Across VA homeless programs, there is an emphasis on engaging and providing services to vulnerable Veterans who are chronically homeless or at risk of homelessness with serious health and mental health diagnoses. There is also ongoing concern to address the needs of Veterans who have high rates of emergency department/urgent care (ED/UC) use and hospitalization. It is in this context that NCHAV and the National Health Care for Homeless Veterans (HCHV) Program in the VA Homeless Programs Office (HPO) are collaborating to replicate the VA Boston HCHV Program – Care Coordination, Advocacy, Treatment, and Connections to Housing (CATCH) program.

For additional information on CATCH, please contact us.

The Grant & Per Diem (GPD) Low Demand program offers VA funded GPD providers an opportunity to revise their program designs using a low demand/harm reduction model to better accommodate chronically homeless Veterans who cannot stay clean and sober or who have difficulty being fully compliant with their mental health care. Low Demand programs do not require sobriety or compliance with mental health/substance use treatment as a condition of admission or continued stay. Demands are kept to a minimum; the environment of care is as non-intrusive as possible to foster trust between staff and residents; rules focus on staff and resident safety; and case management, education, and treatment services are offered and highly encouraged, but are not a condition of admission or continued stay.

Developing specialized programs to accommodate chronically homeless Veterans who have difficulty with compliance in traditional homeless programs became a high priority in 2009 as VA developed plans to end homelessness among Veterans. In 2014, NCHAV partnered with the national GPD Program in the VA Homeless Programs Office and staff affiliates from the University of South Florida (USF) to develop an implementation process for a low demand program specifically tailored to GPD providers. The first site became operational in March 2015. We continue to offer training and technical assistance to providers through USF via biweekly calls and teleconferencing and individual consultation as needed. Fidelity assessments are conducted annually to help ensure that the model is being implemented as intended.

In FY 2022, 82 GPD providers used the low demand model, serving 1,836 Veterans. Upon exiting the program, 61.7% were discharged to permanent housing. Fidelity data indicate that the Low Demand model is being implementing as intended.

For more information about Grant & Per Diem Low Demand, please contact us.

The Safe Haven model provides a housing environment that is safe, sanitary, flexible, and stable. The small facilities, typically with 25 beds or fewer, provide a low-demand, non-intrusive setting designed to re-establish trust and re-engage residents in treatment services and permanent housing options.

A Safe Haven is a 24-hour/7 days-a-week, community-based, early recovery model of supportive housing that serves hard-to-reach and hard-to-engage Veterans with severe mental illness and/or substance use problems who are living on the street and have been unable or unwilling to participate in traditional treatment and supportive services. This model, consistent with principles of Housing First, does not require sobriety or full compliance with treatment for admission or continued stay in the program.

In FY 2010, NCHAV established a Safe Haven model development initiative in collaboration with partners at the University of South Florida that could be replicated throughout the VA to address the special needs of chronically homeless Veterans. We initially tested the model with community-based partners at five sites. In 2013 the VA Homeless Programs office funded 15 additional sites. During this initial period more than 700 Veterans were served. Over 55% of the Veterans who exited the program moved into stable housing. Upon discharge, 63% were receiving VA benefits or had pending applications and 67% were receiving non-VA benefits or had pending applications. Service linkages with VA and non-VA providers were in place for most of the Veterans following discharge: 62% for alcohol treatment, 64% for drug treatment, 76% for mental health treatment, and 85% for medical treatment.

Safe Havens were initially authorized by the McKinney-Vento Act of 1994, and today, the VA Homeless Program Office now has over 24 contracted Safe Haven programs with community-based homeless service providers.

For more information about Safe Havens, please contact us.