the 
comfort of our own homes, these folks were out there doing the 
work. And we lost a lot of people during the Great Resignation 
and people just burning out, and I think whatever we can do 
together to support and incentivize that workforce to stay 
engaged is going to pay off.
    Chair Smith. Thank you very much.
    Let me just get one more question in, one more point in. We 
are seeing innovative solutions for addressing homelessness and 
emergency shelter. I really am quite intrigued by a project we 
have in Minneapolis called Avivo Village, which is basically 
providing tiny homes, completely indoors, also with services 
for folks.
    It was created, as we have been talking about, with people 
who have experienced homelessness, who have talked about how 
difficult it is to move indoors when you do not have privacy, 
when you cannot have your pet with you. And it is really, 
really working, the Avivo Village model. People have privacy, 
they have autonomy, and they are able then to be able to focus 
on getting the services they need to be able to move forward.
    I am sure you see examples of this kind of innovation in 
our work around addressing homelessness in other parts of the 
country. Maybe, Mr. Olivet, you would like to comment on this.
    Mr. Olivet. Senator, your State is doing some of the most 
remarkable things. Minnesota is leading the way in so many ways 
on innovative program models and reducing racial disparities in 
homelessness and really integrating tribal leaders into 
responding to homelessness and so many things. I have heard 
wonderful things about Avivo Village. I have not been able to 
come to the Twin Cities since that got up and running.
    But what we are seeing around the country is a lot of 
innovation. People know that this is a crisis. They know that 
we need to address the crisis of encampments and unsheltered 
homelessness and rural homelessness. And what we are trying to 
do is spur that innovation. We need all good ideas right now 
because the crisis is still with us. And I think we need a 
range of short-term bridge housing options. I wish we had 
enough permanent housing supply to solve the problem right now 
and enough wraparound support, but the reality is that as we 
are expanding housing and support, we also need really creative 
ideas to get people safe and sheltered right now.
    Chair Smith. Thank you very much. Senator Lummis.
    Senator Lummis. Thank you, Madam Chair.
    It was alluded to earlier that during the pandemic, the 
American Rescue Plan Act, the COVID Relief Bill, and the CARES 
Act combined, nearly $85 billion toward emergency housing and 
homelessness assistance. But during those years the levels of 
homelessness essentially remained unchanged, partly due to 
this, you know, some people exiting homelessness and others 
entering. Yet at some point that money is going to expire 
because it was one-time money.
    What are some concrete ideas for improving the programs we 
already have without spending more money? It is just 
unsustainable to fund at the levels we did during COVID, and 
not just fund housing but fund a lot of things.
    Mr. Cho. Yes, thank you for that question, Senator. I think 
much of that--and I have never seen that tallying up of all the 
funding in that way--and a lot of that was actually for 
emergency rental assistance that was intended to prevent 
evictions and people from losing their homes.
    I would agree that we need to think through some creative 
solutions to figure out how to do that. That was, in some ways, 
the first significant Federal program intended to prevent 
evictions and housing loss for people, and that did have, I 
believe, an effect on reducing inflow into homelessness in the 
last 2 years. But there are questions about how we are going to 
sustain that, so that is an important thing.
    We are also just looking at how to take some of the 
innovations, regulatory flexibilities that had through the 
CARES Act and American Rescue Plan and figure out how to make 
those part. So that is one thing that can be done without 
necessarily new resources, is just look at the regulatory 
flexibilities and what worked for our voucher programs for 
homelessness programs that cut the red tape and helped people 
move into housing more quickly.
    Senator Lummis. I think you have really identified 
something important with the flexibility because every State's 
needs are different. You know, in Arizona they do not need 
nearly the insulation that we need in our northern States, and, 
you know, insulation and snow load. We actually have to build 
our roofs at a much stouter load-bearing level because of the 
snow load. It is just so heavy. And yet there are issues in 
States that are subject to tornadoes, that are very different 
than what I have to deal with in my State. That might be 
something that Senator Britt has to deal with.
    How can we make sure that these programs incorporate those 
kinds of local, unique challenges?
    Mr. Cho. Well, Senator, many of those regulatory issues may 
be at the State and local level, and so I think what HUD has 
been doing and the Administration has been doing is encouraging 
communities to address some of those regulatory issues that 
prevent the creation of more housing. And so that is something 
we have been looking at.
    But also just within the Federal programs that we 
administer we had additional waiver authorities that were 
provided through Congress for those special programs through 
the American Rescue Plan and CARES Act programs. CARES Act 
waivers have largely expired or will expire soon. I think it 
may be a good conversation to think about how to provide HUD 
with the regulatory flexibilities through the regular programs 
that we administer, the things that we have learned, how to cut 
through red tape so that communities do not have to let 
documentation be a barrier to obtaining housing assistance, or 
people can house people and then obtain documents to have 
additional time.
    Some communities were actually able to increase their 
payment standards for vouchers because we gave them 
flexibility. We were able to do that through emergency housing 
vouchers through the American Rescue Plan. But housing 
authorities do not always have that flexibility with the 
regular voucher programs.
    Senator Lummis. Well, I think this is a really important 
conversation. With interest rates as high as they, it has not 
only dried up the creation of new housing stock but it has 
dried up the creation of new build-ready lots, because the cost 
of even PVC pipe, sewer pipe infrastructure has gone so high 
that you cannot put a build-ready lot on the market that a 
buyer can afford to build a product on, that is affordable to 
home buyers. And I think it hurts attainable housing and 
affordable housing more than any other market.
    So I hope that some of the monies that were available under 
the American Rescue Plan and CARES is still available during 
time of high interest, because it is only going to get worse 
for a while, until we can get over this inflation and 
approaching recession.
    We just heard from Fed Chairman Powell yesterday that they 
expect higher interest rates perhaps in increments coming 
sooner. It is not good news. And so this dialogue is really 
important and it needs to continue.
    Thank you. Thank you so much for being here.
    Chair Smith. Thank you, Senator Lummis, and I want to just 
mention that follow up on the hearing that we had last summer, 
we have done some preliminary work on legislation to address 
some of these issues around streamlining and overcoming some of 
the red tape burdens. So I would welcome the opportunity to 
work with any of my colleagues on that legislation going 
forward.
    Senator Britt, do you have any additional questions?
    Senator Britt. Yes. Thank you so much, Madam Chair. I just 
wanted to ask a couple of process questions, specifically first 
about definitions. I am an attorney by trade so I have learned 
that definitions matter. And I just want to know, from your 
perspective, the definition of homelessness for HUD programs 
includes ``people living on the street or other places not 
meant for human habitation, in emergency shelters or 
transitional housing.''
    Additionally that differs from some other Federal programs 
such as the Department of Education's Education for Homeless 
Children and Youth Program, which considers a student that is 
experiencing homelessness if they are, quote, ``doubled up'' on 
family or friends' couches or staying there for economic 
reasons. I have also heard, when we are talking about rural 
communities, you know, we are talking about the underhoused. So 
we have used several different definitions.
    My question to you is, in your experience have these 
different definitions created an impediment to success, or 
would conforming them or creating a more comprehensive 
definition help you be able to better coordinate across 
multiple agencies and resources? Yeah, both of you.
    Mr. Cho. I will take that first just because it is HUD's 
definition that you referred to, Senator. Thank you for that 
question.
    You know, we have different definitions of homelessness 
between HUD and the Department of Education because they 
largely serve different purposes. Our definition informs who we 
count on the Point-in-Time Counts, but it also informs who is 
eligible for the roughly $3 billion in homeless assistance 
grants. That is out of a much larger HUD budget and set of 
programs that we administer.
    Education's definition largely governs the rights of 
children and students and their access to educational supports, 
if they are experiencing homelessness or housing instability. 
So schools have an obligation to provide continuing education 
for students regardless of their housing instability.
    I do not think that necessarily changing the definitions 
will solve the problem because essentially many of the doubled-
up families and families who are experiencing homelessness 
already are eligible for many of HUD's other larger homeless 
assistance programs--our affordable housing, our multifamily 
programs, housing vouchers, and public housing. The challenge 
is that there is not enough vouchers in public housing and 
affordable housing to meet their need.
    Simply just redefining them to make them eligible for HUD's 
much smaller set of programs is not going to necessarily meet 
their needs, particularly because that program is not 
necessarily growing. I think the answer is ensuring that 
homeless families who are doubled up or experiencing housing 
instability have access to affordable housing, and that is 
going to take investments across all of HUD's programs.
    Senator Britt. Thank you so much, Dr. Cho. And from your 
perspective, obviously, being the Executive Director for the 
United States Interagency Council on Homelessness, you probably 
have a different perspective with regards to dealing with 
different resources and agencies and others. What are your 
thoughts on that?
    Mr. Olivet. Our council is comprised of 19 Federal 
agencies, and it is our job to help point them in the same 
direction around homelessness strategy. And so this is a 
question we deal with all the time.
    At the community level, I have worked in programs that have 
been funded by Health and Human Services, Veterans Affairs, 
HUD, Department of Education, and probably many others. 
Community-level agencies are pretty sophisticated at blending 
and braiding funding streams to serve the populations that they 
are serving.
    But the reality is that human beings are bigger than these 
definitions, and they are more than their housing status. So if 
we are looking in rural Alabama or Wyoming versus Trenton, New 
Jersey, or San Francisco, California, it looks very different, 
but it also looks different from month to month or year to year 
for people. There might be somebody who is ``doubled up'' now 
who is in a shelter 6 months from now, or somebody who is 
living in their car now who then is staying with friends and 
family next week.
    So I think of these definitions as really program 
eligibility lines. So it helps Department of Ed cast a broader 
net for reaching all of the children they are trying to serve 
in the education setting, or for community health centers that 
are serving people through Health Care for the Homeless grants 
to be able to reach as many people as possible, including a 
broader swath of folks who might be doubled up. As Dr. Cho 
said, the HUD programmatic lines are very targeted, and so the 
tighter kind of conception of who is eligible for those 
programs--I am not going to speak for HUD--allows more narrow 
targeting of where those dollars go.
    Senator Britt. Thank you so much. And last, I just want to 
thank you. When we look at what is happening with our veteran 
population--and you have both referenced getting more and more 
veterans out of homelessness and back having the pride and 
dignity of moving forward on their own--I believe that our 
veterans are the best among us, and put it all on the line, and 
gave us their very best. It is certainly our turn to give them 
ours.
    As you have dealt particularly with that population and 
with those different challenges, what have you seen to be the 
most effective within that community in helping them come back 
out of homelessness?
    Mr. Cho. I think our work collectively between Congress, 
the Executive branch, and communities across the country, 
especially VA, to solve veteran homelessness is a case study in 
what effective Government and partnerships with communities 
looks like--a commitment to evidence-based practices, a 
commitment to working with urgency, and I think the importance 
of Federal leadership as well. When we have seen VA Secretaries 
make a public commitment to ending veteran homelessness, that 
matters, and that pushes that urgency down at the local VA 
medical center level and with their community partners.
    We have seen Secretary McDonough and Secretary Fudge make 
that public commitment when they first came into their offices, 
to end veteran homelessness, and that sent a message widely 
across the Nation to once again use the Federal resources that 
Congress provided to make sure that no veteran is left on the 
streets, and to prevent veteran homelessness. And we are 
seeing, again, that curve on veteran homelessness start to 
decline once again.
    Senator Britt. Thank you.
    Mr. Olivet. And if I could just briefly add to that. I 
think the work on veteran homelessness is one of the bright 
spots. It is bipartisan in nature. It has sustained over 
multiple Presidential administrations over a decade. We have 
seen a 55 percent reduction in homelessness in this population 
since 2010 and 11 percent in the last 2 years. This effort 
takes the best of what HUD does and lets them do it. It takes 
the best of what the VA does and lets them do it.
    As you all probably know, VA Secretary McDonough is 
chairing our Council right now, HUD Secretary Fudge was our 
Chair last year, and HHS Secretary Becerra is our Vice Chair. 
That continuity across HUD, VA, HHS, and all of our other 
agencies is what is working. And I think we could take the 
veteran successes as a case study of how to do this with other 
populations.
    Senator Britt. Absolutely. Thank you, and thank you, Madam 
Chair.
    Chair Smith. Thank you very much. Unless we have any other 
questions from the Subcommittee I want to thank our witnesses 
for being here today and for providing your testimony.
    For Senators who wish to submit questions for the record 
those questions are due 1 week from today, which will be 
Wednesday, March 15th. For our witnesses, you will have 45 days 
to respond to any questions for the record.
    Thank you again for being with us, and thanks to my 
colleagues. And with that this hearing is adjourned.
    [Whereupon, at 3:49 p.m., the hearing was adjourned.]
    [Prepared statements and responses to written questions 
supplied for the record follow:]
                 PREPARED STATEMENT OF CHAIR TINA SMITH
    Good afternoon. The Subcommittee on Housing, Transportation, and 
Community Development will come to order.
    I'm glad to have Sen. Lummis as my new partner and Ranking Member 
on this Subcommittee. I look forward to working with you over the next 
2 years.
    Both Senator Lummis and I are concerned about the shortage of 
housing in rural communities, and the unique challenges we see on 
tribal lands. And we both are focused on getting things done. So I'm 
confident we can find common ground, and I look forward to the work 
ahead.
    I'm also glad to welcome Sen. Fetterman, Sen. Kennedy, Sen. Vance, 
and Sen. Britt to the Subcommittee this year.
    Without safe, decent housing, nothing in your life works. It's 
nearly impossible to maintain a job, go to school, or stay healthy.
    Almost 600,000 Americans experience homelessness on any typical 
night. Of this number, 60 percent of those experiencing homelessness 
are sheltered, while the other 40 percent are unsheltered.
    Homelessness is a significant challenge in our country, and getting 
worse. While our Nation made significant strides in reducing 
homelessness in the first half of the last decade, we know that the 
number of people experiencing homelessness, began rising again around 
2016. The pandemic only exacerbated the challenges individuals and 
families have faced.
    The backdrop to the issue of homelessness is that our Nation is 
facing an affordable housing crisis. According to data published by the 
National Low Income Housing Coalition, not one State in our country has 
an adequate supply of affordable rental housing for the lowest income 
renters. In fact, for the 10.8 million families with extremely low 
incomes in the U.S., there is a shortage of more than 7 million 
affordable homes. This is an incredibly alarming problem that we are 
facing.
    The challenge of funding and keeping a safe, affordable place to 
live is real in every part of our country--urban, suburban, and rural. 
It affects everyone.
    However, homelessness also disproportionately affects some 
communities more than others, including Black, Latino, and Native 
communities. In my home State of Minnesota, while Native Americans make 
up only 1 percent of the adult population, the 2018 Statewide Homeless 
study found that Native Americans made up 12 percent of adults 
experiencing homelessness.
    In December, the U.S. Interagency Council on Homelessness published 
``All In'': the Federal Strategic Plan to Reduce and End Homelessness. 
The plan calls for a 25 percent reduction in homelessness by 2025. 
That's an aggressive goal, but I'm glad they're aiming high.
    We've learned a lot in the last few years about what it takes to 
effectively address homelessness. The American Rescue Plan provided 
70,000 emergency housing vouchers to rapidly re-house individuals at 
risk of homelessness, especially veterans and victims of domestic 
violence and sexual assault.
    And just last month, Secretary Fudge announced $315 million in 
awards to address unsheltered homelessness and homelessness in rural 
communities along with thousands of vouchers. This is the first time 
HUD has coordinated grants and vouchers. This type of coordination is 
critical, and I look forward to hearing more about it from our 
witnesses.
    I'm also looking forward to hearing more about how we can cut red 
tape, improve staffing, and make it easier for service providers and 
housing providers to do their jobs, instead of worrying about 
administrative tasks. We heard a number of suggestions at the hearing 
Sen. Rounds and I held in this Subcommittee last year and I hope we can 
find some bipartisan ways to make existing programs work more 
effectively.
    I often hear from people who work on homelessness that we know what 
to do to solve this problem, we just need the will to fix it. We have 
data-driven strategies that have proven effective in addressing 
homelessness in recent years. Those approaches can be effective, most 
of the time, in helping people who fall into homelessness. But we must 
also address the housing affordability challenges at all levels that 
are driving people into homelessness in the first place.
    Addressing homelessness and the challenges of housing affordability 
has long been an issue that Republicans and Democrats are both 
concerned about. I hope that in this hearing we can continue this 
bipartisan work, and look for concrete steps we can take together to 
address this deep challenge--with a comprehensive approach, effective 
strategies and the resources we need.
                                 ______
                                 
