Indiana Legislature Moving to Help Homeless

CSH and the Indiana Housing and Community Development Authority (IHCDA) appeared today before members of the Indiana House Committee on Family, Children and Human Affairs to urge passage of Indiana House Bill 1380. The bill, sponsored by Rep. Donna Harris and co-authored by Rep. Cindy Kirchhofer, Rep. John Bartlett, and Rep. David Frizzell, establishes the Indiana housing first program to provide housing and support services for eligible homeless persons. The Committee approved the bill 10-0.

In this photo image, CSH joins IHCDA and Rep Harris (center, red jacket) to celebrate passage of the bill.

In this photo image, CSH joins IHCDA and Rep Harris (center, red jacket) to celebrate passage of the bill.

Pay for Success Advances in Denver

With the Denver City Council’s approval of two Pay for Success contracts, Denver will begin to provide new supportive housing and wraparound services to 250 chronically homeless individuals. Through a unique financing program called Social Impact Bonds, Denver will use funds from lenders to serve chronically homeless individuals who frequently use the city’s emergency services. CSH has been tapped as the project manager.

Mayor Hancock Announces Social Impact Bonds to Serve First 25 Participants at North Colorado Station (February 16, 2016)

Denver Pay for Success Summary & Denver Pay for Success Fact Sheet (February 16, 2016)

Denver Social Impact Bonds Pay for Success Contract

Denver Ready to Provide New Housing and Services to Homeless

Denver Homelessness Program Funded – The Denver Post


Denver Ready to Provide New Housing and Services to Homeless with City Council Vote Tonight

Social Impact Bond program to help 250 chronically homeless at lower cost

Denver, January 25, 2016 – With the Denver City Council’s approval of two contracts tonight, Denver will begin to provide new permanent supportive housing and wraparound services to 250 chronically homeless individuals in Denver.

Through a unique financing program called Social Impact Bonds, Denver will use funds from lenders to serve chronically homeless individuals who frequently use the city’s emergency services – police, jail, the courts and emergency rooms — at a cost of approximately $7 million per year. The savings and benefits from reduced costs in the criminal justice system will be captured by the city and used to repay lenders for their upfront investment to cover the cost of the program.

“Through this innovative Social Impact Bond program, Denver is serving our most vulnerable population smarter and more effectively by getting these individuals out of a cycle of jail and hospital visits and into permanent supportive housing with wraparound services,” said Mayor Michael B. Hancock. “We’re addressing a critical need to expand affordable housing options and mental health services with this new program, which are priorities of my administration.”

A limited number of homeless individuals will begin moving into new apartment units this month and plans are underway to begin construction on new housing units this spring. Combined, the 210 planned new housing units represents the most ever built for Denver’s homeless in such a short period of time. Forty existing units will also be utilized to provide housing through this program.

“For the first time, the city is paying only for successful impacts on the lives of our homeless,” said Deputy Mayor and Chief Financial Officer Cary Kennedy. “By shifting the focus to preventive services, we can both provide better outcomes for this population, and save taxpayers money.”

Social Impact Bonds are a unique type of performance-based contract where private and/or philanthropic lenders loan funds to nonprofits to accomplish a specific social objective and are repaid based on whether the program achieves its goals.

The city will pay for specific performance outcomes, which if achieved, will measurably improve the lives of participants and generate reduced costs to the criminal justice and health systems. The total private investment of the program is expected to be nearly $8.7 million; while an additional $15 million in Federal resources will be leveraged over the next five years.

“This is not only an opportunity for us as investors to come together to help ensure 250 of our community’s most vulnerable people receive services and housing, but it also allows us to participate in a public-private-nonprofit partnership to address homelessness in Metro Denver, support the nonprofit organizations doing the work and increase funding efficiencies,” said Kate Lyda, Philanthropic Services Director & Impact Investing Specialist at The Denver Foundation. “The Denver Foundation is thrilled to invest in this initiative and to offer our donors and fund-holders an innovative opportunity to invest along with us to change lives and our community.”

