JJacobson_Policy Analysis Paper
- 1. Jacobson 1 Veteran Homelessness Jacquelyn Jacobson University of Washington, Tacoma Professor Tom Diehm, PhD, MSW, MA TSOCW 501: Social Policy and Economic Security July 26, 2015
- 2. Jacobson 2 Social Problem: Homeless Veterans Societal contributions to the problem of homelessness are measureable and can be mitigated within a social context. Veterans returning home from active duty can experience significant challenges related to reintegrating into civilian life. Some of the consequences of poor reintegration may be lack of stable employment, untreated mental illness and lack of stable housing. Other consequences of poor reintegration may be expressed in issues related to poor social functioning, limited productivity or community involvement, and issues related to self-care (Sayer, et al., 2010). The homeless veteran population is a significant issue that has received attention throughout various government agencies such as the Veterans Administration (VA), U.S. Department of Housing and Urban Development and non-government advocacy groups including the National Coalition to End homelessness and the National Alliance to End Homelessness. If our veterans are returning home without adequate supports to facilitate this transition not only are there consequences at the individual level but there are also more far reaching consequences that extend into the community at large. The definition of homeless is generally consistent between sources and for the purposes of this analysis, individuals or families to be considered homeless will be defined as those who lack stable or adequate nighttime housing. Inadequate housing includes emergency shelters or places not otherwise meant for human habitation. Inadequate housing may take the form of: unsheltered, where a person may be on the streets, in the woods, in their car or in abandoned buildings; sheltered, which includes emergency shelters or transitional housing; a category referred to as “doubled up” in which a person may be temporarily staying with friends or family (U.S. Interagency Council on Homelessness, 2010). Nationally the overall homeless population is as high as 656,129 with roughly 67,495 being veteran status (Sermons & Witte, 2011). In a report posted by the National Alliance to End Homelessness (2011) there were 22,782 homeless people in Washington State in 2009, which was 4% higher than in the previous year (National Alliance to End Homelessness, 2010). The Point in Time (PIT) count provided by Washington State’s Continuums of Care (CoC) counted 1,478 homeless veterans throughout the state (HUD: Office of Community Planning and Development, 2011). Within King County there are approximately 1,000-1,150 were homeless with an anticipated 100 new homeless vets each year as a result of the most recent wars in Iraq and Afghanistan (Committee to End Homelessness, 2011). The Veteran population is distributed across multiple eras with the majority of the current population, approximately 50%, being from the Vietnam Era (King County Department of Community and Human Services, 2011). At this time, some significant challenges related to the current homeless veteran population are due to the fact that it is an aging population, with 80% of its members over the age of 55 and 30% over the age of 65 (King County Department of Community and Human Services, 2011).For the younger portion of the veteran cohort, 30%, they are facing new challenges as a result of better medical response times and safety equipment that has allowed them to survive injuries that in previous wars would have killed them; severe disabilities, such as amputation, and undiagnosed traumas are some of the consequences facing our current military. This population of homeless veterans requires special attention because of the needs specific to their experiences and the challenges they face coming out of those experiences. Veteran homelessness is a social problem consistent with the Functional Etiological Approach because it disrupts the functioning of society via measurable consequences demonstrated by fiscal impacts (Dolgoff & Feldstein, 2013). For the homeless population that is also suffering mental illness or drug and alcohol addiction they receive more costly services in an ER, sobering center or even jail as an alternative to having to sleep on the street. Without
- 3. Jacobson 3 adequate stable housing, this population may use these facilities which cost millions of dollars more per year than if we were to provide them with long-term or permanent housing assistance (Committee to End Homelessness, 2010). Within the city of Seattle when housing services were provided to individuals who had experienced long-term homelessness or were chronically homeless alcoholics there was a financial savings, to the city, of about $3.2million dollars and a significant reduction in use of medical center and sobering center services (Seattle Mayor's Office, 2008). Veteran Homelessness as a social problem requires special attention because the causes, needs, and interventions to address this problem are distinct in many ways from the general problem of homelessness within our society. The general causes of homelessness across populations are: substance abuse, mental illness, poverty or unemployment, limited availability of affordable housing, institutional discharge from a penitentiary or psychiatric facility, high costs for legal or healthcare issues or natural disasters (U.S. Department of Housing and Urban Development, 2009). Within the homeless veteran population there are three primary causes for homelessness, which can be mitigated with effective reintegration assistance services, these include a lack of available or stable employment, housing options and mental health services (Root Cause, 2011). The primary causes for homelessness, identified at various levels of administration, are: lack of affordable housing and housing security, lack of stable employment, poverty, substance abuse, mental illness, domestic violence, and lack of community supports (HEARTH, 2009; Committee to End Homelessness, 2010). Interventions designed to address