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HUD-VASH UpdateFebruary 10,2009

Vince Kane, MSW

Office of Mental Health Services

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HUD-VASHHUD-VASH

Goal: To move veterans and their families out of homelessness.

• Primary Components:

– Permanent independent community-based housing.

– VA case management services, designed to improve the veteran’s health and mental health, and to enhance the veteran’s ability to remain stable, housed, and community-integrated.

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HUD-VASHHUD-VASH

• The HUD-VASH Program is a collaborative partnership between the Department of Housing and Urban Development (HUD) and the Department of Veterans Affairs (VA) Supported Housing (VASH)

• In this partnership, HUD provides Housing Choice vouchers for permanent housing to homeless veterans while VA provides veterans with case management and supportive services to promote and maintain recovery and housing.

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HUD- VASH EligibilityHUD- VASH Eligibility

• DEFINITIONS

Homeless. The HUD VASH definition of homeless is the definition in the McKinney Act, Title 42, United States Code, Section 11302. See 38 USC 2002(1). The definition of “homeless” is as follows:

• An individual who lacks a fixed, regular, and adequate nighttime residence,

or

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Homeless Definition, ContinuedHomeless Definition, Continued

• An individual who has a primary nighttime residence that is:– 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;

– An institution that provides a temporary residence for individuals intended to be institutionalized; or

– A public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings

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HUD VASH EligibilityHUD VASH Eligibility

• Veteran-participants in the HUD-VASH

Program must meet VA health care eligibility as defined by law and regulation (including enrollment in the VA health care system)

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HUD VASH EligibilityHUD VASH Eligibility

• Based on historical demographic information, the expected referral population for HUD-VASH are homeless veterans, usually with mental health and addiction disorders

• Other homeless veterans with diminished functional capacity and resultant need for case management are also eligible for the program

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HUD VASH EligibilityHUD VASH Eligibility

Expanded focus goes beyond chronic

homelessness and now includes:

• Homeless veterans with children

• OEF-OIF homeless veterans

• Women homeless veterans

• Homeless veterans with other medical conditions

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Principle Sources of ReferralPrinciple Sources of Referral

• HCHV Outreach Program– Primary contact with homeless veterans– Helps to direct homeless veterans to appropriate services

• Other VA Homeless Programs– Residential Treatment Programs– Grant & Per Diem

• Other VA Programs– Mental Health programs– Social Work– Primary Care, etc.

• Community Agencies– Community agencies may make direct referrals– Community education provides referrals to VA

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HUD-VASH OutreachHUD-VASH Outreach

• HUD-VASH case managers visit community agencies that provide services to homeless veterans to: – Educate the agency about the HUD-VASH program

– Meet with potential program candidates

• HUD-VASH case managers work with VA homeless programs to: – Assist veterans who are involved in the VA homeless

continuum of care

– Determine if the veteran is an appropriate candidate for the program

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Assessment ProcessAssessment Process

1. Confirm eligibility

2. Assess for suitability– If not housing ready, possible acceptance pending

treatment in residential and/or inpatient setting– If not appropriate, alternative treatment plan

developed

3. Determine need for other services to ensure adequate income, skills and support to maintain housing status once placed

4. Multidisciplinary team to make determination on acceptance

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Entry Into HUD-VASHEntry Into HUD-VASH

• Once accepted, an individualized treatment plan is developed by the case manager and the veteran.

• Treatment plan reflects the goals of the veteran, addressing– Potential strengths and– Barriers to maintaining housing placement

• Establish process to monitor treatment plan – Parameters of alcohol and drug screening– Frequency of medical and mental health appointments– Assistance with employment and income needs – Resolution of legal and financial issues

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Case Management GoalsCase Management Goals

• Establish a therapeutic relationship

• Provide support for long-term recovery by working toward treatment plan goals

• Reassess needs and goals based on changing conditions– Inability to maintain sobriety does not generally lead to

discharge from case management if veteran can maintain housing

– Veteran may require brief intervention or higher level of care

• Foster community integration and independence

• Maintain veteran in housing

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Case ManagementCase Management

• Work to obtain and sustain stability and functioning

• Work to obtain items required to secure housing

• Credit History and Repair• Identification (Photo)

– Driver’s License or other government issued picture ID» Birth certificate» DD-214

• Income

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Case Management: Credit HistoryCase Management: Credit History

• Poor credit history delays housing process– Landlords require credit history report – Lengthy process

• Begin at first contact to seek credit report• Work toward resolving credit history• Expense involved• Money management and budgeting classes• Work with landlords to “vouch” for veteran’s

future payment of rent/ utility bills

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Case Management: IdentificationCase Management: Identification

• Veterans need identification for obtaining voucher and apartment– Limiting factors:

• Income shortage• No stable address to receive mail or put on ID• Illiteracy – problems with forms/ requests• One form of ID requires another – to get birth

certificate, need picture ID

• DD-214 is usually acceptable as one form of ID

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Case Management: IncomeCase Management: Income

• Certain level of income is required in order to improve success of veteran in program– Not covered by voucher:

• Security Deposit• Utilities• Food• Furniture• Necessities (ex. Soap, towels, sheets, dishes,

etc.)

