1. { Homeless Programs Patricia A. Bradford Southeast Network Homeless Coordinator

2. VETERANS HEALTH ADMINISTRATION HUD Background Housing Choice (tenant) Based Vouchers (HCV) – Allows a Veteran to choose The community within the case management “zone” The housing unit Project Based Voucher (PBV) – Vouchers are tied to the project – Provides a unit in a specific project development – Project usually has additional services on site 1

3. VETERANS HEALTH ADMINISTRATION HUD-VASH Background Voucher allocations Are collaboratively determined by HUD with VA input Based on a relative need formula using PIT and VA data In all 50 states, Guam and Puerto Rico Determine VA staffing levels for case management and supportive services VA is implementing the HOUSING FIRST model – HUD-VASH eligibility does not require sobriety or treatment compliance 2

4. VETERANS HEALTH ADMINISTRATION Scope – Case Management Case Management may include: – Exit from homelessness assistance – Coordinating care with the VA medical facility – Skill development – Other functional assistance as needed by the individual Veteran and family to stay housed CM monitors progress and intervenes to ensure that Veteran remains housed The Housing First approach best serves Veterans who experienced chronic homelessness, complicated by MI and SUD 3

5. VETERANS HEALTH ADMINISTRATION Scope – Housing First Utilizing the Housing First approach requires: – Assertive community outreach – Employing a low-demand, low barrier approach – Rapid placement into housing with no requirements for a period of stabilization, sobriety, or full compliance with mental health treatment Educating Housing First staff on the model Needing - for Housing First to be optimally successful: – Readily available housing stock – Cadre of housing providers/landlords – Cooperative PHAs – Clinical staff who are knowledgeable and supportive of Housing First 4

6. VETERANS HEALTH ADMINISTRATION HUD-VASH Program Referral Sources for Veteran Participants Doors for Veterans to enter HUD-VASH: Local CoC, community partners & other community stakeholders VA’s National Call Center for Homeless Veterans – – 877-424-3838 or 877-4AID-VET Veteran self-referral Other VA Homeless programs Other VA or community medical facilities and programs including CBOC’s and Vet Centers Targeting chronically homeless Veterans 5

7. VETERANS HEALTH ADMINISTRATION HUD-VASH Program Participant Targeting Must: – Be Homeless – Meet VA health care eligibility Need to include: – Chronically homeless Veteran; – Other Veterans with diminished functional capacity and thus need for case management Assess each case on an individual basis, Use clinical judgment Dependent on resource availability 6

8. VETERANS HEALTH ADMINISTRATION HUD-VASH Program Screening and Evaluation for Admission Criteria for admission does not include any expectation of a period of sobriety nor any treatment compliance or completion Verify Veteran meets VHA eligibility criteria If new to VHA, ensure enrolled in VA health care – Seek H&P if not seen by PCC in 1+ years Coordinate and facilitate MH care Provide referrals to alternative programs or services for Veterans not appropriate for HUD-VASH 7

9. VETERANS HEALTH ADMINISTRATION HUD-VASH Program Admission and Assessment Admission: Case Manager’s CLINICAL decision (or mutual decision with other providers when complex) Acceptance for HUD-VASH case management is program admission Have 24 hours to make a decision after screening Assessment: Newly-accepted Veterans are assigned to a HUD-VASH CM CM ensures the “Initial Assessment” is completed in HOMES for each new Veteran 8

10. VETERANS HEALTH ADMINISTRATION HUD-VASH Program Housing Plan Must develop a “Housing Plan” Specific, individualized goals that focus the direction of care Veteran drives the care and case management goals Veteran’s self-determination is respected and empowered Veteran’s participation is documented – Primary goal is for the Veteran to stay housed – Objectives are in support of retaining housing – Mental or physical health or SUD symptom reduction may support housing retention Review and update plan regularly Integrate plan into the Veterans’ overall VA care plan 9

11. VETERANS HEALTH ADMINISTRATION HUD-VASH Program Housing Placement - VA Staff VA Staff will: Work with the PHA to streamline voucher application process Work with community partners to access resources Assist the Veteran – Obtain the needed documentation – Complete the PHA application – Obtain a HUD-VASH voucher from the PHA – Provide Veteran support at appointment(s) Obtain a signed ROI indicating permission for information exchange with PHAs and other community agencies 10

12. VETERANS HEALTH ADMINISTRATION HUD-VASH Program Housing Placement - PHA Staff The PHA has the responsibility to: Verify income eligibility Complete very limited background check – Only ensure that Veteran is NOT on a state requirement for lifetime registration for sex offense Issue a HUD-VASH voucher after Veteran passes above Assist with porting vouchers to another PHA Provide housing-search resources to HUD-VASH Veterans Inspect housing units in a timely fashion to ensure safe and decent housing 11

13. VETERANS HEALTH ADMINISTRATION HUD-VASH Program Housing Placement - Veteran The Veteran (with HUD-VASH staff assistance) will: Choose a suitable apartment within the voucher timeframe Request local PHA to inspect and approve the dwelling Ensure PHA and landlord sign the Housing Assistance Payment (HAP) contract Contact the landlord and sign a standard lease Move into the housing unit on the agreed upon date Utilize the Housing Plan and other strategies to sustain in housing 12

14. VETERANS HEALTH ADMINISTRATION HUD-VASH Program PHA Denial of Assistance Why Veterans and/or family members are ineligible : Veteran family is over-income (locally-based income thresholds) Veteran or Veteran family member is on a state lifetime registration requirement for sex offense If the PHA denies assistance they must provide: Prompt notice of the decision denying assistance Brief statement of the reason for denial Allow the family an information review per 24 CFR § 982.55(a) and (b) Violation of PHA Rules Veteran must follow the usual PHA rules or face possible loss of their voucher assistance PHA must follow their usual procedure in terminating assistance, including an appeal process 13

15. VETERANS HEALTH ADMINISTRATION Family Members Minus the Veteran Using the Voucher Family Members in some situations may use the voucher without the presence of the Veteran: Death of the Veteran By law, the family receiving protection as a victim of DV, dating violence, or stalking, and the perpetrator is the Veteran In both, only for the family registered on the voucher and lease – VA CM is not available without the Veteran, but can be arranged through referral to non-VA programs – May continue to utilize the HUD-VASH voucher until another voucher from PHA is available (considered “participants” so not on waiting list for “regular” vouchers) – Must remain otherwise eligible (income limits, follow rules) 14

16. VETERANS HEALTH ADMINISTRATION HUD-VASH Program Case Management Frequency and intensity of contacts depends on the unique needs of the Veteran Continually assess the needs of the Veteran Match service intensity to Veteran’s needs and situation – Early stages require more frequent, intense services – Stabilized Veterans need fewer interventions – Independent functioning with more confidence and more community support need the least interventions – Veterans transition to less CM interventions over time – Most transitioned Veteran contacts consist of monitoring and crisis resolution 15

17. VETERANS HEALTH ADMINISTRATION Reference http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2446 Handbook 1162.05 16