USICH Executive Director Barbara Poppe presented a workshop to NLIHC Annual Conference recipients entitled, "Life After HPRP." This workshop detailed lessons learned from the success of HPRP, how the tenets of HPRP are now included in the new Emergency Solutions Grant program at HUD, the importance of improving a community's crisis response system, and how best to fund rapid re-housing and other successful programs for those experiencing a housing crisis. For the entire presentation, please download the slideshow from the box on the right.

New Orleans, LA

Good afternoon. It is terrific to see so many friends and colleagues gathered together. Thanks Bill for that very generous introduction and all you’ve done to further Housing First across the country and especially in Los Angeles.I also want to thank Bill and Sam Tsemberis for creating the vision and then hosting this historic conference. It’s an honor to precede Assistant Secretary Mercedes Marquez who has been such an exceptional leader on supportive housing at HUD, as well as a Housing First pioneer in her hometown of Los Angeles.

Two years ago, with the help of many of you, we launched Opening Doors. The first ever comprehensive federal strategic plan to prevent and end homelessness builds upon and leverages the innovative efforts underway in communities across the country. Many of these efforts are showcased in the impressive array of workshops that have been put together for this conference.

There are four goals in Opening Doors, but most significantly, for today’s purposes, I want to focus on our work together to finish the job of ending chronic homelessness by 2015.

Opening Doors calls out that permanent supportive housing implemented by using Housing First principles is the primary solution to end chronic homelessness. The Plan highlights key strategies to increase the availability of housing and supportive services. Taking permanent supportive housing to the scale necessary to end homelessness requires a deep understanding of the population of people experiencing chronic homelessness. 

Fortunately, there are new and promising practices to better inform communities about the types of services and housing interventions that are needed. The 100,000 Homes Vulnerability Index survey based on Jim O'Connell's research or DESC's Vulnerability Assessment Tool are good examples of assessment tools.

Equipped with this information, communities can map the mainstream and targeted housing programs that exist in your community that can be brought to bear on these needs, and identify the gaps then create alignment to form a system of care. Supportive housing at a scale sufficient to meet the housing needs of the most vulnerable is the centerpiece of a community strategy to end chronic homelessness.

The key supporting strategies are integrating primary and behavioral health care services and increasing access to mainstream programs. We also need to stop the flow from publicly supported institutions that discharge to homelessness – hospitals, jails, and prisons. The final key ingredient is leadership.

For those with serious mental illness, chronic addiction, and traumatic brain injury, integration of primary and behavioral health care not only gets better results, it is also a promising practice to reduce overall health care costs. When you think about the people you work with who have multiple health conditions, say schizophrenia and diabetes or depression and heart disease, you just cannot deal with one without knowing something about what’s going on with the other.When we hosted a group of people doing integrated care in Baltimore with the Center for Medicaid back in the fall of 2010, one of the providers said it best, “We started doing this because our clients led us there.”
 
We know that when care is practiced in silos, people with mental illness do not get preventive health care, they do not get good care for chronic medical conditions, and they do not get good dental care. As a result, people with mental illness will die 25 years earlier than others, largely from medical conditions that went untreated.

Helping supportive housing tenants to access disability benefits whether through the VA, Social Security Administration, or state programs will increase their economic security and housing stability. Adoption of SOAR practices has been shown to expedite and increase to SSI/SSDI and other benefits.

One of the most important mainstream programs that chronically homeless people need to access is Medicaid. The Affordable Care Act provides tremendous lift to our work in ending chronic homelessness through vehicles such as Medicaid expansion and Health Homes.  Right here, the state of Louisiana is building permanent supportive housing into its behavioral health managed care contract. We are cheering for your success. Other great efforts are happening in New York, Illinois, Minnesota, Connecticut, and Los Angeles.

To take this to scale, States will need to re-design their Medicaid plans to pay for some services that are part of the Housing First approach - AND - supportive housing providers  will need to  either partner with organizations that can provide Medicaid eligible services or transform their agency to become a provider of Medicaid eligible services.

To stem the flow of individuals from jails and prisons into homeless services systems, public institutions working alongside community based and mainstream organizations need to align efforts to provide housing stabilization and supports to men and women who are re-entering the community. 

In order to improve chances of keeping the most vulnerable individual from experiencing homelessness, permanent supportive or affordable housing along with the right mix of services is believed to be the best response for those with prior histories of homelessness.  While resources are scarce, we need to be as creative as ever and use these precious resources wisely while balancing with the housing needs of those already homelessness on the streets or in shelters.

The final key ingredient is Leadership. Change is difficult.  Breaking down the silos and working collaboratively requires commitment. Interdisciplinary, interagency, and intergovernmental action is required to effectively create comprehensive responses to the complex problem of homelessness.  We have seen this type of transformation in HUD-VASH as a result of the leadership by VA Secretary Eric Shinseki and HUD Secretary Shaun Donovan.  

As the business experts would note, this is an adaptive, not a technical problem. So participatory leadership is required.

• We need to build broad support for Housing First in every community, organize a community response, and then hold each other accountable for achieving the results. 
• It will take leadership to be sure that permanent supportive housing is truly targeted to those who are most vulnerable, most in need of it.
• It takes leadership to address NIMBY and build allies rather than opponents. It takes collaborative leadership to prioritize and align resources.

So back to our primary solution – Housing First permanent supportive housing. If it’s a proven and cost effective solution, then why aren’t we at scale? 

First there are considerable challenges in assembling the financing and funding sufficient to make your projects work. Expertise in everything from Low Income Housing Tax Credits to the Federal Home Loan Bank to Housing Choice Voucher to Medicaid is required to bring together the resources for development, operations, and services.

As if the financing weren’t complex enough the rest is equally challenging.  Here’s my running list of clinical practices that are useful to know: ACT team, Critical Time Intervention, Harm reduction, IDDT, Motivational interviewing, Peer support, SOAR, and Trauma informed care. 

And to make a Housing First program work you’ve got to ensure all these service needs are met:  Outreach and engagement, case management, care coordination – health care access, housing retention, benefits acquisition, financial management/payee services, treatment, family reunification, employment and vocational services.

To be successful you need to cultivate myriad relationships from the CoC and other homeless providers to Public Housing Agencies, VA, community mental health centers, Federally Qualified Health Centers to name a few. 

And then you also need to pay attention to community building within program and into the community, manage data collection and evaluation, be effective in public advocacy and education, of course be exceptional in administration…from compliance to staff training to accounting. And too often you have to deal with NIMBY and those who don’t believe in harm reduction and housing first.

Super powers are needed just to understand every acronym let alone to master everything you need to pull off a successful project. You are my super heroes for taking on this challenge. I want to applaud each of you in this room for stepping up and into this great mission.

Given the immense complexities of this work, it’s really no wonder that we sometimes get lost among the trees and can’t tell the story of how we end chronic homelessness in ways the ordinary person can understand. To create the political will this movement needs, we must be able to convince the American public that it’s possible to end chronic homelessness. We cannot only afford to end it but that we can’t afford not to.

Home for Good in Los Angeles has just created a PSA to break it down in a clear and compelling story.

Let's take a moment to watch it:

Our window of opportunity is now. We all need to be aligned and pushing harder. Harder than we thought when we all signed up for this. We won’t be able to achieve these goals without you.

On behalf of President Obama and Council Chair, HHS Secretary Kathleen Sebelius, thank you for all of the hard work you do and for being our partner in this mission.

Los Angeles, California

Two years ago, I stood here and shared with you a few thoughts on where we were headed with the first ever federal strategic plan to prevent and end homelessness.

With your help, we launched Opening Doors at the White House with Cabinet Secretaries, the head of the Domestic Policy Council, and Members of Congress. In big bright lights the federal government committed to preventing and ending family, youth, and children homelessness by 2020.

Opening Doors has stimulated unprecedented collaboration across federal agencies. We’ve seen the adoption of best practices by federal agencies and continued progress in communities across the nation.

I’m especially proud that ending homelessness remains a priority for the Administration -   five Cabinet Secretaries are engaged - including for the first time an Education Secretary thanks to Secretary Arne Duncan.

We have also had some bi-partisan Congressional support, which is certainly a result of the tremendous efforts of many of you in this audience.

The Recovery Act has helped save over 1.2 million people from homelessness through your work to implement HPRP. This is a tremendous feat.

In the midst of the worst economic downturn since the Great Depression, we saw a drop in Veterans experiencing homelessness by nearly 12 percent and we’ve seen an overall 2.1 percent decline among all populations.

And just this past week, the unemployment rate dropped to 8.3% and on Friday the President announced a new Veterans Job Corps initiative. The Administration’s new veteran employment initiatives, coupled with the work that President Obama has already accomplished in creating employment opportunities for veterans, will put tens of thousands of veterans back to work.