              PREPARED STATEMENT OF SENATOR CYNTHIA LUMMIS
    Thank you, Madam Chair. And thank you to our witnesses for being 
here today.
    Right now, many American families are struggling to find safe, 
affordable housing. For some of these families, housing insecurity is a 
growing concern.
    There are many challenges that can drive an individual or family to 
homelessness and make it harder to regain housing. The availability of 
affordable housing is part of the problem, but mental health 
challenges, physical disabilities, and struggles with substance use can 
lead to homelessness and make it harder to escape when it occurs.
    These problems cut across demographics. As a result, communities in 
every State right now, including my home State of Wyoming, are 
challenged to help those who are homeless or who lack stable housing.
    Today's hearing on the Biden administration's strategic plan to 
prevent and end homelessness provides a good opportunity to talk about 
what's worked and where we can do better.
    Housing First, a centerpiece of the Administration's plan, is a 
policy that places individuals into supportive housing without any 
conditions. Individuals are offered supportive services but are not 
required to use them.
    The term ``housing first'' raises an important question: ``If 
housing comes first, what comes second?''
    Individuals are placed into housing and then may choose whether to 
undertake the mental health treatment or substance abuse counseling 
they need to live healthy lives. But how many people caught in the 
cycle of addiction or the grips of a severe mental health crisis can 
recognize the help they need in the moment?
    At some point, when Housing First fails--and it does fail for some 
people--there need to be other paths to help.
    Shuttling vulnerable people between programs without needed 
treatment is not the path to housing independence. It perpetuates the 
problem.
    I'm disheartened at the Administration's continued focus on a 
version of housing first without the integrated wraparound services 
some individuals and families require to overcome homelessness.
    As a result, we've drifted too far to ``housing only.'' Funding 
does not allow local organizations the flexibility to act on what 
they've seen work in their local community.
    I'd also like to see HUD and USICH spend more time on the unique 
needs of rural communities and tribes. These are important issues in 
Wyoming.
    Homelessness and housing instability looks different in rural areas 
and reservations. Shelters are rare, and so many people turn to family 
and friends to get through a period of homelessness.
    As a result, homelessness shows up as overcrowding rather than 
tents on the street. But given how HUD conducts its counts of the 
homeless, these individuals and families living with family and friends 
would not be counted.
    We cannot fix problems when we are unsure of how big they are or 
where they are.
    Homelessness is a challenging issue, one that requires our best 
ideas.
    I look forward to hearing more from the witnesses about specific 
ideas to reduce red tape and help programs better serve vulnerable 
Americans.
                                 ______
                                 
