Homelessness:End Homelessness among veterans in 5 yrs

OutpatientInpatient

Community

Domiciliary/MHRRTP

Accessing VA Services and Income Accessing VA Services and Income for Homeless for Homeless VeteransVeterans

• HCHV Program: M. Chick-Ebey, LCSW Program Coordinator; A. Sager, MD; E. Woods, MSW; J. Miles, MSW; RN: Vacant, GPD: David Wall, LiCSW; Verneka Hudson, LCSWHUD/VASH: L, Adams, LMSW Program Coordinator Debra Christian-Grandy, MSW; R. Haynes, LCSW; LCSW;Anthony Miller, LCSW, Adam Coleman, MSW, Doris Cruea, MSW; Corrie Williams, MSW, ; F. Culley, PSA

Synchronizing Plans

Increasing Leadership, Collaboration, and Civic

Engagement Increase Access to

Stable and Affordable Housing

Retool the Homeless Crisis Response System

Improve Health and Stability

Increase Economic Stability

Community Partnership

Housing and Supportive

Services

Employment Income and

Benefits

Treatment

OutreachHomeless Prevention

Plan: 6-PillarsOutreach / Education Treatment

Focus in shelters, streets, Homeless Event Fairs (Stand Down, Project Homeless Connect) , Veterans Justice Outreach (local jails).

National Call Center 24/7 Hotline

Educating Community Partners and Internal Stakeholders – “No wrong door.”

“Right Size services, Rapid-Re-housing

Improved Access: DIGMA/HPACT Primary Care and Mental Health, daily walk-in screening slot for Dom MHRRTP.

Comprehensive Treatment and Rehabilitation

Mental Health Residential Rehabilitation Programs (MHRRTP / Dom)

LINK program: 7 beds for Chronically Homeless Veterans.

Homeless Veterans Dental Initiative

Plan: 6-Pillars (Cont.)Prevention Housing/Supportive

ServicesSupportive Services for Low

Income Families Grant – NOFA recently closed: at least three local applications submitted.

Relapse Prevention Justice Involved Services

VJO – Veterans Justice Outreach

HCRV – Healthcare for Re-Entering Veterans

Grant and Per Diem Transitional Housing (GPD); Three programs, 90 beds (16 specifically for female Veterans).

HUD VASH – Housing and Urban Development Veterans Affairs Supportive Housing

Community Housing Resources: CANLINK, SRO’s, Project Based vouchers.

Plan: 6-PillarsIncome/Employment Community

PartnershipsVRT Programs

(CWT/IT for MHRRTP Veterans

HVSEP : Homeless Veteran Supported Employment Program

Expedite VA Disability claims for Homeless Veterans

Engagement of Community Partners : 6 COC Committees, Military Affairs Committee

Leveraging resources – Continuum of Care Committees (six in our area – Veterans now getting priority with HUD

Homeless Outreach: Healthcare for Homeless Veterans (HCHV)

Minimum of twelve outreach visits per month; more in winter monthsOutreach sites in Newport News, Portsmouth, Norfolk and Virginia

Beach (St. Vincent’s, Church shelters, Oasis, VOA, St. Columba, Salvation Army 19th Street shelter, Union Mission).

Seasonal outreach to church shelter programsServices also provided at Project Homeless Connect, Stand Down

and other Homeless Resource Fair eventsAlso Available for drop-in visits at VAMC Offices

DIGMA (Drop-IN Group Medical Appointment), Primary Care clinic

Drop-in clinic designed to reduce barriers to careFull array of Primary Care services provided Clinic meets Tuesday afternoons and Friday morningsHealth and Resource Education built in to design of clinicVeterans can remain in DIGMA clinic once housed if they

wish.Approximately 269 veterans currently enrolled, over 1030

have received care in DIGMA clinicMental Health Care also available at DIGMA clinicClinic recently awarded funding through Central

Office Pilot Project to become a full-time, PACT Primary Care Clinic (will add individual slots. Target date: April , 2012).