Earlier this week, we heard the exciting news that the President has again requested one billion dollars to fund the National Housing Trust Fund in Fiscal Year 13. 

Despite this progress, there is still so much more work ahead of us.

When it comes to family homelessness, the solutions are known. We need to focus on prevention and rapid re-housing. This includes optimizing access to affordable housing not spending scarce resources on long shelter and transitional housing stays.

HEARTH implementation is absolutely vital. One of the core elements that is critical for families is a coordinated community system that focuses on prevention and diversion, with shelter admission as a last resort. Across the nation, quicker exits from shelter and transitional programs into permanent housing need to become the norm.

Local communities must accommodate all types of families – two parent, LGBT parents, families with teenagers, multi-generational families. It is unacceptable for any child, youth, or parent to be left on our streets. 

Since 2009, we’ve learned a tremendous amount from HPRP. Strategic prevention works.  More importantly communities that focused their HPRP dollars on rapid rehousing clearly achieved a much more significant impact - getting families out of shelter as quickly as possible. Going forward, we need a laser-like focus on this. Expensive, intensive, interventions for families need to be reserved and available to those who need it most. 

I promise, you are not the only ones who are worried about HPRP coming to an end. Communities will need to become more creative by utilizing federal funding through HUD’s re-designed Emergency Solutions Grant and VA’s new Supportive Services for Veterans Families program.

When it comes to youth, we can all agree that we need a better understanding of the size and scope of the need. Of even greater importance is that we need a better understanding about what works and what doesn’t for the sub-populations among youth experiencing homelessness.

This isn’t an excuse for inaction -- too many homeless youth – in nearly every community - are not well served.

USICH’s Deputy Director Jennifer Ho and I are working together to create momentum on this issue. We so appreciate those of you in this room that have been resources to help us better understand needs, barriers, and solutions. Thanks for speaking up.

Just this past December, the Council meeting focused on youth homelessness for the first time. The Cabinet Secretaries told us loud and clear - they want action.

We are now facilitating an unprecedented dialogue among agencies to determine the most strategic actions we can take right now. Your insights and input are encouraged and welcomed.

Reflecting back on where we were two years ago, I am proud of the work we all have accomplished together.  But there is so much more that needs to be done. We need your continued creativity, energy, and focus now more than ever.

I have three requests.

One, we need your help to secure resources. Not just in Washington, but at the state and local levels as well. How can we work together to make the case that we need more affordable housing? More resources for youth?

Second, promote best practices and help with implementation of Opening Doors in the field. Commit to doing what works. That’s what Opening Doors is all about. We must better target resources to provide the right intervention at the right time to the youth or family at risk of or experiencing homelessness.

Third, sign on to our call to action – known as Opening Doors Across America.   This campaign will demonstrate that across the country there is commitment to achieving the vision of ending homelessness for families, youth, children, those experiencing chronic homeless and Veterans. Opening Doors lays out the road map and makes the case for the resources that are needed to achieve the vision.

To sign on, we ask you to demonstrate four commitments.

1. Align your community or state plan with Opening Doors.
2. Commit to incremental targets and measure your progress toward the goals of Opening Doors.
3. Act strategically: collaborate, invest, and act on strategies that are proven to make an impact.
4. Partner with us. Keep lines of communication open with public officials at all levels to share what you are doing and learning.

Can I see a show of hands from folks who like Connecticut, Kentucky, Philadelphia, Seattle, Fresno, and Lancaster County, Pennsylvania have signed on to or are working to sign on to Opening Doors Across America?

Thank you for your support and leadership.

At your urging, the Obama administration set out a bold vision two years ago – end Veterans and chronic homelessness by 2015 and end family, youth, and child homelessness by 2020. The window of opportunity is now. We all need to be aligned and pushing harder. Harder than we thought when we all signed up for this. We won’t be able to achieve these goals without you.

On behalf of President Obama and Council Chair, HHS Secretary Kathleen Sebelius, thank you for all of the hard work you do, day after day to make this country a better place for all of us.

Hearing on "H.R.32, the Homeless Children and Youth Act of 2011: Proposals to Promote Economic Independence for Homeless Children and Youth."

Washington, DC

Good morning. Chairman Biggert, Ranking Member Gutierrez, and Members of the Subcommittee, thank you for the opportunity to testify about the impact of homelessness on children and youth.

I want to thank Chairman Biggert for her leadership on the passage of the HEARTH Act. Today we are here to discuss three requirements in that Act: a change in HUD’s homeless definition, a GAO study of federal definitions, and the development of a federal plan. I am pleased to report that we have made progress on all three. HUD’s new definition reflects the agreement that was reached in the HEARTH Act. And we have followed up on the GAO study to advance federal work on a common vocabulary. And as you know, we have the first ever federal strategic plan to prevent and end homelessness.

It is horrifying in a nation as wealthy as ours that nearly one million school children experience homelessness. The testimony we have just heard underscores this tragedy.

As Deputy Assistant Secretary Mark Johnston has noted, the latest HUD data shows that nearly 240,000 family members experienced homelessness on a single night in January 2011.
While the 2011 Point-in-Time count was less than the 2010 count, other trends are not positive.  There is a significant mismatch between income and housing. More families are experiencing foreclosure. The shrinking affordable housing stock, falling household incomes, and increased competition from higher-income renters have widened the gap between the number of low-income renters and the number of affordable units.

The needs of families, youth, and children vary, and often require not only housing and employment, but also attention to education, health care and other needs. These operate out of different silos at a local level, often managed by different jurisdictions. Instead of a tailored and holistic response, families and youth confront a highly fragmented, uncoordinated set of services that they are usually left to navigate on their own.

Not only is this tragic for homeless families, there is a growing body of evidence that repeated housing instability is costly to public systems.

The good news is there are solutions. Investing in more housing assistance now can save money over the long term for schools, child welfare, the health care system, and other public institutions.

In June 2010, the Obama administration acted. For the first time, the federal government set a goal to end family, youth, and child homelessness by 2020. Opening Doors is based on a growing body of evidence that shows how targeted comprehensive solutions are more cost effective than temporary fixes. 

Affordable housing is the cornerstone of any effort to reduce and ultimately end homelessness. The preservation and expansion of affordable housing through rehabilitation, new construction, and rental assistance is critical to ending family homelessness.

Unfortunately, the trend lines for affordable housing are going in the wrong direction. Too many Americans cannot afford a safe place to call home. Despite the growing need, housing assistance programs are threatened at all levels of government in the current budget environment.

Next to more affordable housing, prevention is also critical.  Targeted interventions that keep families from losing a home in the first place spare children the trauma of homelessness, absences from class or changes in schools. The key drivers are access to affordable housing, financial assistance and support during a crisis.

Another proven solution is rapid re-housing. Short-term assistance helps families quickly move out of homelessness and into permanent housing. HPRP made an enormous impact around the country and helped many communities shift to cost-effective programs focusing on prevention and rapid re-housing.     

Housing stability over the long term requires the right types of supports provided in a highly coordinated way. These include good health care, education, transportation, childcare, and a job that pays enough to meet household needs.

Federal collaboration is moving from silos to solutions that connect these systems to prevent homelessness whenever possible and when it does happen, to resolve it as quickly as possible. That is work we are doing across federal agencies. So too this needs to occur in every state and community across the nation.

What gets measured gets done. This Administration has improved data collection, analysis, and reporting. Agencies within HHS and the VA are coordinating with HUD on these efforts.

Our nation has faced economic uncertainties during the first 18 months of Opening Doors’ implementation, but one thing remains clear: homelessness is an urgent problem – not only is it devastating to families and individuals who experience it, but it is very costly to society as a whole.

Republicans and Democrats in Congress and across the country have collaborated for decades to fight homelessness. Family, youth, and child homelessness is an outrage that should know no partisan boundaries and is an area where we can make a real difference - together. We need to invest in what works. We need to invest in our future our children.

Let us work together to ensure that by 2020 not a single American child or youth experiences homelessness. Thank you again for this opportunity to testify. I look forward to your questions.

Read Barbara Poppe's written testimony

Washington, DC - Department of Housing and Urban Development

Thank you, Ellen for your generous introduction. And more importantly, thank you for your leadership and the great work that you and the National Center on Family Homelessness do for children and families across the nation. I’ve admired your work for years and wish you all the best as the Center transitions to new leadership – you’ll be a very tough act to follow.

It is wonderful to be here with all of you today to kick off the National Homeless Awareness Month. Let me also thank our friends at HUD for hosting this important briefing, as well as for the tremendous year round leadership in this work.