                   PREPARED STATEMENT OF JEFF OLIVET
        Executive Director, Interagency Council on Homelessness
                             March 8, 2023
    Good afternoon, Chair Smith, Ranking Member Lummis, and 
distinguished Members of the Subcommittee. I am Jeff Olivet, executive 
director of the U.S. Interagency Council on Homelessness (USICH). It is 
an honor to appear before you today. I am here to discuss the tragedy 
of homelessness and the Administration's current and planned work to 
prevent and end it.
About USICH
    USICH is the only Federal agency solely focused on ending 
homelessness. USICH brings together the collective power of 19 other 
Federal agencies to coordinate the Federal response to homelessness, 
which includes programs administered by our member agencies 
specifically to address homelessness, as well as numerous mainstream 
programs that provide support for people experiencing poverty and 
housing instability. \1\ USICH has a team of Senior Regional Advisors 
across the country who work directly with mayors and governors across 
the political spectrum, and with service providers in urban, rural, and 
Tribal areas to help them use their resources effectively.
---------------------------------------------------------------------------
     \1\ https://www.usich.gov/fsp/appendix-b-inventory-of-targeted-
and-non-targeted-federal-programs-to-prevent-and-end-homelessness
---------------------------------------------------------------------------
    USICH began in 1987 when large bipartisan majorities in Congress 
passed the Stewart B. McKinney Homeless Assistance Act, later renamed 
the McKinney-Vento Homeless Assistance Act, which was signed into law 
by President Reagan. The law, amended and reauthorized by the HEARTH 
Act in 2009, recognized the complexity of coordinating Federal efforts 
to address homelessness. Then, as now, Congress understood that 
homelessness is a cross-system problem that requires cross-system 
solutions and that no single agency, system, sector, or jurisdiction 
can end homelessness on its own. That is why the McKinney-Vento Act 
requires USICH to develop and annually update a national strategic 
plan. Such a plan provides a shared vision of the work required to end 
homelessness and the strategies necessary to accomplish that vision.
    Today, I would like to provide a picture of homelessness in 
America, explain recent efforts that have flattened the curve on rising 
homelessness, discuss the challenges we still face, and provide an 
overview of ``All In'', the bold new Federal strategic plan for a 
future in which everyone has a safe, affordable, and stable place to 
call home. \2\
---------------------------------------------------------------------------
     \2\ `` `All In': The Federal Strategic Plan To Prevent and End 
Homelessness'', 2022, https://www.usich.gov/all-in.
---------------------------------------------------------------------------
Homelessness in America
    Homelessness is a life-and-death public health crisis. Tens of 
thousands of people die every year due to the dangerous conditions of 
living without a home, \3\ and the life expectancy of people who are 
experiencing homelessness is about 20 years shorter than people who are 
housed. \4\ According to the latest annual Point-in-Time Count, 582,462 
individuals experienced homelessness in the United States on a single 
night in January 2022. \5\ But this is only a snapshot in time. Over 
the course of a year, at least twice that number, more than 1.2 million 
people, experience homelessness. \6\ When we consider households that 
are precariously housed people, people in substandard housing, and 
people who are severely rent burdened or ``doubled up''--where multiple 
families or generations are living together out of necessity--the 
numbers surge adding millions to those who live each year without safe, 
adequate, and stable housing. \7\
---------------------------------------------------------------------------
     \3\ ``Homeless Mortality Toolkit'', National Health Care for the 
Homeless Council, 2021, https://nhchc.org/wp-content/uploads/2020/12/
Homeless-Mortality-Toolkit-FULL-FINAL.pdf.
     \4\ ``Remembering Those Lost to Homelessness''. National Coalition 
for the Homeless. (2018). https://nationalhomeless.org/remembering-
those-lost-to-homelessness/
     \5\ Office of Community Planning and Development. ``The Annual 
Homeless Assessment Report (AHAR) to Congress''. U.S. Department of 
Housing and Urban Development. https://www.hudexchange.info/
homelessness-assistance/ahar/
     \6\ Office of Community Planning and Development. ``The Annual 
Homeless Assessment Report (AHAR) to Congress''. U.S. Department of 
Housing and Urban Development. https://www.hudexchange.info/
homelessness-assistance/ahar/
     \7\ ``Quantifying Doubled-Up Homelessness: Presenting a New 
Measure Using U.S. Census Microdata'' (nlihc.org).
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    People of color are disproportionately affected by homelessness. 
While Black Americans comprise 12 percent of the overall population, 
they represent 37 percent of the homeless population. American Indians, 
Alaska Natives, and Asian Americans are even more disproportionately 
represented. Latinos, who are undercounted, are also overrepresented 
compared to their general population numbers. \8\ Other populations are 
also disproportionately affected by homelessness, including based on 
sex, sexual orientation, gender identity, and disability.
---------------------------------------------------------------------------
     \8\ ``HUD 2020 Annual Homelessness Assessment Report Part 1'': 
https://www.huduser.gov/portal/sites/default/files/pdf/2020-AHAR-Part-
1.pdf.
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    Homelessness impacts both the young and old. According to the 
National Center for Homeless Education more than 1 million youth were 
identified as homeless during the 2020-2021 school year using the 
Department of Education's definition of homelessness which includes 
those who are doubled up. \9\ Children--who make up 17 percent of the 
homeless population in the United States--are more likely to experience 
serious health conditions, abuse, and violence if they have experienced 
homelessness.\10\ \11\ Additionally, between 31 percent and 46 percent 
of young people who exit foster care experience homelessness by age 26. 
\12\
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     \9\ https://profiles.nche.seiservices.com/
ConsolidatedStateProfile.aspx
     \10\ ``The 2022 Annual Homelessness Assessment Report (AHAR to 
Congress) Part 1'': Point-In-Time Estimates of Homelessness, December 
2022 (huduser.gov)
     \11\ Smith-Grant, J., Kilmer, G., Brener, N., Robin, L., and 
Underwood, J.M. (2022). ``Risk Behaviors and Experiences Among Youth 
Experiencing Homelessness--Youth Risk Behavior Survey'', 23 U.S. States 
and 11 local school districts, 2019. Journal of Community Health, 
47(2). https://doi.org/10.1007/s10900-021-01056-2
     \12\ Dworsky , A., Napolitano , L., and Courtney , M. (2013). 
``Homelessness During the Transition From Foster Care to Adulthood''. 
American Journal of Public Health. https://ajph.aphapublications.org/
doi/abs/10.2105/AJPH.2013.301455
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    Older Americans--who face the same rising housing costs as everyone 
else, but often with fixed incomes and rising health needs--are one of 
the fastest-growing groups of people experiencing homelessness. Single 
adults over 50 now make up half of the homeless population, and if 
nothing changes in the next 15 years, Harvard University estimates that 
an additional 2.4 million seniors in the U.S. will have no access to 
affordable housing.\13\ \14\ Further, adults who experience 
homelessness age faster than their housed peers, with elevated rates of 
serious, chronic, and often avoidable medical conditions.
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     \13\ https://generations.asaging.org/homelessness-older-adults-
poverty-health
     \14\ www.jchs.harvard.edu/sites/default/files/Harvard-JCHS-
Housing-Americas-Older-Adults-2019.pdf
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    During the first 2 years of the pandemic, from 2020 to 2022, 
family, youth, and veteran homelessness all dropped. \15\ Meanwhile, 
unsheltered \16\ and chronic homelessness rose 3 percent and 16 
percent, respectively. \17\ The rise in unsheltered homelessness means 
people are seeing more tents in their neighborhoods and more people 
living in vehicles. As homelessness has become more visible, public 
pressure to solve it has intensified, and some State and local 
policymakers are resorting to criminalization and forced 
institutionalization. \18\ These ``out of sight, out of mind'' policies 
are ineffective, expensive, and have harmful, even deadly, 
consequences. The solution to public concern about unsheltered 
homelessness is to make sure everyone has a home.
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     \15\ Office of Community Planning and Development. ``The Annual 
Homeless Assessment Report (AHAR) to Congress''. U.S. Department of 
Housing and Urban Development. https://www.hudexchange.info/
homelessness-assistance/ahar/
     \16\ Unsheltered refers to people sleeping in places not designed 
for regular sleeping accommodation such as tents, cars, or on the 
street.
     \17\ Office of Community Planning and Development. ``The Annual 
Homeless Assessment Report (AHAR) to Congress''. U.S. Department of 
Housing and Urban Development. https://www.hudexchange.info/
homelessness-assistance/ahar/
     \18\ https://homelesslaw.org/criminalization/
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    Health and homelessness are inextricably linked. Illness, injury, 
and medical expenses can put people at risk of homelessness, and the 
experience of homelessness creates and exacerbates health problems. 
Many people who are homeless--though fewer than half--have mental 
health conditions and substance use disorders. While we must do 
everything we can to treat these conditions while people are homeless, 
we know that stable housing is the real solution. Permanent housing 
with robust wraparound supports not only helps people exit 
homelessness, but also provides the stable foundation upon which they 
can get healthy, address mental health and substance use disorders, 
deal with past trauma, and reconnect with jobs and school, family and 
community.
Causes of Homelessness
    Among the root causes of homelessness are the lack of affordable 
housing and incomes that do not keep pace with the cost of housing. A 
job has never guaranteed a home--and that is even more true today. By 
some measures, half of the people living in shelters or on the streets 
are employed. \19\ But full-time minimum-wage workers cannot afford 
even a modest apartment in any county in America. \20\ Meanwhile, rents 
have risen far faster than wages. Often evictions come too fast, while 
Government assistance is often too slow. Decades of growing economic 
inequality have left far too many Americans living paycheck to paycheck 
and one unexpected car repair or medical bill away from homelessness. 
\21\
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     \19\ https://bfi.uchicago.edu/insight/finding/learning-about-
homelessness-using-linked-survey-and-administrative-data/
     \20\ ``Out of Reach: The High Cost of Housing''. National Low 
Income Housing Coalition. (2021). https://nlihc.org/sites/default/
files/oor/2021/Out-of-Reach-2021.pdf
     \21\ https://www.cnbc.com/2022/10/24/more-americans-live-paycheck-
to-paycheck-as-inflation-outpaces-income.html
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    Even when people can afford a home, one is not always available. In 
1970, the United States had a surplus of 300,000 affordable homes. 
Moody's Analytics estimates a shortfall in the housing supply of more 
than 1.5 million homes nationwide. \22\ Today only 37 affordable units 
are available for every 100 extremely low-income renters. \23\ Where do 
we expect the others to go? Furthermore, people using housing vouchers 
struggle to find landlords who will rent to them, widening the gap.
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     \22\ https://www.moodysanalytics.com/-/media/article/2021/
Overcoming-the-Nations-Housing-Supply-Shortage.pdf
     \23\ ``The GAP A Shortage of Affordable Homes''. National Low 
Income Housing Coalition. (2022). https://nlihc.org/gap
---------------------------------------------------------------------------
    Preventing homelessness is critical: every day, roughly 2,500 
people, or around 900,000 people each year, exit homelessness--yet 
roughly the same number fall into homelessness. To end homelessness, it 
is critical that we not just house people experiencing homelessness 
now, but that we also find ways to ensure people do not become homeless 
in the first place.
    The current state of homelessness is heartbreaking. This is not the 
way it should be, and this is not the way it has to be.
What Is Working: The Impact of Unprecedented Federal Investment
    We are beginning to see some progress. In 2016, after years of 
steady drops, homelessness began trending upward. Then in 2020, the 
Nation was hit by a global pandemic and its resulting economic crisis. 
Against all odds, homelessness did not continue to rapidly rise. In 
fact, between 2020 and 2022, we were able to flatten the curve. Since 
the pandemic began, the number of people experiencing homelessness in 
the U.S. has remained relatively flat, increasing less than 1 percent. 
Meanwhile--thanks in large part to Congressional investments in 
programs like the Department of Labor's Homeless Veterans' 
Reintegration Program and the Jobs for Veterans State Grants, the 
Department of Veterans Affairs' (VA) Supportive Services for Veteran 
Families, the Department of Education's Education for Homeless Children 
and Youths, HHS's Runaway and Homeless Youth Program, and HUD's Youth 
Homelessness Demonstration Program--veteran, family, and youth 
homelessness dropped 11 percent, 5 percent, and 13 percent, 
respectively. \24\
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     \24\ Office of Community Planning and Development. ``The Annual 
Homeless Assessment Report (AHAR) to Congress''. U.S. Department of 
Housing and Urban Development. https://www.hudexchange.info/
homelessness-assistance/ahar/
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    Such progress occurred during a time of massive layoffs, 
skyrocketing rents, shuttering shelters, and lagging housing supply, 
that were exacerbated by the COVID-19 pandemic. But this also happened 
at a time of unprecedented Federal investment and collaboration--and we 
have Congress to thank for that. When shelters had to shrink their 
capacity or close their doors due to COVID protocols, we did not shrug 
our shoulders and let people languish. We put our differences aside and 
our heads together to develop creative solutions, like converting 
unused buildings into noncongregate shelters where people could 
socially distance and protect themselves from a deadly disease.
    When the pandemic put millions of people out of work, Congress did 
not sit on the sidelines and watch evictions pile up and hunger grow. 
Congress came together to expand unemployment assistance, to launch 
bold new programs like emergency rental assistance and provide stimulus 
checks that saved families from starving and losing their homes. In the 
process, you helped reduce overall poverty by 45 percent. These efforts 
prevented what could have been a massive new wave of homelessness.
    Congress came together to pass the CARES Act, and then the American 
Rescue Plan, amounting to the largest investments in ending 
homelessness at any point in our history. \25\ These investments have 
saved lives. The CARES Act and the American Rescue Plan included tens 
of billions of dollars for emergency rental assistance that has 
prevented millions of evictions and kept evictions below prepandemic 
levels--even after the Federal moratorium had ended. The legislation 
sent 70,000 emergency housing vouchers to communities, which served as 
an important tool to keep people housed. \26\ More than $5 billion in 
the American Rescue Plan is being used to expand access to housing and 
shelter. In 2022 alone, the Department of Housing and Urban Development 
(HUD) approved plans to build 10,000 affordable or supportive homes. 
Some of the new homes and shelters are in hotels and motels that were 
sitting vacant for years. With the help of these Federal funds, 
communities are renovating them and putting them to use. In just the 
last year, the VA and the 105 communities that joined USICH and HUD's 
House America Initiative used the American Rescue Plan to move more 
than 100,000 people out of shelters, off the streets, and into 
permanent homes. \27\ During the same period, the initiative added more 
than 40,000 affordable homes into the pipeline.
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     \25\ ``Guide to American Rescue Plan Funding That Impacts People 
Experiencing Homelessness''. U.S. Interagency Council on Homelessness. 
