7/17/12

USICH's Barbara Poppe and Joshua Leopold, along with Joyce Probst-McAlpine of Dayton, OH and Greg Shinn of Tulsa, OK presented the session Chronic Homelessness: Getting to Zero by 2015 at the 2012 National Alliance to End Homelessness Annual Conference. USICH presented an analysis of chronic homelessness, which includes potential factors that may be slowing progress on ending chronic homelessness and what is needed to accelerate progress moving forward. The session also featured two communities that have made significant progress in ending chronic homelessness - Dayton, OH and Tulsa, OK - and how they have been able to move the needle on chronic homelessness in their communities using innovative and effective approaches. 

Access the slideset

8/17/12

The pins on your collar say:  I am Home For Good.  I feel that way when I am in Los Angeles; as you might know, I consider LA to be my third home along with DC and Columbus.

Frankly, I didn’t always feel that way.  We all know the problems of the past, the lack of a unified vision for change, the idea the LA was just too big, too segmented to work together.

Still, the fact that making progress in Los Angeles is absolutely critical to the national effort to prevent and end homelessness was as true then as it is now. Los Angeles has to be the place we can point other communities to and say: This is how you solve homelessness.This is how you strategically align goals and collaborate, and use resources effectively and push them toward quality providers; this is how you create tools to measure success. Simply put, Los Angeles hasto be the home for our best practices. Two years ago, I wasn’t sure that was possible.

But when the Obama Administration launched Opening Doors, the first ever federal strategic plan to prevent and end homelessness, Home For Good was there to adopt this vision alongside the federal government. 

Los Angeles started to collaborate. Partnerships grew out of the Collaborative Leadership Summit and out of efforts to get Veterans off the streets and into housing using the HUD VASH program, both of which are paying huge dividends to our cause. The awards being announced here today signal further evidence that collaboration works in LA. Let’s keep it working.

Yes, solving homelessness requires resources. Just since my visit in February, HUD and VA awarded a record 800 new HUD-VASH housing vouchers to LA, worth over seven million dollars. VA announced nearly one million dollars in Supportive Services to Veterans Family grants to the area, and HUD gave close to 100 million dollars for supportive housing through the Continuum of Care competition, including fourteen million dollars for nine new projects. The Corporation of National and Community Service through CSH awarded the Economic Roundtable with a highly competitive, five-year annual grant of $375,000 that will help build a model of supportive housing linked to health services that saves public dollars and improves the lives of vulnerable men and women.

The charge is placed before this community to continue to use resources strategically and continue to achieve better outcomes.  You must look to unlock more mainstream resources and identify more new local private and public funding.

I want to thank and congratulate the City and County Housing Authorities, the Los Angeles Housing Department, and the County Departments of Mental Health, Health Services, and Public Health for their dedication and creativity in bringing resources to the table today.

I want to thank the private sector partners who dedicate their resources and serve as flexible, efficient partners to leverage public resources. The leadership of the Conrad N. Hilton Foundation is particularly commendable. 

Resources have to have quality providers and programs to support.  And today, we honor 25 providers who have demonstrated their effectiveness and commitment to the goals we’ve set forward.

To you, I say, keep expanding capacity; keep transforming outdated models, and keep evolving your network into a true system of care for each individual who is now on the streets or in shelter.

And hats off to Home for Good, Hilton Foundation, and the County for your commitment to better performance measurement systems. You’re almost there. Soon, we can point to Los Angeles as an example of how to use data transformation ally. 

Today, we celebrate the Home For Good initiative and the Funders Collaborative.These awards represent incredible signs of progress toward aligning public and private sector resources.

To any potential partners, collaborators, or funders here who have not yet come to the table, please use today as your inspiration to join us.  The need is evident all around us – you have a chance to make a real difference by joining the Funders Collaborative.

The US Interagency Council is committed to partnering with everyone in this room. We recognize Los Angeles as a home for solutions, a home for best practices, and a home for collaboration where the goal is clear and singular:  no one should experience homelessness;no one should be without a safe, stable place to call home. 

Los Angeles is a Home for All.

On behalf of President Obama and Council Chair, HHS Secretary Kathleen Sebelius, thank you for all of the hard work you do, day after day to make Los Angeles – and this country - a better place. 

2/21/13

I begin by bringing greetings from Council Chair and VA Secretary Eric Shinseki and Council Vice Chair and HUD Secretary Shaun Donovan.  I’d like to recognize the members of the USICH team that are present:  Laura Zeilinger our Deputy Director, Katharine Gale who has just joined us as a Policy Director, and our extraordinary team of Regional Coordinators, Matthew Doherty, Beverley Ebersold, Bob Pulster, and Amy Sawyer.

I’d also like to thank our DC-based Federal partners who have joined us, Mark Johnston and Ann Oliva from HUD, Don Moulds, Mark Greenberg, Barbara Broman, Sonali Patel and Resa Matthew from HHS, and  Vince Kane, Pete Dougherty, and John Kuhn from Veterans Affairs, along with other Federal partners who are here from across the country.

Before I begin my remarks on youth, I want to note that yesterday HHS released an Information Memorandum expressing the importance of addressing family homelessness with TANF funding for families experiencing or at risk of experiencing homelessness. 

The memo highlights the innovative work of our partners at the Massachusetts Department of Housing and Community Development, the Mercer County Board of Social Services in New Jersey, The Utah Department of Workforce Services, A Safe Haven in Chicago, as well as the Diversion Cash Assistance program and the Gates Foundation here in Washington State. 

Our partners are proving that real solutions can come from existing monies and existing authorities, and that bringing mainstream resources to bear is essential to the goals of Opening Doors—to ending and preventing homelessness in America.

Why do we care about youth? 

I care about youth because I am a mother of two youth.  My son was fifteen when I started this position and my daughter was 22. As they’ve struggled through adolescence, they have needed tremendous support (as have my husband and I to be supportive parents).  All kinds of resources were needed to get them through high school to college and launched on a career path. We view these as investments in their future.

For me, youth homelessness is personal, as my children have friends who are struggling with family conflict, domestic violence, and other types of traumatic situations.  They are at risk of and have experienced homelessness.  Caring adults stepped in and they were connected to resources to complete their education and get a meaningful job, and my children’s friends are succeeding day by day.  There are the usual ups and downs of adolescence but they are on a pathway to stability. 

Everyone in this room knows the struggles of adolescence.  It’s personal for each of us, and we can tap that energy to create a national movement to invest in youth now. Many of you have stepped up already, and I’m hoping everyone will step up to create more and better solutions for youth.

For me, I decided to work through the Council and join with other stakeholders to make ending youth homelessness a national priority.  Today, I’ve been asked to share what the federal government is doing.

So how did we get started?

As you know when Opening Doors was released in 2010, we set the goal of ending youth homelessness by 2020. This past December, the 19 agencies that make up the Council along with our colleagues at the White House recommitted to this goal for action during our second term.

My bosses at the Council are all Cabinet Secretaries, who once they commit to a goal, get very serious about success.  We began this work by believing that we needed to:

• Be honest about what we know and what we don’t know
• Not let the absence of good numbers get in the way of figuring out how to leverage Federal investments to act more strategically
• Fill in the gaps in our knowledge through more research on effectiveness of interventions
• Focus especially on connecting Federal resources for underserved populations, including LGBTQ youth, foster care and justice involved youth, pregnant and parenting youth, and others
• Illuminate what harm reduction and housing first means for youth

We knew that homelessness among youth differs from homelessness among other populations. Youth—aged 13 to 24—have distinct developmental needs.  Youth are not mini-adults.  Lives change rapidly during these ages so interventions must be flexible and responsive to this unique developmental period.  There is also a subset of youth who are young parents, presenting another critical dynamic which must be considered when developing homelessness interventions for youth.

The problem of youth homelessness is often invisible. We knew that many youth do not access shelters. They do not want to be identified for various reasons.  In many states, it is illegal for youth under 16 to be “runaways.”  For older youth, the stigma of homelessness (especially if they are still attending school) is not something they want known.  We knew that adult shelters are too often not safe for youth. 

We also knew that multiple Federal agencies—HHS, Education, Justice, HUD, Labor—have programs for youth, but none were solely responsible for addressing youth homelessness. This created greater complexity and opaqueness about this critical segment of people who experience homelessness.

And we knew, most importantly, that there was not a clear understanding of the scope of the problem, and that there was limited to no national consensus on the best interventions for homeless youth.

To make youth homelessness more visible and to identify the most promising strategies that solve the problem, the Council in 2011 charged Commissioner Bryan Samuels at HHS-Administration on Children, Youth, and Families and USICH Deputy Director Jennifer Ho to co-chair an interagency workgroup to propose a framework to end youth homelessness by 2020. 

In addition—from the development of the plan up to the present—USICH has continuously engaged stakeholders across the country and our national partners, conducted focus groups with youth who had first-hand experience of homelessness, made site visits to programs, and held discussions with youth providers. Early last spring, USICH also launched a crowd-sourcing platform to provide an opportunity for all stakeholders to provide input.

The Federal interagency work group provided two reports to the Council along with a set of policy recommendations that were described as the Framework to End Youth Homelessness, in addition to recommending that the Opening Doors plan be amended. Acting on the workgroup recommendations, the Council amended Opening Doors in September 2012 to include new strategies to prevent and end youth homelessness.

All of this work is intended as the necessary preamble to organize ourselves to prevent and end youth homelessness. Once we know what works for different groups of youth experiencing homelessness, we can scale up what works and reduce interventions that are less effective.

What are we doing now? 

Earlier today, USICH released the Framework to End Youth Homelessness, a resource for communities and States, which you can find on our website at usich.gov. The Framework is more detailed than the Plan amendment that was issued last September.

The Youth Framework calls on the Federal government working with communities, agencies and systems at all levels to work together on a strategic approach to getting to better youth outcomes in stable housing, permanent connections, education, employment, and wellbeing. 

The Framework involves two complementary and concurrent strategies: getting to better data on youth homelessness, and building capacity for service-delivery system to end youth homelessness.  

At the Federal level, we are taking a number of steps to improve our data on youth.  Most significantly, HUD revised the PIT data tables for the 2013 Count.  This means that for the first time we will have national data from every community about the number of youth up to age 24 who were counted.  Previously youth were grouped in with adults up to age 30.

This year we also launched the Youth Count! Initiative, a study to identify strategies used to reach unaccompanied homeless youth and to assess promising practices and interesting challenges to implementing a youth-targeted count. Nine study sites participated, including Seattle and Washington State. The early reports show that by involving youth and youth providers, better counts are possible, but it’s still tough to enumerate and survey youth.

HUD and HHS, with support from USICH, have been working to integrate HHS’ youth data system, RHYMIS, with HUD’s homeless data system, HMIS. This will improve these data systems by making them work better for youth-serving agencies while painting a clearer picture of young people touched by federally-funded services across agencies. 

The next steps to appear publicly will occur as HUD issues the new HMIS data standard. In the meantime, HUD, HHS, and USICH are actively engaged on the details of the integration.

These data steps can also pave the way for a new National Prevalence Study focused on youth experiencing homelessness. Stay tuned…

The Council is also working with local communities that are interested in adopting the Youth Framework’s preliminary intervention model. We are collecting and sharing tools that can identify risk and protective factors to help providers determine the type and level of intervention needed to improve outcomes for youth.  

A systems model for homeless youth is a new approach to the provider community for how they think about front-end assessment for youth experiencing homelessness and connections to the most effective services. Some communities, like Minneapolis, Portland, Boston, and Los Angeles are already beginning to organize their services systematically around addressing the needs of youth and testing screening and assessment tools that include risk and protective factors. Please let us know if your community is planning for how the intervention model can be applied to your community.

Even if your community hasn’t yet embraced the preliminary intervention model and a systems approach for youth, at a minimum, create stronger collaborations between systems that work with youth, including HHS’ Runaway and Homeless Youth providers, HUD’s CoC system and providers, and Education’s homeless liaisons. Our Federal partners have encouraged their grantees to reach across the silos of child welfare, public education, and juvenile and adult justice to integrate their efforts with community-driven approaches to youth homelessness.

What will it take to end youth homelessness?

Ending youth homelessness will take all of us working together – aligned in our approach and our advocacy. We will only meet our shared goal of preventing and ending youth homelessness by 2020 if we build the evidence of what works, identify the gaps and the resources that are needed, then build an effective case to attain those resources to fill the gap. Only by working together can we build a smart case and the solutions necessary to end youth homelessness. 

On behalf of President Obama and this administration, thank you for your hard and necessary work.  As he said in his State of the Union Address last week, “we need to build ladders of opportunity...” Together, we can make sure that homelessness will never stop a young person in this country from reaching that first wrung.  Together, it’s possible to end the national crisis of youth homelessness and ensure that everyone has a safe and stable place to call home.  Thank You. 

Policy experts from ED and HUD discuss why collaboration between CoCs and local school systems is important and how to implement new strategies for building relationships around targeted activities that advance the goal to prevent and end youth and family homelessness by 2020.

On this webinar you’ll learn more about the CoC program and the Education for Homeless Children and Youth (EHCY) program and how these programs can be better coordinated to improve housing stability and educational outcomes for youth and families. You’ll also hear how homeless service providers and educators in Houston, Texas collaborated to conduct HUD’s Point-in-Time (PIT) and the challenges and benefits they experienced.