these causes within the veteran population include “finding and retaining employment, securing affordable housing, and implementing outreach to facilitate provision of available services (Committee to End Homelessness, 2011). Women veterans also experience higher risk of homelessness than the general population. Some characteristics that may contribute to this increased risk are: sexual assault during duty, unemployment, having a disability, worse over-all health, or screening positive for an anxiety disorder or PTSD (Washington, Yano, McGuire, & Hines, 2010) Individuals who are homeless may experience “loss of education, productivity and long- term health risks” which may have long-term social consequences (Committee to End Homelessness). The problem of homelessness is not one that is limited to city streets and business doorways, homeless individuals may also stay in wooded outdoor areas between cities and suburbs or more recently, with the economic recession, they may be sleeping in their cars or abandoned buildings. Veteran homelessness is also considered a social problem within the value- conflict approach, which states that a problem evolves when majority (or influential minority) decides it is a problem (Dolgoff & Feldstein, 2013). Homelessness, in general, is a problem that is widespread and in a King County Survey, courtesy of United Way, 24% of those surveyed reported that they or someone in their family has been homeless. There have also been calls to address this issue throughout the nation, courtesy of both government and private sector advocates. Private agencies and coalitions have made concerted efforts to address the problem of veteran homelessness within the legislature and raise funds to support programs designed to address this need. At the government level, there are policies and funding resources designed to address the problem of homelessness and in each of these broad overarching policies there is often an identification of particularly concerning or at risk populations including veterans. Social Policy: Opening Doors The development of social policy related to the issue of homelessness had its first serious break-through in 1987when President Ronald Reagan passed the McKinney-Vento Homeless
- 4. Jacobson 4 Assistance Act; this policy provided federal funding to shelter services in an effort to combat homeless needs across the nation (National Coalition for the Homeless, 2006). Since then, this policy has been reauthorized multiple times but underwent a significant amendment in 2009 when President Obama signed the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act. The HEARTH Act emphasizes preventative support services and incentives for rapid re-housing while restructuring the current system to become more streamlined by consolidating existing housing assistance programs under a single Continuum of Care (National Alliance to End Homelessness, 2008). At the federal level we see a prominent shift of focus geared towards streamlining service delivery methods and calling upon agencies at all levels to collaborate in an effort to implement this policy. In 2010 the Opening Doors: Federal Strategic Plan to End Homelessness was introduced and within Washington State there are also provisions in the Revised Code of Washington (RCW) for addressing homelessness. RCW 43.185C mandates counties to develop individual plans to address homelessness and methods for measuring their performance and recommendations for change and for the Department of Commerce to facilitate implementation of these services and to coordinate annual reporting and provide technical support. In response to the HEARTH Act there was the establishment of the Opening Doors plan outlined a national strategy to end homelessness, within which it also identified specific target groups to be addressed such as families with children, unaccompanied youth, individual adults, and veterans. This plan focuses on goals related to: ending chronic homelessness; ending and preventing homelessness among specific populations such as the Veterans, families, youth, and children; and setting a path to end all types of homelessness (U.S. Interagency Council on Homelessness, 2010). This policy calls on various levels of administration to cooperate, collaborate and implement streamlined services to address the problem of Homelessness. The Opening Doors: Federal Strategic Plan to End Homelessness is consistent with social works values. All people have worth and dignity and in this policy that is demonstrated by the efforts to provide a level of service that treat people like people and strives to meet their needs. As a foundation to Opening Doors one of the core values of this plan is that “there are no ‘homeless people,’ but rather people who have lost their homes and each of them deserve to be treated with dignity and respect” (U.S. Interagency Council on Homelessness, 2010). Throughout Opening Doors, the HEARTH Act and similar legislation there are efforts made to implement services at a more personal level. Rather than putting applicants with service providers outside of their relevant region these policies call on agencies at the local level and community-based partners to provide and implement the services available and provide outreach to those who may be underserved. As one of its core values Opening Doors recognizes that homelessness is unacceptable and preventable, consistent with social work’s value of social justice. In an effort to remain relevant, and as mandated by the HEARTH Act, Opening Doors will be revised and updated annually to reflect progress and identify areas of improvement to better meet the needs of those being served. Human dignity and the accessibility of adequate housing are values that can be found across the nation. Homelessness is not concentrated in specific regions nor is it a problem that is limited within certain demographics or types of communities. Whether in the city or the suburbs, regardless of race or economic background no one person is exempt from the risks of homelessness. Our Declaration of Independence says that we have unalienable right to “life, liberty, and the pursuit of happiness” but also that we have a right to lay our foundations on interests that protect our safety and happiness. Opening Doors is a roadmap for the United States Interagency Council on Homelessness (USICH), the USICH is comprised of over 19 federal agencies and is working to fight homelessness
