"Ask the Expert" Welcomes Barbara Poppe

“Ask the Expert” features an interview with a leading expert on homelessness or co-occurring mental and substance use disorders. The following is an interview with Barbara Poppe, Executive Director of the United States Interagency Council on Homelessness.

We are pleased to welcome Barbara Poppe, the executive director of the United States Interagency Council on Homelessness (USICH). In this role, Barbara oversees the Federal response to homelessness by working with 19 Federal agencies to create a national partnership at every level of government and with the private sector to reduce and end homelessness in the Nation. In June 2010, Barbara and four cabinet secretaries announced Opening Doors, the Nation’s first-ever comprehensive Federal plan to prevent and end homelessness. Barbara has more than 25 years of non-profit experience working on homelessness with housing-related organizations. She was appointed to serve as executive director of the USICH in 2009. She served as executive director of the Columbus, Ohio-based Community Shelter Board (CSB) from 1995 to 2009. CSB is a nationally recognized non-profit organization that creates collaborations, innovative solutions, and invests in quality programs to end homelessness in Columbus and Franklin County, Ohio. Barbara provided visible leadership in achieving community-wide homeless services and prevention objectives. She was responsible for strategic planning and collaborative efforts, private sector fundraising, resource development, effective governmental systems, and private sector relationships.

Question: What is the central message of Opening Doors: Federal Strategic Plan to Prevent and End Homelessness?

Answer: Opening Doors is based on the vision that no one should experience homelessness. No one should be without a safe, stable place to call home. Its development and implementation are the result of unprecedented collaboration at the Federal level among the 19 USICH member agencies. It represents a dramatic shift in Federal policy. To date, the Federal Plan to address homelessness has been, by default, defined by the targeted programs. But now we are embarking on a Strategic Plan that has homelessness prevention at the center and brings mainstream resources to bear. Solving homelessness will require that people access mainstream resources effectively and sufficiently to meet their needs and avoid homelessness. In our shift to mainstream resources, we’re moving to where the dollars are. Fiscally prudent government response is imperative—local, State, and Federal Governments cannot afford to invest in anything but the most evidence-based, cost-effective strategies. That’s why Opening Doors includes only those strategies that have been working at the local level.

Question: How does Opening Doors help specific homeless populations, such as people experiencing homelessness who have substance abuse disorders or mental health issues?

Answer: Permanent supportive housing has emerged as the solution for people facing the greatest challenges to housing stability, including serious and persistent physical and behavioral health problems. The Plan has an entire section that looks at how health and behavioral health care need to be integrated with housing, just as people with behavioral health conditions need a health care system that attends to both their physical and behavioral health conditions.

Question: You’ve emphasized collaboration in Opening Doors. How do you see this happening at the Federal level, and what implications does and will that have?

Answer: USICH is committed to preventing and ending homelessness by bringing Council members’ mainstream and targeted resources to the table and forming partnerships among agencies that leverage those resources most effectively. A great example of this is the signature initiative in Opening Doors that pairs HUD’s housing resources with services from HHS for 6,000 vouchers that will serve families with children who are homeless or at risk of homelessness. The Department of Education collaborates in that initiative as well, with its homelessness liaisons available to identify homeless students and coordinate their families’ access to the vouchers. USICH is also facilitating collaborative efforts by the Departments of Veterans Affairs, Housing and Urban Development, Labor, and Health and Human Services to target resources and undertake joint efforts to prevent and eliminate veterans homelessness. This initiative is designed to spur increased inter-governmental collaboration at a Federal and local level, inclusive of both government and community providers. When cabinet secretaries are talking with each other about how to end homelessness, they’re bringing together the force of their entire departments and agencies to address the problem at the Federal level, as well as on the ground. All 19 of the Council’s member agencies are committed to the goals and strategies in Opening Doors. Leadership at all levels is needed to inspire and energize Americans to commit to the vision of preventing and ending homelessness. Communities across the country must include Federal partners at the table in strategizing on Continuum of Care development and Ten-Year Plans. While we work every day at the Federal level to improve interagency collaboration, partnerships must occur at the local level as well. States make decisions about how to invest Federal substance abuse prevention and treatment dollars and mental health block grants and will make significant decisions related to implementation of health reform. When we look at which communities have been most successful at reducing homelessness, this collaborative effort is foundational in building that success.

Question: The Plan has some aggressive goals, including ending veterans and chronic homelessness by 2015 and ending homelessness among children, families, and youth by 2020. What will it take to achieve these goals?

Answer: Opening Doors details five areas we need to focus on to get the job done. The first is Federal leadership and collaboration, which is an area we’ve demonstrated we’re strong in through development of Opening Doors and the President’s commitment to ending homelessness. The second is housing, or, as we like to say, housing, housing, and housing. People who are homeless need homes they can afford. HUD Secretary Shaun Donovan is a tremendous leader on this issue, and through both new investments and better use of existing resources, he’s doing all he can to get the Federal Government back in the business of affordable housing. Our third focus area is to increase income and employment. The best defense against homelessness is a job that pays, and that’s a current challenge across our Nation. Increasing employment is a national priority right now, but we also need to improve access to income supports for people living in poverty. Our fourth focus area is on improving health and stability, and with the Affordable Care Act, we will have more tools to do that, particularly through Medicaid expansion. The final area of focus is retooling the homeless crisis response system. Communities all over America must shift their service delivery away from managing homelessness with emergency services like shelters, towards ending it with housing and supportive services. It will take political will at all levels of government to achieve these goals. As Secretary Donovan mentioned in Opening Doors, “...working together we can harness public resources and build on the innovations that have been demonstrated at the local and in cities nationwide....” to see the Plan through fruition.

