National Health Care for the Homeless Council Conference

Introduction

Thank you, John [Lozier].

I know many of you have worked with Richard Frank, our Assistant Secretary for Planning and Evaluation here at the Department, and we're glad to have him. When Richard told me more about the work of this Council, he said, and I quote, "To put it simply, they are doing God's work."

And it's hard to disagree.

I've always believed the Biblical proverb that our compassion and generosity for the least of us--the sick, the hungry, the stranger and the imprisoned--is felt by God himself.

This idea of service is at the heart of our American values as well. As President Johnson said: "There is [a] tradition that we share today. It calls upon us never to be indifferent toward despair. It commands us never to turn away from helplessness. It directs us never to ignore or to spurn those who suffer untended in a land that is bursting with abundance."

During my time at the Gates Foundation, I had the opportunity to get involved in this work.

While many people know the state of Washington for its innovation, fewer might know that across the state, 20,000 people are homeless on any given night. In partnership with Bill Gates Sr., we led the Foundation's Pacific NW Giving Initiative -- which to this day focuses on creating opportunities for families across the state, with homelessness as one of its focus areas. Together, we visited with homeless men, we met women and their children on the brink of losing their homes, and we learned firsthand the impact we can have working together across the public and private sectors.

The important work that you do every day serves hundreds of thousands of men, women and children all over this nation, including over 20,000 veterans.

You give people a second--and sometimes third and fourth--chance at life. You give people a path forward. You give them dignity.

The Affordable Care Act and Homelessness

You've also been important partners in our Affordable Care Act efforts. I want to thank all of you for your support, from advocating for reform to supporting implementation and enrollment efforts.

Thanks to your work, the Affordable Care Act has given us important resources to serve those experiencing homelessness.

It supported and extended the community health center program with $11 billion for expanded operational capacity, renovation of existing facilities, and construction of new centers. These resources are crucial for this community, and we're pleased that the SGR fix that just passed included another $7.2 billion over the next two years to further support this critical program.

The Affordable Care Act has also increased access to needed behavioral health services. Among those experiencing chronic homelessness, 75 percent or more are estimated to have serious mental illnesses, substance use disorders, or both. Before the law was passed, people struggling with these problems often couldn't get treatment. Now those treatments are essential benefits and are required for Medicaid and plans bought on the Marketplace. With this support, more people have been able to find and maintain stable housing and stay out of the justice system.

Medicaid Expansion

Another way we're working to strengthen communities is through the Medicaid expansion, which has a big impact on this population. Not only has expansion helped connect homeless patients to life-saving treatments and care, we learned from a report by this Council and the Kaiser Foundation that it's helping improve their lives in other ways as well. When individuals can manage their health, they have a better ability to work and maintain stable housing.

We know there are impacts for the community at large.

Medicaid expansion can lower health care costs and boost state economies, freeing up resources to help them better serve the people of their states. A Deloitte study on Kentucky's expansion, for example, found that hospitals saved $1.15 billion in uncompensated care charges. Overall, expanding Medicaid will have a positive cumulative impact of more than $30 billion on the Bluegrass State economy through Fiscal Year 2021.

That's why it remains one of our top priorities.

So far, 28 states and D.C. have decided to expand. We've worked closely with governors of both parties to get that far, and will continue to do so. We believe it can make a big difference for this community and we are committed to finding a solution that works for every state.

Permanent Supportive Housing

Of course access to care is only one piece of the puzzle. It's difficult for individuals or providers to consistently address basic health needs if that person doesn't know where they will sleep on any given night.

With permanent supportive housing, people struggling with housing insecurity have one less threat to their health and well-being. And the evidence shows that permanent supportive housing not only serves individuals in need but can also lower costs -- reducing avoidable hospitalizations and institutional care, for example.

At HHS, we're working to make sure our services incorporate this need. We're focused on how Medicaid can best support this population by helping manage chronic conditions and other challenges. That's because we know that when people get quality health care through Medicaid, permanent supportive housing has a better chance of success -- and the community benefits as a result.

The Substance Abuse and Mental Health Services Administration, or SAMHSA, supports behavioral health services that lead to more stability. Connecting people to the mental illness or substance use treatments they need is another key factor in making permanent supportive housing solutions work.

At the same time, we are working across the federal government, and in close coordination with the Department of Housing and Urban Development, to support the essential health components of a system that addresses the full array of needs.

We are always looking for ways to improve and better serve this community -- and we want to learn from you. We know that many of the Health Care for the Homeless grantees are innovators and are building holistic programs aimed at supporting housing stability and better health.

For example, Central City Concern in Portland, Oregon, runs a permanent supportive housing program, provides medical care, and offers employment services. And the Denver Stout Street Clinic and Colorado Coalition for the Homeless provide integrated primary and behavioral health care, dental services, substance treatment services, and permanent supportive housing. Thanks to the Medicaid expansion, these clinics were able to get more people the services they need. This kind of work doesn't just improve the health of our struggling neighbors; it helps them get back on their feet and ultimately strengthens our entire community.

U.S. Interagency Council on Homelessness

Homelessness is a complex issue, but one that we know how to solve. Together, with our colleagues across the federal government, and with the leadership of President Obama, we're committed to finding meaningful solutions.

By coordinating the different kinds of support that people and communities need--like integrating health care with housing--we'll be able to take a step closer to ending homelessness. We're specifically focused on veterans, families and children, and putting an end… finally… to chronic homelessness.

Our goal is ambitious, but so are we.

And we've already made some great headway, especially with regards to veterans. This past January, New Orleans became the first major American city to end veterans' homelessness entirely. Several other major cities, including Salt Lake City and Phoenix, have ended chronic homelessness among veterans. The overall number of veterans experiencing homelessness has declined by 33 percent--nearly 25,000 veterans--since 2010, and we are on a path to reach our goal by the end of this year.

I am grateful to Secretary Perez for all that he has accomplished in his role as Chair of the U.S. Interagency Council on Homeless, and I am pleased to say that in 2016, I will be taking over as the Chair.

This issue is important to me, and I am excited to build on the progress that we've made together.

My commitment to you all is to keep this conversation alive. You are the experts and we want to hear from you on how we can keep our progress going.

Conclusion

We truly live in a land of abundance. It is a blessing and a responsibility. A responsibility to care for those among us who are struggling, who have fallen through the cracks of our workforce and our social systems.

This isn't charity and it isn't kindness. It is the work we do to live up to our own values, to be the kinds of people we hope we are. It is our honor to serve.

Thank you.

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