Strategic Action Plan on Homelessness. 2003 Strategic Action Plan Goal 1: Help eligible, chronically homeless individuals receive health and social services


The objective of goal one was to expand the capacity of HHS programs to assist persons experiencing chronic homelessness.  Many HHS programs lack the funding to serve individuals with multiple, complex needs.  If the funding is available, effective service delivery interventions may not be applied when working with this population.  The activities developed to meet this goal centered on strengthening outreach and engagement activities, improving the eligibility review process, exploring way to maintain program eligibility, and improving the transition of clients from targeted homeless programs to mainstream service providers. 

  • Collaborative Initiative to Help End Chronic Homelessness: Between2003 and 2005, HHS partnered with the HUD, VA, and USICH to sponsor the Collaborative Initiative to Help End Chronic Homelessness.  Funds from HHS Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA), are helping to support eleven communities that are working to integrate housing and treatment services for disabled persons who have experienced long-term and repeated homelessness.  HHS contributed $10 million to the initial $35 million in funding in 2003, and an additional $10 million each in both fiscal years 2004 and 2005 for these projects.  An additional $1 million has been made available within HHS in order to provide technical assistance to the grantees.  An evaluation of the initiative is also being sponsored by HHS, HUD, and VA; with HHS contributing a total of $600,000 towards the evaluation project.   
  • Supplemental Security Income and Social Security Disability Insurance Outreach, Access and Recovery (SOAR):  In 2003, SAMHSA, in consultation with the Social Security Administration, published a volume entitled: Stepping Stones to Recovery, A Case Manager's Manual for Assisting Adults who are Homeless, with Social Security Disability and Supplemental Security Income Applications.  This volume is designed to provide an overview of the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs, and to provide frontline caseworkers with the tools to assist persons experiencing homelessness to apply for SSA disability programs.
  • Supplemental Security Income and Social Security Disability Insurance Outreach, Access and Recovery (SOAR) Technical Assistance Initiative:  This training initiative utilizes SAMHSAs Stepping Stones for Recovery curriculum, with the goal of providing states and local community providers with the tools to implement a specific set of action steps that will lead to increased access to SSA disability benefits for people who are chronically homeless.  Participating states receive in-state facilitation to devise a plan that identifies the staff, training, and interagency coordination needed to increase such access, learn how to use the curriculum and receive follow-up technical assistance, including training for two or more trainers per state to create on-going local training capacity.  SOAR training has been funded through the pooled resources of the funders of the Homeless Policy Academies: HHS, HUD, DOL, and VA.  Since 2005, 25 states have participated in the SOAR training initiative. 
  • Documenting Disability: Simple Strategies for Medical Providers:  HRSA sponsored the development of this manual, which is a guide to documenting medical impairments in support of applications for the Social Security Administrations disability benefits programs.  It is primarily for health care providers in the United States serving individuals with disabilities who are homeless or marginally housed.  The purpose of the manual is to inform clinicians about SSAs disability criteria and to explain how they can expedite the disability determination process.  By understanding the process of applying for SSA disability benefits and the requirements for providing evidence in support of a disability claim, providers can do so more efficiently and effectively.     
  • Evaluation of Housing Approaches for Persons with Serious Mental Illnesses:  SAMHSA sponsored a project to identify models of housing for adults with serious mental illnesses and co-occurring substance abuse disorders that may reduce homelessness and institutionalization and promote community living.  The study evaluated a cross-site evaluation on six sites using a common data collection protocol and site-specific evaluations, with the goal of developing a supportive housing tool kit.  The Supportive Housing Implementation Resource Kit is under development and will be piloted in 2007.
  • Funding Health, Behavioral Health, and Support Services for Persons Who Are Homeless with Medicaid:  CMS is developing a primer for policy makers and others who wish to understand what medical, behavioral health, and support services can be reimbursed by Medicaid that would benefit individuals who are homeless.  This report will address an important knowledge gap identified by states, providers, consumers and consultants and is due to be published in 2007.
  • Health Care for the Homeless/Community Mental Health Center Collaboration Project:  Between 2002 and 2005, HRSA and SAMHSA funded a demonstration project to expand access to health and behavioral health services for homeless persons with psychiatric and substance use disorders.  Twelve program sites funded with $3.1 million annual funding.  Additional funding was provided by SAMHSA and ASPE to support an evaluation of the demonstration project, and the final evaluation is expected in 2007.
  • Blueprint for Change: Ending Chronic Homelessness for Persons with Serious Mental Illnesses and/or Co-Occurring Substance Abuse Disorders:  In 2003, SAMHSA developed a report designed to help states and local communities develop integrated systems of care to address homelessness among people who have serious mental illnesses and/or co-occurring substance abuse disorders.
  • How States Can Use SAMHSA Block Grants to Support Services for People Who are Homeless:  In 2003, SAMHSA published a report to highlight efforts of many states to use the federal block grant funds for mental health and substance abuse services to provide more effective care for people who are homeless.
  • Medicare Prescription Drug Coverage and Persons Experiencing Homelessness:  In 2005/2006, the Centers for Medicare and Medicaid Services developed a flyer entitled What do I need to know about Medicare prescription drug coverage to help my homeless clients? and circulated the material widely to homeless assistance providers.
  • Benefits for individuals leaving institutional settings In 2004, HHS issued policy guidance to encourage states to suspend and not terminate Medicaid benefits while an individual is in an institutional setting. 
  • National Institutes of Health (NIH) Research Initiatives:  Since 2002, the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) have jointly issued a program announcement to support research on homelessness and to develop further knowledge and evidence-based practices for treating and preventing the development of chronic homelessness in vulnerable populations.  A number of research projects have been or are currently supported via this mechanism.

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