Roundtable on Homeless Children - Discussion Synthesis

Introduction

On May 18, 2010, the Office of the Assistant Secretary for Planning and Evaluation convened a Roundtable on Homeless Children. The purpose of the Roundtable was to understand the impact of homelessness on children, identify the resources currently available to address the needs of homeless children, and discuss opportunities for coordination. While other meetings have focused on the adults in homeless families, the Roundtable focused specifically on the children in families that are experiencing homelessness.

A diverse group of 63 policy experts, researchers, practitioners, and federal agency staff (see Appendix A for a list of participants) were invited to:

• Review the latest research on homeless children;
• Discuss the impact of the current recession on the number and condition of homeless children;
• Assess the range of services currently available to homeless children; and
• Strategize for an improved response to children experiencing homelessness or at risk of becoming homeless.

Description of the Roundtable

David Harris, Deputy Assistant Secretary for Human Services Policy at the U.S. Department of Health and Human Services, welcomed participants and set the stage for the Roundtable. His remarks focused on the importance of increasing our understanding of the issue, deepening partnerships, improving services to homeless families, and identifying new areas of collaboration.

A background paper, Homeless Children: Update on Research, Policy, Programs, and Opportunities, was prepared and circulated to attendees prior to the Roundtable to help shape the discussion by summarizing what is known about homeless children and effective strategies and programs to assist them. The summary of the research literature was prepared by three researchers in this field: Judith Samuels from The Nathan S. Kline Institute for Psychiatric Research and Department of Child and Adolescent Psychiatry, NYU School of Medicine; Marybeth Shinn from Department of Human and Organizational Behavior, Peabody College, Vanderbilt University; and John Buckner of Children’s Hospital Boston, Harvard Medical School.

The paper was divided into five sections:

• Context and data, including definitions and counts of homeless children
• Current research on homeless children, including health, mental health, education, and interventions
• Research on children at-risk of homelessness including economic stressors, residential and school mobility, food insecurity, and cumulative risks
• Targeted and mainstream programs, including access to health and mental health care, and education (including pre-K), food and nutrition programs
• Discussion questions related to data and definitions, education, prevention and research.

A panel of seven researchers, practitioners, representatives of advocacy organizations, and a young woman who had been homeless as a child presented brief responses to the background paper. Themes from the respondents’ comments were summarized and the discussion was opened to the larger group for the remainder of the day. The agenda for the Roundtable can be found in Appendix B.

Major Themes

Nature of Homelessness among Children

Research has shown that homeless families are heterogeneous in terms of their needs, their pathways into homelessness and their experience of it. They are typically from a larger population of poor families, where housing is precarious. Homelessness in families is largely a temporary state, which is encouraging, but memories of experiences in shelter, hunger, lack of privacy and impermanence remain. The average length of time for any one episode of family homelessness is 30 days, but repeat episodes are common. At-risk families frequently move from homelessness to shelter to a doubled-up situation back to shelter and then return to homelessness. There is anecdotal evidence that the recent economic downturn has increased the number of homeless children seeking McKinney-Vento-funded services, although there is no research on this group of homeless children.

There are many risk factors for homelessness, including poverty, single mother-headed families, history of foster care, exposure to violence, and food insecurity. The risks are cumulative; the more risk factors a family has, the more likely the family is to experience homelessness. The number of risk factors may be more important than homelessness itself. Research has shown variability in how children respond to these risks. It has also shown that poverty itself, especially persistent poverty, has a number of other negative consequences, including impaired cognitive development, poor physical and mental health, and behavior problems.

On the other hand, some children are more resilient than others in the face of adversity. More research is needed to understand risk and resilience among children experiencing homelessness. Promising interventions have been identified that bolster resilience in children and offer protection from negative academic and behavioral outcomes associated with homelessness.

Homeless children experience significant mobility that can result in frequent changes in schools, despite McKinney-Vento protections. Changing schools frequently can impact academic performance, and exacerbate physical and mental health and behavioral problems. In addition, crowding (in shelter or in doubled-up situations) can be a cause of distress, aggression and other behavioral issues, as well as poor outcomes in school and lower cognitive competency.

Areas of Collaboration

The need for more collaboration at all levels of government was stressed throughout the Roundtable as an important strategy to assist homeless children and their families. Participants noted that the United States Interagency Council on Homelessness (USICH) is about to release a new Plan to End Homelessness, in which addressing family homelessness is expected to be an integral part. Current Federal efforts include a Health and Human Services (HHS) and Housing and Urban Development (HUD) collaboration that targets housing and service programs for homeless families within communities. An overview of Federal programs that serve children who are homeless or at risk for homelessness can be found in Appendix C.

