VA homelessness studies yield insight on Housing First approach


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In 2009, VA announced the goal to end homelessness among Veterans. In a recent article in Veterans Affairs & Military Medicine Outlook, Craig Collins explores some of the research being conducted in VA to achieve this goal.

Homelessness disproportionately affects Veterans compared with the general U.S. population. While about seven percent of Americans are Veterans, Veterans account for 11 percent of the homeless population. To combat this problem, VA partnered with the Department of Housing and Urban Development to form the HUD-VA Supportive Housing (HUD-VASH) program. HUD-VASH has given out more than 85,000 housing vouchers to provide rental subsidy and support services to Veterans and their families, with encouraging results. Veteran homelessness declined by 36 percent from 2010 to 2015*. However, reports show that more than 47,700 Veterans were homeless as of 2015.

One particular HUD-VASH program that Collins highlights is based on the increasingly popular approach to subsidized housing called Housing First. Many U.S. and international agencies are moving to a Housing First model to address homelessness in various populations. This program provides homeless Veterans with housing vouchers unconditionally in the hope that having a place to stay will help them in other areas as well.

The traditional approach to subsidized housing has involved providing long-term housing only after homeless people meet conditions such as finding work or completing addiction and mental health treatment. Housing First flips this strategy. In providing housing without conditions, VA hopes that Veterans will have a better chance of moving forward with recovery and employment when they do not have to worry about finding permanent housing.

“Housing First is a major change of clinical philosophy and a giant logistic change at the same time,” said Stefan Kertesz, M.D., of the Birmingham VA Medical Center. “The clinical philosophy takes housing and treats it as a human right instead of a reward for doing well.”

Housing First involves more than just providing a place to stay. The program also includes case management by a social worker and referrals for health and social services. So far, Housing First has been successful: studies show that this approach leads to better long-term housing outcomes, as well as better health care outcomes.

Implementing this program is not without its difficulties, however. Housing First requires VA caseworkers to deal with logistical problems involving real estate, bills, and material needs such as clothing and furniture in addition to resolving clinical and psychological issues. These extra responsibilities have led to some turnover or burnout of social workers working in VA. As Kertesz explains, Housing First requires a collaborative effort across VA among social workers, VA leadership, vehicle fleets, information technology people, mental health services, emergency departments and many others.

VA is conducting ongoing studies to figure out how to best implement this program VA-wide. Some of the difficulties found so far involve variations in the way Housing First is being implemented across different VA medical centers, and concerns about competing responsibilities getting in the way of social workers’ case-management duties.

In his article, Collins goes on to discuss a few other examples of how VA researchers are working to end homelessness. He ends his article by pointing out that changing how the largest health care system in the country delivers services to tens of thousands of Veterans is a “colossal undertaking.” But as VA expands these and other programs to understand Veteran homelessness and find workable solutions, there is reason to hope that the rate of this problem among Veterans will continue to decline.

For more on VA’s efforts to end Veteran homelessness you can read the Veterans Affairs & Military Medicine Outlook article here.

* Updated data revealed a 17-percent decrease in Veteran homelessness between January 2015 and January 2016—quadruple the previous year’s annual decline—and a 47-percent decrease since 2010.


About the author: Tristan Horrom is a writer-editor with VA Research Communications and with VA’s Journal of Rehabilitation Research and Development.

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Anthony Knox    

    Doesn’t look so unconditional to me. Having a case worker is a condition.Just gimme the voucher. Not that I wouldn’t relocate out of state but where I live housing costs are astronomical and inflating rapidly. I assume the vouchers still have a max limit and I doubt that would work where rents are among the highest in the country. Recently a senior rent controlled building landlord began evictions on dozens of retirees to upgrade the building and increase rents. Where are all those folks going to go as non-rent controlled units are way over priced for most on SS retirement. And as my health deteriorates with age I find the climate (w or w/o GW) I need to relocate to a more user friendly area and that would be in another county. Since HUD/VASH is pegged to individual VAMCs how would/do I make it function at another med center in another county. Needs be more connected nationally. And BTW, giving COLAs @ .3% isn’t going to help anyone sustain housing. And peg min pensions to state’s minimum wage.

    1. Phillip E.Euper    

      Why not take the housing areas on closed down bases. Give the homeless vets the job of
      Cleaning, Painting and Repairing these
      Useless facilities and in return allow them to
      Live in these units.
      Give some of them the job of oversite to maintain the units while the others use other VA programs to get educated, learn new job skills and move back
      Into the civilian communities!!

