SAMHSA’s Efforts to Prevent Homelessness

Learn about SAMHSA’s grant programs and partnerships committed to ending and preventing homelessness among people with mental and/or substance use disorders.

Prevention

SAMHSA’s grant programs and services are helping to address homelessness by ensuring that permanent housing and supportive services are available for individuals with mental and/or substance use disorders. SAMHSA works closely with the U.S. Interagency Council on Homelessness (USICH), chaired by the Secretary of the Department of Health and Human Services (HHS), to coordinate the activities of various federal departments that focus on homelessness prevention and housing.

As a part of its contribution to USICH, SAMHSA led a session to establish guiding principles to prevent and end homelessness. SAMHSA also led an expert panel on the role of outreach and engagement in ending homelessness – 2016 (PDF | 480 KB).

Policy Academy to Reduce the Prevalence of Chronic Homelessness

The Policy Academy to Reduce the Prevalence of Chronic Homelessness was initiated in November 2012 as a way of providing intensive technical support to selected states with a high prevalence of chronic homelessness. With support from its federal partners, SAMHSA sought to reduce the rate of chronic homelessness in each participating state through a SAMHSA-sponsored, cross-agency federal effort to provide intensive, targeted technical assistance to state teams.

Four states (California, Georgia, Louisiana, and Washington) were provided a faculty team that met regularly with state leaders by telephone throughout the project. Each team was led by a senior federal staff member. Members of the team travelled to the state for three site meetings at the beginning, middle, and end of the supported planning period. The in-state meetings allowed more agencies to be represented, facilitating collaboration, and the longer time for planning made it possible to build consensus on direction through dialogue.

State and faculty teams agreed that all the participating states made significant, sustainable progress in addressing chronic homelessness. State teams were unanimous in their preference for an approach in which technical assistance unfolded over time, with in-state meetings, as opposed to one in which technical assistance was concentrated at a single point in time in Washington, D.C. The innovative approach gave them time to solidify relationships with new partners, involve more stakeholders, and access support during implementation. At the same time, travel restrictions made the process less effective than it might have been. This included limitation placed by HHS on travel by the faculty team (especially the federal team lead) as well as in-state travel by federal agency representatives and state participants.

One of the revelations of the policy academy process was the uniqueness of each state’s planning process and focus. Different aspects of the challenge of chronic homelessness were ripe for consideration in each state, and plans took very different directions depending on agency motivation, politics, infrastructure, historical factors, resources, and many other variables. Each proceeded in strategic directions defined by clear needs and open doors. California seized the opportunity presented by health reform to increase access to mainstream resources. Georgia capitalized on its governor’s commitment to reduce recidivism, pointing out the causal relationship between institutional discharge policies and chronic homelessness. Louisiana, observing that its permanent supportive housing was not allocated to its most vulnerable residents, concentrated some of its efforts on the development of a coordinated screening and assessment system. Washington was galvanized by the recognition that approximately 3,000 people were experiencing chronic homelessness in the state—a finite number that made ending chronic homelessness seem possible—and began testing approaches to address the challenge to take to scale and implement statewide. The faculty teams flexibly supported each state in a distinctive journey over time.

SAMHSA grants and programs helping to support the goal of ending homelessness among people with mental and/or substance use disorders include the following:

Cooperative Agreement to Benefit Homeless Individuals (CABHI)

The CABHI program is jointly funded by the Center for Mental Health Services (CMHS) and the Center for Substance Abuse Treatment (CSAT). It supports the development and expansion of local implementation and community infrastructures that integrate treatment and services for people with mental and/or substance use disorders by providing permanent housing and other critical services. Grants are awarded competitively for up to 3 years to community-based public or nonprofit entities to build upon the success of the CMHS SSH and CSAT Treatment for Homeless–SSH programs. The major goal of the CABHI program is to ensure that the most vulnerable individuals who experience chronic homelessness receive access to permanent housing, treatment, and recovery support services. To achieve this goal, SAMHSA funds are used to provide the following:

  • Behavioral health treatment and other recovery-oriented services
  • Coordination of housing and sustainability of integrated community systems that provide stable and affordable housing, as well as other related supportive services
  • Increased client enrollment for health insurance, Medicaid, and other mainstream benefits

One of the major requirements of this grant program is the establishment of a community consortium and steering committee to help guide program integration and implementation.

CABHI Programs

The purpose of the CABHI program is to enhance or develop the infrastructure of states, local communities, and tribal and nonprofit organizations, increasing their capacity to provide accessible, effective, comprehensive, coordinated/integrated, and evidence-based treatment services; permanent supportive housing; peer supports; and other critical services to veterans, youth, and families experiencing homelessness and people experiencing chronic homelessness, who also have serious mental illnesses or serious emotional disturbances, substance use disorders, or co-occurring substance use and mental disorders.

