Transcript Non-VA Care for Lincoln area veterans

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August 6-8, 2013
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Veterans & Homelessness
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VA Nebraska-Western Iowa
Health Care System
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Care Sys
NWIHCS Mission:
Honor America’s veterans by providing
exceptional health care that improves their
health and well-being.
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Ending Veteran Homelessness
Eliminate Veteran homelessness by 2015
Tools to accomplish this goal:
 6 Strategic Pillars
 5 Year Plan
 Collaboration
 Utilization of resources
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The term "homeless" or "homeless individual or homeless person"
includes––
1. an individual who lacks a fixed, regular, and adequate nighttime
residence; and
2. an individual who has a primary nighttime residence that is––
A. a supervised publicly or privately operated shelter designed to
provide temporary living accommodations (including welfare hotels,
congregate shelters, and transitional housing for the mentally ill);
B. an institution that provides a temporary residence for
individuals intended to be institutionalized; or
C. a public or private place not designed for, or ordinarily used as,
a regular sleeping accommodation for human beings."
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Overview of Homelessness
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62,619 Veterans estimated to be homeless on any given
night*
Homelessness is often a consequence of multiple
psychosocial factors, including unstable family supports, job
loss, inadequate job skills, health problems, substance use
disorder, or other mental health concerns.
Homeless services cannot be provided in isolation.
Homeless services must be comprehensive
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recovery-oriented,
support physical and mental health stabilization and treatment,
provide substance use disorder treatment,
enhance independent living skills,
address vocational rehabilitation and employment maintenance,
assist with housing searches and placement.
*VA Community Homelessness Assessment, Local Education and Networking Group (CHALENG) Annual Report, 2008
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Health and Mental Health Needs
of Homeless Veterans
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66% Alcohol Abuse
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51% Drug Abuse
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54% Serious Psychiatric Diagnosis
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39% Dual Diagnosis
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58% Health/Physical
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National Coalition for Homeless
Veterans
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About 20% of general homeless population are
Veterans; Veteran make up only 8 percent of the
population
Nearly half of homeless Veterans are from the
Vietnam Era
Two-thirds served at least 3 years and one-third
served in a war zone
1.5 million Veterans are at-risk for homelessness
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VA Five-Year Comprehensive Plan to
Eliminate Homelessness
Among Veterans
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VA will expand existing programs and develop new initiatives
to prevent Veterans from entering into homelessness and to
treat those who are currently homeless.
 Increase the number and variety of housing options including
permanent, transitional, contracted, community-operated, and
VA-operated
 Provide more supportive services through partnerships to
prevent homelessness, improve employability, and increase
independent living for Veterans
 Improve access to VA and community based mental health,
substance abuse, and support services
These program enhancements will provide housing, VA health
care and benefits, gainful employment and residential stability
to more than 500,000 Veterans
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Causes of homelessness
Extreme shortage of affordable housing
 Lack of livable income
 Access to health care
 PTSD and addiction issues
 Childhood abuse and poverty
 Involvement in the legal system
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VA Five-Year Comprehensive Plan to
Eliminate Homelessness Among Veterans
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The provision of safe housing is
fundamental. However, programming must
include:
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mental health stabilization; substance use
disorder treatment services; enhancement of
independent living skills; vocational and
employment services; and assistance with
permanent housing searches and placement.
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National Research Findings
Dennis Culhane & Research Team
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30% reduction in use of publicly funded
services if a homeless mentally ill person
uses service-enriched housing vs.
emergency shelters.
33% decrease in the use of medical and
mental health services directly attributable to
service-enriched housing.