(2021). https://www.usich.gov/tools-for-action/a-guide-toamerican-
rescue-plan-funding-that-impacts-people-experiencing-homelessness/
     \26\ https://www.hud.gov/press/press-releases-media-advisories/
HUD-No-22-213
     \27\ https://www.usich.gov/news/biden-administration-helps-105-
communities-end-homelessness-for-more-than-140000-americans
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    Additionally, Congress provided $800M in ARP dedicated funding that 
was dispersed within 60 days to help deliver services to ensure that 
students experiencing homelessness get the services they need to ensure 
they are able to stay in school and thrive.
    Last year, the White House released its Housing Supply Action Plan, 
which includes legislative and administrative actions that represent 
the most comprehensive in history to help end America's housing 
shortage--and in just 5 years. \28\ The White House also released 
national strategies to transform mental health and social services and 
to combat the overdose epidemic.\29\ \30\ This year, USICH and the 
White House are launching a new Federal initiative to help key cities 
and States address unsheltered homelessness through dedicated Federal 
staff, maximum flexibility and regulatory relief, and technical 
support.
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     \28\ ``President Biden Announces New Actions To Ease the Burden of 
Housing Costs''. The White House. (2022). Retrieved from https://
www.whitehouse.gov/briefing-room/statements-releases/2022/05/16/
president-biden-announces-new-actions-to-ease-the-burden-of-housing-
costs/.
     \29\ https://www.whitehouse.gov/briefing-room/statements-releases/
2022/03/01/fact-sheet-president-biden-to-announce-strategy-to-address-
our-national-mental-health-crisis-as-part-of-unity-agenda-in-his-first-
state-of-the-union/
     \30\ https://www.whitehouse.gov/briefing-room/statements-releases/
2022/04/21/fact-sheet-white-house-releases-2022-national-drug-control-
strategy-that-outlines-comprehensive-path-forward-to-address-addiction-
and-the-overdose-epidemic/
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    While we are only beginning to see the impact of these commitments, 
the results show that we can make progress even during the most 
difficult times.
Challenges
Lack of Housing Supply
    Housing is the fundamental solution to homelessness, but the United 
States suffers from a severe shortage of safe, affordable, and 
accessible rental housing. \31\ The shortage is caused by many factors, 
including a shortage of available land and labor, increased costs of 
raw materials, local zoning restrictions, land-use regulations, 
opposition to inclusive development, and the destruction of homes in 
the path of natural disasters. \32\ Compounding this, people with 
housing vouchers or other rental assistance compete for limited housing 
in a highly competitive rental market, and they often face stigma, 
barriers, and discrimination by landlords. In addition, many landlords 
deny housing to people based on their criminal records or credit 
history. And many renters of color, LGBTQI+ renters, and renters with 
disabilities continue to face discrimination when they apply for 
housing. The lack of accessible housing for people with disabilities 
further complicates the situation.
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     \31\ ``The GAP A Shortage of Affordable Homes''. National Low 
Income Housing Coalition. (2022). https://nlihc.org/gap
     \32\ Zhang, J., Cummungs, R., Maury, M., and Bernstein, J. (2021). 
``Alleviating Supply Constraints in the Housing Market''. The White 
House. https://www.whitehouse.gov/cea/written-materials/2021/09/01/
alleviating-supply-constraints-in-the-housing-market/
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Rise of Rent Amid Slow Wage and Income Growth
    Wage growth has been slow for the lowest-paid workers for decades, 
and for many Americans, rental housing is unaffordable because wages 
have not kept up with rising rents. According to a 2021 report, in no 
U.S. State can a person working full-time at the Federal minimum wage 
afford a two-bedroom apartment at the fair market rent. \33\ As a 
result, 70 percent of the lowest-wage households routinely spend more 
than half of their income on rent, placing them at risk of homelessness 
if any unexpected expenses or emergencies arise. Housing 
unaffordability disproportionately impacts people with disabilities, 
LGBTQI+ people, and people of color. Discriminatory employment 
practices toward these groups further contribute to these disparities. 
Similarly, there is no housing market within the U.S. in which a person 
living solely on Supplemental Security Income (SSI) can afford housing 
without rental assistance. \34\
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     \33\ https://nlihc.org/sites/default/files/oor/2021/Out-of-Reach-
2021.pdf
     \34\ ``Priced Out: The Housing Crisis for People With 
Disabilities'', Technical Assistance Collaborative, https://
www.tacinc.org/resources/priced-out/. Please note that this website 
lists a prior maximum monthly SSI benefit amount. The current one is 
$914 for an unmarried individual.
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Inadequate Access to Quality Health Care, Education, and Supportive 
        Services
    Culturally appropriate, readily available, and accessible 
supportive services--including treatment for mental health conditions 
and substance use disorders--often are not available at a level to meet 
the need. This is particularly true in rural areas where transportation 
barriers, lack of community-based supports, and large geographical 
distances can inhibit access to services. As a result, people seeking 
these services may face long waits or may not receive them at all, and 
service providers may only be reimbursed for a fraction of the cost of 
care. Furthermore, collaboration and coordination between homelessness 
response and other systems--including health, victim services, 
workforce development, aging- and disability-related services, early 
care, and education--is often not as strong as it could be. \35\ People 
of color and other marginalized populations face greater barriers \36\ 
to receiving the supports they need, which leads to severe health 
inequities and disparities in health outcomes.
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     \35\ ``Early Care and Education Supports for Young Children 
Experiencing Homelessness''. The Administration for Children and 
Families, 2020, https://www.acf.hhs.gov/opre/report/early-care-
andeducation-supports-young-children-experiencing-homelessness.
     \36\ Cogburn, C.D. (2019). ``Culture, Race, and Health: 
Implications for Racial Inequities and Population Health''. The Milbank 
Quarterly, 97(3). https://doi.org/10.1111/1468-0009.12411
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Limited Alternatives to Unsheltered Homelessness
    The number of people living in unsheltered locations is rising, and 
has for the first time exceeded the number of people staying in 
shelters, yet there are often not enough safe, low-barrier shelter or 
interim housing options for people waiting for permanent housing and 
support. Many shelters are full or deny entry to people who have a 
mental health and/or substance use disorder, have a criminal record, 
live with a disability or chronic condition, or identify as LGBTQI+ 
despite regulations that prohibit this discrimination. People with 
disabilities, pets, partners, or older children (especially male 
teenagers) have fewer options for sheltering together. Additionally, 
shelters may not be equipped to meet the specific needs of a diverse 
population or have the capacity to provide adequate support and 
accommodations for people with significant physical disabilities and 
those with mental health or substance use disorders. As unsheltered 
homelessness increases in some communities, the impact on surrounding 
neighborhoods has eroded support for further investments in homeless 
services.
Criminalization of Homelessness
    In some communities, a rise in encampments has resulted in harmful 
public narratives and opposition to development of affordable housing 
and programs that serve people experiencing homelessness. As elected 
leaders respond--and not always in the most effective ways--some have 
resorted to clearing encampments without providing sufficient notice or 
alternative housing options for the people living in them. Many 
communities have made it illegal for people to sit or sleep in public 
outdoor spaces or have instituted public space designs that make it 
impossible for people to lie down or even sit in those spaces. \37\ 
Unless encampment closures are conducted in a coordinated, humane, and 
solutions-oriented way that makes housing and supports adequately 
available, these ``out of sight, out of mind'' policies can lead to 
lost belongings and identification; breakdowns in connection with 
outreach teams, health care facilities, and housing providers; 
increased interactions with the criminal justice system; and 
significant trauma--all of which can create challenges in the pathway 
to housing.
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     \37\ https://nlihc.org/sites/default/files/AG-2020/6-08-
Criminalization-of-Homelessness.pdf
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    Despite these formidable challenges, I believe that it is possible 
to end homelessness in this country. Programs in communities across the 
country have gotten better and better at getting people housed, 
providing wraparound supports, and making sure people don't fall back 
into homelessness. Lessons learned through the pandemic offer hope 
around increased collaboration, creativity, and urgency in our work to 
end homelessness. The way has become clear: we need to prevent 
homelessness before it happens, respond to the crisis of unsheltered 
homelessness, and connect people as quickly as possible with the 
housing and services that help people exit homelessness. I believe that 
we can come together as a Nation to do just that.
``All In'': The Federal Strategic Plan To Prevent and End Homelessness
    Our new Federal strategic plan, ``All In'', sets the bold goal of 
reducing homelessness 25 percent by 2025 and lays out a path to 
ultimately ending homelessness in America. With the help of Congress 
and communities, we believe we can achieve this ambitious goal.
    ``All In'' is built around six pillars: three foundations--equity, 
data and evidence, and collaboration--and three solutions--housing and 
supports, crisis response, and prevention. The plan includes dozens of 
strategies and actions the Federal Government will pursue to prevent 
homelessness, to urgently address the basic need for shelter, and to 
expand housing and supports that help people exit homelessness. At the 
foundation of our plan is the need to do this work with an evidence-
based, all-hands-on-deck approach based on what people who have 
experienced homelessness say they need and want.
    ``All In'' recommits the Federal Government to a Housing First 
approach to homelessness. This approach is simple but often 
misunderstood. It is built on a strong evidence base that a home 
provides the best foundation for rebuilding one's life. Without a home, 
every other aspect of a person's life suffers. How can you improve 
mental and physical health without a safe and stable place to live? How 
can you get and keep a job without a place to store belongings and 
maintain adequate hygiene?
    Housing First works--and it's cheaper than the alternatives. 
According to multiple scientific studies that span three decades, 75 
percent to 91 percent of people are still in their homes a year after 
Housing First assistance. \38\ Housing First shows increases in 
individual income, \39\ costs three times less than criminalization, 
\40\ and saves up to $23,000 \41\ per year per person compared to 
providing emergency shelter.
---------------------------------------------------------------------------
     \38\ Peng, Y., Hahn, R.A., Finnie, R.K.C., Cobb, J., Williams, 
S.P., Fielding, J.E., Johnson, R.L., Montgomery, A.E., Schwartz, A.F., 
Muntaner, C., Garrison, V.H., Jean-Francois, B., Truman, B.I., 
Fullilove, M.T.; Community Preventive Services Task Force. ``Permanent 
Supportive Housing With Housing First To Reduce Homelessness and 
Promote Health Among Homeless Populations With Disability: A Community 
Guide Systematic Review''. J. Public Health Manag. Pract. 2020 Sep/
Oct;26(5):404-411. doi: 10.1097/PHH.0000000000001219. PMID: 32732712; 
PMCID: PMC8513528.
     \39\ www.kansascityfed.org/Research%20Working%20Papers/documents/
8716/rwp22-03cohen.pdf
     \40\ https://homelessvoice.org/the-cost-to-criminalize-
homelessness/
     \41\ Stefancic, A., Tsemberis, S. ``Housing First for Long-Term 
Shelter Dwellers With Psychiatric Disabilities in a Suburban County: A 
Four-Year Study of Housing Access and Retention''. J. Prim. Prev. 2007 
Jul;28(3-4):265-79. doi: 10.1007/s10935-007-0093-9. Epub 2007 Jun 26. 
PMID: 17592778.
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    Of course, Housing First does not work for every person. There is 
limited research to understand the factors that predict whether a 
person will stay housed after receiving support. \42\ That work needs 
to continue, coupled with the development and testing of new 
interventions that could be effective in helping people maintain stable 
housing. Having a humane response to homelessness means treating every 
person with individualized care based on what works best for them. 
There are other evidence-based approaches--such as Trauma-Informed 
Care, Motivational Interviewing, and Critical Time Intervention--that 
communities and providers should include in their response. Our plan 
includes strategies to build a stronger evidence base for what works 
and to address research questions that need further study.
---------------------------------------------------------------------------
     \42\ Byrne T., Tsai J. ``Actuarial Prediction Versus Clinical 
Prediction of Exits From a National Supported Housing Program''. Am. J. 
Orthopsychiatry. 2022;92(2):217-223. doi: 10.1037/ort0000603. Epub 2022 
Jan 13. PMID: 35025573.
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    While housing is the immediate solution to homelessness, it is of 
course not the only solution. Housing must be matched with the 
availability of wraparound services to help people rebuild their lives. 
We must help people address the range of challenges they face around 
health, education, and employment.
Implementing ``All In''
    Work to implement ``All In'' is already underway. This is a 
multiyear roadmap to create the systemic changes needed to end 
homelessness in our country. To drive progress toward the ambitious 
goal of reducing overall homelessness 25 percent by 2025, USICH is 
developing implementation work plans and putting the strategies in the 
plan into action during FY 2023. These implementation work plans will 
include specific action steps, expected outcomes, and timelines for 
when action steps will be completed.
    As we continue our work on implementing ``All In'', we are 
committed to partnering with and incorporating regular input from 
people with lived expertise and stakeholders representing a broad range 
of groups and perspectives. We will work across the Federal Government 
and identify opportunities to make programs more efficient and 
effective. And we will work with governors, mayors, providers, and 
people on the front lines of this tragedy to implement effective 
strategies.
    ``All In'' represents a long-term commitment, and our 
implementation will be dynamic, results-driven, and transparent. 
Progress will be assessed regularly, and the implementation work plans 
will be adapted in real-time to reflect new actions and commitments as 
well as new data and information that can inform future work. USICH 
will publish an annual update to the plan that will include progress 
toward the 25 percent reduction goal, adjustments to the plan, and 
updates on implementing strategies at the Federal level and across the 
country. USICH will share information as it is available on its 
website, usich.gov, and report to the USICH Council, Congress, and the 
public on progress and actions taken to implement this plan.
Conclusion
    Any successes the Federal Government and State and local leaders 
have achieved in reducing homelessness are rooted in decisions made 
when we were united. We all have a role to play--the Administration and 
Congress, State and local leaders, faith and business communities, 
local service organizations, and leaders from across the political 
spectrum. Homelessness did not happen overnight, and it will not be 
solved overnight. But with resources, resolve, and cooperation, I 
believe we can end homelessness. I believe we can come together to 
build a country where no one experiences the trauma and indignity of 
homelessness, and everyone has a safe and affordable place to call 
home. ``All In'' provides a roadmap to help achieve this vision.
                                 ______
                                 
