Rural Homelessness
Better Collaboration by HHS and HUD Could Improve Delivery of Services in Rural Areas Gao ID: GAO-10-724 July 20, 2010The Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009 directed GAO to conduct a broad study of homelessness in rural areas. In this report, we provide information about rural homelessness issues, based in significant part on our work in rural areas within six selected states. Specifically, the report addresses the following questions: (1) What are the characteristics of homelessness in rural areas? (2) What assistance is available to individuals or families experiencing homelessness and what amount of funding have the federal departments and agencies awarded to organizations that assist persons experiencing homelessness in rural areas? (3) What barriers do persons experiencing homelessness and homeless service providers encounter when seeking assistance or funding to provide assistance? To address these issues, GAO reviewed relevant literature, conducted site visits, and interviewed agency officials.
Rural homelessness involves a range of living situations but comparing the extent of homelessness in rural and nonrural areas is difficult primarily due to data limitations. Based on GAO visits to six states, persons experiencing homelessness in rural areas could be living in one of a limited number of shelters, in extremely overcrowded situations, in severely substandard housing, or outdoors. While HUD and other agencies collect some data on homeless populations, several challenges exist in using these data to compare the extent of homelessness in rural and nonrural areas. They include difficulties in counting transient populations, limited reporting by service providers in federal data systems, inconsistent reporting across programs, and focusing on the segments of the homeless population that the agency serves. Definitional differences also make comparisons difficult. For instance, the three most common federal definitions of rural use differing criteria such as population or proximity to urban areas. Even within one measure such as population, different agencies can use different parameters and therefore identify different areas as rural. A number of federal programs exist to support those experiencing homelessness in rural areas. Targeted and nontargeted programs fund permanent and emergency housing and supportive services such as mental health services, case management, and job training. However, federal agencies maintain limited data on the amount of homeless assistance awarded to rural areas, making comparisons with assistance awarded to nonrural areas difficult. For instance, HUD maintains some data on the amount of homeless assistance awarded to rural areas through its targeted programs, but the data are based on providers' identification of locations as rural or not. Nontargeted programs can serve persons experiencing homelessness but do not track how much funding is used for homeless assistance. As a result of data limitations such as these, comparisons of funding levels offer limited insight into the relationship between the size of the homeless population in an area and the amount of funding received. Barriers to accessing and providing homeless services in rural areas include limited access to services, large service areas, dispersed populations, and a lack of transportation and affordable housing according to state and local officials and persons experiencing homelessness in the states we visited. For instance, many rural areas have few shelters or shelters with few beds serving very large areas. A program in which HUD provides housing vouchers to homeless veterans and the Department of Veterans Affairs provides clinical and case management services to these same veterans is one of a limited number of examples of formal collaboration and leveraging of federal resources that link housing and supportive services. The effects of limited collaboration may be particularly acute in rural areas because of the barriers cited above. Without a more formal linking of housing and supportive services by HUD and HHS, two of the key agencies for funding these activities, the effectiveness of federal efforts to address homelessness may be diminished. GAO recommends that the Departments of Housing and Urban Development (HUD) and Health and Human Services (HHS) explore further opportunities to strengthen formal collaboration on linking housing and supportive services to address homelessness, with specific consideration for how such collaboration can minimize barriers to service provision in rural areas. HHS and HUD generally agreed with the recommendation.
RecommendationsOur 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.
Director: Alicia P. Cackley Team: Government Accountability Office: Financial Markets and Community Investment Phone: (202) 512-7022GAO-10-724, Rural Homelessness: Better Collaboration by HHS and HUD Could Improve Delivery of Services in Rural Areas
This is the accessible text file for GAO report number GAO-10-724
entitled 'Rural Homelessness: Better Collaboration by HHS and HUD
Could Improve Delivery of Services in Rural Areas' which was released
on July 20, 2010.
This text file was formatted by the U.S. Government Accountability
Office (GAO) to be accessible to users with visual impairments, as
part of a longer term project to improve GAO products' accessibility.
Every attempt has been made to maintain the structural and data
integrity of the original printed product. Accessibility features,
such as text descriptions of tables, consecutively numbered footnotes
placed at the end of the file, and the text of agency comment letters,
are provided but may not exactly duplicate the presentation or format
of the printed version. The portable document format (PDF) file is an
exact electronic replica of the printed version. We welcome your
feedback. Please E-mail your comments regarding the contents or
accessibility features of this document to Webmaster@gao.gov.
This is a work of the U.S. government and is not subject to copyright
protection in the United States. It may be reproduced and distributed
in its entirety without further permission from GAO. Because this work
may contain copyrighted images or other material, permission from the
copyright holder may be necessary if you wish to reproduce this
material separately.
Report to Congressional Committees:
United States Government Accountability Office:
GAO:
July 2010:
Rural Homelessness:
Better Collaboration by HHS and HUD Could Improve Delivery of Services
in Rural Areas:
GAO-10-724:
GAO Highlights:
Highlights of GAO-10-724, a report to congressional committees.
Why GAO Did This Study:
The Homeless Emergency Assistance and Rapid Transition to Housing
(HEARTH) Act of 2009 directed GAO to conduct a broad study of
homelessness in rural areas. In this report, we provide information
about rural homelessness issues, based in significant part on our work
in rural areas within six selected states. Specifically, the report
addresses the following questions: (1) What are the characteristics of
homelessness in rural areas? (2) What assistance is available to
individuals or families experiencing homelessness and what amount of
funding have the federal departments and agencies awarded to
organizations that assist persons experiencing homelessness in rural
areas? (3) What barriers do persons experiencing homelessness and
homeless service providers encounter when seeking assistance or
funding to provide assistance? To address these issues, GAO reviewed
relevant literature, conducted site visits, and interviewed agency
officials.
What GAO Found:
Rural homelessness involves a range of living situations but comparing
the extent of homelessness in rural and nonrural areas is difficult
primarily due to data limitations. Based on GAO visits to six states,
persons experiencing homelessness in rural areas could be living in
one of a limited number of shelters, in extremely overcrowded
situations, in severely substandard housing, or outdoors. While HUD
and other agencies collect some data on homeless populations, several
challenges exist in using these data to compare the extent of
homelessness in rural and nonrural areas. They include difficulties in
counting transient populations, limited reporting by service providers
in federal data systems, inconsistent reporting across programs, and
focusing on the segments of the homeless population that the agency
serves. Definitional differences also make comparisons difficult. For
instance, the three most common federal definitions of rural use
differing criteria such as population or proximity to urban areas.
Even within one measure such as population, different agencies can use
different parameters and therefore identify different areas as rural.
A number of federal programs exist to support those experiencing
homelessness in rural areas. Targeted and nontargeted programs fund
permanent and emergency housing and supportive services such as mental
health services, case management, and job training. However, federal
agencies maintain limited data on the amount of homeless assistance
awarded to rural areas, making comparisons with assistance awarded to
nonrural areas difficult. For instance, HUD maintains some data on the
amount of homeless assistance awarded to rural areas through its
targeted programs, but the data are based on providers‘ identification
of locations as rural or not. Nontargeted programs can serve persons
experiencing homelessness but do not track how much funding is used
for homeless assistance. As a result of data limitations such as
these, comparisons of funding levels offer limited insight into the
relationship between the size of the homeless population in an area
and the amount of funding received.
Barriers to accessing and providing homeless services in rural areas
include limited access to services, large service areas, dispersed
populations, and a lack of transportation and affordable housing
according to state and local officials and persons experiencing
homelessness in the states we visited. For instance, many rural areas
have few shelters or shelters with few beds serving very large areas.
A program in which HUD provides housing vouchers to homeless veterans
and the Department of Veterans Affairs provides clinical and case
management services to these same veterans is one of a limited number
of examples of formal collaboration and leveraging of federal
resources that link housing and supportive services. The effects of
limited collaboration may be particularly acute in rural areas because
of the barriers cited above. Without a more formal linking of housing
and supportive services by HUD and HHS, two of the key agencies for
funding these activities, the effectiveness of federal efforts to
address homelessness may be diminished.
What GAO Recommends:
GAO recommends that the Departments of Housing and Urban Development
(HUD) and Health and Human Services (HHS) explore further
opportunities to strengthen formal collaboration on linking housing
and supportive services to address homelessness, with specific
consideration for how such collaboration can minimize barriers to
service provision in rural areas. HHS and HUD generally agreed with
the recommendation.
View [hyperlink, http://www.gao.gov/products/GAO-10-724] or key
components. For more information, contact Alicia Cackley at (202) 512-
8678 or cackleya@gao.gov.
[End of section]
Contents:
Letter:
Background:
Conclusions:
Recommendation for Executive Action:
Agency Comments and Our Evaluation:
Appendix I: Scope and Methodology:
Appendix II: Comments from the Department of Health and Human Services:
Appendix III: Comments from the Department of Housing and Urban
Development:
Appendix IV: GAO Contact and Staff Acknowledgments:
Tables:
Table 1: Typology of Definitions of "Homelessness" among Federal
Agencies with Targeted Homeless Assistance Programs, as of July 2010:
Table 2: Rural Funding within HUD's CoC Programs, Based on Grant
Applicant Reporting as Rural or Not:
Table 3: Urban and Rural Fiscal Year Funding for VA's Capital Grant
Awards for the Grant and Per Diem Program Based on Grant Applicant
Reporting as Rural or Not:
Table 4: Possible Needs of the Homeless Population and Potential
Corresponding Barriers in Rural Areas:
Table 5: Examples of Supportive Services That Federal Agencies,
Excluding HUD, Can Provide to Persons Experiencing Homelessness:
Figures:
Figure 1: Federal Programs That May Benefit Persons Experiencing
Homelessness in Rural Areas:
Figure 2: Percent of Total Federal Funding Targeting Homelessness by
Agency for Fiscal Year 2009:
Figure 3: HUD's CoC Housing and Supportive Services Distribution:
Abbreviations:
AHAR: Annual Homeless Assessment Report:
BIA: Bureau of Indian Affairs:
CDBG: Community Development Block Grant:
CHALENG: Community Homelessness Assessment Local Education and
Networking Groups:
CoC: Continuum of Care:
CICH: Collaborative Initiative to Help End Chronic Homelessness:
DHS: Department of Homeland Security:
Education: Department of Education:
ESG: Emergency Shelter Grant:
ESEA: Elementary and Secondary Education Act of 1965:
HEARTH: Homeless Emergency Assistance and Rapid Transition to Housing
Act of 2009:
HHS: Department of Health and Human Services:
HMIS: Homelessness Management Information System:
HUD: Department of Housing and Urban Development:
Labor: Department of Labor:
NAHASDA: Native American Housing Assistance and Self-Determination Act:
PATH: Projects for Assistance in Transition from Homelessness:
PIT: Point-in-Time:
RHYMIS: Runaway and Homeless Youth Management Information System:
USDA: Department of Agriculture:
VA: Department of Veterans Affairs:
VASHVA: Supportive Housing:
[End of section]
United States Government Accountability Office:
Washington, DC 20548:
July 20, 2010:
Congressional Committees:
Homelessness has sometimes been characterized as the "extreme end of
poverty."[Footnote 1] In rural areas of the United States,
homelessness has not attracted the same level of attention as in urban
areas, although research has shown that the highest poverty rates
occur in rural areas as well as center cities. Although some studies
have examined the issue of homelessness in rural areas, little
comprehensive data exist on the extent of homelessness in these areas
or the extent to which various federal programs meet the needs of
those experiencing homelessness in rural areas or support providers
that serve this population. The Homeless Emergency Assistance and
Rapid Transition to Housing (HEARTH) Act of 2009 created the Rural
Housing Stability Grant Program.[Footnote 2] This grant program is
seen as to allow rural areas more flexibility to identify and address
the needs of persons experiencing homelessness or those in the worst
housing situations and reserves Department of Housing and Urban
Development (HUD) funding for which rural communities may apply
separately.
The HEARTH Act also directed GAO to conduct a broad study of
homelessness in rural areas, including tribal lands and colonias.
[Footnote 3] In this report, we provide information about rural
homelessness issues, based in significant part on our work in rural
areas within six states. Specifically, the report addresses the
following questions:
1. What are the characteristics of homelessness in rural areas?
2. What assistance is available to individuals or families
experiencing homelessness and what amount of funding have the federal
departments and agencies awarded to organizations that assist persons
experiencing homelessness in rural areas?
3. What barriers do persons experiencing homelessness and homeless
service providers encounter when seeking assistance or funding to
provide assistance?
To address these questions, we conducted a review of relevant reports,
studies, and our prior research. We also conducted site visits in
Arizona, Kentucky, Maine, Minnesota, New Mexico, and Texas. During
these visits, we interviewed federal, state, and local housing and
homelessness officials and nonprofit homelessness organizations, and
toured rural areas in which homelessness was present. We selected the
site visit locations based on several factors, including (1)
discussions with knowledgeable individuals in the field of
homelessness, (2) a review of studies and reports on local and state
efforts to serve the homeless in rural areas, (3) the presence of
tribal lands and colonias, and (4) geographical diversity. We also
reviewed relevant laws, regulations, and program documentation and
interviewed officials from various federal agencies as well as
national stakeholder organizations. For purposes of this report, we
did not limit ourselves to any one federal definition of homelessness
and did not specify a specific definition when speaking with
researchers, providers, and relevant government officials, but they
did clarify on how they defined homelessness in the context of their
comments.
We conducted this performance audit from July 2009 to July 2010 in
accordance with generally accepted government auditing standards.
Those standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our
findings and conclusions based on our audit objectives. We believe
that the evidence obtained provides a reasonable basis for our
findings and conclusions based on our audit objectives.
Background:
Several federal programs--mainstream and targeted--may be available to
assist those experiencing homelessness in rural and nonrural areas.
Mainstream programs--such as Temporary Assistance for Needy Families,
public housing, the Supplemental Nutrition Assistance Program,
Medicaid, and the Workforce Investment Act--provide a wide range of
assistance, such as cash assistance, housing, food, health care, and
job training, for low-income people including those experiencing
homelessness. Targeted programs--such as the Emergency Shelter Grant
and Runaway and Homeless Youth programs--also provide a range of
services but are designed specifically for individuals or families
experiencing homelessness.[Footnote 4]
The McKinney-Vento Homeless Assistance Act (McKinney-Vento) is the
principal federal legislation designed to provide funding for shelter
and services to persons experiencing homelessness.[Footnote 5]
McKinney-Vento originally consisted of 15 programs providing, among
other things, resources for emergency shelter, transitional housing,
job training, primary health care, education, and permanent housing.