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Case Management: IncomeCase Management: Income

• Evaluate Income: – Employable?– Disabled?– How much income/ source– Eligible for any income benefits?

• Social Security• Veterans Benefits

– Service Connected Benefits– Non-Service Connected Benefits– NSC Pension

• Food Stamps, etc.

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Case Management: IncomeCase Management: Income

• Seek Employment Income– Apply for work

– Apply for Compensated Work Therapy (CWT) program

– Seek Vocational Rehabilitation, if appropriate• VBA• VHA• State• Special Veterans Programs with Labor

Department, etc.

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Case Management: IncomeCase Management: Income

• Seek Benefits

– Follow-up on status of benefits claims that are already being processed

– Apply for benefits that veteran appears to be eligible for• Social Security Office visit(s)• Meet with Veterans Benefits Officer

– Assist veteran with getting documents needed to process claim (lengthy and time consuming process)

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PHA ReferralPHA Referral

• VA HUD-VASH Case Managers determine veterans to be eligible for the HUD-VASH Program – Veterans have been through assessment,

stabilization, treatment and participating in recovery plan development

– Veterans have the items they need for the PHA• Identification• Income source(s)• Completed PHA required forms, etc.

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PHA ReferralPHA Referral

• Referral is in writing to the PHA from the VA Case Manager

• If functionally indicated, the Case Manager assists with: – Completing forms – Transportation– Supporting veteran in meeting PHA and through

the PHA process– Addressing obstacles and barriers – Providing organization to the process– Communication between PHA and veteran, etc.

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VoucherVoucher

• VA HUD VASH Case Managers determine clinical eligibility

• PHA determines if the veteran meets their/ HUD criteria

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Housing PlacementHousing Placement

• Alert PHA of referral in writing

• As needed, assist veteran in completing and assembling required documentation

• Following PHA guidelines, assist veteran in locating suitable housing

• Request PHA inspection and approval of selected unit

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Housing PlacementHousing Placement

• Assist veteran and landlord to complete lease

• Prepare for the move as needed by providing planning assistance and guidance – Turning on utilities – Obtaining furnishings and supplies– Transportation to complete the move

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Delivery of ServicesDelivery of Services

• Coordinate VA and community interventions– Act as a liaison with critical partners

• Landlord • Other service providers

• Make regular home visits to assess veteran’s ability to maintain themselves in a safe environment that promotes – Sobriety – Physical health – Mental well-being

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Delivery of ServicesDelivery of Services

• Schedule individual and group meetings– Individual sessions will focus on treatment plan

and current needs– Group meetings should foster peer support

• Provide linkages for – Child care– Medical coverage for family members (ex.

Medicaid) – Family therapy – Legal and income assistance programs

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ContinuanceContinuance

• Regular Re-assessment by Case Managers

• Revision of treatment plan as: – Goals reached– Treatment needs change– Veteran’s goals change– Veteran becomes more independent– Level of care changes

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ContinuanceContinuance

• Coach and mentor • Monitor and sustain• Goal and outcome focus• Foster independence• Celebrate goal/ outcome completion• Maintain appropriate boundaries and

ethics• Support positive growth• Promote healthy choices

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CompletionCompletion

• Veterans who no longer require case management services may:– Need longer “trial” periods without case

management to determine veteran’s ability to manage independently

– May have case management services stop following mutual agreement that • Goals and objectives have been met • Veteran has been able to independently sustain

housing • Veteran no longer requires supportive case

management services

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CompletionCompletion

Case manager and veteran meet with PHA to

discuss termination of case management

services

– If PHA has alternative voucher they are willing to give to the veteran, then HUD-VASH will get the original voucher back to use with another eligible homeless veteran

– If PHA does not have alternative voucher, veteran would continue with HUD-VASH voucher until it was no longer needed

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HUD VASH Program Updateas of November 2008HUD VASH Program Updateas of November 2008

• 4,979 veterans in case management

• 4,519 veterans referred to Public Housing Authority

• 3,538 vouchers issued to veterans

• 1,160 formerly homeless veterans are housed

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HUD- VASH ExpansionHUD- VASH Expansion

• OMHS Program officials are working with HUD to collaboratively discuss expansion of the program

• 10,000+ new vouchers are projected for implementation in late second quarter of 2009

• Number of new case managers being finalized