United States Interagency Council on Homelessness - No on should experience homelessness. No one should be without a safe, stable place to call home.
An End to Chronic Homelessness

March 26, 2014

An End to Chronic 

Homelessness in 2016


A Message from Laura Zeilinger
Executive Director of USICH

As the new Executive Director of USICH, many people have asked me what I plan to do in this role. Leading an agency that builds collaboration across Federal, State, and community partners means that the opportunity is not about what I will do, but about what we will do together. The President's Fiscal Year (FY) 2015 Budget creates an unprecedented opportunity for what we can do together to end chronic homelessness in 2016.

HUD Secretary Shaun Donovan and USICH Executive Director Laura Zeilinger discuss Council priorities at a recent meeting.

Earlier this month, President Obama released his FY 2015 Budget, in which he calls for historic new resources to end homelessness. These resources support the implementation of Opening Doors, positioning us to end homelessness among Veterans in 2015 and sustain and advance programs that serve our families and youth. These historic new resources also include $301 million to create 37,000 new units of permanent supportive housing,finally bringing the national inventory of permanent supportive housing to a scale that will end chronic homelessness and prevent its recurrence.

While ending chronic homelessness in 2016 is a year later than we had originally planned in Opening Doors, this timeline reflects our ongoing commitment to act with urgency, while adjusting for the fact that the resources requested by the President to increase permanent supportive housing in previous years were not funded by Congress.

Ending chronic homelessness requires both new resources and strategic local policy changes. We are more successful at securing needed resources when communities are demonstrating that the goal is achievable through strategic action. For example, using Opening Doors as a guide, New Orleans, Phoenix, Salt Lake City, and others have maximized Federal, State, and local resources. They have leveraged commitments from public housing agencies to increase permanent supportive housing, and they are ending chronic homelessness.

We can end chronic homelessness throughout the nation, leveraging new and existing resources, if we can do these five things:


  • Prioritize the most vulnerable and highest need people experiencing chronic homelessness for assistance through permanent supportive housing. 
  • Adopt Housing First community-wide to ensure that people experiencing chronic homelessness can obtain housing without preconditions.




States See Ending Chronic Homelessness as Important to Medicaid Goals

Evidence that permanent supportive housing improves health and lowers health care costs is spreading. Just recently, Congressman Paul Ryan's assessment of Federal anti-poverty efforts, while critical of many Federal programs, noted that supportive housing programs "have been shown to decrease homelessness and reduce costs related to health care and institutionalization." 


New developments now indicate that this evidence on permanent supportive housing has reached the health care sector as well.  As states and health policymakers seek ways to achieve better health outcomes while containing Medicaid costs, more and more are realizing that ending chronic homelessness through permanent supportive housing should be part of their strategy.  


A Conversation with Jeffrey Brenner
A Conversation with Jeffrey Brenner
  • Last week, HUD invited Dr. Jeffrey Brenner of the Camden Coalition of Health Care Providers to discuss his groundbreaking "hot spotting" work, through which he found that the highest cost users of health care services in the city of Camden were living in HUD-assisted housing or experiencing significant housing challenges and homelessness. Through this work, he discovered that in order to improve the health of people with complex health needs and lower costs, health care must also address housing and social circumstances.  "Many of the patients we identified are the same chronically homeless people you have been working to house," Dr. Brenner explained. For these individuals, he added, "housing is the best pill." 
  • In their guest blog, Dr. Kelly M. Doran and Dr. Roberta Capp discuss their research that found significant rates of homelessness among emergency department and hospital "super users." For these individuals, they argue, the traditional tools used by the health care system, like care coordination and patient navigation, will be inadequate to contain costs and achieve better health.  Instead, the authors note that "supportive housing should be considered a critical element of any effort to reduce frequent hospital use for patients who are homeless." 
  • The National Governors Association (NGA) Center on Best Practices recently launched the Developing State-Level Capacity to Support Super-Utilizers policy academy to improve the State-level response to Medicaid "super-utilizers," the small subset of beneficiaries that consume a disproportionate share of Medicaid costs. Six states, including Alaska, Colorado, Kentucky, New Mexico, West Virginia, and Wisconsin, along with the territory of Puerto Rico, were selected to participate. At the launch of the policy academy, participating states and national experts recognized how homelessness and housing crises contribute to frequent emergency room visits and hospitalizations. In February, at NGA's request, HUD and USICH provided a training session to participating state teams on permanent supportive housing.

