Chairman Filner, Ranking Member Buyer, and members of the Committee, my name is Libby Perl and I am an analyst at the Congressional Research Service (CRS). Thank you for the opportunity to testify today. As requested, in my testimony I will provide a summary of research regarding homeless veterans, a brief overview of federal programs that assist homeless veterans, and funding levels for those programs.

Research Regarding Homeless Veterans

Research that has captured information about the entire national homeless population, including veteran status, is rare. While the Department of Housing and Urban Development (HUD) is engaged in ongoing efforts to collect information about homeless individuals, the most extensive information about homeless veterans specifically comes from earlier studies. Possibly the most comprehensive national data collection effort regarding persons experiencing homelessness took place in 1996 as part of the National Survey of Homeless Assistance Providers and Clients (NSHAPC), when researchers interviewed thousands of homeless assistance providers and homeless individuals across the country.1 Prior to the NSHAPC, in 1987, researchers from the Urban Institute surveyed nearly 2,000 homeless individuals and clients in large cities nationwide as part of a national study.2 The data from these two surveys serve as the basis for more in depth research regarding homeless veterans. No matter the data source, however, research has found that veterans make up a greater percentage of the homeless population than their percentage in the general population.

Research from the 1980s and 1990s . Two studies—one published in 1994 using data from the 1987 Urban Institute survey (as well as data from surveys in Los Angeles, Baltimore, and Chicago), and the other published in 2001 using data from the 1996 NSHAPC—found that male veterans were overrepresented in the homeless population. In addition, researchers in both studies determined that the likelihood of homelessness depended on the ages of veterans.3 During both periods of time, the odds of a veteran being homeless were highest for veterans who had enlisted after the military transitioned to an all-volunteer force (AVF) in 1973.

In the earlier study, researchers found that 41% of adult homeless men were veterans, compared to just under 34% of adult males in the general population. Overall, male veterans were 1.4 times as likely to be homeless as nonveterans.4 Notably, though, those veterans who served after the Vietnam War were four times more likely to be homeless than nonveterans in the same age group.5 Vietnam era veterans, who are often thought to be the most overrepresented group of homeless veterans, were barely more likely to be homeless than nonveterans (1.01 times).

In the second study, researchers found that nearly 33% of adult homeless men were veterans, compared to 28% of males in the general population. Once again, the likelihood of homelessness differed among age groups. Overall, male veterans were 1.25 times more likely to be homeless than nonveterans.6 However, the same post-Vietnam birth cohort as that in the 1994 study was most at risk of homelessness; those in the cohort were over three times as likely to be homeless as nonveterans in their birth cohort. Younger veterans, those age 20-34 in 1996, were two times as likely to be homeless as nonveterans. And Vietnam era veterans were approximately 1.4 times as likely to be homeless as their nonveteran counterparts.

Like male veterans, women veterans are more likely to be homeless than women who are not veterans. A study published in 2003 examined two data sources, one a survey of mentally ill homeless women, and the other the NSHAPC, and found that 4.4% and 3.1% of those homeless persons surveyed were female veterans, respectively (compared to approximately 1.3% of the general population who are women veterans).7 Although the likelihood of homelessness was different for each of the two surveyed populations, the study estimated that female veterans were between two and four times as likely to be homeless as their nonveteran counterparts.8 Unlike male veterans, all birth cohorts were more likely to be homeless than nonveterans. However, with the exception of women veterans age 35-55 (representing the post-Vietnam era), who were between approximately 3.5 and 4.0 times as likely to be homeless as nonveterans, cohort data were not consistent between the two surveys.

HUD’s Annual Homeless Assessment Reports . HUD is engaged in an ongoing effort to establish database systems at the local level to collect information about persons experiencing homelessness. Using these data, HUD has released two Annual Homeless Assessment Reports (AHARs), one in 2007 using data from 2005, and one in 2008, using data from 2006. While both AHARs provide information about homeless veteran status, there are limitations. Both report the number of sheltered homeless individuals, so persons living on the street are not captured, and in both reports, data regarding veteran status are incomplete. The first AHAR estimated that 18.7% of the adult homeless population was made up of veterans, compared to 12.6% of the general population.9 Of the records used, however, 35% were missing information on veteran status. The second AHAR estimated that 14.3% of the homeless adult population were veterans compared to 11.2% of the general population.10 In this case, 20% of records were missing information on veteran status.11

Federal Programs Targeted to Homeless Veterans

The majority of the federal programs that target services specifically to homeless veterans are part of the Department of Veterans Affairs. One program, the Homeless Veterans Reintegration Program, is a Department of Labor (DOL) program. In addition, HUD collaborates with the VA to provide permanent supportive housing for homeless veterans through the HUD-VA Supported Housing, or HUD-VASH program. HUD also provides services to homeless veterans through its Homeless Assistance Grants, though these funds are not targeted to veterans.