Grants are awarded to states, communities, and tribal and nonprofit organizations with the objectives of:

  • Improving community level or statewide strategies to address planning, coordination, integration of behavioral health and primary care services, and permanent housing to reduce homelessness;
  • Increasing the number of individuals residing in permanent housing who receive behavioral health treatment and recovery support services; and,
  • Increasing the number of individuals placed in permanent housing and enrolled in Medicaid and other mainstream benefits, such as Supplemental Security Income / Social Security Disability Insurance (SSI/SSDI), Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), etc.

In 2016, SAMHSA awarded a total of $19,475,985 through 30 CABHI Program grants.

CABHI – States

The CABHI-States program is jointly funded by CMHS and CSAT to enhance or develop the infrastructure of states and their treatment service systems to increase capacity to provide:

  • Accessible, effective, comprehensive, coordinated/integrated, and evidence-based treatment services
  • Permanent supportive housing
  • Peer supports
  • Other critical services to veterans and other individuals with serious mental illness, substance use disorders, or co-occurring mental and substance use disorders who experience homelessness or chronic homelessness

Grants are awarded competitively for up to 3 years to state substance abuse and mental health agencies to:

  • Enhance statewide planning and infrastructure development
  • Deliver behavioral health, housing support, peer and other recovery-oriented services
  • Engage and enroll individuals in Medicaid and other mainstream benefits

One of the major requirements of this grant program is the establishment of a state interagency council to guide program integration and implementation.

Grants for the Benefit of Homeless Individuals-Services in Supportive Housing (GBHI-SSH)

Initiated in 2001, this discretionary grant program is designed to enable local communities to expand and strengthen treatment services for individuals experiencing homelessness who also have substance use disorders, mental disorders, or co-occurring substance use and mental disorders. Under GBHI-SSH services must be provided using a supportive housing approach. For this program, "supportive housing" is defined as housing that is permanent, affordable, and linked to health, mental health, employment, and other support services that provide individuals with long-term, community-based housing options. This approach combines housing assistance and intensive individualized support services for those individuals experiencing chronic homelessness who also have substance use disorders, mental disorders, or co-occurring substance use and mental disorders.

Homeless and Housing Resource Network (HHRN)

HHRN is the SAMHSA training and technical assistance center that shares knowledge and best practices for preventing and ending homelessness. Audiences include grantees; homeless, housing, and service providers; consumers; policymakers; researchers; and public agencies at federal, state, and local levels. These efforts reflect SAMHSA’s vision of ending homelessness by supporting individuals through a process of change as they improve their health and wellness, live a self-directed life, and strive to reach their full potential.

Projects for Assistance in Transition from Homelessness (PATH) Program

PATH grants are distributed based on a formula to the 50 states, the District of Columbia, Puerto Rico, the Northern Mariana Islands, Guam, American Samoa, and the U.S. Virgin Islands. PATH serves people with serious mental illnesses and those with co-occurring substance use disorders who are experiencing homelessness or who are at risk of becoming homeless.

Nearly all states use PATH funds to conduct outreach to contact and engage people who are disconnected from mainstream resources. PATH-funded providers also offer mental health treatment, substance use treatment, case management, other support services, and a limited set of housing services. Some 500 local organizations provide PATH-funded services.

Learn more about PATH.

SSI/SSDI Outreach, Access, and Recovery (SOAR) Technical Assistance

Funded by SAMHSA, SOAR is a national project designed to increase access to the disability income benefit programs administered by the Social Security Administration for eligible adults who are homeless, or at risk of homelessness, and have a mental and/or substance use disorder.

Data Partnership

In December 2009, SAMHSA announced an initiative to move towards PATH reporting in Homelessness Management Information Systems (HMIS). As part of HHS, SAMHSA is working with the Department of Housing and Urban Development (HUD) to align and standardize data collection efforts for homeless services programs by integrating the PATH program’s client-level data collection into local HMIS. Improved data collection for programs that serve people who are at risk of, or are experiencing homelessness, is important for tracking progress on ending homelessness and accurately capturing the nature and extent of homelessness across the country. More importantly, this integrated data effort will lead to more streamlined, effective, and collaborative services at the community level for those individuals and families who are experiencing homelessness.

In August 2016, HUD released the 2016 HMIS Data Standards, which reflect data collection requirements for homeless services programs across HUD, the Administration for Children and Families, Department of Veterans Affairs, and SAMHSA. The standards were released in three documents:

Last Updated: 06/29/2017