                   PREPARED STATEMENT OF RICHARD CHO
  Senior Advisor for Housing and Services, Department of Housing and 
                           Urban Development
                             March 8, 2023
    Good afternoon, Chair Smith, Ranking Member Lummis, and other 
distinguished Members of the Subcommittee. Thank you for this 
opportunity to testify on behalf of the Department of Housing and Urban 
Development on our efforts to help communities address the Nation's 
homelessness crisis.
    I'd like to start by reiterating the point made by Director Olivet 
that homelessness in America is a national crisis, but it is a crisis 
that we can solve.
    I know that homelessness is solvable because communities are 
solving and reducing homelessness every day. There was also a time, not 
long ago, when homelessness was decreasing overall. Specifically, from 
2010 to 2016, overall homelessness decreased by 14 percent--from over 
637,000 people on any given night to under 550,000 people. Homelessness 
decreased both among people in sheltered and unsheltered settings. In 
fact, from 2010 to 2016, unsheltered homelessness decreased by over 24 
percent.
    During this same period, from 2010 to 2016, homelessness among 
military veterans declined by 47 percent (from 74,087 veterans on a 
single night to 39,471 in 2016); homelessness among families with 
children declined by nearly 23 percent (from 79,442 families to 61,265 
families); and chronic homelessness declined by 27 percent (from 
106,062 individuals to 77,486 individuals).
    Those reductions did not happen by accident. They were the result 
of policies enacted by Congress. In 2009, Congress passed the Homeless 
Emergency Assistance and Rapid Transitions to Housing (HEARTH) Act of 
2009, which required communities receiving Federal homelessness 
assistance funds to track measurable outcomes and incentivize a focus 
on producing those outcomes. Specifically, are more people exiting 
homelessness into permanent housing? Are lengths of homelessness 
episodes decreasing? Are fewer people returning to homelessness once 
assisted?
    Over the next few years, HUD implemented the directives in the 
HEARTH Act to focus on system performance and outcomes. As a result, 
communities shifted their approaches and reallocated resources towards 
programs that produced those measurable outcomes, namely permanent 
supportive housing and rapid re-housing. From 2010 to 2016, communities 
added over 104,000 units of permanent supportive housing nationally. 
They also expanded the number of rapid re-housing beds from 0 in 2010 
to nearly 73,000 by 2016.
    At the same time, Congress provided significant new investments in 
the HUD-Veterans Affairs (VA) Supportive Housing (VASH) program that 
provides permanent supportive housing and rapid re-housing 
interventions through the Supportive Services for Veteran Families 
program for veterans experiencing homelessness. Those investments, 
coupled with the implementation support from HUD, VA, Department of 
Labor (DOL), and the United States Interagency Council on Homelessness 
(USICH), are directly responsible for the steep reduction in veteran 
homelessness.
    During this time, both the VA and local Continuums of Care 
implemented coordinated systems for identifying and assessing needs, 
delivering housing and supportive services, and matching people to the 
right level of assistance based on assessed needs.
    This overall shift is what we refer to as the Housing First 
approach, which provides people experiencing homelessness assistance in 
obtaining permanent housing as quickly as possible, without 
preconditions of treatment or sobriety, through a range of housing and 
supportive services interventions. Housing First is not a one-size-
fits-all approach, nor is it a ``housing only'' model. It is about 
implementing an array of programs that provide tailored levels of 
housing and services to help as many people as possible with the 
stability of a home as the foundation for achieving other goals and 
meeting other needs.
    Those decreases were driven by the combination of Federal 
leadership on homelessness, the commitment to Housing First, a focus on 
evidence-based programs and overall system performance, and Federal 
investments in housing interventions that connect people experiencing 
homelessness directly to permanent housing.
    However, when the Biden-Harris administration began, the trajectory 
of homelessness in America had changed. It had gone from decreasing to 
increasing. From 2016 to 2020, homelessness rose by 6 percent overall. 
In that 5-year period, the number of homeless adult individuals rose by 
15 percent, the number of people in unsheltered settings rose by 28 
percent, and the number of chronically homeless individuals--
individuals with disabilities who are homeless long-term--rose by 43 
percent. In 2020, among adult individuals, there were more individuals 
sleeping in unsheltered settings than in shelters for the first time 
ever.