Tell us what you thought about the webinar. Complete this short survey and let us know more about what is helpful for you and your work to end homelessness. 

In this speech delivered at the Georgia Supportive Housing Association annual conference, USICH Policy Director Richard Cho discusses the importance of breaking down silos between sectors and systems to end homelessness.  He discusses how permanent supportive housing embodies the notion of “silo-busting” and creating inter-subjectivity between sectors, and challenges the State of Georgia to create a supportive housing policy for all—people with disabilities under the Olmstead community integration mandate, people experiencing chronic homelessness, and people with chronic health conditions leaving correctional settings.  

Thank you Paul for your introduction, and thanks to the Georgia Supportive Housing Association for inviting me to join your event. 

I’m here today representing the United States Interagency Council on Homelessness, and bring greetings from our Executive Director Barbara Poppe, from our Council Chair VA Secretary Eric Shinseki, Council Vice Chair HUD Secretary Shaun Donovan, and the 17 other agencies that comprise our Council.  I want to acknowledge Alvera Crittendon and Mykl Asante from HUD’s Atlanta office and Aileen Bell Hughes from the Department of Justice who are here today.

I’m here to deliver a message today.  And my message to you is, that in order to house everyone, we need to tear down some walls.  Let me repeat that, in order to house everyone, we need to tear down some walls.

Now, you have probably figured out that I am not referring to actual walls or buildings, but rather to the figurative walls that separate our efforts into silos, into isolated and fragmented efforts.  If we want to make sure that everyone in America, especially those who are most vulnerable, have a safe and stable place to call home, we must break down silos and work across sectors, systems, and even the policy and population constructs under which we operate.

This idea of breaking down silos underpins the very premise of USICH.  USICH’s role is not to be the sole Federal department responsible for ending homelessness, but rather, to foster a sense of shared responsibility across the 19 Federal agencies that make up our Council, and build collaborative solutions across department boundaries.

The thread of breaking down of silos runs through Opening Doors, the Federal strategic plan to end homelessness.  Adopted in 2010, Opening Doors set forth the Administration’s vision that no one should experience homelessness in America, and that no one should be without a safe and stable place to call home.  It lays out the Administration’s goals of ending chronic and Veterans homelessness by 2015 and homelessness among families, children, and youth by 2020.

To achieve these goals, the Federal strategic plan lays out 58 strategies organized around five themes.  And the very first of the five themes is to build collaboration between Federal, State, and local government, across the public, non-profit, and private sector, and between sectors like housing, health, social services, employment, justice and more.

Underlying Opening Doors is the recognition of three fundamental truths about ending homelessness:

1) That homelessness is a problem that is too complex to be the sole responsibility of any one agency, sector or system.

2) That solutions to homelessness—like permanent supportive housing—require the coordination of the housing, health, behavioral health, and other service systems.

3) That the collective knowledge and expertise of multiple agencies, sectors, and systems results in solutions that are better than what any one of those agencies, sectors, and systems could create on their own.

I face these three truths every day in my role as a Policy Director for USICH.  My role and portfolio entails working with HUD on housing policy, working with HHS to encourage states to use Medicaid to help create and finance services that support housing stability, working with the Social Security Administration and SAMHSA to improve access to SSI/SSDI benefits for people experiencing homelessness, and working with the Justice Department to align our efforts to end homelessness with efforts to enforce the community integration mandate under Olmstead and efforts around prison and jail re-entry.

Managing a portfolio that encompasses all of that would seem impossible.  But what makes this mix not only manageable, but fruitful, is that the solutions that emerge when we work across agencies and silos are always better than what any one of us could create or achieve on our own.

That idea is also what makes supportive housing such an effective solution for helping those with the most complex social and health needs achieve stability, dignity, and independence.  What makes supportive housing work is not just that it’s a combination of affordable housing and supportive services.  Those of us who have worked to make supportive housing available over the years know that it’s so much more than just a layering of those two components.  What makes supportive housing work is that it brings together the expertise of the housing and community development sector and the expertise of the social, behavioral health, and health services sectors to help troubleshoot the challenges that its tenants have in achieving that stability, dignity, and independence.

And we are seeing the supportive housing at work all across the country.  In places like Seattle, where supportive housing—using a Housing First approach—has been shown to decrease emergency room and alcohol crisis services use among people experiencing chronic homelessness, translating to a Medicaid savings of 41%.  We see it in New Orleans, where investments in permanent supportive housing made possible because of the Hurricane Katrina relief package, and targeted at the most vulnerable people experiencing chronic homelessness, has enabled the city to achieve an 85% decrease in chronic homelessness since 2010.   New Orleans is now housing people at a rate of two people a day.  I think Atlanta can beat that, right?

Supportive housing is a testament to the power of inter-subjectivity, which is another way of saying that only through the merging and negotiation of multiple vantage points can true solutions be found.

Folks in this room have probably witnessed that inter-subjectivity in action.  When a case manager works with a landlord to prevent eviction by allowing the tenant to pay rent arrears on an installment plan.  That synergy that enables a property manager and services provider to come up with a plan to address the victimization of a tenant by a drug dealer.  It’s inter-subjectivity that enables a supportive services provider to come together with public housing agencies to find creative ways to speed up the time from engagement to housing placement by helping people complete their voucher applications and even conduct apartment inspections.

Supportive housing has been a lever for creating change and inter-subjectivity at the systems-level as well.  Numerous states and municipalities including Georgia have inter-agency councils and funder collaboratives to coordinate funding across the housing, services, and health silos, to engage in multi-year planning with the non-profit and private sectors, to set unit creation goals, and troubleshoot barriers to supportive housing creation and implementation.  At their best, these inter-agency and public-private collaborations bring together the ideas and ingenuity of all of the agencies and organizations that participate.

It’s that inter-subjectivity that makes supportive housing such a powerful, silo-busting tool.  It’s why increasing supportive housing is a key objective of Opening Doors and a centerpiece of our strategy for ending chronic homelessness.  It’s also why supportive housing is a key part of efforts by numerous states including Georgia to comply with the Olmstead community integration mandate for people with disabilities and an increasing part of State and community efforts to ensure that people leaving prisons and jails are able to stay in the community and avoid returns to incarceration.

We need to take that silo-busting inter-subjectivity to the next level and fully realize the potential of supportive housing as a tool for solving all of the complex social problems that affect vulnerable people who need housing and services to achieve stability, dignity and independence.  That means breaking down the silos between our own policy and population constructs to create solutions that work to help all of the vulnerable people for whom those constructs mean little. 

I want to share a story to illustrate this further.

About 14 or so years ago, I was working in the State of Massachusetts on a project to assess the needs of people living with HIV/AIDS who were leaving prisons and jails.  As part of a focus group I had held, one of the participants told the group that he had figured out a solution that could make sure that people like him got the quickest access to affordable housing.  It went something like this: “If you have a serious mental illness, you can get special access to some housing. If you have an AIDS diagnosis, you can also get special access to other types of housing.  If you have both, you win the lottery.”  (Again, these were his words, not mine.)  “If you are in a shelter, you also get a point.  But if you are coming out of jail or prison, all of that gets closed off to you.”

This brief statement has stayed with me over the years. It’s a concise summary of all the problems and challenges that still lie ahead of us. That the ways that we have set up access to housing and services have created a kind of perverse puzzle and contest for people, where people have to struggle to fit into the categories we have set up through our well-intentioned policies.

Access to supportive housing should not be a puzzle or a game show, where people with real needs, disabilities, and life-threatening conditions should be forced to find ways to “game the system.”  Access to supportive housing should be a right and a natural part of an effective response to people with disabilities and chronic health challenges.  Time and time again, we’ve shown that supportive housing is not only the right thing to do, it’s the smarter and fiscally sound thing to do. 

This view is reflected in this conference, where the agenda spans topics related to ending homelessness, prison and jail re-entry, and community integration for people with disabilities.  You have gotten this very right in scoping this event and in the kind of cross-sector and cross-population dialogue that is happening over these past two days and in the days that come in the State of Georgia.  And I think it reflects the fact that the State of Georgia is on the verge of being a national innovator in breaking down the silos to create a statewide supportive housing delivery system that works for all.

In so doing, you have a chance to fix a problem that dates back decades.

Chronic homelessness and the institutionalization of people with disabilities are two legacies of what has been a fragmented and inadequate system of care for nearly four decades.  They stem from the failed promise to create a true mental health care system.  They stem from decades of criminal justice policies that have relied on prisons and jails to address social and mental health needs, resulting in the warehousing of thousands of people with mental illness and other disabilities.  They stem from the failure to create a comprehensive affordable housing policy for all, and especially those at the lowest ends of the income spectrum.

We’ve responded to these problems often on the tail end, only once people have reached a state of crisis.  And so emerged the separate policy arenas of our effort to end homelessness, efforts to ensure the right of community integration for people with disabilities under Olmstead, and efforts to address prison and jail re-entry.

We’ve been like the proverbial people in the dark touching an elephant and thinking that we are touching a tree trunk, a snake, or a palm leaf.

But I think the time has come to recognize the elephant, to rejoin these three arenas and create a comprehensive solution to the needs of people with disabilities and chronic health challenges who have in common the need for an affordable place to live, adequate incomes, access to services that can help them achieve maximum independence, and which prevent the over-reliance on the most expensive crisis systems.

When we begin dialogue across these arenas, we realize that although our frameworks and lenses have evolved differently, and our population and eligibility definitions are slightly different, overall we share more in common than not.

We’ve been engaging in that cross-agency dialogue in Washington, between DOJ, HUD, and USICH.  And through that dialogue we have had several insights.

We realize we have a shared population, and perhaps even more than we’ve realized.  Whereas Olmstead encompasses people with disabilities leaving or at-risk of entering institutional/segregated settings, our effort to end homelessness, especially chronic homelessness focuses on people with “disabling conditions.”  And while there are certainly differences between the ADA and HUD definitions of disability, there is more overlap than not.  And while Olmstead focuses on people either at-risk of institutionalization or in institutional settings, we know that many people experiencing chronic homelessness cycle in and out of institutional settings.

We realize that we have shared goals, that is, to maximize affordable housing opportunities, access voluntary supportive services, and support the ability to live independently.

We have shared values of supporting people to be able to have access, choice, be integrated in the community.

And we share a common solution, namely, permanent supportive housing.

Now I know there have been many discussions and concerns around housing models, particularly with regard to single-site supportive housing.  And questions have been raised about whether or not single-site supportive housing is consistent with community integration.

DOJ’s perspective, is that their focus of Olmstead enforcement is on increasing most integrated housing options, and not decreasing or taking down community housing options.  HUD’s guidance makes clear that certain HUD programs (e.g. CoC, Section 811) are statutorily permitted to target people with disabilities.

USICH believes that communities should include a range of PSH models that increase housing opportunities for people experiencing chronic homelessness.   At the same time, we should challenge ourselves to think about who the design of our models is benefiting, and whether the choice of models is for the benefit of tenants or are for the convenience of programs.

Perhaps the question we should be asking is not, is single-site supportive housing a permissible model, but rather, how we are going to create enough permanent supportive housing to meet the needs of all populations—people with disabilities leaving institutional settings, people experiencing chronic homelessness, and the subset of people involved in the justice system who have chronic health and behavioral health challenges?

And how are we going to leverage all available resources and funding, including mainstream housing resources, to increase permanent supportive housing?  We cannot rely on just the targeted homeless programs like the Continuum of Care program to create supportive housing. We need to leverage mainstream resources as well.  Housing Choice Vouchers, Section 8 Project Based Rental Assistance, HOME, low-income housing tax credits, bond financing.

And how do we strike the right balance between our two values of maximizing housing opportunities and access and ensuring community integration?

Neither value should supercede the other.  A housing policy that focuses on increasing housing opportunities at the expense of integration will not meet our goals.  A housing policy that focuses on community integration, but which decreases housing options also does not meet our goals.  We need a housing policy that can achieve both.

The opportunities that come from tearing down the walls, breaking down the silos between homelessness, Olmstead, and prison and jail re-entry are enormous.

Here in Georgia, that cross-sector dialogue is taking place, that creative inter-subjectivity is being unleashed, and the silos are being broken down.  Georgia was a participant in SAMHSA Policy Academy on Olmstead, and is now a participant in the Policy Academy on ending chronic homelessness.  Georgia’s a recipient of HUD’s Section 811 Project Rental Assistance Demonstration.  Terrific progress is being made to leverage mainstream affordable housing resources, namely Housing Choice Vouchers, for permanent supportive housing.  There is new energy and enthusiasm behind the state interagency council on homelessness.

The time is now to tear down the walls between our separate efforts and create a unified statewide supportive housing policy and plan focused on addressing the needs of all of the most vulnerable Georgians.  The time is now to bring supportive housing to scale, taking into consideration the right to integration among tenants.  To clarify the overlap in populations through data integration. To leverage mainstream housing resources alongside targeted programs like CoC and Section 811. To fix the front door to supportive housing through assertive and coordinated outreach.  To use targeting approaches that will ensure that the highest need, most chronic, and highest cost people experiencing chronic homelessness will get priority access to housing.  To adopt a Housing First approach that reduces barriers and pre-conditions to entry and helps people obtain housing as quickly as possible.

I, and the US Interagency Council, applaud and support you in this work.

