HUD-VASH: The VA Perspective

1. HUD-VASH: The VA Perspective Teresa S. Pittman, LCSW HUD-VASH Program Analyst

2. Eliminating Veteran Homelessness • President Obama and Secretary Shinseki are committed to eliminating homelessness for our nation’s Veterans. • Eliminating Veteran homelessness is a very high national priority. • VA has developed a comprehensive Five Year Plan to achieve this goal. • HUD-VASH is a prominent element of the Five Year Plan.

3. Program Design • The HUD-VASH program was developed to provide case management and supportive services paired with a “Housing Choice” Section 8 voucher to eligible homeless Veterans • HUD-VASH case managers work to maintain Veterans recovery and independence • HUD-VASH has the opportunity to provide permanent, stable, and safe housing to homeless Veterans

4. VA Side of HUD-VASH • HUD-VASH is a partnership between the VA and HUD and VA case managers and PHAs • Both sides need to work together to have good and timely outcomes • For VA, case management is the heart of this program • VA also needs other community partnerships to successfully implement this program – referrals from community, landlords, assistance with deposits, furniture, etc.

5. Size &Scope • Over 20,000 housing vouchers • 10,150 allocated in FY08 • 10,290 allocated in FY09 • Almost 600 case managers • 291 case managers funded in FY08 • 292 additional case managers funded in FY09 • 283 FY08 Case managers are hired (97%)

6. Progress on FY08 Allocation • 20,295 Veterans have been screened • 13,825 Veterans have entered case management • 11,970 Veterans have been referred to the PHA • 10,707 Veterans have been issued vouchers • 6,906 Veterans have been housed as of September 30, 2009

7. FY 08 Allocation Progress

8. Eligibility Priority focus for HUD-VASH • Chronically homeless with SMI • Homeless Veterans with dependent Children (OEF/OIF)

9. Eligibility • VA determines clinical eligibility • PHA determines legal eligibility • Meet income requirements • Not on lifetime sexual offense registry requirement

10. Program Requirements • VA Health Care Eligible Veteran • Homeless (McKinney Act Definition) • Needs case management to obtain and sustain independently housed in the community • Must agree to participate in the case management portion of the program

11. Program Requirements • Sustained periods of sobriety are not prerequisites for admission to HUD VASH • Case managers are to coordinate and collaborate with MH and SUD providers to co-manage the treatment needs of the Veterans • HUD VASH is about promoting and sustaining access to treatment and housing and other supports that nourish the Veterans Recovery and enhance their quality of life

12. VA Case Managers • “Community Reintegration Specialist” • Evolving to team approach – CM, SUD, Peer Support, Housing Specialist • Will network with community advocacy groups, service providers, landlords, and local homeless Continuum(s) of Care

13. VA Case Management Intensity • Target case management Ratio is 35:1 but program needs to match intensity of services with the needs of the veteran. • Chronic homeless and families may require more intensive services especially during the engagement & stabilization phase • VA moving toward the evidence based Critical Time Intervention case management model

14. VA Case Manager Functions • Promote recovery from homelessness • Mental health • Substance use • Physical health • Assist Veteran to obtain treatment or services, as indicated • Provide access to benefits & vocational services • Assist with housing needs

15. Vital Functions of Case Management Throughout the case management process: • Assessment/ Reassessment • Functioning • Stability • Progress on established goals • Developing and revising mutually agreed upon goals and actions to accomplish those targets

16. HUD-VASH Flow Chart Connected with other programs and/or services: HCHV, RRTP, GPD, MH, SUD, Inpatient, Community Services, etc. for assistance Referral Outreach to Veterans and Community Referred for Non-HUD-VASH assistance Screening Veteran not eligible for Voucher Admitted Meet With PHA Voucher Issued Case Management Task: “Housing Search” Landlord development Locate suitable housing unit Inspection LeaseMove Into housing unit Case Management Task: “Housing Ready” Assessment Housing and Service Plan Referral for concurrent MH, SUD, PCC Income Assistance CWT/ Employment Services VA and SS Benefits Money Management/ Credit Repair PHA Application and Documentation PHA Referral Voucher Returned to PHA Case Management Task: Sustain Housing Recovery in MH, SUD, Physical Health Transition TimeSkill Development/ Practice Foster Independence Monitor Stability and Functioning Exit HUD-VASH

17. VA Case Manager Basics • Provide case management services in: • VA setting • Veteran’s home • Community settings • Group settings • Face to face meetings at least weekly • Stop code 522 • Group meetings count as face to face • Telephone contacts • Stop code 530

18. Exit from Case Management • Veterans ready to exit from case management will have: • Developed skills • Achieved sustained recovery from clinical symptoms • Demonstrated ability to live independently • Stage transition – fewer visits, longer time between visits • Communicate with PHA at all stages

19. Exiting from HUD-VASH • Why Veteran may be exiting HUD-VASH: • Veteran no longer needs case management or voucher • Veteran refuses to participate in case management • Veteran is incarcerated • Veteran loses voucher due to PHA rule violation • Veteran evicted from housing unit • All reasonable efforts will be made to assist Veteran to keep the Veteran involved in the Program, unless program not needed

20. Community Partnerships • PHAs • HUD – Field Offices/ National Office • Landlords • Homeless Service Providers • Veteran Service Organizations • Law Enforcement/ Justice System • Faith Based Organizations • Local Homeless Continuum of Care • Community at large

21. FY 2010 HUD-VASH Dashboard • Must be accurate - shared with HUD and Congress • Monitored by the year of the award (FY 08 and FY 09) • Four primary sections: • Hiring status information (internal to VA) • Cumulative implementation of the program • Current number of Veterans with vouchers and number of Veterans housed

22. DASHBOARD • VISN • Site identification information • Voucher awards • Case manager allocations

23. FY 09 Dashboard

24. DASHBOARD • Cumulative Data • Automatic Calculations for: • Pink = Performance Monitor • Purple = Performance Measure • VISN Totals

25. DASHBOARD • Current Data • Automatic Calculations for: • Current Vouchers in Use • Percentages • VISN Totals

26. HUD-VASH Outcome Goals • End homelessness for Veterans through permanent supportive housing • Veterans will sustain housing and will: • Remain stable and in Recovery (Improved quality of life) • Learn and use new skills and strategies • Participate in cultural and social activities • Be good tenants • Engage in healthy practices • Make thoughtful and appropriate decisions • Gain independence

27. HUD-VASH • Low Barrier Access • Maintain Hope for Veterans VHA Handbook 1162.05 • Internet http://www1.va.gov/vhapublications/ • Intranet http://vaww1.va.gov/vhapublications/ Sharepoint: http://vaww.national.cmop.va.gov/MentalHealth/HUDVASH/Forms/AllItems.aspx

28. Contact Information Please contact me if you have questions or want to discuss specific program concerns: Teresa Pittman VA Central Office 810 Vermont Ave. NW Washington, D.C. 20420 202-461-7308 Teresa.Pittman@va.gov