An Environment for Change. In 2001, the Secretaries of HHS and HUD met and committed to a collaboration that capitalized on the expertise of HHS in service delivery and the expertise of HUD in housing. A leading concern was for the services funded by HHS to be more accessible to eligible homeless persons residing in HUD-funded housing. Subsequently, HHS, HUD and VA explored goals and activities of mutual interest and concluded that collaboration was best achieved by adopting a specific and targeted focus on the issue of long term and repeated homelessness. Concurrently, in 2002, the Administration revitalized the U.S. Interagency Council on Homelessness (USICH) to coordinate the federal response to homelessness across twenty federal departments and agencies, and to create a national partnership at every level of government and the private sector, with the goal of reducing and ending homelessness across the nation. The final development of major significance came in the release of the Administrations budget for fiscal year 2003, where President George W. Bush officially endorsed ending chronic homelessness as a goal of his Administration.
The Secretarys Work Group on Ending Chronic Homelessness. In support of the articulated Administration goal of ending chronic homelessness, senior leadership within HHS established a Departmental work group in 2002 and tasked the group with developing a strategic action plan that would articulate a comprehensive approach for enabling the Department to better serve individuals experiencing chronic homelessness. This work group, entitled the Secretarys Work Group on Ending Chronic Homelessness, comprises senior leadership from seven operating divisions and numerous staff divisions within the Office of the Secretary and has expanded to encompass more offices as the Work Group has matured (see Figure 1).
Members of the Secretarys Work Group on Ending Chronic Homelessness
- Immediate Office of the Secretary
- Administration for Children and Families
- Administration on Aging
- Centers for Medicare and Medicaid Services
- Health Resources and Services Administration
- National Institutes of Health
- Substance Abuse and Mental Health Services Administration
- Program Support Center
- Center for Faith-Based and Community Initiatives
- Office on Disability
- Office of the Assistant Secretary for Resources and Technology
- Office of the Assistant Secretary for Legislation
- Office of the Assistant Secretary for Planning and Evaluation
- Office of Intergovernmental Affairs
- Office of the General Counsel
In early 2002, the Secretarys Work Group on Ending Chronic Homelessness was charged with designing a plan to:
- improve access to treatments and services;
- improve coordination across these services;
- identify strategies to prevent additional episodes of chronic homelessness; and
- itemize accountability and evaluation processes.
The strategic action plan developed by the Work Group, entitled Ending Chronic Homelessness: Strategies for Action, was released in 2003. The purpose of the 2003 Plan was to define the chronically homeless population and itemize the service needs of the population; analyze the response of HHS mainstream assistance programs to these needs; specify outcomes and objectives that would improve the response of mainstream programs to the chronically homeless population; and offer actions the agencies could take that would improve access to and coordination of services. The 2003 Plan has served as the framework for developing and implementing activities across the Department related to chronic homelessness. The general premise of the strategic action plan posits that homelessness is a complex social problem, and ending chronic homelessness requires housing combined with the types of services supported by the programs funded and operated by HHS. The goals outlined within the strategic action plan provided a course of action for the Department to follow in order to improve access to needed health and social services for individuals experiencing chronic homelessness, empower states to improve their response to individuals experiencing chronic homelessness, and to prevent future episodes of homelessness within HHS clientele.
From its inception to the present time, the Secretarys Work Group has met regularly in order to discuss policy issues related to chronic homelessness, as well as homelessness among families and youth, review progress, and report about key activities occurring in the various operating divisions. The Work Group has developed an activities tracking matrix, which allows agencies to chart homeless-related activities under the specific goals and strategies outlined in the Plan noted above. The matrix provides Work Group members with a way to measure progress towards achieving these goals and strategies and also provides a simple measure of the level of activity within each key area of focus.