Current Issues

Definitions of homelessness. One issue frequently raised by Roundtable participants was the differing definitions of homelessness for families and children used by Federal agencies, particularly those used by HUD and the U.S. Department of Education (ED). Differing definitions can impact the ability to coordinate services (where eligibility varies with differing definitions) and to understand the true extent of the problem (i.e., how many children are homeless). One participant suggested that homelessness be viewed on a continuum as it is in Europe, which includes in its definition those who are precariously housed, doubled-up, in shelter and “sleeping in the rough.” Services could then be provided based on what is needed along this continuum.

Data and information. Having accurate data is critical. While HUD’s Homeless Management Information System (HMIS) was acknowledged as being very helpful, the need to monitor the quality of what was submitted was stressed. State and local education agencies (SEAs and LEAs) also play important roles in collecting information about children who are homeless, particularly those enrolled in school.

Among mainstream programs, little is known about the services people who are homeless receive because questions about housing status typically are not asked. For example, there is very little information about pre-school children who are homeless.

Another issue raised was the collection of information about victims of domestic violence. Better data would improve understanding of the problem as well as how to best intervene, but data collection with this population has been hampered by concerns about privacy and safety.

Prevention/intervention. There are numerous Federal, state and local programs that intervene to prevent and end homelessness among persons of all ages, including children and youth. Appendix C provides an overview of Federal programs that assist children who experience homelessness. With some exceptions, notably Head Start, most of these programs focus on school-age children.

Head Start can assess pre-school children for developmental disabilities and provide other services needed by homeless children and families. However, homeless children are underrepresented in Head Start for a variety of reasons, including program capacity issues and family mobility. Due to the episodic nature of homelessness, homeless children who enroll in Head Start often do not remain enrolled. The question of how to identify and serve children under the age of five was raised as an important and neglected area of focus.

Schools can play a key role in identifying and assisting school age children experiencing homelessness by providing structure and stability. Through the U.S. Department of Agriculture’s National School Lunch and National School Breakfast programs, schools can also address food insecurity. Finally, schools can use McKinney-Vento funding to provide vouchers for glasses, clothes, and hygiene items. Participants reminded one another several times of the importance that even one supportive individual can make in the life of a child experiencing trauma of any sort.

Understanding the pathways into homelessness, including domestic violence, was stressed when planning intervention and prevention strategies. Many who are in shelter are young mothers with very young children, have poor academic achievement, have served in the military, and/or have been involved with the juvenile and/or criminal justice system.

Mainstream programs were also discussed with a focus on identifying families that are homeless, as well as ensuring that those leaving mainstream programs do not become homeless. Increasing points of access, such as food banks, clinics, and hospitals, was recommended as a way to increase identification, assessment and service provision for homeless families.

Participants identified housing subsidies and other housing-related strategies, such as rapid re-housing, as important interventions for homeless families that can ameliorate many of the negative effects of homelessness on children.

Research. It was noted that research is frequently a long-term process, taking from five to 10 years to plan, conduct, analyze, and disseminate. Discussion revolved around critical areas of need for further research. Several areas were identified:

• Poverty and resilience
• Subgroups of homeless children, including “doubled-up”, children not in shelter, those in foster care
• Rural homelessness
• Pathways to homelessness
• Mobility issues in homeless children
• Food insecurity and its impact
• Homelessness in children due to economic downturn
• Evaluation of interventions

Several areas of potential funding were discussed, including the National Institutes of Health, especially investigator-initiated research and USICH. Attendees also suggested that better instruments need to be developed to adequately capture the heterogeneity in homeless children. Current measures are often not culturally competent or validated. The need for longitudinal studies was stressed, especially in light of the episodic nature of homelessness in families and children.

Areas for Future Consideration or Exploration

Federal Policies and Programming

Participants agreed that despite numerous Federal programs that serve homeless children, the system for delivering these services is fragmented. Among the contributing factors that participants identified were differing definitions of homelessness, varying eligibility criteria across these programs, and the episodic nature of family homelessness. There is a need to evaluate promising practices and create evidence-based practices for homeless children. Participants also emphasized the variation and differing needs among homeless children.

Suggestions also included:

• Consider a flexible service system that can serve the varying needs of homeless children and families — from basic needs, to education, to physical and mental health treatment, and safe permanent housing.
• Adopt a more uniform definition of homelessness across Federal agencies to facilitate the coordination of care and access to needed services; adopt a continuum of homelessness approach and fund services and programs along a continuum of needs.
• Simplify enrollment procedures for mainstream programs, following the procedures used by school lunch programs.
• Include homeless (or formerly homeless) children in policy and program decisions.
• Develop standards of care for shelters, which could be tied to McKinney-Vento funds.

Data and Research

Currently HMIS, SEAs and LEAs provide most of the data we have on homeless children. Participants requested that housing status be included among the data collected by mainstream programs, such as child care, TANF, or SNAP, so that we can learn more about homeless children and their families.