As Labor Secretary and Council Chair Solis has pointed out at the last Council meeting, we have accomplished a lot together, but as you all know too well there is so much more we need to do. With the support and input of many you, we launched Opening Doors, the first ever federal strategic plan to prevent and end homelessness last year.

Could I see a show of hands of those who have had a chance to read and use this Plan? Thank you! You join over 300,000 others who have downloaded the plan.

Opening Doors has four bold goals:

• First, we will finish the job of ending chronic homelessness by 2015.
• Second, we will prevent and end homelessness for America’s Veterans and their families by 2015.
• Third, we will prevent and end homelessness for families, youth, and children by 2020.
• Fourth and finally, Opening Doors sets a path of ending all types of homelessness.

Opening Doors is a very comprehensive plan that outlines 10 objectives and 52 strategies.

The bold and measurable goals in Opening Doors are meant to prompt strategic efforts at the federal, state, and local levels to work collaboratively to prevent and end homelessness. There is widespread agreement that only by prioritizing and aligning resources – both mainstream and targeted - can we make progress on our goals. We can’t afford “business as usual” in today’s tight economy.  Only the most effective and cost-efficient policies and practices must be utilized.

Over the last 17 months, there has been unprecedented collaboration among federal agencies—with one another, and with state and local governments and nonprofits. We are laying the groundwork for future successes through better collaboration, better data collection, better use of mainstream resources, and engaging states and local communities in the plan’s goals and strategies. Increased investment in federal programs that target homeless persons and are successful at reducing homelessness, has been a priority as well.

In the 2009-10 school year, public schools reported nearly 940,000 homeless students were enrolled. What a national disgrace to have children and youth counted among those who experience homelessness. That’s one reason for the bold decision the Council made last year to tackle family homelessness head on.

The goal to prevent and end homelessness for families, youth, and children by 2020 commits our Administration to do all we can to reverse the growing trend of family and child homelessness in partnership with Congress, States, tribes, counties, cities, philanthropy, the business sector and non-profits.

So you may be wondering how we plan to tackle this. We think there are four keys:

1. Housing
2. Jobs
3. Mainstream services – health, human services, income supports, and education
4. Coordinated local response and better collaboration

As I noted earlier, we can’t afford “business as usual” in today’s tight economy, we must ensure that only the most effective and cost-efficient policies and practices are utilized.

Access to affordable housing is especially vital for families.  Unfortunately the trend lines are going in all the wrong directions. Too many Americans cannot afford a safe place to call home.

• More than 8 million renters pay more than half of their income yet are extremely low income.
• There has been a 13% increase in extremely low income renter households over the last decade, while the number of units affordable to this population decreased by 14%.

Fortunately, public housing agencies have stepped up their efforts to prioritize and target public housing and all types of housing vouchers to homeless families. Secretary Donovan and Assistant Secretary Sandra Henriquez have been clear that these partnerships will be important today and over the next decade as we work to end homelessness among families.

As Assistant Secretary Marquez highlighted, both mainstream CPD programs, like HOME and targeted resources through HOPWA and the Continuum of Care, can be leveraged to ensure housing solutions.  HPRP made an enormous impact around the country and helped many communities make the important shift to more cost-effective programs focusing on prevention and rapid re-housing.

We know the best defense against homelessness for a family, is a job that pays enough to cover the basics – including the cost of housing. With continuing high levels of unemployment, a good job remains elusive for too many Americans. President Obama’s push for Congressional passage of the American Jobs Act would prevent 6 million Americans looking for work from losing their benefits. The American Jobs Act would also support programs that build real skills, connect to real jobs, and help the long-term unemployed.

Specific to our work, the proposed legislation would create a new Pathways Back to Work Fund that would, among other things, build on the success of the Temporary Assistance for Needy Families Emergency Contingency Fund (TANF/ECF) by supporting subsidized employment opportunities for unemployed low-income individuals. But as President Obama has said, families and children don’t have the luxury of waiting for Congress to act. Your voices matter in this debate and we need Congress to move on this immediately.

To further family stability, mainstream programs will need to be aligned at the local level to support families through better collaboration and greater accountability for housing stability.  What we can’t have is an ever-expanding homeless system that becomes responsible for everything a family needs from early childhood education, education generally, employment, to all types of health and human services.

Secretary Sebelius and her team at HHS have been working to expand access to health insurance and health care through the Affordable Care Act. Already, provisions are in places that allow young adults to stay on their families’ health insurance and prevent screening out of children with high medical needs. Future provisions that create more affordable health insurance options for families will decrease the chances that an unexpected health event will lead to job loss or foreclosure, driving a family into homelessness. There will be new tools available to help families with the most complex health problems and related challenges get access to more holistic care and support through Health Homes and Accountable Care Organizations. We need the experts in working with families most vulnerable to homelessness to partner with local health care policy makers and systems to ensure that the needs of families experiencing homelessness are taken into account in local implementation of the Affordable Care Act.

We are also very excited about Secretary Arne Duncan’s team at the Department of Education. They are working to bring all programs within the agency around the table to identify ways in which all the programs within Education might contribute to accomplishing the goals in the plan. More work will be needed over the next year to get more local school systems on board and working with local Continuum of Care and local plans to end homelessness. We also expect that these local plans will consider ways to keep children in their same school without requiring long bus rides. One emerging solution is to re-purpose emergency shelter and transitional housing to prevention, rapid re-housing, and transition in place models.

As Secretary Donovan has highlighted in speeches across the country, for the past two years, HPRP made an enormous impact and helped many communities make the important shift to more cost-effective programs focusing on prevention and rapid re-housing.

As HEARTH Act implementation begins with the new Emergency Solutions Grant, communities will be able to adapt the lessons learned about prevention and rapid re-housing as they work to re-tool their Continuum of Care system. One promising practice is to shift transitional housing to target those most in need. Another is re-purposing scattered site transitional housing to transition-in-place models that provide greater stability for children and their parents and can reduce school mobility. Helping kids stay stable in school can lead to improved academic achievements – a long term return on investment.

As has been demonstrated in Massachusetts, in the Midwest in Columbus and Minneapolis and the West Coast in Seattle – by bringing all mainstream programs to the table with the homeless system, the sum of collaborative work is far greater than the parts.

There’s a growing movement for communities to decide that they have the capacity to use available resources to actually solve their own local problems – some in this movement have said “we realized no one was going to come save us so we decided to act together”. 

Over the next year, USICH will continue to work with our key partners at Education, HHS, HUD, and Labor to develop greater details about the strategies – both policy and practice – combined with a focused use of resources that will be required to reach our bold goal of ending family homelessness by 2020. We expect housing, jobs, services, and improved collaboration to be the framework.

I know we are on the right collective path. But each of us in this room is absolutely vital to ensuring we can achieve this.  In the end, it comes down to commitment – not just by the President, the Administration, Congress, Governors, local elected officials – it is up to each of us.  Thank you.

Good afternoon. It is wonderful to be back in Colorado. This is my third visit to the state since taking my position in Washington. I’ve had the chance to see and tour some of the great housing developed in Denver. I’ve met with the Boulder Housing Partners, and also had the chance to meet with former First Lady Jeannie Ritter when she hosted the Colorado Interagency Council on Homelessness last year. I’ve been very impressed by the innovative work happening across the state. Denver, Boulder, and other Colorado communities serve as national models – thank you for your great work.  Yet with all that’s being done, I think you’ll agree that there is still much more for all of us to do.

I would like to congratulate Nancy Engelken and her staff at Housing Colorado for putting together an exceptional conference. Kudos also to Housing Colorado for developing a statewide education campaign to make the economic case for effective affordable housing policy. As everyone will agree, broadening support should generate strong community acceptance and  help avoid and manage NIMBY.  Now more than ever, we need ordinary citizens to value the importance of affordable housing as integral to the fabric of healthy and economically sound communities.

I also want to recognize a few Colorado leaders who have contributed to the national efforts to end homelessness – these include John Parvensky from the Colorado Coalition for the Homeless, Governor Hickenlooper’s point people on homelessness Public Policy Director Jamie van Leeuwen, Randle Loeb and the Peoples’ Leadership Council and Gary Sanford the Director of the Colorado Interagency Council on Homelessness.

Since 1983, I have been involved in the movement to end homelessness – it is my work and my passion.  It is a movement that seeks to ensure that all people have a right to safe and affordable housing.  Too often, this basic human need – the need for a place to call home – is not met.  

I have met thousands of persons – men, women, and children -- who have directly experienced homelessness.  For many, it’s a simple economic situation – they don’t earn enough to pay the rent. For others they have also experienced racism, sexism, classism, and prejudices related to their diseases of AIDS/HIV, domestic violence, mental illness, alcoholism and addiction.  For some they have the further burden of a past criminal record.  Each of them deserves a home.