HUD-VASH. Beginning in 1992, through a collaboration between HUD and the VA, funding for approximately 1,753 Section 8 vouchers was made available for use by homeless veterans with severe psychiatric or substance abuse disorders.12 Section 8 vouchers are subsidies used by families to rent apartments in the private rental market. Through the program, called HUD-VA Supported Housing (HUD-VASH), local Public Housing Authorities (PHAs) administer the Section 8 vouchers while local VA medical centers provide case management and clinical services to participating veterans. HUD distributed the vouchers to PHAs through three competitions, in 1992, 1993, and 1994. Prior to issuing the vouchers, HUD and the VA had identified medical centers with Domiciliary Care and Health Care for Homeless Veterans programs that were best suited to providing services. HUD does not separately track these vouchers. However, the VA keeps statistics on veterans with vouchers who receive treatment thourgh the VA. In FY2006, 1,238 veterans with HUD-VASH vouchers received treatment during the year, with 1,028 veterans still receiving treatment at the end of that year.13

In 2001, Congress codified the HUD-VASH program (P.L. 107-95) and authorized the creation of an additional 500 vouchers for each year from FY2003 through FY2006.14 A bill enacted at the end of the 109th Congress (P.L. 109-461) also provided the authorization for additional HUD-VASH vouchers. However, not until FY2008 did Congress provide funding for additional vouchers: the Consolidated Appropriations Act (P.L. 110-161) included $75 million for Section 8 vouchers for homeless veterans. HUD has estimated that this will fund between 9,800 additional vouchers.15 The Administration has also requested an additional $75 million for HUD-VASH vouchers in FY2009.16

Research has found that permanent supportive housing, like that provided through the HUD-VASH program, improves outcomes for formerly homeless individuals. HUD-VASH specifically has been found to result in both improved housing and improved substance abuse outcomes among veterans who received the vouchers over those who did not.17 Veterans who received vouchers experienced fewer days of homelessness and more days housed than veterans who received intensive case management assistance or standard care through VA homeless programs alone.18 Analysis also found that veterans with HUD-VASH vouchers had fewer days of alcohol use, fewer days on which they drank to intoxication, and fewer days of drug use.19 HUD-VASH veterans were also found to have spent fewer days in institutions.20

Health Care for Homeless Veterans. The first federal program to specifically address the needs of homeless veterans, Health Care for Homeless Veterans (HCHV) was created as part of an emergency appropriations act for FY1987 (P.L. 100-6) in which Congress allocated $5 million to the VA to provide medical and psychiatric care in community-based facilities to homeless veterans suffering from mental illness.21 Through the HCHV program, VA medical center staff conduct outreach to homeless veterans, provide care and treatment for medical, psychiatric, and substance abuse disorders, and refer veterans to other needed supportive services.22 In some cases, veterans may stay in residential treatment facilities while receiving treatment. According to the most recent data available from the VA, in FY2006, the HCHV program treated approximately 60,857 veterans.23 Of those, 82% had either a serious psychiatric or substance abuse problem.

Domiciliary Care for Homeless Veterans. The Domiciliary Care Program for homeless veterans was implemented to reduce the use of more expensive inpatient treatment, improve health status, and reduce the likelihood of homelessness through employment and other assistance. The DCHV program operates at 38 VA medical centers and has 1,991 beds available.24 In FY2006, the number of veterans completing treatment was 5,282.25 Of those admitted to DCHV programs, 92.7% were diagnosed with a substance abuse disorder, more than half (56.7%) were diagnosed with serious mental illness, and 52.5% had both diagnoses.26 The average length of stay for veterans in FY2006 was 104.4 days, in which they received medical, psychiatric and substance abuse treatment, as well as vocational rehabilitation.

