the Secretary's Work Group
on Ending Chronic Homelessness
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Each year homelessness affects 2 3 million individuals in the
United States. For most people, homelessness is a short, one-time event.
But a relatively small and visible group experiences homelessness repeatedly
or for long periods and places heavy demands on available assistance.
This group, persons experiencing chronic homelessness, is most often
made up of single, poor adults with prevalent disabilities.
Ending their homelessness requires housing combined with the types of services
supported by the programs of the Department of Health and Human Services
(HHS). To improve the response of these programs to chronic homelessness,
and to address a collaboration agreed to with Secretary Mel Martinez of the
Department of Housing and Urban Development, the Secretary established a
Work Group on Ending Chronic Homelessness. The Work Group was charged to
develop a comprehensive approach for the Department to better serve these
The Work Group assigned the task of developing a comprehensive approach to
an Interagency Subcommittee that focused on four tasks:
Defining chronic homelessness and identifying effective treatments and services
Understanding how relevant Departmental programs respond to the identified
treatments and services
Identifying objectives and desirable outcomes that would improve responsiveness
Formulating a comprehensive action plan.
To develop a plan, eight assistance programs of the Department were identified
as relevant to the treatment and service needs of chronically homeless persons.
The programs were asked to enumerate barriers and opportunities on service
use for this population. The eight programs were:
Temporary Assistance for Needy Families
Social Services Block Grant
Community Services Block Grant
Community Health Centers
Ryan White Programs
Substance Abuse Prevention and Treatment Block Grant
Community Mental Health Services Block Grant
Availability of the services:
The eight assistance programs have considerable flexibility to offer
treatments and services needed by chronically homeless persons. However,
no mainstream program is sufficiently comprehensive to serve as a
single source for the full range of identified treatments and services.
Use of the services by homeless persons:
While each of the eight programs indicated that at least some of the treatments
and services are used by homeless persons, the absence of data to
validate access was pervasive.
The Department's assistance programs are authorized and funded as responses
to specific conditions (e.g., poverty, lack of insurance) or populations
(e.g., HIV/AIDS patients). The multi-problem nature of chronic homelessness
revealed several issues of significance when trying to bridge these categorical
Coordination The lack of a requirement for coordination across
categorical programs makes the creation of a seamless service delivery
system a challenge. The flow of HHS resources to different State agencies
and community based organizations means that both providers and homeless
persons may have to interact with many different agencies.
Eligibility Gaps A person experiencing chronic homelessness may
meet eligibility standards in one categorical program but not another.
This creates problems in constructing a comprehensive service response to
the multi-problem nature of chronic homelessness.
Flexibility There are few incentives to support State
and local providers as they search for ways to combine these programs flexibly.
There may be numerous structures and rules that present challenges
when working across categorical programs.
Programs may lack any funding leeway to take on clients with complex,
multiple needs, may not have staff with the skills to work with these
individuals, or may not be familiar with the effective service delivery
Help eligible, chronically homeless individuals receive health and social
Strengthen outreach and engagement activities
Improve the eligibility review process
Explore ways to maintain program eligibility
Improve the transition of clients from homeless-specific programs to mainstream
Empower our State and community partners to improve their response to people
experiencing chronic homelessness.
Use State Policy Academies to help States develop specific action plans to
respond to chronic homelessness
Permit flexibility in paying for services that respond to the needs of persons
with multiple problems
Reward coordination across HHS assistance programs to address the multiple
problems of chronically homeless people
Provide incentives for States and localities to coordinate services and housing
Develop, disseminate and use toolkits and blueprints to strengthen outreach,
enrollment, and service delivery
Provide training and technical assistance on chronic homelessness to mainstream
Establish a formal program of training on chronic homelessness
Address chronic homelessness in the formulation of future HHS budgets or
in priorities for using a portion of expanded resources
Develop an approach for baseline data, performance measurement, and the
measurement of reduced chronic homelessness within HHS
Establish an ongoing oversight body within HHS to direct and monitor the
Work to prevent new episodes of homelessness within the HHS clientele
Identify risk and protective factors to prevent future episodes of chronic
Promote the use of effective, evidence-based homelessness prevention
The strategies in the plan are for consideration within HHS. It is assumed
that no strategy would be implemented without going through the Department's
normal policy and budget approval processes, particularly since some strategies
may require additional financial and staffing resources and/or review for
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Human Services Policy (HSP)
Assistant Secretary for Planning and Evaluation
U.S. Department of Health and Human Services