In this speech, USICH Executive Director Barbara Poppe discusses USICH's accomplishments, the challenges ahead, and where we all need to focus our attention. 

02/19/2014

Opening

Thank you, Nan [Roman], for your kind remarks and your continued excellence in leading the Alliance.

It’s an honor to precede Bryan Samuels, who was such a great partner at ACYF. I’m grateful for his leadership, which was critical for USICH to craft an interagency approach to youth homelessness, create the Youth Framework, and amend the Opening Doors plan to better address the needs of youth and young adults. We’re delighted to continue our partnership in his new role at Chapin Hall.

It’s also great to be among so many friends and allies in the work to address and end homelessness. You inspire and encourage me. Thank you!

One thing I’ve learned is that it is always a good idea to do what Nan suggests. So I’m going to do just that and focus my remarks on:

• The accomplishments of USICH in this Administration
• The challenges ahead, and
• Where we all need to focus our attention

Context of USICH and the Nation:  2009

As President Obama took office, I was very energized and looking forward to the possibilities of a new administration. Despite the difficult time we were experiencing in Columbus – with an escalating number of foreclosures, soaring unemployment, and an uncertain economy – I was still very hopeful that this administration could bring positive change.

I was ecstatic when Shaun Donovan was announced as the HUD Secretary. He was highly regarded and had always been committed to the expansion of affordable housing. He had a great track record of making permanent supportive housing a critical piece of New York City’s work to end chronic homelessness.

When the President and Congress included HPRP in the Recovery Act, I think everyone in this room will agree that we knew this administration was going to mean business when it came to scaling up housing-focused solutions to homelessness.

I was also overjoyed when the HEARTH Act passed Congress after a 10 year battle that was largely advocates fighting amongst ourselves about the definition of homelessness.

The HEARTH Act signaled the promise of being able to work together across constituencies to modernize HUD’s homelessness assistance programs—aligning them with the best practices and innovations that had been developed in communities across the country.

Little did I know in the early days of this administration, that my personal and family life would be changed forever. It’s been quite the ride for someone with no prior government experience. It’s probably a good thing that I didn’t really know what I was getting into.

I joined USICH in November, 2009. Working on a six-month deadline, we sprinted to deliver a high-quality, comprehensive, and inclusive response to the congressional and presidential call for a Federal strategic plan to end homelessness.

2010 – Developing and Launching Opening Doors

Today, as in 2010, USICH is chaired by HUD Secretary Shaun Donovan, and is comprised of 19 federal agencies with the purpose of coordinating the Federal response to homelessness.

Beginning in January 2010, USICH held regional stakeholder meetings, organized Federal working groups focused on specific populations, solicited public comment through an interactive website, and engaged experts from across the country to develop an action plan to solve homelessness for Veterans, adults, families, youth, and children.

All told, over 9,000 people participated in the development of the Plan. The breadth of ideas as well as the clarity and concurrence around key themes was remarkable.

On that historic day in June 2010 when Opening Doors was launched at the White House, I joined four Cabinet Secretaries to announce the first ever comprehensive Federal plan to end homelessness. In my opening remarks, I recalled President Obama who said that “it is simply unacceptable for individuals, children, families, and our nation’s Veterans to be faced with homelessness in this country.”

Onward to Implementation

Immediately following the launch of the Plan we tackled all 52 strategies within the Federal government, across our 19 agencies, and with partners across the country as well.  (Jennifer Ho, now at HUD, and Anthony Love, now with the VA, were both deputy directors at USICH at that time. They are here today and can back me up on that).

We were, and still are, grateful to everyone in this room who has embraced the Plan and who has helped to execute the strategies of Opening Doors at the national, State, and local level.

That day at the White House, I set forth our intentions for execution of the Plan. Today, I ask you to assess whether we have achieved them.

I said then:

• “We need Federal leadership to highlight goals and timeframes”.
• “This is not just a Federal issue. To meet these goals, States, local governments, and the private, non-profit, and philanthropic sectors must be part of the solution. “
• “There is not a one-size-fits-all plan. We recognize the importance of taking into account local conditions when applying this strategy at the local and State levels.”
• “Local, State, and Federal governments cannot afford to invest in anything but the most evidence-based, cost-effective strategies.”
• “We recognize that the best ideas to end homelessness are found outside of Washington.”

I hope your reflection is that we have, together, been true to our intentions.

So what’s been the impact?

Over the last three years (since the launch of Opening Doors), overall homelessness is down by six percent, family homelessness by eight percent, chronic homelessness by 16 percent, and homelessness among Veterans by 24 percent. These aren’t just numbers; these represent real people’s lives impacted by your collective action.

But beyond the numbers and the launch of the Plan, what’s been the impact?

To help me prepare a thoughtful response to Nan’s charge, I enlisted help from the collection of committed, talented, and resourceful individuals who are part of today’s USICH team. The first question I posed was “beyond the launch of Opening Doors, what achievement by USICH has proved the most impactful during our administration? Several staff noted the overall shift in how mainstream programs and services are leveraged to create access for people experiencing homelessness, including:

• HUD’s guidance to and the engagement of PHAs (where ending homelessness is increasingly becoming central rather than peripheral to their work),
• HHS’ TANF guidance on rapid re-housing,
• Medicaid as a payer of services in permanent supportive housing, and,
• HUD’s multifamily housing preference.

And this progress is not isolated to one program; the overall notion that mainstream programs should, and can, have a specialized focus on homelessness has become an accepted truth. Perhaps more internal to the Federal government is how we’ve transformed the way in which agencies work together and with external partners in trusting relationships.

By using participatory leadership practices to guide our work, frame and re-frame problems, and create effective strategies to combatting immediate and long-term issues, agencies are better able to collaborate with each other and consider solutions that before were out of reach. A good example is the newly released shared definition of rapid re- housing designed in a partnership with the Alliance, HUD, VA, and other Federal agencies.

Our mastery of data intelligence has advanced major federal policy shifts that played out at a community level in system change, program re-design, and budget reprioritization. Nowhere is this truer than the implementation of Housing First in the HUD-VASH program. In 2009, utilization rates and the time to lease-up vouchers were unacceptable to HUD, VA, and also to Congress.

Since then, VA has adopted a Housing First approach and joined forces with HUD, USICH, Community Solutions, and the Rapid Results Institute. The results are remarkable. Targeting of VASH to chronically homeless Veterans is up from less than half to nearly 70 percent of all admissions, with vulnerable families and single adults accounting for the balance.

VA medical centers working with PHAs and CoCs have increased utilization and reduced time from homelessness to housing stability.
Congress did its part and fully funded the VASH program in an era when examples of bipartisanship are difficult to point out.
Most impressive, as I noted, the number of Veterans counted as homeless during the annual PIT count has decreased by 24 percent over the last three years.

The second question I posed to my talented team was, “beyond the fiscal uncertainty of the Federal budget, what is the one challenge you worry the most about?”

Here’s what I heard:

• I worry that success or failure of Opening Doors will be judged solely by whether people will continue to experience homelessness, ever, even if briefly.
• I worry that the larger accomplishment of transforming homeless services to a crisis response system that prevents homelessness, or rapidly returns people to stable housing, might be lost in the headlines.
• Another said: I worry that that rapid re-housing will not get traction and will not become institutionalized as standard practice due to ongoing resistance among local policy makers and provider agencies.

For me, personally, I worry that there will be a next generation of homeless youth if we don’t have the courage to make the changes in policies and programs they need, and if we don’t fight for the resources necessary to scale up the interventions specific to the needs of youth.

Finally, I worry that there will continue to be lack of bipartisan political support for a comprehensive national affordable housing policy, and that we won’t stay united to fight for the affordable housing resources we need.

Nan’s third question was, “What advice would you give the audience?”

• Keep the families, the youth, the Veterans, the single adults and couples at the center of your work. It’s about them. It’s not about you, your agency, or your ego.
• Look up and see the bigger picture, how can you join with others for better policy and more resources?
• K.I.S.S. – keep it simple. We won’t win the hearts and minds of the American public, nor our elected leaders, if we can’t tell the simple story of why and how it’s possible to end homelessness.
• Change is hard. Change requires resilience. Resilience is about dynamic response. Let go of the status quo.
• YOLO – you only live once so make it count. Don’t bicker over small things, join forces and make a big difference.  And enjoy and support each other along the way.

Onward to the Next Chapter

Yesterday, Laura Zeilinger was announced as the next Executive Director of USICH.

Laura is the epitome of a dedicated and effective public servant. Her commitment to ending homelessness is absolute. And the urgency and focus to which she approaches each day, each task, and each opportunity to expand our work and make a difference in the lives of people who are looking for stability is so powerful you can’t help but follow her.

Laura believes in partnership, collaboration, setting goals, and reaching them. Over the past three years Laura has helped USICH become a better partner, a better collaborator, and a better supporter of our communities and the work of the Council. I am proud of the work we’ve accomplished together.

She, along with the extremely talented USICH staff, is focused on working with you in the right way, on helping you reach your goal to end homelessness in your community and across this nation. She has a high expectation for the work of USICH—and for the work we’ll do together.

Let’s meet that expectation. Let’s make my list of “worries” obsolete by acting together. In the words of my favorite modern prophet Bono, “there is no them –only us”.

Onward! Together, we can make it possible for all of us to have a safe, stable, and affordable place to call home. Let’s end homelessness.

Thank you.

Remarks by Eric Grumdahl at a gathering of community stakeholders focused on ending Veteran and chronic homelessness

Thursday, March 27, 2014

Today, I would like to share what we at USICH see as key components of an effective coordinated assessment system. I will talk about some questions you might be wrestling with, some tactics you can use to make progress, and then review key components of coordinated assessment.

Before coming to Washington, I was responsible for housing and homelessness programs for a metropolitan county, where we were pushing in fits and starts toward a no-wrong-door coordinated assessment system linked to our mainstream systems. I understand that coordinated assessment sounds straightforward, but in practice it can be really challenging.

We suspect that your community is wrestling with some of these critical questions:

• Is your response effectively reducing how many people experience homelessness?

• Does it ensure that resources are used well?

• Does it contain the right mix of interventions?

We know that communities are facing challenges to ensure that the success rate of your response to homelessness is as high as it can be, and that permanent housing is obtained as quickly as possible by everybody served by it. We know that in a resource-constrained environment a central challenge is to make sure that the resources that are available are designed and delivered strategically.

We also know that homelessness-specific resources are not the only game in town, and that indeed we won't end homelessness through targeted programs alone. Communities must engage mainstream resources as much as possible.

So how do we make progress? The key tactics that we've identified among communities making progress include the following:

• Communities need to use data to focus efforts and drive performance.

• Mainstream systems and resources need to be engaged completely.

• Communities have to make hard choices about where interventions and resources are focused and do that in a systemic way, not just a program-specific way.

• Communities have to be using proven practices. There's a large and growing body of proven practices to end homelessness, like adopting a Housing First approach to reduce barriers to accessing services and focus on interventions on achieving housing outcomes.

• Finally, we know that the challenge of using the limited resources available is to be wise and strategic about how they should be invested, especially as new opportunities present themselves.

So, how do we create a coordinated assessment system that helps us do these things?

We view coordinated assessment as being about people. Coordinated assessment sounds fancy and clinical, but fundamentally it is about shifting the orientation of our response to homelessness toward identifying the best options for each individual and family experiencing homelessness. It is about structuring the way we use our resources, with shared, explicit criteria, and a common process and a common purpose for how decisions get made.

It is not about simply following the output of a tool, but it does require yielding program-specific decision-making. It's about buying into the benefits of a shared response – for the people served, for the system as a whole, and even for programs themselves – rather than preserving business as usual.

Coordinated assessment puts people – not programs and not tools – at the center of offering the interventions that work best. Offering interventions: we need a system that enables people to choose what intervention best responds to their needs and goals, to have those options informed by helpful assessment and on-the-ground insight and understanding, and to have our entire system oriented to ensure that the smartest choices for people are the choices people make.

Rather than a mysterious black box that spits out matches between people and interventions, consumer choice and practitioner wisdom both have a central place in an effective coordinated assessment system. Policies and practices that screen out the people most in need of an intervention do not.

Here are some of the key components of coordinated assessment:

First, we know that the path from homelessness to housing varies significantly from person to person, from family to family. We would ideally have a system that whatever front door somebody entered, they could quickly be connected to the right resources. That means making sure that there's meaningful coordination between the homeless response system and the intake processes for mainstream systems. Creating those linkages can be challenging, but ultimately mainstream systems have as much to benefit from having an option for the people experiencing or at risk of homelessness that they encounter as people experiencing homelessness and the homeless response system have to benefit from a connection to those mainstream resources.

Next, we know that if we're not connected with the people in need of interventions, it's impossible for coordinated assessment system to make smart connections between people and resources. That means that outreach is essential for a coordinated assessment system to function well.

We also know that these systems have to leverage the local capacities and resources including data systems like your local Homelessness Management Information System and take into account the specific and unique factors in every community, including the physical and political geography, the capacity of partners in your community, and the opportunities unique to your context.

The purpose of coordinated assessment is to make sure that the right access to services is established. This can happen in a variety of ways: access to services can be centralized, a one-stop shop approach; access can be coordinated, leveraging outreach capacity and linking or integrating with mainstream systems. There isn't a single path or option for how best to increase access to services -- how you do that depends a lot on the details of your community. The point here is simply that increased access is central to the purpose.