Compensated Work Therapy/Therapeutic Residence Program. Through the Compensated Work Therapy Program, the VA enters into contracts with private companies or nonprofit organizations which then provide disabled veterans with work opportunities.27 Veterans must be paid wages commensurate with those wages in the community for similar work, and through the experience the goal is that participants improve their chances of living independently and reaching self sufficiency. The CWT program also provides work skills training, employment support services, and job development and placement services. The VA estimates that approximately 14,000 veterans participate in the CWT program each year.28 In addition, a transitional housing component provides housing to participants in the CWT program who have mental illnesses or chronic substance abuse disorders and who are homeless or at risk of homelessness.29 As of September 2006, the VA operated 66 transitional housing facilities with 520 beds.30

Grant and Per Diem Program. Initially called the Comprehensive Service Programs, the Grant and Per Diem program was introduced as a pilot program in 1992 through the Homeless Veterans Comprehensive Services Act (P.L. 102-590). The law establishing the Grant and Per Diem program, which was made permanent in the Homeless Veterans Comprehensive Services Act of 2001 (P.L. 107-95), authorizes the VA to make grants to public entities or private nonprofit organizations to provide services and transitional housing to homeless veterans. According to the most recent data available from the VA, in FY2006 the Grant and Per Diem program funded more than 300 service providers. These providers had a total of 8,200 beds available and served more than 15,000 homeless veterans.31 The Grant and Per Diem program is permanently authorized at $130 million (P.L. 109-461).

The program has two parts: grant and per diem. Eligible grant recipients may apply for funding for one or both parts. The grants portion provides capital grants to purchase, rehabilitate, or convert facilities so that they are suitable for use as either service centers or transitional housing facilities. The capital grants will fund up to 65% of the costs of acquisition, expansion or remodeling of facilities.32 Grants may also be used to procure vans for outreach and transportation of homeless veterans. The per diem portion of the program reimburses grant recipients for the costs of providing housing and supportive services to homeless veterans using the domiciliary care per diem rate. The per diem rate increases periodically; the FY2007 rate was $31.30 per day.33 The supportive services that grantees may provide include outreach activities, food and nutrition services, health care, mental health services, substance abuse counseling, case management, child care, assistance in obtaining housing, employment counseling, job training and placement services, and transportation assistance.34

Grant and Per Diem for Homeless Veterans with Special Needs. In 2001, Congress created a demonstration program to target grant and per diem funds to specific groups of veterans (P.L. 107-95). These groups include women, women with children, frail elderly individuals, those veterans with terminal illnesses, and those with chronic mental illnesses. The program was initially authorized at $5 million per year for FY2003 through FY2005. P.L. 109-461, enacted on December 22, 2006, reauthorized the program for FY2007 through FY2011 at $7 million per year.

Loan Guarantee for Multifamily Transitional Housing Program. The Veterans Programs Enhancement Act of 1998 (P.L. 105-368) created a program in which the VA guarantees loans to eligible organizations so that they may construct, rehabilitate or acquire property to provide multifamily transitional housing for homeless veterans.35 Eligible project sponsors may be any legal entity that has experience in providing multifamily housing.36 The law requires sponsors to provide supportive services, ensure that residents seek to obtain and maintain employment, enact guidelines to require sobriety as a condition of residency, and charge veterans a reasonable fee.37 Supportive services that project sponsors provide include outreach; food and nutritional counseling; health care, mental health services, and substance abuse counseling; child care; assistance in obtaining permanent housing; education, job training, and employment assistance; assistance in obtaining various types of benefits; and transportation.38 Not more than 15 loans with an aggregate total of up to $100 million may be guaranteed under this program.