      Just my thoughts

      Phil Euper Etcmss USN Ret.

  2. Daniel hammond    

    Forcing vets that are homeless to live by your progressive regressive rules is why they won’t live in those stalag camps!

    They wanna smoke or do drugs or drink that’s what their gonna do or they leave

    1. Jacqueline Culbreth    

      Not only that but telling a 55 year old woman that before I can get help I would have to live in the woods for at least a year. How many others have been told that and not lived to tell us about it. It’s just sad!

  3. Daniel hammond    

    How about building veteran neihborhoods for the homeless
    With a managing agency but without all the crazed lifestyles management crap!

    1. Rosaura Brazill / Uttamjot Kaur    

      Segregation is not the answer…the veteran should choose the neighborhood they want to live in. As a Non-smoker vet i wouldn’t want to be placed, visit or be in a facility where smoking is permitted. We fight for FREEDOM but the choices for some of US are not so free, they have a BIG HOOK attached to them.

  4. Nancy Elizabeth Hobson    

    In Australia we have two private organisations dealing with general homelessness, Michael Projects and Brisbane Housing Company working with the Salvation Army, other churches, and the government, getting homeless people first into temporary housing, then into permanent housing owned by the government and Brisbane Housing Co. An approach that is working.

  5. Connell Sims    

    I am a veteran myself and I do care about homeless people in how they can live out in this weather when it is so cold. I am a Realtor also here in the Charlotte NC area if I can with help in kind of way please let me know what I can do to help! My infomation is below.

    Connell Sims

  6. Daniel Erline    

    i am a ex transsexual who was homeless in 2013 2014 and i surrendered my life to Jesus the Christ and he turned my life around. I now am buying a home with my non service veterans pension which is barely above 1k a month. I know many more can do it but the choice is theirs to surrender their lives to the only one whom saves..

  7. Rosaura Brazill / Uttamjot Kaur    

    the VA IS SO FULL OF SHIT…the only ones benefitting from the veteran’s mental, psychological and physical ordeals are the same agencies that are exploiting it. They want to look and show they care, but the veterans have to climb boulders in order to get benefits. Keep the bullshit going VA…

  8. Jacqueline Culbreth    

    This is a little deceptive. As a veteran who is on the verge of becoming homeless and in desperate need of help due to a foreclosure I was told that I would have to live in the woods for at least a year. I am 55 years old and have medical issues. The previous time i was homeless I was denied help because I wasn’t homeless long enough. My child and I have been homeless since he was in 9th grade. So when I see articles like this it upsets me because it’s not true. I would love for someone to write the truth. If you want the real truth contact me and other Veterans and not the public relations department.

  9. Rosaura Brazill / Uttamjot Kaur    

    i was living in an abusive relationship and left to a homeless shelter in the VA. In that facility, the Social Services of the county that i was living in, was paying over 1,600.00 a month to give me a roof in the rundown facility. They had me sharing a room with smokers that were constantly entering and exiting the bedroom, disrupting my sleep and rest at all hours. My food that was purchased with food stamps had to be stored in their “kitchen” facilities, and i was unable to reach or snack whenever i felt appropriate. Why are they paid 1,600.00 when i can get a one bedroom apartment for about the same? It doesn’t make any sense, and Judge Judy says: ” If it doesn’t make any sense it is not truth”. I had to leave and live in my car and when it got cold i had to ask the abusive person to let me stay there again, which is insane, but is a familiar situation. I’m currently still homeless and not able to to secure a job that pays the basics on Long Island, because the inefficiency of all these agencies that are supposed to be helping. I deserve the best, and the feedback i get from it all is that i demand too much. They tell you one thing and do something else.

  10. Jacqueline Culbreth    

    There needs to be policing of agencies that are suppose to help people and the people that needs help don’t get the help. I have seen people help out their families instead of the people that needs help.

  11. Carlos Navarro    

    ☆☆☆☆☆☆☆☆☆☆☆☆☆☆

    I can only speak for myself !