- 5. Jacobson 5 across political lines. There was a spike in bi-partisan support in the 1980’s as a result of unprecedented levels of homelessness which at that time had only been matched by the Great Depression, and from that we saw the inception of the McKinney-Vento Act (National Alliance to End Homelessness, 2008). The relevant interest groups affected by this policy are the veterans who receive these services and the providers implementing these services. There is optimism among the relevant interest groups regarding this policy because it offers some improvements to the current policies that have otherwise been complex and difficult to navigate (Applewhite, 1997). The service providers are optimistic regarding the prognosis of the social problem as they see increased efficiency and implementation of preventative supports that may broaden the scope of what services they are to provide and subsequently be reimbursed for. Program: Five Year Plan to End Homelessness among Veterans in King county The Five Year Plan to End Homelessness among Veterans in King County aims to “close housing gap for current homeless, secure funding, address diverse needs, identify and replicate best practices.” (Committee to End Homelessness, 2011). The intention of the plan is to guide the implementation of services to better meet the new challenges faced by a growing veteran population, to identify challenges in meeting these needs work towards a more user friendly system that is not as alienating to the population it is trying to serve. King County’s Five Year Plan aims to provide benefits that not only target the current homeless Veteran population but that also provide preventative steps for those who may be at increased risk of homelessness. Within this program benefits provided fall into categories of residual, developmental and socioeconomic asset development. The residual benefits would be finding room in a shelter as a last resort for those who are currently homeless. Within the preventative strategies of the program both veterans who are currently homeless or at risk of becoming homeless can receive benefits related to their quality of life in the form of mental health counseling, employment services or case management. In addition to meeting these basic needs the Five Year Plan has the ultimate goal of finding permanent and stable housing, this benefit is a social investment as it reduces the use of emergency services for individuals who otherwise do not have any other way of meeting their basic needs. There is a universal eligibility for the services provided within the Five Year Plan. This means that those individuals who VA’s definition of homeless and veteran, honorably discharged with a specific interval of active-duty, are eligible to receive some portion of these services (Veterans Administration, 2012). However, the services rendered are specific to an individual’s level of need and therefore the more at risk one is then the more intensive services they are eligible to receive. The basis of the program is coordinating services and preventing the occurrence of homelessness. Funding for services provided within King County’s Five Year Plan to End Homelessness comes from a combination of sources including both public and private funds. Federal, state and local dollars go towards funding these services in the form of grants or vouchers. The primary agencies that fund the programs in the Five Year Plan are HUD, VA and a local levy in King County, which is dedicated to assisting veterans and their families (Committee to End Homelessness, 2011). King County’s Veterans Relief Fund and Veterans and Human Services Levy allocated nearly $13 million, for six years from when it was passed by voters in 2005 (Department of Community and Human Services, 2012). In addition to federal grants and housing vouchers, such as VASH, services to end Veteran Homelessness are also provided by private agencies in the form of cash money or volunteer service provision (Committee to End Homelessness, 2011). The level of administration for King County’s program to end homelessness would be considered a mix of local administration and “grant-in-aid” level of administration. The “grant-
- 6. Jacobson 6 in-aid” style of administration says that funds or grants may be administered for specific purposes at a higher level of government, but that implementation and coordination of services is done semi-independently at the local levels (Dolgoff & Feldstein, 2013). This means that implementation of the program goals has some flexibility because of local funding sources but because of contributions from the national and state levels the program remains accountable their specific requirements to remain eligible for their funding. Accessibility for the Five Year Plan has faced similar challenges to other veteran’s services prior to its inception. These challenges are not new, namely the difficulty one has navigating the complex system of benefits, an aversion to seeking benefits because of the stigma attached to receipt of these services and also a general lack of awareness that these programs exist (Applewhite, 1997). The Five Year Plan calls upon current veteran service agencies such as the VA, WDVA, and KCVP as well as community based organization partners to address limitations in accessibility and provide service outreach in the community. Community based organizations, especially, will play an integral role in implementing the Five Year Plan because of the aversion some veterans have to VA services and the limitations in service provisions just from the volume of individuals who need services. The providers of these services are a combination of professional and lay depending on the services provided. Because the Five Year Plan calls on interventions and preventions at various levels it relies on a variety