Acquired Property Sales for Homeless Veterans. The Acquired Property Sales for Homeless Veterans program is operated through the Veterans Benefits Administration (VBA). The program was originally enacted as part of the Veterans Home Loan Guarantee and Property Rehabilitation Act of 1987 (P.L. 100-198); it is authorized through December 31, 2008.39 Through the program, the VA is able to dispose of properties that it has acquired through foreclosures on its loans so that they can be used for the benefit of homeless veterans. Specifically, the VA can sell, lease, lease with the option to buy, or donate, properties to nonprofit organizations and state government agencies that will use the property only as homeless shelters primarily for veterans and their families. The VA estimates that over 200 properties have been sold through the program.40

Homeless Veterans Reintegration Program. Established in 1987 as part of the McKinney-Vento Homeless Assistance Act (P.L. 100-77), the HVRP is authorized through FY2011 as part of the Veterans Benefits, Health Care, and Information Technology Act of 2006 (P.L. 109-461) and is administered through the Department of Labor (DOL). The program has two goals. The first is to assist veterans in achieving meaningful employment, and the second is to assist in the development of a service delivery system to address the problems facing homeless veterans. Eligible grantee organizations are state and local Workforce Investment Boards, local public agencies, and both for- and non-profit organizations.41 Grantees receive funding for one year, with the possibility for two additional years of funding contingent on performance and fund availability.42

HVRP grantee organizations provide services that include outreach, assistance in drafting a resume and preparing for interviews, job search assistance, subsidized trial employment, job training, and follow-up assistance after placement. Recipients of HVRP grants also provide supportive services not directly related to employment such as transportation, provision of or assistance in finding housing, and referral for mental health treatment or substance abuse counseling. In program year (PY) 2006, HVRP grantees served a total of 13,346 homeless veterans, of whom 8,713, or 65%, were placed in employment.43

Incarcerated Veterans Transition Program Demonstration Grants. The Homeless Veterans Comprehensive Assistance Act of 2001 (P.L. 107-95) instituted a demonstration program to provide job training and placement services to veterans leaving prison.44 Authorization for the incarcerated veterans transition program expired on January 24, 2006 and no additional funding has been provided. The DOL reported that grant recipients enrolled 2,191 veterans in the program from FY2004 to FY2006 and that of these enrollees, 1,104 (54%) entered employment.45

Funding for Targeted Federal Programs

In FY2008, total funding for targeted federal programs for homeless veterans is estimated to be about $317 million. In FY2007, approximately $282 million was obligated or appropriated for these programs. (See Table 1.) This total does not include the HUD funds used for HUD-VASH vouchers. The costs of Section 8 vouchers vary based on the size of a unit rented and fair market rents across the country. The average cost of a Section 8 voucher in 2007 was between $6,000 and $7,000, however, the amount needed for a HUD-VASH voucher could be different. In addition, the estimate does not include VA funds for treatment of homeless veterans, including inpatient medical, surgical, psychiatric, and long term care.

HUD Homeless Assistance Grants

Though the HUD Homeless Assistance Grants do not specifically target homeless veterans, homeless veterans benefit from the grants. The Homeless Assistance Grants account was established in 1987 as part of the Stewart B. McKinney Homeless Assistance Act (P.L. 100-77). The grants, administered by HUD, fund housing and services for homeless persons. There are four Homeless Assistance Grants: the Emergency Shelter Grants (ESG) program, Supportive Housing Program (SHP), the Shelter Plus Care (S+C) program, and the Section 8 Moderate Rehabilitation Assistance for Single-Room Occupancy Dwellings (SRO) program.

In FY2007, approximately $1.3 billion was awarded to homeless services providers through the Homeless Assistance Grants. A total of 5,911 projects received funding.46 Of the grantees, HUD estimates that 149 were veteran specific projects, meaning that 70% or more of those served are veterans. These veteran specific organizations received approximately $135 million. Veterans may also be served by projects where veterans make up less than 70% of clients.

In addition, since 2003, HUD has participated with the VA and the Department of Health and Human Services (HHS) in the Collaborative Initiative to Help End Chronic Homelessness, coordinated through the Interagency Council on Homelessness. Through the initiative, HUD funds permanent supportive housing for chronically homeless individuals while the VA and HHS fund supportive services. The initiative has provided housing for 1,242 individuals; according to an evaluation of the initiative, 30% of program participants who took part in the evaluation surveys were veterans.47

For more information about the programs described in this report, please see CRS Report. RL34024, Veterans and Homelessness. Thank you again for the opportunity to speak here today, and I look forward to your questions.