The current act has been amended several times and was most recently
reauthorized by the HEARTH Act. For the most part, these amendments
have expanded the scope and strengthened the provisions of the
original legislation by expanding eligible activities and creating new
programs. This legislation continues to represent the primary source
of funding for targeted programs serving persons experiencing
homelessness. HUD administers both competitive and formula-based
McKinney-Vento programs that fund activities to address homelessness
in rural and nonrural areas. HUD's competitively awarded homeless
programs comprise the "Continuum of Care" (CoC) system. According to
HUD, the program is based on the understanding that homelessness is
not caused solely by a lack of shelter, but also involves other
physical, social, and economic needs. Through the CoC system HUD
allocates homeless assistance grants to organizations that participate
in homeless assistance program planning networks. The planning network
or CoC refers to a group of providers and key stakeholders in a
geographical area--a city, a county, a metropolitan area, or an entire
state--that join to plan for the homeless housing and service system
within that geographic area and apply for HUD's competitive homeless
program funding.[Footnote 6] Rural areas typically organize into
regional or balance-of-state (areas in the state not already covered
by other continuums) CoC systems which may include a mixture of rural
and nonrural areas. Areas in 37 states or territories are organized as
balance-of-state CoCs, while other states such as Minnesota and
Nebraska have organized into regional CoC systems. Several other
federal agencies also have programs targeting homelessness that
primarily provide supportive services--including the Departments of
Education (Education), Homeland Security (DHS), Labor (Labor), Justice
(DOJ), Health and Human Services (HHS), and Veterans Affairs (VA).
[Footnote 7]
McKinney-Vento also authorized the creation of the U.S. Interagency
Council on Homelessness (Interagency Council), which currently
includes 19 member agencies.[Footnote 8] McKinney-Vento mandated that
the Interagency Council identify duplication in federal programs and
provide assistance to states, local governments, and other public and
private nonprofit organizations to enable them to serve those
experiencing homelessness more effectively. The HEARTH Act revises the
Interagency Council's mission to coordinate the federal response to
homelessness and create a national partnership at every level of
government and with the private sector to reduce and end homelessness.
[Footnote 9] HEARTH also mandates that the Interagency Council develop
and annually update a national strategic plan to end homelessness. The
Interagency Council's plan, which was released in June 2010, aims to
align federal resources effectively and appropriately with four key
goals: (1) prevent and end homelessness for families, youth, and
children; (2) prevent and end homelessness among veterans; (3) end
chronic homelessness; and (4) "set a path" to end all types of
homelessness.
As described in our June 2010 report, federal programs define
homelessness differently. HUD administers programs under McKinney-
Vento that specifically target persons experiencing "literal"
homelessness (that is, living in shelters or in places not meant for
human habitation, but not in precarious housing situations).[Footnote
10] According to HUD officials, Congress directs federal agencies as
to which definition of homelessness shall be used within each program;
furthermore, as HUD's housing resources are not an entitlement,
funding must be targeted to those most in need.[Footnote 11] The
statutory definition of homelessness for Education, DOJ, and some HHS
targeted programs is broader than that for HUD programs. For example,
under McKinney-Vento, the Education for Homeless Children and Youth
program's definition of homelessness includes children and youth who
are living in substandard housing, while the Healthcare for the
Homeless program's definition includes those who are "doubled up," or
living temporarily with another household because they cannot afford
housing of their own.[Footnote 12] Table 1 categorizes definitions of
homelessness across federal agencies with targeted homeless assistance
programs. In our June 2010 report, we recommended that Education, HHS,
and HUD develop a common vocabulary for homelessness and determine if
the benefits of collecting data on housing status in targeted and
mainstream programs would exceed the costs.
Table 1: Typology of Definitions of "Homelessness" among Federal
Agencies with Targeted Homeless Assistance Programs, as of July 2010:
Federal agency: Education;
Homelessness definition: McKinney-Vento children and youth[B].
Federal agency: DHS;
Homelessness definition: McKinney-Vento individual[A].
Federal agency: Labor;
Homelessness definition: McKinney-Vento individual[A.
Federal agency: DOJ;
Homelessness definition: Other[C].
Federal agency: HHS;
Homelessness definition: Other[C].
Federal agency: HUD;
Homelessness definition: McKinney-Vento individual[A].
Federal agency: VA[D];
Homelessness definition: McKinney-Vento individual[A];
Homelessness definition: Other[C].
Source: GAO.
[A] Someone who lacked a fixed, regular, and adequate nighttime
residence or has a nighttime residence that is a supervised shelter
designed to provide temporary accommodations; an institution providing
a temporary residence for individuals awaiting institutionalization;
or a place not designed for, nor ordinarily used as, a regular
sleeping accommodation.
[B] Children and youths who meet the McKinney-Vento individual
definition or those who are sharing the housing of other persons due
to loss of housing, economic hardship, or similar reasons (doubled
up); living in motels, hotels, trailer parks, or camping grounds due
to the lack of alternative adequate accommodations; awaiting foster
care placement; or living in substandard housing.
[C] Definitions of homelessness other than McKinney-Vento individuals
or children and youth definitions. For example, HHS' Runaway and Youth
Act's Transitional Living program defines a homeless youth as being
generally from the ages of 16 to 22, unable to live in a safe
environment with a relative, and lacking any safe alternative living
arrangements.
[D] VA definitions depend on the program.
[End of table]
The HEARTH Act broadens the McKinney-Vento definition of "homeless
individual," and also defined the terms "homeless," "homeless person,"
and "homeless individual with a disability."[Footnote 13]
Federal agencies also do not employ a single definition of "rural" and
the definitions generally are not comparable across agencies. In a
prior GAO report, we discussed the three most common federal
definitions of rural--from the Bureau of the Census, the Department of
Agriculture's (USDA) Economic Research Service, and the Office of
Management and Budget--which have differing criteria, such as
population threshold or proximity to urban areas.[Footnote 14]
However, even within one measure such as population threshold,
different agencies can use different parameters and therefore identify
different areas as rural.
The mandate for this report in the HEARTH Act identifies two distinct
communities to be included in this review of homelessness in rural
areas--tribal lands and colonias. Because the federal government has a
unique legal and political relationship with Native American tribes
and Alaska Native entities, the administration of housing, homeless
assistance, and supportive service programs on tribal lands differs.
Federal agencies that have distinct roles and responsibilities to
these groups include the Bureau of Indian Affairs (BIA), HUD, and HHS.
BIA-administered programs include social services, economic
development, housing improvement, and disaster relief. HUD's Office of
Native American Programs is responsible for the implementation and
administration of programs, such as housing and community development,
that are specific to Native Americans and Alaska Natives. The Indian
Health Service within HHS is responsible for providing federal health
services to Native Americans and Alaska Natives.
Unlike Native Americans and Alaska Natives, the federal government
does not have a unique legal and political relationship with colonias.
However, the Cranston-Gonzalez Act of 1990 recognized colonias within
U.S. borders as distressed communities and designated set-aside
funding to advance opportunities for homeownership and economic self-
sufficiency in these areas.[Footnote 15] Individuals and families in
colonias may lack safe, sanitary, and sound housing and be without
basic services such as potable water, adequate sewage systems,
utilities, and paved roads.
Forms of Rural Homelessness Encompass Situations Ranging from the More
Visible, Such as Living in Shelters, to the Less Visible, Such as
Living in Overcrowded Housing or Outdoors:
The characteristics or forms of homelessness in the rural areas we
visited ranged from the more visible, such as living in shelters, to
the less visible, such as living in overcrowded or substandard
housing. The range of living situations of persons experiencing
homelessness in rural areas may overlap with the living situations of
those experiencing homelessness in nonrural areas. Some persons
experiencing homelessness lived in shelters or transitional housing.
Shelters, where they existed, provided one of the visible entry points
to receiving both housing assistance and supportive services. Some
shelters we visited conduct initial assessments of individuals and
families experiencing homelessness to determine their needs. The
shelters may provide case management or mental health services or
provide referrals to services within the area. We also observed
various shelter types--some served specific groups, such as domestic
violence victims or youth, while others were multipurpose. Some
shelters were traditional, small communal shelters; some organizations
used scattered site housing as shelters; and some shelters had no
fixed location. For example, some service providers issued hotel
vouchers, while others had moving shelters in which churches or other
organizations would offer space. The shelter would be located in one
organization's donated space for a set period of time before moving to
another organization. Services available to clients also varied
greatly among shelters. Some shelters offered a full range of on-site
services such as mental health services, substance abuse treatment,
case management, and job training. Other shelters offered limited
services or lacked the funding to pay for 24-hour staff. Some areas
without shelters relied on volunteers for homeless services because of
limited or nonexistent funding.
Other forms of homelessness we observed or heard about in rural areas
we visited included persons who owned or rented substandard housing or
had established temporary alternative living arrangements such as
doubling-up (short stays with persons who offer space). In some rural
areas, infrastructure challenges contributed to substandard housing.
For example, we observed some houses built in floodplains in colonias
we visited in Texas. Additionally, building codes may not exist or may
not be enforced in some rural areas. We also observed houses with
boarded-up windows, caved-in floors or ceilings, and dangerous
alternative heating sources in rural areas in several states. Persons
living in similar housing in urban areas may more easily be identified
as literally homeless as such structures could be condemned. Some
individuals and families in rural areas lived in overcrowded homes,
sometimes with multiple generations living together. In some places we
visited, we heard that doubling-up or multigenerational living was a
cultural norm or an accepted practice because people "take care of
their own." Some people had very few options. For example, on tribal
lands many families have lived for long periods in overcrowded housing
because waiting lists for housing are extremely long and private
financing is rare due to legal issues with land ownership. Tribal
officials from the Pueblo of Acoma reservation recently conducted a
housing inventory and found approximately 155 overcrowded units on the
reservation out of approximately 700 occupied units.[Footnote 16]
Providers told us that severely overcrowded situations often were
associated with domestic violence and child abuse. Providers said
youth experiencing homelessness often "couch surfed," trading goods or
services such as drugs, sex, money, or child care for a temporary stay
in someone's home. Not all federal programs include such living
conditions in their definitions of homelessness, and persons living in
these situations may not be eligible for some federal assistance.
Finally, some individuals and families experiencing homelessness in
the rural areas we visited were sleeping in areas not meant for human
habitation, including outdoor locations, vehicles, and abandoned
buildings. For example:
* On tribal lands in Arizona, we heard of persons living in dry river
beds or in outbuildings such as barns or backyard sheds.
* In Maine, we were informed of year-round encampments in the woods.
In one case, the local fire department inspected and sanctioned a
large fire pit for an encampment with the intent of minimizing the
number of smaller pits.
* In Minnesota, we observed abandoned buses and ice houses that were
used by persons without regular shelter and heard from a previously
homeless woman about how she built a structure using a pallet, a large
cardboard box, and a tarp to keep out the rain. She told us that she
placed the structure in an old mining pit to avoid detection.
These individuals meet both the existing McKinney-Vento and HEARTH Act
definitions of homeless and could be eligible for federal assistance.
However with a limited number of shelters or other outreach, they may
not be accessing services. Providers and persons experiencing
homelessness emphasized that some persons experiencing homelessness
wanted to remain hidden as they often were sought by abusive partners,
parents, creditors, or the police. In the case of some families,
parents were afraid that their children would be taken from them by
social services.
Challenges in Collecting Comprehensive Data Make Understanding the
Extent of Homelessness in Rural and Nonrural Areas Difficult:
Due to limited comprehensive data and challenges in combining data
from different federal sources, understanding the extent of
homelessness in rural and nonrural areas is difficult. Several
agencies are required to collect data on segments of the homeless
population, but as described in our June 2010 report, these data have
shortcomings and do not fully describe the incidence and prevalence of
homelessness in rural or nonrural areas.[Footnote 17] HUD developed
two sources of data--the Homelessness Management Information System
(HMIS) and the biennial Point-in-Time (PIT) count--for understanding
the extent of homelessness. These data are reported to Congress
annually for the Annual Homeless Assessment Report (AHAR) on the
extent and nature of homelessness in the United States. Under the
direction of Congress, HUD created a set of technical data collection
standards for local HMIS, instructed programs receiving HUD McKinney-
Vento funding to report to those local systems, and encouraged all
programs for homeless people, regardless of their funding source, to
report data to HMIS.[Footnote 18] HMIS records and stores client-level
information on the characteristics (on an ongoing basis throughout the
year) and service needs of homeless persons and the data are used to
produce counts of the sheltered homeless population over a full year.
In addition to HMIS, the PIT counts of both sheltered and unsheltered
homeless populations are based on the number of persons experiencing
homelessness on a single night during the last week in January (every
other year), and the data are included as part of the CoC
applications, which are submitted to HUD annually.[Footnote 19] CoCs
conduct a PIT count every other year with 452 CoCs completing a count
in 2009. PIT counts include the "street counts" that estimate the
number of unsheltered homeless people in each community, as well as
estimates of sheltered homeless people based on a census of shelter
and transitional housing occupants on a particular night.
Although other programs are encouraged to report data to HMIS,
agencies such as HHS, Education, and VA have their own systems for
collecting data. For example, HHS's Runaway and Homeless Youth
Management Information System (RHYMIS) collects demographic and
service data on runaway and homeless youth being served by HHS's
Family and Youth Services Bureau's programs. To demonstrate compliance
with the Elementary and Secondary Education Act of 1965 (ESEA), as
amended, Education collects data on homeless children and youth served
by ESEA programs and the Education of Homeless Children and Youth
program through the Consolidated State Performance Report. The
McKinney-Vento Act requires local school districts to have
Homelessness Liaisons, provide appropriate services and support, and
collect and report data to Education annually. Additionally, through
VA's Northeast Program Evaluation Center, VA collects data on each
individual veteran that enters one of VA's specialized homeless
veterans programs. And, through the Community Homelessness Assessment
Local Education and Networking Groups (CHALENG) process, VA collects
population-based data by conducting local community group surveys with
VA staff and community participants. CHALENG data is nationally
compiled in an annual report to provide prevalence estimates of
veteran homelessness and to assess the needs of the population as well
as gaps in local services. Lastly, the Census Bureau's decennial
population and housing census collects data on places in which the
homeless population receive services as well as targeted nonshelter
outdoor locations. While the Census makes an effort to count all
residents, including those experiencing homelessness, the 2010 Census
does not plan to report a separate count of the population
experiencing homelessness or a count of the population who use
homelessness services, and the Census Bureau advises against using its
data on homelessness from the 2000 Census.