I have seen first hand the difference that having a place to call home – one that is safe, affordable, however modest, is a foundation for making one’s way in the world. The most gratifying days of my work in Columbus were to talk with men, women, youth, and children who’d moved from the streets and shelters into their own apartment. They always looked visibly better, healthier, and more hopeful. I know that studies back up this obvious and outward sign of health.

I remember bringing a Columbus City Council member to tour a permanent supportive housing community on the day after it opened. I introduced him to Denise – a new tenant with just a few days of sobriety.  We asked her what was the best thing about moving in. She said, “I woke up last night and was hungry. I laid in bed then remembered that I was in my own place and could get up since I wasn’t in a shelter and get something to eat. I made a peanut butter and jelly sandwich at 4 a.m. and I was so happy”. We were struck by the simplicity of her happiness – the ability  to meet her basic needs for food and shelter, and her ability to be in control of her life – not ruled by shelter curfews, kitchen hours, and other regulations. I keep a photo of Denise, the council member, her case manager and me on my desk to remind me that housing is the best solution to homelessness and that it matters to real people.

It is their faces, their courage, and their struggles that inspire me to continue as their advocate. And that was what brought me to my current role as executive director of the United States Interagency Council on Homelessness.

The mission of the Council is to coordinate the Federal response to homelessness and to create a national partnership at every level of government and with the private sector to reduce and end homelessness in the nation while maximizing the effectiveness of the Federal Government in contributing to the end of homelessness.  Department of Labor Secretary Hilda Solis is the current chair of the Council, which also includes 18 other Federal agencies.
 
Before starting my position in Washington, DC, I worked in Columbus, Ohio as executive director of the Community Shelter Board, a public-private nonprofit committed to ending homelessness. Learning from our peers across the country, including Denver, we developed local practices to divert families from shelter to community services thus avoiding homelessness altogether as well as creating alternatives to shelter through quick placement in their own apartments and providing transitional services to stabilize them in their new homes. 

We also pioneered development of permanent supportive housing as a solution to long term homelessness. Using Housing First practices we were able to take men and women directly from the streets into their own apartments without requiring periods of sustained treatment as a pre requisite to housing. We were able to document what was working because we used community wide data to track progress and modify our approaches as needed.

The foundation of our work was the creation of a community strategic plan – Rebuilding Lives that was launched in 1997.  We collaborated across all sectors – nonprofit, business, government, faith, advocates and community around what we call the “moral foundation”.  We believed that “homelessness was unacceptable in our community, even for one night”.

Today, I will discuss the progress we have made in ending homelessness over the last decade, I’ll touch on Opening Doors, the first ever federal comprehensive plan to prevent and end homelessness and discuss how the State of Colorado and many of you here today  can become more engaged and align your efforts to build upon best practices.

Homelessness and Progress over the Last Decade

Homelessness is a complex and complicated issue. On any single night in our country, there are approximately 650,000 individuals, 15,000 here in Colorado, without safe and stable housing.  One in 500 Americans and one in 67 Americans living below the poverty line is in a shelter or on the street every night. More than one third are persons in families.

Over 76,000 are our nation’s veterans. Nearly 13,000 of our young service members returning from Afghanistan and  Iraq lived on the streets or in homeless shelters last year. And more Vietnam-era veterans are homeless today than troops who died during the war itself. That is a national shame. Yet, over the last few years with bipartisan support we have made progress mainly through a new program called HUD-VASH. Since 2008, Colorado has received 715 VASH vouchers for its Veterans and has one of the highest lease-up rates in the nation.

Over the past decade, communities across the nation have made remarkable progress in reducing chronic or long-term homelessness. Yet, chronic homelessness annually affects over 110,000 adults and families.  Individuals are considered chronically homeless if they have a disabling condition and are either homeless continuously for one year or more or have experienced four or more bouts of homelessness in the last three years. Six out of 10 chronically homeless adults are living on the street, and most suffer from acute and debilitating health problems exacerbated without a roof over their head.
Chronic homelessness incurs high costs for individuals and society as these individuals are frequent users of public services. Health care expenses are the most common costs due to frequent and avoidable inpatient hospitalizations, emergency room visits, sobering centers, and nursing homes. Other high costs are associated with the criminal justice system. Consequently, chronic homelessness can cause a major strain on local community budgets.

The leading solution to ending chronic homelessness is and has been the development of permanent supportive housing - affordable rental housing coupled with supportive services that target the specific needs of an individual or family.

Across the country, the number of chronically ill, long-term homeless individuals has been reduced by over one-third in the last six years due to the increase in the number of permanent supportive housing units targeted to this population and using a Housing First approach. In addition, collaboration between all sectors has driven this success:  the banking and lending sector specifically play a pivotal role in developing and financing these units to help end chronic homelessness.

Here in Colorado, you have discovered that strategic partnerships shaped by community strategic plans that promote efficient outcomes have yielded positive results. Such communities include Denver, Boulder County, Fort Collins, Colorado Springs, and Longmont. These strategic partnerships need representation from all key stakeholders involved, those include public housing authorities, county/city governments, housing developers, finance institutions, as well as nonprofit and advocacy organizations.

Opening Doors

So now, let me tell you what the Obama administration has done about homelessness. Soon after the inauguration, President Obama and HUD Secretary Shaun Donovan took decisive action through the Recovery Act by investing $1.5 billion in the Homelessness Prevention and Rapid Re-Housing Program, otherwise known as HPRP. Last month, I joined Secretary Donovan to celebrate the milestone that the Recovery Act has helped save one million people from homelessness. That's one million people who won't be forced to sleep on our nation's streets, in their cars or doubled up at a relative's house.

Then in June of last year, with the help of stakeholders from across the United States, including some of you in the audience, we launched Opening Doors at a White House event headlined by four cabinet secretaries – HUD Secretary Shaun Donovan, Labor Secretary Solis, HHS Secretary Kathleen Sebelius, and VA Secretary Eric Shinseki, as well the head of the Domestic Policy Council Melody Barnes. 
Could I see a show of hands of those who have had a chance to read this Plan?  Thank you! You join over 300,000 others who have downloaded the plan on our website.

Opening Doors is based on the vision that no one should experience homelessness. No one should be without a safe, stable place to call home. This vision was articulated by President Obama when he stated that “it is simply unacceptable for individuals, children, families and our nation’s Veterans to be faced with homelessness in this country.”

Opening Doors represents a dramatic shift in our approach.  Opening Doors is based on the idea that solving homelessness requires that people access MAINSTREAM resources effectively and sufficiently to meet their needs and avoid homelessness. Mainstream programs are designed for people regardless of their housing status, programs like Medicaid, Social Security, food assistance programs, employment, and education.

Opening Doors has four bold goals:

• First, we will finish the job of ending chronic homelessness by 2015.
• Second, as Department of Veterans Affairs Secretary Eric Shinseki has championed, we will prevent and end homelessness for America’s Veterans and their families by 2015.
• Third, we will prevent and end homelessness for families, youth, and children by 2020.
• Fourth and finally, Opening Doors sets a path of ending all types of homelessness.

Opening Doors outlines 10 objectives and 52 strategies. As I learned in Ohio and have seen in everywhere I’ve visited, there is not a “one-size-fits all” plan. We are considering regional opportunities and challenges when acting with our community partners at local and state levels. I understand Colorado has unique challenges with rural, resort, suburban, and metro community needs and opportunities.

Despite the economic challenges, progress in implementing strategic plans – at the local level, in states, and here in the federal government— has occurred across the United States. While it is too soon to tell the full impact of Opening Doors, evidence is emerging that local and state efforts supported by federal resources operating in partnership with the private and nonprofit sectors, have made a significant difference.  There is widespread agreement that by dedicating resources and focusing on implementing the Plan, we will reduce and ultimately end homelessness in America.

Over the last 16 months, there has been unprecedented collaboration among federal agencies—with one another, and with state and local governments and nonprofits—in our efforts to implement the plan. The federal government is laying the groundwork for future successes through better collaboration, better data collection, better use of mainstream resources, and engaging states and local communities in the plan’s goals and strategies.

The bold and measurable goals in Opening Doors are meant to prompt efforts to prevent and end homelessness. For the first time, the federal government is measuring progress against clear numerical targets.

Importance of Housing

Now that you have heard what we have been up to in Washington, many of you might wonder where you fit in with all of this. Let me first address the underlying reason for the growth in homelessness. Too many Americans cannot afford a safe place to call home. More than 8 million renters pay more than half of their income yet are extremely low income. There has been a 13 percent increase in extremely low income renter households over the last decade, while the number of units affordable to this population decreased by 14 percent.