    After 27 + year’s of Addiction and 5 + year’s of a documented Clean & Sober Lifestyle , I’ll Creteque my Journey :

    1) Clean Date 8/MAY/2011

    2) First stop local hospital , waiting for pick-up to Pacific Garden Mission (☆) &(Chicago’s Largest Shelter) , stayed (+/-) 1 – month

    3) Next , Haymarket (Drug Treatment Center) stayed (+/-) 3-months

    4) Next , ASAFEHAVEN (Recovery Facility w/Veteran’s Accommodation) stayed (+/-) 3-months

    5) Next , Feather-Fist Fort -1 ( Recovery Home For Veteran’s only) stayed (+/-) 2 – months

    6) Next , my own (Rent-Free) Apartment (I was helped by Ezra – Housing / NorthSideHousing [Funded By Hud-Vash Veteran’s Program] & Heartland Alliance)

    7) After (+/-) 1-year I started receiving Social Security Disability Benefits then , began paying 30% of my Benefits and I continue to FLOURISH today

    8) JBMC (ATP Program) I started with a Homeless Assessment & followed thru incorporating Health / Mental Health & Recovery initiatives (☆☆)

    9) Fast Forward to today ; I have invested 100% in my Recovery , Volunteering , Community Leader , Mentor & Sponsor For Veteran’s & Board Of Director (EdgeAlliance – We house & support 125 / HIV-AIDS Tenants) and Resident Council Member – Leland Building

    ALL THAT HAS HAPPENED AND CONTINUES , IS THE ” CAUSE AND EFFECT ” OF – – HOUSING FIRST !

    The initiative of being housed 1st was , Monumental to my Sobriety & Positive Outlook (Spirituality) . Giving me a Foothold then Succeeding in our Society .

    Equally important , IS my Attitude , from the Beginning accepting the Concept of Living a Sober Lifestyle . Although , few achieve the belief at first , or with any sustainability . I absolutely without any reservation knew , I fell in that 10-20 % who were destined for SUCCESS !

    I don’t consider myself Lucky or Special , I just Accepted Responsibility for my Actions . Note : Not everyone is bound to succeed . Statically , it’s extremely Daunting and to some Inconceivable .

    FOR ME AND I’M CERTAIN FOR OTHERS THIS HAS.BEEN A GODSEND . PLEASE , DO NOT DIVEST IN THIS PROGRAM . AT MINIMUM INCREASE FUNDING . IT LITERALLY , HAS SAVED MY LIFE ! AND MY COMMUNITY HAS REAPED CONTINUED BENEFITS .

    (☆) I HAD TO GO PGM BECAUSE , HAYMARKET WOULDN’T ACCEPT ME UNTIL I WAS CLEARED BY M.D. FOR T/B .

    (☆☆) THE JESSIE BROWN MEDICAL CENTER , CARED FOR ME IN MY DARKEST HOURS . AT FIRST I HAD LIFE ALTERING PHYSICAL AILMENTS AND UNDIAGNOSED MENTAL PROBLEMS (CHILDHOOD-PTSD) DEPRESSION & ANXIETY . I BENIFITTED BY FOLLOWING THROUGH (ATP PROGRAM) W/ANGER MANAGEMENT & COGNITIVE THINKING FOR PTSD CLASSES-REPEATEDLY) . I WILL NEVER GIVE UP THE DAILY RITUAL OF ACKNOWLEDGING MY ADDICTIVE BEHAVIORS .

    AND GOOD LUCK TO THOSE , BEGINING
    THIS WORTHY , STRUGGLE !

  12. Nancy Pepper    

    To help with the logistical — rent, furniture, bills, etc. — issues, perhaps volunteers could provide help with some of the routine matters that ordinary people handle all the time, yet can be so daunting in periods of stress.

  13. david reitter    

    re: RADIO talk show , Lars Larson , recent interview with an a person representing Veterans from the most recent wars , Iraq , etc.

    The authority was describing 34,000 Combat Veterans receiving a letter from President elect Mr. Trump . The letter stated the Veteran would never have to worry or be concerned with the future of their VA healthcare benefits. There was no mention from this authority about Korean War or Vietnam veterans. Or other veterans with hardship.

    Mr. Trump has been known in his campaigning to lean toward union, especially , A.F of L. These special group of 34,000 could be police officers of the Police Union. The law enforcement hires combat veterans.

    Sad, United States Congress & the President seems have made most veterans homeless with their pick & choose status quo , blind eye of past history justice all.

  14. Eugene Nadig    

    This is an attempt to fix the result not the cause. If the vet had a trade when he left the service he/she would not be so at risk of becoming homeless. Money would be better spent by making sure the vet had such a trade when they leave the service. No one wants to be dependent on handouts.

Comments are closed.