VA's Health Care for Homeless Veterans Program (HCHV) operates at 135 sites, where extensive outreach, physical and psychiatric health exams, treatment, referrals, and ongoing case management are provided to homeless veterans with mental health problems, including substance abuse. As appropriate, the HCHV program places homeless veterans needing long-term treatment into one of its 200 contract community-based facilities. During the last reporting year, this program assessed more than 40,000 veterans, with 4,300 receiving residential treatment in community-based treatment facilities. The average length of stay in community-based residential care is about 70 days. More sites with contract residential services will be added this year.
VA's Domiciliary Care for Homeless Veterans (DCHV) Program provides medical care and rehabilitation in a residential setting on VA medical center grounds to eligible ambulatory veterans disabled by medical or psychiatric disorders, injury or age and who do not need hospitalization or nursing home care. There are 1,791 operational beds available through the program at 35 VA medical centers in 26 states. The program provided residential treatment to nearly 5,500 homeless veterans in FY 1999. The domiciliaries conduct outreach and referral; admission screening and assessment; medical and psychiatric evaluation; treatment, vocational counseling and rehabilitation; and post-discharge community support.
Veterans Benefits Assistance is provided at Regional Offices by designated staffs who serve as coordinators and points of contact for homeless veterans. The Homeless Eligibility Clarification Act enables eligible veterans without a fixed address to receive VA benefits checks at VA regional offices. VA also has procedures to expedite the processing times for homeless veterans; benefits claims. Last year over 21,000 veterans received services from VA staff members.
Special Outreach and Benefits Assistance is provided through funding from VA's Veterans Health Administration to support 12 veterans' benefits counselors from the Veterans Benefits Administration (VBA) as members of VA's Homeless Chronically Mentally III Veterans Programs and DCHV programs.
Acquired Property Sales for Homeless Providers Program makes available properties VA obtains through foreclosures on VA insured mortgages for sale to homeless provider organizations at a discount of 20 to 50 percent. To date, 173 properties have been sold to non-profit organizations to provide housing for the homeless.
Readjustment Counseling Service's Vet Centers have homeless coordinators who provide outreach, psychological counseling, supportive social services and referrals to other VA and community programs. Some 140,000 veterans make more than 800,000 visits to VA's 206 Vet Centers each year. As many as 10% of Vet Center clients are homeless during winter months.
Drop-In Centers provide homeless veterans who sleep in shelters or on the streets at night with safe, daytime environments. Eleven centers offer therapeutic activities and programs to improve daily living skills, meals, and a place to shower and wash clothes. At these VA-run centers, veterans also participate in other VA programs that provide more extensive assistance including a variety of therapeutic and rehabilitative activities. Linkage with long-term assistance is also available.
Compensated Work-Therapy (CWT) and Compensated Work-Therapy/Transitional Residence Programs have had dramatic increases in activity during the past few years. Through its CWT/TR programs, VA offers structured work opportunities and supervised therapeutic housing for at-risk and homeless veterans with physical, psychiatric and substance abuse disorders. VA contracts with private industry and the public sector for work to be done by these veterans, who learn new job skills, re-learn successful work habits and regain a sense of self-esteem and self-worth. The veterans are paid for their work and, in turn, make a monthly payment toward maintenance and upkeep of the residence.
VA operates 51 community-based group homes with a more than 425 beds in transitional residences. Nine program sites with 14 houses exclusively serve homeless veterans. The average length of stay is approximately six months. Currently there are more than 100 individual CWT operations connected to VA medical centers nationwide. More than 15,000 veterans participated in the programs in FY 1999, an increase of more than 5,000 since 1996. CWT programs developed contracts with companies and agencies of government valued at a national total of $43.8 million. At discharge, 44 % of the veterans were placed in competitive employment and 7% were placed in training programs.
VA's National Cemetery Administration and Veterans Health Administration have formed partnerships at 20 national cemeteries, where more than 120 formerly homeless veterans from the CWT program have received therapeutic work opportunities while providing VA cemeteries with a supplemental work force. Increased competitive therapeutic work opportunities are occurring each year.
Joint Social Security Administration (SSA)/VA Pilot Project provides benefits and services to homeless mentally ill veterans at three sites. HCHV and DCHV staff coordinate outreach and benefits certification with SSA staff to locate and assist homeless veterans in obtaining SSA benefits.