With wages going down and the cost of housing going up, low income earners are in a dire situation than the rest of the populous. The shares of extremely low income and very low income renters who are paying over 30 percent of their income on housing costs, living in substandard housing, or living in an overcrowded unit are higher nationally and in nearly every state now than they were in 2000.
Not only is homelessness a tragic and troubling issue, it is expensive. The cost of homelessness - not only in the dollars we spend as taxpayers, but also in the terrible price individuals and families experiencing homelessness pay when we spend those dollars in a disjointed, fragmented way.

For many persons living in poverty, the lack of stable housing leads to costly cycling through crisis and institutional care. In addition, health care costs are the leading cause of personal bankruptcies - with almost half of all foreclosures caused in part by financial issues stemming from medical costs. We are seeing families falling into homelessness whose incomes have plummeted as a result of the recession - through foreclosures, evictions, layoffs, or health care costs. For most people, the threat of homelessness stems from the gap between their current income and the cost of housing. People are extremely poor at the time they become homeless. More affordable housing is needed for people with extremely low incomes who are most at risk of homelessness.

Housing needs to be affordable to those households with the lowest incomes who are most at risk of homelessness. The households most vulnerable to homelessness are those from no income up to 30 percent of Area Median Income. As you know, housing is affordable if the cost is no more than 30 percent of the monthly household income.

Opening Doors lays out a number of strategies for us to combat this growing need for affordable housing.

We need additional rental housing subsidies through federal, state, local, and private resources to individuals and families experiencing or most at risk of homelessness. The rent subsidies should be structured so that households pay no more than 30 percent of their income for housing.

We need to expand the supply of affordable rental homes where they are most needed. In order to do this, we are urging state and local governments to focus rental assistance and low-cost capital for new construction and rehabilitation of housing for individuals and families experiencing or most at risk of homelessness. We are encouraging State Housing Finance Agencies to give preference in the awarding of Low Income Housing Tax Credits to increase investments for housing targeted to people experiencing or most at risk of homelessness. And for Public Housing Agencies, you can make project-based vouchers available to housing developers who target projects to extremely low income households.

Another tool in our arsenal is rapid re-housing. The solution uses short-term strategies to help families quickly move out of homelessness and into permanent housing. These may include providing supportive services to help a household quickly secure housing, providing short-term financial and rental assistance, and addressing barriers to long-term housing stability.

As I mentioned earlier, HPRP provided communities a significant infusion of dollars to implement this solution. Now that the HPRP dollars are drying up, we are asking communities to become creative with their crisis response systems and to utilize federal funding streams through the Emergency Solutions Grant from HUD and the Supportive Services for Veterans Families program from the VA.

For some who experience homelessness, their needs are greater than can be met through rapid re-housing and affordable housing strategies.

To solve chronic homelessness, we see permanent supportive housing as the solution. It is a type of specialized affordable rental housing where rents are always subsidized to ensure affordability for tenants who typically will have extremely low incomes. It is reserved only for households with significant disabling conditions who require integrated supportive services to maintain housing stability. While many families and single households might benefit from supportive housing, in these tight economic times, we need to target this precious resource only to households that have experienced chronic homelessness or are at high risk of becoming chronically homeless.

Here in Colorado, we have seen a 13 percent increase in permanent supportive housing over just the last three years. This is a great start and I know more is in the pipeline.

Supportive housing can be provided through three primary strategies: 1) pairing a rental subsidy with dedicated services; 2) building new or rehabilitated units at a single site and providing a rental subsidy and on-site services; or 3) set-aside units within an affordable housing community and providing a rental subsidy with on-site supportive services. Supportive housing is most cost-effective when it is targeted to people with the most extensive needs, including individuals with mental illness, chemical dependency, HIV/AIDS, and other co-occurring conditions that incur high costs in the public sector. 

The most effective type of supportive housing utilizes the Housing First model which seeks to “screen in” rather than “screen out” individuals with substance abuse and mental illness that may not be eligible to receive housing assistance in other programs. These models move hard to house individuals into permanent housing quickly and can then provide intensive supportive services to help these individuals achieve and maintain housing stability.

Evaluations of Housing First permanent supportive housing have demonstrated significant improvements in housing stability and reductions in days of homelessness. And when it comes to cost-effectiveness there is no better strategy for the ever tightening state and local social services budget. The reductions in the utilization and costs of public services from emergency shelter, hospital emergency room and inpatient care, sobering centers, and jails are substantial.

For instance, a study in Denver showed that an overall reduction in emergency service costs for chronically homeless individuals with disabilities. The total emergency related costs for the sample group declined by 73 percent, or nearly $600,000 in the 24 months of participation in the Denver Housing First Collaborative program compared with the 24 months prior to entry in the program. The total emergency cost savings averaged $31,545 per participant. 

In addition to saving taxpayers money, the local and national evaluations of the program documented overall improvement in the health status and residential stability of program participants. For these persons who averaged nearly 8 years of homelessness each prior to entering the program, 77 percent of those entering the program continued to be housed in the program when the study concluded. Here are a few more interesting facts:

• Fifty percent of participants had documented improvements in their health status
• 43 percent had improved mental health status
• 15 percent had decreased their substance use
• And 64 percent had improved their overall quality of life. 
• Furthermore, the overall quality of life for the community improved as the negative impacts of individuals living and sleeping on the streets were reduced.

Taking Action

So now that I’ve laid out the path to ending homelessness, I’ve come here today to ask Colorado if you’ll be the first state to end homelessness. (Utah and Rhode Island both believe they will be the first).
Across the United States, we are calling on states and communities to join us in implementing Opening Doors.  Last month, USICH announced Opening Doors Across America. We are asking you to join us by doing four things.

I’m encouraging the implementation of local plans and a state plan to align with Opening Doors.  Governor Hickenlooper is a national leader on ending homelessness due to his tremendous commitment while he was the mayor of Denver. I understand that his administration is working to develop the first Colorado strategic plan to prevent and end homelessness that builds upon the local and regional needs within Colorado. We hope that the results will be a Colorado plan that aligns with the goals of Opening Doors. He needs your help to make ending homelessness a reality in Colorado. Can you work to get your local plans aligned too?

Second, commit to incremental targets, measure your progress toward the goals, and implement strategies that will enable you to achieve these goals. What gets measured gets done.   Can you get your community to commit to measuring your progress?

Third, we need a sense of urgency.  In this tight budget environment, community-wide and cross-government strategic planning is a pivotal step in ending homelessness.  When the plans are well-crafted and implemented there are better results -- decreases in homelessness and cost savings.  Now is the time to collaborate, invest, and act on strategies that are proven to make an impact.  Can you help keep homelessness as an urgent issue that can be solved?

So here’s some things you might want to move on across Colorado:

• Develop affordable housing targeted to the lowest income households those who earn at or below 15% of Area Media Income.
• Implement Housing First and Rapid Re-Housing practices broadly across all homeless programs
• Use Emergency Solutions Grants and Continuum of Care resources to provide Rapid Re-Housing
• Continue to build a pipeline of  Housing First Permanent supportive housing targeted to chronically homeless individuals and families
• Collaborate with Public Housing Agencies to identify how families and individuals who are homeless can be prioritized for housing.
• Get healthcare and human service providers engaged as allies and partners in your work. Get smart on Medicaid. It is truly a game changer. By 2014, Medicaid will cover all households with incomes up to 133 percent of the federal poverty level.
• For instance, the National Church Residences- a national non profit housing development organization - recently hired a Medical Director to meet the needs of seniors, people experiencing homelessness, and people with special needs. They also hired the position to create a business model that accesses Medicaid.
• Work collaboratively and build relationships to streamline resources and efforts: involve health and human services, housing agencies, VA, education, corrections, law enforcement and the private sector, including business, philanthropy, faith-based and community organizations. Invest state, local, and philanthropic dollars toward strategies aligned with the strategic plan.

And the last part of this call to action is that while you implement strategic plans, keep lines of communication open with public officials at all levels to share what you are doing and learning.   Participate in USICH-sponsored discussions with us. Share solutions and let us know when federal policies are working and when these policies can be improved. We need you to partner with us.  We need all hands on deck to complete the job of ending homelessness.

I want to see Colorado sign on to this initiative and I have faith that you will help us achieve these bold goals we have set out.