Because of different statutory requirements for each federal agency--
including data collection requirements and differences in definitions--
these data do not reflect the full extent of homelessness in rural or
nonrural areas. Each agency focuses on the segments of the homeless
population that the agency serves, resulting in incompatible data for
comparison and analysis. For example, HHS's Runaway and Homeless Youth
Program, for which data is collected in RHYMIS, focuses on the runaway
and homeless youth being served by the Basic Center Program, the
Transitional Living Program for Older Homeless Youth, and contacts
made by the Street Outreach Program grantees. HHS provides homeless
assistance to adult individuals and families through programs such as
Health Care for the Homeless, Projects for Assistance in Transition
from Homelessness (PATH), Grants for the Benefits of Homeless
Individuals, and Service in Supportive Housing. All of these programs
collect data on their relevant populations based on statutory
requirements.[Footnote 20] VA collects data on homeless veterans as
part of its annual CHALENG survey, in accordance with different
statutory requirements.[Footnote 21] However, in December 2009, HHS
established an agreement with HUD for PATH providers to move towards
reporting under the HMIS. Also, according to HUD officials, there has
been an initial evaluation of aligning some of VA's homelessness data
with HUD's homelessness data.
The varying definitions of "homelessness" and "rural"--as well as the
extent to which "rural" is reported--also limit the ability to
understand the incidence and prevalence of homelessness in rural
areas. For example, according to officials, doubled-up persons are
included in some VA and HHS program definitions but excluded from
HUD's definition. Thus, data on homelessness are captured differently
across federal agencies. Similarly, although our work did not focus on
potential reasons for the different definitions, these differences
across federal programs make comparing the extent of homelessness in
rural and nonrural areas difficult. For instance, HUD's AHAR formally
classifies locations into two groups--principal cities and suburban or
rural areas. Specifically, HUD estimates that about 1.56 million
people were homeless in emergency shelters or transitional housing at
some point during fiscal year 2009. More than two-thirds (or about 1.1
million) of them were located in principal cities, while one-third (or
about 0.5 million) were in suburban or rural jurisdictions. HHS's
RHYMIS and VA's CHALENG do not break out the counts of homelessness
between rural and nonrural areas.
HUD's PIT count is the only data collection effort designed to obtain
a national count of those experiencing homelessness, and while a more
in-depth discussion of the difficulties associated with collecting the
data can be found in our June 2010 report, there are some additional
challenges particular to rural areas.
* Persons experiencing homelessness are inherently difficult to count.
They are mobile, can seek shelter in secluded areas, and may not wish
to attract the notice of local government officials. Moreover, rural
areas are often large and have widely dispersed populations and
difficult-to-reach locations, exacerbating the difficulties of finding
and counting persons experiencing homelessness, including those who do
not necessarily want to be found.
* Count methodologies vary by CoCs and might not be well implemented.
Service providers who conduct the PIT counts are meeting their
mandated requirements under McKinney-Vento. However, with no funding
to pay for the count, service providers often rely on volunteers to
meet an unfunded mandate. Particularly in areas of the United States
where average temperatures are below freezing in January, finding
unsheltered persons and recruiting volunteers to count them becomes
difficult. Although HUD officials told us that the benefit of a
January count relates to the increased demand for shelters at the
coldest time of year, homeless shelters and services are limited in
rural areas, and in some counties, nonexistent. In a few of the states
we visited, commitments from state and local officials and advocates
have enhanced the process, resulting in an ability to recruit
volunteers and local organizations who have built a trusting
relationship with homeless populations.
According to officials and service providers in the states we visited,
HUD's PIT count likely has undercounted the rural homeless population,
but to what extent is unknown. While HUD officials acknowledge the
shortcomings of their counts, they believe significant progress has
been made in recent years in collecting homelessness data,
particularly their estimate annually since 2005 of the extent of
homelessness and their efforts to ensure data quality through
providing technical assistance.[Footnote 22]
Another factor associated with the completeness of federal agency data
is the lack of migration data. According to federal agency officials
and service providers, very little is known about the migration
between rural and nonrural areas of those experiencing homelessness
because there is no requirement or formal system for tracking
migration patterns. Although no federal programs formally track or are
required to track migration information, some local service providers
maintain that information for their own purposes. For example, the
Kentucky Housing Corporation, beginning in 2009, included
questionnaires to track migration within and across states. Those
experiencing homelessness may migrate to and from nonrural areas for
many reasons. For example, service providers told us that persons
experiencing homelessness in rural areas have migrated to nonrural
areas following a job loss, to reconnect with families, and to obtain
supportive services. Conversely, people have migrated from nonrural
areas to rural areas to connect with families and, in the case of
tribal lands, to receive services. Furthermore, because persons
experiencing homelessness are more mobile, and formal migration data
do not exist, the potential exists for duplicated counts--complicating
any comparison of the extent of homelessness between rural and
nonrural areas.
Several Federal Agencies Fund Programs through State Intermediaries or
Local Homeless Providers That Assist Persons Experiencing Homelessness
in Rural Areas:
Several federal agencies fund programs, through state intermediaries
or local homeless providers, which are targeted to the homelessness
population or which assist low income persons and families including
those experiencing homelessness. Some federal programs specifically
target homelessness, while others assist low income persons and
families, including those experiencing homelessness, or include
assistance for persons experiencing homelessness among eligible uses.
In total, these programs fund permanent and short term housing and a
variety of supportive services such as mental health services,
substance abuse treatment, case management, and job training. Targeted
homeless funding is often further targeted to segments of the
population such as youth or veterans. See figure 1 for examples of
targeted and mainstream or nontargeted programs that may benefit
persons experiencing homelessness and the types of assistance
available under each program.
Figure 1: Federal Programs That May Benefit Persons Experiencing
Homelessness in Rural Areas:
[Refer to PDF for image: table]
Federal programs: HUD; Single Room Occupancy; [Program targeted at
homelessness]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: HUD; Shelter Plus Care[E]; [Program targeted at
homelessness]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: HUD; Supportive Housing Program; [Program targeted
at homelessness]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Check];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Check].
Federal programs: HUD; HUD-VA Supportive Housing[F]; [Program targeted
at homelessness]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Empty].
Federal programs: HUD; Emergency Shelter Grant; [Program targeted at
homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Check];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Check].
Federal programs: HUD; Native American Housing Assistance and Self
Determination Act; [Mainstream or nontargeted program]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: HUD; Self-help Homeownership Opportunity Program;
[Mainstream or nontargeted program]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: HUD; HOME Investment Partnerships; [Mainstream or
nontargeted program]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: HUD; Community Development Block Grant; [Mainstream
or nontargeted program]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: HUD; Housing Choice Voucher (Section 8); [Mainstream
or nontargeted program]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: HUD; Public Housing; [Mainstream or nontargeted
program]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: HHS; Runaway and Homeless Youth; [Program targeted
at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Check];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Check].
Federal programs: HHS; Projects for Assistance in Transition from
Homelessness; [Program targeted at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Empty].
Federal programs: HHS; Health Care for the Homeless; [Program targeted
at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Empty].
Federal programs: HHS; Federal Surplus Real Property[G]; [Program
targeted at homelessness]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: HHS; Grants for the Benefits of Homeless
Individuals; [Program targeted at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Check].
Federal programs: HHS; Services in Supportive Housing; [Program
targeted at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Check].
Federal programs: HHS; Medicaid; [Mainstream or nontargeted program]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Empty].
Federal programs: HHS; Temporary Assistance for Needy Families;
[Mainstream or nontargeted program]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Check].
Federal programs: HHS; Headstart; [Mainstream or nontargeted program]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Check].
Federal programs: VA; Grant & Per Diem; [Program targeted at
homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Check];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Check].
Federal programs: VA; Health Care for Homeless Veterans; [Program
targeted at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Empty].
Federal programs: VA; Domiciliary Care for Homeless Veterans; [Program
targeted at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Empty].
Federal programs: VA; HUD-VA Supportive Housing[H]; [Program targeted
at homelessness]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Empty].
Federal programs: VA; Medical Centers; [Mainstream or nontargeted
program]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Check].
Federal programs: VA; Disability Compensation; [Mainstream or
nontargeted program]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Check].
Federal programs: Labor; Homeless Veterans Reintegration Program;
[Program targeted at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Check].
Federal programs: Labor; Workforce Investment Act; [Mainstream or
nontargeted program]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Check].
Federal programs: Education; Education for Homeless Children and
Youth; [Program targeted at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Check];
Supportive services: Other[D]: [Check].
Federal programs: DOJ; Transitional Housing Assistance for Child
Victims of Domestic Violence, Stalking, or Sexual Assault; [Program
targeted at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Check].
Federal programs: DHS; Emergency Food and Shelter; [Program targeted
at homelessness]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Check];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Check].
Federal programs: BIA; Human services programs such as Welfare
Assistance, Housing Improvement and others; [Mainstream or nontargeted
program]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Check].
Federal programs: USDA; Housing programs such as Single-Family Housing
and Multi-family housing; [Mainstream or nontargeted program]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: USDA; Community Facilities Loan; [Mainstream or
nontargeted program]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Check];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: USDA; Food programs such as Supplemental Nutrition
Assistance Program; Special Supplemental Nutrition Program for Women,
Infants, and Children; school meals; Commodity Supplemental Food
Program; and others; [Mainstream or nontargeted program]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Check];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: IRS; Low Income Housing Tax Credit; [Mainstream or
nontargeted program]
Category of services: Housing: Permanent[A]: [Check];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Empty].
Federal programs: SSA; SSI, SSI-Disability; [Mainstream or nontargeted
program]
Category of services: Housing: Permanent[A]: [Empty];
Category of services: Housing: Short term[B]: [Empty];
Supportive services: Food: [Empty];
Supportive services: Health[C]: [Empty];
Supportive services: Other[D]: [Check].
Source: GAO.
[A] Permanent refers to permanent supportive or affordable housing:
[B] Short term refers to emergency or short-term shelters. Examples
include homeless shelters, domestic violence shelters, transitional
housing, and hotel vouchers.
[C] Examples include mental health services, physical health services,
substance abuse treatment, residential treatment, and case management.
[D] Examples include general or cash assistance, job training,
employment assistance, education, child care and development, and
transportation assistance.
[E] Although the Shelter Plus Care program does not pay for supportive
services, recipients must match each dollar of funding for housing
with a dollar of funding for supportive services.
[F] HUD-VA Supportive Housing is a joint program in which HUD funds
the housing and VA funds the supportive services.
[G] The Federal Surplus Real Property program, established by title V
of McKinney-Vento, provides surplus land or buildings in support of
persons experiencing homelessness. These properties can be used for
housing and a wide range of supportive services but the program
provides no monetary support for any activity. See 42 U.S.C. § 11411.
[End of figure]
HUD funds programs targeted to the homeless populations through state
or local entities for the Emergency Shelter Grant (ESG) program and to
providers who participate in CoCs. The ESG program is dispersed by
formula, while three grant programs--the Single Room Occupancy,
Shelter Plus Care, and Supportive Housing programs--are awarded
competitively through the CoC process.[Footnote 23] HUD receives a
single appropriation for its targeted programs and administratively
determines the amount of funding for the ESG program.[Footnote 24] ESG
funding is awarded based on the Community Development Block Grant
(CDBG) formula, which designates that 70 percent of funding is awarded
directly to entitlement cities and counties and 30 percent is awarded
to state entities that determine the dispersion of funding for the
more rural parts of the state.[Footnote 25] Organizations located in
areas or municipalities not receiving direct ESG allocations compete
for funding through the state entity. For example in 2009 in Maine,
only Portland received its own allocation of about $94,000, while
organizations from all other areas or municipalities within the state
competed for about $770,000.
HUD's three competitive homeless assistance grants are awarded through
the CoC process using a scoring system where HUD scores the planning
document submitted by the CoCs as part of the application.[Footnote
26] Programs that have previously received funding, referred to as
renewals, receive a higher funding priority and are funded before new
programs are considered for funding. In 2008, 86 percent of the
competitive homeless assistance grants were renewals. Although CoC
funding is awarded competitively, HUD determines a need factor called
the pro rata need (also based on the CDBG formula) for each CoC.
According to a HUD official, in calculating the preliminary pro rata
need, HUD allocates 75 percent of funding to entitlement cities and
counties that qualify for direct ESG allocations and 25 percent of
funding to all other areas.[Footnote 27] All CoCs have an identified
need factor, but CoCs may not have funded programs as new funding is
awarded in order of CoC score, which is based on multiple factors.
HHS and other federal agencies--including Education, Labor, VA, DHS,
and DOJ--largely operate their targeted programs through state
entities or by directly funding community-based public or nonprofit
entities. HHS provides funding for a number of programs, including
Runaway and Homeless Youth, Health Care for the Homeless, and PATH.
Funding for Health Care for the Homeless is distributed competitively,
while PATH funding is distributed to states, Washington, D.C. and U.S.
territories that distribute the funding. The PATH formula, which has
remained unchanged since 1990, primarily considers the urban
population of the state or territory and designates a minimum of
$300,000 for states and $50,000 for territories. In 2009, 18 states
and the District of Columbia received the state minimum. DHS, through
the Federal Emergency Management Agency, funds the Emergency Food and
Shelter Program, which distributes funding to local entities through
the United Way of America or similarly functioning organizations.
Funding is formula-based and considers poverty rate and unemployment.
Some providers in very small communities told us that they receive
federal funding only through the Emergency Food and Shelter Program.
Mainstream federal programs may assist persons experiencing
homelessness but the level of assistance directed towards homelessness
is generally unknown as some programs are not required to track if
participants have been or are experiencing homelessness. Mainstream
programs provide assistance to individuals and families and include
HHS' Temporary Assistance for Needy Families; USDA's food programs
such as the Supplemental Nutrition Assistance Program and the Special
Supplemental Nutrition Program for Women, Infants, and Children; HUD's
housing programs such as public housing and the Housing Choice Voucher
program; the Social Security Administration's Supplemental Security
Income and disability insurance programs; and VA's disability
compensation program.