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

    In January 2020, when the COVID-19 pandemic began, more than 
580,000 people were experiencing homelessness on any given night, 
including people with disabilities, unaccompanied youth, families with 
children, and older adults. They tend to have poor health status, often 
co-occurring chronic health conditions, and premature mortality rates, 
and they are disproportionately Black or African American, Native 
American or American Indian, and other people of color.
    The COVID-19 pandemic added to the challenges faced by people 
experiencing homelessness and the organizations and people who assist 
them. Communities put in place new measures to protect people 
experiencing homelessness from the pandemic, including decreasing 
congregate shelter capacity and limiting shelter entries. Efforts to 
connect people to housing faced new challenges as landlords and housing 
providers switched to virtual operations, and illnesses and health 
risks decreased workforce capacity and hampered the delivery of in-
person and home-based case management.
    This was the state of homelessness in America when the Biden-Harris 
administration began: Four years of homelessness growing nationally, a 
growing number of people sleeping outdoors, and the added challenges of 
the pandemic. Homelessness among veterans and families decreased, but 
did so at a slower rate than previously.
    To be clear, increases in homelessness after 2016 did not happen 
everywhere. Out of the 386 Continuum of Care (CoC) communities, 255 
CoCs (66 percent of total) achieved reductions in homelessness between 
2010-2022. And while the Nation and some CoCs saw an overall rise in 
homelessness from 2016-2020, 199 CoCs saw further decreases from 2016 
to 2022.
    This shift in the trajectory of homelessness starting in 2016 was 
driven by a combination of factors, which can be summarized as follows: 
after 2016, in many communities, particularly those with the highest 
homeless populations, the number of people who became newly homeless 
began to exceed the number of people whose homelessness was resolved.
    Data from HUD's AHAR Part 2 reports shows that from 2017 to 2019, 
approximately 901,000 people exited homelessness annually and 
approximately 909,000 people became newly homelessness in each of those 
3 years. In other words, in each of those years, approximately 8,000 
more people entered the ranks of homelessness than exited it, and hence 
homelessness at a point-in-time increased by approximately 25,000 
people.
    The increase in homelessness from 2016-2020 is not because the 
Housing First approach is ineffective--in fact, more people were 
exiting homelessness into permanent housing during this period than 
ever before. Rather, it is because housing market conditions and other 
factors were leading more people to become newly homeless than were 
being exited from homelessness into housing than in the prior years. In 
other words, Housing First works, but it must be scaled proportional to 
the level of need and supported by Federal policy. For example, from 
2016 to 2020, only 32,000 new units of permanent supportive housing 
were created, compared with over 104,000 new units during the prior 6 
years. In addition, greater efforts are needed to prevent people from 
becoming homeless in the first place.
    The contrast in homelessness trends in these two periods 
illustrates what is possible when the Federal Government provides 
leadership, resources, and support to help communities solve a problem. 
It shows what happens when targeted investments are made in evidence-
based interventions. It shows how a focus on outcomes and performance 
measurement can produce results. It also shows why ongoing Federal 
leadership and attention is needed to continually adapt in its response 
to changing dynamics.
    HUD, alongside USICH and other Federal agencies in the Biden-Harris 
administration, is providing that Federal leadership and attention. 
HUD's specific contributions to the implementation of `` `All In': The 
Federal Strategic Plan to Prevent and End Homelessness'' focus on 
scaling Housing First interventions, directing resources to underserved 
communities and unmet areas of need, mobilizing and strengthening 
collaboration among all of HUD's grantees and recipients to address 
homelessness, and providing ongoing support and technical assistance to 
help communities implement the Housing First approach effectively.
Scaling Housing First Interventions
    After Congress passed President Biden's American Rescue Plan Act, 
HUD provided communities with historic resources to scale Housing First 
interventions for all populations.
    At the top of this list is the Emergency Housing Voucher (EHV) 
program. EHVs are HUD's first housing vouchers specifically targeted to 
people experiencing or at risk of homelessness, including people 
fleeing or attempting to flee domestic violence, sexual assault, or 
human trafficking, and who are not veterans. The American Rescue Plan 
provided $5 billion for EHVs, and HUD awarded communities nearly 70,000 
vouchers.
    To implement the EHV program, HUD drew upon lessons learned from 
the HUD-VASH program regarding the importance of public housing 
authority (PHA) and service provider partnerships. HUD required that 
the 609 public housing authorities administering these vouchers partner 
with Continuums of Care and victim services provider organizations to 
receive referrals and to provide housing navigation and other 
supportive services to voucher holders, as evidenced by execution of a 
Memorandum of Understanding. All 609 PHAs executed these MOUs. 
Approximately 1\1/2\ years after the issuance of vouchers and program 
requirements, all vouchers have been issued to households and nearly 
two-thirds of the vouchers have been leased. Through the EHV program, 
nearly 47,000 households have found stable, affordable housing to date. 
This is the fastest take-up rate of any voucher program HUD has ever 
administered and demonstrates both the demand for these resources and 
the effectiveness of housing vouchers as a tool for addressing 
homelessness. We will continue to assist the 609 PHAs and their 
partners to lease up and utilize EHVs to reduce homelessness.
    Through the American Rescue Plan, HUD also awarded communities $5 
billion in funds through a special homelessness-focused allocation, the 
HOME Investment Partnerships Program, which HUD calls ``HOME-ARP''. 
HOME-ARP provides communities with grants to build permanent supportive 
housing or other deeply affordable housing, as well as to fund 
supportive services, short-term tenant-based rental assistance, or the 
acquisition of noncongregate shelter. HUD required that the 
participating jurisdictions (cities, counties, and States) that receive 
HOME-ARP allocations review data on needs, consult with Continuums of 
Care and victim services providers, as well as obtain public input, to 
determine the allocation of these funds. Participating jurisdictions 
have been submitting their allocation plans for HUD approval, and HUD 
expects to review all plans by June 2023. HOME-ARP will further 
increase communities' resources for housing assistance and supportive 
services to sustain their momentum on addressing homelessness over the 
next few years.
    In FY 2023, Congress also provided HUD with $75 million in 
additional funds to help Continuums of Care create more permanent 
supportive housing. As I mentioned earlier, the slowdown in permanent 
supportive housing production over the last few years coincides with 
the increase in chronic homelessness. Our Nation needs to get back to 
increasing permanent supportive housing for people experiencing chronic 
homelessness and other people with more severe service needs. We are 
currently working on developing the program requirements for this new 
$75 million program.
    HUD will also continue to administer our annual Continuum of Care 
Program competitive grant program, including funding for programs that 
serve survivors of domestic and dating violence, sexual assault, and 
human trafficking, as well as to expand the Youth Homeless 
Demonstration Program (YHDP).
Directing Resources to Unmet Areas of Need
    HUD is working to bring more Housing First interventions to the 
populations and geographic areas where homelessness has been rising, 
specifically, people in unsheltered settings and rural communities.
    In FY 2020, Congress gave HUD the authority to re-issue Homeless 
Assistance Grant funds returned by or recaptured from communities, 
allowing HUD to repurpose the recaptures through the Continuum of Care 
or Emergency Solutions Grants programs and set-aside funding for rural 
communities and for disaster response. Last June, HUD used this 
authority to issue a special Notice of Funding Opportunity (NOFO) that 
made over $300 million in grants available to help Continuums of Care 
implement coordinated approaches to address unsheltered homelessness by 
scaling housing and supportive services, including in rural areas. 
Communities were incentivized to leverage health care and supportive 
services partnerships, as well as mainstream housing resources. In 
addition, HUD issued a notice to public housing authorities that it 
would allocate over $43 million for special purpose housing vouchers 
that it received in FY 2021 to PHAs that formally partnered with 
Continuums of Care that will receive grant awards to address 
unsheltered or rural homelessness through our special NOFO. HUD 
received an overwhelming response to both the special NOFO and the 
voucher notice. Over 200 Continuum of Care communities out of 386 
applied to the special NOFO. Over 400 PHAs applied for the special 
purpose vouchers.
    On February 2 of this year, HUD announced that it would award over 
$300 million to 46 Continuum of Care communities to address unsheltered 
or rural homelessness. These communities represent large urban areas 
like Los Angeles, Chicago, and Dallas, as well as rural communities in 
Tennessee, Minnesota, and Missouri, and large Balance of State 
Continuums of Care that cover urban, suburban, and rural areas in 
States like Connecticut, Kentucky, and Kansas. Meanwhile, HUD has 
recaptured additional Homeless Assistance Grant funding and is 
currently seeking congressional approval to award these recaptured 
funds to additional qualified communities who applied to the special 
NOFO. Pending congressional approval, HUD expects to make these awards 
in the coming weeks. Also in the coming weeks, HUD will issue the $43 
million in special purpose vouchers to the PHAs that partnered with 
CoCs awarded under our special NOFO for addressing unsheltered and 
rural homelessness. HUD will accompany these resources with technical 
assistance to help communities implement the coordinated approaches and 
will scale Housing First interventions to address unsheltered and rural 
homelessness. HUD anticipates that these resources will help these 
communities reduce unsheltered homelessness as well as homelessness in 
rural areas.
    HUD will also continue to expand access to our Continuum of Care 
Program for tribal Nations and tribally designated housing entities. 
Through technical assistance, information resources, and direct 
engagement, HUD is reaching out to tribes to help them either join an 
existing Continuum of Care or to establish a new Continuum of Care, and 
thereby, apply for funds to address homelessness in tribal communities.
Providing Federal Leadership and Fostering Collaboration at All Levels
    HUD, alongside USICH and other Federal agencies, have been 
providing renewed Federal leadership to mobilize a national all-hands-
on-deck effort to solve homelessness. Solving homelessness cannot be 
the work of homeless services providers alone, but must be a shared 
responsibility with local and State governments, housing developers and 
providers, public housing authorities, philanthropy, the faith 
community, and the private sector.
    In September 2021, HUD Secretary Marcia Fudge launched the House 
America Initiative, a national initiative to address homelessness. She 
called upon mayors, county leaders, and governors to partner with HUD 
and USICH to set and achieve specific numeric goals for re-housing 
people experiencing homelessness and adding new units of housing to 
address homelessness to the development process by the end of 2022. 
State and local elected leaders from 105 communities across 31 States 
and the District of Columbia, representing over 50 percent of the 
Nation's homeless population, joined the initiative, convened local 
partners, and set local re-housing and unit creation goals. Over a 15-
month period, HUD, USICH, and other agencies provided technical 
assistance to help these communities to achieve their goals. By the end 
of 2022, these 105 communities collectively re-housed over 100,000 
households experiencing homelessness and placed 40,000 units of deeply 
affordable housing into the development process.
    To reinvigorate efforts to end veteran homelessness, the 
Secretaries of HUD and VA issued a joint statement and announced 
strategies to achieve an end to veteran homelessness. These joint 
strategies re-elevated the interagency effort to end veteran 
homelessness as a Secretarial priority. These strategies helped inspire 
greater focus across local VA Medical Centers, their public housing 
authority, and community partners and helped to set the trajectory on 
veteran homelessness back on a downward trend.
    Secretary Fudge and Secretary McDonough also served as the first 
Chair and Vice Chair, respectively, of the United States Interagency 
Council on Homelessness under this Administration. Under Secretary 
Fudge's leadership, the Council was re-established as a Cabinet- and 
principal-level body, a new USICH Executive Director was hired, and a 
new Federal strategic plan to prevent and end homelessness was 
developed. HUD is proud to have played a significant role in developing 
and informing the Biden-Harris administration's strategic plan ``All 
In''. The plan is centered on the Housing First approach but also adds 
a greater focus on addressing the racial inequities in homelessness, 
engaging people with lived experience of homelessness, and preventing 
people from becoming homeless in the first place.
Providing Ongoing Support and Technical Assistance to Communities
    In addition to deploying resources and providing leadership, HUD is 
also continuing to provide ongoing support and technical assistance to 
help communities improve their local systems and processes for 
connecting people experiencing homelessness to housing and supportive 
services.
    Areas of technical assistance include assisting communities with 
improving the leasing of Emergency Housing Vouchers and other vouchers 
for people experiencing homelessness, including addressing challenges 
related to collecting documentation, as well as with housing search and 
landlord engagement. HUD is also assisting communities to resolve 
homeless encampments through connections to housing and supportive 
services using an emergency management-style approach that has been 
honed in Houston and other communities. We refer to this as ``Housing 
First with a disaster response mindset.'' We are also helping 
Continuums of Care improve their coordinated entry systems, which serve 
as the locus of intake and triage for people experiencing homelessness, 
to ensure that they are efficient and equitable. We are particularly 
focused on ensuring that communities are addressing the racial 
disparities in homelessness by analyzing data on racial disparities in 
outcomes and conducting analyses to identify and address the drivers of 
these disparities.
    Most of HUD's programs fund housing and rental assistance, but we 
recognize that many people experiencing homelessness also need 
supportive services either to help them find and secure housing or to 
help support ongoing tenancy. To that end, HUD has been working closely 
with agencies at the Department of Health and Human Services (HHS) to 
help communities coordinate housing assistance with the various HHS 
programs that fund and cover supportive, health, and behavioral health 
services, including Medicaid home and community based services which 
include certain housing-related support, mental health and substance 
use services grant programs, and services provided by community health 
centers (including Health Care for the Homeless programs), certified 
community behavioral health centers (CCBHCs), and more. In December 
2021, HUD and HHS launched a joint technical assistance center, the 
Housing and Services Resource Center, to create a ``one stop shop'' for 
providing information to communities on the health and supportive 
services programs at HHS that can be coordinated with the housing 
assistance programs at HUD to assist people experiencing homelessness, 
older adults, and people with disabilities.
Conclusion
    HUD's latest data shows that Federal actions, including the safety 
net investments made through the American Rescue Plan, likely helped to 
prevent a spike in homelessness between 2020 and 2022. Homelessness 
grew by only 0.3 percent amidst a global pandemic. Family homelessness 
decreased by nearly 6 percent. Homelessness among unaccompanied youth 
decreased by 12 percent. And homelessness among veterans decreased by 
11 percent--the largest drop in 5 years. Veteran homelessness has now 
been reduced by 55 percent since 2010. We are once again bending the 
curve on homelessness, and we will continue to work to set the 
trajectory in the right direction--downward.
    I thank this Subcommittee for its deep concern for the national 
crisis of homelessness. And while the Nation's homelessness crisis is 
dire, I hope that my testimony has shown that homelessness is solvable, 
and that it can be solved when we fully invest in Housing First 
interventions for all populations, continue to focus on outcomes and 
performance, and mobilize partnerships across all levels and sectors. 
With Congress' support, HUD has made progress in reducing homelessness 
before, and, together, we can do so again. As President Biden likes to 
say, ``There is no problem that America cannot solve if we work 
together.'' Thank you for the opportunity to provide this testimony.
         RESPONSES TO WRITTEN QUESTIONS OF CHAIR SMITH
                        FROM JEFF OLIVET

