Needs of homeless veterans: 5 years of the CHALENG Survey 2012-16.

BACKGROUND: National surveys of homeless veterans have been conducted for over a decade, but there has been no examination of changes in the needs of homeless veterans. METHODS: Annual surveys of convenience samples of homeless veterans conducted for Project Community Homelessness Assessment, Local Education and Networking Groups (CHALENG) from 2012 (n = 6859), 2013 (n = 7741), 2014 (n = 7126), 2015 (n = 3765) and 2016 (n = 3191) were analyzed. CHALENG surveys collected background information about respondents and their ratings of unmet needs of homeless veterans. RESULTS: Across years, the majority of respondents were males, white, 45-60 years old, Army veterans, lived in urban areas, had no dependent children, and were enrolled in VA healthcare. Over time, the proportion of respondents who were over 60, female, and white increased. There was little change in reported unmet needs with the highest rated unmet needs related to credit counseling, utility assistance, furniture and housewares, dental care and disability income. Among subsamples of veterans with specialized needs, the top three reported unmet needs were housing for registered sex offenders, legal assistance for evictions/foreclosures, and legal assistance for child support. CONCLUSIONS: Several intractable unmet needs of homeless veterans have persisted in contemporary time.

Unmet needs of homeless U.S. veterans by gender and race/ethnicity: Data from five annual surveys.

There has been insufficient research on gender, race, and ethnic differences in unmet needs of homeless populations. This study analyzed 5 years of data collected by Project Community Homelessness Assessment, Local Education, and Networking Groups (CHALENG) surveys from 2012 to 2016 to examine gender, race, and ethnic differences in "literally homeless" veterans (i.e., veterans living in the streets, shelters, vehicles, or any other place not meant for habitation). Of 7,040 participants, there were 6,335 male and 705 female literally homeless veterans from 4 self-identified racial/ethnic categories (White, Black, Hispanic, and Other). The results showed that homeless female veterans were significantly more likely to report unmet needs related to emergency shelter, transitional housing, and dental care than male veterans. Among men, White veterans reported greater unmet needs in housing, healthcare, basic needs, and specialized needs than racial/ethnic minority veterans. Among women, veterans who were racial/ethnic minorities reported greater unmet needs than their White counterparts. These findings suggest programmatic attention to gender, race, and ethnicity is important in addressing diverse needs of homeless veterans and specialized services may be needed to address their specific and consistent unmet needs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Co-location of health care services for homeless veterans: a case study of innovation in program implementation.

This case study examines how the Veterans Affairs Greater Los Angeles Healthcare System (GLA) improved homeless veteran service utilization through program innovation that addressed service fragmentation. The new program offered same-day co-located mental health, medical, and homeless services with a coordinated intake system. The program is analyzed using a framework proposed by Rosenheck (2001) that has four phases: the decision to implement, initial implementation, sustained maintenance, and termination or transformation. GLA was able to successfully implement a new program that remains in the sustained maintenance phase five years after the initial decision to implement. Key factors from the Rosenheck innovation model in the program's success included coalition building, linking the project to legitimate goals, program monitoring, and developing communities of practicing clinicians. The key lesson from the case study is the need for a coalition to persistently problem solve and act as advocates for the program, even after successful initial implementation. Social work leadership was critical in all phases of program implementation.

Developing programs for homeless veterans: understanding driving forces in implementation.

Between 1992 and 2003, services for homeless veterans at the Veterans Affairs Greater Los Angeles Healthcare System went from inappropriate utilization of hospital medical and psychiatric beds, to a continuum of residential treatment, transitional housing, and employment programs through arrangements with private agencies. The authors use elements of Hasenfeld and Brock's Political Economy Model (1991) to explain this transformation in service delivery that was spearheaded by a VA social work leadership team. It is argued that three driving forces crucial to program implementation were present: technological certainty, economic stability, and concentration of power. Evidence of the implementation's impact includes creation of new homeless program beds, a reduction in use of medical/psychiatric beds, and a large number of formerly homeless veterans with housing and employment at program discharge. Study limitations and implications for future studies are discussed.