of providers to meet the needs of the population being served. Evaluation of Policy/Program The Five Year Plan to End Homelessness among Veterans in King County and the Opening Doors policy have ambitious intentions to attain both horizontal and vertical adequacy. The horizontal goals for this program, and the policy by which it is guided, seek to end homelessness within five years and prevent the addition of newly homeless individuals to this population (Committee to End Homelessness, 2011) (U.S. Interagency Council on Homelessness, 2010). At this time accomplishing this goal is limited as a result of a complex system and veteran’s lack of awareness of services available. To respond to this gap in service, the program calls on preventative measures like discharge planning when a veteran leaves the military and community outreach by volunteers and community based services providers. Educating our veterans on the services available and how to go about attaining these services is a necessary piece in increasing program policy implementation efficacy. Financially our system is facing numerous budget cuts, the mission to end homelessness at multiple levels of government has fortunately allowed continued funding to go to programs that support this cause but the funding is still short of what it needs to be in order to best meet program goals. The Five Year Plan also identifies the need to procure more funding beyond what is currently available through state and federal allocations and aims to increase efficiencies to mitigate the consequences of this limitation. From the vertical adequacy perspective the program is adequate in its intentions, namely that it seeks to streamline services but also provide a variety of services to address the cause of the problem, including case management, counseling, permanent housing, employment and other services meant to mitigate the risk of veterans becoming homeless. Agencies who are working to end homelessness were consolidated under the HEARTH Act into local CoCs that may be providing services to towns, cities, regions or whole states depending on the size and in need within a given population (U.S. Department of Housing and Urban Development, 2009). This consolidation should facilitate vertical integration of services to better meet the needs of those being served.
- 7. Jacobson 7 The Five Year Plan is consistent with other policies and programs such as Opening Doors and the HEARTH Act. The timeline based model and the methods for trying to achieve success are consistent at the federal, state and local levels. Although details of each plan become increasingly narrow in scope as the level moves from a macro-scale looking at the nation as a whole down to the micro-scale of meeting out local needs within King County they all still tie into consistent goals and values. At the federal level there is a broad focus on prevention and rehousing that talks about funding sources and national goals and then when we examine implementation at the local level we see that it ties back into those funding sources but then outlines steps to be implemented to meet the needs of that local population. Latent consequences are inevitable for any new policy or program. One of the strengths of both the King County Five Year Plan and the Opening Doors policy is that they have built into them feedback mechanisms to drive them forward. Guided by the requirements of the HEARTH Act, the Opening Doors policy evaluates progress towards the goal of ending homelessness on annual basis and then updates its policy accordingly. There are notable efforts at each level of administration that call upon the implementation of feedback mechanisms to measure and identify outcomes to guide evidence based practice moving forward. In Opening Doors it also identifies the need to recognize effective strategies at local levels across the nation and incorporate those into best practices on a larger scale (U.S. Interagency Council on Homelessness, 2010). In King County for example we may see consequences related to a shifting veteran population that in 2008 was predominantly represented by Vietnam era veterans but is seeing a significant increase in veterans returning from the wars in Iraq and Afghanistan especially is our country works towards ending these wars over the next few years. Commitment to social justice and social change are demonstrated within this policy consistent with utilitarianism. A utilitarian perspective on social justice would say that both the policy and program outlined above are socially just. That is they are designed to “ensure the poorest members of society have access to a social minimum” and that as a result all of society benefits (Dolgoff & Feldstein, 2013). In an effort to provide a maximum production of welfare for the largest number, Opening Doors also identifies collaboration and cost-effectiveness as core values to the plan. The cost of homelessness is exorbitant relative to the cost of effective solutions and by addressing this aspect alone Opening Doors is able to outline definitive timelines for when they would like to reach their goals and how that positively impacts the individual and society; the plan calls for prevention and termination of chronic and veteran homelessness within five years and for families, youth and children within ten years. Many of the programs and policies related to ending homelessness are still in the early stages relative to the historical context of the problem but have allot of work to do if they are going to attain their goals. Per Nakashima, McGuire, Berman and Daniels (2005) there are clear distinct implication for best practice and how to measure effective outcomes. If we are going to end homelessness within our designated timelines we need to focus on economic stability for our veterans and concentrate the power structure to more efficiently deliver services. Evidence of positive outcomes can be measured by the number of beds available to our currently homeless veterans, a reduction in utilization emergency service beds, and once our veterans are rehoused that they are in stable housing and have gainful employment.