“The Social Innovation Fund is tremendously proud to have supported the development of this innovative project through its Pay for Success grant to the Nonprofit Finance Fund,” said Damian Thorman, Director of the Social Innovation Fund. “By deploying permanent supportive housing to 250 of Denver’s residents most in need, and the city only paying for outcomes, this project presents a unique opportunity to at once implement evidence-based solutions to improve outcomes, and at the same time, be the best possible stewards of taxpayer dollars.”

Denver currently spends about $29,000 for each chronically homeless individual who is frequently arrested and in need of medical attention, which includes jail, police, courts, detox, emergency room and other medical costs. Permanent supportive housing will help these individuals lead a more stable and productive life. And will save taxpayer money and free up room in the county jails.

The estimated repayment to investors will be $9.4 million if the program achieves a 35 percent reduction in the number of days that the population spends in jail and if at least 83 percent of all participants remain stably housed for 1 year or longer. The repayment will be less if these outcomes are not achieved.

The full contracts approved by Denver City Council can be found here.

Organizations that are assisting with oversight and coordination of the project include:

  • Corporation for Supportive Housing – CSH (Project Manager)
  • Enterprise Community Partners

The service providers involved in this contract include:

  • Colorado Coalition for the Homeless
  • Mental Health Center for Denver

The commitment of the investors is subject to board or credit approval and final loan execution. The investors involved in this contract include:

  • The Denver Foundation
  • The Piton Foundation
  • The Ben and Lucy Ana Walton Fund of the Walton Family Foundation
  • Laura and John Arnold Foundation
  • Living Cities Blended Catalyst Fund LLC
  • Nonprofit Finance Fund
  • The Colorado Health Foundation
  • The Northern Trust Company

“I thank the Denver City Council and our amazing organizational and lending partners for their support of this ground breaking solution,” the Mayor said. “Together, I believe we will make a meaningful impact on the lives of many vulnerable people and our city as a whole.”

Technical assistance and support to develop the initiative was provided by Social Impact Solutions. Denver also received support from the Harvard Kennedy School’s Social Impact Bond Lab, which provides pro bono technical assistance to state and local governments interested in pursuing Pay for Success and Social Impact Bond contracts.

CSH – SIF National Demonstration Sets Path to End Homelessness

Sarah Gallagher

We enter 2016 with momentum, opportunity and a confluence of national initiatives uniting local and state-level stakeholders in the movement to end homelessness. Over the last year, with the support of the US Interagency Council on Homelessness (USICH) and the US Department of Housing and Urban Development (HUD), such places as Virginia, Las Vegas, Houston and New Orleans have announced an end to veteran homelessness.  And Salt Lake City and Utah are on their way to ending chronic homelessness.

However, in order to truly end chronic and veteran homelessness on a national scale that lasts, we must make sure communities have the resources and systems in place to prevent people from becoming homeless.  Communities must have an adequate supply of supportive housing, and systems and practices that ensure people with the highest needs have priority access to the housing and supports.  Among the people who must be prioritized are those who cycle in and out of crisis services (e.g. emergency rooms, hospitals, detox, correctional health, etc.), rarely finding the stability required to exit homelessness.

Through administration of a Social Innovation Fund (SIF) grant from the Corporation for National & Community Service, CSH has been working with four communities across the country to reach and end homelessness among individuals with complex health needs and housing instability who also turn to high-cost emergency and crisis health services on a regular basis. CSH’s approach entails a strategic, phased (five-year) grant-making and model development effort that provides supportive housing connected to coordinated health services to the highest-cost users of publicly funded crisis health services.

The core components of this SIF effort are: 1) the use of data to target and identify the cohort of homeless high utilizers in each community, 2) intensive outreach and engagement in several settings, 3) a Housing First approach, 4) facilitated access to health care and behavioral health care and 5) care coordination for each participant through a patient navigator or community health worker.

