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Ending homelessness requires housing combined with the types of services supported by HHS programs.  The delivery of treatment and services to persons experiencing homelessness are included in the activities of the Department, both in five programs specifically targeted to homeless individuals and in fourteen non-targeted or mainstream, service delivery programs.

Targeted Homeless Assistance Programs

This multi-disciplinary comprehensive program provides primary health care, substance abuse treatment, emergency care with referrals to hospitals for in-patient care services, and outreach services to help difficult-to-reach homeless persons establish eligibility for entitlement programs and housing.  

  • Projects for Assistance in Transition from Homelessness (PATH) (Substance Abuse and Mental Health Services Administration)

    PATH is a formula grant program that provides financial assistance to states to support services for homeless individuals who have serious mental illness or serious mental illness and substance abuse.  Eligible programs and activities include outreach services; screening and diagnostic treatment services; habilitation and rehabilitation services; community mental health services; alcohol or drug treatment services; staff training; case management services; supportive and supervisory services in residential settings; referrals for primary health services, job training, educational services, and relevant housing services; and a prescribed set of housing services. 

  • Services in Supportive Housing (Substance Abuse and Mental Health Services Administration)

    The SSH program helps prevent and reduce chronic homelessness by funding services for individuals and families experiencing homelessness living with a severe mental and/or substance use disorder. Grants are awarded competitively for up to five years to community-based public or nonprofit entities. Services supported under the SSH funding include, but are not limited to, outreach and engagement, intensive case management, mental health and substance abuse treatment, and assistance in obtaining benefits.

  • Grants for the Benefit of Homeless Individuals (Substance Abuse and Mental Health Services Administration)

    GBHI is a competitively awarded grant program that enables communities to expand and strengthen their treatment services for people experiencing homelessness. Grants are awarded for up to five years to community-based public or nonprofit entities and funded programs and services include substance abuse treatment, mental health services, wrap-around services, immediate entry into treatment, outreach services, screening and diagnostic services, staff training, case management, primary health services, job training, educational services, and relevant housing services.

  • Programs for Runaway and Homeless Youth (RHY) 

This program establishes or strengthens locally-controlled, community, and faith-based programs that address the immediate needs of runaway and homeless youth and their families.  Centers provide youth with temporary shelter, food, clothing, and referrals for health care.  The grants may also be used to provide counseling, outreach activities, and aftercare services for youth once they leave the shelter.   Locate a Family and Youth Service Bureau Program.

The program provides stable, safe living accommodations, basic life-skills, career counseling, educational training, and physical and mental health support services to youths, ages 16 through 21, who are homeless, for a continuous period, generally not exceeding 18 months.  Minors may remain in the program for an additional 180 days or until their 18th birthday, whichever comes first.   Locate a Family and Youth Service Bureau Program.

The Street Outreach Program provides educational and preventive services to runaway, homeless and street youth who have been subject to, or are at risk of, sexual exploitation or abuse.  The program establishes and builds relationships between street youth and program outreach staff to help youths find safe and appropriate alternative living arrangement.  Support services include: treatment, counseling, information and referral services, individual assessment, crisis intervention, and follow up support.   Locate a Family and Youth Service Bureau Program.

Non-targeted or Mainstream Programs

Access to Recovery supports a grantee-run voucher program to expand clinical substance abuse treatment and recovery support services to reach those in need.  These competitive grants are awarded to grantees who approach and target efforts to areas of greatest need, areas with a high degree of readiness, and to specific populations, including adolescents. 

The Child Support Enforcement Program is a federal/state/tribal/local partnership to help families by promoting family self-sufficiency and child well-being.  All States and territories run a child support enforcement program.  Families seeking government child support services must apply directly through their state/local agency or one of the tribes running the program.  Services are available to a parent with custody of a child whose other parent is living outside the home, and services are available automatically for families receiving assistance under the Temporary Assistance for Needy Families (TANF) program. 

The Community Mental health Services Block Grant is a formula grant awarded to states and territories to improve access to community-based health care delivery systems for adults with serious mental illnesses and children with serious emotional disturbances.  The formula for determining the federal allocations of funds to the states is determined by Congress.  Block grant funds are used by each state as they determine their needs.

The Community Services Block Grant funds a network of community action agencies that provides services and activities to reduce poverty, including services to address employment, education, better use of available income, housing assistance, nutrition, energy, emergency services, health, and substance abuse needs.  Funds are allocated by formula to 50 states and the District of Columbia, Puerto Rico, Guam, American Samoa, the Virgin Islands, the Northern Marianas, and state and federally-recognized Indian tribes. 

The centers provide health-care services and help ensure access to primary care to undeserved populations.  Services are provided without regard for a person’s ability to pay.  Fees are discounted or adjusted based upon the patient’s income and family size from current Federal Poverty Guidelines.  