Grant and Per Diem (GPD)Community Agencies

partner with VA to provide transitional housing to homeless Veterans.

1. Salvation Army TR: On VA grounds, must provide own food. Clean/Sober, transitional environment. Stay from several weeks up to several months.

2. Malachi House: For female veterans and veterans with dependents. Apartment units – stay up to two years.

Judeo- Christian Outreach- 16 beds (2 Female)

- 14 Bed new apartment style building for single Veterans (male or female)

- Tw0 female beds. * New NOFA just announced

for Transition In Place GPD!!

HUD-VASH ProgramSection 8 voucher and

VA Case Manager 360 currently, ratio of

1/35 Case Mgr. to veteran. Over 300 housed.

Currently over 200 on wait list

Chronic Homeless prioritized

Families with children also a priority.

To be ready for HUD-VASH: need ID’s, birth certificates (for all family members); can’t owe landlords or utilities, need deposits, credit reports.

Rapidly re-housed over 40 Veteran families with HPRP assistance in FY11.

Homeless Hotline: 1-877-4AID VET

1-877-4AIDVET went live 3/1/10.

Homeless team staff rotate to handle calls: responders must return calls within one business day.

Calls/data logged nationally and locally.

- 399 in FY’11 (ninth nationally)

- Avg. 50 calls per month since October 1st.

Several registrations, GPD/MHRRTP admissions from Hotline.

Vocational programs Supported Employment (SE). SE is an evidence-based clinical

model that helps individuals with serious mental illness or physical impairments co-occurring with mental illnesses engage in competitive employment in the community.

Homeless Veteran Supported Employment Program (HVSEP). A modified version of SE, HVSEP helps Veterans who are homeless or

at risk of being homeless engage in competitive employment in the community with some additional support for first 90 days. HVSEP is staffed by Vocational Rehabilitation Specialists who are formerly Homeless Veterans. Referral from MD required.

CWT-Transitional Work Experience (TWE). TWE is a transitional work program to enable participants to gain work experience and work hardening while in a therapeutic rehabilitation treatment program in the Domiciliary.

Domiciliary Residential Rehabilitation Programs & TR

DAP: Drug Alcohol Program - 80 bedsDom PTSD Program – 10 bedsRehabitat – Homeless, SMI, Dual Diagnosis, -30

bedsDCM: Dom Case Management “Homeless Program”:

life skills, Must have Rehab Goals - 47 bedsCWT/TR: Community Residences for Homeless

Veterans active in the CWT Vocational Program: 6 month length of stay, generally following MHRRTP.

Length of stay is individualized but generally no more than 90 days

• Over 95% of those who complete recovery oriented treatment have a place to stay upon discharge (may be transitional housing).

• 66% of discharges from GPD and the DCHV program in Q1FY12 went to stable housing (not transitional: apartments, houses, Oxford Houses, family reunification).

VA Programs Work!

Local Status:

GAPS AND BARRIERS• Prevention money lacking in

region• Shelter: Extremely limited year-

round shelter for single males, disabled, couples, families & sex offenders.

• HUD VASH & Income Based Housing: need far outstrips supply.

• Wait /Interest lists • No placements for

convalescence• Limited Outreach Staff• Transportation• Limited rental room options:

overpriced, often illegal or unsafe

• Difficulty navigating VA appointment system from Homeless Status

OPPORTUNITIES• SSVF Grant: local applicants • Emergency Housing &

Medical Respite Contracts (pending $$)

• Project Based Developments• New GPD NOFA: Transition -in

Place.• Partnerships with other

supported housing programs (CANLINK, VBCDC, Access, Project Based).

• Cross-train community providers

• Oxford Houses• Work with communities to

develop more Affordable housing

• Homeless PACT Primary Care grant

FY11’ At A GlanceSome numbers are duplicated (e.g. one Veteran went through several programs).