To date, the SIF initiative has identified and placed 573 vulnerable individuals into housing nationwide—individuals with severe and complex health conditions who may not have gained access to supportive housing without this data-driven program.

Through data-driven targeting and efforts to bridge the gap between systems of care, SIF is changing lives: 91 percent of participants in CSH-funded supportive housing initiatives have located stable housing, and 85 percent are currently connected to a primary health care provider.[1]

Four years into our five year initiative, tenants and their case managers are reporting utilization of primary care services coupled with drops in hospitalizations and emergency room visits. Moreover, tenants are reporting that they are overall satisfied with their housing, health care and quality of life and self-rated health.

Philanthropy, healthcare providers, public systems, and all levels of government have begun to recognize the potential for innovative programs like SIF to have tremendous impact.

In a recent interview, Fred Karnas of the Kresge Foundation said:

“People don’t come with a HUD problem, or an HHS problem, or a VA problem. They come with a set of issues …. These new partnerships that are emerging in communities between the housing world, managed care organizations, and hospitals are really the key to recognizing we can’t operate in two siloed systems …. Building this network at the local level is critical …. The hospitals I’ve talked to … are really looking at this partnership as a new way of doing business … The ability to meet their bottom line, have better outcomes for their clients, and create a better working system is high on the list.” Click here to watch Fred share Kresge’s perspectives on CSH and SIF.

Federal partners, such as USICH, have also noted SIF’s efficacy:

“CSH’s SIF demonstration provides a clear blueprint for how to end chronic homelessness—the smart use of data, partnerships with the health care system, and the proactive targeting of people with the highest needs in permanent supportive housing.  That’s why USICH is partnering with CSH to integrate the lessons learned from this demonstration as part of our national strategy to end chronic homelessness,” said Matthew Doherty, Executive Director, USICH.

Through SIF, we are refining a valuable approach for how to achieve and sustain an end to homelessness. We are building the evidence and ensuring the practices and systems will stand the test of time.

As we move forward in 2016 and beyond, CSH and our partners are eager to learn as much as we can and want to work with even more communities to widely embed the innovations found in SIF.

For more information on SIF and how your community can get involved, please contact Sarah Gallagher at

[1] Damian Thorman, Director, Social Innovation Fund.

Read the first in a series of papers on the CSH – SIF initiative: Supportive Housing for Homeless Super-Utilizers of Crisis Health Services.

In addition to the Corporation for National and Community Service, a number of philanthropic organizations have supported CSH – SIF throughout the years, including: Conrad N. Hilton Foundation, Melville Charitable TrustSan Francisco Foundation, Hearst Foundations, Henry E. Niles Foundation, L.A. Care, Glendale Memorial Hospital & Health Center, Fairfield County’s Community Foundation, California Hospital Medical Center Foundation, Robert Wood Johnson Foundation, and Kresge Foundation.



Congressman Stivers Visits Returning Home Ohio Program

Congressman Steve Stivers recently met with staff from CSH and Faith Mission, located in Columbus, Ohio to meet first-hand people helped through Returning Home Ohio. This program breaks the cycle of homelessness, recidivism and then return to jail by providing those leaving incarceration with safe, stable homes and supportive services to foster successful community reintegration. Supportive services include employment supports, health care, mental and behavioral health, and ongoing case management to assist tenants in reaching their goals.

305_Congressman St and Tenant_15During this site visit, Congressman Stivers met one of the participants (pictured on the left), who discussed the importance of stable housing as he seeks to go back to school, find employment, and improve his health.

The stability of supportive housing has helped this participant lay the foundation for a strong life-plan and access the services he needs to ensure successful outcomes.

Congressman Stivers’ interest in Returning Home stems in part from his service on the US House Financial Services Committee, which has jurisdiction over US Department of Housing and Urban Development (HUD) programs.