While I have the bully pulpit, I have a few more asks of those of you in the audience that will allow Colorado to succeed:

• Housing Colorado - could you include ending homelessness and affordable housing at less than 30 percent AMI and permanent supportive housing production as a specific advocacy initiative?
• State leaders - How will you help urban, suburban, and rural communities across Colorado increase housing resources – particularly for homeless youth, families and especially the chronic homeless who are in need of housing with supportive services?
• Housing providers – how can you facilitate peer-to-peer supports ?  How can you be more inclusive of tenants in planning and implementation?
• Everyone - How can you ensure that every Veteran in Colorado has a place to call home? -- One thing you could do this week is to participate in the VA’s outreach and awareness event this Friday. The Denver VA Medical Center’s Homeless Program will announce community partner initiatives around Healthcare, Housing, Education/Career Benefits, Veterans Justice and American Indian Partnerships.   Events like this are happening in many cities across the country to bring awareness and support to ending Veterans homelessness by 2015.  If you can, get to Denver and show your support.

Finally, I want to encourage you to engage in state, regional, and local efforts to align resources and streamline access to services for those at-risk or experiencing homelessness. We need to see local and state investment. You can’t just expect dollars to flow from Washington. 

I know that I’m asking a lot, but with Colorado as a national leader in ending homelessness, it would be great to see Colorado to be the first state to end homelessness.

In the end, it comes down to commitment – not just by the President, the Administration, Congress, Governors, local elected officials – it is up to you.

Your actions matter, your perseverance matters, your quest to be as efficient and effective with the available resources matters. Strong leadership. Effective collaboration across sectors and disciplines. A bold vision and clear goals.  Focus on what works, Solid, transparent data to tell the honest story. Nimbleness to respond to changing needs and opportunities. These keys will serve you well in the months ahead. Join us in implementing Opening Doors.

On behalf of the Obama Administration, thank you for the work you do every day to help people get and stay off the streets. And thank you in advance for the hard work that you will do in the coming years to forge new partnerships and collaborations in order to prevent and end homelessness here in Colorado.

Buenos dias, good morning. It is wonderful to be here and I want to thank Francisco Rodriguez for the invitation to join you all today. First, I would like to recognize the leadership and efforts the Coalicion de Coaliciones have made over the last number of years. Aguadilla is the last stop on my trip to Puerto Rico. I have met with federal government officials from the Departments of Housing and Urban Development and Veterans Affairs, I had a productive dialogue with Secretary Irizarry at the Department of Family, I’ve met with mayors, and have seen some of your homeless service providers. I am very thankful for how gracious and welcoming all of you have been.   In Washington, we are aware of the struggles you face, but we also recognize the progress that has been made here over the last ten years, especially the work you have done to decrease the overall population since 2006. I am here today as your partner to discuss what we are doing on the federal level and to lend a hand as you make progress in your communities. 

Since 1983, I have been involved in the movement to end homelessness – it is my work and my passion.  It is a movement that seeks to ensure that all people have a right to safe and affordable housing.  Too often, this basic human need – the need for a place to call home – is not met.  

I have met thousands of persons – men, women, and children -- who have directly experienced homelessness.  For many, it’s a simple economic situation – they don’t earn enough to pay the rent. For others they have also experienced racism, sexism, classism, and prejudices related to their diseases of AIDS/HIV, domestic violence, mental illness, alcoholism and addiction.  For some they have the further burden of a past criminal record.  Each of them deserves a home.

It is their faces, their courage, and their struggles that inspire me to continue as their advocate. And that was what brought me to my current role as executive director of the United States Interagency Council on Homelessness. The mission of the Council is to coordinate the Federal response to homelessness and to create a national partnership at every level of government and with the private sector to reduce and end homelessness in the nation while maximizing the effectiveness of the Federal Government in contributing to the end of homelessness.  Department of Labor Secretary Hilda Solis is the current chair of the Council, which also includes 18 other Federal agencies.  Over the last 22 months, I have had the opportunity to work with communities across America and I’m delighted to be in Puerto Rico to extend our efforts to open doors across America here on the island.

Before starting my position in Washington, DC, I worked in Columbus, Ohio as executive director of the Community Shelter Board, a public-private nonprofit committed to ending homelessness. Learning from our peers across the country we developed local practices to divert families from shelter to community services thus avoiding homelessness altogether as well as creating alternatives to shelter through quick placement in their own apartments and providing transitional services to stabilize them in their new homes.  We also pioneered development of permanent supportive housing as a solution to long term homelessness. Using Housing First practices we were able to take men and women directly from the streets into their own apartments without requiring periods of sustained treatment as a pre requisite to housing. We were able to document what was working because we used community wide data to track progress and modify our approaches as needed. The foundation of our work was the creation of a community strategic plan – Rebuilding Lives that was launched in 1997.  We collaborated across all sectors – nonprofit, business, government, faith, advocates and community around what we call the “moral foundation”.  We believed that “homelessness was unacceptable in our community, even for one night”.

Although your assets and challenges may be different from Columbus, I am here today because I believe that Puerto Rico can also make even greater progress by using data, adapting best practices, and collaborating across all sectors to achieve your common goal of ending homelessness.

Today, I will provide an overview of Opening Doors, the first ever federal comprehensive plan to prevent and end homelessness and discuss how Puerto Rico can become more engaged and align its efforts to build upon best practices. I will also discuss using performance measures to drive success, and our new exciting initiative that we are launching this week with states and local communities called Opening Doors Across America.

With the help of stakeholders from across the United States, on June 22, 2010 we launched Opening Doors at a White House event headlined by four cabinet secretaries – HUD Secretary Shaun Donovan, Labor Secretary Solis, HHS Secretary Kathleen Sebelius, and VA Secretary Eric Shinseki, as well the head of the Domestic Policy Council Melody Barnes.  Could I see a show of hands of those who have had a chance to read this Plan? -- Thank you! You join over 300,000 others who have downloaded the plan on our website.

Opening Doors is based on the vision that no one should experience homelessness. No one should be without a safe, stable place to call home. This vision was articulated by President Obama when he stated that “it is simply unacceptable for individuals, children, families and our nation’s Veterans to be faced with homelessness in this country.”

Opening Doors represents a dramatic shift in our approach.  Opening Doors is based on the idea that solving homelessness requires that people access MAINSTREAM resources effectively and sufficiently to meet their needs and avoid homelessness. Mainstream programs are designed for people regardless of their housing status, programs like Medicaid, Social Security, Food Assistance Programs and Education.

Historically, the Federal Government’s approach to addressing homelessness was defined by using those programs specifically TARGETED to serving people who alreadyhomeless Opening Doors places PREVENTION at the center and brings ALL human services resources to bear. In our shift to mainstream resources, we are moving to where the dollars are.As important as resources that are specific to homelessness have been to our cause, we need to access these mainstream resources if we are truly going to make progress.

Opening Doors has four bold goals:

First, we will finish the job of ending chronic homelessness by 2015. By greatly increasing the number of permanent supportive housing units, we’ve reduced the number of people experiencing chronic homelessness nationally by one-third in the last five years. Permanent supportive housing rebuilds people’s lives, and is a far wiser investment of scarce public resources than having people continuously go in and out of  emergency rooms, jails, and detox facilities. Here in Puerto Rico, less than one in every six beds in your inventory of homeless programs are permanent supportive housing.

Second, as Department of Veterans Affairs Secretary Eric Shinseki has championed, we will prevent and end homelessness for America’s Veterans and their families by 2015.

Third, we will prevent and end homelessness for families, youth, and children by 2020.

Fourth and finally, Opening Doors sets a path of ending all types of homelessness.

Opening Doors outlines 10 objectives and 52 strategies. As I learned in Ohio and have seen in everywhere I’ve visited, there is not a “one-size-fits all” plan. We are considering regional opportunities and challenges when acting with our community partners at local and state levels.

Four goals. Five areas of focus.

1. Federal leadership and collaboration
2. Housing, housing and housing
3. Increasing income and employment
4. Improving health and stability
5. Re-tooling the homeless crisis response system

Let’s start with leadership and collaboration. Now more than ever, leadership is needed to set out clear goals, timeframes, and strategies.  A fiscally prudent and collaborative response is imperative—local, state, and federal governments cannot afford to invest in anything but the most evidence-based, cost-effective strategies. 

Collaboration, as you well know, is hard work. Sometimes it is easier just to say, “I’ll do it myself.” But collaboration is critical for ending homelessness. Here’s why.

People experiencing or most at risk of homelessness are first and foremost people. They are people in a heightened state of need and the situations that threaten them with homelessness are varied and complex. Their challenges are not neatly divided into discreet problems. Getting a Veteran into a decent paying job is tied to transportation is tied to housing situation, is tied to health.

Here are a few examples of how we have been collaborating back in Washington:

To reduce chronic homelessness, HUD, VA, HHS, and the Social Security Administration are working together to get more permanent supportive housing under development through better use of mainstream resources for health care, services, and benefits.

