Homelessness: End Homelessness among veterans in 5 yrs

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Homelessness: End Homelessness among veterans in 5 yrs. Domiciliary/MHRRTP. Veteran ~ Veteran ~ veteran ~ Veteran ~ veteran ~ veteran ~. Inpatient. Outpatient. Community. Accessing VA Services and Income for Homeless Veterans. - PowerPoint PPT Presentation

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  • Homelessness:End Homelessness among veterans in 5 yrsOutpatientInpatientCommunityDomiciliary/MHRRTP

    Quality Improvement Project completed by PCMH December 2010

  • Accessing VA Services and Income for Homeless Veterans HCHV Program: M. Chick-Ebey, LCSW Program Coordinator; A. Sager, MD; E. Woods, MSW; J. Miles, MSW; RN: Vacant, GPD: David Wall, LiCSW; Verneka Hudson, LCSWHUD/VASH: L, Adams, LMSW Program Coordinator Debra Christian-Grandy, MSW; R. Haynes, LCSW; LCSW;Anthony Miller, LCSW, Adam Coleman, MSW, Doris Cruea, MSW; Corrie Williams, MSW, ; F. Culley, PSA

    Quality Improvement Project completed by PCMH December 2010

  • Synchronizing Plans

    Increasing Leadership, Collaboration, and Civic Engagement Increase Access to Stable and Affordable HousingRetool the Homeless Crisis Response SystemImprove Health and StabilityIncrease Economic StabilityCommunity PartnershipHousing and Supportive ServicesEmployment Income and BenefitsTreatmentOutreachHomeless Prevention

    Quality Improvement Project completed by PCMH December 2010

  • Plan: 6-PillarsOutreach / EducationTreatmentFocus in shelters, streets, Homeless Event Fairs (Stand Down, Project Homeless Connect) , Veterans Justice Outreach (local jails).National Call Center 24/7 HotlineEducating Community Partners and Internal Stakeholders No wrong door.Right Size services, Rapid-Re-housing Improved Access: DIGMA/HPACT Primary Care and Mental Health, daily walk-in screening slot for Dom MHRRTP.Comprehensive Treatment and RehabilitationMental Health Residential Rehabilitation Programs (MHRRTP / Dom)LINK program: 7 beds for Chronically Homeless Veterans. Homeless Veterans Dental Initiative

    Quality Improvement Project completed by PCMH December 2010

  • Plan: 6-Pillars (Cont.)PreventionHousing/Supportive ServicesSupportive Services for Low Income Families Grant NOFA recently closed: at least three local applications submitted.Relapse PreventionJustice Involved ServicesVJO Veterans Justice OutreachHCRV Healthcare for Re-Entering VeteransGrant and Per Diem Transitional Housing (GPD); Three programs, 90 beds (16 specifically for female Veterans). HUD VASH Housing and Urban Development Veterans Affairs Supportive HousingCommunity Housing Resources: CANLINK, SROs, Project Based vouchers.

    Quality Improvement Project completed by PCMH December 2010

  • Plan: 6-PillarsIncome/EmploymentCommunity PartnershipsVRT Programs (CWT/IT for MHRRTP VeteransHVSEP : Homeless Veteran Supported Employment ProgramExpedite VA Disability claims for Homeless VeteransEngagement of Community Partners : 6 COC Committees, Military Affairs CommitteeLeveraging resources Continuum of Care Committees (six in our area Veterans now getting priority with HUD

    Quality Improvement Project completed by PCMH December 2010

  • Homeless Outreach: Healthcare for Homeless Veterans (HCHV)Minimum of twelve outreach visits per month; more in winter monthsOutreach sites in Newport News, Portsmouth, Norfolk and Virginia Beach (St. Vincents, Church shelters, Oasis, VOA, St. Columba, Salvation Army 19th Street shelter, Union Mission).Seasonal outreach to church shelter programsServices also provided at Project Homeless Connect, Stand Down and other Homeless Resource Fair eventsAlso Available for drop-in visits at VAMC Offices

    Quality Improvement Project completed by PCMH December 2010

  • DIGMA (Drop-IN Group Medical Appointment), Primary Care clinic

    Drop-in clinic designed to reduce barriers to careFull array of Primary Care services provided Clinic meets Tuesday afternoons and Friday morningsHealth and Resource Education built in to design of clinicVeterans can remain in DIGMA clinic once housed if they wish.Approximately 269 veterans currently enrolled, over 1030 have received care in DIGMA clinicMental Health Care also available at DIGMA clinicClinic recently awarded funding through Central Office Pilot Project to become a full-time, PACT Primary Care Clinic (will add individual slots. Target date: April , 2012).

