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SAMHSA News - Volume XI, Number 1, Winter 2003

Collaborative Effort Combats Chronic Homelessness

On January 27, the U.S. Department of Health and Human Services (HHS) joined with the Departments of Housing and Urban Development (HUD) and Veterans Affairs (VA) to announce the $35 million Collaborative Initiative To Help End Chronic Homelessness.

"We are keenly aware that serious health, psychiatric, and substance use disorders contribute to the complexities of long-term and repeated homelessness," said HHS Secretary Tommy G. Thompson. "The expert contributions of health care professionals, combined with the provision of permanent housing [in the Initiative] will help break the cycle of chronic homelessness and put people on the road to recovery and self-sufficiency."

HHS will contribute $10 million to the Initiative-$7 million directed toward substance abuse treatment, mental health and related support services from SAMHSA, and $3 million for primary health care services from the Health Resources and Services Administration (HRSA). These funds will be combined with $20 million from HUD to fund permanent housing for chronically homeless persons and $5 million of in-kind support from the VA, to assure the provision of services to homeless veterans.

"Our goal," says Philip Mangano, Executive Director of the U.S. Interagency Council on Homelessness, which is coordinating the Initiative, "is to focus on those who are most at risk and to offer a permanent solution."

Of the approximately 2 million people who experience homelessness in the United States each year, approximately 10 percent are considered chronically homeless-they have been continuously homeless for more than a year, or experienced repeated episodes of homelessness over multiple years.

According to SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W., "For many, the most significant reason for chronic homelessness is the existence of serious mental illnesses combined with addictive disorders."

The chronically homeless population uses a disproportionate amount of homeless services, and yet chronically homeless individuals do not have sufficient access to mainstream services for which they qualify, including Medicaid, Temporary Assistance for Needy Families, Food Stamps, and mental health or drug/alcohol addiction programs.

"The barriers include fragmented service systems in which services are offered in different locations and have different eligibility criteria. Also, staff may not have experience with the array of needs exhibited by chronically homeless individuals," explains Michael English, J.D., Director of the Division of Service and Systems Improvement within SAMHSA's Center for Mental Health Services.

Applicants for Initiative funding must demonstrate a comprehensive and integrated provision of services designed to meet the housing, mental health, substance abuse, and primary health care needs of chronically homeless persons—including veterans.

"Rather than make the individual try to integrate a fragmented system of services," explains Mr. English, "the comprehensive plan should do the job of making applications for services easier for the individual client. The housing and stability needs of chronically homeless people must be addressed early on in order for treatment and recovery efforts to take hold."

Applicants for Initiative funding must also address agency specific requirements tied to the four funding streams (HUD, HHS-SAMHSA, HHS-HRSA, VA). SAMHSA funding may be used for a variety of programs and activities, including: street outreach and engagement, intensive case management, and motivational interventions, among others.

"This collaboration assures that there is no wrong door for chronically homeless people seeking services," says Jane Taylor, Ph.D., Chief of the Co-Occurring and Homeless Activities Branch within SAMHSA's Center for Substance Abuse Treatment. "They will be able to enter the system anywhere and have access to all the services they require."

For further information, visit the Web site for the Interagency Council on Homelessness at For information regarding SAMHSA's role, contact Lawrence Rickards, Ph.D., SAMHSA, Room 11C-05, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-3707; e-mail: Or contact Melissa Rael, SAMHSA, Rockwall II, Room 7-213, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-8236; e-mail:

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