- 8. Jacobson 8 References: Applewhite, S. L. (1997). Homeless veterans: Perspectives on social services use. Social Work, 42(1), 19- 30. doi:10.1093/sw/42.1.19 Committee to End Homelessness. (2010). Homelessness Facts for King County . Retrieved from Committee to End Homelessness: http://www.cehkc.org/scope/cost.aspx Committee to End Homelessness. (2011). The Ten-Year Plan. Retrieved from Committee to End Homelessness: http://www.cehkc.org/plan10/plan.aspx Committee to End Homelessness. (n.d.). FAQs about Homelessness. Retrieved November 2012, from Committee to End Homelessness: http://www.cehkc.org/scope/FAQhomelessness.aspx Department of Community and Human Services. (2012). Community and Human Services: Services: Levy. Retrieved from King County: http://www.kingcounty.gov/operations/DCHS/Services/Levy.aspx Dolgoff, R., & Feldstein, D. (2013). Understanding Social Welfare : A Search For Social Justice (9th ed.). Boston, MA: Pearson. Homeless Housing and Assistance. 43 Revised Code of Washington 43.185C. Retrieved from http://apps.leg.wa.gov/rcw/default.aspx?cite=43.185C HUD: Office of Community Planning and Development. (2011). Resource Detail. Retrieved from Homelessness Research Exchange: http://www.hudhre.info/documents/PIT- HIC_SupplementalAHARReport.pdf King County Department of Community and Human Services. (2011). The Ten-Year Plan. Retrieved from Committee to End Homelessnes: http://www.cehkc.org/plan10/plan.aspx Nakashima, J., McGuire, J., Berman, S., & Daniels, W. (2005). Developing Programs for Homeless. Social Work in Health Care, 40(2), 1-12. National Alliance to End Homelessness. (2008). Summary of HEARTH Act. Retrieved from National Alliance to End Homelessness: http://www.endhomelessness.org/library/entry/summary-of- hearth-act National Alliance to End Homelessness. (2010). National Alliance to End Homelessness. Retrieved from National Alliance to End Homelessness: www.endhomelessness.org National Association of Social Workers. (2009). National Association of Social Workers code of ethics. National Coalition for the Homeless. (2006). Fact Sheets. Retrieved from National Coalition for the Homeless: http://www.nationalhomeless.org/publications/facts/McKinney.pdf Root Cause. (2011). Ending Chronic Homelessness. Retrieved from Root Cause: http://rootcause.org/ending-chronic-homelessness Sayer, N. A., Noorbaloochi, S., Frazier, P., Carlson, K., Gravely, A., & Murdoch, M. (2010, June). Reintegration problems and treatment interests among Iraq and Afghanistan combat veterans receiving VA medical care. Psychiatric Services, 61(6), 589-597. Seattle Mayor's Office. (2008). News Releases. Retrieved from Seattle.gov: http://www.seattle.gov/news/detail.asp?ID=8078&Dept=40 Sermons, M. W., & Witte, P. (2011). State of Homelessness in America in 2011. Retrieved from National Alliance to End Homelessness: http://www.endhomelessness.org/library/entry/state-of- homelessness-in-america-2011 U.S. Declaration of Independence. Retrieved from http://www.archives.gov/exhibits/charters/declaration_transcript.html U.S. Department of Housing and Urban Development. (2009). Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act. Retrieved from Homelessness Research Exchange: http://www.hudhre.info/hearth/ U.S. Department of Veterans Affairs. (2011). VA’s Commitment to End Veteran Homelessness. Retrieved from: http://www.va.gov/homeless/nationalcenter.asp
- 9. Jacobson 9 U.S. Interagency Council on Homelessness. (2010). Opening Doors: Federal Strategic Plan to End Homelessness. Retrieved from United States Interagency Council on Homelessness: http://www.usich.gov/opening_doors/ Washington, D. L., Yano, E. M., McGuire, J., & Hines, V. (2012). Risk factors for homelessness among women veterans. Journal of Health Care for the Poor and Underserved, 21(1), 82-91. doi:10.1353/hpu.0.0237