Table 1. Funding for Selected Homeless Veterans Programs FY1988 - FY2008
(dollars in thousands)

Sources: Department of Veterans Affairs Budget Justifications, FY1989-FY2009, VA Office of Homeless Veterans Programs, Department of Labor Budget Justifications FY1989-FY2009, and the FY2008 Consolidated Appropriations Act P.L. 110-161.

a Health Care for Homeless Veterans was originally called the Homeless Chronically Mentally Ill veterans program. In 1992, the VA began to use the title “Health Care for Homeless Veterans.”

b Congress appropriated funds for the DCHV program for both FY1987 and FY1988 (P.L. 100-71), however, the VA obligated the entire amount in FY1988. See VA Budget Summary for FY1989, Volume 2, Medical Benefits, p. 6-10.

c For FY1991 and FY1992, funds from the Homeless Chronically Mentally Ill veterans program as well as substance abuse enhancement funds were used for the Compensated Work Therapy/Therapeutic Residence program.

d For FY1995 through FY1997, Grant and Per Diem funds were obligated with funds for the Health Care for Homeless Veterans program. VA budget documents do not provide a separate breakdown of Grant and Per Diem Obligations.

e Congress appropriated $5.011 million for HVRP in P.L. 103-333. However, a subsequent rescission in P.L. 104-19 reduced the amount.

f The obligation amounts for FY2008 are estimates.

1 Martha R. Burt, Laudan Y. Aron, et al., Homelessness: Programs and the People They Serve: Findings of the National Survey of Homeless Assistance Providers and Clients, Technical Report, December 1999, available at [http://www.huduser.org/publications/homeless/homeless_tech.html].

2 Martha R. Burt and Barbara E. Cohen, America’s Homeless: Numbers, Characteristics, and Programs that Serve Them (Washington, DC: The Urban Institute Press, July 1989).

3 See Robert Rosenheck, Linda Frisman, and An-Me Chung, “The Proportion of Veterans Among Homeless Men,” American Journal of Public Health 84, no. 3 (March 1994): 466; Gail Gamache, Robert Rosenheck, and Richard Tessler, “The Proportion of Veterans Among Homeless Men: A Decade Later,” Social Psychiatry and Psychiatric Epidemiology 36, no. 10 (October 2001): 481.

4 “The Proportion of Homeless Veterans Among Men,” p. 467.

5 Ibid.

6 “The Proportion of Homeless Veterans Among Men: A Decade Later,” p. 483.

7 Gail Gamache, Robert Rosenheck, and Richard Tessler, “Overrepresentation of Women Veterans Among Homeless Women,” American Journal of Public Health 93, no. 7 (July 2003): 1133.

8 Ibid., p. 1134.

9  U.S. Department of Housing and Urban Development, The Annual Homeless Assessment Report to Congress, February 2007, p. 31, available at [http://www.huduser.org/Publications/pdf/ahar.pdf].

10 U.S. Department of Housing and Urban Development, The Second Annual Homeless Assessment Report to Congress, March 2008, p. 23, available at [http://www.hudhre.info/documents/2ndHomelessAssessmentReport.pdf].

11 For more information about HUD’s efforts to collect information about homeless individuals, see CRS Report RL33956, Counting Homeless Persons: Homeless Management Information Systems.

12 The first announcement of voucher availability was announced in the Federal Register. See U.S. Department of Housing and Urban Development, “Invitation for FY1992 Section 8 Rental Voucher Set-Aside for Homeless Veterans with Severe Psychiatric or Substance Abuse Disorders,” Federal Register vol. 57, no. 55, p. 9955, March 20, 1992.

13 Wesley J. Kasprow, Robert A. Rosenheck, Diane DiLello, Leslie Cavallaro, and Nicole Harelik, Healthcare for Homeless Veterans Programs: Twentieth Annual Report, U.S. Department of Veterans Affairs Northeast Program Evaluation Center, March 31, 2007, pp. 272-273.

14 42 U.S.C. §1437f(o)(19).

15 Testimony of Alphonso Jackson, Secretary of Housing and Urban Development, House Appropriations Committee, Subcommittee on Transportation and Housing and Urban Development, FY2009 Appropriations, 110th Cong., 2nd sess., February 13, 2008.

16 See Budget of the United States Government FY2009—Appendix, Department of Housing and Urban Development, p. 541, available at [http://www.whitehouse.gov/omb/budget/fy2009/pdf/appendix/hud.pdf].