NY/NY supportive housing costs 48 % less
than emergency housing
Corporation for Supportive Housing Summary,
May 2001
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Strategy to End Homelessness
Among Veterans
Treatment
Outreach/
Education
Prevention
Housing and
Supportive
Services
Income/
Employment/
Benefits
Community
Partnerships
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Prevention
Homeless Prevention
Services
Types
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Universal Prevention
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Public information regarding the availability of resources/services
Medical Treatment
Mental Health Treatment
Substance Use treatment
Economic Benefits
Targeted Prevention
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Supportive Services for Low Income Families
Homelessness Prevention Pilot (HUD-VA)
Relapse prevention services
Justice Involved Veterans
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Prevention
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Programs for Justice-Involved Veterans
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Homeless Prevention
Services
Transitional planning for Veterans discharging from the justice system
Veterans Justice Outreach Specialists at each VA medical center
Outreach and education for law enforcement
Linkage to VA services for Veterans in treatment courts, including Veterans
Courts
FY 09: 4,500 aided by 39 VHA Re-entry Specialists
FY 10: 7,500 Veterans served (HCRV and VJO); staffing enhancements for
VJO
FY 12: 7,694 Veterans Served.
Supportive Services for Low-Income Veteran Families
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Grants to provide case management and supportive services for low-income Veteran
families
Services include financial assistance to prevent Veterans falling into homelessness
FY 09: Program development
FY 10: Award Grants; 5,000 Veterans served
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Prevention
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HUD-VA Prevention Pilot
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Homeless Prevention
Services
Collaboration with HUD to provide housing and intensive case management
OEF/OIF focus
Targeting areas with large numbers of returning Veterans
FY 10: 200-250 Veterans and families served
FY 12: 329 Unique Veteran served.
Health Care for Homeless Veterans Contract Residential Care
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An immediate resource at each VA medical center to realize the
commitment to “no wrong door”
Homelessness prevention and rapid re-housing
FY 09: 1,600-2,000 Veterans expected to be served
FY 10: 4,800 Veterans served
FY 11: 8,141 Veterans served
FY 12: 11,402 Veterans served
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Outreach &
Education
Outreach&
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Outreach & Education
Outreach by VA and community partners
 Shelters
 Soup
Kitchens
 Street Outreach
 Stand Downs
 Justice Outreach and Re-entry Services
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VA National Homeless Call Center
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Outreach &
Education
Outreach&
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Outreach & Education
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Homeless Registry
 Database to track and monitor prevention and treatment outcomes
 Dual focus: Program performance and outcomes for Veterans
 FY 09: No registry exists
 FY 10: 200,000 Veterans entered into registry
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National Call and Referral Center
 Resource for homeless Veterans and advocates seeking immediate
assistance
 Linkage to wide array of VA and community resources
 FY 09: No formal system exists
 FY 10: 15,000 Veterans served
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Treatment
Treatment
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Access, Access, Access and the “no wrong door policy”
Assessment, Comprehensive Treatment and Rehabilitative
Treatment includes:
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Medical care
Mental Health Care
Substance Abuse Care
Dental Care
Assessment and development of comprehensive treatment
plans for:
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Psychosocial Issues
Family Issues
Legal Issues
Vocational Issues
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Treatment
Treatment
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VA Residential Rehabilitation and Treatment Programs
 VA-operated residential care programs
 Access to full spectrum of available services, plus in-house
programming
 FY 09: 2,000 residential beds; 5,000 Veterans served
 FY 10: 5,300 Veterans served
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Dental Care
 Enhanced effort to promote dental care for homeless Veterans
 FY 09: 11,000 Veterans served
 FY 10: 20,000 Veterans served
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Housing and
Supportive
Services
Housing and Supportive
Services
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Provision of transitional and permanent
housing with supportive services in
collaboration with Federal and Community
Partners.
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Provision of Community based Residential
Treatment
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Housing and
Supportive
Services
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HUD-VASH Program
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Housing and Supportive
Services
Nation’s largest supported permanent housing initiative; combines permanent
housing with case management and supportive services that promote and maintain
recovery and housing stability
HUD Housing Choice vouchers
VA dedicated case management services
FY 09: 20,000 vouchers allocated
FY 10: 30,000 vouchers allocated; 22-24,000 Veterans housed
FY 12: 48, 183 vouchers allocated.