    Quality Improvement Project completed by PCMH December 2010

  • Grant and Per Diem (GPD)Community Agencies partner with VA to provide transitional housing to homeless Veterans.1. Salvation Army TR: On VA grounds, must provide own food. Clean/Sober, transitional environment. Stay from several weeks up to several months.

    2. Malachi House: For female veterans and veterans with dependents. Apartment units stay up to two years. Judeo- Christian Outreach- 16 beds (2 Female) - 14 Bed new apartment style building for single Veterans (male or female) - Tw0 female beds. * New NOFA just announced for Transition In Place GPD!!

    Quality Improvement Project completed by PCMH December 2010

  • HUD-VASH ProgramSection 8 voucher and VA Case Manager 360 currently, ratio of 1/35 Case Mgr. to veteran. Over 300 housed.Currently over 200 on wait listChronic Homeless prioritizedFamilies with children also a priority.

    To be ready for HUD-VASH: need IDs, birth certificates (for all family members); cant owe landlords or utilities, need deposits, credit reports.Rapidly re-housed over 40 Veteran families with HPRP assistance in FY11.

    Quality Improvement Project completed by PCMH December 2010

  • Homeless Hotline: 1-877-4AID VET1-877-4AIDVET went live 3/1/10.Homeless team staff rotate to handle calls: responders must return calls within one business day.Calls/data logged nationally and locally. - 399 in FY11 (ninth nationally) - Avg. 50 calls per month since October 1st. Several registrations, GPD/MHRRTP admissions from Hotline.

    Quality Improvement Project completed by PCMH December 2010

  • Vocational programs Supported Employment (SE). SE is an evidence-based clinical model that helps individuals with serious mental illness or physical impairments co-occurring with mental illnesses engage in competitive employment in the community. Homeless Veteran Supported Employment Program (HVSEP). A modified version of SE, HVSEP helps Veterans who are homeless or at risk of being homeless engage in competitive employment in the community with some additional support for first 90 days. HVSEP is staffed by Vocational Rehabilitation Specialists who are formerly Homeless Veterans. Referral from MD required.CWT-Transitional Work Experience (TWE). TWE is a transitional work program to enable participants to gain work experience and work hardening while in a therapeutic rehabilitation treatment program in the Domiciliary.

    Quality Improvement Project completed by PCMH December 2010

  • Domiciliary Residential Rehabilitation Programs & TRDAP: Drug Alcohol Program - 80 bedsDom PTSD Program 10 bedsRehabitat Homeless, SMI, Dual Diagnosis, -30 bedsDCM: Dom Case Management Homeless Program: life skills, Must have Rehab Goals - 47 bedsCWT/TR: Community Residences for Homeless Veterans active in the CWT Vocational Program: 6 month length of stay, generally following MHRRTP. Length of stay is individualized but generally no more than 90 days

    Quality Improvement Project completed by PCMH December 2010

  • Over 95% of those who complete recovery oriented treatment have a place to stay upon discharge (may be transitional housing).

    66% of discharges from GPD and the DCHV program in Q1FY12 went to stable housing (not transitional: apartments, houses, Oxford Houses, family reunification).

    VA Programs Work!

    Quality Improvement Project completed by PCMH December 2010

  • Local Status:

    GAPS AND BARRIERSPrevention money lacking in regionShelter: Extremely limited year-round shelter for single males, disabled, couples, families & sex offenders.HUD VASH & Income Based Housing: need far outstrips supply. Wait /Interest lists No placements for convalescenceLimited Outreach StaffTransportationLimited rental room options: overpriced, often illegal or unsafeDifficulty navigating VA appointment system from Homeless Status

    OPPORTUNITIESSSVF Grant: local applicants Emergency Housing & Medical Respite Contracts (pending $$)Project Based DevelopmentsNew GPD NOFA: Transition -in Place.Partnerships with other supported housing programs (CANLINK, VBCDC, Access, Project Based).Cross-train community providersOxford HousesWork with communities to develop more Affordable housingHomeless PACT Primary Care grant