17 Robert Rosenheck, Wesley Kasprow, Linda Frisman, and Wen Liu-Mares, “Cost-effectiveness of Supported Housing for Homeless Persons with Mental Illness,” Archives of General Psychiatry 60 (September 2003): 940. An-Lin Cheng, Haiqun Lin, Wesley Kasprow, and Robert Rosenheck, “Impact of Supported Housing on Clinical Outcomes,” Journal of Nervous and Mental Disease 195, no. 1 (January 2007): 83.

18 “Cost-effectiveness of Supported Housing for Homeless Persons with Mental Illness,” p. 945.

19 “Impact of Supported Housing on Clinical Outcomes,” p. 85.

20 Ibid.

21 Shortly after the HCHV program was enacted in P.L. 100-6, Congress passed another law (P.L. 100-322) that repealed the authority in P.L. 100-6 and established the HCHV program as a pilot program. The program was then made permanent in the Veterans Benefits Act of 1997 (P.L. 105-114). The HCHV program is now codified at 38 U.S.C. §§2031-2034.

22 38 U.S.C. §2031, §2034.

23 Healthcare for Homeless Veterans Programs: Twentieth Annual Report, p. 25.

24 Sandra G. Resnick, Robert Rosenheck, Sharon Medak, and Linda Corwel, Eighteenth Progress Report on the Domiciliary Care for Homeless Veterans Program, FY2006, U.S. Department of Veterans Affairs Northeast Program Evaluation Center, March 2007, p. 1.

25 Ibid., p. 9.

26 Ibid., p. 10.

27 The Compensated Work Therapy program was authorized in P.L. 87-574 as “Therapeutic and Rehabilitative Activities.” It was substantially amended in P.L. 94-581, and is codified at 38 U.S.C. §1718.

28 VA Fact Sheet, “VA Programs for Homeless Veterans,” September 2006, available at [http://www1.va.gov/opa/fact/docs/hmlssfs.doc] (hereafter “VA Programs for Homeless Veterans”).

29 The VA’s authority to operate therapeutic housing is codified at 38 U.S.C. §2032.

30 “VA Programs for Homeless Veterans.”

31 Healthcare for Homeless Veterans Programs: Twentieth Annual Report, p. 154.

32 38 U.S.C. §2011(c).

33 U.S. Department of Veterans Affairs, Department of Geriatrics and Extended Care, Description of the State Veterans Home Program, available at [http://www1.va.gov/geriatricsshg/docs/FY07STATEVETHOMEPROGRAMHistory.doc].

34 38 CFR §61.1.

35 38 U.S.C. §§2051-2054.

36 U.S. Department of Veterans Affairs, Multifamily Transitional Housing Loan Guarantee Program: Program Manual, April 6, 2007, p. 9, available at [http://www1.va.gov/homeless/docs/Loan_Guarantee_Program_Manual_4-6-07.pdf].

37 38 U.S.C. §2052(b).

38 Multifamily Transitional Housing Loan Guarantee Program: Program Manual, p. 10.

39 The program was most recently authorized in the Veterans Health Care, Capital Asset, and Business Improvement Act of 2003 (P.L. 108-170). The program is codified at 38 U.S.C. §2041.

40 “VA Programs for Homeless Veterans.”

41 Veterans Employment and Training Service Program Year 2007 Solicitation for Grant Applications, Federal Register vol. 72, no. 71, April 13, 2007, p. 18682.

42 Ibid., p. 18679.

43 Presentation of Charles S. Ciccolella, Assistant Secretary for Veterans’ Employment and Training, U.S. Department of Labor, to the VA Advisory Committee on Homeless Veterans, January 31, 2008.

44 38 U.S.C. §2023.

45 Presentation of Charles S. Ciccolella.

46 U.S. Department of Housing and Urban Development, FY2007, Summary of Competition Awards Report, available at [http://www.hudhre.info/documents/2007_NationalHomelessAwardsSummary.pdf].

47 Alvin S. Mares and Robert A. Rosenheck, Evaluation of the Collaborative Initiative to Help End Chronic Homelessness, Northeast Program Evaluation Center, February 26, 2007, Table 4, available at [http://www.hudhre.info/documents/CICH_ClientOutcomesReport.pdf].