Grant and Per Diem
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Transitional housing (up to 24 months) and supportive services for homeless Veterans
Enhancement will allow grantees to provide 1500-2000 additional beds
FY 09: 18,000 Veterans served
FY 10: 20,000 Veterans served
FY 11: 21, 412 Veterans served
FY 12: 22, 983 Veterans served
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Income, Employment
& Benefits
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Income, Employment
& Benefits
Employment assistance
Entitlement assistance
 Expanded GI Bill
 Social Security Benefits
 Veteran’s Compensation
and Pension
 VRAP
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Short-term financial assistance
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Shallow subsidies through HUD-VASH
General Assistance (GA)
Temporary Assistance to Needy Families (TANF)
Vocational Rehabilitation
Supportive Employment/CWT
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Income, Employment
& Benefits
Income, Employment
& Benefits
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Supportive Employment/Compensated Work Therapy (CWT)
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Expedited Claims for Homeless Veterans
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Employment program targeted at Veterans with significant health problems
Access to full spectrum of available services, plus in-house programming
FY 09: Approximately 5,000 Veterans served
FY 10: 5,500 Veterans served
Collaboration with VBA
Ensure timely processing of homeless Veterans’ benefits claims
FY12: 14,650 Veterans served
FY13 (YTD): 10,872 Veterans served
Homeless Veteran Reintegration Program (HVRP)
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Collaboration with Department of Labor
Provide Veterans with gainful employment
FY 09: 15,000 Veterans served
FY 10: 20,250 Veterans served
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Homeless Services
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Outreach
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year provided outreach to 1,422
Veterans last year
 109 of these individuals were women
 Female Veterans were 8% of uniques
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Current Programming
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Contract Residential Housing
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22 beds with 12 at Lutheran Home in Omaha and 10 with
CenterPointe in Lincoln
Grant & Per Diem (136 beds total)
30 in Lincoln at People’s City Mission; 25 in Lincoln at
CenterPointe (Transition In Place)
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12 at Salvation Army
25 at Salvation Army (Transition in Place)
16 at Siena/Francis House
4 Stephens Center
26 Christian Worship Center/New Visions
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Contract Residential and
Grant and Per Diem
Collaboration with community partners.
 Referral process.
 Discharge planning.
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Current Programming
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HUD/VASH
 315
vouchers
 80 vouchers in Lincoln, 225 in Omaha, and 10
in Council Bluffs
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Veterans Justice Outreach
 Working
with justice involved Veterans to
consider treatment vs. incarceration
 Jail outreach
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HUD VASH
Collaboration with community partners.
 Housing First.
 Team approach.
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New Programs
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Compensated Work Therapy – Transitional Residence
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Homeless Veterans Supported Employment Program
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Located on Grand Island Campus with 9 beds
5 new staff hired to assist homeless Veterans in finding
jobs
Supported Services for Veterans Families Program
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Grant program to help Veterans who are experiencing a
housing crisis
 Central Nebraska Community Services
 Together, Inc (2013 Award)
 Will serve Veterans in 22 counties
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Focus on FY2013 Priorities
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Expand outreach to unsheltered areas and collaborate with agencies on
outreach teams.
Continue to implement a Critical Time Intervention Model in HUD/VASH.
Implement Housing First across the homeless programs.
Locate Community Resource and Referral Center in downtown Omaha.
Incorporate primary care services into this clinic.
Screen all Veterans receiving care at VA for homelessness or housing
crisis's.
Actively participate in HUD Point-In-Time counts across the State.
Enhance outreach to improve outreach and engagement to Veterans in rural
communities.
Develop Child Support Assistance for Housing Stabilization.
Implement Transition in Place transitional housing model.
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Questions/Answer
Contact information:
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Linda Twomey
 [email protected]
 402.599.2193
Kerry Miller Loos
 [email protected]
 402.599.0083
Lea Anne Peterson
 [email protected]
 402.599.2195
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