Rockford, Illinois is Addressing Veteran Homelessness in 2015

Rockford Completes Mayors Challenge

Lauded as First City in the Nation to

Reach Functional Zero and Effectively End Veteran Homelessness


Rockford, Illinois – The City of Rockford Department of Human Services, a community action agency serving Boone and Winnebago counties, announced today that the Department of Housing and Urban Development (HUD) and the Department of Veteran Affairs have recognized Rockford as the first community in the national Zero: 2016 movement to reach functional zero and effectively end homelessness among local Veterans.

The City of Rockford has also been recognized by the United States Interagency Council on Homelessness for successfully completing the Mayors Challenge to End Veteran Homelessness; an initiative led by First Lady Michelle Obama. The Mayors Challenge calls upon mayors and other state and local leaders across the country to publicly express their commitment and provide the leadership to implement the strategies necessary for their communities to end homelessness among all Veterans within their communities by the end of 2015.

“Ensuring every person has a safe, stable place to call home takes teamwork and dedication at every level. Rockford stepped up to this challenge and today has every reason to celebrate its incredible achievement in effectively ending Veteran homelessness. Communities around the country can now look to the Forest City as a model for serving our nation’s heroes,” said HUD Secretary Julián Castro. 

The Zero: 2016 movement, coordinated by Community Solutions with coaching from the Corporation for Supportive Housing (CSH), consists of 75 communities working to end Veteran and chronic homelessness by the end of 2016. The national effort supports participants in optimizing local resources, tracking progress against monthly housing goals, and accelerating the spread of proven strategies, such as those implemented through the Mayors Challenge. Rockford was selected for Zero: 2016 through a competitive, national application process. 

Functional zero is a key component to ensuring every Veteran in the community has a permanent home. In Zero: 2016, functional zero is reached when, at any point in time, the number of Veterans experiencing literal homelessness, both on the streets and in shelters, is no greater than the city’s monthly Veteran housing placement rate. Rockford has housed a total of 73 Veterans to date. To remain at functional zero, Rockford must have no more than eight homeless Veterans awaiting housing and any new homeless Veteran is housed within 30 days.


CSH & Partners Work to Strengthen Housing Continuum for Young Adults in CT

Connecticut providers from across the housing continuum joined CSH in early December for a statewide convening that included a focus on tailoring the supportive housing model for young adults and transition-aged youth (TAY) to promote positive youth development and facilitate a young person’s transition to adulthood.

Policymakers from the State Department of Housing (DOH), Department of Children and Families (DCF), and the Young Adult Services (YAS) division of the Department of Mental Health and Addiction Services (DMHAS) engaged statewide intermediaries and providers on efforts to fill gaps along the housing continuum for TAY. Kathleen Durand from DOH announced her Commissioner’s decision to move forward with a competitive capital round of between $ 5 and 8 million dollars for young adult supportive housing in 2016 that could potentially include rental subsidies. This major commitment was reinforced when Amy Marracino from DMHAS YAS and Kim Somaroo-Rodriguez from DCF shared information on new endeavors to create more drop-in centers for youth as well as new crisis response services across the state.

The good news of a competitive capital round for young adult supportive housing set the stage for Dr. Eric Rice of the University of Southern California’s School of Social Work to share learnings from CT’s implementation of a pilot to identify homeless youth in Connecticut at most risk for long-term homelessness, and for CSH New England program staff to provide an overview on their work to assess the state of supportive housing for young adults in the state.

Dr. Rice’s presentation summarized the results of the Connecticut TAY Triage Tool pilot and provided recommendations to stakeholders on assessing youth and young adults for housing options and supportive services. The TAY Triage Tool is a youth-specific set of non-invasive questions that can be quickly delivered to determine whether a homeless young person is on a trajectory to experiencing five or more years of homelessness. The tool consists of a six point scale, with the recommendation that homeless youth with a score of 4 or higher should be prioritized for supportive housing.