Since 2003, the Department has worked in partnership with the states, other federal Departments, and the U.S. Interagency Council on Homelessness to advance the goals outlined in the strategic action plan. As the plan approached its third anniversary, the Work Group collectively reviewed the Departments progress towards achieving the goals outlined in the plan, and has concluded that significant progress has been made towards certain goals and strategies, where other goals and strategies needed additional focus. Furthermore, though the 2003 Strategic Action Plan focuses solely on the chronically homeless population, the scope of work and focus of the Work Group was actually much broader, and includes activities that focus on homeless families with children, as well as homeless youth. The Work Group concluded that the Department would benefit from a new plan that would provide a framework for future efforts. The intent of this revision is not to usurp or replace the original strategic action plan, but rather to refine the goals and strategies to reflect the changing set of challenges and priorities three years after the development of the first plan.
Key Events Shaping Strategic Action Plan Revision
Between 2001 and 2006, several key events and activities guided the development of the 2007 Plan. First, HHS partnered with HUD, VA, ICH, the U.S. Department of Labor (DOL), and the U.S. Department of Education (ED) to fund nine Homeless Policy Academies that were designed to bring together state-level program administrators and homeless service providers in order to develop state-specific action plans designed to increase access to mainstream resources for persons experiencing homelessness. Five Policy Academies focused on chronic homelessness, and in response to demand, the remaining four Academies focused on homeless families with children. To date, every state (including the District of Columbia) and U.S. Territory has attended a Homeless Policy Academy. HHS, along with our federal partners, has provided significant technical assistance resources to these jurisdictions to assist them in the implementation of their Policy Academy action plans over the past several years.
Another key effort extending into the states is the work of the ICH to encourage the development of State Interagency Councils on Homelessness as well as state and local ten-year planning processes to end chronic homelessness. As part of the Councils strategy to create intergovernmental partnerships to end homelessness, Governors of 53 states and territories have taken steps to create a state-level ICH, while over 280 Mayors and County Executives have initiated a ten-year planning process. Currently, many of the states and Territories are leveraging the support and infrastructure of the ICH and the Homeless Policy Academies to strengthen and coordinate their State Interagency Councils on Homelessness, Homeless Policy Academy teams and state and local planning processes that may already be institutionalized through HUDs Continuum of Care process.
A cornerstone effort of the increased focus on chronic homelessness was the development of the Collaborative Initiative to Help End Chronic Homelessness, also known as the Chronic Homelessness Initiative (CHI), an innovative demonstration project coordinated by the ICH and jointly funded by HUD, HHS (SAMHSA and HRSA) and the VA. Recognizing that homelessness is an issue that cuts across various agencies in the federal government, this unique effort across the Department offered permanent housing and supportive service funding through a consolidated application process. Successful applicants described an integratedand comprehensive community strategy to use funding sources, including mainstream service resources, to move chronically homeless individuals from the streets and emergency shelters into stable housing. Once housed, the residents would be able to access the range of services needed to promote and maintain greater self-sufficiency. The CHI is important because it operationalizes many of the key goals and strategies outlined in both the original and revised strategic action plans; for example, use of interagency partnerships on both local and federal levels, increasing the effectiveness of integrated systems of care, and the use of mainstream resources. In October 2003, 11 grantees received funding for three years, FY 2003-2005. HHS funding totaled $30 million for the three-year period.
Another key event that influenced the Secretarys Work Group was Hurricane Katrina, which occurred in August 2005. A special meeting of the Secretarys Work Group was held in September 2005 on this topic. At this meeting, a literature review compiled for the meeting was used to guide discussion pertaining to: the key players during the hurricane; housing and health issues; the impact on the historically homeless; and data pertaining to and lessons learned from previous disasters. Furthermore, agency representatives at the meeting described their experiences providing concrete assistance during Hurricane Katrina. Lessons learned from this disaster have led the Department to carefully consider how HHS should prepare for and respond to homelessness and human service needs in future disasters, and how the structure of the Work Group might be used as a tool for future natural disasters.
Finally, one of the original charges to the Work Group was to itemize accountability and evaluation processes. This called for establishing monitoring and evaluation benchmarks pertaining to chronic homelessness. However, the absence of data to inform the Department about a baseline suggested considerable developmental work would be needed before empirical benchmarks could be established. Over the past several years, the ability to demonstrate results towards ending and reducing homelessness in a quantitative fashion has increased, and thus, where the original plan included a recommendation for this work, a more focused effort to develop data and performance measurements will be critical to documenting future success and is a key component to the revised strategic action plan.