National surveys could also include questions on housing status. In Massachusetts, a question about housing status was added to the CDC’s biannual Youth Risk Behavior Surveillance (YRBS) survey. Other national surveys where housing status could be included are the National Longitudinal Health Survey and the American Community Survey. Housing status could also be included in other research studies, such as HIV/AIDS, or studies sponsored by NIH or other Federal agencies funding research.

Opportunities for Collaboration

There are currently numerous collaborations among Federal agencies that serve homeless children, most notably those between HHS and HUD, and the USICH’s new Federal Strategic Plan to Prevent and End Homelessness. However, discussion at the Roundtable identified areas of fragmentation in the service delivery system that require additional collaboration and collaboration with new Federal partners. Collaboration with the Department of Education was singled out in particular given the key role that schools and school-based programs play in providing structure and stability for homeless children.

Other Federal agencies suggested as significant collaborators include the Department of Justice (including domestic violence programs as well as criminal justice), the Administration for Children and Families (including child care and foster care), Health Resources and Services Administration, and the Department of Veterans Affairs.

Conclusion

The Roundtable on Homeless Children was an important first step to explore the impact of homelessness on the youngest members of society. Participants look forward to the outcomes and next steps resulting from this meeting.

Appendices

Appendix A: Roundtable Attendees

Non-Federal Participants

Ben Allen
National Head Start Association
Alexandria, VA

Jean Beil
Catholic Charities USA
Alexandria, VA

Kelly Bovio
Horizons for Homeless Children
Roxbury, MA

Diana Bowman
National Center for Homeless Education at SERVE
Greensboro, NC

John Buckner
Children's Hospital Boston
Harvard Medical School
Boston , MA

Janice Cooper
The National Center for Children in Poverty
New York, NY

Dennis Culhane
University of Pennsylvania
Philadelphia, PA

Mary Cunningham
The Urban Institute
Washington, DC

Deborah DeSantis
Corporation for Supportive Housing
New York, NY

Barbara DiPietro
National Health Care for the Homeless Council
Baltimore, MD

Barbara Duffield
National Association for the Education of Homeless Children and Youth
Washington, DC

Amy Dworsky
Chapin Hall at the University of Chicago
Chicago , IL

Gloria Finkelman
New York City Housing Authority
New York, NY

Betty Jo Gaines
Bright Beginnings, Inc.
Washington, DC

Samantha Harvell
First Focus
Washington, DC

Sue Heilman
Horizons for Homeless Children
Roxbury, MA

Vitoria Lin
Building Changes
Seattle, WA

Margarita Lopez
New York City Housing Authority
New York, NY

Michelle Martin
Horizons for Homeless Children
Roxbury, MA

Ann Masten
University of Minnesota, Twin Cities
Institute of Child Development
Minneapolis, MN 

Sharon McDonald
National Alliance to End Homelessness
Washington, DC

Anna Melbin
National Network to End Domestic Violence
Yarmouth, ME 

Beth Poffenberger Lovell
Volunteers of America
Alexandria, VA 

Debra Rog
Westat
Rockville, MD 

Nan Roman
National Alliance to End Homelessness
Washington , DC

Jeremy Rosen
National Policy and Advocacy Council on Homelessness
Washington , DC

Denise Ross
Prince George's County Public Schools
Landover, MD

Judith Samuels
Nathan S. Kline Institute for Psychiatric Research
Orangeburg, NY 

Maryanne Schretzman
City of New York
New York, NY

Marybeth Shinn
Vanderbilt University
Peabody College
Nashville, TN

Aruna Sukhu
Queens College of CUNY
South Ozone Park, NY 

Tanya Tull
Beyond Shelter
Los Angeles, CA 

Wendy Vaulton
National Center on Family Homelessness
Newton Center, MA 

Ruth White
National Center for Housing and Child Welfare
University Park, MD 

Aurora Zepeda
Institute for Children and Poverty
New York, NY 

Federal Participants

Kiersten Beigel
Office of Head Start
Washington , DC

Carolyn Dean
U.S. Department of Health and Human Services
Child Care Bureau
Washington, DC

Anne Fletcher
U.S. Department of Housing and Urban Development
Washington, DC

Kathi Grasso
U.S. Department of Justice
Office of Juvenile Justice and Deliquency
Washington, DC

David Harris
Office of the Assistant Secretary for Planning and Evaluation
Washington, DC

Robin Harwood
Health Resources and Services Administration
Rockville , MD

Jennifer Ho
United States Interagency Council on Homelessness
Washington, DC

Mark Johnston
U.S. Department of Housing and Urban Development
Washington, DC

Chryston Jones
Office of Community Services
Alexandria, VA 

Elise Kessler
Administration for Children and Families
Washington, DC

Charlene Le Fauve
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
Rockville, MD