Q.1. Under the Biden administration there are important efforts 
to better connect and leverage the health programs under HHS--
including Medicaid, SAMHSA grants, and community health 
centers--in order to help provide housing-related supportive 
services.
    Housing is clearly a social determinant of health. One 
thing I have heard from advocates and experts is that no 
medicine is as powerful as housing and many times doctors wish 
they could write a prescription for housing.
    With that in mind, what specifically can Federal 
policymakers do to help forge a better connection between our 
health care system, including the Medicaid program, and our 
homelessness response system?

A.1. Preventing homelessness, housing people, and promoting 
well-being requires close alignment between the homelessness 
response and health care systems. The success of the U.S. 
Department of Housing and Urban Development-Veterans Affairs 
Supportive Housing (HUD-VASH) program, which pairs Federal 
housing vouchers with Veterans Affairs (VA) supportive 
services, models these effective and collaborative partnerships 
in VA medical centers and community-based outpatient clinics.
    ``All In'' includes several strategies to improve 
coordination between the homelessness response system and 
health care systems and Medicaid, ranging from integrating 
treatment for mental health conditions and/or substance use 
disorders into primary health care settings to encouraging 
States to consider Medicaid financed service approaches and 
models.
    Collaboration: USICH encourages creating and sustaining 
local partnerships, particularly among housing and health care 
providers. These partnerships can promote holistic treatment 
for mental health conditions and/or substance use disorders 
with the goal of co-locating, coordinating, and integrating 
health, mental health, substance use disorder, safety, and 
wellness services with housing. Such collaborations can improve 
outcomes for groups that have historically been marginalized, 
including people of color, LGBTQ+ people, and people with 
disabilities. ``All In'' further calls on Federal agencies to 
deploy targeted funding and technical assistance that fosters 
collaboration among diverse entities, such as outreach, housing 
navigation, and aging and disability network organizations, as 
well as health centers, hospitals, and public health, and 
mental health crisis interventions teams. As part of this 
approach, Federal agencies will promote harm reduction and low-
barrier \1\ and accessible models to provide primary health 
care services and treatment for mental health conditions and/or 
substance use disorders and integrate treatment for mental 
health conditions and/or substance use disorders into primary 
health care settings and other nontraditional settings that 
lower barriers to services.
---------------------------------------------------------------------------
     \1\ Shelter or service provision that are designed to screen-in 
rather than screen-out applicants with the greatest needs and to 
provide assistance without service participation requirements and 
restrictive rules related to pets, partners, possessions, etc. All-
In.pdf (usich.gov).
---------------------------------------------------------------------------
    To increase access to resources, ``All In'' calls on 
agencies to review requirements for Federal programs that fund 
or support access to basic sanitation supplies and resources, 
health care services (including services for mental health 
conditions and/or substance use disorders), and other supports 
and resources that specifically impact areas where unsheltered 
people reside to identify barriers to program implementation. 
Furthermore, ``All In'' recognizes the need to increase the 
availability of, and access to, medical respite care to meet 
the needs of people who need recuperative care after hospital 
discharge, as well as to incentivize, strengthen, and expand 
opportunities for people with lived experience of homelessness 
to serve as outreach workers and service providers through 
programs like Peer Recovery Support, 50 Community Health 
Workers, and Medicaid HCBS.
    Data-Sharing: Preventing and ending homelessness will 
require programs to facilitate greater datasharing. ``All In'' 
calls on Federal agencies to expand communities' capacity to 
integrate Homeless Management Information System data and other 
Federal data sources with State and local administrative data, 
such as Medicaid data, to inform planning and decision making, 
while also protecting individuals' confidentiality and not 
excluding victim service providers from strategic decision 
making. For example, these health and administrative data 
sources can inform community assessment and prioritization 
approaches to service delivery and help determine who is most 
at risk of becoming homeless.
    Medicaid: More effectively leveraging Medicaid funds and 
partnerships can improve the health of people experiencing 
homelessness and help them stay stably housed once they exit 
homelessness. ``All In'' calls on Federal agencies to highlight 
and promote successful Medicaid-financed service approaches and 
models where State Medicaid, aging, disability, and health care 
agencies have coordinated housing assistance with Medicaid-
financed health care and supportive services for people with 
high medical vulnerability. USICH also encourages States to 
consider Medicaid-finance services approaches and models.
    Disaster Response: As highlighted by the COVID-19 pandemic, 
natural disasters and public health emergencies can disparately 
impact people experiencing homelessness. Thus, ``All In'' calls 
on greater collaboration among Federal partners that play a key 
role in disaster and public health response--including HUD, 
HHS, and DHS--and national emergency management associations 
and trade groups--including the Association of Healthcare 
Emergency Preparedness Professionals. Through increased 
collaboration, these entities can provide guidance, technical 
assistance, and training for emergency shelter operators on 
providing housing-focused services and integrating health care 
and supportive services into the provision of noncongregate 
shelter. For families with children, these efforts should also 
include resources to address the health and developmental needs 
of children and to improve environmental conditions while 
children are living at a shelter. Furthermore, these 
collaborations can illustrate to cities and counties how to 
create multisystem coalitions that partner with local public 
health agencies to drive down homelessness and reduce barriers 
to permanent supportive housing.
    Prevention: Finally, greater collaboration between the 
homelessness response and health care systems can help prevent 
new experiences of homelessness. Through the implementation of 
``All In'', USICH and member agencies will provide guidance and 
technical assistance to local systems of care for better 
integration of housing stability screening to determine who is 
most at risk of homelessness and to allow for earlier 
intervention and support. We will encourage community partners, 
including hospitals and health systems, to adopt housing 
problem solving that is inclusive in its approach. We will also 
provide accompanying guidance, training, and technical 
assistance on housing problem solving, providing 
accommodations, and associated practices, such as motivational 
interviewing and mediation.
                                ------                                


        RESPONSES TO WRITTEN QUESTIONS OF SENATOR SINEMA
                        FROM JEFF OLIVET

Q.1. I am concerned about chronic homelessness and supporting 
those with serious mental illness. My office recently heard 
that Arizona used to have a Safe Haven project, but it no 
longer does. I heard about the value of this form of supportive 
housing to help those with severe mental illness who come 
primarily from the streets or have been unable or unwilling to 
participate in housing or supportive services. I noticed that 
this intervention was largely left out of the national 
strategy. Mr. Olivet, what is the Council doing to ensure that 
this intervention also plays a role in ending and preventing 
homelessness?

A.1. Safe Havens were an eligible component under the former 
Supportive Housing Program as a form of supportive housing that 
served hard-to-reach persons experiencing homelessness with 
severe mental illness conditions and who have been unable or 
unwilling to participate in housing or supportive services. The 
Homeless Emergency Assistance and Rapid Transition to Housing 
Act of 2009 (HEARTH Act) amended the McKinney-Vento Homeless 
Assistance Act and repealed the ``Safe Havens for Homeless 
Individuals Demonstration Program'', meaning that the 
Department of Housing and Urban Development would not fund any 
new Safe Haven projects under the Continuum of Care Program but 
would continue to renew funding for an existing safe haven 
project as long as the community prioritized it. Today, very 
few safe havens remain operational, as many communities have 
redirected funds that were used for Safe Havens towards the 
creation of permanent supportive housing projects for persons 
with disabilities.

Q.2. My office has been in contact with GAO, and they mentioned 
that the Council was developing an interactive decision-making 
tool to help clarify which Federal definitions apply to 
different types of living arrangements and to help providers 
navigate the various homeless programs and match their clients 
to the programs that they are eligible for. Mr. Olivet, can you 
explain why this tool has not been created and what is being 
done in the interim to ensure that service providers can 
quickly and easily help connect their clients to Federal 
homelessness assistance programs?

A.2. Following internal discussions and those with key Federal 
partners, we have determined that the utility of such a tool at 
the community level would be limited and that developing and 
maintaining such a tool would require significant resources. 
Further, we believe that other mechanisms could provide 
clarification and guidance more effectively. Therefore, we 
determined that the development of this tool is not a priority, 
and USICH does not plan to develop an interactive mobile app or 
web-based tool. The agency has communicated this clearly to 
GAO.
    However, as part of USICH's work with its interagency 
Council, the agency has initiated an interagency discussion on 
the different definitions of homelessness to determine if there 
is an opportunity to create greater clarity and alignment. 
Furthermore, the recently released Federal Strategic Plan to 
Prevent and End Homelessness, ``All In'', includes several 
strategies that recognize barriers faced by communities and 
commits to Federal action focused on providing additional 
clarity and support. For example, ``All In'' calls on USICH and 
member agencies to: ``[p]ursue Executive actions, legislative 
amendments, and policy changes around eligibility and other 
definitions that limit access to programs for youth, 
individuals, and families who have prior involvement with a 
publicly funded institutional system.''