Comprehensive Homeless Centers place a variety of VA's homeless programs in a community into a single organizational framework to promote integration within VA and coordination with non-VA homeless programs. VA currently has eight comprehensive homeless centers connected to medical centers in Anchorage, Brooklyn, Cleveland, Dallas, Little Rock, Pittsburgh, San Francisco and West Los Angeles.
Stand Downs are 1-3 day safe havens for homeless veterans that provide a variety of services and a positive means for VA and community-based homeless providers to reach more homeless veterans. Stand downs give homeless veterans a temporary place of safety and security where they can obtain food, shelter, clothing and a range of community and VA assistance. In many locations VA provides health screenings, referral and access to long-term treatments, benefits counseling, ID cards and linkage with other programs to meet their immediate needs. VA participated in 179 stand downs run by local coalitions in various cities in calendar year 2000. Surveys show that more than 34,000 veterans and family attended these events held in 47 states and the District of Columbia. More than 20,000 volunteers contributed to this effort.
VA's Homeless Providers Grant and Per Diem Program
The Grant and Per Diem program is offered annually (as funding permits) by the VA to fund community-based agencies providing transitional housing or service centers for homeless veterans. Under the Capital Grant Component VA may fund up to 65% of the project for the construction, acquisition, or renovation of facilities or to purchase van(s) to provide outreach and services to homeless veterans. Per Diem is available to grantees to help off-set operational expenses. Non-Grant programs may apply for Per Diem under a separate announcement, when published in the Federal Register, announcing the funding for "Per Diem Only."
Total VA funding for grants has exceeded $53 million. When these projects are completed, approximately 5,000 new community-based beds will be available for homeless veterans. Nearly 2,500 homeless veterans are being cared for through these programs today and supported by VA per diem payments to service providers.
Mainstream VA Programs Assisting Homeless Veterans
Health Care for Homeless Veterans (HCHV) Program Sixty-six new sites have been created which will increase outreach and expand treatment services to veterans who are homeless.
Compensated Work Therapy (CWT) Program Created to assist homeless veterans improve mental health and obtain employment and stable housing, nine new CWT sites will provide a means for living independently and productively while minimizing reliance on institutional care.
Homeless Women Veterans Program Eleven VA facilities will implement a specialized program that will focus on outreach, case management and community residential care for homeless women veterans and homeless women veterans with children.
Therapeutic Employment Placement and Support (TEPS) Ten VA sites will implement a specialized program focusing on immediate permanent employment for homeless veterans who are dually diagnosed with mental illness and substance abuse disorders.
Critical Time Intervention (CTI) Staff Training. VA has funded 8 facilities to implement an intense but time limited case management program for hospitalized homeless veterans.
Oral Health (Dental) Care for Homeless Veterans. VA has provided funding to 10 VA facilities to implement an oral health care (dental) program for homeless veterans engaged in rehabilitation. Services will be provided through contracts with community based dental care programs.
Outreach to Seriously Mentally III Homeless Veterans. VA will support outreach to some of our nation's hardest to reach homeless veterans at five sites.
As part of the national VA effort to help homeless veterans, helping homeless veterans may benefit selected students. Working with VA staff, eligible VA beneficiary-students may receive funds to help defray school and living expenses. If you are a veterans or a VA eligible beneficiary, attending school and receiving VA education assistance, you may be entitled to participate in this work-for-pay program authorized through the VA Work-Study in this work-for-pay program authorized through the VA Work-Study-Allowance Program and the AmeriCorps Education Awards.
Loan Guarantee Program for Homeless Veterans Multifamily Housing. This new initiative authorizes VA to guarantee no more than 15 loans with an aggregate value of $100 million within 5 years for construction, renovation of existing property, and refinancing of existing loans, facility furnishing or working capital. No more than 5 loans may be guaranteed under this program prior to November 11, 2001. The amount financed is a maximum of 90% of project costs. Legislation allows the Secretary to issue a loan guarantee for large-scale self-sustaining multifamily loans. Eligible transitional project are those that: 1) Provide supportive services including job counseling; 2) Require veteran to seek and maintain employment; 3) Require veteran to pay reasonable rent; 4) Require sobriety as a condition of occupancy; and 5) Serves other veterans in need of housing on a space available basis.
In VA's Compensated Work Therapy/Transitional Residence (CWT/TD) Program, disadvantaged, at-risk, and homeless veterans live in CWT/TR community-based supervised group homes while working for pay in VA's compensated Work Therapy Program (also known as Veterans Industries). Veterans in the CWT/TR program work about 33 hours per week, with approximate earnings of $732 per month, and pay average of $186 per month, toward maintenance and up-keep of the residence. The average length of stay is about 174 days. VA contracts with private industry and the public sector for work done by these veterans, who lean new job skills, relearn successful work habits, and regain a sense of self-esteem and self-worth.