Valerie Maholmes
Eunice Kennedy Shriver National Institute of Child Health and Human Development 
Rockville, MD

John McLaughlin
U.S. Department of Education
Washington, DC

Nakia McMorris
U.S. Department of Housing and Urban Development
Washington, DC

Martha Moorehouse
Office of the Assistant Secretary for Planning and Evaluation
Washington, DC

Sarah Oberlander
Office of the Assistant Secretary for Planning and Evaluation
Washington, DC

Libby Perl
Congressional Research Service
Washington, DC

Canta Pian
Office of the Assistant Secretary for Planning and Evaluation
Washington, DC

Sarah Potter
Office of the Assistant Secretary for Planning and Evaluation
Washington, DC

Beverly Pringle
National Institute of Mental Health
Bethesda, MD

Bryan Samuels
Administration on Children, Youth, and Familes
Washington, DC

Darla Sims
U.S. Department of Justice

Susie Sinclair-Smith
Office of the Assistant Secretary for Planning and Evaluation
Washington, DC

Gretchen Stiers
Substance Abuse and Mental Health Services Administration
Center for Mental Health Services
Rockville, MD

Duke Storen
U.S. Department of Agriculture
Food and Nutrition Service
Alexandria, VA 

John Tambornino
Social Security Administration
Washington, DC

Susan Williams
U.S. Department of Justice
Washington , DC

Policy Research Associates

Deborah Dennis
Policy Research Associates, Inc.
Delmar, NY

Margaret Lassiter
Policy Research Associates, Inc.
Delmar, NY

Pamela Root
Policy Research Associates, Inc.
Delmar, NY

Appendix B: Roundtable Agenda

9:00 – 9:20                   Welcome
                                    David R. Harris
                                        Deputy Assistant Secretary for Human Services Policy
                                        U.S. Department of Health and Human Services

9:20 – 9:30                   Overview of the Day
                                    Deborah Dennis
                                        Vice President for Technical Assistance, Policy Research Associates, Inc. 

9: 30 – 10:30                Presentation of the Background Paper
                                    Judith Samuels
                                        Head, Child and Adolescent Mental Health Policy and Services Research Lab,
                                            Nathan Kline Institute for Psychiatric Research

                                    Marybeth Shinn
                                    Professor of Human and Organizational Development
                                        Peabody College, Vanderbilt University 

                                    John C. Buckner
                                        Assistant Professor of Psychology, Department of Psychiatry
                                        Children's Hospital Boston, Harvard Medical School

10:45 – 11:30               Stakeholder Panel
                                    Ann Masten
                                        Distinguished McKnight University Professor
                                        Office of Child Development, University of Minnesota 

                                    Tanya Tull
                                        President/CEO, Beyond Shelter 

                                    Aruna Sukhu
                                        Student, Queens College/CUNY 

                                    Wendy Vaulton
                                        Director of Research, National Center on Family Homelessness

                                    Denise Ross
                                        Homeless Education Liaison, Homeless Education Office
                                        Prince George's County (Maryland) Public Schools 

                                    Maryanne Schretzman
                                        Family Services Coordinator, New York City 

                                    Nan Roman
                                        Executive Director, National Alliance to End Homelessness

11:30 – 12:00              Summary of the Morning’s Themes
                                    Debra Rog
                                        Vice President, Westat

12:00 – 1:00                 LUNCH

1:00 – 1:30                   DISCUSSION: Data/Information
                                    Dennis Culhane, Facilitator
                                        Professor, University of Pennsylvania School of Social Policy and Practice
                                        -- How can mainstream programs collect and report on housing status?

1:30 - 1:45                   DISCUSSION: Definitions
                                    Judith Samuels, Facilitator
                                        -- What is the impact of varying definitions of homelessness? 

1:45 – 2:30                   DISCUSSION: Education
                                    Barbara Duffield, Facilitator
                                        Policy Director, National Association for the Education of Homeless Children and Youth
                                        -- What are schools doing effectively? What could be done better?
                                        -- Are there models that could be replicated?
                                        -- Are schools the best or only place to address homeless among children?

2:45 – 3:30                   DISCUSSION: Prevention
                                    Marybeth Shinn, Facilitator
                                        -- How can mainstream programs be targeted and coordinated to prevent and end homelessness among                                                                      at-risk families?
                                        -- What are the gaps in mainstream programs for homeless children?

3:30 - 4:15                   DISCUSSION: Research
                                    John Buckner, Facilitator
                                        -- How can homelessness become part of a broader national research agenda on poverty and other                                                                              traumatic events in the lives of children?
                                        -- What do we want to know about the effectiveness of housing and services for homeless children?

4:15 – 4:30                   Next Steps

Appendix C. Selected Federal Programs That Assist Homeless Children and Their Families