HUD – VASH Update September 19, 2008 Vince Kane, MSW Office of Mental Health Services

1. HUD – VASH Update September 19, 2008 Vince Kane, MSW Office of Mental Health Services

2. HUD-VASH • The HUD-VASH Program is a collaborative partnership between the Department of Housing and Urban Development (HUD) and the Department of Veterans Affairs (VA) Supportive Housing (VASH). • In this partnership, HUD provides Housing Choice vouchers for permanent housing to homeless veterans while VA provides veterans with case management and supportive services to promote and maintain recovery and housing.

3. HUD- VASH • Expansion of the program in 2008 was designed to address the national goal of ending chronic homelessness for the hardest to serve veterans and their families. • Over 10,000 new vouchers • 291 Case managers authorized in April 2008

4. Principle Sources of Referral • HCV Outreach staff • May make direct referrals from community to HUD-VASH. • Community education can generate referrals to VA from community providers (i.e. shelters, food kitchens, welfare offices, etc.) • VA Homeless Programs • Residential Treatment Programs • Grant & Per Diem

5. Assessment Process • Confirm eligibility. • Assess for suitability. • If not housing ready, possible acceptance pending treatment in residential and/or inpatient setting. • If not appropriate, alternative treatment plan developed. • Determine need for other services to ensure adequate income, skills and support to maintain housing status once placed. • Multidisciplinary team to make determination on acceptance.

6. Entry Into HUD-VASH • Once accepted, an individualized treatment plan is developed by the case manager and the veteran. • Treatment plan reflects the goals of the veteran. Potential strengths and barriers to maintaining housing placement are addressed. • Establish process to monitor treatment plan including: use of alcohol and drug screening, frequency of medical and mental health appointments, assistance with employment and income needs, resolution of legal and financial issues.

7. Case Management Goals • Establish a therapeutic relationship. • Provide support for long-term recovery by working towards treatment plan goals. • Reassess needs and goals based on changing conditions. Inability to maintain sobriety does not generally lead to discharge from case management if veteran can maintain housing. • Foster community integration and independence. • Maintain veteran in housing.

8. Housing Placement • Alert PHA of referral. • As needed, assist veteran in completing and assembling required documentation. • Following PHA guidelines, assist veteran in locating suitable housing. • Request PHA inspection and approval of selected unit. • Assist veteran and landlord to complete lease. • Prepare for the move as needed providing guidance on turning on utilities, obtaining furnishings and supplies, and transportation to complete the move.

9. Delivery of Services • Coordinate VA and community interventions, acting as a liaison with critical partners (the landlord and other service providers). • Make regular home visits to assess veteran’s ability to maintain themselves in a safe environment that promotes sobriety, physical, and mental well being. • Schedule individual and group meetings. Individual sessions will focus on treatment plan and current needs. Group meetings should foster peer support. • Provide linkages for child care, medical coverage for family members (ex. Medicaid), family therapy, legal and income assistance programs.

10. Implementation Plan • Funding for implementation was sent to participating VA medical facilities in April 2008 to recruit and hire case managers. • The hiring was expected to be finalized within 90 days and programs were to be operational by the end of August 2008. • National training related to implementation was held for VISN leads in August 2008.

11. Despite Best Efforts • To promote timelier implementation, Deputy Under Secretary for Health Operations and Management requesting that Mental Health and Human Resources at the participating medical centers provide the utmost collaboration to achieve rapid implementation of this program. • If staff has not been hired, appropriate clinical staff must be detailed into vacant positions to ensure veterans receive both case management services and a referral for a HUD-VASH voucher to obtain permanent housing.

12. Expectations for Implementation & Program Monitoring • To support timely implementation, a performance monitor will be implemented in FY 2009 requiring that permanent staff be hired, that case management services be provided and that a percent of the awarded vouchers be issued as follows: • 25 percent of vouchers issued by November 1, 2008. • 50 percent of vouchers issued by end of 1st Quarter, FY 2009. • 75 percent of vouchers issued by the end of the 2nd Quarter, FY 2009. • 90 percent of vouchers issued by the end of the 3rd Quarter, FY 2009.

15. Next Steps • Monthly monitoring (starting October) • Briefing with VISN leadership • Joint Broadcasts with HUD • Future trainings • Handbook Implementation • Conference Calls 1st & 3rd Friday of the Month