Homeless Webinar 3 Transcript

Welcome to webinar number 3 in the Promoting Employment for Homeless Veterans series of presentations, brought to you by the U.S. Department of Labor’s Veterans’ Employment and Training Service, the National Veterans’ Training Institute, or NVTI, and the National Coalition for Homeless Veterans

For the next 25 minutes, we’ll be looking at ways we can assist homeless veterans overcome some of the most challenging barriers to employment that exist: physical and mental health issues, substance use disorders, and meeting basic survival needs, including food and shelter.

Along the way, we’ll learn about the service providers and other resources who can help our clients tackle these challenges. We’ll explore strategies for connecting our clients with these services, in part by providing effective referrals. And we’ll discuss how we can provide reinforcement to help our clients persevere in the face of frustrating setbacks as they work to overcome these challenges.

We’ll start by meeting Sue, an Army veteran in her early 30’s.

During the initial meeting between Sue and a DVOP Specialist, American Job Center or AJC employment specialist, she was somewhat guarded at first. But after some time, she began to open up and shared several personal things about herself.

Sue served in Afghanistan with a transportation company and, thanks to her natural leadership abilities and technical knowledge, she became acting platoon sergeant for the last four months she was in country.

But, without going into details, she also said she had some very difficult and painful experiences while in uniform.

After 6 years of active military duty, she transitioned out of the military and moved back to a small town about 25 miles from an American Job Center to be near her sister.

About a year ago she began having flashbacks from her experiences in the military that make it difficult for her to concentrate. She’s had trouble sleeping at night, and headaches have become increasingly common, and more painful, over the past several months.

During the meeting, the DVOP Specialist asked Sue about her work experience since she left the Army. She mentioned several short-term minimum-wage jobs she had, and then, after a long pause, she explained that it’s been difficult to keep a job because, as she put it, most nights she has a few drinks, or takes something, to help her deal with troubling memories and get to sleep. When that happens, it’s very difficult to wake up and get to work on time.

In fact, it’s been several months since she drew her last paycheck.

She lived with her sister until 5 weeks ago, and she has been staying with a cousin since then, but space is really tight and she and her cousin agreed this morning that is would be best for everyone if Sue could find another place to live by next week.

Those of us working in AJC typically do not have advanced certifications in medical or counseling specialties, so we shouldn’t try to diagnose or treat our clients, but if we’ve done a good job developing trust and rapport with them, and they open up to us, we may notice signs of some of the most common risk factors associated with homelessness.

As we saw in webinar number one, past traumatic experiences, substance use disorders, and mental health issues are commonly related to becoming homeless. Often these issues are co-occurring, in other words, our clients may be wrestling with two or more of these challenges at the same time.

Our Roles: Resources, referrals and reinforcing our clients’ efforts to gain control of their lives.

As we mentioned a moment ago, we are not experts when it comes to dealing with substance use disorders, treating medical or mental health problems, nor navigating the complicated regulatory and eligibility factors that impact availability of subsidized housing or other services. But we can play a vitally important role in our clients’ lives by providing targeted and informed resources, referrals, and reinforcement.

Let’s take a look at each of these in turn.

Let’s imagine that we’re the person that Sue has just met with, and she had agreed to meet with us again in several days. That gives us several days to begin assembling a team of specialized service providers who can assist Sue to manage or neutralize these barriers that are keeping her from finding a job and succeeding at work.

Homeless clients may need to draw upon a wide range of resources and services as they make progress towards self-sufficiency, including food, emergency shelter, transitional or permanent housing, medical care, mental health care, substance use counseling, and assistance managing a variety of physical, cognitive, or psychological challenges.

Several points to make up front:

First, no community is likely to have all of the programs or resources that we will introduce here. If we work in small cities and rural communities, we may have to get very creative when identifying or developing ways to provide assistance to homeless veterans or those at imminent risk of becoming homeless..

Second, no single agency or program will be able to provide all of the services many of our homeless clients will need. We’ll need to assemble a team of service providers, rather than searching for a single magic-bullet agency that can do it all.

Third, when it comes to assisting a homeless veteran with many of the issues around becoming job ready, including achieving sobriety, obtaining stable shelter, and managing medical and mental health issues, our effectiveness will depend in large part on the quality of the team we can assemble, and the quality of the referral process we use to connect clients with our partner agencies.

Fourth, to be really useful, a database or directory should contain more than just the name of a program, contact information, and the list of services we can find on their website or in their brochure. If our goal is to help our clients select the most appropriate and realistic sources of assistance, and to provide them with effective referrals, we’ll need more detailed information about each program.

Fifth, asset mapping is an ongoing process. Key personnel in local programs may come and go. For that matter, the programs themselves, especially if they rely on unpredictable funding or demonstration grants may come and go as well. Maintaining an accurate contact list can be a challenge.

Which brings us to our final point: it’s unlikely that any of us will have the time or personal knowledge to create and maintain a comprehensive database of all the programs that our homeless clients would benefit from.

Fortunately, there’s a good chance that someone in our community has already begun the work of identifying a network of providers. We’ll look at some of these organizations in a moment.