The Community Homelessness Assessment, Local Education, and Networking Groups (CHALENG) for veterans is a nationwide initiative in which VA medical center and regional office directors work with other federal, state, and local agencies and non-profit organizations to assess the needs of homeless veterans, develop action plans to meet identified needs, and develop directories that contain local community resources to be used by homeless veterans.
More than 10,000 representatives from non-VA organizations have participated in Project CHALENG initiatives, which include holding conferences at VA medical centers to raise awareness of the needs of homeless veterans, creating new partnerships in the flight against homelessness, and developing new strategies for future action.
This joint Supported Housing Program with the Department of Housing and Urban Development provides permanent housing and ongoing treatment services to the harder-to-serve homeless mentally ill veterans and those suffering from substance abuse disorders. HUD's Section 8 Voucher Program has designated 1,780 vouchers worth $44.5 million for homeless chronically mentally ill veterans. VA staff at 35 sites provide outreach, clinical care and ongoing case management services. Rigorous evaluation of this program indicates that this approach significantly reduces days of homelessness for veterans plagued by serious mental illness and substance abuse disorders.
Like the HUD-VASH program identified above, staff in VA's Supported Housing Program provides ongoing case management services to homeless veterans. Emphasis is placed on helping veterans find permanent housing and providing clinical support needed to keep veterans in permanent housing. Staff in these programs operate without benefit of the specially dedicated Section 8 housing vouchers available in the HUD-VASH program but are often successful in locating transitional or permanent housing through local means, especially by collaborating with Veterans Service Organizations.
In this pilot project with the Social Security Administration, HCMI and Homeless Domiciliary staff coordinate outreach and benefits certification with SSA staff to increase the number of veterans receiving SSA benefits and otherwise assist in their rehabilitation. In this demonstration project, both applications and benefits awards increased significantly and the time to process applications has decreased dramatically.
Comprehensive Homeless Centers
VA's Comprehensive Homeless Centers (CHC's) place the full range of VA homeless efforts in a single medical center's attachment area and coordinate administration a centralized framework. With extensive collaboration among non-VA service providers, VA's CHC's in Anchorage, AK; Brooklyn, NY; Cleveland, OH; Dallas, TX; Little Rock, AR; Pittsburgh, PA; San Francisco, CA; and West Los Angles, CA, provide a comprehensive continuum of care that reaches out to homeless veterans and helps them escape homelessness.
VBA-VHA Special Outreach and Benefits Assistance
VHA has provided specialized funding to support twelve Veterans Benefits Counselors as members of HCMI and Homeless Domiciliary Programs as authorized by Public Law 102-590. These specially funded staff provide dedicated outreach, benefits counselor referral, and additional assistance to eligible veterans applying for VA benefits. This specially funded initiative complements VBA's ongoing efforts to target homeless veterans for special attention. To reach more homeless veterans, designated homeless veterans coordinators at VBA's 58 regional offices annually make over 4,700 visits to homeless facilities and over 9,000 contacts with non-VA agencies working with the homeless and provide over 24,000 homeless veterans with benefits counseling and referrals to other VA programs. These special outreach efforts are assumed as part of the ongoing duties and responsibilities. VBA has also instituted new procedures to reduce the processing times for homeless veterans' benefits claims.
VBA's Acquired Property Sales for Homeless Providers
This program makes all the properties VA obtain through foreclosures on VA insured mortgages available for sale to homeless provider organizations at a discount of 20 to 50 percent, depending on time of the market.
VA Excess Property for Homeless Veterans Initiative
This initiative provides for the distribution of federal excess personal property, such as hats, parkas, footwear, socks, sleeping bags, and other items to homeless veterans and homeless veteran programs. A compensated Work Therapy Program employing formerly homeless veterans has been established at the Medical Center in Lyons, NJ to receive, warehouse, and ship these goods to VA homeless programs across the country.
Program Monitoring and Evaluation
VA has built program monitoring and evaluations into all of its homeless veterans' treatment initiatives and it serves as an integral component of each program. Designed, implemented, and maintained by the Northeast Program Evaluation Center (NEPEC) at VAMC West Haven, CT, these evaluation efforts provide important information about the veterans served and the therapeutic value and cost effectiveness of the specialized programs. Information from these evaluations also helps program mangers determine new directions to pursue in order to expand and improve services to homeless veterans.