For Connecticut, the tool provides a mechanism for collecting targeted data to inform how the state will prioritize young adults for new supportive housing projects that will come on-line in the future. To implement the tool in Connecticut, Dr. Rice suggested utilizing Orgcode’s Next Step Tool, which includes the six items which constitute the TAY Triage Tool. Additionally, the pilot found that youth and young adults who score higher on the TAY Triage Tool report higher levels of trauma and depression, meaning that mental health and possibly substance abuse interventions may be needed for youth and young adults who are placed into housing. Click here for a full summary of Connecticut’s TAY Triage Tool Pilot.

From enhanced data collection efforts to new commitments for permanent housing options for TAY, the state is uniquely positioned to develop and operate supportive housing for young adults in Connecticut that implement a youth framework and promote positive youth development without the traditional time limitations that exist in other housing interventions that currently exist for Connecticut’s young people.

With support from the Melville Charitable Trust, CSH has developed a general service model that is more youth-specific for Connecticut’s supportive housing providers that are serving young adults in the traditional model. CSH will continue to work with providers and other stakeholders to pilot viable demonstration projects, including developing a finance model, provide recommendations on staffing structures, and creating a learning community for providers with an interest in serving young adults in supportive housing.

The event provided CSH the opportunity to re-assemble a learning community of supportive housing providers serving young adults in traditional supportive housing and connect them not only to providers along the housing continuum, but also with Opening Doors-CT, a statewide initiative that aims to serve runaway and “unaccompanied” minors as well as young adults (18+) experiencing homelessness and housing instability. The event took place almost a year after Opening Doors-CT launched a statewide action plan to address the unique needs of youth and young adults who are precariously housed and at higher risk for exploitation, offering a day of reflection on work that’s unraveled over the past eight months and where the state has yet to go to serve these young people.

In early 2016, CSH will release a comprehensive report that assesses the current supportive housing landscape for Connecticut’s young adults and provides recommendations on next steps.

Strategically Expanding Housing-Healthcare Partnerships

finger lakesSLLast month, CSH President and CEO Deb De Santis was the featured speaker at the 8th Annual North American Housing Conference: “Housing is Health Care” in Niagara Falls, New York. One of the participants at the Conference, Teresa Bales, Project Manager for the Transitional Supportive Housing project and the Housing Advisory Group at the Finger Lakes Performing Provider System (FLPPS), reflected on what she heard in Niagara, her observations on housing-healthcare integration and collaborations, and submitted the following guest blog. 

When an assessment of community needs[1] identified housing as a primary barrier to improved outcomes, leadership of the Finger Lakes Performing Provider System (FLPPS) took action, selecting Transitional Supportive Housing (TSH), as one of eleven projects that FLPPS would implement under New York State’s (NYS’s) Delivery System Reform Incentive Payment (DSRIP)[2] program. DSRIP is an incentive payment model federally funded by Medicaid 1115 waivers. As part of NYS’s efforts to change how health care services are delivered and paid through under Medicaid Redesign, DSRIP incentivizes health and community-based providers to form regional collaborations, Performing Provider Systems (PPS), and implement innovative system transformation. The overarching objective of DSRIP is to improve clinical outcomes and reduce avoidable hospital use by 25% over five years.

The TSH project targets high risk individuals with housing instability who have difficulty transitioning from a hospital to community-based setting. Somewhat a misnomer as supportive housing is a long-term, permanent evidence-based intervention, TSH based on the NYS-defined scope, must help stabilize these high-risk individuals by ensuring access to a combination of non-permanent housing combined with the full range of supportive services required by their medical and/or behavioral conditions.  Selection of the TSH project prioritized housing stability across FLPPS’s 13 county service area and dedicated funds to tackle housing as both a social determinant of DSRIP’s clinical outcome goals as well as a vital intervention in the transformation of health care delivery towards value-based reimbursement.

I was hired in November 2014 to manage TSH project and soon experienced a myriad of challenges associated with project implementation.  First and foremost, there is a lack of comprehensive data that systematically links housing status with health information.  Housing status is absent from medical claims data and pockets of data held by housing providers varies greatly.  Furthermore, patient consent and data sharing agreements required to coordinate and match data across systems are not commonplace.  As a result, it is virtually impossible to quantify supply and demand for the range of housing options that either exist or are needed.  A recent study conducted by CSH is the first attempt to assess the supportive housing need for individual and family households in certain geographies of NYS and found an unmet supportive housing need of over 1,500 units in Monroe County in 2013.

