Housing First: Veteran centered care helping to end Veteran homelessness

When it comes to homeless programs, VA’s policy is “Housing First,” an evidence-based, low-barrier, supportive housing model that emphasizes permanent supportive housing to end homelessness.  This Housing First approach contributed to a 33 percent reduction in homelessness among Veterans between 2010 and 2014, as measured during annual point-in-time counts.

This approach provides Veterans who are experiencing homelessness—particularly those who have been homeless for prolonged periods, and have mental health and/or addictive disorders—with permanent housing, as quickly as possible.  There are no prerequisites for receiving housing, instead, permanent housing is provided as the initial service, followed by other services, such as healthcare and employment, based on the Veteran’s needs and preferences.

For Veterans in the U.S. Department of Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program, the Housing First approach is often provided over a longer period of time to support community-based housing stability.  In Supportive Services for Veteran Families (SSVF), the principles of Housing First are incorporated into the practice of rapid rehousing.  Rapid rehousing is intended for shorter durations than HUD-VASH, but it still places a priority on moving a Veteran or Veteran family experiencing homelessness into permanent housing as quickly as possible.  While originally aimed primarily at Veterans experiencing homelessness due to short-term financial crises, SSVF programs across the country have begun to assist single Veterans and families with limited or no income,  survivors of domestic violence and those struggling with mental health conditions and addictions.

Studies conducted inside and outside of VA have demonstrated that Housing First is both a clinically effective and fiscally efficient model of permanent supported housing that can be implemented successfully in all VA homeless programs.  In 2010, 177 homeless Veterans entered a demonstration project comparing Housing First programs to treatment-first programs. The Housing First initiative successfully reduced waiting time from 223 to 35 days, housing retention rates were significantly higher among Housing First tenants, and emergency room use declined significantly among the Housing First cohort. Housing First works, because Veterans are more likely to achieve stability and improved quality of life when the risks, uncertainty and trauma associated with homelessness are removed.

Vincent Kane, the former Director of the National Center on Homelessness Among Veterans, oversaw various initiatives to promote research and data-driven solutions for Veterans who are homeless or at risk for homelessness. Through research, evaluation, dissemination science, and model development efforts, Kane and the team at the VA National Center on Homelessness among Veterans supports a comprehensive set of initiatives designed to prevent and end homelessness among Veterans.   These activities include collaborating on a research agenda that assesses the current portfolio of services offered to Veterans experiencing homelessness; developing and validating various practice models and program implementation strategies to prevent homelessness and maximize community engagement; and introducing evidence-based practices to VA.