Substance Abuse and Mental Health Services Administration

SAMHSA programs were last reauthorized in 2000. Since then, the way services, including mental health and substance treatment, are delivered to homeless populations has changed. The Department of Housing and Urban Development has decreased the percentage of funds that go toward services other than housing and SAMHSA has funded demonstration projects directed toward ending homelessness including the Collaborative Initiative to End Long Term Homelessness. In addition, in the last seven years almost 200 communities across the country have developed Ten Year Plans to End Homelessness with a focus on placing people in permanent housing and redesigning the services to help them remain stably housed.

The Collaborative Initiative grants and other SAMHSA programs have demonstrated the role that state and local mental health departments and substance use treatment programs can play in ending homelessness. Collaborative Initiative grantees have ended homelessness for approximately 600 people who had been homeless for an average of nearly a decade. SAMHSA reauthorization is an excellent opportunity to take what we have learned from this and other grant programs and implement these best practices on a wider scale. To do this the Alliance has two main priorities for SAMHSA reauthorization.

The Systems of Care proposal is comprehensive and would coordinate the mental health system for all homeless populations, thus preventing and ending homelessness for many people. The Services to End Long Term Homelessness Act (SELHA) would allow SAMHSA to target resources to an extremely underserved population. With a better coordinated system.

Create a System of Care for Homeless Individuals, Families and Youth
Funding streams, particularly mental health funding, are often inadequate and difficult to coordinate. This proposal, drawn largely from the successful Children’s Mental Health System of Care approach within the Substance Abuse and Mental Health Services Administration, would give states, counties and cities funding to develop, within their existing mental health system, the infrastructure necessary to provide coordinated social services to mentally ill homeless individuals, families, and youth. This initiative would have the following features:

• To receive funds, jurisdictions must submit a comprehensive plan for community-based, system-wide services for individuals, families, children and youth with a mental illness or emotional disturbance who are homeless or at-risk of becoming homeless.
• Services and supports that would fall under the comprehensive plan include mental health, health care, peer support, substance abuse treatment, housing support, medical treatment, assistance to access benefits such as SSI or SSDI, Medicaid, Medicare, Food Stamps, Veterans benefits and rental subsidies.
• Grantees must coordinate with other services such as housing assistance, educational, vocational, social security benefits, Medicaid and other serviceoriented programs targeting homeless individuals and families.
• $100 million is the proposed authorization level.

Authorize the Services to End Long-Term Homelessness Act (SELHA) (S. 593)
Between 200,000 and 250,000 people experience long term or chronic homelessness. They are homeless for long periods of time or repeatedly. They have one or more disabilities, and they often cycle between homeless shelters, the streets, mental health facilities, emergency rooms, hospitals, and jails. The public cost for their care is extremely high, and their outcomes are very poor.

Permanent supportive housing successfully and cost-effectively ends homelessness for this group. A study of supportive housing found that each unit saved taxpayers approximately $16,000 in public costs for health care, mental health, criminal justice, shelters, and other emergency systems of care. More importantly, the people in supportive housing have better mental health, less substance abuse, fewer arrests, more employment, and less reliance on public assistance than when they were homeless.

SELHA would authorize funding for an array of services in permanent supportive housing, focused on helping people move toward recovery and self-sufficiency.