Question: Now that we have a Federal plan, where do we go from here? What’s the next critical step?

Answer: Building off of the momentum generated across the country by the release of Opening Doors, USICH and its member agencies immediately turned from planning to action. USICH’s three deputy directors have divided up the 52 strategies and 4 population-based signature initiatives between them. We have also divided up responsibility for the 19 Federal agencies that make up the Council. President Obama has asked for an 11.5 percent increase in funding for targeted homeless assistance programs in his FY2011 budget. And we are continuing to break down silos across agencies that prevent people experiencing homelessness from fully accessing the resources that are available. The development of the President’s FY2012 budget is under way. Member agencies are looking at the Plan’s priorities as they make important budget decisions. At the regional and State level, we’re asking interagency councils to realign their own plans with the goals and objectives outlined in Opening Doors. Funding decisions need to focus on proven solutions like supportive housing. On-the-ground agencies need to learn more about mainstream resources and evaluate their strategy for tapping into mainstream programs.

Question: What is the greatest impact the Affordable Care Act will have specifically for people experiencing or at risk of homelessness with co-occurring disorders?

Answer: Health reform generally, Medicaid expansion in particular, is the secret weapon in the fight against homelessness. My first few months in DC were a roller coaster ride for health reform. Would it pass? Wouldn’t it pass? But then in March, the seemingly impossible happened—Congress passed the Health Reform bill and President Obama signed it into law. The passage of the Affordable Care Act in March put an incredible lift in our efforts to prevent and end homelessness. Health reform offers new economic security—individuals and families are significantly less likely to be made bankrupt or enter into a downward economic spiral when they have health insurance. For the first time ever, all poor single adults will become eligible for Medicaid. They will have access to health care before they get sick, which will prevent some people from becoming homeless. People with mental illness and substance use disorders, who are disproportionately represented among the chronically homeless, will especially benefit by the improvements that will come with the implementation of parity. No longer can insurance companies exclude treatment of these disorders from the coverage offerings. Of course there are tremendous challenges our country’s health care system must overcome to improve care coordination and provide integrated care to people with co-occurring conditions, whether they be co-occurring mental illness and substance abuse, or co-occurring behavioral and medical conditions. The Affordable Care Act presents many opportunities for changing how care is both provided and financed to incentivize better systems of care. Community health Centers and mental health centers have the opportunity to lead the way.

Question: Apart from the Affordable Care Act, are there other types of new funding available to agencies serving this special population?

Answer: The President’s FY2011 budget expands substance abuse prevention and treatment services, treatment capacity at drug courts, and invests in re-entry programs, all part of funding for the Departments of Health and Human Services and Justice to reduce the Nation’s demand for drugs. The President’s FY2011 budget also provides critical support for young children and their families by building on historic increases provided in the Recovery Act, including Head Start, Early Head Start, and the Child Care and Development Fund. The Department of Veterans Affairs has significantly expanded its substance abuse and mental health staff to provide more community-based services to veterans experiencing or at risk of homelessness. They are also increasing contracts with community-based providers for homelessness prevention, emergency services, transitional housing, and other services that will reduce homelessness among veterans. And there are increases in HUD’s Homeless Assistance Grants to fund permanent supportive housing, transitional housing, rapid-rehousing, emergency shelter and dollars to prevent homelessness. The President’s request for HUD Homeless Assistance Grants FY2011 was $2.055 billion, $188 million and 11 percent increase from FY2010 enacted. There was an addition request for $85 million for two collaborative housing projects with HHS—4,000 vouchers for the chronically homeless and 6,000 vouchers for families with children. Interagency teams have been hard at work crafting the structure of the programs to pair housing with appropriate services. HUD is also working with the VA to expand Veterans Supportive Housing through the VASH program. VA, DOL, and HUD have just launched a new prevention demonstration program targeting new veterans who have recently returned from wars in Afghanistan and Iraq.

Question: What can people at the local level—communities, organizations, individuals—do to prevent and end homelessness, especially for people with co-occurring disorders?

Answer: First, we hope that you have downloaded the Plan and read it. You’ll see that Opening Doors stresses that communities must focus on results. We are asking communities to commit to achieving the four goals. We challenge communities to measure progress on these goals as well as two additional measurements in the Plan. As you consider the strategies described in Opening Doors, determine which can be implemented in your community. Look for opportunities to align your work with Opening Doors. We especially encourage you to get involved today in the decisions being made in your state to prepare for Medicaid expansion. Aggressively implement Housing First and Rapid Re-Housing practices—get your homeless services and housing providers to tear down admission barriers and throw out “housing readiness” approaches that don’t contribute to positives results. Take action to ensure that the diversity of needs is met. And keep us informed on what works and how Federal policy can be improved. Let us know when you come up against barriers, when you need Federal agencies to work better together, and if you have ideas on how to make funding and mainstream resources more efficient and effective. We are your ombudsman and advocate within the Federal Government.

Publication Date: 
2010