Updates from Our Partners


HUD Announces Funding to Provide Permanent Housing & Services to Low-Income People with Disabilities 


HUD announced the availability of approximately $120 million in funding for state housing agencies to provide long term project-based rental assistance to extremely low-income persons with disabilities, many of whom are transitioning out of institutional settings or are at high risk of homelessness. 


HUD's support of these state agencies is made possible through the Section 811 Project Rental Assistance (PRA) program.


Read HUD's Notice of Funding Availability (NOFA)




CDC, NHCHC, and USICH Release 

TB Risks & Prevention Fact Sheet 


March 24 was World Tuberculosis (TB) Day, a day to raise awareness about TB-related issues, discuss solutions, and support world-wide TB-control efforts. As part of this effort, the Centers for Disease Control (CDC), the National Health Care for the Homeless Council (NHCHC), and USICH released a factsheet on preventing and addressing tuberculosis among people experiencing homelessness.


TB remains a serious health concern for people experiencing homelessness as they are ten times more likely to be affected by the disease.


View the Fact Sheet 



HUD Awards $1.8 Billion to Improve & Preserve 
Public Housing Nationwide


On March 19, HUD Secretary Shaun Donovan announced the Department would award $1.8 Billion in order to improve and maintain existing public housing. The award includes all 50 states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin islands.


"This funding is critically important to public housing agencies as they work to provide the best housing possible for their residents," said Secretary Donovan.


SAMHSA Releases 2013 SOAR Outcomes


The Substance Abuse and Mental Health Services Administration (SAMHSA) released the 2013 outcomes of their SSI/SSDI Outreach, Access and Recovery (SOAR) process.


Since its implementation in 2006, the SOAR approach has allowed 19,000 people at risk or experiencing homelessness access to SSI/SSDI benefits. In addition, 3,000 applications that were initially denied have been approved on reconsideration or appeal.


There are SOAR practitioners in all 50 states, and SAMHSA has recently received 18 applications from Continuum of Care (CoC) programs applying for targeted SOAR technical assistance. 


Learn More About SOAR



SAMHSA Announces CABHI Grants for States


The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced their request for applications for the Cooperative Agreement to Benefit Homeless Individuals for States  (CABHI) grant.


This grant is designed to increase capacity to provide accessible, effective, comprehensive, coordinated/integrated, and evidence-based treatment services; permanent housing; peer supports; and other critical services.


The deadline for applications is April 14, 2014.


Learn More about CABHI-States



 SAMHSA Accepting Applications for GBHI-SSH Grants


The Substance Abuse and Mental Health Services Administration's (SAMHSA's) Center for Substance Abuse Treatment (CSAT) is accepting applications for fiscal year (FY) 2014 Grants for the Benefit of Homeless Individuals-Services in Supportive Housing (GBHI-SSH). 
The purpose of this program is to support the development and/or expansion of local implementation and community infrastructures that integrate treatment and services for substance use, co-occurring substance use and mental disorders, permanent housing, and other critical services for the following: veterans who experience homelessness or chronic homelessness, and other individuals (non-veterans) who experience chronic homelessness.


 Learn More about GBHI-SSH


Table of Contents
An End to Chronic Homelessness in 2016
States See Ending Chronic Homelessness as Important to Medicaid Goals
Updates from Our Partners
BLOG: Trading Hospital Doors for Front Doors
BLOG: How Innovative Communities are Using the ACA to Improve Homeless Services
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By Dr. Kelly Doran 
& Dr. Roberta Capp

As emergency physicians, caring for patients experiencing homelessness is a routine part of our job. Very rarely does an ER shift go by when we do not encounter at least one patient who is experiencing homelessness, and more often than not we will see many on a single shift. Often, we know these patients by name and their medical histories by heart because they come to the emergency department so frequently. 