For Veterans,  HUD and VA have turned VASH around and nearly 30,000 veterans have been housed.

We’re tackling youth homelessness by listening to youth and providers who are in the trenches in the battle to help youth escape homelessness. We have been connecting our federal partners at Departments of Education, Labor, HHS, HUD, Justice, and the Social Security Administration to develop a more unified and strategic approach to federal policy that will enable us to achieve an end to youth homelessness by 2020.

We’re also not losing sight of the needs of families with children. HHS, HUD, and Education have developed an innovative demonstration project that is awaiting Congressional approval. It includes 6,000 supportive housing vouchers through HUD, mainstream services like TANF through HHS, and homeless student identification and service coordination by Education’s homeless liaisons in school systems.
 
This federal interagency collaboration is only one piece of the puzzle. We are asking communities across the country to be active partners -- with one another and with us as we implement Opening Doors. 
This involves interagency collaboration at the federal regional level, state level, and in your local communities. I can’t stress it enough, collaborating at the local level is absolutely vital. This involves bringing all of the key players to the table – Ten Year Plan leaders and State Interagency councils, VA staff, public housing authorities, state and local officials, service providers, the faith based community, philanthropy and housing developers and property managers.

We have a lot of work to do in Puerto Rico and it needs to be an all hands on deck approach so that we can make significant progress towards ending homelessness. For the two Continuums of Care here in Puerto Rico, it is very important for the respective local governments to support them and remain engaged.

So the first theme of the plan is leadership and collaboration. The second is housing, housing, housing.

People who are homeless need homes. Affordable housing. For many persons living in poverty, the lack of stable housing leads to expensive and repeated visits to crisis and institutional care facilities.

Stable housing provides an ideal foundation for the delivery of health care and other social services focused on improving outcomes for individuals and families.

HUD Secretary Shaun Donovan is a tremendous leader on this issue and has been doing all he can to get the federal government back in the business of affordable housing.

Included in this area is the call for more permanent supportive housing for people who need that intensive combination of housing and services to stabilize and succeed. Committing to Housing First practices is important to our success in ending chronic homelessness.

Let me spend a few minutes on the importance of permanent supportive housing and Housing First. It is a proven solution that leads to improvements in health and well-being. AND is cost-effective when it is targeted to people with the most extensive needs.

For people experiencing chronic homelessness, the research is clear that permanent supportive housing using a Housing First approach is the most effective solution.

Housing First supportive housing minimizes barriers to housing access or pre-conditions of housing readiness, sobriety, or engagement in treatment. Participants move directly from the streets and shelters into permanent housing.  Individualized supportive services help residents maintain housing stability and improvements in the quality of their life. These low barrier practices seek to “screen people in” rather than “screen them out” and end homelessness for people with the greatest barriers to housing success.

Evaluations of Housing First permanent supportive housing have demonstrated significant improvements in housing stability and reductions in days of homelessness. And when it comes to cost-effectiveness there is no better strategy for the ever tightening state and local social services budget. The reductions in the utilization and costs of public services from emergency shelter, hospital emergency room and inpatient care, sobering centers, and jails are substantial.

For instance:

In Seattle, Housing First supportive housing was shown to reduce Medicaid costs by 41 percent and reduce sobering center admissions by 87 percent. Average total costs reduced more than 75 percent after one year.

In the federal Collaborative Initiative to Help End Chronic Homelessness – a demonstration program at 11 sites across the country -95 percent of  participants were in independent housing after one year. Average costs for health care and treatment were reduced by about half. The largest decline was associated with costs for inpatient hospital care.

You may be skeptical that this model works.  I know I certainly was after having been a provider of abstinence-based transitional housing using a therapeutic community model.  I was however convinced when I saw the successes that were occurring across the country. 

One of those who convinced me was Sam Tsemberis, the founder of Pathways to Housing. Their model provides housing in apartments scattered throughout a community. This model fosters a sense of home and self-determination, and it helps speed the reintegration of Pathways’ clients into the community. 

Sam challenges skeptics by noting: "Some people think when you give housing away that you’re actually enabling people as opposed to helping them get better. Our experience has been that the offer of housing first, and then treatment, actually has more effective results in reducing addiction and mental health symptoms, than trying to do it the other way. The other way works for some people, but it hasn’t worked for the people who are chronically homeless."

The third area is employment and income.

The best defense against homelessness is a job that pays a good wage. We know that here in Puerto Rico that you have very high unemployment. There is strong competition for available positions, which makes it very difficult for homeless persons to compete for the few jobs available against other low and middle income persons.

Earlier this month, President Obama President Obama unveiled the "American Jobs Act." The President’s plan would help out-of-work Americans and their families by extending unemployment insurance to prevent 6 million Americans looking for work from losing their benefits, while at the same time reforming the system to help support programs that build real skills, connect to real jobs, and help the long-term unemployed.

Specific to our work, the proposed legislation would create a new Pathways Back to Work Fund that would, among other things, build on the success of the Temporary Assistance for Needy Families (TANF) Emergency Contingency Fund (ECF) by supporting subsidized employment opportunities for unemployed low-income individuals.

The fourth theme is health and stability.

Health reform generally, Medicaid expansion in particular, is the secret weapon in the fight against homelessness. Health reform offers new economic security - individuals and families are significantly less likely to be made bankrupt, or enter into a downward economic spiral, when they have affordable health insurance. 

For the first time ever, all poor single adults will become eligible for Medicaid. People with mental illness and substance use disorders, who are disproportionately represented among the chronically homeless, will especially benefit by the improvements that will come with the implementation of parity. No longer can insurance companies exclude treatment of these disorders from the coverage offerings.
The Affordable Care Act will triple Medicaid funding for Puerto Rico in the next decade. The additional Medicaid funding received from the Affordable Care Act will expand the government sponsored health insurance plan coverage to 200,000 more residents in Puerto Rico. This will increase the number of Government Health Insurance Plan beneficiaries to over 1.5 million of a total population of 3.7 million. 
Many of the services for people living in supportive housing are Medicaid eligible, yet only a very small number of supportive housing service providers bill Medicaid for these services.

Successfully using Medicaid to help end chronic homelessness requires adjustment at multiple levels: the federal and state government where they manage Medicaid; managed care organizations; mainstream health and behavioral health providers; and supportive housing providers.

Within this area, is the need to integrate primary and behavioral health care services with homeless assistance programs and housing to reduce people’s vulnerability to and the impacts of homelessness. People with serious mental illness are disproportionately poor and cannot afford even modestly priced rental housing without government housing assistance. Like other communities across the United States, access and availability to mental and physical health services is important in serving the homeless population. We face the issue of a lack of access to mental health services, including detox, prior to or during housing create revolving door back to the streets. No one player can provide all services needed. I urge you to integrate government, non-profit and private sector efforts  to make services not only available, but accessible.

The fifth area is re-tooling or reorganizaing the homeless crisis response system.

Local crisis response systems of care must focus on housing stabilization (not just providing emergency shelter and outreach). These community based systems must offer alternatives to shelter admission whenever possible, make shelter available to all who need it, and result in quick housing placement and housing retention.

Emergency shelters and transitional housing programs are expensive, so it’s critical to be sure that investment in these programs is aligned with community strategies that prevent and end homelessness. Communities need to consider whether the transitional housing program should be evolved to serve households with greater needs through conversion to transition in place and/or supportive housing. I also understand that there are serious concerns about the lack of services and shelter for victims of domestic violence. There are innovative new practices being developed with support from the Bill and Melinda Gates Foundation that may be useful to you as you develop a better crisis response system for women and children fleeing abuse. I urge all of you here today to return to your communities and work together to develop and provide these critical crisis response systems.

So that’s the federal plan in five easy pieces: collaborative leadership, housing, income, health and re-tooling/reorganizing the homeless crisis response system.

Like most things in life, it is important for you to know where you have been and where are you are going. What gets measured gets done!  A serious effort to end homelessness must have a strong focus on data driven solutions.  The results of well collected data tell a story – poor results point to the need for a course correction; positive results point toward opportunities to align resources to be used more effectively.  The good news is that implementing performance management is possible using federally mandated systems known as HMIS.

In 2004, Congress directed HUD, and HUD directed jurisdictions to implement a Homeless Management Information System (HMIS) to collect real time data on, who is homeless, why they became homeless, and what services/interventions are effective in ending their homelessness.  By collecting this data communities can then make informed decisions, and develop appropriate action steps that will reveal availability and improve access to critical services like housing, mental and physical health services and employment that are essential to reduce and eventually eliminate homelessness in their community. 
Puerto Rico needs to get more serious about implementing HMIS as a performance management tool - to become best in class. Performance management can ensure the wisest use of increasingly scarce resources. If your efforts do not have system and program reporting from HMIS, you can’t understand which programs and set of services are making a difference. If you aren’t using data, you can't prioritize admissions for vulnerable populations, and you can't understand how system functions as well as how programs function within the system. HMIS can help you understand which programs actually solve homelessness rather than just providing services that support people staying homeless.