Funding in other federal programs also may be used for homeless
assistance based on the decisions of state, local, or tribal
governments. Homeless programs are one of many eligible uses for
funding in programs such as HUD's CDBG program and USDA's Community
Facilities Loan program. CDBG is formula-based with state entities
receiving and dispersing the portion of funding intended for rural
areas, while the Community Facilities Loan program is awarded
competitively through USDA's state offices. Some programs direct
funding to areas that are in particular need of housing
infrastructure. For example, the Cranston-Gonzalez Act requires states
that share a border with Mexico to set aside CDBG funds for the
colonias. This funding may be used to expand water and sewer services
and to provide housing assistance.[Footnote 28] USDA's agency for
rural development also funds programs to improve infrastructure in the
colonias.
Tribes receive funding for housing, health care, and other services
through HUD's Native American Housing Assistance and Self-
Determination Act (NAHASDA) programs and a variety of programs offered
through HHS and BIA. These programs, although not specifically
targeted at homelessness, may assist persons experiencing
homelessness. They are available to recognized tribes only and funding
generally is formulaic, based on tribal enrollment. Generally, NAHASDA
money is distributed to tribal-designated housing entities that use
money to build or refurbish housing. BIA programs are funded as
contracts awarded to designated tribal entities to provide a range of
services. In both cases, tribal governments determine priorities,
usage, and eligibility. Housing funds are distributed to regional BIA
offices through a formula process and individuals receive assistance
based on priority until funds are exhausted.
Limited Data Are Available on the Amount of Targeted and Nontargeted
Assistance to Rural Versus Nonrural Areas:
The amount of federal funding for targeted homeless assistance
programs in rural areas is uncertain. According to the Congressional
Research Service, in fiscal year 2009 federal agencies spent more than
$2.85 billion on programs targeted to address the needs of individuals
and families experiencing homelessness.[Footnote 29] HUD's targeted
homeless programs represent the largest funding source for federal
targeted homeless assistance, which for fiscal year 2009 totaled more
than $1.7 billion or more than 62 percent of total targeted funding.
Figure 2 shows the targeted funding by federal agency. We were unable
to determine the total portion of this funding that went to rural
areas.
Figure 2: Percent of Total Federal Funding Targeting Homelessness by
Agency for Fiscal Year 2009:
[Refer to PDF for image: pie-chart]
DOJ: 0.6%;
Labor: 0.9%;
Education: 2.3%;
DHS/FEMA: 7.1%;
HHS: 12.9%;
VA: 13.7%;
HUD: 62.3%.
Source: GAO analysis of Congressional Research Service data.
Note: Data do not include assistance from mainstream programs which
may also provide support to persons experiencing homelessness.
[End of figure]
Determining what funding went to rural areas is difficult because some
federal agencies use self-reported data that may not be accurate, do
not distinguish between rural and nonrural areas, or do not track
whether funding went to such areas. As discussed earlier in this
report, federal agencies use multiple definitions of rural,
complicating any determination of what types of areas received
funding. For instance, HUD's CoC programs maintain data on the amount
of assistance for rural areas; however, grant applicants could
designate (self-identify)--based on a HUD provided definition of rural
area--whether they were in rural areas or not. Table 2 shows the
funding based on this designation for fiscal years 2006-2008. In
fiscal year 2008, according to the HUD data, 9.3 percent of CoC
funding went to rural areas, which represented about 15 percent of
total projects.
Table 2: Rural Funding within HUD's CoC Programs, Based on Grant
Applicant Reporting as Rural or Not:
Fiscal year: 2008;
Total funding awarded in billions: $1.40;
Funding awarded to rural projects in millions (percentage of total):
$129.9; (9.3%);
Total projects funded: 6336;
Rural projects funded (percentage of total): 960; (15.2%).
Fiscal year: 2007;
Total funding awarded in billions: $1.33;
Funding awarded to rural projects in millions (percentage of total):
99.82; (7.5);
Total projects funded: 5911;
Rural projects funded (percentage of total): 718; (12.2).
Fiscal year: 2006;
Total funding awarded in billions: $1.21;
Funding awarded to rural projects in millions (percentage of total):
69.82; (5.8);
Total projects funded: 5288;
Rural projects funded (percentage of total): 538; (10.2).
Source: GAO analysis of HUD data.
[End of table]
Similarly, VA can determine spending levels in rural areas for its
grant and per diem program using self-reported data. Table 3 shows
funding and the number of beds based on this designation for fiscal
years 2007-2009. In fiscal year 2009, according to VA data, 13.5
percent of capital grant awards under the Grant and Per Diem program
funding went to rural areas, which represented 8.5 percent of the
funded beds. HUD's ESG program targets 30 percent of its funding
toward nonentitlement cities or counties, which represent more rural
areas. However, according to HUD, ESG provides discretion to the state
entity to decide how to allocate ESG funds. A state may limit funds to
nonentitlement areas and metropolitan cities and urban counties that
did not receive individual allocations, or may choose to fund
entitlement cities and counties that received direct allocations from
HUD.
Table 3: Urban and Rural Fiscal Year Funding for VA's Capital Grant
Awards for the Grant and Per Diem Program Based on Grant Applicant
Reporting as Rural or Not:
Funding in millions (percentage of total): Urban;
2009: $11.67; (68.9%);
2008: $29.14; (82.1%);
2007: $11.3; (77.1%);
Total: $52.11.
Funding in millions (percentage of total): Rural;
2009: $2.28; (13.5%);
2008: $4.1; (11.6%);
2007: $3.35; (22.9%);
Total: $9.73.
Funding in millions (percentage of total): Unidentified;
2009: $3; (17.7%);
2008: $2.24; (6.3%);
2007: $0; (0);
Total: $5.24.
Funding in millions (percentage of total): Total;
2009: $16.95;
2008: $35.48;
2007: $14.65;
Total: $67.08.
Beds (percentage of total): Urban;
2009: 827; (71.8%);
2008: 1337; (88.2%);
2007: 691; (80.1%);
Total: 2855.
Beds (percentage of total): Rural;
2009: 98; (8.5%);
2008: 127; (8.4%);
2007: 172; (19.9%);
Total: 397.
Beds (percentage of total): Unidentified;
2009: 227; (19.7%);
2008: 52; (3.4%);
2007: 0; (0);
Total: 279.
Beds (percentage of total): Total;
2009: 1152;
2008: 1516;
2007: 863;
Total: 3531.
Source: VA.
Note: Percentages may not add to 100 percent due to rounding.
[End of table]
Other agencies also maintain limited information on the amount of
targeted homeless funding that is allocated to rural or nonrural
areas. Depending on the program, HHS and Education do not track
whether funding is for providers or projects in rural or nonrural
areas. Labor has two size categories within its targeted Homeless
Veterans' Reintegration program, one for urban areas and one for
nonurban areas, with different dollar amounts available. However,
Labor officials said their definition of nonurban was an area with
less than 569,463 persons, which is at least 10 times the population
limit specified in other agencies' definitions of rural.[Footnote 30]
Similarly, funding information on the mainstream and other nontargeted
programs that can provide support to individuals or families
experiencing homelessness is limited. Individuals and families who
meet the qualifications for services under mainstream programs are
eligible regardless of whether they live in rural, tribal, or nonrural
areas. Some mainstream programs, such as Temporary Assistance for
Needy Families, that may offer assistance to individuals or families
experiencing homelessness are not required to track housing status,
which prevents a determination of how much funding went to persons in
rural and nonrural areas. For other nontargeted programs, funding for
homelessness is often difficult to disaggregate from other spending.
For example, HUD's CDBG funds have many eligible uses as well as usage
clauses that required a certain percentage of funding to be used for
projects that benefit low-income persons. The building of shelters and
transitional housing are among several eligible uses that would assist
persons experiencing homelessness; however, the total amount of
assistance to specific types of projects is unknown. A certain
percentage of CDBG funds for states bordering Mexico are targeted to
the colonias, but the amount of funding that specifically addresses
homelessness is unknown. For NAHASDA and other programs that fund
assistance to tribal entities, individual tribal governments determine
usage and disaggregating funds used for persons experiencing
homelessness would need to be done at the tribal level. However, USDA,
which has nonfood programs that primarily serve rural areas, was able
to disaggregate funding within its Community Facilities Loan Program.
Eligible uses under this program include homeless and domestic
violence shelters, community centers, and fire stations. For fiscal
years 2004-2009, the program financed a total of 7 homeless shelters
and 76 domestic violence shelters for a total of about $29.7 million
of the program's $4.5 billion total for those years.
We were unable to determine whether the distribution of federal
funding for supporting persons experiencing homelessness was
proportional to need in rural and nonrural areas. Such a determination
would require complete data on the total number of persons
experiencing homelessness in both rural and nonrural areas, as well as
reliable information on the funding available in both rural and
nonrural areas. We found that the counts of homelessness are not
complete for this purpose, and as stated above, funding levels are
nondeterminable for a variety of reasons.
Barriers to the Rural Homeless Population Seeking Assistance Include
Limited Availability of Services, Lack of Transportation, and Lack of
Affordable Housing:
According to state and local officials, as well as individuals
experiencing homelessness we interviewed in the states we visited,
limited availability of services, lack of transportation, and lack of
affordable housing have been some common barriers that the rural
homeless population encounters when seeking assistance. Factors such
as geography, population density, and socio-economic conditions also
can make access to services challenging in rural areas--particularly
when considered in combination with the barriers cited above.
Providers we spoke to in the states we visited said homeless shelters
and transitional housing in rural areas are scarce and serve a wide
geographical area, and in some instances, counties do not have
shelters. A shelter we visited in Maine with 63 beds is the only multi-
purpose shelter that serves the entire homeless population in a county
of nearly 1,000 square miles. In addition, 4 of the 16 counties in
Maine are without emergency shelters, with 1 of those 4 counties using
hotels as an alternative in the winter. Some shelters may dedicate
services to a specific subpopulation such as youth, domestic violence,
and substance abuse clients, which could narrow the availability of
assistance for some individuals or populations. Many of the providers
with whom we spoke have had to turn away individuals and families
because their shelters were full and backlogged. According to
officials in Maine, between June and August 2009, shelters across the
state turned away 500 families, including a total of 200 children.
Because shelters are one of the visible points of entry to a network
of services such as health care, alcohol and drug treatment, job
training, and case managers, those experiencing homelessness in rural
areas who are without shelters may be more likely to be disconnected
from caseworkers who can provide referrals to these supportive
services. However, community action agencies, faith-based
organizations, and other nongovernmental entities may offer assistance
to networks of services. Similarly, supportive services, such as
medical and dental, mental health, food, and job training, are also
limited in rural areas. For example, one service provider in rural
Kentucky stated that the closest mental health center was 50 minutes
away, while another service provider in rural Maine told us that the
closest psychiatrist was about an hour and a half away. Also in Maine,
rural service providers told us that there is no funding to support
job training. Furthermore, officials said that domestic violence is
associated with homelessness in rural communities and tribal areas,
and those individuals have limited resources or services.
According to those we interviewed, the lack of transportation in rural
areas has hindered the homeless population in accessing services.
Rural areas can be isolating due to the combination of expansive land
size and sparse population. Persons experiencing homelessness might be
geographically cut-off from the limited homeless service providers
available in their area, and would need to travel long distances to
receive needed services. Many of the state and local officials,
service providers, and individuals experiencing homelessness
interviewed told us that public transportation either was nonexistent
or limited (i.e., infrequent service and limited coverage areas). If
homeless individuals missed their appointments, they have to
reschedule for another appointment at a later time thereby delaying
services, or their services could be denied according to one service
provider in Minnesota. Individuals experiencing homelessness in some
of the areas we visited with no public transportation reported that
they utilized dial-a-ride services provided by community action
agencies or relied on friends or caseworkers. The cost of public
transportation can also be an issue for those with very little income,
although some local service providers with whom we spoke were able to
give bus passes to their clients. Alternatively, some local nonprofits
provided automobiles or buses to connect individuals and families to
services, but coverage areas also were limited.
According to many of the people we interviewed, persons experiencing
homelessness and seeking assistance also may encounter the barrier of
limited safe and affordable housing in rural areas. Providers in
certain areas of the states we visited raised concerns about the
shortage of affordable housing and, in some cases, quality of housing
available in the areas, noting that they were aware of some properties
that lacked complete plumbing or heat.[Footnote 31] In some of the
rural areas we visited, deteriorating housing conditions for private
market units may be more severe due to the absence of building code
enforcement. According to a service provider in eastern Kentucky, many
homes in the areas are heated with wood or coal (a potential fire
hazard), and others lacked complete plumbing. Moreover, because market
rents in eastern Kentucky have been so low compared to nonrural areas
due to high poverty rates, programs, such as the Low-Income Housing
Tax Credits (LIHTC) are examples of financial incentives to attract
investors who have shied away from supporting low-income housing
development in the area.[Footnote 32] Furthermore, according to
providers we spoke with in Kentucky and Texas, topographic conditions,
such as limited flat land in eastern Kentucky and flood plains in the
colonias in Webb and Hidalgo counties in Texas, have discouraged
investors and developers from investing in these rural areas.
According to a service provider in Arizona, development on tribal
lands is restricted by legal issues relating to sovereign land, which
reduces banks' willingness to finance projects. Resistance in local
communities also has presented obstacles to building new housing as
described by those we interviewed. For example, Minnesota state
officials noted that some local communities have resisted the building
of shelters and other housing for the homeless or low-income
populations because they believe that undesirable persons will move to
their communities. For similar reasons, a local government in Texas
has not sought funds from state or other sources to fund homeless
programs, according to a local shelter provider. Compounding the issue
of lack of affordable housing, service providers in some of the states
we visited have experienced long waiting lists (about 2 years) for the
Housing Choice Voucher Program (tenant-based Section 8).[Footnote 33]
For example, service providers in Maine told us that they have not
been able to obtain tenant-based Section 8 vouchers since December
2008.
Based on those with whom we spoke and relevant research, individual
barriers such as mental health issues, felony records, and no proof of
identification have hindered those seeking assistance. According to
the 1996 National Survey of Homeless Assistance Providers and Clients,
two-thirds of the rural homeless population report having a mental
health or substance abuse problem and may require specialized services
such as psychiatric referral and treatment.[Footnote 34] Several
individuals with whom we spoke in a shelter indicated that they felt
more mentally and emotionally stable after being put on medication
received under public health care coverage through the help of shelter
staff. Also, program eligibility and rules may exclude some felons
from federal housing assistance, including tenant-based and project-
based Section 8 programs. Without federal housing assistance, these
individuals could remain homeless because the ability to find a job
that would pay for market rent could also be affected by their
criminal records.[Footnote 35] Another individual barrier is the lack
of documentation to prove identity. Without birth certificates,
driver's licenses, and Social Security cards which, according to some
providers with whom we spoke, some persons experiencing homelessness
lack, individuals and families might not be able to apply for and
obtain services. Table 4 illustrates some examples of barriers for
persons experiencing homelessness, as discussed above and further
identified in our interviews with local service providers and homeless
individuals in the states we visited.