We also want to be sure we have access to the right stuff. We know that at a systems level, that means making sure that the various types of interventions that are available are all aligned and used strategically where they're most helpful. Again, we have to yield on making decisions about access to resources in isolation in order to get the benefits of a true systems approach and the best use of our limited resources.

Slide 10 provides a schematic view of how some of these pieces fit together. Coordinated assessment is linked with outreach, with a strong assertive outreach linkage to the discharge processes for a variety of mainstream systems. That "in-reach," as it is sometimes called, can be in addition to the other connections to the intake processes for other mainstream resources. These connections, informed by an assessment process with clear criteria to guide the prioritization of access to some services over others, leads to rapid connection to the housing and services that each person served needs and wants.

The push to establish for coordinated assessment systems is enshrined in the HEARTH Act and HUD's regulations for it. Those regulations stipulate the following criteria for a coordinated assessment system:

• It must cover the entire continuum of care.

• It must be easily accessible and well-advertised.

• It must use an assessment tool that is standardized across the whole system.

• It must be attuned to the local needs and conditions.

• It must include at least the Continuum of Care and Emergency Solutions Grant programs.

The last point here is really important, because even though the HEARTH Act regulations require that the Continuum of Care and Emergency Solutions Grant programs are in the coordinated assessment system, that is really just a starting point. Many communities are exploring how mainstream systems can also play a part, either as feeders into coordinated assessment, or as additional resources that a coordinated assessment process can access.

VA's vision for a coordinated assessment system reinforces the HEARTH Act requirements: a coordinated assessment system needs to be centralized or coordinated, easily accessible, and use a tool that puts people at the center and is based on established criteria. The purpose, or benefit, is to have a better process for connecting people to services, including better referrals and better coordination between programs, which produces better results for people.

I want to emphasize that coordinated assessment is a process, not a tool. The process serves your community's efforts to end homelessness by bringing into the open, in a more explicit way, how resources are deployed – and should be deployed – to serve the members of your community experiencing homelessness. Tools are an important part of assessment systems, but the tool alone is not sufficient.

So the shift that we are calling for is from thinking about access to programs in isolation, to thinking about options for individuals and families, shifting from "should my program accept this person," to thinking about "which programs offer the best options for this person or family." Another way to think about this is it's having good social work at a systemic level, while maximizing the impact of the resources you have by targeting them intentionally.

We acknowledge that yes, there are challenges with putting a system like this in place. Yes, there are thorny issues about control, discretion, history, and inertia. The point of departure on every community's journey to establish a coordinated assessment system is recognizing the benefits that come from having a system in place, committing to moving toward a systemic response, and to confronting these challenges.

So, what can communities do? Here are some suggestions.

First, you can begin to coordinate the efforts across your community to identify people experiencing homelessness and engage them in services. This coordination provides you with the platform for shared decision-making about access to resources. Often, parallel outreach efforts are not aware of each other’s efforts to engage the same individual, which makes coordinated anything tough.

Outreach also needs to be oriented to achieve housing outcomes. We understand that the purpose of outreach is engagement, and yes, engagement can take time. But the purpose of engagement is housing, and so we must make sure that every engagement attempt has housing as the goal.

Of course, you also need to assess the variety and capacity of programs in your community, to identify and fill critical gaps, and to ensure that there's a range of those options needed for a coordinated assessment system to work well. We can't have a response to homelessness that recognizes that one size does not fit all if we only have one size to offer.                                             

Next, you can begin to engage the programs and interventions in your community about adopting a common way to make decisions. Yes, this can be hard. The Federal government has your back in this work. HUD's regulations and VA's vision require communities to move in this direction. I know many communities have already begun this work, and a few have their systems in place. Learn from each other.

There are also some "must-haves" for your local system. Every community must adopt a Housing First approach, but we also have to make sure that local adoption of Housing First is meaningful —commit  to remove preconditions from each person's access to housing, focus on housing outcomes, and delink service expectations from housing --. It's easy to say your community adopts Housing First. Make sure you're doing it in a meaningful way. VA, HUD, and USICH all have tools to help you.                                                      

Similarly, we need supportive services that don't screen out or alienate the very people who would most benefit from them.

Every community must commit to making careful decisions about how we target the most intensive interventions like permanent supportive housing. In fact, how we should prioritize access for permanent supportive housing can be a case study of how coordinated assessment can work more generally. What we need is to shift from reacting and having a passive role in identifying supportive housing tenants to a more deliberate and intentional engagement of those most in need of that resource and intentionally prioritizing who gets access based on clear and objective measures of need.

In terms of mainstream resources, communities are not alone in trying to identify ways to link mainstream services to your local efforts to end homelessness. HUD has provided some really helpful guidance for public housing authorities and for multifamily housing developments. USICH has released a guidebook focused on partnerships between public housing authorities and other parts of the homeless response system, which can help you in thinking about how to maximize the impact of those partnerships.

In addition to public housing authorities, make sure that you are making connections in your community to your healthcare system, with the workforce development system, and with mainstream income and benefits. These resources are not only critical for each person experiencing homelessness, but also serve as an important front door for people to access care.

Finally, just as coordinated assessment itself is a process, the process of building a coordinated assessment system can yield a lot of benefits. These include creating new partnerships and collaborations, increasing your understanding of how homelessness manifests locally, and most importantly making sure you're using resources wisely to achieve our intended outcomes. As your community moves toward coordinated assessment, you will undoubtedly identify gaps in your system, and the collaboration you create can help you identify options for filling those gaps.

On behalf of USICH and the Obama Administration, thank you for the work that you do and for your commitment to establishing the systems we need in place to achieve our shared goal of ending homelessness.

Thank you.

Remarks delivered by Eric Grumdahl, Policy Director, at the National Human Services Data Consortium conference, Minneapolis, MN, May 2, 2014.

Thank you all for the opportunity to be with you today. I feel like I'm in a room of kindred spirits: people eager to solve complex technical problems in the service of complex social problems. Although I now work in DC, I cut my teeth on HMIS and other data systems right here in Minnesota. I'm probably the geekiest USICH director to address this conference. Thanks for having me.

As many of you probably know, USICH is a small, independent Federal agency responsible for coordinating the Federal response to homelessness across the big 19 agencies on the Council. The Council itself is composed of the heads of those agencies, with HUD Secretary Shaun Donovan serving as our Chair for 2014.

For all of you gathered together today for this conference to help us use data to solve tough social problems, I'm personally grateful for the work you are doing on homelessness and bring the greetings and appreciation of the Obama Administration with me. I know your loved ones, school buddies, and distant relatives may not really understand what you do. "Something to do with data and IT." I want you to know that this Administration does understand what you do. Thank you, for helping to build the infrastructure for social change.

Social change is never easy, is it? Only 10 years ago, the first HMIS data standards were published, and it is easy to forget that before then, most places struggled to have meaningful data to guide homelessness policy, especially locally. Only a decade ago, the data we had was often drawn from studies and research that pointed the way forward but most likely came from somewhere else and so were always prone to the objection that "yeah, but it's not like that here." 

Today, thanks to the infrastructure you build and maintain and enhance and use, most places in our nation have access to readily available, regularly refreshed local data on the magnitude and nature of the problem and the impact of our various interventions and responses. That is critical progress, but as many of you know, that is just the beginning.

Today, I want to reflect on our data about homelessness: how we've used it and how it has shaped our response to the problem; how we need to push ourselves to use it better today; and how are data and practice might evolve together. 

First, how we've used data.

Since the launch of Opening Doors in 2010, we have measured national progress on the goals of the Federal strategic plan to prevent and end homelessness using the annual Point-in-Time count and Annual Homeless Assessment Report data. The story the data tell is compelling, showing unprecedented decreases in homelessness throughout a challenging recession, with progress led by decreases in Veteran and chronic homelessness.

I'm sure most here know the statistics, but they bear repeating: since 2010, Veteran homelessness has decreased by 24 percent. That's one in four. Chronic homelessness has dropped by 16 percent. Unsheltered homelessness across all populations has decreased by 13 percent, with a 30 percent decrease among unsheltered Veterans. How this has happened is a story of courage and dedication and hard work among thousands of people who experienced homelessness and thousands more who supported them. 
It is also a story about our data. 

Let's talk about the linkages between data and investments and impact. The Federal budget is the most powerful vehicle for establishing the Administration's priorities. It is not a wish list: investments proposed in the budget telegraph both what the Administration values but also the confidence that an investment made will have commensurate impact. 

As you can probably imagine, when the Administration develops its budget, there are many, many important and worthy efforts that vie for attention and funding. Every proposal, every detail has to withstand the scrutiny not only of the Administration's best and brightest trying to eke every ounce of impact out of every dollar, it also must be ready for the scrutiny of the taxpayers, the media, advocacy groups, and the Congress itself. To do all of this, it is not enough to be good and important; big investments require strong evidence of impact.

You know that this Administration has committed to ending homelessness. Ending it, not managing it. We know that ending homelessness requires big investments. 

I say all of this because I want to convey the full meaning and weight of this fact: The President's fiscal year 2015 budget proposes the investments needed to end Veteran homelessness in 2015 and to end chronic homelessness in 2016. To end it.

A decade ago, imagining this level of investment may have strained belief. Homelessness is no more worthy or important today than it was then. One of the most important things that has changed is our data. Today, we have a track record to show of investments that have yielded impact. We have a better understanding of the problem than we have ever had. We have an ability to forecast -- that is, to quantify -- the impact of the strategies that will help us reach this bold and ambitious goal. And we have developed new, more effective and cost-efficient approaches to ending homelessness. All of that owes a debt of thanks to the data that we've assembled and that the systems you build collect, manage, and analyze that data.

These benefits of data in the context of the Federal budget also apply locally — perhaps even more so. Data help elected officials and Continuum of Care leaders who want to propose changes or investments in at least two important ways: first, data on impact and effectiveness will help us make sure that these changes are for the better. Using data to guide changes means we are following the evidence, not ideology and not inertia. Second, having strong data provides cover — political or otherwise — to help us be bold in those decisions. We have 20 months until we have committed to end Veteran homelessness. Now is a time for courageous action, not half-measures.   

All of this progress and the role that data have played in it are exciting. Let me pause now and recognize that we have not arrived. We still have a lot of work to do. 

My portfolio at USICH includes our work on Veteran homelessness, youth homelessness, and homelessness among Native Americans. Across those overlapping populations, we see huge differences in terms of access to data. VA has some of the best data available on homelessness, and a national center led by Vince Kane with Dr. Dennis Culhane as the head of research to understand what VA's data say about how to end Veteran homelessness, and how to apply it to practice. 

In contrast, our work on youth homelessness and homelessness among Native Americans routinely confronts the limits of our data, and what we know that we don't know often stymies our most earnest efforts to advance solutions. Again, remember that advocacy for new funding must be grounded in evidence of impact. That's why the Federal framework to end youth homelessness sets out two equally urgent strategies: to improve our data on youth homelessness while at the same time building our capacity to respond. There are many parallels with our work on Native homelessness, but we have much further to go. Wilder Research's partnership with tribal governments to conduct a survey on homelessness on reservations is one of a few bright spots we can point to nationally.

Apart from filling in our knowledge gaps, how else does our data on homelessness need to evolve?

The investments proposed in the budget will only get us to the goal if communities and providers make the hard, ethical decisions needed to use those resources to their greatest effect — to target resources wisely based on people's needs, not just filling vacancies or service slots. To make sure that we are investing in the programs that yield housing outcomes as cost-effectively as possible, not just supporting all the programs we've supported because that is the easy, default thing to do.

We know that ending homelessness, like all social change, is hard. But, for the first time ever, the Federal government has proposed investments that can take us to the goal, with your help. 

We need your help.

Our data are powerful, but too often, in far too many communities, we're not really using that power fully. Helping communities use resources wisely is neither easy nor always popular work. I am here to tell you that it is critical to our success.

How many folks here either offer or use an HMIS system with built-in ways to help communities understand the relative impact of various programs in achieving housing outcomes, in a way that illuminates differences between the people engaged? Labor Secretary Perez recently compared this kind of analysis to competitive diving, where divers' scores are based on both the execution of the dive and the degree of difficulty. To understand the impact of programs, we need to understand both who they engage as well as their effectiveness. HMIS has a critical role to play illuminating both sides of that question. Are we using that capability well?

How many of your systems help service providers identify and engage Veterans and people experiencing chronic homelessness in real time? If you are working in communities that are still taking a first-come, first-serve approach to outreach efforts and in access to critical resources, are they aware of the alternatives? Do they know how other communities are doing it differently, and the impact that targeted engagement and access to resources has on moving the needle? This is happening in places like Salt Lake City and should be happening more broadly. Targeting resources is obviously linked to your work on coordinated assessment, but you do not need to wait for your coordinated assessment system to be fully developed to improve targeting. 

How many systems have links to mainstream data systems, so that data that originated in a school or public assistance department or a hospital or a jail can help you focus on who is being engaged through those systems but doesn't have their housing needs met? The data on who is homeless exist in HMIS, and the data on who uses emergency room frequent exist -- why wouldn't we have those two systems talking to each other? Yes, there are legal hurdles and technical challenges. But it is possible, and we should be doing it.