Inadequate staffing, including shortages in visiting nurse services, is a second hurdle to project implementation: when discharging housing-unstable patients with co-morbidities, hospitals often feel compelled to choose between prioritizing either a patient’s medical or behavioral health condition, particularly in the absence of sites capable of managing both.

Finally, lack of safe and affordable permanent housing is a critical risk to successful project implementation.  If there are insufficient long term solutions available, we will simply move the bottleneck from hospital beds to transitional housing sites.

As an early first step towards project success, much of my work over the last year has involved relationship-building between hospitals, housing and care management providers to address the TSH project’s emphasis on improved care transitions and tailored support services upon discharge.  Building bridges between housing and health systems to better coordinate assessment and care for behavioral, medical health and social needs will enable the FLPPS network to provide quality population health management for its neediest and highest cost patients.

While attending the North American Housing Conference in November, I was struck that my experience working on the TSH project might offer guidance to community and Housing and Urban Development (HUD)-funded housing providers looking to realize the opportunities presented by health system transformation and the move to value based payment.  I encourage housing providers to begin identifying opportunities to strategically expand partnerships with health systems, measure the impact of housing on health outcomes and ultimately leverage the transition to value-based payment to realize billable residential and supportive services. Further, if we embrace genuine collaboration, openness to eliminate duplicative services, and willingness to leverage the value-add for each type of service provider, we should find ourselves truly at the helm of a unique and momentous opportunity to build an integrated delivery system that is poised to deliver patient-centered population health management.

Teresa Bales is Project Manager for the Transitional Supportive Housing project and the Housing Advisory Group at the Finger Lakes Performing Provider System (FLPPS). Visit the FLPPS website for more information.


[1] Finger Lakes Health Systems Agency, “Community Needs Assessment: Finger Lakes Performing Provider System Delivery System Reform Incentive Program Final Grant Application.” December 18, 2014.

[2] More information can be found the NYS DOH website.

HUD Defines Chronically Homeless

Final Rule on Defining “Chronically Homeless” Part I:

How We Got Here

Tomorrow, the Final Rule on Defining “Chronically Homeless” will be published in the Federal Register with an effective date of January 15, 2016. It is available for public inspection in the Federal Register today. It has been a long road getting to this final definition, and we think it is important as we release this rule to provide some context on how we got here and explain why we made the decisions we made. Today’s message is the first of two messages about the rule and focuses more on the process we used to develop the final definition. Next week you will hear from my Senior Advisor, Marcy Thompson, who heads up our efforts on chronic homelessness and had the responsibility of getting the final rule completed. Her message will focus on what we think this new definition will mean for the work that you do.

While ending chronic homelessness has been a goal since the early 2000s, with better data we have only more recently begun to understand how people meet the definition and how the definition impacts the way programs operate at the local level. We assumed that most people met the definition of chronic homelessness based on long and continuous periods of homelessness rather than the episodic pattern of homelessness. However, when HUD and the U.S. Interagency Council on Homelessness (USICH) examined the data in 2012, we found that communities were identifying many more people who met the definition based on having experienced four or more episodes (now referred to as “occasions”) instead of the long and continuous periods as we had assumed.

At that point we had already made our first attempt at proposing a new definition of chronically homeless – it proposed that each occasion of homelessness include a total of at least 15 consecutive days. Technically, this would have allowed someone to be considered chronically homeless in as few as 60 days over a period of 3 years while someone experiencing homelessness continuously would have to be homeless for at least 12 months consecutively. Taking into consideration comments we received and what we were learning about the nature of chronic homelessness we realized that we needed to take a step back and reconsider what we were trying to accomplish with this new definition.

