Homeless Veterans

Despite spending $640 million on homeless programs between fiscal years 1987 and 1997, the Department of Veterans Affairs (VA) has little information about their effectiveness. VA's homeless program sites routinely submit data about the clients' characteristics and site operations. Yet little is known about whether the clients remain housed or employed or relapse into homelessness, and VA's Northeast Program Evaluation Center has little information about whether its programs are more beneficial than other strategies for helping the homeless. GAO recommends that VA undertake program evaluations to clarify the effectiveness of its homeless initiatives and to obtain information on how to improve them. Where appropriate, VA should make decisions about the type of data needed and the methods to be used in coordination with other federal agencies that have homeless programs. VA is trying to develop a comprehensive continuum of care for the homeless, which experts agree should include a range of housing and service alternatives, with specific approaches at any one site reflecting local needs and local resources. Housing options should include emergency shelter, transitional housing, and permanent housing all linked to support services. Treatment programs should include options suitable for mentally ill, substance abusing, dually diagnosed, and convalescent persons. The available research includes some promising approaches. Experts also note that attention to the individual's preferences is important and that flexibility is needed in serving individuals and in arranging partnerships among organizations.

GAO noted that: (1) VA's homeless assistance and treatment programs address diverse needs of homeless veterans by providing services such as case management, employment assistance, and transitional housing; (2) VA also provides medical, mental health, substance abuse, and social services to homeless veterans through its hospitals, outpatient clinics, and other health care facilities; (3) because of resource constraints and legislative mandates, VA expanded its homeless veterans efforts by better aligning itself with other federal departments, state and local government agencies, and community-based organizations; (4) the goal of this effort is to develop a continuum of care for the homeless--that is, to identify or create options for addressing the full array of housing, health, and service needs of this population; (5) VA has little information about the effectiveness of its homeless programs; (6) VA has relied on the Northeast Program Evaluation Center (NEPEC) to gather and report information about its homeless programs; (7) each of VA's homeless program sites routinely submits extensive data, mostly related to client characteristics and operations at individual program sites; (8) these data are used primarily to provide program managers with information about service delivery and are of limited use in assessing program effectiveness; (9) to evaluate effectiveness, information must be gathered about intended program results; (10) the outcome measures that NEPEC uses focus on housing, employment, and changes in substance abuse and mental health at the time veterans are discharged from VA's homeless programs; (11) little is known about whether veterans served by VA's homeless programs remain housed or employed, or whether they instead relapse into homelessness; (12) many questions about how to treat homelessness remain unanswered; and (13) experts agree, however, that a comprehensive continuum of care for the homeless--such as that which VA is striving to achieve--should include a range of housing and service alternatives, with specific approaches at any one site reflecting local needs and local resources.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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