Table 4: Possible Needs of the Homeless Population and Potential
Corresponding Barriers in Rural Areas:
Physical housing:
Possible needs: Temporary housing;
Structural barriers:
* No shelters or shelters are full;
* Shortage of transitional housing;
* Communities' resistance to homeless programs;
Applicant-related barriers:
* Felons generally do not qualify for federal housing assistance.
Possible needs: Permanent Housing;
Structural barriers:
* Shortage of permanent and permanent supportive housing;
* Limited number of tenant-based Section 8 vouchers;
* Substandard housing ineligible for tenant-based Section 8 vouchers;
* Limited investors for affordable housing development;
Applicant-related barriers:
* Limited income to pay the difference between actual rent and amount
subsidized by tenant-based Section 8 vouchers.
Possible needs: Adequate income to afford housing:
Structural barriers:
* Economic environment has resulted in job losses or lower wages;
* Lack of public transportation to get to a job;
Applicant-related barriers:
* Criminal record may discourage employers from hiring people;
* Lack of personal identification;
* Lack of contact information;
* Low educational attainment rate;
* Mental health or substance abuse issues not being treated;
* Lack of child care options.
Possible needs: Services:
Structural barriers:
* Limited health care providers, including dental and vision care;
* Limited mental health providers;
* Limited or no substance abuse services;
* Limited access to providers;
* Limited case managers;
* Lack of transportation to get to services;
Applicant-related barriers:
* May not qualify for services due to program definitions;
* Lack of personal identification;
* Lack of contact information;
* May not seek services due to pride or privacy;
* Lack ability to successfully apply for services;
* Lack knowledge of available assistance.
Source: GAO.
[End of table]
Barriers to the Rural Homeless Service Providers Include
Administrative Burden, Lack of Affordable Housing, and Challenges
Related to Geography and Population Density:
According to state and local officials and local service providers in
the states we visited, administrative burden, lack of affordable
housing, and challenges related to geography and population density
were barriers for rural homeless service providers. Some of the local
service providers with whom we spoke indicated that they operated with
limited staff and, due to capacity issues, assumed a wide variety of
responsibilities from providing direct service to clients to applying
for federal and other grants. In particular, service providers in
rural areas with whom we spoke have responded to limited resources by
applying to, and assembling multiple funding sources from both state
and federal programs. As a result, the time consumed in grant writing
and meeting the various compliance and review requirements set by
statute represented an administrative and workload burden, according
to service providers and state officials with whom we spoke. For
example, providers in Maine expressed frustration with the duplicative
review for the Supportive Housing Grant Program and tenant-based
Section 8 Program, both of which HUD administers but under separate
authorities. According to some service providers with whom we spoke,
many grant applications also require data to demonstrate resource
needs. Especially in rural areas with no shelters or visible points of
entry for services, counts of the homeless are not documented, and
without data it is hard to prove that the services are needed. Because
of the administrative burden and challenges in meeting application
requirements, some providers with whom we spoke were discouraged from
applying for funds from certain programs. A coalition we spoke to in
Maine said that many of its members were discouraged by the
requirements of programs that received stimulus funds and therefore
considered not applying for them. Also, as described in our June 2010
report, issues related to multiple federal definitions of homelessness
have posed challenges for service providers.[Footnote 36] Moreover,
according to Minnesota state officials and service providers we spoke
with, Minnesota's definition of homelessness is different from some
federal programs, creating another level of complexity in
understanding the definition and determining client eligibility.
According to state officials, Minnesota's definition of homelessness
includes those who, as long as the person or family's situation is not
stable are doubling up and "couch surfing" for at least a year or four
separate occasions over a 3 year period. While this is consistent with
a broader definition of homelessness used by Education under the
McKinney-Vento Act, it has not been consistent with HUD's definition
of chronic homelessness.
State and local officials and rural service providers cited a lack of
affordable housing as another challenge for service providers when
addressing homelessness in rural areas. Specifically, some of the
local service providers with whom we spoke have been unable to move
people from emergency shelters, homeless shelters, or transitional
housing programs to permanent housing due to shortages of tenant-based
Section 8 vouchers and a shortage of affordable housing. According to
service providers in multiple locations, due to the shortage in tenant-
based Section 8 vouchers, the shelters they work with are full and
stays at shelters have lengthened. Without financial assistance, those
experiencing homelessness may find it challenging to move out of short-
term housing. Furthermore, to the extent that tenant-based Section 8
vouchers have been available, some providers told us in their
communities that the current housing stock has been deteriorating and
limited new housing units have been built, so there is nowhere for
that voucher to be used. According to HUD, between 1995 and 2007,
LIHTC--the principal federal subsidy mechanism for supporting the
production of new and rehabilitated rental housing for low-income
households--were used predominately for new construction. With that
said, the number of new construction units has declined since 2005.
[Footnote 37] Moreover, according to HUD regional office officials,
the lack of affordable housing also is attributable to the significant
reduction in size of the housing projects being built. As a result,
some providers told us long waiting lists for tenant-based Section 8
vouchers exist. According to a rural service provider in Kentucky, the
tenant-based Section 8 voucher waiting list had 3,000 names on it.
The persons with whom we spoke also consistently said the size of
service areas and low population densities in rural areas presented
obstacles to service provision. The combination of expansive service
areas and sparse populations require many service providers to drive
long distances to serve their clients. For example, several rural
service providers, particularly case workers, described their vehicles
as their offices because of the amount of time they spent traveling
between meetings with other service providers and serving clients.
Furthermore, according to HUD, because funding is limited, many rural
service providers cannot afford large staffs and often wear many hats.
In an urban area, separate staff or separate agencies might be
responsible for assessing different needs such as housing, nutrition,
education, job-search, mental and physical health, and substance abuse
needs. However, in a rural area, one individual may be the client's
primary point of contact and may have to consider the whole range of
issues. Furthermore, some rural areas do not have broadband services
and some providers we spoke with said that they are excluded from some
of the communications and resources available over the Internet. For
instance, HUD regional office officials acknowledged that some rural
service providers have been unable to connect to some of their
technical assistance workshops and learn about application
preparation, project administration, and management.
Local officials and service providers have cited other barriers such
as variability of local commitments and diminishing purchasing power.
In some of the states we visited, some service providers mentioned
variability in local and state commitment, which can influence the
homeless assistance programs. For example, 10 years ago Minnesota
invested in an intensive case management pilot program which provides
housing and supportive services to assist people with long histories
of homelessness. Because of the success of the pilot, the Minnesota
legislature has continued to appropriate funding to finance supportive
housing for five long-term homeless projects in areas that include
approximately 80 percent of Minnesota's population, according to a
service provider in Minnesota. In contrast, other communities have
been resistant to supporting homeless programs, such as one community
organization in Texas described that their local government resisted
acquiring additional funds in fear of attracting more homeless
individuals and families to the community. Diminishing purchasing
power also affects the ability of local service providers to address
needs in their communities. According to CoC participants, Maine
receives PATH funds, but the amount has remained steady at $300,000
per year for the last 17 years. According to officials, the buying
power of the program has diminished to $158,000 (in real dollars)
today compared to 17 years ago. Similarly, the per diem rate, funded
through HUD's ESG program, has diminished from $12.41 in 2008 to
$11.21 in 2009, nearly a 10 percent decrease, although service
providers in Maine have increased services such as adding more beds in
the shelter.[Footnote 38]
Limited Effective Collaboration among Federal Homelessness Programs
Has Hindered Opportunities to Integrate Services:
While a few examples of federal collaboration regarding homelessness
have demonstrated aspects of effective collaboration, effective
collaboration has been limited between HUD and HHS, two of the key
federal agencies funding housing and supportive services that include
programs for more than one subpopulation. In an October 2005 report,
we identified key collaborative practices among federal agencies that
include agreeing on roles and responsibilities, defining and
articulating a common outcome, establishing mutually reinforcing or
joint strategies, and identifying and addressing needs by leveraging
resources.[Footnote 39] Collaboration to link supportive services and
housing is particularly significant for rural areas because of the
complex system of barriers in rural areas, such as limited bed
capacity in shelters, distance to services, and lack of
transportation. Such linkage can enhance strategies to address
challenges that limited resources and the other barriers pose. One
study regarding the linking of affordable housing with supportive
services--supportive housing--indicated that over the long term, it
could save public resources by reducing the cycle of homelessness
through improved housing stability and behavioral health
outcomes.[Footnote 40] Moreover, some studies indicated that offering
housing with supportive services resulted in fewer hospital days and
emergency room visits, which are publicly provided.[Footnote 41]
Two completed demonstration projects--Collaborative Initiative to Help
End Chronic Homelessness (CICH) and Ending Chronic Homelessness
through Employment and Housing--and the existing HUD-VASH program
demonstrated key collaboration practices identified in our October
2005 report, such as defining roles and responsibilities and
leveraging resources. Under the CICH, HUD, HHS, and VA agreed on roles
and responsibilities and leveraged resources by allotting 3-year
grants from HHS and VA and up to 5-year grants from HUD to 11
communities.[Footnote 42] Similarly, Ending Chronic Homelessness
through Employment and Housing was a partnership between Labor and HUD
in which, through a cooperative agreement, HUD and Labor defined roles
and responsibilities and leveraged resources, also consistent with key
collaboration practices.[Footnote 43] Since 2008, under the HUD VASH
program, HUD has designated more than 30,000 tenant-based Section 8
vouchers to public housing authorities for veterans who are homeless
and VA provided funding for supportive services, including case
management and clinical services.[Footnote 44] Particularly, VA
identified a number of Veterans Affairs Medical Centers to participate
in the program and provide case management resources. While these
efforts demonstrated practices that enhanced and sustained
collaboration, particularly linking housing assistance and supportive
services, HUD-VASH has not demonstrated collaborative strategies that
could benefit rural areas specifically, according to officials and
rural service providers in some of the states we visited. Because the
HUD vouchers must be linked to VA facilities, the recipients of the
vouchers have been mostly in nonrural areas in which most VA medical
centers are located. However, according to HUD officials, innovative
approaches, such as using a mobile clinic, are now being used to serve
rural areas. Furthermore, according to VA officials, HUD and VA have
discussed opportunities to improve voucher allocation in rural areas.
[Footnote 45]
Additionally, the Interagency Council has developed the first-ever
Federal Strategic Plan to Prevent and End Homelessness. The plan,
which was presented to Congress on June 22, 2010, reflects interagency
agreements on a set of priorities and strategies agencies will pursue
over 5 and 10-year timeframes according to population. Also, according
to HUD and HHS officials, the two departments, as part of the
President's fiscal year 2011 budget, are proposing two demonstration
initiatives, one involving 4,000 housing vouchers with health,
behavioral health, and other supportive services for chronically
homeless persons, and another involving 6,000 housing vouchers linked
with mainstream services like job training and income assistance
through TANF for homeless and at-risk families with children.
Additionally, according to HUD and HHS officials, the two departments
established working groups to identify collaboration opportunities
related to homelessness. However, given that the Council's strategic
plan has only recently been released and that the proposal in the
President's fiscal year 2011 budget has yet to be approved, the impact
of both of these efforts is uncertain.
According to officials and providers we interviewed, HUD and HHS are
the key agencies serving the general population of those experiencing
homeless. For instance, HUD officials noted that the agency was the
only federal provider of permanent supportive housing for the
homeless. While several agencies provide supportive services,
including HUD, the health-related services on which HHS focuses
correspond to needs often associated with persons experiencing
homelessness, particularly mental health and substance abuse treatment
(see table 5).[Footnote 46] Service providers with whom we spoke
consistently cited HHS as the appropriate agency for supportive
services.
Table 5: Examples of Supportive Services That Federal Agencies,
Excluding HUD, Can Provide to Persons Experiencing Homelessness:
Health services:
Types of supportive services: Case management;
Subpopulation: Adult or family: HHS;
Subpopulation: Youth: Health services: HHS;
Subpopulation: Veteran: Health services: VA and HHS.
Types of supportive services: Mental health;
Subpopulation: Adult or family: HHS;
Subpopulation: Youth: Health services: HHS;
Subpopulation: Veteran: Health services: VA and HHS.
Types of supportive services: Medical;
Subpopulation: Adult or family: HHS;
Subpopulation: Youth: Health services: HHS;
Subpopulation: Veteran: Health services: VA and HHS.
Types of supportive services: Substance abuse treatment;
Subpopulation: Adult or family: HHS;
Subpopulation: Youth: Health services: HHS;
Subpopulation: Veteran: Health services: VA and HHS.
Nonhealth services:
Types of supportive services: Education;
Subpopulation: Adult or family: [Empty];
Subpopulation: Youth: Health services: Education;
Subpopulation: Veteran: Health services: [Empty].
Types of supportive services: Food;
Subpopulation: Adult or family: DHS and USDA;
Subpopulation: Youth: Health services: DHS, HHS, and USDA;
Subpopulation: Veteran: Health services: DHS and USDA.
Types of supportive services: Job training;
Subpopulation: Adult or family: Labor and HHS;
Subpopulation: Youth: Health services: Labor;
Subpopulation: Veteran: Health services: Labor and HHS.
Source: GAO.
[End of table]
However, according to officials and rural providers we interviewed
(and nonrural providers interviewed for our June 2010 report), there
is little evidence that HUD and HHS have formally agreed on their
respective roles and responsibilities, or identified ways to leverage
resources to support the delivery of coordinated housing and
supportive services.[Footnote 47] According to HUD officials,
beginning in 2002, in response to a requirement in the 2001 HUD
Appropriations Act, HUD shifted its emphasis towards funding housing
for persons experiencing homelessness.[Footnote 48] This reduced the
proportion of the total CoC funding which went to supportive services
from 50 percent in 2002 to 34 percent in 2008, as illustrated in
figure 3. In subsequent years, CoCs submitted new and renewal projects
with mostly housing activities (such as operation and leasing), and
according to HUD officials, this resulted in more than 40,000 newly
constructed housing units.[Footnote 49] During this shift towards
housing assistance, HUD required new and renewal applicants to provide
information on how those projects planned to coordinate and integrate
with other mainstream health, social services, and employment
programs. Even though HUD officials noted that it relied on other
federal agencies to fill the supportive services gap, providers we
visited told us they are challenged to secure supportive services
funding from agencies other than HUD. A requirement that HUD
applicants provide information on plans to coordinate with other
agencies does not directly address this concern of these service
providers.