In May 2012, we convened a group of experts—providers, researchers, and advocates—to get varying perspectives on how we could use the definition to better ensure that we were really focusing on those persons with disabilities whose homelessness had been persistent. At the conclusion of that meeting there was almost unanimous agreement that the definition should require a minimum of 12 months either continuously or cumulatively. That discussion planted the seed that would become the definition included in the final rule. In early 2013, HUD again requested public comment on a proposed definition of chronically homeless that would have required the four occasions to total 12 months cumulatively. We received 177 public comments about the proposed definition. The preamble in the final rule available today includes the comments that were received and how each was addressed, and explains HUD’s policy reasons for the decisions we made.

Following is a summary of the most significant changes between the definition of chronically homeless currently in effect and the definition included in the final rule:

  • To be considered chronically homeless, a person must have a disability and have been living in a place not meant for human habitation, in an emergency shelter, or a safe haven for the last 12 months continuously or on at least four occasions in the last three years where those occasions cumulatively total at least 12 months;
  • Replaced “disabling condition” with “homeless individual with a disability”;
  • There is not a minimum number of days in which each occasion must total but instead, occasions are defined by a break of at least seven days not residing in an emergency shelter, safe haven, or residing in a place meant for human habitation;
  • Stays in institutions of fewer than 90 days do not constitute a break and count toward total time homeless; and
  • The final rule establishes recordkeeping requirements for documenting chronic homelessness that take into account how providers use Homeless Management Information Systems (HMIS) and that does not require documentation of each day of homelessness but a method that can be more easily implemented.

We understand that implementing this new definition will have a significant impact in communities. Beginning January 15, 2016 when the new definition goes into effect, any persons served in permanent supportive housing (PSH) that is required to serve persons that are chronically homeless (either dedicated or prioritized) may only accept new participants that meet this definition. Program participants who are already residing in these programs will not be affected.

In the coming weeks, we will be offering multiple webinars to ensure that all Continuums of Care (CoCs), recipients of CoC Program-funded PSH, and other stakeholders have the opportunity to hear more about the definition and what HUD expects. We will send out a listserv with information about those dates and how to register. A new help desk is now available for questions specific to the definition of chronically homeless. Those questions can be submitted through the HUD Exchange Ask A Question (AAQ) Portal. Select “CoC: Continuum of Care Program” from the “My question is related to” drop down list on Step 2 of the question submission process and type “Chronically Homeless Definition” in the subject line.

Thank you, as always, for your efforts to end homelessness.

Ann Oliva

Deputy Assistant Secretary for Special Needs

United States Department of Housing and Urban Development


Download this SNAPS In Focus: Final Rule on Defining Chronically Homeless Part I: How We Got Here

View SNAPS In Focus Messages


HHS Stresses Services for Homeless Families



Health Resources and Services Administration

Maternal and Child Health Bureau Rockville, MD 20857

November 30, 2015


Dear Maternal, Infant, Early Childhood Home Visiting Program Grantees,

We are writing you today to stress the importance of providing Home Visiting services to homeless families and their young children from pregnancy to kindergarten entry. Ensuring the well-being of our youngest children is essential to the work of the Maternal and Child Health Bureau and is especially urgent when considering the vulnerability of such young children who experience homelessness. The U.S. Department of Health and Human Services (HHS) is particularly focused on the challenges faced by families with young children who are homeless or at risk for homelessness. In fact, HHS Secretary Sylvia Mathews Burwell will soon assume the chair of the U.S. Interagency Council on Homelessness.

In the United States, more than 1.6 million children, many under the age of six, live on the streets, in homeless shelters, in campgrounds, temporarily doubled up with others, or are otherwise without a stable home. A cause for a young family to become homeless is the birth of a new baby. Research shows that children who experience homelessness also experience higher rates of chronic illness, developmental delays, anxiety, and depression than children who live in stable homes.

Home Visiting programs partner with homeless shelters, Housing and Urban Development (HUD) Continuum of Care (CoC) projects, and local homelessness initiatives to support stable housing for vulnerable families, to address the critical needs of homeless families, and to address the health and development of mothers and their children.