Elected officials can help make this happen by supporting the Continuum in its effort to broadly implement HMIS and ensure that all homeless programs contribute data to HMIS. It’s also important to require that data be entered in timely, accurate, and comprehensive manner.  If your communities can do a better job, then your data can be contributed to the AHAR – an annual report on homelessness.  You can also then use the data to better understand the extent of homelessness and to create your own local reports. With the implementation of the new HUD Emergency Solutions Grant (which is a block grant to many local jurisdictions) cities are required to track programs through HMIS.  Increasingly HUD is expecting communities to achieve results with HUD funding both through the Continuum of Care program and the ESG program that demonstrate successful permanent housing placement. Now is the time to work closely with Coalicion to take full advantage of the opportunity to use HMIS as your performance management platform.

Across the United States, we are calling on states and communities to join us in implementing Opening Doors.  Earlier this week, USICH announced Opening Doors Across America. I’m excited that Puerto Rico is the first place I’ve been to roll out this new initiative.

We are asking respective states and communities to adopt the four goals of Opening Doors.  I’m here to urge the government of Puerto Rico, mayors, and Coalition members that we need you to lead on homelessness as well. Your leadership is vital for Puerto Rico to build on the progress over the last decade. I urge the elected officials to adopt the Federal Strategic Plan and implement its goals and strategies.

Second, commit to incremental targets, measure your progress toward the goals, and implement strategies that will enable you to achieve these goals. As I said earlier, “What gets measured gets done.”  

Third, we need a sense of urgency.  In this tight budget environment, community-wide and cross-government strategic planning is a pivotal step in ending homelessness.  When the plans are well-crafted and implemented there are better results -- decreases in homelessness and cost savings.  Now is the time to collaborate, invest, and act on strategies that are proven to make an impact.  And here are the key strategies that I recommend you to focus on:

• Collaboration! The Continuum’s leadership, elected officials, and heads of local and state offices and departments need to work collaboratively and build relationships.
• Strategic planning. It is critical for Puerto Rico to implement the new  long-term statewide housing plan. We urge you to consider implementing Housing First and Rapid Re-Housing practices as you move forward.
• Use data as a management tool. As I mentioned earlier, improve HMIS by committing to using data as a management tool to identify system and program strengths, weaknesses, and opportunities for improvement.
• Coordinate with your VA Medical Center and the satellite clinics, as they implement the VA’s 5 Year Plan to End Veterans Homelessness. The Continuum of Care, , and the State Interagency Council should be working hand-in-glove with the VA and their partners.
• Seize the opportunity created by health reform, both through expansion of Medicaid and expansion of community health centers by making sure eligible individuals and families are enrolled in Medicaid.
• Adopt Best Practices – implement only what has worked and adapt approaches to be sure you get the best results for the greatest number of people. 

And the last part of this call to action is that while you implement strategic plans, keep lines of communication open with public officials at all levels to share what you are doing and learning.   Participate in USICH-sponsored discussions with us. Share solutions and let us know when federal policies are working and when these policies can be improved.

It comes down to commitment – not just by the President, the Administration, Congress, Governors, local elected officials – it is up to you. With HUD’s engagement led by Assistant Secretary Mercedes Marquez and my visit and commitment here, the federal government is your partner and we look forward to opening doors in Puerto Rico.

Your actions matter, your perseverance matters, your quest to be as efficient and effective with the available resources matters. Strong leadership.  Effective collaboration across sectors and disciplines. A bold vision and clear goals.  Focus on what works, Solid, transparent data to tell the honest story. Nimbleness to respond to changing needs and opportunities. These keys will serve you well in the months ahead.

On behalf of the Obama Administration, thank you for the work you do every day to help people get and stay off the streets. And thank you in advance for the hard work that you will do in the coming years to forge new partnerships and collaborations, to move towards mainstream programs, to prevent and end homelessness here in Puerto Rico.

Deputy Director Jennifer Ho was featured on National Health Care for the Homeless' recurring podcast which features stories from the field, advocacy tips, and self-care for the Health Care for the Homeless provider.  Follow the link below to access her speech.

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Thank you Maria and congratulations to you, your board, and staff for hosting this conference. Also to be commended on the publication of the report last week.  I read it over the weekend and found it to be very useful.

We gather today at a difficult time as the affordable housing crisis for both renters and homeowners is escalating. With the foreclosure crisis strangling the owner-occupied housing market, there has been an increase in the number of households competing for affordable rental units.  The shrinking affordable stock, falling incomes, and increased competition from higher-income renters have widened the gap between the number of very low-income renters and the number of affordable, adequate, and available units. This supply gap has also pushed many low-income households into “doubled-up” housing situations.

In the face of this, one year ago this month, the Obama administration released the first ever federal strategic plan to prevent and end homelessness. The plan was agreed to by 19 federal agencies along with the support of the White House. It has received bipartisan praise across the nation and we immediately moved from drafting the plan to implementation with the 300,000 people who’ve downloaded the plan.

Within the federal government, we are laying the groundwork for future success through better collaboration, better data collection, and engaging states and local communities in the goals and strategies set forth in Opening Doors.

Our administration is working hard to spread the message that ending homelessness is not only the right thing to do, it’s also possible. The President, 5 Cabinet Secretaries, and the Chairman of the Joint Chiefs of Staff Admiral Mullen are all talking about ending homelessness. We have the First Lady and Second Lady on board in our efforts on this front as well.

While, we have accelerated the momentum in this Administration toward real solutions, we all know that the best ideas have a price tag attached to them. Targeted comprehensive solutions are far more effective and cost-efficient than temporary fixes; funding prevention and support to end homelessness today will save the economic and social costs we would all pay in the future
We’ve backed up our vision with action.

• Nearly 900,000 people avoided or more quickly exited homelessness thanks to the Recovery Act’s $1.5 Billion dollar investment in HPRP.
• The President’s FY12 budget proposed a 23.4% in funding for targeted homeless programs compared to the FY10 investment.
• More homeless Veterans are moving from the streets and shelters into housing due to the HUD VASH program.
• Better collaboration between HUD and Education is helping more children, youth and families get the services they need.
• Passage of the Affordable Care Act and working to implement Medicaid expansion is helping prevent and end homelessness for all low income people. ACA includes implementation of parity which will ensure persons with all types of disabilities have access to treatment.
• HUD’s implementation of the VAWA protections for the Section 8 and Public housing as well as protections for LGBTQ households is unprecedented.
• USICH hosted a summit to discuss alternatives to criminalization of homelessness and will be releasing its report this summer.

Despite these accomplishments, we are concerned that the resources to fully implement Opening Doors are at risk. The President’s FY2011 budget proposal was not fully funded. This means that the landmark bi-partisan homelessness reform legislation – the HEARTH Act won’t be fully implemented this year. Opening Doors’ signature initiatives for family and chronic homelessness are deferred as well.  As we approach the full spend down of the Recovery Act’s HPRP program, communities are struggling to figure out how to maintain the progress. We agree that the funding debate is a question of priorities. We’ll need your support to push for full funding of the President’s FY2012 Budget proposal.

Budget negotiations not only matter here in Washington, but in state capitals across the nation. Your voices matter in this debate. We need to ensure all of the progress we made won’t be undone in the next few months.
Not only has our Administration taken our commitment to end homelessness to the American people, we’ve been active in the international community.

Earlier this year, in response to the U.N. Human Rights Council’s Universal Periodic Review, the Administration stated that they support the reinforcement of the “broad range of safeguards for the homeless people to allow them the full enjoyment of their rights and dignity.” This was tremendous news for many of us in the audience today. I view the work that we are doing at ICH as building upon the legacy and upholding the spirit of President Franklin Roosevelt commitment to a “second Bill of Rights” and the Federal Housing Act of 1949.

At USICH, we view the State Department’s position as an additional reinforcement of what we are trying to achieve in Opening Doors. At the same time, I urge that our focus should be on implementing the plan at the federal level, ensuring that all states and local communities adopt the goals as well, and advocate for the funding that these best practices need.

I would like to close by quoting FDR from his State of the Union address where he noted the right of every American to a decent home, “Each and every one of us has a solemn obligation under God to serve this Nation in its most critical hour—to keep this Nation great -- to make this Nation greater in a better world.”

Thank you for your time this morning and most importantly thank you for all that you do on behalf of people experiencing homelessness across our beloved nation.