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 are specifically designed for individuals or families who are experiencing homelessness.
- Supportive Services: Non-targeted or Mainstream programs are designed to serve those who meet a set of eligibility criteria, which is often established by individual states, but are generally for use in serving low-income populations. Very often, persons experiencing homelessness may be eligible for services funded through these programs.
Targeted Homeless Assistance Programs
- State Medicaid-Housing Agency Partnerships
CMS’ Medicaid Innovation Accelerator Program (IAP) is a collaboration between the Center for Medicaid and CHIP Services (CMCS) and Center for Medicare & Medicaid Innovation (CMMI). The six month State Medicaid-Housing Agency Partnerships begins May 2016. It is designed to be intensive and hands-on to move toward building collaborations with key housing partners. CMCS is partnering with several federal agencies on the planning and coordination of the program support: the United States Department of Housing and Urban Development; SAMHSA; the Office of the Assistant Secretary for Planning and Evaluation; and the US Interagency Council on Homelessness. The eight participating states (California, Connecticut, Hawaii, Illinois, Kentucky, Nevada, New Jersey, and Oregon) will work with subject matter experts to develop an action plan to use supportive housing as an evidence-based solution to address policy challenges related to long-term services and supports.
- Health Care for the Homeless (Health Resources and Services Administration)
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, in conjunction with permanent housing, 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.
- Runaway and Homeless Youth Programs
- Basic Center Program (Administration for Children and Families)
The Basic Center Program helps create and strengthen community-based programs that meet the immediate needs of runaway and homeless youth under 18 years old. In addition, BCP tries to reunite young people with their families or locate appropriate alternative placements. Locate a basic center program.
- Transitional Living Program for Older Homeless Youth (Administration for Children and Families)
The Transitional Living Program supports projects that provide long-term residential services to homeless youth. Young people must be between the ages of 16 and 22 to enter the program. Services are provided for up to 21 months. Young people who have not yet turned 18 at the end of the 21 months may be able stay until their 18th birthday. Maternity Group Homes for Pregnant and Parenting Youth, which are also funded through TLP, support homeless pregnant and/or parenting young people, as well as their dependent children. Locate a transitional living program.
- Street Outreach Program (Administration for Children and Families)
The Street Outreach Program enables organizations around the country to help young people get off the streets. The program promotes efforts by its grantees to build relationships between street outreach workers and runaway, homeless and street youth. Grantees also provide support services that aim to move youth into stable housing and prepare them for independence. The program’s ultimate goal is to prevent the sexual abuse or exploitation of young people living on the streets or in unstable housing. Locate a street outreach program.
- Basic Center Program (Administration for Children and Families)
- Cooperative Agreements to Benefit Homeless Individuals (CABHI) (Substance Abuse and Mental Health Services Administration)
The CABHI program supports the development and/or expansion of local efforts to integrate treatment and services for people with mental, substance use, or co-occurring disorders with permanent housing and other critical services. Grants are awarded competitively for up to three years to community-based public or nonprofit entities to build upon the success of the Services in Supportive Housing (SSH) programs. The program aims to ensure that individuals who experience chronic homelessness receive access to permanent housing, treatment, and recovery support services. Funds provide behavioral health treatment and other recovery-oriented services; improve the sustainability of integrated community systems that provide stable and affordable housing and other related supportive services; and increase client enrollment for health insurance, Medicaid, and other mainstream benefits. Grantees must establish a community consortium and steering committee to help guide program integration and implementation.
- Cooperative Agreements to Benefit Homeless Individuals for States (CABHI-States) (Substance Abuse and Mental Health Services Administration)
The CABHI-States program works to enhance states’ treatment services infrastructure to better provide accessible, effective, comprehensive, coordinated/integrated, and evidence-based treatment services; permanent supportive housing; peer supports; and other critical services to veterans who experience homelessness or chronic homelessness, and other chronically homeless individuals with SMI, substance use disorders, or co-occurring disorders. Grants are awarded to enhance statewide planning and infrastructure development; deliver behavioral health, housing support, peer and other recovery oriented services; and engage and enroll individuals in Medicaid and other mainstream benefits. Grantees must establish a state interagency council to guide program integration and implementation.
Supportive Services: Non-targeted or Mainstream Programs
- Access to Recovery (Substance Abuse and Mental Health Services Administration)
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.
- Child Support Enforcement Program(Administration for Children and Families)
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.
- Community Mental Health Services Block Grant (Substance Abuse and Mental Health Services Administration)
The Community Mental Health Services Block Grant (MHBG) 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. States must set aside 5 percent of their increased FY 2014 MHBG appropriation to support evidence-based programs that provide treatment to those with early serious mental illness, including psychosis at any age. SAMHSA is working with the National Institute of Mental Health in this effort.
- Community Services Block Grant (Administration for Children and Families)
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.
- Community Health Center Program (Health Resources and Services Administration)
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.
