by Gay Koerber, Associate Chief Consultant for Health Care for Homeless Veterans
VA Central Office, Washington, DC
The Department of Veterans Affairs operates more than 130 sites where extensive outreach to find homeless veterans takes place. At these sites, physical and psychiatric health exams, treatments, referrals, and ongoing case management are provided to homeless veterans with mental health or substance abuse problems. Following an assessment, the homeless veterans in need of long-term treatment are helped into community-based programs. In 2002, the VA provided services to approximately 77,000 homeless veterans through its specialized homeless programs.
The VA operates the Domiciliary Care for Homeless Veterans Program, which provides mental health and medical care in a residential setting. Care is given to eligible ambulatory veterans disabled by medical or psychological problems who do not need hospitalization or nursing home care. Nearly 1,800 domiciliary care beds are available at 35 VA medical centers in 26 states.
In 1988, the Vietnam Veterans of San Diego partnered with the VA for the first Homeless Stand Down, patterned after the military concept of providing relief after active military action. This is a short-term (usually one- to three-day) event that includes shelter, food, clothing, legal aid, medical assistance, social services, job referrals, and transitional housing options. The VA medical centers have been participants in the stand downs over the past 15 years; this year, more than 100 Homeless Stand Downs are scheduled nationwide. There are thousands of volunteers, including many formerly homeless veterans, and hundreds of private-sector businesses participate. This event often serves as an entry point into the VA health care system, where more comprehensive services are provided to eligible veterans.
Compensated Work Therapy offers employment opportunities for at-risk and homeless veterans with physical, psychiatric, and substance abuse problems. The VA works with private industries as well as the public sector to find work for these veterans, where they will have the opportunity to learn new job skills, relearn successful work habits, and regain self-esteem. In conjunction with the Work Therapy program, the VA operates more than 50 community-based transitional residences with more than 432 beds. Homeless veterans stay in the housing an average of six months while they gain work skills.
Finding permanent housing is a daunting task. The VA’s Supported Housing Program links veterans with private landlords, public housing authorities, and nonprofit organizations that are willing to make creative arrangements to house the formerly homeless. In 2000, VA staff at 26 Supported Housing Program sites helped veterans find 1,950 transitional or permanent residences in the community.
An expanding resource is the VA’s Homeless Providers Grant and Per Diem Program, which awards grant money to public and nonprofit organizations to help them establish and operate supportive housing and service centers. Grants have exceeded $63 million, and approximately 5,500 new community-based beds are being made available. More than 11,000 homeless veterans were served by this program in 2002. With the expansion of the Grant and Per Diem Program, many more will be served.
The number of homeless veterans remains high, and it is estimated that veterans make up about one-third of all homeless people. A congressional initiative proposed by Rep. Chris Smith (R-NJ) sets a national goal of eradicating chronic homelessness within 10 years. The Homeless Veterans Comprehensive Act of 2001, signed by President Bush in December 2001, urges all departments and agencies of federal, state, and local governments to work cooperatively and to pool resources with private and public-sector entities, including faith-based organizations. For the first time, three federal agencies—VA, Health and Human Services (HHS), and Housing and Urban Development (HUD)—will jointly provide funding for housing, treatment, and case management to help end chronic homelessness among veterans. The emphasis is on coordination among various agencies.
There is definite political will to end the tragedy of homeless veterans, but it will take the combined effort of all those who work in the various programs to reach this goal. In the words of Rep. Smith, "It will take sustained, focused, aggressive intervention to break the homeless veteran cycle."
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