Figure 3: HUD's CoC Housing and Supportive Services Distribution:
[Refer to PDF for image: stacked vertical bar graph]
Year: 2002;
Housing: 50%;
Supportive services: 50%.
Year: 2004;
Housing: 58%;
Supportive services: 42%.
Year: 2006;
Housing: 60%;
Supportive services: 40%.
Year: 2008;
Housing: 66%;
Supportive services: 34%.
Source: HUD.
[End of figure]
HUD and HHS, which both have missions to address homelessness, have
not adopted some of the key practices that could be used to enhance
collaborative efforts, particularly during the period when HUD shifted
its resources and responsibilities. HUD officials said that they
consulted with HHS prior to their shift in resources and
responsibilities. HHS officials told us that there was no formal
discussion or agreement between them and HUD about how HHS might fill
the gap in supportive services created by HUD's shift toward housing.
We previously have recommended that federal agencies adopt a formal
approach--including practices such as a memorandum of agreement or
formal incentives focused on collaboration, signed by senior
officials--to encourage further collaboration. However, while HUD and
HHS have not previously done this, they reported that they have
started discussions as part of their demonstration initiatives for
fiscal year 2011.[Footnote 50]
Without formally linking housing and supportive services across
federal agencies, federal efforts to address homelessness may not be
as effective as they could be. According to HUD officials, from 2001
to 2007, HUD and several partners--HHS, VA, Labor, Education, and the
Interagency Council--held a series of Policy Academies which focused
on fostering collaboration, enhancing partnerships, and building
capacity. Additionally, HHS and HUD collaborated to create FirstStep
to encourage use of mainstream services. However, the impact of this
collaboration is not clear, as evidenced by numerous rural providers
who were not aware of the collaboration. In addition, service
providers with whom we spoke in both rural and nonrural areas
consistently raised concerns about the lack of coordination between
HUD and HHS. In spite of HUD's housing emphasis, which encouraged
local communities to coordinate with other mainstream supportive
services programs, and HUD's efforts in issuing guidance to rural
areas on ways to collaborate with other organizations, some service
providers we spoke with mentioned that they did not observe
coordination across federal agencies.[Footnote 51] They cited the
administrative challenges they faced in developing programs for the
homeless that incorporated both housing and services.[Footnote 52]
Particular to Kentucky, state officials and service providers told us
that HHS's PATH program, due to state stipulations, limits resources
for serving rural clients, many of whom suffer from mental health or
substance abuse problems. The lack of service dollars also affects
organizations that could access HHS funding. Officials who administer
several shelter and transitional housing programs in rural Maine told
us they sought nongovernmental funding to fill the gaps in services.
For example, HHS's Transitional Living Program provided $200,000 for
supportive services over 5 years, but the officials had to seek
additional supportive services funds through foundations and private
donors. Development by HUD and HHS of formal efforts to link housing
and services, which may include their proposed collaboration in the
President's fiscal year 2011 budget, could enhance the effectiveness
of federal efforts to address homelessness.
Conclusions:
The issue of rural homelessness presents a number of challenges for
federal agencies, not the least of which is determining its extent.
Data limitations and the array of federal programs, some of which are
not specifically targeted toward homelessness and some of which do not
track if their services or dollars have been expended in rural areas
or on persons experiencing homelessness, have resulted in multiple
data sets that do not allow for an overall assessment of the
characteristics and extent of rural homelessness or a comparison with
nonrural homelessness. The data issues are enormously challenging, but
they also highlight the importance of coordinating within existing
programs to mitigate some of the impact of the information gaps and to
effectively deliver services.
As HUD and HHS consider collaborative efforts to address homelessness,
formal coordination across these agencies that links supportive
services and housing--a model that has shown to be effective--needs to
include tangible and accessible opportunities for providers to bridge
the gap in funding for supportive services that can be joined with
housing for persons experiencing homelessness. Providers with whom we
met in rural areas were generally unaware of any collaborative efforts
between HUD and HHS that would assist them in linking housing and
supportive services. Particularly during HUD's shift in its resources
and responsibilities in 2002, HHS and HUD, the primary agencies for
supportive services and housing, did not implement some of the key
practices for effective collaboration that could have limited gaps in
services. More effective collaboration can create incentives and
opportunities for homeless housing and supportive services to be
linked, which is considered to be important for the effective delivery
of assistance to persons experiencing homelessness, and to further
reduce administrative challenges for local service providers. By more
formally linking housing and supportive services, HUD and HHS could
increase their ability and opportunities to address gaps in efforts to
effectively address homelessness and decrease challenges to service
providers and persons experiencing homelessness.
Recommendation for Executive Action:
To strengthen formal collaboration efforts, we recommend that the
Secretary of Housing and Urban Development and the Secretary of Health
and Human Services direct the appropriate program offices to further
explore opportunities to more formally link housing and supportive
services--in the most appropriate forms and combinations of mainstream
and targeted programs identified by both agencies--with specific
consideration for how such collaboration could minimize barriers to
service provision in rural areas.
Agency Comments and Our Evaluation:
We provided draft copies of this report to the Departments of
Agriculture, Education, Health and Human Services, Housing and Urban
Development, Interior, Labor, and Veterans Affairs and the Executive
Director of the U.S. Interagency Council on Homelessness for their
review and comment. Both HHS and HUD generally agreed with our
recommendation and provided technical comments which we incorporated,
as appropriate. Letters from the Deputy Assistant Secretary for
Legislation at the Department and Health and Human Services, and the
Assistant Secretary of Community Planning and Development at the
Department of Housing and Urban Development, are reprinted in
appendixes II and III of this report, respectively. The Departments of
Labor and Veterans Affairs and the staff of the U.S. Interagency
Council on Homelessness did not provide formal comments but provided
technical comments which we also incorporated, as appropriate. The
Departments of Agriculture and Interior did not provide any comments.
HUD's Assistant Secretary of Community Planning and Development stated
in written comments that HUD agrees that increased collaboration among
federal agencies would improve the delivery of services in rural
areas. In addition, HUD stated that due to statutory requirements,
federal agencies do not employ a single definition of "rural" and it
may not be reasonable for all agencies to utilize the same definition
of rural as the purposes of the programs may be vastly different. We
do not recommend that agencies utilize a single definition of rural
but rather recognize that the varying definitions limit the ability to
understand the incidence and prevalence of homelessness in rural
areas. HUD also commented that this report presents a limited review
of HUD's data collection and reporting efforts and does not
acknowledge the progress that HUD has been making in this area or the
value of the data currently being collected, or that their Annual
Homeless Assessment Report is the only national estimate of
homelessness to use longitudinal data. Since we recently issued a
report that provides a detailed review of HUD's data collection and
reporting efforts and discusses the efforts HUD has taken to improve
the data, we did not provide this same level of detail in this report.
[Footnote 53] We have added a reference to our June 2010 report for
additional information on these topics. In addition, as noted in our
June 2010 report, HUD's data in their Annual Homeless Assessment
Report are not longitudinal in that they do not follow specific
individuals over time; rather HUD collects aggregated data that track
numbers of homeless over time.
HUD commented that they have undertaken efforts to better align their
homelessness data with homelessness data from HHS and VA. We
acknowledged these efforts in the report. HUD also commented that the
report indicates that effective collaboration hinges predominately on
the use of a common vocabulary and offered barriers it considers more
significant to effective collaboration. Discussions of issues related
to a common vocabulary are not described in this report but are
included in our June 2010 report.[Footnote 54] Additionally, while HUD
agrees with our discussion about the proportion of CoC dollars awarded
for supportive services activities having decreased, they commented
that the total dollar amount associated with those service remains
significant. We do not suggest that the total dollar amount of HUD
funded supportive services is insignificant, but rather that the
decrease in the proportion of dollars for supportive services has
contributed to a gap in funding for providers. Further, HUD commented
that it has worked with HHS to improve access by homeless persons to
their programs and that federal coordination and collaboration are
evident in the U.S. Interagency Council on Homelessness's Federal
Strategic Plan to Prevent and End Homelessness. We recognize in our
report actions that HUD and HHS have taken to collaborate; however, we
believe that we correctly assess the opportunities for further
progress by the agencies in linking housing and supportive services
across their programs.
HUD also commented that it agreed that a common vocabulary among
federal agencies and increased collaboration would improve the
delivery of services in rural areas, but that the existence of both of
these elements does not equate to a seamless integration of various
streams of funding to create a project to serve homeless persons. We
are not suggesting that a common vocabulary and increased
collaboration by themselves will equate to a seamless integration of
funding streams, but we believe that it could help to improve the
delivery of services. Finally, HUD commented that it believes our
report's focus on the anecdotal experiences of local providers does
not provide a complete picture of efforts made by HUD regarding data
collection, interagency collaboration, and the funding of supportive
services. As noted earlier, we did not seek to repeat the level of
detail on HUD's efforts regarding data collection as had already been
included in our June 2010 report and we refer readers to this report
for additional information.[Footnote 55] Also, while our report
provides the perspectives of local providers as gathered from six site
visits, we also conducted numerous interviews with national
stakeholder groups and federal agency officials, and reviewed relevant
reports and federal agency documents. Based on all of the information
we gathered and reviewed, we believe we have correctly assessed the
data collection, interagency collaboration, and funding of supportive
service issues referred to by HUD in their comment.
HHS's Deputy Assistant Secretary for Legislation stated in written
comments that HHS strongly agrees with the importance of collaboration
with HUD to effectively address homelessness. In addition, HHS
commented that GAO's reference to the demonstration initiative--around
housing vouchers for homeless people--included in the Fiscal Year 2011
President's Budget was incomplete. We added an expanded description of
this initiative. HHS commented that the Patient Protection and
Affordable Care Act will contribute to filling gaps in supportive
services for homeless people. We did not examine the Patient
Protection and Affordable Care Act as part of our review. HHS also
commented that the discussion of funding and services in the report
needs to distinguish between linking homeless individuals with the
services that they need and aligning services with housing programs
that target specific homeless populations. We acknowledge that
collaboration between HHS and HUD related to housing and supportive
services could take different forms. As we state in our
recommendation, the two agencies should explore opportunities to link
housing and supportive services while considering the most appropriate
forms and combinations for this collaboration.
We will send copies of this report to interested congressional
committees, the United States Interagency Council for the Homeless,
and to the Departments of Agriculture, Education, Health and Human
Services, Housing and Urban Development, Interior, Labor, and Veterans
Affairs. This report will also be available on our home page at no
charge at [hyperlink, http://www.gao.gov].
If you have any question about this report, please contact me at (202)
512-8678 or cackleya@gao.gov. Contact points for our Offices of
Congressional Relations and Public Affairs may be found on the last
page of this report. GAO staff who made key contributions to this
report are listed in appendix IV.
Signed by:
Alicia Puente Cackley:
Director, Financial Markets and Community Investment:
List of Committees:
The Honorable Christopher J. Dodd:
Chairman:
The Honorable Richard C. Shelby:
Ranking Member:
Committee on Banking, Housing, and Urban Affairs:
United States Senate:
The Honorable Robert Menendez:
Chairman:
The Honorable David Vitter:
Ranking Member:
Subcommittee on Housing, Transportation and Community Development:
Committee on Banking, Housing, and Urban Affairs:
United States Senate:
The Honorable Barney Frank:
Chairman:
The Honorable Spencer Bachus:
Ranking Member:
Committee on Financial Services:
House of Representatives:
The Honorable Maxine Waters:
Chairwoman:
The Honorable Shelley Moore Capito:
Ranking Member:
Subcommittee on Housing and Community Opportunity:
Committee on Financial Services:
House of Representatives:
[End of section]
Appendix I: Scope and Methodology:
To address all of our objectives, we conducted site visits to six
states--Arizona, Kentucky, Maine, Minnesota, New Mexico, and Texas.
During these visits, we interviewed federal, state, and local housing
and homelessness officials and nonprofit homelessness organizations,
and toured rural areas in which homelessness was present. We selected
the site visit locations based on several factors, including (1)
discussions with advocates and researchers in the field of
homelessness--including the Housing Assistance Council, the National
Alliance to End Homelessness, the National Law Center on Homelessness
and Poverty, and the Urban Institute--to learn about rural
homelessness issues and the outcomes across different states; (2) a
review of studies and reports on local and state efforts to serve the
homeless in rural areas, including papers prepared for the 2007
National Symposium on Homelessness Research that highlighted issues
related to rural homelessness; (3) the presence of tribal lands and
colonias; and (4) geographical diversity. While on site visits we
interviewed federal field office officials, state officials, local
providers, and local advocates, and in Minnesota panels of homeless
individuals. We also toured service areas and providers facilities,
and in Texas we toured several colonias. On the site visits to Arizona
and New Mexico we visited the tribal lands of the San Carlos Apache
Tribe of the San Carlos Reservation, Arizona; the Tohono O'odham
Nation of Arizona; the Pueblo of Acoma, New Mexico; and the Pueblo of
San Felipe, New Mexico. We interviewed tribal officials from the
tribal designated housing entities, service providers on and off
tribal lands, and advocates. We reviewed relevant laws, regulations,
and program documentation and interviewed officials from various
federal agencies, including Departments of Agriculture, Education,
Health and Human Services, Housing and Urban Development, Interior,
Labor, Veterans Affairs, and the U.S. Interagency Council on
Homelessness (Interagency Council). We also conducted interviews with
a variety of stakeholders, including advocates and researchers.
To describe the characteristics of homelessness in rural areas, we
reviewed existing research and studies on homelessness issues,
particularly those that are related to rural homelessness. We
conducted interviews with relevant federal and state officials,
service providers, national homeless and poverty organizations, and to
the extent possible, homeless individuals and families to obtain their
perspectives on the conditions of homeless in rural areas and the
extent of migration to nonrural areas for assistance. Specifically, we
interviewed federal officials to understand the extent data is
available in estimating the incidence and prevalence of homelessness
in rural areas and how it compares to nonrural areas.