How many support outreach and engagement in the field? I don't mean "yes, I guess you could load the webpage on a smartphone," I mean really useful mobile features and functionality? There are communities like Houston that are making data available in a street outreach context that not only facilitate connections to housing, but also to other resources like health care coverage. 

Without minimizing the challenges — technical, financial, legal, and otherwise — if we are not doing these things now, what are we waiting for? These are the kind of things data systems are good at and the kinds of problems that people in this room can solve.

By now, I suspect everyone in this room will have read and absorbed the new HUD data standards released yesterday afternoon. Actually, in this room, I think that's possible.

Here's what I hope you see in the evolution of these standards. First, a bold — truly courageous — decision to make the HMIS data standards a tool that serves purposes broader than reporting to HUD. At USICH, we live in this interagency space all the time, and it is wonderful and inspiring to see an agency take something good, something that has had a transformative impact like the HMIS data standards have within HUD's programs and across our efforts to end homelessness, and make them as useful to other agencies as they have been to HUD. Thank you, HUD, especially to the SNAPS team led by Ann Oliva and a special shout out to Karen DeBlasio, who's work on the new data standards makes them what they are. As you probably know, for the past several years, HUD has been working with its partners at HHS and the VA to shape the data standards in a way that reflects the values that their grantees bring to your community. The data standards are better because of their involvement in the process.

This cross-jurisdictional application of HMIS means work in the field can be organized better around people instead of disconnected reporting requirements, to simplify some of the administrative complexity that exists right now and to align our semantic understanding of homelessness across programs. Using HMIS across programs also means that a single data standard can span the expertise of multiple agencies: we are making HMIS smarter on youth homelessness by bringing in the wisdom of HHS's Runaway and Homeless Youth Act grantees; HMIS is better on Veteran homelessness because VA's Supportive Services for Veteran Families (SSVF) grantees use the system. And I don't mean "smarter" just in terms of the data standards -- I also mean that we'll actually have better data about individuals and families experiencing homelessness in the system as well. 

For some of you, the data standards will support work your communities are already doing to address homelessness across populations and funding sources. For others of you, the new standards may lead to growing pains in your community, as additional stakeholders are being brought to the table and being held to the high standards you are setting for your data. I know these transformations can be painful, and I know that your systems don't reprogram themselves overnight. Thank you for the work to create this kind of alignment and to use HMIS as a platform for this kind of evolution. This is tremendously important work. 

The structural changes to the data standards also mean that the data can be more and more useful to practice. They are evolving in a way that support the work that case managers and outreach workers and supportive housing programs do every day. Some of you have heard me talk about the need to shift from a compliance orientation in our use of HMIS to a focus on supporting practice — the actual eligibility determinations and resource allocation decisions that should be informed by all of this data. Again, coordinated assessment already pushes us in this direction. The new data standards take some important steps in this direction structurally in clarifying the stages and frequency of data entry and in helping communities think about HMIS as a community-wide system instead of a siloed reporting database for each specific program. The changes help us understand homelessness locally, by making destination-at-exit a universal data element collected for all programs and tracking homelessness chronicity.

I think these new data standards are important and exciting, and I hope you agree. 

Now I want to turn to the last part of my talk: how do we think about the future? If what we can dream to be today is based on what we know today, what might we dream?
I suspect most of us agree that how we frame homelessness matters. In his dissertation on the importance of framing in the context of social movements, David Wesley said it well: 

Frames have several purposes. They align participants with certain ideologies and beliefs, they challenge existing beliefs, and they create new perceptions of reality. As such, frames are important in the development of social movements that, by definition, seek to challenge the status quo. 

David Wesley, "Social movement heterogeneity in public policy framing: a multi-stakeholder analysis of the Keystone XL pipeline" (2014). Law and Public Policy Dissertations. Paper 16

Frames have several purposes. They align participants with certain ideologies and beliefs, they challenge existing beliefs, and they create new perceptions of reality. As such, frames are important in the development of social movements that, by definition, seek to challenge the status quo.  -David Wesley, "Social movement heterogeneity in public policy framing: a multi-stakeholder analysis of the Keystone XL pipeline" (2014). Law and Public Policy Dissertations. Paper 16.

Data standards are, themselves, a form of framing. They articulate a paradigm — a frame of reference in which we elevate some things as important over others, where we define a scope of options that are anticipated to be possible or at least most probable. We can derive and refine these standards or this paradigm from experience, but experience itself is also mediated. There is no fixed Archimedean point from which to evaluate the merits of each paradigm. Our view is partial, and so is every other view.

So what do we want our view to convey?

As part of the Homelessness to Housing Stability Strategy for the Region of Waterloo in southern Ontario, Canada, the Region of Waterloo Social Service has a language guide that suggests reframing our discussion from focusing on homelessness to focusing on housing stability. Yesterday, you heard Cathy ten Broeke, Minnesota's Director to Prevent and End Homelessness, talk about how in Minnesota, focusing on housing stability has engaged stakeholders in finding options to end homelessness that a focus on homelessness alone may not. In addition to the practical and strategic considerations about this reframing, let's recognize that this also focuses us on the solution, it defines the response in terms of the future we seek.

One of the things I have really appreciated about working for USICH is that my documents are  never edited for brevity when I use person-first language. Person-first language is not about political correctness. It is about conceptual clarity. It is about choosing not to perpetuate the mistaken notion that homelessness is a characteristic of a person, rather than an experience that people survive and that remains fundamentally a social artifact, not a quality of someone's character. It is also about respect. I guess I would rather be known as a person within a bureaucracy than as a bureaucratic person. So, let's challenge ourselves to keep people first in how we frame the problem in our thoughts, in our concepts, and in the words we use.

Slate's The Eye design blog recently ran a piece asking the question whether the international symbol of accessibility needed to be redesigned.

These icons provide a powerful example of how the framing of our concepts embeds all kinds of beliefs, assumptions, and ideologies. Comparing these two symbols, ask yourself which wheelchair you would you prefer to use. We cannot avoid our frames being laced with assumptions and beliefs. But we can try to bring those assumptions into view, and my challenge to us all today is that we think hard about the beliefs that we want to hold. 

If an end to homelessness is increasingly in sight, how do we envision the end in the way that we frame the problem today? If we are going to end homelessness, what do our data systems and what does our homelessness response system — or our housing stability system — need to look like as we do?

Thankfully, our work together on homelessness is not the first time a social problem has been solved. Our colleagues in the 

public health world have been here before. The health impact pyramid developed by Dr. Thomas R. Frieden in the American Journal of Public Health suggests the answer, in calling for increasingly population-based responses, to change the context and socioeconomic conditions so that people at risk of homelessness are predisposed to housing outcomes, not bouts of homelessness.

Interestingly, this shift mirrors the same semantic and conceptual shifts we just talked about — moving from focusing on one person's homelessness as the problem, to focusing on the environmental and contextual factors that determine whether risks of homelessness lead to exposure to homelessness.  

This table suggests how these concepts from the public health world might apply in the context of housing stability.

But what does this mean for our data systems? A lot, I suspect. Let me call out three key points.

First, if we recognize that context shapes homelessness, how is context part of the story of homelessness that we tell? Do we describe that homelessness exists in a context of unprecedented worst-case housing needs? At a local level, do we quantify the availability of affordable housing alongside our population measures of homelessness? Do we frame homelessness in the context of parallel efforts to improve access to skills and employment? If not, why not? Homelessness Analytics, a collaborative effort of VA and HUD, can help situate data on homelessness in the context of other social indicators. 

Second, as population-based responses to homelessness become more and more essential to taking us across the finish line, how are our efforts — and our data systems — linking to the broad population-based services delivered through our health care and economic assistance systems? If we think about effective prevention, we cannot wait until someone shows up at shelter -- that is too late. So, how are we engaging these mainstream systems to help identify people in danger of becoming homeless to intervene appropriately early and to make those mainstream systems an essential part of the response? This work must happen locally, and our data systems can support it happening well. 

Third, how are we ensuring that those systems are sufficiently sensitive to detect the warning signs of homelessness, to guide those interventions? The know-how for doing so must come from our experience ending homelessness. The best example I'm aware of is the clinical reminder that VA has implemented in every VA medical center in America. Since October 2012, any time a Veteran is engaged for health care services they are asked two questions, the responses to which are strongly correlated with risk of homelessness: 

・    In the past two months, have you been living in stable housing that you own, rent, or stay in as part of a household?
・    If not, are you worried or concerned that in the next two months you may not have stable housing that you own, rent, or stay in as part of a household?

More than 4 million Veterans have been screened to date, and Veterans experiencing homelessness or at risk are referred to appropriate services. Can we imagine a world in which we could say the same about every hospital visit? We need your help — and your data systems — to get there.

Big questions, big opportunities. I think it is a measure of our success to date that they are becoming increasingly relevant ones.

So, in closing, let me say again, thank you for the work you do. Thank you for the progress that has been driven by the data you painstakingly collect, analyze, and improve. We are at an exciting and critical time in the history of our nation's efforts to end homelessness. Thank you for your partnership to make sure that we have the full benefit of the data in your systems and the human stories they tell as we bring about an end to homelessness in this country, and safe and stable housing for all.

Thank you.

Remarks delivered by Richard Cho, USICH Senior Policy Director, at the Arizona Coalition to End Homelessness Annual Conference in Phoenix, Arizona.

I’m so thrilled to be here with you today here in the beautiful state of Arizona and to be among colleagues and friends who are working to end homelessness.  Thank you to Joan, Mike, and all of the folks at the AZ Coalition to End Homelessness for inviting me to speak with you.

I have a very simple purpose in being here today.  And that is to deliver the message that we can and we will end the tragedy of homelessness in America.  How many of you are already true believers in that statement?  Can I have a show of hands?  Those of you who didn’t raise your hands, let’s talk.

For those of you who did raise your hands, you can count me among you.  And you can count in my boss, Laura Zeilinger, and the small but mighty staff of 20 or so people we have at USICH.  You can also count in Department of Labor Secretary Tom Perez, the current Chair of our 19 agency Council, HHS Secretary Sylvia Mathews Burwell, HUD Secretary Julian Castro, VA Secretary Bob McDonald, and the other Cabinet-level officials who make up our Council.  They are true believers as well.

And you can count in the White House as well.  Some of you may have heard earlier this year First Lady Mrs. Michelle Obama talk about how she believes that we can and must end homelessness, not only for Veterans, but for all adults and children in America. 

And you have a President who is a true believer as well.  The President frequently tells his own team at the White House that that our effort to end homelessness through Opening Doors: the Federal Strategic Plan to Prevent and End Homelessness exemplifies exactly how the Federal government should work in solving big problems:

• By breaking down silos between Federal departments and resources
• By using metrics to track and improve our progress and to hold ourselves accountable for the goals and commitments we set, and
• By working to support those who are doing the real work of ending homelessness—all of you working in your own communities to help people get off the streets and into stable permanent homes and realize their full potential and dreams. 

We have no delusions that the Federal government can solve this problem on our own.  Our job is to support you.  Opening Doors is not just the Federal government’s plan; it is all of our plan.

Earlier this year, we announced that since we began implementing Opening Doors in 2010, the nation has seen a 33 percent reduction in homelessness among Veterans.  We’ve cut it down by a third.  Unsheltered homelessness among Veterans is down by 43 percent.  And of course, since not everyone believes the Federal government, I’m happy to report that Nate Silver’s Five-Thirty-Eight blog had checked the math and they say it’s true. 

Make no mistake.  That reduction is not a Federal government victory.  That is a victory that belongs to every one of you and all communities who have been working to end homelessness. And the victory is not just in terms of the numbers of Veterans sleeping on the streets or in shelters, but about a victory over hearts and minds.

Let me tell you, what you have done here in Phoenix to end chronic homelessness among Veterans has changed everything. It has changed minds around the country that ending homelessness is not a pie-in-the sky dream, but something we can achieve. 

Even if you don’t work directly with Veterans, this victory belongs to you.  All of the solutions we’ve been using to drive a reduction in homelessness among Veterans in the last four years are the same solutions that we’ve been putting into place to end homelessness for all populations—Housing First, permanent supportive housing, rapid re-housing—solutions and technologies that were invented, refined, and implemented over the past decade or more by all of you.  So I want you all to take a moment and picture that downward trend line on homelessness among Veterans in your minds and I want you to reflect on the part you played in that. 

The progress we’ve made on Veterans is our proof-point that ending homelessness is possible for all populations. 

It shows what happens when we collaborate—certainly at the Federal level but also with the State and local levels and with the private and non-profit sectors—to solve problems together. 

It shows what happens when you invest in the right kinds of solutions.  When you take the latest of what we know works to end homelessness, and not only apply it, but also bring these solutions to scale in a rapid timeframe.  Think about it.  We’ve seen a six-fold expansion in permanent supportive housing through the HUD-VASH program in four years.  We’ve seen a fourteen-fold increase in rapid re-housing in five years.  Imagine what we could achieve if we had that kind of scaled investment for all populations?

The progress on Veterans also shows what happens when you take a traditional health care and benefits system (the VA) and charge them to also take responsibility for ensuring that none of their clients becomes or remains homelessness. And that to me is the really exciting thing.  When preventing or responding to homelessness becomes core to the mission of mainstream health care and other public systems, that’s when homelessness will be a thing of the past.