Many of you are already serving families who are homeless or at risk for homelessness through evidence-based home visiting models and/or promising approaches. We ask that you continue to examine the ways you are serving homeless women and children, and identify additional strategies to do so through home visiting services and coordination and collaboration with early childhood partners. The Division of Home Visiting and Early Childhood Systems will provide technical assistance to help you continue to provide high-quality services and system coordination to improve the wellbeing of families who are homeless or at risk for homelessness.

In particular we encourage you to consider the following:

Provide Quality Services for Homeless Families: Ensure that high-quality services are available to and meet the needs of homeless families or those at risk for homelessness. Programs can screen families for homelessness and assess risk for homelessness as well as collect and analyze data about families’ housing needs. Home visitors can meet with families where they currently live, provide ongoing support and consistency in the lives of children who may be highly mobile, and strengthen parents’ capacity to promote their children’s developmental milestones.

Have Policies in Place for Families who are Temporarily Homeless after a Disaster: Policies and procedures should ensure that families have streamlined access to services that are essential to recovery in an emergency situation. The home visiting workforce may assist in relief efforts through family engagement in emergency shelters, and referrals to and coordination with local services.

Offer Flexibility to Homeless Families: Examine the documentation required to enroll in a home visiting program and, where appropriate and in fidelity to home visiting model(s), provide “grace periods” that give families sufficient opportunity to gather the required documentation for participation, such as for immunization, within a reasonable time frame.

Coordinate with HUD CoC, and Local Liaisons: Coordinate at both state and local levels to reach out to homeless families or those at risk for homelessness. Connect families served by your programs to available CoC resources as well as health and social services. Collaborate with key partners serving homeless families, including the state Office of Coordinator for Education of Homeless Children and Youths authorized by the McKinney-Vento Act, runaway and homeless youth programs, and state and local housing authorities, among others.

Work with Homeless Coalitions: The home visiting community should participate on homeless coalitions which bring together homeless programs with other community organizations. The purpose of these coalitions is to ensure that services available to families experiencing homelessness (particularly support services beyond housing) reflect the needs of the community. Participation on these coalitions will ensure that the unique needs of pregnant women and young children are well represented.

The wellbeing of our youngest children is essential, not only for the development of the child and the stability of the family, but for the ongoing success of our nation. We thank you for your tireless efforts to serve our most vulnerable children, and stand committed to supporting your work to further ensure access to high-quality home visiting services for young children and families who are homeless.


David Willis, M.D., FAAP

Director, Division of Home Visiting and Early Childhood Systems


DIVISION OF HOME VISITING AND EARLY CHILDHOOD SYSTEMS – Contact Information for Maternal, Infant, and Early Childhood Home Visiting State Leads



You Can Make A Difference Today

For RWJF "Keeping Families Together" BRONX, NEW YORK - MAY 19: Jose Soto, his wife, Evelyn, and their daughter Destiny, 3, spend time together in their apartment and neighborhood in the Bronx, New York May 19, 2010.

It’s Giving Tuesday


Today nonprofit organizations, local businesses, philanthropists and people like you come together to promote and participate in giving to ensure better, vibrant and stronger communities throughout the country.

We hope you will take a few minutes this morning to support CSH, the national leader in creating access to affordable housing and support services for vulnerable people and families.

CSH is elevating the needs of families like Sonya, Joe and their daughter, Katie, impacted by serious mental health issues, recurring homelessness and repeat involvement with child welfare agencies. To escape their downward spiral of trauma and despair, they needed a safe, stable and affordable home as well as access to mental health and other services. Supportive housing came to their rescue with a nice apartment, and the case management and the recovery programs they need to move forward, together, as a family.

There are thousands of families like Sonya, Joe and Katie who need our help. Your tax-deductible gift can transform their lives from hopelessness to ones where they are housed and healthy.

We thank you for your support and generosity.


Click Here to Donate to CSH Now