To identify the federal homeless assistance and amount of funding
awarded, we reviewed statutes, regulations, and reports, including our
prior work, on federal homeless assistance for both targeted and
mainstream programs. We interviewed federal, state, and local
officials, to understand the range of assistance that is available to
assist homeless individuals or families in rural areas, how those
assistance programs are delivered, and the amount of funding that has
been awarded. To the extent that data were available for comparison,
we interviewed selected federal officials to understand funding
differences between rural and nonrural areas. Specific data from some
programs funded by the Departments of Agriculture, Housing and Urban
Development, and Veterans Affairs were determined to be reliable
enough to use in this report.
To identify the barriers persons experiencing homelessness and
homeless service providers encounter, we interviewed state and local
officials, homeless service providers, and to the extent possible,
homeless individuals and families for information on barriers
encountered when seeking assistance, barriers encountered when
providing assistance, and any challenges related to federal
coordination and efforts. We also interviewed select federal
officials, including officials from the Interagency Council, to
understand the extent of federal collaboration in providing services
to persons or families experiencing homelessness in rural areas.
We conducted this performance audit from September 2009 to July 2010
in accordance with generally accepted government auditing standards.
Those standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our
findings and conclusions based on our audit objectives. We believe
that the evidence obtained provides a reasonable basis for our
findings and conclusions based on our audit objectives.
[End of section]
Appendix II: Comments from the Department of Health and Human Services:
Department Of Health & Human Services:
Office Of The Secretary:
Assistant Secretary for Legislation:
Washington, DC 20201:
July 12, 2010:
Alicia P. Cackley:
Director, Financial Markets and Community Investment:
U.S. Government Accountability Office:
441 G Street N.W.
Washington, DC 20548:
Dear Ms. Cackley:
Attached are comments on the U.S. Government Accountability Office's
(GAO) draft report entitled: "Rural Homelessness: Better Collaboration
by HHS and HUD Could Improve Delivery of Services in Rural Areas" (GAO
10-724).
The Department appreciates the opportunity to review this
correspondence before its publication.
Sincerely,
Signed by:
Andrea Palm:
Deputy Assistant Secretary for Legislation:
Attachment:
[End of letter]
General Comments Of The Department Of Health And Human Services (HHS)
On The Government Accountability Office's (GAO) Draft Report Entitled,
"Rural Homelessness: Better Collaboration By HHS And HUD Could Improve
Delivery Of Services In Rural Areas" (GAO-10-724):
The Department appreciates the opportunity to comment on this GAO
draft report.
GAO Recommendations:
To strengthen formal collaboration efforts, we recommend that the
Secretary of Housing and Urban Development and the Secretary of Health
and Human Services direct the appropriate program offices to further
explore opportunities to more formally link housing and supportive
services--in the most appropriate forms and combinations of mainstream
and/or targeted programs identified by both agencies, with specific
consideration for how such collaboration could minimize barriers to
service provision in rural areas.
HHS Response:
The Department strongly agrees with the importance of collaboration
with the Department of Housing and Urban Development (HUD) to
effectively address homelessness. The Administration for Children and
Families (ACF) and the Office of the Assistant Secretary for Planning
and Evaluation (ASPE) have been actively working with HUD in efforts
to design a voucher program demonstration effort for improving
services to homeless families. In addition, on June 17, 2010, HIIS and
HUD issued a letter highlighting the opportunities for state Temporary
Assistance for Needy Families programs and HUD's Homelessness
Prevention and Rapid Re-Housing Program to coordinate resources and
improve services to homeless families. [hyperlink,
http://www.acf.hhs.gov/proqrams/ofa/policy/colleague-ltr/2010_TANF-
HUD.html]
On page 31, GAO makes a brief reference to HUD and HHS's
collaboration on a demonstration initiative around housing vouchers
for homeless people, but the description is incomplete. This important
initiative, which is part of a broad collaboration between HUD and HHS
warrants a more extensive description in the GAO report. Last summer,
HHS Secretary Sebelius and HUD Secretary Donovan initiated a
collaboration to better integrate the nation's housing, health, and
human services delivery systems. The two Departments established
workgroups co-facilitated by senior HHS and HUD officials to identify
concrete opportunities in three related areas: homelessness, community
living (for people with disabilities and the elderly), and livable
homes and communities (macro-level, healthy housing and community
planning and design). Two demonstration initiatives are included in
the FY 2011 President's Budget, one involving 4,000 housing vouchers
with health, behavioral health and other supportive services for
chronically homeless persons and the other involving 6,000 housing
vouchers, linked with a range of mainstream services like job training
and income assistance through the Temporary Assistance for Needy
Families program, for homeless and at-risk families with children.
Concerning the report's discussion of the need to fill gaps in
supportive services for homeless people, we note that the landmark
Patient Protection and Affordable Care Act will contribute greatly to
filling those gaps. Medicaid will be expanded to nearly all
individuals under the age of 65 with incomes up to 133 percent of the
federal poverty level. This significant expansion will allow more
families and adults without dependent children to enroll in Medicaid
in 2014 or before. In addition, the Affordable Care Act will support
demonstrations to improve the ability of psychiatric facilities to
provide emergency services. It will also expand the availability of
medical homes for individuals with chronic conditions, including
severe and persistent mental illness. Expansion of Community Health
Centers is another major change that will serve many vulnerable
populations, including those who are homeless or at risk of being
homeless.
The discussion about services and their funding sources throughout the
report needs to distinguish between linking homeless individuals with
the services that they need and aligning services with housing
programs that target specific homeless populations. Homeless
populations range from those who experience a crisis driven short-term
experience of homelessness to those who are chronically homeless for
long periods and have complex and multiple service needs. Many
individuals and families only need temporary access to housing
assistance to escape homelessness, while others, especially
chronically homeless individuals, may need longer term housing along
with supportive services.
The following are two current examples of demonstration projects in
ACF's Family and Youth Services Bureau (FYSB) that focus on rural
homeless populations.
Rural Host Home Demonstration Project:
The Basic Center Program (BCP) provides shelter and support services
to assist youth in crisis, re-unite them with their families, as
appropriate, strengthen their family relationships; and help them
transition to safe and appropriate alternative living arrangements
where they can become independent, self-sufficient and contributing
members of society. The Rural Host Homes Demonstration Project was
designed to expand those services to runaway and homeless youth who
reside in rural areas not served by shelter facilities.
* Expanding Opportunities for Service:
Organizations funded through this demonstration project are required
to recruit, screen, train, and provide ongoing support to host home
families that provide services to youth in their homes. While in the
program, youth under age 18 receive:
* shelter for up to 21 days,
* transportation,
* individual, family, and group counseling services,
* assistance staying connected with their schools or staying current
with the curricula, in accordance with the provisions of the McKinney-
Vento Homeless Assistance Act, and,
* an after-care plan to ensure continuing support after they leave the
program.
* Finding Solutions:
Through the demonstration project, FYSB will attempt to assess the gap
in services to rural RHY. It will evaluate whether host homes were
utilized, and if the youth were able to receive the same services as
those in large metropolitan areas.
Support Systems for Rural Homeless Youth: A Collaborative State and
Local Demonstration Project:
FYSB recently awarded grants to three States ” Colorado, Iowa, and
Minnesota ” to carry out demonstration projects helping young people
in rural areas, including Tribal lands and other rural Native
communities, who arc approaching young adulthood and independence but
have few or no connections to a supportive family or community
resources.
Specifically, grant awards provide funding to States to collaborate
with local community-based organizations to influence policies,
programs, and practices that affect the design and delivery of
services to RHY, ages 16-21, in the Transitional Living Program (TLP),
as well as youth aging out of State child welfare systems and into the
Independent Living Program (ILP).
* Focusing on Three Areas:
The demonstration project focuses on improving coordination of
services and creating additional supports for rural youth, especially
in three vital areas:
* survival support services, such as housing, health care, substance
abuse, and/or mental health,
* community service, youth and adult partnerships, mentoring, peer
support groups, and/or Positive Youth Development activities, and,
* education and employment, such as high school/General Equivalency
Diploma completion, post-secondary education, employment, training,
and/or jobs.
* Involving Youth in All Phases:
This demonstration project is being conducted in two phases: planning
and implementation. Currently, grantees are in the planning phase:
identifying, convening and consulting with local FYSB-funded agencies
providing services to youth in TLP and ILP programs in rural
communities.
FYSB sees youth participation as fundamental to the success of the
projects. Each project will emphasize youth participation and
leadership development in the planning and implementation of project
strategies and activities.
[End of section]
Appendix III: Comments from the Department of Housing and Urban
Development:
U.S. Department Of Housing And Urban Development:
Assistant Secretary For Community Planning And Development:
Washington, DC 20410-7000:
July 9, 2010:
Ms. Alicia Cackley, Director:
Financial Markets and Community Investment:
U.S. Government Accountability Office:
441 G Street, NW, Room 2017:
Washington, DC 20548:
Dear Ms. Cackley:
This is in response to the Government Accountability Office's draft
report entitled Rural Homelessness: Better Collaboration by HHS and
HUD Could Improve Delivery of Services in Rural Areas (July 2010)-”GA0-
10-724. HUD provided specific technical comments under separate cover.
HUD agrees with the overall GAO recommendation regarding the value of
collaboration among federal partners. However, HUD is including in
this letter additional information that may provide context on complex
issues presented in this report, particularly related to the
definition of rural, HUD's data collection efforts, and collaboration
with other federal agencies. This report contains references to GAO's
recently released report on the definition of homelessness. HUD
provided extensive comment and a letter for the record to GAO on that
report and will not repeat many of those concerns here, and encourages
readers to review both reports in order to fully understand HUD's
position on the issues. HUD's specific comments related to this report
are as follows:
* GAO points out that federal agencies do not employ a single
definition of "rural." In many cases, this is due to statutory
requirements rather than policy decisions made by the federal
agencies. The Office of Special Needs Assistance Programs (SNAPS), for
example, has used the definition of rural that was included as part of
the "Rural Homelessness Grant Program" that was created in the Stewart
B. McKinney Homeless Housing Assistance Amendments Act of 1992.
Furthermore, it may not be reasonable for all agencies to utilize the
same definition of rural as the purposes of their programs may be
vastly different.
* Since 2005, HUD has been reporting local and national level homeless
data to Congress through the Annual Homeless Assessment Report (AHAR)”
the first and only national estimate of homelessness to use
longitudinal data. GAO's report presents a limited review of HUD's
data collection and reporting efforts and does not acknowledge the
progress that has been made in this area or the value of the data
currently being collected or reported.
* This report discusses the need for better coordination between
federal agencies that require homeless data collection systems. HUD
agrees, and has been working since 2006 with the Departments of Health
and Human Services (HHS) and Veterans Affairs (VA) to improve and
align data collection and reporting requirements for federally funded
programs addressing homelessness. The partnership with HHS has
resulted in successful alignment with the Projects for Assistance in
Transition from Homelessness (PATH) program noted by a December 2009
joint announcement of HHS' intent to utilize HMIS for the PATH
program. The partnership with the VA has resulted in an initial
evaluation of alignment for the Grant and Per Diem and HUD VASH
programs.
* GAO's report indicates that effective collaboration hinges
predominantly on the use of a common vocabulary. HUD offers that,
while a common vocabulary and definitions would improve coordination
for rural areas, key differences in authorizing statutes, implementing
regulations, and administrative processes are more significant
barriers to effective collaboration.
* The report discusses the reduction in Continuum of Care (CoC) funds
for supportive services costs and indicates that HUD "emphasized the
funding of housing activities and decreased its own funding for
supportive services." While it is true that the proportion of dollars
being awarded for supportive service activities has decreased, the
total dollar amount associated with those services remains
significant. In 2008, HUD awarded $453 million for supportive service
budget requests.
* The report asserts that there "is little evidence that HUD and HHS
have formally agreed on their respective roles and responsibilities,
or identified ways to leverage resources to support the delivery of
coordinated housing and supportive services." HUD remains committed to
ensuring that participants in all of its homeless assistance projects
receive needed supportive services and has worked with HHS to improve
access by homeless persons to their programs. In fact, this type of
federal coordination and collaboration is evident in the U.S.
Interagency Council on Homelessness' (USICH) Federal Strategic Plan to
Prevent and End Homelessness, which was announced by USICH Chair and
HUD Secretary Shaun Donovan last month.
The Department agrees that a common vocabulary amongst federal
agencies and increased collaboration would improve the delivery of
services in rural areas. However, the existence of both of these
elements does not equate to a seamless integration of various streams
of funding to create a project to serve homeless persons, especially
given that agencies often have differing statutory requirements or
Congressional direction. In addition, the Department believes that the
GAO report's focus on the anecdotal experiences of local providers
does not provide a complete picture of efforts made by HUD regarding
data collection, interagency collaboration, and the funding of
supportive services.
The Department appreciates the opportunity to respond to this report.
Sincerely,
Signed by:
Mercedes Marquez:
Assistant Secretary:
[End of section]
Appendix IV: GAO Contact and Staff Acknowledgments:
GAO Contact:
Alicia P. Cackley, (202) 512-8678 or cackleya@gao.gov:
Staff Acknowledgments:
In addition to the individual named above, Marshall Hamlett, Assistant
Director; Aglae Cantave; Chir-Jen Huang; Karen Jarzynka; John Lord;
Paul Thompson; Marc Molino; LuAnn Moy; Andrew Pauline; and Barbara
Roesmann made key contributions to this report.
[End of section]
Footnotes:
[1] K. Hopper and J.Hamburg, "The Making of America's Homeless: From
Skid Row to New Poor, 1945-1984," Critical Perspectives on Housing, R.
G. Bratt, C. Hartman, and A. Myerson (Eds.), (Philadelphia, PA.,
Temple University Press 1986).
[2] The HEARTH Act is contained in Division B of Public Law 111-22.
Pub. L. No. 111-22 § 1001, et seq., 123 Stat. 1669 (May 20, 2009). The
Rural Stability Housing Grant Program was established in section 1401
of the HEARTH Act. The pertinent provisions of the act become
applicable on November 20, 2010, or 3 months after the Department of
Housing and Urban Development's (HUD) publication of final regulations
under section 1504 of the act, whichever is earlier. The act requires
HUD to promulgate the regulations not later than 1 year after the date
of enactment. Id. §§ 1503, 1504.