Now it is not lost on me that we are here in Phoenix and that the VA has faced some challenges recently.  Last week, Laura and I had the chance to sit down with VA Secretary McDonald. He told us that while he is fully focused on fixing the access issues at the VA, the work of ending homelessness among Veterans is absolutely one of his top priorities.  In fact, he doesn’t see this work as separate from fixing access issues, but as central to them.  Ending homelessness among Veterans is mission critical to improving access to VA health care and services. 

When I hear statements like these, and as I look across the country at what is happening in communities, it makes me think that we have entered a new era—the next phase—in the evolution of homelessness policy.  That is the era of systems.  Local problem-solving systems.

Those days when the response to homelessness was just about responding to basic needs and managing the symptoms are long behind us.  So are the days when we thought moving people from one step to another in a long series of therapeutic programs. 

We’ve learned that what it takes to end homelessness is first and foremost about housing—permanent housing. And we learned that everyone—no matter how complex their health and behavioral health challenges—can achieve stability in permanent housing.  We learned that it just takes different types and levels of help for people to achieve that stability.  No one is hard-to-house or hard-to-engage.  It’s just that we needed the right tools.  And we needed to make sure that we were putting the right tools to the right problems.

We’re learning now that just operating even great programs is also not enough.  Even the best programs achieving the best outcomes will not end homelessness on their own.  A bunch of isolated virtuosos playing their own beautiful melodies in a room does not a symphony make. 

The communities that are making the greatest progress on ending homelessness are those where those programs are working as a part of a system of programs, where programs working in concert as part of coordinated system that:

• Rapidly detects and identifies people experiencing or at-risk of homelessness
• Prevents homelessness wherever possible
• Quickly connects people to permanent, stable housing with access to appropriate supports,
• And while stable permanent housing is being secured, people are given access to safe shelter and emergency services. 

The next phase of our work to end homelessness is to build local problem-solving systems for ending homelessness.

Building these systems to end homelessness means taking the Housing First concept from the individual program level, to Housing First as a whole system orientation.  Where a coordinated set of programs is working together, planning together, talking together to rapidly and without barriers or preconditions deliver the right kind of housing and services that help people achieve stability in permanent housing.

Thinking of Housing First as a whole system orientation takes us away from those fights that we used to have.  You know what I’m talking about.  Those fights between whether we need more shelter or housing.  Whether your program or my program should get to apply for Continuum of Care funds.  When a community comes together to work as a single system, those decisions get made together.  And they get made on the basis of outcomes and measure and data.  They get made on the basis of whether or not you are meeting your primary outcomes of connecting people to permanent housing quickly, ensuring that people stay in housing, and people don’t come back to homelessness.

Now the Federal government cannot create local systems for ending homelessness.  That work happens at the community levels and through the efforts of people like you in this room.

Our job is to provide the resources, the tools, and the guidance on how to use those resources and tools to support your efforts.  And to remove the bureaucratic obstacles to using those resources and tools.  

At the Federal level, we are already engaged in the work of supporting the creation of local systems to end homelessness premised on Housing First principles. 

We are doing that for Veterans through the collaboration between USICH, VA and HUD.  With HUD-VASH, SSVF, and other programs both within the VA and outside the VA, the programs are in place.  Our attention must turn to how we can engage all public and private resources and stakeholders to work collaboratively to identify and engage Veterans experiencing homelessness and connect them to these programs.  The VA’s 25 Cities effort is supporting communities to implement coordinated entry systems and housing delivery systems.  I know Phoenix and Tucson are in the house.   They are doing great work through this effort.  We can and must take the lessons of this work beyond the 25 communities.

We are doing it for families.  Earlier this year, we issued a simple blueprint known as Family Connection for how to create the systems we need to end family homelessness.  It talks about investing in and providing tailored interventions like permanent supportive housing, rapid re-housing, and affordable housing.  It talks about coordinated assessment as a way to target those interventions.  It also talks about the use of evidence-based practices that improve educational outcomes and well-being for children, and to strengthen family functioning and parenting. It talks about connecting to mainstream and community-based services.  We are working to leverage mainstream housing and services resources like Housing Choice Vouchers, Multifamily housing, TANF, Community Services and Social Services Block Grants, Head Start, the list goes on.  There are myriad Federal programs that can provide housing and services to families. 

We are building the foundation we need to build systems that can end homelessness for youth—a population that we are still learning more about and learning the different interventions and solutions that they need. 

And we are working on helping communities build the systems to permanently end the costly and tragic cycle of chronic homelessness.

Let me pause for a moment and say that I believe that there has never been a better moment than the present to build the systems that will end chronic homelessness.

The Affordable Care Act gives us the tools that make it possible to ensure that people experiencing chronic homelessness are provided with the wrap-around supportive services in permanent supportive housing that can end their homelessness, improve their health outcomes, and save taxpayer dollars.  In states like Arizona, the expansion of Medicaid coverage means that nearly all individuals experiencing chronic homelessness will be eligible for Medicaid.  And that is great.  But without connection to the right kinds of supports, we know that people experiencing chronic homelessness tend to use emergency rooms, inpatient hospital services, and acute care—and will drive up Medicaid costs.  On the other hand, we know that supportive housing improves health while lowering costs.  By financing the supportive services in supportive housing, Medicaid can help bring supportive housing to scale—at least on the services side of the equation—while achieving their goals of cost containment.

In the same way that we have made ending homelessness a core part of the mission of the VA health care system, we have the opportunity to make supportive housing a standard Medicaid benefit for people with chronic health conditions who experiencing homelessness.  Think of that.  A world in which the mainstream health care system does everything in its power to prevent and end homelessness simply because it knows that doing so will achieve better health and lower costs.

The week before last, HHS released some long-awaited guidance that clarifies and makes a clear statement that the services in permanent supportive housing are services that states can absolutely cover in their Medicaid plans.  And this includes not just the primary care and behavioral health services, but also the critical tenancy, pre-tenancy, and move-in supports that we know make all of the difference for people experiencing homelessness.  The decision on whether and to what degree and how to pay for those services are covered remains with States.  But States have a variety of options whether through things like the 1915i Home and Community Services option, Medicaid Health Homes, through 1115 waivers, or through managed care.  

I firmly believe that we are on the verge of many states fully embracing permanent supportive housing as part of their Medicaid plans and strategies.  And when that happens, we’ll have solved one-half of the equation for how to bring permanent supportive housing to scale.  That leaves the housing side.  We’ve been working with HUD to expand the housing side of PSH through reallocations, through the better targeting of existing units, and through the $40 million permanent supportive housing bonus and other strategies.  However, even with these strategies, we’ve determined that nationally we need another 37,000 units of permanent supportive housing to end chronic homelessness in 2016.  And we are asking Congress to fund a $301 million increase in HUD’s budget to meet that gap.  Thus far, they have not responded to this request, but it is not over.  We need Congress to understand that these resources are critical to ending chronic homelessness, as well as to put taxpayer dollars to better use.  The cost of doing nothing is not nothing.  Ending chronic homelessness is not only the right thing to do, it is also the fiscally smart thing to do.

Meanwhile, we are also working with HUD and SAMHSA to encourage and support community-level efforts to pursue assertive and persistent outreach and in-reach to identify and engage individuals experiencing chronic homelessness who have complex conditions and systematically connect them to permanent supportive housing. 

I know it’s hard to see sometimes what is coming out of Washington.  I can tell you that we are working at a furious pace to provide the guidance, resources, and information you need to build the systems to end homelessness for all.  Whether that is on how to use Medicaid to finance services in supportive housing, how to leverage TANF for rapid re-housing, how to engage PHAs to collaborate on homelessness or make decisions about what CoC-funded programs to reallocate.  And I want to hear from you what other support you need.

Because ultimately, it is you who are doing the hard work of ending homelessness.  It is you who ultimately need to build the systems of response that will signify an end to homelessness.

Whether you are a housing provider, a shelter provider, a behavioral health agency, a case manager, a peer support specialist, an executive director, or a local government official, you must now also think of yourselves as systems designers, systems engineers, and systems participants.  This means realizing the inherent interdependence and interconnectedness of your work.  You are inextricably linked.  That what decisions you make, the actions you take, the way you operate your programs all impact your colleagues and fellow organizations and homelessness overall.  Just like a symphony, if one instrument is out of tune or plays the wrong note, it can sour the whole piece. 

As systems designers, you take on new responsibilities and new challenges.  Those of you grappling with the development of coordinated entry systems know what I mean.  You now face questions about how to create a coordinated and streamlined means of accessing help without creating unnecessary bureaucracy and closing doors.  You now face questions about how to effectively target interventions to the right people, and how to assess people in a way that is uniform and standardized across programs, but do so in a way that is not rigid and robotic, or that overly simplifies the complexity of a person’s needs and strengths. 

You are grappling with what has been called the integration-fragmentation paradox.  That the more integrated a system becomes internally, the more fragmented it tends to become from other systems.  In other words, how do you create a coordinated system for ending homelessness that doesn’t become yet another silo alongside the health care silo, the child welfare silo, the workforce silo and so on? 

As much as we are working to get the response to homelessness to be more coordinated, we must not make the homeless response system another silo.   Let’s remember that homelessness is the result of fragmented systems in the first place.  It results from the failure of multiple systems to adequately address needs of people experiencing homelessness.

The solution to homelessness is not to create yet another silo but to weave together homeless programs seamlessly with mainstream and other public systems.  The solution to homelessness is not to create a separate system and silo, but to weave together homeless programs seamlessly with other public systems to wrap around the needs of people, and not the other way around.

Coordinated entry systems provide a locus for doing just that.  Coordinated entry is a way to bring programs and services and systems to the client.  It is about creating a rapid and streamlined housing and services delivery system to people, tailored to their individual needs and strengths.  It is a way for homeless programs to interface with Medicaid and TANF and behavioral health and corrections and schools and the workforce system and child welfare.   It is not about creating yet another door, yet another place where people must undergo a lengthy assessment, yet more bureaucracy. 

I will be honest with you that a lot is expected of you.  We are expecting you to design your systems to a standard that few other sectors have met.  Certainly the mental health system has not met the standard of creating streamlined access or being not fragmented from other systems.  Certainly the mainstream health care sector has not figured this out.  Child welfare, corrections, housing, education—none of them have gotten all of this right.

What I think you have going for you that sets you apart from other systems and which gives me hope that you/we will get this right is that the response to homelessness has always been a cross-sector partnership.  Aside from a handful of places, there is no single local or state government agency responsible for homelessness.  Instead, the work has always been led by non-profits, working alongside government partners and the private sector.  Those of you working to end homelessness have always collaborated.  Previously out of sheer necessity—because you didn’t have the resources to do it all—and now because you know that is the way to solve the problem.  The work of ending homelessness is, when done right, a case study in collaborative governance. 

That gives me faith.  I have faith that you can build the systems of programs needed to end homelessness. I have faith that you can build those systems in a way that always keeps the people at the center.  I have faith that working together, we can end homelessness, first for Veterans and then for all.  You have the tools and the know-how and we are fighting to give you the resources you need.   Now is the time to prove that ending homelessness is a reality.  Phoenix stuck a big flag in the ground with its work on ending chronic homelessness among Veterans.   

You are one big symphony playing one of the most moving and important pieces of our lifetime.  Your sheet music are your goals.  The notes and measures are your data and metrics.  Your instruments are your programs, your know-how, and your compassion.  It will be a masterpiece.  

Remarks delivered by Laura Green Zeilinger, USICH Executive Director, at the End Youth Homelessness Call to Action Event hosted by the Family and Youth Services Bureau

National Press Club, Washington DC

Wednesday, October 22, 2014

I am so honored to be here today. It’s vitally important that we keep shining the spotlight on youth homelessness; keep the issue front and center.

Ending youth homelessness is a social justice issue.

In each of our cities and towns, every night, there are young people who face the unimaginable risk of exploitation, of abuse, of countless traumas that threaten not only their immediate health and well-being but that can inflict long-term damage.

Everyone, from the federal government, to change agents and like Cyndi Lauper and the True Colors Fund, to every youth provider and school in America—we all have the shared responsibility and the opportunity to be the caring adult who brings young people back to safety, back to stable housing, helping them establish permanent connections, and improve their outcomes in education, employment, and well-being.

Because of the very nature of youth homelessness, what we know about it is limited and improving data on youth is vital. Which is why the release of this new study from HHS is so important to this effort—it adds to our understanding.

We also know that what gets measured gets done, which is why getting to confident estimate of the size of the problem is critical. The federal government, with partners across sectors, is at work now to get the quality of the data to where it needs to be through focused efforts to improve the point-in-time count for youth.

But let me be clear, while better data is critical to solving this problem, there are things we know we can do today, to improve the lives and outcomes of youth experiencing or at-risk of homelessness.

To do so, we need to make some changes. We need to be smarter about how we understand and meet the needs of youth. We need to work together to connect youth with the resources and assistance they need in a meaningful and systematic way.  We can take action today, to identify and use the touch points that we have to more effectively understand and meet the needs of young people—this report gives us that much more to work with.

No single program is the magic pill. No one agency could alone end youth homelessness, but many play a part. When a young person is in crisis, it is not fragmented by government program, it is whole and overwhelming.  Yet when solutions are viewed through the lens of programs, the scope of their interaction is often narrowly defined by whether they’re part of a school, or law enforcement, or juvenile justice, protective services.