    Quality Improvement Project completed by PCMH December 2010

  • FY11 At A GlanceSome numbers are duplicated (e.g. one Veteran went through several programs). 577 Intakes, 200 from Outreach, 1012 Veterans seen by HCHV/GPD Staff.214 Admissions to GPD transitional Housing,; 50 Admissions to CWT TR. Over 400 admissions to MHRRTP and Treatment Programs; 97 from Outreach.HCHV/GPD workload increased 43% over FY10. Homeless Staff Attended 185 Community Meetings314 Veterans Attained non-HUD-VASH Permanent Housing.252 Veterans received Dental care through Homeless Dental Initiative.260 Veterans enrolled in DIGMA399 Homeless Hotline consults (Minimum of over 20 enrolled, 16 MHRRTP admits, 18 GPD Admits)92 veterans moved in to HUD-VASH apartments75 Veterans visited within local jails.

    Quality Improvement Project completed by PCMH December 2010

  • Local Five Year PlanInformation sessions and trainings for stakeholders across settings and catchment areaBlanket region with brochures and hotline publicityPublicize SSVF and GPD NOFAs: write support letters. Develop & manage contracts in the community for Medical Respite and Emergency Housing (pending funding)Annual Summit and Annual Report (target September 2012). Establish Full-time Homeless PACT Primary Care Clinic

    Quality Improvement Project completed by PCMH December 2010

  • Accessing the VA: EligibilityEvery Veteran is not eligible for the same services: Eligibility for Healthcare Benefits is based on four factors:Discharge Status and LOS (Length of Service): must have two years after 1980 or combatFull-time Active Duty or Activated / Deployed Reserve/Guard service is required. Service Connection Rating: injuries or illnesses caused or made worse by military service. Income: if primarily non-service connected (NSC), must be low-income (Category A), or pay co-pays.

    Quality Improvement Project completed by PCMH December 2010

  • Eligibility Priority CategoriesVeterans who are 70% or more Service Connected are highest priority and are eligible for: VA Nursing home careDental Care (unemployable or 100% SC only). Prosthetics of all sortsNo co-pays or income restrictions Domiciliary MHRRTP residential programs require income waiver

    OTHER DESIGNATIONS: Must be 10% or more Service Connected to receive free eyeglassesMust be service connected for hearing loss (or 100% svc. Connected) to receive hearing aids. Care of Service Connected condition is coveredCo-pay is not required if income is under NSC pension threshold ($1021 per month single). Highest numbers of Homeless Veterans are NSC or low % SC.O

    Quality Improvement Project completed by PCMH December 2010

  • Registering For VA Services: Veterans must be registered to receive care: like an insurance planNSC and Veterans less than 10% SC must complete annual means test or risk getting billedMust have photo ID to registerDD214 or HINQ (computer inquiry to verify service) requiredBest to register in person and not by mail (backlog).Homeless Veterans should request to be seen day of registrationCall Wayne Hopkins at 722-9961 x3040 if you have more questionsOutreach staff can help (if photo id)

    Quality Improvement Project completed by PCMH December 2010

  • VA Financial Benefits: All Veterans that receive VA Healthcare benefits are NOT eligible for Financial Benefits. Service ConnectionNSC Pension (war era only)Amount is determined by percentage of disability determined by VBA0% no money but not a bad thing 10% is $127 per month100% is $2769 per month50% is not half of 100%See handout or VBA website for more details: www.VA.govAvailable to Veterans who are unemployable due to disability (regardless of cause) or over age 65 with income less than $1021 per monthMeans testedMany restrictionsCurrent payment is $1021 per month, about $1700 for Aid and Attendance (if qualify).Restrictions similar to SSIQsee VA Benefits handout for more details

    Quality Improvement Project completed by PCMH December 2010

  • Where / How to file a ClaimVirginia Department of Veterans Services (VADVS) offices in Norfolk and Hampton: both take walk-ins (certain hours may apply). DAV, American Legion, VFW or other Veterans Service Organization (VSO): nearly all VSOs have claims representatives. Veterans can also self-file online or on paper.Homeless Claims can be expedited/rushed: must contact HCHV staff for verification.Hardship status can also rush claims (must show evidence).

    Quality Improvement Project completed by PCMH December 2010

    Quality Improvement Project completed by PCMH December 2010

  • Questions???Please take some goodies: pens, brochures, key-chains. Let us know if youd like us to present to your colleagues or group. Thank you for your interest in helping Homeless Veterans!

    Quality Improvement Project completed by PCMH December 2010

    **

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