Homeless Veterans Programs:

Improved Communications and Follow-up Could Further Enhance the Grant and Per Diem Program

GAO-06-859: Published: Sep 11, 2006. Publicly Released: Sep 11, 2006.

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About one-third of the nation's adult homeless population are veterans, according to the Department of Veterans Affairs (VA). Many of these veterans have experienced substance abuse, mental illness, or both. The VA's Homeless Providers Grant and Per Diem (GPD) program, which is up for reauthorization, provides transitional housing to help veterans prepare for permanent housing. As requested, GAO reviewed (1) VA homeless veterans estimates and the number of transitional housing beds, (2) the extent of collaboration involved in the provision of GPD and related services, and (3) VA's assessment of GPD program performance. GAO analyzed VA data and methods used for the homeless estimates and performance assessment, and visited selected GPD providers in four states to observe the extent of collaboration.

VA estimates that on a given night about 194,000 veterans were homeless in 2005. The estimate, generally lower than the numbers reported prior to 2004, is considered by VA officials to be the best available. VA officials believe that its new estimation process and use of better local data have improved the estimate. While VA has increased the capacity of the GPD program over the past several years, VA reports that an additional 9,600 transitional housing beds from various sources are needed to meet current demand. VA has plans to make 2,200 additional GPD beds available. GPD providers collaborate with other agencies to help veterans regain their health and obtain housing, jobs, and various services to enable them to live independently. However, resource and communications gaps may stand in the way of VA and provider efforts to meet these goals. Limited availability of affordable permanent housing, for example, may make it difficult to move veterans out of homelessness, according to GPD providers. We also identified instances of misunderstandings of program policies related to eligibility and program stay limits that could prevent homeless veterans from being admitted into the GPD program. VA assesses overall program performance by the success of veterans in attaining stable housing, income, and self-determination at the time they leave the program. VA data show that the percentage of veterans achieving these goals has generally increased or held steady over time. In 2006, VA also stepped up its assessment of the performance of GPD providers. While these assessments do not indicate how veterans fare after they leave the program, preliminary results of a onetime VA study indicate positive housing outcomes were maintained 1 year later. However, VA does not routinely collect follow-up data and may not be able to determine how veterans who were not included in the study are faring after they leave the program.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: In 2006, VA reported it had developed a program handbook that is accessible via VA's intranet site and a training regimen for Grant and Per Diem (GPD) liaisons that includes a feedback mechanism to determine the extent to which liaisons use the training in practice. VA also reported it had appointed a national clinical manager to serve as an expert on veteran care and program design issues and to facilitate monthly conference calls for GDP liaisons, network homeless coordinators, and providers. In 2007, VA reported it contacted new GPD providers to explain policies and procedures and that the agency summarized their regular and quarterly conference call results on a new webpage to ensure that all providers received the same information. In addition, VA reported it conducted its first two-day training conference for new GPD liaisons in February 2009, which provided an overview of the role and responsibilities of the liaison position. A second conference is reportedly scheduled for later in the year.

    Recommendation: To improve and evaluate the GPD program, and to aid GPD providers in better understanding the GPD policies and procedures, VA should take steps to ensure that its policies are understood by the staff and providers who are to implement them. For example, VA could make more information, such as issues discussed during conference calls, available in writing or online, hold an annual conference, or provide training that may also include local VA staff.

    Agency Affected: Department of Veterans Affairs

  2. Status: Closed - Implemented

    Comments: In 2009, VA reported their program evaluation center implemented a new follow-up form, which is part of a larger online data collection system, to collect data on the status of veterans one month after leaving the program. The form collects such information as housing and employment status, whether the veteran is a substance abuser, and whether the veteran in receiving mental health treatment.

    Recommendation: To improve and evaluate the GPD program, and to better understand the circumstances of veterans after they leave the GPD program, VA should explore feasible and cost-effective ways to obtain such information, where possible using data from GPD providers and other VA sources. For example, VA could review ways to use the data from its own follow-up health assessments and from GPD providers who collect follow-up information on the circumstances of veterans whom they have served.

    Agency Affected: Department of Veterans Affairs


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