So we often find ourselves in a place, where, on some level, many are responsible in-part, but nobody is responsible for the whole, and without a system in place it’s impossible for people to even understand their part.  This has to change, and we are focused on changing this. Programs have to break out of silos and be able to put youth at the center of their work -- that is how we solve complex problems.

At the United States Interagency on Homelessness, we have necessary and extraordinary mission of coordinating among 19 federal agencies, state and local governments and the private and non-profit sectors to prevent and end homelessness.

In 2010, The Obama Administration launched Opening Doors, the first comprehensive federal strategic plan to prevent and end homelessness. In Opening Doors, we set forth bold, measurable goals: end Veteran homelessness in 2015; end chronic homelessness in 2015; end Family homelessness in 2020; and prevent and end youth homelessness in 2020.

Since 2010, we have changed the trajectory of homelessness in this country, and have established a trend line toward ending homelessness across each of our goals.

We know now that homelessness is not an intractable problem; homelessness is a problem we can solve—and a problem we are solving.

In fact, since 2010, we’ve reduced homelessness among Veterans by a third nationwide. We’ve made significant progress ending Veteran homelessness because we knew from years of study and research what interventions worked, and with bipartisan support in Congress, we asked for and received the resources to meet the needs.

With Veteran homelessness as a proof-point, we are making the case for our youth as well.

We have a federal framework to end youth homelessness, where we set a path to progress by improving data and building systems that connect youth the services they need.

This progress was made not by government alone, but in partnership with stakeholders from partners all across the country. We are stronger; we are effective when we work together toward the shared vision that every young person deserves a safe and stable place to call home.

Which is why I am so honored to introduce the next speaker.

She is someone I truly admire.  Her passion and dedication to who she calls ‘her kids” is an inspiration and force that is moving our work with greater urgency and focus.

Too many, she is a Grammy, Emmy and Tony award winning artist, and to thousands of young people and to people who are a part of this effort, she is an unwavering advocate for equality. In 2008, she co-founded the True Colors Fund, which works to end gay, lesbian, bisexual and transgender youth who experience homelessness.

Just a few weeks ago, I heard her speak about choosing a path for the Colors Fund, where she described the two choices for the direction of the organization: one, raise awareness of the issues and share best practices; or two, roll up your sleeves and do the hard work of ending youth homelessness.  She and her amazing team chose the latter.

One thing I appreciate about Cyndi is her emphasis on the importance of learning from young people about what matters, and how to make a difference. I am grateful that we'll get to hear from Jesse, Anthony and Syncere today. To borrow a phrase: "Nothing about us without us"

I’m honored to introduce the one and only, Cyndi Lauper.

Remarks delivered by Laura Green Zeilinger, USICH Executive Director, at the ground breaking of the John and Jill Ker Conway Residence in DC, a 124-unit mixed income apartment building with 60 units of permanent supportive housing for veterans exiting homelessness.

I have been looking forward to this day for a long time—as I know all of us have.

Breaking ground today on DC’s first permanent supportive housing residence for Veterans is a testament to the tenacity and resiliency of this town—which I am proud to call my home—and to the many partners who made today possible.

I know…I have been in and around this project since the very beginning, and after several starts and stops, true partnerships emerged to take a hold of it and they haven’t looked back: the District of Columbia, the DC Housing Authority, Community Solutions, A wider Circle, HUD, McCormack Baron Salazar, a braid of public, private, and philanthropic support, and countless others.

It’s because of your efforts that 60 Veterans (all formally, chronically homeless) will show up right here with keys in their hands—ready to make 1005 North Capitol Street home. Right here in view of the Capitol Dome, under which works the very democracy their service fought to defend.  

And while in this democracy of ours there seems to be many things we can’t agree on, ensuring that Veterans have a safe and stable place that is home, thankfully, is not one of them.

This project is a testament to the power of public-private partnerships and faith-based leadership. Most importantly, it’s a testament to the commitment this country has made to every Veteran:  you will have a safe and stable place that IS home. 

The Obama Administration has drawn a line in the sand: no Veteran who has served this country will go without a home in this country. For far too long, being a Veteran meant you were at a higher risk of experiencing homelessness; it’s time to turn that shameful statistic around.  It’s time to end homelessness among Veterans, and we have set a goal to so by the end of 2015.

Since the launch Opening Doors in 2010, the first-ever federal strategic plan to prevent and end homelessness, we have made real progress— reducing homelessness among Veterans by 33 percent, including a 43 percent drop in number of Veterans living in unsheltered situations. In the same time, we’ve also reduced overall homelessness by 10 percent, family homelessness by 15 percent, and chronic homelessness by 21 percent.

Of course, this progress wasn’t done by government working alone.  Not in the least.  This progress has been made by communities all across the country— like DC, where the city has reduced homelessness among veterans by 22 percent.

It’s been made by partners like Community Solutions, who ,with communities, connected more than 105 thousand people experiencing homelessness to permeant housing through their 100,000 Homes Campaign. Over 31 thousand were Veterans.

This progress has been made by commitment of leaders all across this country, including Mayor Gray, who joined the  267 (and counting….) mayors, governors, and county executives in the Mayors Challenge to End Veteran Homelessness.

This progress has been made because we have invested in and implemented evidence-based best practices—like Housing First, permanent supportive housing, and rapid rehousing.  Real solutions that are the foundation of progress and of projects like the John and Jill Ker Conway Residence.

But we have more work to do. And while I’ve been looking forward to this day a long time, I’m looking forward to the day 60 Veterans make this place home so much more; I’m looking forward to the day in the near future  when every community has the leadership, capacity and resources they need to ensure no Veteran has to sleep a single on the streets, and that every Veteran has rapid access to a safe, stable home.  Doing this will show that homelessness is solvable, and is a critical step in the movement to end homelessness for youth, families and all others.  We have never had a Presidential Administration more committed to achieving this.

Which is why I’m honored to introduce Julián Castro, Secretary of the Department of Housing and Urban Development.  Someone who understands how to problem solve at the local level, who knows the needs of communities. Who is committed whole-heartedly this issue; who is determined to ensure communities are places of hope and opportunity for every American, no matter their station in life.  Please welcome, Secretary Julián Castro!

Remarks delivered by Laura Green Zeilinger, USICH Executive Director, at Ballard Spahr’s National Housing Symposium in Washington, DC.

Thank you Sharon Geno for the kind introduction and for asking me here today. I’m honored to have the privilege to join this important discussion.

As Executive Director of the United States Interagency Council on Homelessness, I bring greetings from Council Chair, Secretary Tom Perez.

Together, we are responsible for coordinating the federal response to homelessness by creating an interagency platform to maximize the effectiveness of our 19 federal agency partners, sharing best practices, and driving collaborative solutions.

I am here today to deliver a message on behalf of our Administration that we can solve homelessness by working together.

I’ve made a career of trying to tackle complex social problems, first in an international context, then in local government and now at the Federal level, figuring out ways government can work effectively and efficiently for people, the greatest test of which is people with the highest levels of vulnerability.

Through this work I have come to know that homelessness is not an intractable problem; it persists because we choose to let it persist.  But we can choose a different outcome. I’ve seen it... I’ve seen what happens when we choose to work towards a different outcome…a better outcome.

A little more than 4 years ago, when I was working in city government, we held an event to mark the day the 1,000th person (a female Veteran) moved into her apartment in the District’s Housing First initiative.

I ran into Bill, an outstanding outreach worker. Bill said to me,

“I want you to know that I do not have the same job as I used to. It used to be, no one had any reason to really engage with me; they didn’t believe that I had anything real to offer them.  That has changed,” he said. “People have seen others, who have lived outside a very long time, move into housing. They understand now that it is possible for them too.  Now they want to talk with me. It is clear there is a different sense of hope and motivation to begin to access services.”

You see, when you start working towards creating better outcomes for people—people who may have lost hope—they now have a reason to hope, and they do things no one thought possible. They have faith in a better future for themselves.

A few years ago, in an article in Stanford Social Innovation Review, John Kania and Mark Kramer coined the term “collective impact” to describe the success that is possible when key actors from different sectors set a common goal to solve a complex problem, and work in a structured process to pursue mutually reinforcing actions towards that goal, and routinely measure progress against that goal using data, and adjust their efforts. 

They distinguish collective impact from ‘isolated impact’ which is “an approach oriented toward finding and funding a solution embodied within a single organization, combined with the hope that the most effective organizations will grow or replicate to extend their impact more widely.”  They write that there is little evidence that isolated initiatives are the way to solve many of the social problems in today’s complex and interdependent world.

Our work here would fit this description of collective impact: a broad set of stakeholders from the public, private, non-profit, sectors united around and worked towards a common goal of ending homelessness.  The good news is that across the country, communities are beginning to better organize themselves to create collective impact on homelessness.

USICH’s approach to the federal government: coordinating the expertise and efforts of 19 Federal agencies to develop and adopt Opening Doors, the first ever Federal strategic plan to end homelessness. 

It was through the collective impact of our Federal partners that we were able to set the goal of ending homelessness in America, specifically to:

• Prevent and end homelessness among Veterans in 2015,
• Finish the job of ending chronic homelessness in 2016,
• Prevent and end homelessness for families, youth, and children by 2020, and
• Set a path for ending all types of homelessness.

Through a collective impact approach, we are changing the trajectory on homelessness in our nation.

In four years, we have reduced overall homelessness by nearly 10 percent, including a 25% reduction in unsheltered homelessness—meaning fewer and fewer or our neighbors, our families, our Veterans are facing nights on the streets, in cars, in abandoned buildings or other places not meant for human habitation.

• Homelessness among Veterans down by 33%
• Chronic Homelessness down 21%
• Family homelessness down 15%, including 53% drop in unsheltered homelessness among families

Ending homelessness requires a long-term vision, a commitment to policy change, the redirection of resources, new investments in evidence informed practices, and sustained collaborative leadership at the federal, state, and local levels.  Examples of outstanding federal collaboration include the work of HUD and VA to improve the Veterans Affairs Supportive Housing program (HUD-VASH) and to implement Supportive Services for Veteran Families.

VASH pairs a HUD housing voucher with VA health care and services to create supportive housing targeted to vulnerable and chronically homeless Veterans.  VASH has strong bipartisan support and has been the largest new supportive housing investment over the last five years. Since 2008, HUD has awarded 68000 vouchers which have enabled 80000 Veterans to obtain permanent housing.

Supportive Services for Veterans Families was created during the first term of our administration and takes the lessons learned from the Recovery Act’s HPRP to scale for Veterans.  Grant announcements later for rapid re-housing and prevention assistance will total $300million in awards to non-profit organizations and consumer cooperatives.

Our work on solving homelessness among Veterans demonstrates that interagency collaboration, strategic new investment, and the adoption of proven tools points the way for success in other areas.

Another example of how federal agencies have collaborated is our work to accelerate our progress on ending chronic homelessness.  In 2012, however, the Council realized that we were not on track to achieve this goal. We determined that our slow progress was due to four factors:

1) Despite the increase in units, many supportive housing units were not actually targeted to people experiencing chronic homelessness (only 45 percent of the nation's 166,000 supportive housing units were designated for people experiencing chronic homelessness);

2) The expansion of permanent supportive housing was concentrated in the North and East, whereas there were also high needs in the South and West;

3) Our estimates of the need did not adequately account for people experiencing chronic homelessness who cycled in and out of institutional settings; and

4) Congress had failed to act on the repeated requests made by the Administration for resources to increase permanent supportive housing.

In April 2013, the Council developed and adopted a bold interagency strategy to accelerate our progress on ending chronic homelessness. 

We also conducted a careful analysis of the impact of these actions on our goal.  We found that even by fully utilizing every existing resource, we still had a gap of about 37,000 units to achieve the goal. With support from the White House and OMB, this led to the inclusion of a $301 million increase in the President’s FY 2015 Budget to create 37,000 new units of permanent supportive housing.  This request is still being considered by Congress as part of the FY 2015 Omnibus.

Our strategy also focuses on leveraging the opportunities in the Affordable Care Act to finance services that can end homelessness, particularly for people experiencing chronic homelessness.   

One of the biggest pieces of legislation supporting our effort to end homelessness was national health reform through the Affordable Care Act.  The ACA is a game changing policy that will improve the lives of low-income families and individuals.

First, it makes possible affordable health coverage to all low-income families and individuals through both the expansion of Medicaid eligibility and health insurance exchanges.  Families burdened by both high rents and high health care costs can get some reprieve.

It also means that low-income families and individuals may be entitled to a comprehensive package of health care services that encompasses not only doctor’s visits and hospital-based care, but also behavioral health care and (depending on the state) case management services.  This is possible because of provisions in the Affordable Care Act that seek to transform what health care means and how it is delivered. It focuses on health and stability, not just on encounters and procedures, and that includes the kind of care and services that low-income families and individuals, including those experiencing homelessness, need. 

The ACA has unleashed a whole set of innovations in health care delivery, and there is an active search for innovative solutions to improving health outcomes while lowering costs.  Those of us in the room know that for many people with complex health conditions, housing is fundamental to improved health and to helping people avoid more expensive forms of care.  We have seen the evidence on permanent supportive housing’s ability to reduce hospitalizations and emergency room visits.  The door has been opened for us to build on this evidence, and firmly establish that affordable housing is a health care intervention and another means of bending the health care cost curve.

