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 many HHS agencies including:
- Administration for Children and Families (ACF)
- Centers for Medicare & Medicaid Services (CMS)
- Health Resources and Services Administration (HRSA)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
Administration for Children and Families (ACF)
Runaway and Homeless Youth Programs
Each year, thousands of U.S. youth run away from home, are asked to leave their homes, or become homeless. Through the Runaway and Homeless Youth Program, the Family and Youth Services Bureau supports street outreach, emergency shelters and longer-term transitional living and maternity group home programs to serve and protect these young people.
Basic Center Program
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
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
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.
Child Support Enforcement Program
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 Services Block Grant
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.
Family Violence Prevention and Services Grant Program
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.
More than 1 million children ages birth to 6 experience homelessness in the U.S. These children are automatically eligible for Head Start and Early Head Start programs. These resources include homelessness related eligibility, recruitment, selection, enrollment, attendance (ERSEA) strategies and resources for enrolling and engaging families in Head Start and Early Head Start programs. 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 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.
Social Services Block Grant
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, childcare, 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.
Temporary Assistance for Needy 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
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 childcare 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.
The Child Care and Development Block Grant Act of 2014 has several provisions that specifically benefit children and families experiencing homelessness, including requiring States to:
- Use CCDF funds for activities that improve access to childcare 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
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.
Title V, Federal Real Property Assistance Program
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.
Centers for Medicare & Medicaid Services (CMS)
Medicaid is a jointly funded, federal-state health coverage program serving low-income families, children, pregnant women, adults without children, and also seniors and people living with disabilities. In FY 2021, Medicaid provided coverage to more than 74.2 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. State Medicaid programs cover health care, behavioral health care and supportive services for eligible individuals.
Children’s Health Insurance Program
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).
Health Resources and Services Administration (HRSA)
Health Care for the Homeless
Health Care for the Homeless is a 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.
Maternal and Child Health Services Block Grant
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.
Community Health Center Program
The Community Health Center Program is comprised of centers that provide health-care services and help ensure access to primary care to underserved 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.
Ryan White HIV/AIDS Treatment Modernization Act of 2006
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.
Substance Abuse and Mental Health Services Administration (SAMHSA)
Projects for Assistance in Transition from Homelessness (PATH)
PATH is a formula grant program that provides financial assistance to states to support services for individuals who are at imminent risk of or experiencing homelessness who have a serious mental illness or co-occurring serious mental illness and substance use disorder. PATH grants are distributed annually to all 50 states, the District of Columbia, Puerto Rico, the Northern Mariana Islands, Guam, American Samoa, and the U.S. Virgin Islands. Each state or territory solicits proposals and awards funds to local public or nonprofit organizations, known as PATH providers. PATH eligible 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.
Grants for the Benefit of Homeless Individuals (GBHI)
GBHI is a competitively awarded grant program that enables communities to expand and strengthen their treatment services for people experiencing homelessness who have substance use disorders or co-occurring mental and substance use disorders. Grants are awarded for up to five years to community-based public or nonprofit entities and funded services include outreach, screening and diagnostic services, treatment, enrollment in mainstream benefit programs, recovery support services, case management, staff training, job training, educational services, and assistance in identification and placement in stable housing.
Treatment for Individuals Experiencing Homelessness (TIEH)
TIEH is a competitively awarded grant program that enables communities to expand access to treatment for people experiencing homelessness who have a serious mental illness (SMI), serious emotional disturbance (SED), or a co-occurring disorder (i.e., a SMI and substance use disorder [SUD] or a SED and SUD). Grants are awarded for up to five years to community-based public or nonprofit entities and funded services include outreach, screening, treatment, peer support, connections to sustainable permanent housing, case management, recovery support services and assistance in enrollment in mainstream benefits.
SSI/SSDI Outreach, Access, and Recovery (SOAR)
The SOAR program increases access to Social Security disability benefits for eligible children and adults who are experiencing or at risk of homelessness and have a serious mental illness, medical impairment, and/or co-occurring substance use disorder.
Community Mental Health Services Block Grant
The MHBG program provides funds and technical assistance to all 50 states, the District of Columbia, Puerto Rico, the US Virgin Islands, and all six Pacific jurisdictions. Grantees use the funds to provide comprehensive, community-based mental health services to adults with serious mental illnesses and to children with serious emotional disturbances and to monitor progress in implementing a comprehensive, community-based mental health system.
Substance Abuse Prevention and Treatment Block Grant (SABG)
The SABG Program is a noncompetitive formula grant program provides funds to all 50 states, the District of Columbia, Puerto Rico, the US Virgin Islands, three Pacific jurisdictions, three Freely Associated Compact States, and one tribal entity to plan, implement, and evaluate substance use disorder (SUD) prevention, treatment (e.g., referrals to housing), recovery support services (e.g., linkages to permanent supportive housing; room and board for transitional housing or recovery residences in conjunction with SUD treatment services) and promote public health. Grantees have the flexibility to distribute program funds to units of local government and subsequently to community- and faith-based organizations to deliver SUD prevention, early intervention, treatment, and recovery support services for individuals and families who need them. The program places emphasis on provision of services for populations of focus and service areas; specifically, persons who inject drugs, pregnant women and women with dependent children, services for persons with or at risk for HIV/AIDS and/or tuberculosis, and individuals in need of primary prevention services.
State Opioid Response (SOR)
The SOR program aims to address the opioid crisis by increasing access to medication-assisted treatment using the three FDA-approved medications for the treatment of opioid use disorder, reducing unmet treatment need, and reducing opioid overdose related deaths through the provision of prevention, treatment and recovery activities for opioid use disorder (OUD) (including illicit use of prescription opioids, heroin, and fentanyl and fentanyl analogs). This program also supports evidence-based prevention, treatment and recovery support services to address stimulant misuse and use disorders, including for cocaine and methamphetamine. These grants are awarded to states and territories via formula. The program also includes a 15 percent set-aside for the ten states with the highest mortality rates related to drug poisoning deaths.
Tribal Opioid Response (TOR)
TOR is a grant program for federally recognized tribes and tribal organizations to address the opioid crisis in tribal communities by increasing access to culturally appropriate and evidence-based treatment, prevention, treatment, and recovery support services. TOR recipients may address client housing needs by providing transitional housing, recovery housing, inpatient/residential treatment, and by providing other direct support to help individuals meet housing needs.