If no one currently maintains a list of supportive services in our community, we might ask a local veteran service organization, a religious congregation, or other volunteers to assist with the process of developing one and periodically updating it.

The resource page for this webinar has links to many of the programs or organizations we will describe. If you are partnering with someone in the creation of this database, we encourage you to share these links with them.

Starting Points

Your first stop for potential partners is the VA Medical Center. If your community has a VA Medical Center or VA facility, you will want to connect with the VA Healthcare for the Homeless Coordinator at this facility. These Coordinators are housed within the VA Medical Center and can often get veterans connected rapidly to resources for which they are eligible.

The VA provides a list of Healthcare for Homeless Veterans Programs by State with contact information; as with all of the resources we are describing, we’ve provided a link to it on our resource page.

Many homeless veterans, especially those who are not eligible for services through the VA Medical Center, are eligible for mainstream homeless services in your community. To identify homeless specific resources in your community, you will want to connect to the Continuum of Care. Every county, city or state is served by a Continuum of Care, or CoC, sponsored by the U.S. Department of Housing and Urban Development. These networks of service providers identify the needs of the homeless individuals in their service area, coordinate the delivery of currently available services and resources, and work together to fill any gaps by developing new services.

Sometimes, one agency is the lead of a CoC. In other places, several agencies form a collaborative effort to execute the CoC’s activities. If you’re not sure if one central agency manages your Continuum of Care, check with one of the agencies that typically assist homeless clients, including the Salvation Army, Goodwill, your local public housing authority, or the United Way.

If you are fortunate enough to have a local agency coordinating your CoC effort, you’ve got a ready-made network to tap into. Ideally, someone in your AJC will become a liaison or point of contact with your local CoC. Many CoCs have quarterly, monthly, or even bi-monthly meetings you can attend. If you can’t attend meetings now and then, try to get on the mailing list for the minutes or reports from their meetings.

To help you get started on your search for homeless veteran-specific partners, you can also visit the website of the National Coalition for Homeless Veterans, or NCHV. The Grants page on the NCHV webpage includes more detailed descriptions of several of the programs we discuss here and serves as a nice introduction to them.

The NCHV’s Step-by-Step webpage outlines the different types of assistance a homeless veteran may need.

The Locate Organization page provides contact information for thousands of community agencies across the country that provide some level of service to veterans who are homeless or at risk.

Another good network-building tool is the United Way 2-1-1 initiative. If your state or region has one, the 2-1-1 website and database will list many of the key service providers by county or metropolitan area.

Finally, many communities hold Stand Downs and these events can provide us with a convenient way to meet the local agencies that provide many of the services our homeless clients may need. We’ve included a link on the resource page to a list of upcoming Stand Down events around the country.

Now that you have a larger view on the resource networks for veterans who are homeless and for all persons who are homeless, let’s look at some specific programs that can help address the barriers you may see.

The U.S. Department of Veterans Affairs Homeless Programs

If a VA medical facility is located within a reasonable distance from our homeless veteran clients, if our clients are eligible for one or more the specific services listed here, and if the nearby VA facility has the capacity to serve our clients in a realistic timeframe, the VA Healthcare for Homeless Veterans Coordinator is likely to be one of our most important partners.

When we meet with VA Coordinators, we’ll want to ask them about the following programs, to learn about local availability, eligibility factors, and capacity. VA services generally include medical care, VA-located homeless services, and VA-granted community programs.

Healthcare services are likely to be a critical issue for many of our homeless clients. Medical conditions that can affect the homeless, including frostbite, parasitic infestations, tuberculosis, Hepatitis or respiratory conditions, infections that develop from minor wounds due to a lack of facilities for maintaining adequate hygiene, and difficulties managing chronic disease like diabetes.

You can work with the VA Coordinator to ensure the veteran has access to adequate healthcare when he or she is eligible. The VA’s Choice Card roll-out expands the availability of services, especially for veterans who are long distances from VA medical facilities. We will discuss healthcare for non-VA eligible veterans in the next section.

The Department of Housing and Urban Development and the Department of Veterans Affairs Supported Housing program, often shortened to “HUD-VASH”, provides housing vouchers through HUD to eligible veteran clients, and supportive services and case management through VA to assist clients manage physical and mental health, substance abuse, and other challenges that contribute to, or result from, homelessness. Although the voucher itself comes from HUD, the services and eligibility determination comes from the local VA.

Community Resource and Referral Centers are a newer VA program testing a “one‐stop shopping” approach to helping clients access a variety of services, ranging from showers, laundry facilities, food, and clothing to rapid referrals to emergency and permanent housing services and medical and mental health services. These CRRCs are not in every community, but be sure to check out the list here to see if one is available where you are.

The Homeless Veterans Coordinator will also be a source of information about several specialized health care offerings, including the Health Care for Homeless Veterans program, Health Care for Reentry Veterans Services program, Veterans Justice Outreach initiative, Homeless Patient Aligned Care Teams, and Homeless Veterans Dental Program.

Not all VA homeless services are provided by the VA Medical Center. Two grant programs, the Grant and Per Diem program and the Supportive Services for Veteran Families program, provide services to homeless and at risk veterans through grants to local community agencies.