Just a few weeks ago HHS released Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants of Permanent Supportive Housing.

We Still Have More Work to Do, National Housing Crisis Poses Significant Challenges

While we have been successful, we know there is much work to be done. That we achieved even these modest reductions is good news, but not cause for much celebration as our work is far from over:

• More than 578,000 people still experience homelessness on any single night.
• More than 67,000 families with children are homeless, which includes more than 216,000 people.
• The U.S. Department of Education also estimates that over the course of a school year more than one million children will lack a stable place to call home.

Infancy is the period of life when a person is at highest risk of living in a homeless shelter in the United States.  Let me say that again because it is so shocking.  The age at which a person is most likely to be found in a homeless shelter in the United States is infancy. 

Rates fall a bit when children are 1-5, although preschool children are still more likely than adults to find themselves in shelter – this fact coupled with what we know about the social determinants of health, hammers home why increasing access to affordable housing and ending homelessness is a critical “strategy for our future”      

Given these numbers, we know we don’t have an easy road ahead.  Our challenges are compounded by a worsening national housing crisis, especially at the lower end of the housing market as the data from NLIHC’s Out of Reach Report and HUD’s Worst Case Housing Needs report shows:

• For every 100 Extremely Low Income renters, there are only 31 available and affordable units.

• National research shows that families experiencing homelessness have incomes at or below 40-50 percent of the Federal Poverty Level, which translates to between 14 and 17 percent of AMI

• For people with disabilities living on SSI, which averages $721 per month in 2014, they can only afford a rent of only $216 per month.  There is not a single county in the U.S. where even a modest efficiency apartment is affordable for this amount.  

It is clear that we cannot end homelessness without addressing the shortage of affordable housing, especially for extremely low-income households and people with disabilities.

On the other hand, it is clear that when we do have investments in affordable housing, we can see the impact it has on homelessness.

Nowhere is that more clear than our work around Veterans experiencing homelessness, where the increased investments have resulted in historic reductions in the number of Veterans experiencing homelessness.  Demonstrating that when we invest, homelessness is a problem that is not too complex to solve.

There is a parallel here to the story I started with about my friend Bill, just as people who had given up hope in themselves started to think differently about what they could do, so too, are leaders, policy makers, and stakeholders throughout our country as we end homelessness among Veterans.

Ending homelessness is not just a good thing to do from a human stand-point; it also makes good fiscal sense.  Many people experiencing chronic homelessness spend their lives cycling through emergency shelters, jails, and hospitals and incur high costs to public systems – sometimes upwards of $50,000 a year. The daily cost of supportive housing for this vulnerable population is a better investment of scarce public resources than the cost of repeated hospital, ER, and detox center admissions. Permanent supportive housing in not only a better public investment, but it results in better health and quality of life for people when they have a home. As HUD Secretary Julian Castro likes to say: ending homelessness works for the common good and the bottom line.

We need to talk about how affordable housing improves health while lowering health care costs, how affordable housing increases public safety and reduces crime and recidivism, how affordable housing creates jobs and improves neighborhoods and property values, how it stabilizes and strengthens families and improves children’s educational outcomes and well-being in life. 

Underlying the ACA was an idea called the “Triple Aim:” that the goal of health reform is:

• To improve health outcomes
• To improve the experience of health care, and
• To lower costs. 

Perhaps we need to clarify our own Triple Aim for affordable housing:

• To improve lives and families,
• To build neighborhoods, and
• To create jobs.

Preventing and ending homelessness is an ambitious but achievable goal.  It requires equally ambitious collaboration, innovation, investment, data driven and outcome-focused planning, and, above all, an aggressive commitment to getting to the finish line.  Communities across the country are providing examples of this commitment every day.  USICH and our federal partners are weaving together our resources and reforms to ease the journey.  Together, we will continue to make great strides toward our goal of preventing and ending homelessness in America.

Thank you.

Remarks delivered by Liz Osborn, USICH Management and Program Analyst, at the U.S. Department of Housing and Urban Development’s consultation on human rights.

Approaching homelessness from a perspective that promotes, protects, and respects human rights has been a focus of USICH since at least the release of Opening Doors, the Federal Plan to End Homelessness in 2010. Reflecting this perspective, the Plan includes a strategy to reduce the criminalization of homelessness by defining constructive approaches to address street homelessness and considering incentives to urge cities to adopt these practices.

With that strategy in mind, and working in partnership with the National Law Center on Homelessness and Poverty (NLCHP), USICH convened a conversation with DOJ and HUD that resulted in the release of Searching Out Solutions, a document that lays out constructive alternatives to criminalization.

In July 2013, we partnered again with the National Law Center to solicit feedback from the 19 agencies that make up our Council on what we are currently doing to support alternatives to criminalization and identify additional opportunities. We reported what we learned to the State Department, where it informed their response to the UN on the ICCPR (International Covenant on Civil and Political Rights), which took place last March in Geneva. NLCHP served as a trusted partner in the process, helping to orient us to the work of the State Department and the role we could play.

Finally, starting in December 2013, and running through January 2014, to share this information with a broader audience, we released a newsletter and blog series to explore human rights as they are related to housing. We continue to foster the dialogue through webinars, peer-to-peer calls, and in our daily communications with partners at the federal, state, and local levels.

There are many benefits to focusing on housing from a perspective that promotes human rights:

1. Helps motivate our work on permanent supportive housing as the primary solution to homelessness, rather than on services to people while they remain homeless.
2. Highlights that the need for respect and individual attention are essential. The strategies we employ depend on understanding the unique needs of individuals and families and listening to the voices of people experiencing homelessness. Approaching the challenges in this manner helps keep those voices at the forefront of our work.
3. Drives a sense of urgency by keeping us aware of the human cost of homelessness and challenges us to act with urgency.
4. Creates more depth to our argument by moving beyond the financial incentive to ending homelessness and allows us to tap into our passions, relationships, and experiences working with people.
5. Broadens our reach. Ending homelessness cuts across all sectors of society, so we need multiple approaches to reach as many people as possible. Promoting human rights opens us up to new audiences and new tactics, and therefor new partners and solutions.

It is not without challenges, but I would strongly advocate that challenges are not a reason to not move forward in this manner. First and foremost is the challenge that there is not always concurrence among partners about what a perspective that promotes human rights means. For example, dialogue in the international community around human rights can have specific, legal implications that are important to be aware of.

I would conclude by saying this has been a very positive experience for USICH. I have heard that Opening Doors has been received very well at State’s international engagements. For example, at the civil society consultation, one questioner led off with a comment that they appreciate our work in the area of criminalization. Also, our blog and newsletter series are some of the most popular and well-read posts on our website.

Thank you for your time, I am happy to speak further on the topic with anyone who is interested.

Secretary Burwell serves as Vice Chair of USICH and delivered these remarks on May 7, 2015 to the National Health Care for the Homeless Council Conference in Washington, DC.

Remarks are presented below, as prepared for delivery. 

Introduction

Thank you, John [Lozier].

I know many of you have worked with Richard Frank, our Assistant Secretary for Planning and Evaluation here at the Department, and we’re glad to have him. When Richard told me more about the work of this Council, he said, and I quote, “To put it simply, they are doing God’s work.”

And it’s hard to disagree.

I’ve always believed the Biblical proverb that our compassion and generosity for the least of us—the sick, the hungry, the stranger and the imprisoned—is felt by God himself.

This idea of service is at the heart of our American values as well. As President Johnson said: “There is [a] tradition that we share today. It calls upon us never to be indifferent toward despair. It commands us never to turn away from helplessness. It directs us never to ignore or to spurn those who suffer untended in a land that is bursting with abundance.”

During my time at the Gates Foundation, I had the opportunity to get involved in this work.

While many people know the state of Washington for its innovation, fewer might know that across the state, 20,000 people are homeless on any given night. In partnership with Bill Gates Sr., we led the Foundation’s Pacific NW Giving Initiative – which to this day focuses on creating opportunities for families across the state, with homelessness as one of its focus areas. Together, we visited with homeless men, we met women and their children on the brink of losing their homes, and we learned firsthand the impact we can have working together across the public and private sectors.

The important work that you do every day serves hundreds of thousands of men, women and children all over this nation, including over 20,000 veterans.

You give people a second—and sometimes third and fourth—chance at life. You give people a path forward. You give them dignity.

The Affordable Care Act and Homelessness

You’ve also been important partners in our Affordable Care Act efforts. I want to thank all of you for your support, from advocating for reform to supporting implementation and enrollment efforts.

Thanks to your work, the Affordable Care Act has given us important resources to serve those experiencing homelessness.

It supported and extended the community health center program with $11 billion for expanded operational capacity, renovation of existing facilities, and construction of new centers. These resources are crucial for this community, and we're pleased that the SGR fix that just passed included another $7.2 billion over the next two years to further support this critical program.

The Affordable Care Act has also increased access to needed behavioral health services. Among those experiencing chronic homelessness, 75 percent or more are estimated to have serious mental illnesses, substance use disorders, or both. Before the law was passed, people struggling with these problems often couldn’t get treatment. Now those treatments are essential benefits and are required for Medicaid and plans bought on the Marketplace. With this support, more people have been able to find and maintain stable housing and stay out of the justice system.

Medicaid Expansion

Another way we’re working to strengthen communities is through the Medicaid expansion, which has a big impact on this population. Not only has expansion helped connect homeless patients to life-saving treatments and care, we learned from a report by this Council and the Kaiser Foundation that it’s helping improve their lives in other ways as well. When individuals can manage their health, they have a better ability to work and maintain stable housing.

We know there are impacts for the community at large.

Medicaid expansion can lower health care costs and boost state economies, freeing up resources to help them better serve the people of their states. A Deloitte study on Kentucky’s expansion, for example, found that hospitals saved $1.15 billion in uncompensated care charges. Overall, expanding Medicaid will have a positive cumulative impact of more than $30 billion on the Bluegrass State economy through Fiscal Year 2021.

That’s why it remains one of our top priorities.

So far, 28 states and D.C. have decided to expand. We’ve worked closely with governors of both parties to get that far, and will continue to do so. We believe it can make a big difference for this community and we are committed to finding a solution that works for every state.

Permanent Supportive Housing

Of course access to care is only one piece of the puzzle. It’s difficult for individuals or providers to consistently address basic health needs if that person doesn’t know where they will sleep on any given night.

With permanent supportive housing, people struggling with housing insecurity have one less threat to their health and well-being. And the evidence shows that permanent supportive housing not only serves individuals in need but can also lower costs – reducing avoidable hospitalizations and institutional care, for example.

At HHS, we’re working to make sure our services incorporate this need. We’re focused on how Medicaid can best support this population by helping manage chronic conditions and other challenges. That’s because we know that when people get quality health care through Medicaid, permanent supportive housing has a better chance of success – and the community benefits as a result.

The Substance Abuse and Mental Health Services Administration, or SAMHSA, supports behavioral health services that lead to more stability. Connecting people to the mental illness or substance use treatments they need is another key factor in making permanent supportive housing solutions work.  

At the same time, we are working across the federal government, and in close coordination with the Department of Housing and Urban Development, to support the essential health components of a system that addresses the full array of needs.

We are always looking for ways to improve and better serve this community – and we want to learn from you. We know that many of the Health Care for the Homeless grantees are innovators and are building holistic programs aimed at supporting housing stability and better health.

For example, Central City Concern in Portland, Oregon, runs a permanent supportive housing program, provides medical care, and offers employment services. And the Denver Stout Street Clinic and Colorado Coalition for the Homeless provide integrated primary and behavioral health care, dental services, substance treatment services, and permanent supportive housing. Thanks to the Medicaid expansion, these clinics were able to get more people the services they need. This kind of work doesn’t just improve the health of our struggling neighbors; it helps them get back on their feet and ultimately strengthens our entire community.  

U.S. Interagency Council on Homelessness

Homelessness is a complex issue, but one that we know how to solve. Together, with our colleagues across the federal government, and with the leadership of President Obama, we’re committed to finding meaningful solutions.

By coordinating the different kinds of support that people and communities need—like integrating health care with housing—we’ll be able to take a step closer to ending homelessness. We’re specifically focused on veterans, families and children, and putting an end… finally… to chronic homelessness.

Our goal is ambitious, but so are we.

And we’ve already made some great headway, especially with regards to veterans. This past January, New Orleans became the first major American city to end veterans’ homelessness entirely. Several other major cities, including Salt Lake City and Phoenix, have ended chronic homelessness among veterans. The overall number of veterans experiencing homelessness has declined by 33 percent—nearly 25,000 veterans—since 2010, and we are on a path to reach our goal by the end of this year.    

I am grateful to Secretary Perez for all that he has accomplished in his role as Chair of the U.S. Interagency Council on Homeless, and I am pleased to say that in 2016, I will be taking over as the Chair.

This issue is important to me, and I am excited to build on the progress that we’ve made together.

My commitment to you all is to keep this conversation alive. You are the experts and we want to hear from you on how we can keep our progress going.

Conclusion

We truly live in a land of abundance. It is a blessing and a responsibility. A responsibility to care for those among us who are struggling, who have fallen through the cracks of our workforce and our social systems.

This isn’t charity and it isn’t kindness. It is the work we do to live up to our own values, to be the kinds of people we hope we are. It is our honor to serve.

Thank you.