The Family Violence Prevention and Services Grants Program assists state agencies, territories and Indian Tribes in the provision of shelter to victims of family violence and their dependents, and for related services, such as emergency transportation and child care. Grantees use additional resources to expand current service programs and to establish additional services in rural and underserved areas, on Native American reservations, and in Alaskan Native Villages.  The program also supports technical assistance and training for local domestic violence programs and disseminates research and information through five resource centers. 

  • Head Start (Administration for Children and Families)

Head Start and Early Head Start are comprehensive child development programs for low-income and homeless children under five, pregnant women and their families. Eligible children and families receive nutrition, developmental, medical and dental screenings, immunizations, mental health and social service referrals, and transportation.

The Maternal and Child Health Services Block Grant has three components: formula block grants to 59 states and Territories, grants for Special Projects of Regional and National Significance, and Community Integrated Service Systems grants.  It operates through a partnership with State Maternal and Child Health and Children with Special Health Care Needs programs.  The Program supports direct care; core public health functions such as resource development, capacity and systems building; population-based functions such as public information and education, knowledge development, outreach and program linkage; technical assistance to communities; and provider training. 

Most of these services are preventive services that are available to everyone such as immunizations, child injury prevention programs, lead poisoning prevention activities, and newborn screening programs.  Activities also include: evaluation, monitoring, planning, policy development, quality assurance, training and research. 

  • Medicaid (Centers for Medicare & Medicaid Services)

Medicaid is a jointly funded, federal-state health insurance program for certain low-income and needy people.  In FY 2006, Medicaid provided coverage to more than 47.9 million individuals including 22.9 million children, the aged, blind and/or disabled, and people who are eligible to receive federally assisted income maintenance payment.

The Ryan White HIV/AIDS Treatment Modernization Act (also known as the Ryan White HIV/AIDS Program), operated by the Health Resources and Services Administration (HRSA), authorizes funding for the bulk of the agency’s work on HIV/AIDS.  Programs are funded through states, disproportionately impacted metropolitan areas, community health centers, dental schools, and health care programs that target women, infants, youth, and families.  An increasing number of the people accessing HIV/AIDS services and housing have histories of homelessness, mental illness, and chemical dependency.  The HRSA bureau responsible for administration of the Ryan White HIV/AIDS Program, the HIV/AIDS Bureau (HAB), has approached the issue of housing and healthcare access through housing policy development, direct service programs, service demonstrations, as well as in technical assistance and training activities to grantees.  According to our FY 2005 CARE Act Data Report (CADR), of the 2,631 providers responding to the question whether they delivered services to special target populations, 1,180 providers indicated that they provided services to persons experiencing homelessness.

The Social Services Block Grant program assists states in delivering social services directed toward the needs of children and adults. Funds are allocated to the states on the basis of population. Funds support outcomes across the human service spectrum and are associated with strategic goals and objectives such as employment, child care, child welfare, adoptions, and youth services. States have flexibility to use their funds for a range of services, depending on state and local priorities. The SSBG is based on two fundamental principles: (1) state and local governments and communities are best able to determine the needs of individuals to help them achieve self-sufficiency; and (2) social and economic needs are interrelated and must be met simultaneously. 

The Children's Health Insurance Program (CHIP) is jointly financed by the Federal and State governments and is administered by the States.  Within broad Federal guidelines, each State determines the design of its program, eligibility groups, benefit packages, payment levels for coverage, and administrative and operating procedures.  CHIP provides a capped amount of funds to States on a matching basis.  Children began receiving insurance through CHIP in 1997 and the program helped states expand health care coverage to over 5 million of the nation's uninsured children.  The program was reauthorized on February 4, 2009, when the President signed into law the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA or Public Law 111-3).

The Center for Substance Abuse Treatment (CSAT) of the Substance Abuse and Mental Health Services Administration (SAMHSA), within the U.S. Department of Health and Human Services (HHS), promotes the quality and availability of community-based substance abuse treatment services for individuals and families who need them. CSAT works with States and community-based groups to improve and expand existing substance abuse treatment services under the Substance Abuse Prevention and Treatment Block Grant Program. CSAT also supports SAMHSAs free treatment referral service to link people with the community-based substance abuse services they need.  

Temporary Assistance for Needy Families (TANF) is a flexible block grant to states, Territories and federally recognized Indian Tribes for use in any manner that is reasonably calculated to accomplish a purpose of the TANF program.  Section 401 of the Act sets forth the following four TANF purposes: (1) provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives; (2) end the dependence of needy parents on government benefits by promoting job preparation, work, and marriage; (3) prevent and reduce the incidence of out-of-wedlock pregnancies and establish annual numerical goals for preventing and reducing the incidence of these pregnancies; and (4) encourage the formation and maintenance of two-parent families.

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