577 Intakes, 200 from Outreach, 1012 Veterans seen by HCHV/GPD Staff.

214 Admissions to GPD transitional Housing,; 50 Admissions to CWT TR.

Over 400 admissions to MHRRTP and Treatment Programs; 97 from Outreach.

HCHV/GPD workload increased 43% over FY’10.

Homeless Staff Attended 185 Community Meetings

314 Veterans Attained non-HUD-VASH Permanent Housing.

252 Veterans received Dental care through Homeless Dental Initiative.

260 Veterans enrolled in DIGMA 399 Homeless Hotline consults

(Minimum of over 20 enrolled, 16 MHRRTP admits, 18 GPD Admits)

92 veterans moved in to HUD-VASH apartments

75 Veterans visited within local jails.

Local Five Year Plan Information sessions and

trainings for stakeholders across settings and catchment area

Blanket region with brochures and hotline publicity

Publicize SSVF and GPD NOFA’s: write support letters.

Develop & manage contracts in the community for Medical Respite and Emergency Housing (pending funding)

Annual Summit and Annual Report (target September 2012).

Establish Full-time Homeless PACT Primary Care Clinic

Accessing the VA: Eligibility Every Veteran is not eligible for

the same services: Eligibility for Healthcare Benefits is based on four factors:

1. Discharge Status and LOS (Length of Service): must have two years after 1980 or combat

2. Full-time Active Duty or Activated / Deployed Reserve/Guard service is required.

3. Service Connection Rating: injuries or illnesses caused or made worse by military service.

4. Income: if primarily non-service connected (NSC), must be low-income (Category A), or pay co-pays.

Eligibility Priority CategoriesVeterans who are 70% or

more Service Connected are highest priority and are eligible for:

VA Nursing home careDental Care (unemployable or

100% SC only). Prosthetics of all sortsNo co-pays or income

restrictions Domiciliary MHRRTP

residential programs require income waiver

OTHER DESIGNATIONS: • Must be 10% or more

Service Connected to receive free eyeglasses

• Must be service connected for hearing loss (or 100% svc. Connected) to receive hearing aids.

• Care of Service Connected condition is covered

• Co-pay is not required if income is under NSC pension threshold ($1021 per month single).

• Highest numbers of Homeless Veterans are

NSC or low % SC.O

Registering For VA Services: Veterans must be registered to

receive care: like an insurance plan NSC and Veterans less than 10%

SC must complete annual means test or risk getting billed

Must have photo ID to register DD214 or HINQ (computer inquiry

to verify service) required Best to register in person and not

by mail (backlog). Homeless Veterans should request

to be seen day of registration Call Wayne Hopkins at 722-9961

x3040 if you have more questions Outreach staff can help (if photo id)

VA Financial Benefits: All Veterans that receive VA Healthcare benefits are NOT eligible for Financial Benefits.

Service Connection NSC Pension (war era only)

Amount is determined by percentage of disability determined by VBA

0% no money but not a bad thing

10% is $127 per month100% is $2769 per month50% is not half of 100%See handout or VBA

website for more details: www.VA.gov

Available to Veterans who are unemployable due to disability (regardless of cause) or over age 65 with income less than $1021 per month

Means testedMany restrictionsCurrent payment is $1021 per

month, about $1700 for Aid and Attendance (if qualify).

Restrictions similar to SSI

Qsee VA Benefits handout for more details

Where / How to file a ClaimVirginia Department of Veterans Services (VADVS)

offices in Norfolk and Hampton: both take walk-in’s (certain hours may apply).

DAV, American Legion, VFW or other Veterans Service Organization (VSO): nearly all VSO’s have claims representatives.

Veterans can also self-file online or on paper.Homeless Claims can be expedited/rushed: must contact

HCHV staff for verification.Hardship status can also rush claims (must show evidence).

Quality Improvement Project completed by PCMH December 2010

Questions???Please take some goodies: pens, brochures, key-

chains. Let us know if you’d like us to present to your colleagues or group.

Thank you for your interest in helping Homeless Veterans!