Q.3. We know that many of those experiencing homelessness have 
prior involvement with or are exiting from publicly funded 
institutional systems, including foster care and mental health 
and substance use treatment facilities. Mr. Olivet, the report 
noted that legislative action is needed to amend eligibility 
criteria and definitions that limit access to programs for 
these populations. Can you elaborate and provide specific 
examples?

A.3. Many people experiencing homelessness have prior 
involvement with, or are exiting directly from, publicly funded 
institutional systems, including child welfare and foster care, 
juvenile and adult corrections, health, and mental health and 
substance use treatment facilities. People, including youth, 
who are exiting an institutional system can face barriers to 
receiving assistance from the homelessness services system. 
Ending homelessness will require a whole-of-Government approach 
to close gaps and provide greater support to increase the 
likelihood of housing stability and decrease the likelihood of 
a subsequent occurrence of homelessness.
    Closing these gaps will necessitate a wide array of tools, 
as well as both statutory and nonstatutory changes. Through the 
implementation of ``All In'', we will work with interagency 
partners to identify legislative changes that may be needed, as 
part of our strategy to: ``[p]ursue Executive actions, 
legislative amendments, and policy changes around eligibility 
and other definitions that limit access to programs for youth, 
individuals and families who have prior involvement with a 
publicly funded institutional system.''

Q.4. The general formula for getting someone back into stable 
housing is to connect them to school, employment, or job 
training. However, we know that this formula does not work for 
seniors on a fixed income. Senior homelessness is on the rise 
in Arizona. What are some ways to amend eligibility criteria or 
increase flexibility in terms of allowable expenses for 
programs that seniors are already participating in order to 
help seniors at risk of becoming homeless or ways to rapidly 
re-house them?

A.4. Poor housing conditions are shown to worsen health 
conditions--especially for older adults and people with 
disabilities--which, in turn, can lead to homelessness. Older 
adults and people with disabilities face dual health and 
housing crises and need more access to community-based health 
care and support services, such as mental health care, 
outpatient treatment for substance use disorders, 
transportation, assistive technology, and personal care 
assistance. This is particularly true for people of color, 
especially Black people and American Indian/Alaska Natives, and 
other marginalized populations.
    ``All In'' commits to reducing housing instability among 
older adults and people with disabilities--including people 
with mental health conditions and/or substance use disorders--
by increasing access to home- and community-based services and 
housing that is affordable, accessible, and integrated. 
Innovative strategies identified in ``All In'' to increase 
supports for older adults include:

    Exploring the feasibility of expanding the scope of 
        programs that provide housing-related supports to allow 
        for greater flexibility in terms of allowable costs and 
        eligibility to ensure that people at risk of 
        homelessness are covered. This could include expanding 
        the permissible use of funds to cover home repairs, 
        modifications, renovations, and costs to address 
        disability-related needs, such as innovative 
        accessibility features, to reduce the likelihood of 
        housing insecurity and potential health impacts.

    Expanding housing options for people with 
        disabilities and older adults by providing guidance and 
        technical assistance and expanding and enforcing 
        requirements related to accessibility of housing.

    Promoting the use of flexible funding to cover 
        first or last deposit for renters with reliable sources 
        of income, such as Supplemental Security Income, which 
        provides for little to no discretionary spending.

Q.5. We know that many individuals experiencing homelessness 
tend to be eligible for multiple programs and services to help 
them get back on their feet to live better lives. Can you speak 
to some of the strategies that the council is considering to 
streamline eligibility to allow people to qualify for multiple 
programs at once without duplicative processes?

A.5. Complicated eligibility and documentation requirements can 
significantly delay the process of getting someone off the 
streets and into housing. The Federal Government should ensure 
that programs ``fit'' people experiencing homelessness and do 
not require people experiencing homelessness to ``fit'' into 
programs. Recognizing such, ``All In'' calls on USICH and 
member agencies to:

    Consider strategies to streamline eligibility and 
        access processes such as ``categorical eligibility'', 
        which would allow people to qualify for multiple 
        programs at once without duplicative processes and 
        ``conditional eligibility,'' which would allow 
        immediate entry into housing with a grace period for 
        required documentation.

    Identify ways to align eligibility criteria across 
        programs (i.e., categorical eligibility) so that people 
        do not have to apply and qualify for each program 
        separately (for example, children in households that 
        receive SNAP are considered categorically eligible for 
        free school meals). Similar categorical eligibility 
        could be applied for other programs.

    Conduct a comprehensive review of available policy 
        mechanisms that can increase access to Federal housing 
        programs among people experiencing or at risk of 
        homelessness, including eligibility, admissions 
        preferences, referral partnerships, funding incentives, 
        and administrative fees.

    Examine ways to ease eligibility and documentation 
        requirements for specific subpopulations, such as 
        people who are chronically homeless.

    Pursue Executive actions, legislation, and policy 
        changes around eligibility and other definitions that 
        limit access to programs for youth, individuals, and 
        families who have prior involvement with a publicly 
        funded institutional system.

    To implement the above strategies, USICH received a 
directive from its Council leadership in March 2023 to work 
with partner agencies to explore opportunities for 
administrative rulemaking related to presumptive and/or 
categorical eligibility for housing and other supports.

Q.6. One thing I've started to hear about from Arizonans is 
that each agency defines homelessness differently and has its 
own set of eligibility criteria. As a result, some providers 
may lack an understanding of the different definitions and 
criteria. What are your thoughts on having a single definition 
for homelessness? And how can the definition of homelessness be 
updated so we can come to a universal understand of what is 
consider homelessness?

A.6. Most programs targeted to people experiencing homelessness 
rely on one of three definitions used by three different 
Federal agencies: the Department of Housing and Urban 
Development, the Department of Education, and the Department of 
Health and Human Services. Each definition requires the 
collection of data elements that play a role in establishing 
eligibility for program benefits. These elements have varying 
degrees of overlap but are not the same.
    USICH and our Federal partners recognize that different 
Federal definitions of homelessness, and different eligibility 
criteria for Federal programs, can create implementation 
challenges in communities. Numerous Federal agencies administer 
programs either targeted exclusively to people experiencing 
homelessness (targeted programs) or available more generally to 
low-income populations (mainstream programs). These programs 
often have different eligibility requirements and use different 
definitions of homelessness. These differences can be confusing 
for both people in need of services and service providers, and 
can make collaboration and data collection difficult.
    As part of USICH's work with its Federal partners, the 
agency has initiated interagency discussions on the different 
definitions of homelessness to determine if there is 
opportunity to create greater clarity and alignment.
                                ------                                


         RESPONSES TO WRITTEN QUESTIONS OF CHAIR SMITH
                        FROM RICHARD CHO

Q.1. Under the Biden administration there are important efforts 
to better connect and leverage the health programs under the 
U.S. Department of Health and Human Services (HHS)--including 
Medicaid, Substance Abuse and Mental Health Services 
Administration (SAMHSA) grants, and community health centers--
in order to help provide housing-related supportive services.
    Housing is clearly a social determinant of health. One 
thing I have heard from advocates and experts is that no 
medicine is as powerful as housing and many times doctors wish 
they could write a prescription for housing.
    With that in mind, what specifically can Federal 
policymakers do to help forge a better connection between our 
health care system, including the Medicaid program, and our 
homelessness response system?

A.1. HUD recognizes housing-related supportive services are 
critical to addressing homelessness, especially for people with 
chronic health and behavioral health conditions. While HUD 
funds supportive services through our Homeless Assistance 
Grants, these resources are limited and are also needed to fund 
rental assistance. At the same time, there are significant 
opportunities to cover and finance housing-related supportive 
services through HHS programs, including Medicaid, SAMHSA 
formula and competitive grants, and community health centers 
that receive grants from the Health Resources Services 
Administration. Whether to use these HHS programs to cover 
housing-related supportive services, however, is at the 
discretion of States and HHS grantees and the degree to which 
States and grantees use HHS programs to cover housing-related 
supportive services varies:

    SAMHSA has five programs and services for those 
        experiencing homelessness. SAMSHA's homelessness 
        programs include discretionary and formula grants which 
        include PATH, CABHI, GBHI, TIEH, and SOAR. SAMHSA's 
        programs support efforts for ending and preventing 
        homelessness among people with mental and/or substance 
        use disorders, works to end homelessness by improving 
        access to treatment and services that support health 
        and wellness, and provides connection to stable housing 
        and linkages to HUD's coordinated entry system. A 
        small, but growing number of States are recognizing the 
        opportunity to cover certain housing-related supportive 
        services under their Medicaid programs. States can 
        cover these health-related social needs by obtaining 
        Federal approval of waivers, demonstration projects, or 
        State plan amendments. However, in most of the States 
        that have obtained approval, implementation is still in 
        its early stages.

    Many federally qualified community health centers, 
        especially those that receive Health Care for the 
        Homeless grants, are also covering housing-related case 
        management in addition to primary and behavioral health 
        care.

    Through our Notices of Funding Opportunities, HUD 
incentivizes Continuums of Care and homeless services 
organizations to leverage health care partnerships and programs 
to provide housing-related supportive services and coordinate 
these services with HUD's housing and homeless assistance 
programs. HUD and HHS also launched the Housing and Services 
Resource Center (HSRC) to provide States and communities with a 
one-stop shop for information, guidance, and technical 
assistance on how to coordinate HUD and HHS programs to 
coordinate housing with housing-related supportive services, 
including to address homelessness.
    Federal policymakers can support the leveraging of HHS 
programs to cover housing-related supportive services in two 
ways. First, additional technical assistance resources for both 
HUD and HHS would enable the agencies to provide enhanced 
coordinated messaging, guidance, and technical assistance that 
would encourage States and HHS grantees to use HHS programs to 
cover and provide housing-related supportive services. Enhanced 
technical assistance is particularly needed to provide 
implementation support to States with recent Federal approval 
of section 1115 Medicaid demonstration programs and State plan 
amendments to cover housing-related supportive services. 
Second, Congress could consider providing authorizing language 
and waiver authorities that enable HUD to better coordinate its 
programs with HHS programs. For example, waiver authorities for 
HUD's Mainstream Voucher program would enable public housing 
agencies to establish waiting list preferences specific to 
Mainstream vouchers for referrals from services partnerships 
with Medicaid and other health and disability services 
agencies.