- Family Violence Prevention and Services Grant Program (Administration for Children and Families)
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)
ACF’s Head Start (with Early Head Start) is a comprehensive child development program that serves children from birth to age five, pregnant women, and their families. It is a child-focused, multi-generational program with the overall goal of increasing the school readiness of young children in low-income families. The children of families experiencing homelessness are categorically eligible for Head Start and are identified and prioritized for enrollment. The children of families experiencing homelessness can apply, enroll and attend while documents are collected in a reasonable time frame. Head Start directly serves children experiencing homelessness from birth to five years old and provides children and their families with services related to nutrition, developmental, medical and dental screenings, immunizations, mental health and social services referrals, family engagement, and in some cases transportation.
Head Start was reauthorized by the Improving Head Start for School Readiness Act of 2007 (Public Law 110-134). In this reauthorization, age-eligible children whose families are determined to be homeless are categorically eligible for Head Start and Early Head Start programs. Many Head Start grantees serve families experiencing homelessness through home-based and center-based programs, both of which provide many supportive services to children and families regardless of their living circumstances. HHS issued a Notice of Proposed Rule Making (NPRM) regarding eligibility on March 18, 2011. This regulation affirms that the McKinney-Vento definition of “homeless” applies for Head Start eligibility and ensures that no requirements in the regulation create barriers for children experiencing homelessness being served in Head Start. Read additional information on the Administration for Children and Families website.
- Maternal and Child Health Services Block Grant (Health Services and Resources Administration)
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.
- Ryan White HIV/AIDS Treatment Modernization Act of 2006 (Health Resources and Services Administration)
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.
- Social Services Block Grant (Administration for Children and Families)
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.
- Children’s Health Insurance Program (Centers for Medicare & Medicaid Services)
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).
- Substance Abuse Prevention and Treatment Block Grant (SAMHSA)
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 (Administration for Children and Families)
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.
- Child Care and Development Fund (Administration for Children and Families)
The Child Care and Development Fund (CCDF), administered by the Office of Child Care (OCC), is a multi-billion dollar Federal and State partnership that promotes family economic self-sufficiency and helps children succeed in school and life through affordable, high-quality early care and afterschool programs. Subsidized child care services are available to eligible families through certificates (vouchers), or grants and contracts with providers. Nearly 1.5 million children receive a child care subsidy from the CCDF program every month.
As a block grant, this program offers States, territories, and tribes significant flexibility in designing their CCDF policies, including the ability to define eligibility and prioritize resources. OCC encourages States to leverage this flexibility to offer access to the most vulnerable populations, including families experiencing homelessness.
On November 19, 2014, the President signed the Child Care and Development Block Grant (CCDBG) Act of 2014, which authorizes the Child Care and Development Fund. The law, which Congress passed with strong bipartisan support, reauthorizes the child care program for the first time since 1996 and represents an historic re-envisioning of the CCDF program. The new law not only benefits the children receiving federal assistance through CCDF, but also improves the health and safety of millions of other children in child care each day and provides important support for working parents.
The new law has several provisions that specifically benefit children and families experiencing homelessness, including requiring States to:
- Use CCDF funds for activities that improve access to child care services, including:
- Procedures to permit enrollment of homeless children (after an initial eligibility determination) while required documentation is obtained
- Training and technical assistance on identifying and serving homeless children and their families
- Specific outreach to homeless families
- Establish a grace period that allows children experiencing homelessness to receive CCDF services while their families take any necessary action to comply with immunization and other health and safety requirements
- Coordinate CCDF services with early childhood programs serving homeless children
- Collect child-level data on whether CCDF children are homeless
- Use CCDF funds for activities that improve access to child care services, including:
- Title V, Federal Real Property Assistance Program (Program Support Center)
Read additional information on the Administration for Children and Families website.
The Federal Real Property Assistance Program (FRPAP) transfers suitable and available Federal surplus real properties for public benefit at no cost to States, political subdivisions thereof (e.g., municipalities), and 501(c)(3) tax-exempt organizations, for homeless assistance purposes. Transferees must use conveyed properties for approved purposes for a proscribed period of years in accordance with key terms and conditions. Eligible programs include supportive services, emergency shelter, transitional housing, and permanent supportive housing.
- Tribal Home Visiting
The Tribal Maternal, Infant, and Early Childhood Home Visiting program provides grants to tribal organizations to develop, implement, and evaluate home visiting programs in American Indian and Alaska Native (AIAN) communities. It is funded by a 3 percent set-aside from the larger Federal Home Visiting (MIECHV) program. Tribal Home Visiting grants are awarded to Indian tribes, consortia of tribes, tribal organizations, and urban Indian organizations.
The Tribal Home Visiting Program is designed to develop and strengthen tribal capacity to support and promote the health and well-being of AIAN families; expand the evidence-base around home visiting in tribal communities; and support and strengthen cooperation and linkages between programs that service AIAN children and their families.
The goals of the Tribal Home Visiting Program include:
- Supporting the development of happy, healthy, and successful AIAN children and families through a coordinated home visiting strategy that addresses critical maternal and child health, development, early learning, family support, and child abuse and neglect prevention needs.
- Implementing high-quality, culturally-relevant, evidence-based home visiting programs in AIAN communities.
- Expanding the evidence base around home visiting interventions with Native populations.
- Supporting and strengthening cooperation and coordination and promoting linkages among various early childhood programs, resulting in coordinated, comprehensive early childhood systems.