Though "frequent utilizers" and "super users" are now common lingo in health care and policy circles, the critical overlap with homelessness is sometimes overlooked. We recently published new research that underscores why we cannot forget homelessness when thinking about "super users." 




Changing the Terms: How Innovative Communities are Using the ACA to Improve Homeless Services


By Lisa Stand, senior policy analyst for the National Alliance to End Homelessness 

Homeless advocates are viewing the implementation of the Affordable Care Act (ACA) with great optimism. As Medicaid enrollment grows and coverage takes effect, more adults experiencing chronic homelessness have better access to comprehensive health care, including mental health services, substance use treatment, and recovery supports. 


In states that are expanding Medicaid, the influx of new funding to communities is an opportunity to take a fresh look at how funds from all sources are spent to serve vulnerable populations. Communities activated to end chronic homelessness are showing the way. The National Alliance to End Homelessness recently looked at strategies in five communities to leverage health care for supportive housing capacity. These communities - Chicago, Cleveland, Minneapolis, Philadelphia, and Portland, OR - tell us what integrating the ACA into homelessness assistance can look like.



Regional Coordinator


USICH is currently recruiting for a Regional Coordinator to join its National Initiatives team and to serve as the bridge between the work of the Council and States and communities across the United States. Regional Coordinators are currently based in several locations throughout the country.  Preference will be given to candidates who are located in or are willing to relocate at their own expense to any of the following states: Arizona, California, Nevada, Oregon, or Washington State.


Find out more here


Communications Specialist

USICH is recruiting for a Communications Specialist to join its team in Washington, D.C. The Communications Specialist is responsible for executing a variety of communications functions. The incumbent will have direct involvement with critical and sensitive projects at the highest levels of the Federal government, and, among other duties, will be responsible for managing the agency's website and other digital communications platforms.

Upcoming Events

National Coalition for Homeless Education Webinar Series
Determining Eligibility for McKinney-Vento Rights and Services 
March 25, 2014
2:00-3:15 PM ET
Paving the Way to College for Students Experiencing Homelessness 
March 26, 2014
2:00-3:15 PM ET


Section 811 Project Rental Assistance Program - NOFA Webinar


Providing an overview of  the Section 811 Project Rental Assistance Program (PRA). This webinar is specifically for state housing finance agencies interested in applying for PRA. 


March 26, 2014
1:00-3:00 PM ET

More Information

TAC Webinar: The Section 811 Project Rental Assistance Program


Focusing on how PRA works, highlights of the PRA NOFA and considerations to assist applicants in getting started 

March 27, 2014
2:00-3:30 PM ET

More Information


Council of Large Public Housing Authorities Membership Meeting

March 27 -28, 2014
Washington, D.C.


Early Head Start--Child Care Partnership Grant Webinar Series

Comprehensive Services Webinar Part III: Family/Community Engagement

March 28, 2014
2:00-3:00 PM ET


SAMHSA webinar on Social Enterprise: Changing the World for the Common Good

Providing an overview of the model, success stories, and information on how to structure and implement social enterprises with an eye to sustainability.

April 1, 2014
2:00-3:00 PM ET

In Case You Missed It

Ending Youth Homelessness: Preliminary Intervention Model Webinar
Last week, USICH, HHS, HUD, DOL, and ED discussed the partnerships and coordinated efforts needed in communities and at every level of government to end homelessness among youth.
PYIM Webinar
PYIM Webinar


President Obama Proposes Historic New Investments to End Homelessness 
The President's Budget includes more than $5.69 billion for targeted homeless assistance funding, a 12 percent increase over Fiscal Year 2014 appropriations.
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