[3] Id. § 1402. Colonia, a Spanish word for neighborhood or community,
refers to a settlement located within 150 miles of the U.S.-Mexico
border that has a majority population composed of individuals and
families of low and very low income and which may lack basic
infrastructure such as water and sewer.
[4] The HEARTH Act changed various aspects of the Emergency Shelter
Grant program and also changed the name of the program to the
Emergency Solutions Grant program. Pub. L. No. 111-22 § 1201.
[5] The act was originally named the Stewart B. McKinney Homeless
Assistance Act, Pub. L. No. 100-77 (July 22, 1987), but was renamed as
the McKinney-Vento Homeless Assistance Act in 2000, Pub. L. No. 106-
400 (Oct. 30, 2000).
[6] The HEARTH Act codified the CoC process. Pub. L. No. 111-22 §
1301. Among other things, the act requires a collaborative application
for each geographic area applying for HUD McKinney-Vento funds.
[7] In this report we use "supportive services" to include all
nonhousing services that may assist persons experiencing homelessness.
[8] The Interagency Council members are HUD; HHS; Education; Labor;
DOJ; VA; DHS; the Departments of Agriculture, Commerce, Defense,
Interior, Energy, and Transportation; the Social Security
Administration; the General Services Administration; the Office of
Management and Budget; the Postal Service; the Corporation for
National and Community Service; and the White House Office of Faith-
Based and Neighborhood Partnerships.
[9] Pub. L. No. 111-22 § 1004.
[10] GAO, Homelessness: A Common Vocabulary Could Help Agencies
Collaborate and Collect More Consistent Data, [hyperlink,
http://www.gao.gov/products/GAO-10-702] (Washington, D.C.: June 30,
2010).
[11] Two of HUD's programs, the Emergency Shelter Grant program and
the Homeless Prevention and Rapid Rehousing program, may fund
homelessness prevention.
[12] The definition of "homeless children and youths" is codified at
42 U.S.C. § 11434a.
[13] In April 2010 HUD published a proposed rule designed to clarify
and elaborate the definitions of "homeless," "homeless individuals,"
"homeless person," and "homeless individual with a disability."
Comments were due on June 21, 2010. 75 Fed. Reg. 20541 (Apr. 20, 2010).
[14] GAO, Rural Housing: Changing the Definition of Rural Could
Improve Eligibility Determinations, [hyperlink,
http://www.gao.gov/products/GAO-05-110] (Washington, D.C.: Dec. 3,
2004).
[15] Cranston-Gonzalez National Affordable Housing Act, Pub. L. No.
101-625 (Nov. 28, 1990).
[16] Tribal officials defined a unit as overcrowded if there were more
than one-and-a-half people per bedroom. Some units had three or more
people per bedroom.
[17] [hyperlink, http://www.gao.gov/products/GAO-10-702].
[18] HUD developed the data standards pursuant to the 2001 amendments
to the McKinney-Vento Act. For a discussion of the Congressional
directive, see HUD, Report to Congress: HUD's Strategy for Homeless
Data Collection, Analysis and Reporting, Congressional Directive/HUD
Study, (August 2001), [hyperlink,
http://www.hud.gov/offices/cpd/homeless/hmis/strategy/].
[19] PIT counts are conducted biennially, but HUD has compiled
national data on homelessness for AHAR in each of the last 5 years
(2005-2009). In the odd numbered years, the PIT was required for all
CoCs and in 2006 and 2008 it was optional. The most recent PIT count
was conducted in January 2010. The last AHAR was issued in June 2010
and includes data collected in January 2009.
[20] According to HHS officials, organizations that receive PATH funds
are required to submit an annual PATH Report, providing information
about funding, staffing, enrollment, services, and demographics of
recipients. Similarly, health centers that receive specific funding as
part of the Health Care for the Homeless Program are required to track
information including patient demographics, services provided,
staffing, clinical indicators, utilization rates, costs, and revenues.
[21] According to VA officials, VA staff, working with community
providers in local meetings and planning processes, collect population
based data on homeless veterans and conduct assessments of local
service needs. For more information on statutory requirements, see
Public Laws 102-405, 103-446, and 105-114.
[22] For additional information on actions HUD has taken to improve
the data, see [hyperlink, http://www.gao.gov/products/GAO-10-702].
[23] GAO, Homelessness: Information on Administrative Costs for HUD's
Emergency Shelter Grants Program, [hyperlink,
http://www.gao.gov/products/GAO-10-491] (Washington, D.C.: May 20,
2010).
[24] ESG has been funded at approximately $160 million per year for
several years.
[25] Eligibility requirements for entitlement cities or counties were
established in section 102 of the Housing and Community Development
Act and include central cities of metropolitan areas, other cities
with a current population of 50,000 or more that are also in
metropolitan areas, counties that are in metropolitan areas and which
have a population of 200,000 or more after excluding metropolitan
cities, small cities that do not participate with the county, and
eligible tribes and cities or counties that retain status as a result
of previously meeting the relevant criteria. The ESG funds are
allocated in a three step process: First, 2 percent of the funds are
set aside for the territories. Second, the balance of the funds is
allocated by the CDBG formula. Third, as required by law, funds for
entitlement jurisdictions that would receive less than 0.05 percent of
the overall allocation--$80,000 in 2009--are added to the allocation
of the state in which the jurisdiction is located. In 2009, 304
entitlement jurisdictions received a separate allocation, while 48
percent of ESG funding was distributed by state entities.
[26] CoCs submit a single application that includes a ranked list of
individual organization projects and a comprehensive CoC wide planning
document that outlines the activities, planning process, and needs
assessment of the CoC. HUD scores the application as a whole but funds
the projects directly.
[27] HUD determines a final pro rata need each year for each CoC
utilizing the CDBG formula, the ESG Program's universe of
jurisdictions, and the funding needed to renew all expiring Supportive
Housing programs for one year. Using the CDBG formula, 75 percent of
the funds are allocated to metropolitan cities and urban counties who
have qualified for a direct ESG allocation since 2004 and the
remaining 25 percent of the funds are allocated to all other
metropolitan cities or urban counties and all other counties. A CoC's
total preliminary pro rata need is the sum of the funds allocated to
each municipality or county that participates in the CoC. A CoC's
final pro rata need may be adjusted up if the funding required to
renew its expiring Supportive Housing projects exceeds its preliminary
pro rata need.
[28] Since 1997, New Mexico, Arizona, and Texas have set aside 10
percent of their CDBG funds for the colonias and California has set
aside from 2 to 5 percent.
[29] Congressional Research Service, Homelessness: Targeted Federal
Programs and Recent Legislation, RL30442 (Washington, D.C., Jan. 20,
2010).
[30] Labor uses "nonurban" rather than rural in its Homeless Veterans'
Reintegration program. Labor chose 569,463 to include the largest 75
cities in its urban category. All other areas below that population
number, regardless of size, are eligible for competition in the
nonurban category.
[31] According to the National Alliance to End Homelessness, a 2007
report noted that between 1997 and 2007, 170,000 public units and
300,000 federally subsidized private market units have been lost due
to deterioration.
[32] The Low-Income Housing Tax Credit program provides an indirect
federal subsidy used to finance the development of affordable rental
housing for low-income households.
[33] Tenant-based Section 8 vouchers assist very low-income families,
the elderly, and the disabled with affordable, decent, safe, and
sanitary housing in the private market. Tenant-based Section 8
vouchers are administered locally by public housing agencies (PHAs).
The PHAs receive federal funds from HUD to administer the voucher
program. A family that is issued a housing voucher is responsible for
finding a suitable housing unit that must meet minimum standards
determined by the PHA.
[34] M.R. Burt, et. al., Homelessness: Programs and the People They
Serve, Findings of the National Survey of Homeless Assistance
Providers and Clients (Washington, D.C., Urban Institute, 1999).
[35] According to VA officials, HUD-VASH allows some waivers for
felons.
[36] [hyperlink, http://www.gao.gov/products/GAO-10-702].
[37] HUD, Office of Policy Development and Research, U.S. Housing
Market Conditions (May 2010).
[38] State and local governments that receive an ESG allocation by
formula establish the reimbursement rate for ESG-funded activities. In
Maine, "bednight" refers to one bed in an emergency shelter occupied
for one night by one individual. The initial bednight per diem
calculation is based on an amount equal to 85 percent of the funds
available for the calendar year, which will be divided by a number
equal to the total number of bednights of all eligible emergency
shelters during the previous calendar year.
[39] GAO, Results-Oriented Government: Practices That Can Help Enhance
and Sustain Collaboration among Federal Agencies, [hyperlink,
http://www.gao.gov/products/GAO-06-15] (Washington, D.C.: Oct. 21,
2005).
[40] In particular, mental illness, alcohol abuse, and drug abuse
decreased for participants in the study, which are among some of the
most costly public health problems in the country.
[41] L. Sadowski, R. Kee, VanderWeele, et al, "Effect of a Housing and
Case Management Program on Emergency Department Visits and
Hospitalizations Among Chronically Ill Homeless Adults: A Randomized
Trial," JAMA, vol. 30, no. 17, 1771-1778 (2009); and T.E. Martinez and
M.R. Burt, "Impact of Permanent Supportive Housing on the Use of Acute
Care Health Services by Homeless Adults," Psychiatric Services, vol.
57, no. 7, 992-999 (2006).
[42] HUD, HHS, and VA (with the coordination of the Interagency
Council) provided housing and supportive services for individuals
experiencing chronic homelessness in 11 communities through CICH.
According to research studies in behavioral sciences, the CICH
demonstration project had positive outcomes due to the combination of
resources including federal funding and oversight, technical
assistance, and opportunities for meetings with other CICH
communities. For more information, see M. Kresky-Wolff, M.Larson, R.
O'Brien, and S. McGraw, "Supportive Housing Approaches in the
Collaborative Initiative to Help End Chronic Homelessness (CICH)," The
Journal of Behavioral Health Services and Research, Vol. 37, No. 2
(2010).
[43] Labor and HUD offered permanent housing, supportive services, and
employment assistance to people who were chronically homeless. Martha
Burt's study of the demonstration project in Los Angeles, California,
found that the project succeeded in its goal of moving chronically
homeless clients into permanent supportive housing and helping them
get and keep employment. Martha Burt, Urban Institute, Evaluation of
LA's HOPE: Ending Chronic Homelessness through Employment and Housing
Final Report (Washington, D.C., 2007).
[44] The 2008 Consolidated Appropriations Act, which authorizes a
joint effort between HUD and VA to coordinate housing and supportive
services for homeless veterans, articulated steps for identifying
roles and responsibilities and a system of leveraging resources. See
Pub. L. No. 110-161 (Dec. 26, 2007).
[45] Although HUD-VASH is not included in the fiscal year 2011 budget,
HUD officials said that they expect it will be included in future
budgets.
[46] According to HHS officials, ongoing funding for services in
permanent supportive housing is frequently funded through contracts
with local departments of health, mental health, behavioral health and
social services using HHS block grant resources.
[47] [hyperlink, http://www.gao.gov/products/GAO-10-702].
[48] The 2001 HUD Appropriations Act included the requirement that no
less than 30 percent of HUD's total appropriation must go to permanent
supportive housing.
[49] Beginning in 2002, HUD began scoring CoCs on housing emphasis,
which is a calculation based on the relationship between funds
requested for housing activities and funds requested for supportive
service activities. Furthermore, HUD began scoring CoCs on enrollment
and participation in various mainstream programs.
[50] GAO, Rural Economic Development: Collaboration between SBA and
USDA Could be Improved, [hyperlink,
http://www.gao.gov/products/GAO-08-1123] (Washington, D.C.: Sep. 18,
2009).
[51] For HUD's guidance to rural communities see HUD, Homeless
Assistance Programs: Rural Continuum of Care (June 2009). Also, as
discussed previously, the McKinney-Vento programs, through the CoC
system, require local communities to assemble partners to develop a
comprehensive plan for housing and supportive service, such as case
management, treatment programs, and training programs, to address the
needs of those who are experiencing homelessness.
[52] [hyperlink, http://www.gao.gov/products/GAO-10-702] identified
similar challenges in nonrural areas.
[53] [hyperlink, http://www.gao.gov/products/GAO-10-702].
[54] [hyperlink, http://www.gao.gov/products/GAO-10-702].
[55] [hyperlink, http://www.gao.gov/products/GAO-10-702].
[End of section]
GAO's Mission:
The Government Accountability Office, the audit, evaluation and
investigative arm of Congress, exists to support Congress in meeting
its constitutional responsibilities and to help improve the performance
and accountability of the federal government for the American people.
GAO examines the use of public funds; evaluates federal programs and
policies; and provides analyses, recommendations, and other assistance
to help Congress make informed oversight, policy, and funding
decisions. GAO's commitment to good government is reflected in its core
values of accountability, integrity, and reliability.
Obtaining Copies of GAO Reports and Testimony:
The fastest and easiest way to obtain copies of GAO documents at no
cost is through GAO's Web site [hyperlink, http://www.gao.gov]. Each
weekday, GAO posts newly released reports, testimony, and
correspondence on its Web site. To have GAO e-mail you a list of newly
posted products every afternoon, go to [hyperlink, http://www.gao.gov]
and select "E-mail Updates."
Order by Phone:
The price of each GAO publication reflects GAO‘s actual cost of
production and distribution and depends on the number of pages in the
publication and whether the publication is printed in color or black and
white. Pricing and ordering information is posted on GAO‘s Web site,
[hyperlink, http://www.gao.gov/ordering.htm].
Place orders by calling (202) 512-6000, toll free (866) 801-7077, or
TDD (202) 512-2537.
Orders may be paid for using American Express, Discover Card,
MasterCard, Visa, check, or money order. Call for additional
information.
To Report Fraud, Waste, and Abuse in Federal Programs:
Contact:
Web site: [hyperlink, http://www.gao.gov/fraudnet/fraudnet.htm]:
E-mail: fraudnet@gao.gov:
Automated answering system: (800) 424-5454 or (202) 512-7470:
Congressional Relations:
Ralph Dawn, Managing Director, dawnr@gao.gov:
(202) 512-4400:
U.S. Government Accountability Office:
441 G Street NW, Room 7125:
Washington, D.C. 20548:
Public Affairs:
Chuck Young, Managing Director, youngc1@gao.gov:
(202) 512-4800:
U.S. Government Accountability Office:
441 G Street NW, Room 7149:
Washington, D.C. 20548:
