Veteran Homelessness: VA and HUD Are Working to Improve Data on Supportive Housing Program
Published: 2012-06-26T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: According to a HUD and VA report, veterans are overrepresented among the homeless population. The HUD-VASH program combines rental assistance for homeless veterans in the form of section 8 Housing Choice vouchers provided by HUD with case management and clinical services provided by VA at VAMCs and community-based outpatient clinics. This collaborative initiative between the two agencies is intended to target the most vulnerable, most needy, and chronically homeless veterans. GAO was asked to examine (1) how VA and HUD determine veteran eligibility for HUD-VASH, (2) what data VA and HUD collect and report on HUD-VASH and their data reliability efforts, and (3) what is known about HUD-VASH performance.
To address these objectives, GAO reviewed HUD-VASH program requirements and reported program data through March 2012; and interviewed VA and HUD headquarters officials, staff at a non-representative sample of 10 VAMCs and 10 PHAs, and representatives of organizations that advocate for veterans or individuals experiencing homelessness.
GAO makes no recommendations in this report. HUD, VA, and the U.S. Interagency Council on Homelessness generally agreed with GAOs conclusions.
section_title: What GAO Found
paragraphs: The Department of Veterans Affairs (VA) and Department of Housing and Urban Development (HUD) rely on VA medical centers (VAMC) and public housing agencies (PHA) that serve veterans directly to determine participant eligibility for the HUD-VA Supportive Housing (HUD-VASH) program. VAMC staff GAO contacted said that they interview veterans interested in the HUD-VASH program to assess whether the veteran met the programs definition of homelessness, check VAs electronic patient record system to determine whether the veteran was eligible for VA health care, and obtain the veterans agreement to participate in case management. VAMCs refer eligible veterans to partnering PHAs (subject to rental assistance voucher availability) and are required to place them on an interest list when no vouchers are available. PHA staff GAO contacted said that they compare the veterans reported income to information provided by third-party sources, such as the Social Security Administration, to verify that the veterans household income did not exceed HUD-VASH program limits and check state sex offender registries to help ensure that no member of the veterans household was subject to a lifetime registration requirement.
VA and HUD collect various data on veteran participation and voucher utilization and are taking steps to address the reliability of data collected and reported on HUD-VASH. Since 2008, VA has used an electronic database referred to as the Dashboard to collect and report various data, such as the number of veterans issued a voucher and seeking housing and the number of veterans housed. VA described taking a number of steps intended to help ensure the reliability of Dashboard-based reports, including routine reviews of underlying reports. VA expects to fully implement reporting based on data collected with its new Homeless Operations Management and Evaluation System (HOMES) by July 2012. According to VA, HOMES incorporates additional data reliability controls, such as data fields that automatically limit responses to predefined ranges. HUD also collects data on HUD-VASH voucher utilization, although HUD officials acknowledged discrepancies between VA and HUD data. VA and HUD are working to finalize an information-sharing agreement intended to help the departments better identify the source of the discrepancies and validate reports based on HOMES data.
HUD-VASH data show that the program has moved previously homeless veterans into housing. As of March 2012, nearly 31,200 veterans lived in HUD-VASH supported housing (about 83 percent of the rental assistance vouchers authorized under the program). The program goal is to have veterans in housing represent 88 percent of authorized vouchers by September 2012; several states had met or exceeded the goal as of March 2012. VAMC and PHA staff GAO contacted also cited challenges in administering the HUD-VASH program, including a lack of resources to assist veterans with moving into housing. In April 2012, HUD released a best practices document that illustrated how some of the challenges identified had been addressed. For example, one PHA applied for county Community Development Block Grant funds to assist veterans with security and utility deposits.

section_title: Letter
paragraphs: According to a Department of Housing and Urban Development (HUD)  and Department of Veterans Affairs (VA) report, veterans are  overrepresented among the homeless population. In 2010, they  accounted for roughly 9.5 percent of the total adult population (over the  age of 18) but 13 percent of homeless adults in shelters or transitional  housing. The report also notes that veterans represented 16 percent of  homeless adults at a given point in time.veterans identified during the point-in-time count may reflect the greater  likelihood of chronic homelessness among veterans. Chronically  homeless veterans include those who cycle between streets and shelters,  have frequent episodes of homelessness, and struggle with physical or  mental health problems.
VA and HUD, in collaboration with other federal agencies, are committed  to preventing and ending veteran homelessness by 2015, and both  departments fund several programs to house homeless veterans. The  HUD-VA Supportive Housing (HUD-VASH) program, a collaborative  initiative between HUD and VA, is intended to target the most vulnerable,  most needy, and chronically homeless veterans. Its primary goal is to  move veterans and their families out of homelessness and promote  housing stability. HUD-VASH combines rental assistance for homeless  veterans in the form of section 8 Housing Choice vouchers provided by  HUD with case management and clinical services provided by VA at  Veterans Administration Medical Centers (VAMC) and community-based  outpatient clinics. HUD provides the vouchers through public housing  agencies (PHA) that partner with eligible medical centers or other  entities. As of March 28, 2012, more than 35,800 HUD-VASH vouchers  were in use. HUD-VASH is the nation’s largest permanent supportive  housing initiative for veterans.
You requested that we review the HUD-VASH program, including  compliance with statutory eligibility criteria, data integrity, and utilization of  performance measures to track long-term outcomes. In this report, we  examine (1) how VA and HUD determine that veterans who participate in  the HUD-VASH program meet the statutory eligibility criteria, (2) what  data VA and HUD collect and report on the HUD-VASH program and the  steps that VA and HUD take to help ensure the reliability of these data,  and (3) what is known about the performance of the HUD-VASH program.
In conducting this work, we reviewed VA and HUD documents that  describe the purpose of the HUD-VASH program and the agencies’ roles  and responsibilities related to HUD-VASH. We reviewed eligibility  requirements in the HUD-VASH statute and program manuals. We  selected a purposive, non-representative sample of 10 locations in which  to interview management and staff at VAMCs and their partnering PHAs.  We asked VAMC and PHA staff about their procedures for administering  HUD-VASH, including making eligibility determinations; cooperation at the  local level; data they collect and report on HUD-VASH; and their  perspectives on the program’s effectiveness. We selected the 10  locations based on several criteria, including a significant presence of  homeless veterans in and a large allocation of HUD-VASH vouchers to  the state for fiscal years 2008 through 2010, identified best practices or  challenges in administering the HUD-VASH program, and geographic  diversity. To obtain information on the presence of homeless veterans by  state, we reviewed the jointly developed veteran supplements to HUD’s  annual homeless reports for 2009 and 2010. We used information from  HUD on annual HUD-VASH voucher allocations by PHA and partnering  VAMC for fiscal years 2008 through 2010, as the program was expanded  with funding for new vouchers in 2008. We also reviewed federal strategic  plans that address veteran homelessness to obtain information on VA’s  and HUD’s goals for reducing veteran homelessness. To determine what  is known about the performance of the HUD-VASH program, we reviewed  VA and HUD reports on HUD-VASH voucher utilization and other VA  reports on the program. In addition, we interviewed representatives of,  and gathered documentation from, HUD and VA headquarters; the U.S.  Interagency Council on Homelessness (Interagency Council); and veteran  and homeless advocacy organizations, including the National Coalition for  Homeless Veterans, the National Coalition for the Homeless, the National  Alliance to End Homelessness, and Vietnam Veterans of America. See  appendix I for a more detailed discussion of our scope and methodology.
We conducted this performance audit from September 2011 through June  2012 in accordance with generally accepted government auditing  standards. Those standards require that we plan and perform the audit to  obtain sufficient, appropriate evidence to provide a reasonable basis for  our findings and conclusions based on our audit objectives. We believe  that the evidence obtained provides a reasonable basis for our findings  and conclusions based on our audit objectives.
subsections: section_title: Background
paragraphs: HUD and VA established HUD-VASH in 1992 to target veterans with  severe psychiatric or substance use disorders. From fiscal years 1992  through 1994, the program provided approximately 1,753 housing   After the initial voucher distributions, no  vouchers to homeless veterans.new vouchers were made available to homeless veterans until fiscal year  2008. From fiscal years 2008 through 2011, the program received funding  for about 37,000 new HUD-VASH vouchers. As of fiscal year 2008,  program participants are no longer required to have chronic mental  illnesses or chronic substance use disorders with required treatment.  However, a significant number of veterans with those issues are expected  to be helped within the program’s target population of veterans  experiencing chronic homelessness.
subsections: section_title: Program Funding
paragraphs: Obligations for new HUD-VASH vouchers and supportive services  increased from $78 million in fiscal year 2008 to $172 million in fiscal year  2011 (see fig. 1).
As of April 2012, more than 140 VA facilities were participating in HUD- VASH. In addition, according to HUD, more than 360 PHAs had  partnered with VA facilities to administer HUD-VASH nationwide since  fiscal year 2008. The allocation process for HUD-VASH vouchers is a  collaborative approach that relies on three sets of data to determine  geographic need: HUD point-in-time data on homeless veterans needing  services in the area, VAMC data on the number of contacts with  homeless veterans, and performance data from PHAs and VAMCs.  Based on this analysis of geographic need (adjusted by the number of  vouchers received in previous years’ allocations), HUD and VA identify  communities that should receive VASH vouchers. The agencies then  determine the exact number to allocate in proportion with each  community’s level of need. VA then identifies VAMCs from these  communities to participate in HUD-VASH, taking into account VA’s case  management resources. HUD considers a PHA’s administrative  performance and in consultation with VA identifies PHAs located in the  jurisdiction of the VAMCs and invites them to apply for HUD-VASH  vouchers. The selected VAMCs and PHAs in a given community must  partner to administer the program. Under certain terms, HUD allows  PHAs to make a portion of their HUD-VASH vouchers project-based (that  is, tied to a specific housing unit and not to a tenant). PHAs can request  that a portion of their allocation of HUD-VASH vouchers be project-based  as long as funding for those vouchers, when added to the funding for  vouchers from the PHA’s regular voucher program that have been  project-based, does not exceed 20 percent of the PHA’s overall voucher  budget authority and the partnering VAMC supports the project.
The Veterans Health Administration within VA issues a HUD-VASH  handbook, which establishes procedures and responsibilities for  administering HUD-VASH. VA also has released a HUD-VASH Resource  Guide that was developed in conjunction with other federal and  community partners. It includes additional HUD-VASH guidance and  provides technical assistance on clinical issues pertaining to individuals in  permanent supportive housing programs.
HUD’s policies and procedures for HUD-VASH, including PHA  responsibilities, are defined in a Federal Register notice, the most recent  of which dates to March 2012. Figure 2 illustrates the processes and  activities for which VA and HUD (through PHAs in compliance with HUD  regulations) are responsible when providing HUD-VASH assistance. For  example, VA screens veterans to help ensure the following.
That they are homeless based on the McKinney-Vento Homeless  Assistance Act definition; that is generally, a person who lacks  regular, adequate housing or will imminently lose housing and lacks  resources to obtain other permanent housing.
That they are eligible for VA health care.
That they are willing to participate in case management services that  are intended to promote housing stability and link the veteran to  needed clinical services. According to VA, many veterans  experiencing homelessness have physical, emotional, or other  problems that make the goal of living independently challenging.
VAMCs refer veterans who meet VA requirements to PHAs, which  determine eligibility based on HUD’s income requirements for section 8.  To be eligible for assistance, households generally must have very low  incomes—not exceeding 50 percent of the area median income, as  determined by HUD.offers several waivers to the regular section 8 voucher requirements.  Specifically, under HUD-VASH, PHAs cannot deny assistance to  potentially eligible households for past section 8 violations, such as  previous nonpayment, or for criminal history. However, no members of   Except for a sex offender provision, HUD-VASH  the veteran household can be subject to a lifetime registration  requirement under a state registration program for sex offenders. Once  the veteran meets HUD’s requirements for the program, the PHA can  issue the voucher for participation in HUD-VASH.
section_title: Data Collection, Analysis, Reporting, and Systems
paragraphs: According to VA, the agency has assumed primary responsibility for  collecting and reporting HUD-VASH data, which it does for internal  performance purposes, monthly congressional reporting, and compliance  with Office of Management and Budget (OMB) reporting. VA and HUD  officials told us that VA also provides HUD with program data, which HUD  uses for internal performance purposes and for OMB reporting.
More than one VA office shares responsibilities for HUD-VASH data  collection and analysis. VA’s National Center for Homelessness among  Veterans (national center), which falls under the National Homeless  Program Office, undertakes development and evaluation of care options  and research and methodology related to VA’s homeless programs.  Additionally, VA’s Northeast Program Evaluation Center supports and  oversees data collection for VA’s mental health programs. According to a  VA official, this center provides sites with day-to-day support on technical  aspects of data collection, and the national center provides specific  feedback on the data collection process and analysis, among other  activities.
VA currently uses two systems to collect HUD-VASH program  information. According to VA, in 2008, it implemented a HUD-VASH  database, referred to as the Dashboard, to collect monthly program status  updates from HUD-VASH sites. VAMC staff submit Dashboard reports to  their respective Veterans Integrated Service Networks (VISN), which in   VA officials told  turn submit facility-level reports to the national center.us that VA implemented a new data collection system, the Homeless  Operations Management and Evaluation System (HOMES), in April 2011,  and VA is in the process of fully implementing reporting mechanisms  required to generate reports based on HOMES data.information for several of VA’s homeless programs, including HUD-VASH.  It is designed to track and maintain data on individual veterans as they  move through VA’s system of care, including HUD-VASH participation.  For example, VA’s HOMES user manual states that a HUD-VASH  clinician who is familiar with the veteran should complete and submit a  HUD-VASH monthly status report form for veterans currently enrolled in  the program. The report is intended to capture various information on the  veteran for the past 30-day period, including the number of contacts the  veteran had for case management, the veteran’s housing arrangement,  amount and source of any income, visits to the emergency room or other  hospitalizations (including those for mental health conditions), use of  alcohol or illegal drugs, and satisfaction (including with their current  accommodations, safety of living, and leisure activities).
According to HUD officials, as part of its section 8 program, HUD collects  voucher utilization and household information using two information  systems, the Voucher Management System (VMS) and Public and Indian  Housing Information Center (PIC). PHAs are responsible for submitting  VMS and PIC data to HUD. HUD uses VMS as a centralized system to  monitor and manage PHAs’ use of vouchers. VMS data include PHAs’  monthly leasing and expenses for HUD-VASH vouchers, which HUD uses  to obligate and disburse PHA funding. PHAs enter voucher totals in VMS  rather than individual records of HUD-VASH voucher activity. HUD uses  PIC as a centralized system to track information on households assisted  and lease activity. PIC data fields include PHA identification, assistance  program type (such as HUD-VASH), and household demographic  information. PIC data fields also include information on income sources  and amounts, assets, rent, housing type, and whether the subsidy is  tenant-based or project-based.
section_title: HUD-VASH Eligibility Is Determined at the Local Level
paragraphs: According to VA and HUD, the departments rely on VAMCs and PHAs to  make determinations on veteran eligibility for the HUD-VASH program.  Based on our meetings with staff at 10 VAMCs and 10 PHAs nationwide,  VAMCs and PHAs generally followed the same procedures to determine  that veterans met statutory requirements.
subsections: section_title: Initial Screening Determines Whether Veterans Meet VA Requirements
paragraphs: VAMC staff that we contacted described how they screened veterans to  determine whether they met requirements for HUD-VASH.
Homeless status: To verify that a veteran met the McKinney-Vento  definition of “homeless,” VAMC staff told us that they interviewed the  veteran. This included, for example, discussing the veteran’s current  housing situation (homeless, precariously housed, doubled up, in own  housing but facing housing loss/eviction, or stably housed), and  history or pattern of housing stability/instability. Some VAMC staff also  told us that community organizations referring veterans into the HUD- VASH program may provide documentation supporting the veteran’s  homeless status.
VA health care: To verify that a veteran is eligible for VA health care,  VAMC staff in several locations told us that they determined if the  individual had an existing record in VA’s electronic patient record  system. VA determines VA health care eligibility based on whether the  individual meets the definition of veteran, has a minimum period of  active duty service, and is enrolled in the VA health care system. A  dishonorable discharge generally disqualifies an individual from  receiving VA benefits.
Case management: According to VAMC staff, a psychosocial  assessment, which evaluates the veteran’s clinical and service needs,  helps them to determine an appropriate level of case management for  each veteran. This involves considering whether the veteran has (1)  complex service needs or health conditions, such as serious mental  illness or substance use disorder; (2) nonchronic service needs that  could be overcome or managed with treatment; or (3) few or minor  service needs and is employable. Prior to enrollment in HUD-VASH,  each veteran must agree to participate in case management.  According to VA guidance, case managers must document the  veteran’s HUD-VASH enrollment using a HOMES form. For veterans  who do not enter the program, the form lists reasons the veteran did  not enter, including the veteran’s refusal to agree with the terms of the  program (case management). In Los Angeles, New York, Washington,  D.C., and Wyoming, VAMC staff explained that they required veterans  to sign a case management agreement. VA officials told us that this  was a local management practice rather than a requirement based on  the HUD-VASH handbook. Following enrollment, the case manager  and the veteran work together to develop an individualized treatment  plan with goals that are revisited over the course of the veteran’s  participation in HUD-VASH. VA views case management as a key  component of HUD-VASH and its case management services are  intended to help improve the veteran’s physical and mental health and  enhance the veteran’s housing stability. Additionally, VA’s case  management aims to support recoveries from physical and mental  illness and substance use disorders. According to VA, HUD-VASH  does not require veterans to be sober prior to program enrollment;  however, the veteran’s treatment plan is recovery-focused and  incorporates his or her recovery goals. In addition to monitoring the  veteran’s treatment plan, the role of the case manager involves  helping the veteran to access other medical and behavioral treatment  resources as needed.
VA regards failure to participate in case management as grounds for  termination or denial of program participation. However, several VAMC  staff told us that VA makes every effort to re-engage veterans in case  management before proceeding with termination for nonparticipation. If  VA determines that the veteran no longer requires case management  services, the veteran may continue to receive the HUD-VASH housing  subsidy. In such cases, the VA case manager should notify the PHA that  case management is no longer required but that the veteran’s eligibility  for a housing voucher remains unchanged. If the PHA has a voucher  available in its regular section 8 program, the PHA can offer that voucher  to the veteran and make the HUD-VASH voucher available to another  homeless veteran.
As previously noted, VA refers veterans who meet its requirements for  HUD-VASH to PHAs, subject to voucher availability. The HUD-VASH  handbook requires that if there are no available case management  openings or vouchers, HUD-VASH program staff place the veteran on an  interest list. According to VA, this list consists of all individuals who have  been in contact with HUD-VASH staff and expressed interest in the  program. These persons are subsequently screened for eligibility and a  determination is made regarding acceptance. If a veteran is not eligible  but vouchers are available, staff would make a referral to other VA or  community resources. If a veteran is eligible but no vouchers are  available, program staff must document the reason for denial in HOMES  as lack of voucher availability. As of March 28, 2012, VA data show that  an estimated 1,689 or 4 percent of the HUD-VASH vouchers authorized  nationwide were available for use. Of the 10 VAMCs we contacted, 6 had  vouchers available for use as of March 28, 2012, including the Bronx  (New York) VAMC with an estimated 63 vouchers available for use and  the Seattle VAMC with an estimated 32 vouchers available for use. The  other four VAMCs had fewer than five remaining vouchers as of the same  date. Regarding interest lists, staff at the Washington, D.C. VAMC told us  that there were about 1,000 veterans on their facility’s interest list. The  staff also told us that they had developed a screening tool to help make  acceptance decisions and prioritize remaining vouchers for veterans on  their interest list. According to VA, in addition to targeting chronically  homeless veterans, consideration for HUD-VASH enrollment also may be  given to women, families with children, disabled veterans, and those who  served in Operations Iraqi Freedom and New Dawn in Iraq and Operation  Enduring Freedom in Afghanistan.
VAMC staff we contacted generally told us that they routinely directed  veterans screened for HUD-VASH to other suitable VA programs,  including VA’s Grant and Per Diem and Domiciliary Care for Homeless  Veterans programs. For example, the staff explained that they might  refer veterans to other VA programs pending HUD-VASH acceptance if  another program was more immediately appropriate for the veteran or if  the veteran needed services not available under HUD-VASH (such as  dental care). Some VAMC staff also mentioned local resources as  another referral option.
section_title: PHAs Conduct Additional Screening on Income and Other Requirements
paragraphs: PHA staff that we contacted described how they screened veterans to  determine whether they met income and other requirements after  receiving a referral from the VAMC.
Income: PHA staff told us that they generally relied on third-party  sources, such as the Social Security or Veterans Benefits  administrations, to verify the reported income of HUD-VASH  applicants. HUD requires PHAs to include certain sources of  household income in determining income eligibility, including earned  and benefits-related income. The HUD-VASH voucher subsidizes  recipients’ rental payments and applicants must provide proof that  their income level qualifies for this assistance.
State sex offender registry status: PHA staff told us that they  checked the sex offender registry for all members of the veteran  household who were at least 18. In New York, the PHA staff informed  us that they checked for all household members over 16 in  compliance with the age limit for that state. If the veteran was subject  to lifetime registration under a state registration program for sex  offenders, the PHA would refuse the voucher application. If a family  member who intended to occupy the assisted unit was subject to  lifetime registration under such a program, the application would  proceed only if that individual was removed permanently from the  household.
To familiarize veterans approved for a HUD-VASH voucher with the  PHA’s requirements for HUD-VASH, staff at some PHAs we contacted  told us that they conducted briefings with veterans. In several locations,  PHAs held such briefings in a group format. Staff at PHAs with a smaller  number of HUD-VASH vouchers sometimes met one-on-one with  veterans.
Once the veteran is in housing, PHAs reverify income and complete a  housing unit inspection, typically on an annual basis. Some PHAs may  conduct recertification procedures less frequently. One of the PHAs in  our sample was in this category and conducted recipient renewals  annually or biannually on a case-by-case basis. The PHA can terminate  assistance when a veteran has been evicted from a unit or for serious  and repeated lease violations. However, prior to terminating any section 8  participant, PHAs must provide the opportunity for an informal hearing.  According to HUD officials, as part of HUD’s routine review of PHA  records (such as to determine the accuracy of family income and rent  calculations), HUD may review HUD-VASH tenant files if the files are  included in a larger sample, but such reviews are not specific to the HUD- VASH program.
section_title: Both VA and HUD Have Been Taking Steps to Address Data Reliability
subsections: section_title: VA Provides the Primary Data for HUD-VASH Reporting
paragraphs: Both VA and HUD report on HUD-VASH using information from VA’s  Dashboard database. VA uses the Dashboard to collect summary count  information from VAMCs and provides monthly Dashboard-based reports  to HUD and Congress. Those reports typically include several data  elements or measures on voucher utilization, including the number of  veterans issued a voucher and looking for housing and the number of  veterans housed (under lease). See table 1 for additional Dashboard data  elements.
In addition to the Dashboard, VA uses HOMES to collect data on  veterans. HOMES data reflect a series of electronic forms that case  managers must complete from the time a veteran is screened for the  program to the time a veteran leaves the program. Although HOMES data  could be used to create the information captured in the Dashboard  database, VA has not yet completed development and testing of report- generating mechanisms necessary to release reports based on HOMES  data, according to VA officials. VA officials also told us that they intended  to begin using HOMES data for congressional reporting purposes by July  2012 and eventually discontinue the Dashboard reporting mechanism.
section_title: VA Has Taken a Number of Steps to Help Ensure Data Reliability
paragraphs: VA has taken a number of steps to help ensure the reliability of HUD- VASH data reported though the Dashboard database. We compared VA’s  processes against standards for internal control, including, among other  things, having processes and procedures that provide reasonable  assurance of the reliability of reports for internal and external use by establishing and supporting a control environment with clearly defined monitoring performance measures and indicators.areas of responsibility and appropriate lines of reporting,  incorporating controls over information processing, and  HUD-VASH reporting responsibilities, as identified in VA’s guidance,  appeared to be consistent with HUD-VASH program responsibilities. For  instance, case managers collect and submit HUD-VASH evaluation data  on veterans. HUD-VASH program coordinators are responsible for  conducting appropriate audits of performance measures. VAMC facility  directors are responsible for verifying that staff provide timely reporting of  veteran activity. Finally, the VISN’s homeless coordinators are  responsible for helping ensure that data are submitted in a timely manner  and the VISN directors are responsible for helping ensure the accuracy of  these data.
According to VA officials, the national center reviews individual weekly  Dashboard reports from VISNs for reasonableness by comparing  submissions with prior week reports. Questions or concerns are  addressed to the respective VISN and the national center corrects weekly  reports accordingly.
As discussed previously, Dashboard reports include a number of program  performance measures, including a specific measure for the program’s  goal of moving veterans out of homelessness (the number of veterans  under lease). In addition to providing data for external reporting, VA  officials told us that the Dashboard database serves as a program  management tool. According to VA officials, the national center uses the  Dashboard reports to monitor program status at individual sites and also  compares program performance across sites.
VA also has taken a number of steps to help ensure the reliability of HUD- VASH data collected through HOMES. Consistent with standards for  internal control, HOMES reporting responsibilities are clearly defined in  VA guidance and, according to VA officials, HOMES data are collected for  individual veterans as opposed to the Dashboard’s facility-level counts  that did not identify individuals. HOMES includes a number of additional  controls. For example, electronic data checks incorporated into HOMES  improve data validity and reduce the risk of errors. Authorized program  service providers enter program and veteran information into HOMES but,  where appropriate, certain data fields automatically limit responses to  predefined data ranges to reduce data entry errors. According to VA  officials, the system is capable of flagging records for review based on  approximate matches of name or Social Security number. Furthermore,  only certain authorized users may edit records after data are submitted.
section_title: VA and HUD Have Been Taking Steps to Reduce Data Discrepancies
paragraphs: Although counts of voucher use generated from HUD’s and VA’s  information systems produce different totals, a proposed information- sharing agreement between HUD and VA is intended to facilitate data  sharing and identify and resolve discrepancies. HUD has compared VA  data with its VMS and PIC data for the purpose of validating HUD-VASH  data. Validating data (in this case, Dashboard data) with an independent  data source (such as HUD data) is an additional standard for internal  control. HUD collects some HUD-VASH data, including the number of  veterans receiving housing assistance (veterans under lease) through its  VMS and PIC systems, but generally does not use these data for HUD- VASH reporting purposes. According to HUD and VA officials, both  departments consistently use Dashboard data for reporting purposes.
HUD provided its analysis of VA, VMS, and PIC data comparisons of  vouchers under lease. For November 2011, HUD’s analysis listed three  totals for vouchers under lease: 27,159 vouchers according to VMS,  24,768 vouchers according to PIC, and 27,285 vouchers according to VA  data. The totals also differed when HUD compared voucher counts at  individual PHAs for the same month. HUD noted three totals for vouchers  under lease at the Harrisburg Housing Authority: 19 vouchers according  to VMS, 33 according to PIC, and 34 according to VA data. In another  example, HUD noted three totals for vouchers under lease at the Housing  Authority of Waco: 116 vouchers according to VMS, 13 according to PIC,  and 119 according to VA data.
According to HUD officials, data discrepancies between VA and HUD  data may have been due to one or more factors, assuming VA data  provided at that time were accurate.
First, PHAs may have incorrectly or inaccurately entered PIC or VMS  data that relate to HUD-VASH participation counts.
Second, PIC and VMS use different methodologies for assigning  HUD-VASH voucher counts when veterans move across PHA  jurisdictions, which could affect comparisons of participation data at  the facility level. Under the HUD-VASH program, a veteran may use a  HUD-VASH voucher in a jurisdiction outside of the PHA that initially  awarded the voucher. VMS voucher counts are associated with the  initial voucher allocation site, regardless of the participating veteran’s  current location. PIC counts veteran households assisted and  associates those counts with the veteran’s current location.
Third, in comparison with VA reporting, HUD has taken longer to  make data available for analysis. For example, up to 80 days may  elapse from the time a PHA must submit VMS data to the time that  VMS information is available for analysis. According to VA, the  agency typically has provided Dashboard data to Congress within 50  days after the end of each reporting month.
HUD’s VMS and VA’s Dashboard data are comparable when veteran  participation is categorized by location; however, these respective data  sources are not tied to personally identifying information. Therefore, the  agencies have a difficult time identifying the specific source of data  discrepancies.
A proposed information-sharing agreement between HUD and VA is  intended to facilitate record-level data sharing between the agencies and  allow them to precisely identify and resolve data discrepancies between  HUD’s PIC data and VA’s HOMES data. According to VA officials, once  VA fully implements new reporting mechanisms, HOMES data will enable  VA to provide summary status reports and identify information for veteran  records used to create the summary totals. Further, they said that the  agreement will allow VA to provide HUD with HUD-VASH data including  the participating VAMC and PHA, and personally identifying information  for each veteran. According to HUD officials, HUD intends to compare  these records with PIC data (which include personally identifying  information) and then the agencies plan to coordinate with field offices to  resolve discrepancies. As of June 2012, the information-sharing  agreement was under review. The agencies expected to complete final  revisions to the agreement by June 25, 2012 and execute the agreement  by August 2012. If VA fully implements HOMES as a data source for  reporting purposes and the agencies execute the agreement as planned,  it would allow the agencies to match case records in the event of data  discrepancies. Although the agreement is not expected to affect VA’s  monthly report submissions to Congress, according to the agencies, the  information-sharing agreement should further improve their ability to  validate HUD-VASH data on an ongoing basis.
section_title: HUD-VASH Data Show the Program Has Moved Veterans into Housing
subsections: section_title: HUD-VASH Performance
paragraphs: Information VA reports for the HUD-VASH program has focused on  voucher utilization (such as the number of veterans housed), but HOMES  is supposed to provide VA with additional data on veteran outcomes. VA  currently reports a number of measures (or various data) related to  voucher utilization in monthly reports to Congress (see table 2).
These measures show that HUD-VASH has moved veterans out of  homelessness. Nearly 31,200 veterans lived in HUD-VASH-supported  housing as of March 28, 2012; veterans in housing represented about 83  percent of the vouchers authorized under the program. In addition, PHAs  issued 4,046 vouchers to veterans who were actively seeking a lease and  VAMCs reserved 620 vouchers for veterans undergoing PHA validation  as of the same date. According to VA, the department’s goal is for  veterans in housing to represent at least 88 percent of authorized HUD- VASH vouchers by September 30, 2012. As figure 3 shows, several  states had achieved or nearly achieved this goal as of March 2012,  including the four states with the largest number of vouchers authorized— California, Florida, New York, and Texas.
For the 10 VAMCs we contacted, the percentage of veterans in housing  varied, ranging from 70 percent to 95 percent as of March 28, 2012. For  VAMCs further from the goal, such as the Sheridan VAMC in Wyoming  (70 percent in housing), challenges with getting veterans placed in  housing may be related to local housing markets. For example, Sheridan  VAMC staff told us that there was a lack of affordable housing in the area.  Similarly, staff at Greater Los Angeles Health Care System (79 percent in  housing) told us that suitable housing stock (meeting program  requirements for cost and housing quality) was limited, particularly in the  West Los Angeles area where the VAMC facility is located. VA data show  that both VAMCs had assigned 100 percent of their authorized vouchers  to a veteran as of March 2012. However, nearly 30 percent of the  Sheridan VAMC’s vouchers and 21 percent of the Greater Los Angeles  Health Care System’s vouchers were assigned to veterans actively  seeking housing at that time. We discuss challenges with getting veterans  placed in housing in greater detail later in this report.
In October 2011, VA submitted a report to Congress that provides  additional descriptive and performance-related information on HUD-VASH  for June 2008 through September 2010. Summary information from the  report includes average number of days at each stage of the admission and housing  characteristics of veterans admitted to the program;  process;  veterans’ typical 90-day housing situation within 3, 6, and 12 months  of beginning case management; and  reasons for ending case management.
For example, according to VA, for veterans who completed the housing  process, the time frame from initial referral to HUD-VASH to the move  into permanent housing averaged 130 days.
VA has plans to report additional information, such as measures of the  time it took to complete various processes within the program (see table  3). In December 2011, VA issued guidance to its service networks  outlining several outcome measures and related targets for which the  department planned to start collecting data in fiscal year 2012.
VA also recently began conducting research (although not always  nationwide) related to (1) the Housing First approach to supportive  housing; (2) positive and negative outcomes for veterans who leave the  HUD-VASH program; and (3) various case management approaches for  treating veterans for substance abuse.intend to use the results of these studies to assess operations and update  policies and procedures accordingly, and to offer guidance on innovative  practices to VAMCs. In June 2012, VA officials provided us with updates  on these studies:   VA officials told us that they
Based on piloting the Housing First approach in Washington, D.C.’s  HUD-VASH program in fiscal year 2009, VA determined that Housing  First yielded several positive outcomes. The study compared results  for 105 HUD-VASH vouchers set aside for Housing First and 70  vouchers that followed VA’s usual treatment process. VA found that,  under Housing First, veteran placement into housing took, on  average, 35 days from admission, compared with 223 days under the  usual treatment process. Additionally, under Housing First, a reduced  proportion of veterans had used emergency room and inpatient  mental health services, and the housing retention rate was 98 percent  after 1 year, compared with 86 percent under the usual treatment  process. The pilot was expanded to 13 additional sites in fiscal year  2012, with VA and HUD monitoring for 3 years. Each site had 50  vouchers set aside for Housing First.
Based on program data available at the end of June 2011, VA  analyzed veterans who were already housed and left HUD-VASH for  reasons categorized as positive (such as accomplishing goals or no  longer needing program supports), negative (such as failing to comply  with program requirements or being evicted), and neutral (such as  death, illness, or transferring to another program site). According to  VA, within the sample, 37 percent of exits were positive, 23 percent  were negative, 30 percent were neutral, and there were insufficient  data for 10 percent of exits. VA officials told us that VA and HUD will  work together to conduct a more in-depth study of veterans leaving  the program for adverse reasons to identify the major factors involved.  The officials informed us that as of March 2012, the departments were  in the process of obtaining OMB approval to follow up with veterans  who had left HUD-VASH.
VA has launched a 3-site research study comparing the effectiveness  of four different intervention methods for veterans with substance use  disorders and mental health problems. Methods tested will include  standard case management, intensive case management, tele- coaching, and electronic interactive practices. As of June 2012, VA  officials told us that they had begun interviewing veterans to  participate in the study. VA did not expect results to be available until  2013.
HUD-VASH case managers have started to complete a monthly status  form in HOMES that includes data on outcomes. For example, case  managers must record (1) changes in the veteran’s community  adjustment and social contacts; (2) hospitalizations for unscheduled  medical conditions or mental health conditions; (3) employment status  and other sources of income or benefits; and (4) use of alcohol or illegal  drugs, using a clinical rating scale. In addition to the monthly status form,  case managers are required to complete in HOMES a HUD-VASH exit  form for each veteran who is discharged from the program. The exit form  includes some of the indicators in the monthly report, the veteran’s status  upon discharge, and the reason for exit.
Housing stability for veterans participating in HUD-VASH is a component  of the program’s primary goal, along with moving those veterans out of  homelessness and into housing. VA’s case management efforts play an  integral role in helping veterans to achieve housing stability. VA’s current  monthly reports, which show the number of veterans housed under the  program, do not address housing stability. However, VA’s October 2011  report to Congress gave some indication of general voucher turnover and  housing tenure. More specifically, the report showed the number and  percentage of veterans leaving the program for positive and negative  reasons at various stages of the housing process. It also showed  veterans’ typical housing situation over the previous 90 days after 3, 6,  and 12 months of participation. Beginning in April 2011, VA told us that  case managers began using HOMES to record information on HUD- VASH participants. This would include entering information on each  veteran’s housing situation upon enrollment, every 30 days following  enrollment, and upon exit from the program. While not enough time has  passed to assess the reporting related to HOMES data, VA expects it to  provide a range of useful data for site monitoring and program  management. Along with other data expected to be collected in HOMES,  detailed information on veterans’ housing situation every 30 days should  provide VA with an opportunity to assess program performance in helping  veterans to achieve housing stability.
section_title: HUD Has Disseminated Strategies to Address Some Program Challenges
paragraphs: Based on our interviews at 10 VAMCs and partnering PHAs, staff  frequently cited four challenges relating to program administration or  processes that they perceived as negatively affecting the goal of housing  homeless veterans and helping them maintain housing stability.
Delayed VAMC referrals to the PHA. As previously noted, for fiscal year  2012, VA’s goal is for VAMCs to refer veterans accepted into HUD-VASH  to the PHA within 15 days of acceptance into the program. However, PHA  staff discussed challenges associated with receiving timely HUD-VASH  referrals from the partnering VAMC, particularly at the beginning of a new  allocation year. In 9 of the 10 locations, PHA staff told us that delayed  referrals from VA slowed the voucher utilization process. While PHAs  generally can begin accepting referrals once HUD awards the vouchers,  delayed referrals from VA extended the time frame between a PHA  receiving the vouchers and getting the voucher holder into housing. Staff  at King County Housing Authority in Seattle suggested that VA’s initial  delay in making HUD-VASH referrals was related to VA needing to hire  and assign case managers, while HUD could move quickly to pass  funding on to the PHAs to issue vouchers. Staff at two VAMCs  acknowledged the challenge in making initial referrals to the PHA. In one  location, the staff explained that to provide an adequate number of case  managers, they would need to know how many new vouchers had been  added and, therefore, how many new HUD-VASH veterans they would  need to serve. Moreover, once new case managers were hired, they had  to undergo training and orientation, resulting in additional delays. Staff in  several PHA locations noted that VAMC referral time frames had been  improving.
HUD-VASH case manager workload. VA’s goal is to have a ratio of 1  case manager to 25 veterans. However, when we contacted VAMCs in  January and February 2012, several VAMC staff told us that some case  managers had 40 or more cases, as the following examples illustrate:  In South Dakota, staff at the Meade County Housing and  Redevelopment Commission expressed general concern that the  workload for the case manager serving their area may have been  unreasonable or otherwise impractical. According to staff at Black  Hills Health Care System, which partners with the housing authority,  the case manager assigned to Meade County and other locations  managed 51 cases in total.
Similarly, case managers at James A. Haley VAMC in Tampa had  between 45 and 50 cases. Staff at the Tampa Housing Authority told  us that more intensive case management could reduce or eliminate  veteran terminations from HUD-VASH due to nonpayment or other  violations of the housing agreement.
Staff at Greater Los Angeles Health Care System told us that efforts  were under way to reduce their average caseload of 45 per case  manager. The facility was accepting applications for additional case  managers and also planning to contract with an external entity to  supplement case management services.
VA has made efforts to address staffing at its VAMCs, and when we later  contacted two of the VAMCs identified with challenges, the staff told us  that hiring additional case managers had reduced their caseloads  significantly. Additionally, VA provided us with a report on HUD-VASH  program hiring as of February 29, 2012. The report showed that 95  percent of program positions across all VISNs were filled. Among the  VAMCs we contacted, the percentage of HUD-VASH positions filled  ranged from 50 percent to 100 percent. Case managers represent the  majority of HUD-VASH positions, but some facilities have also hired  clinical supervisors, substance use disorder specialists, peer support and  housing specialists, and other program support staff.
Identifying housing for veterans. Staff at VAMCs in several locations  told us that veterans experienced challenges with finding housing. In  Wyoming, the VAMC staff explained that the market for affordable  housing was tight in Casper and Sheridan, areas served by the VAMC.  Additionally, they said that the partnering PHA that served Sheridan  recently reduced the maximum allowable housing assistance payment  from $595 to $571 and this amount limited access to decent housing in  the area. The staff added that many landlords also have been reluctant to  rent to veterans with criminal histories. VAMC staff in South Dakota  similarly noted that a partnering PHA had decreased the housing  allowance for the area it served while some landlords had increased their  rents. They explained that they used communications with a local  homeless coalition, community stakeholders, and landlords to identify  options for affordable housing. At Greater Los Angeles Health Care  System, the staff told us that a housing specialist had been hired and kept  staff informed of new housing stock while working with developers and  realtors to identify suitable housing. According to the VAMC staff, the  housing specialist also has conducted outreach to educate landlords on  HUD-VASH and advocate for veterans, making them aware that case  management will be available to HUD-VASH tenants.
Move-in resources for veterans. Both PHA and VAMC staff discussed  challenges veterans experience accessing the funds and household items  that they needed to move in once they found a suitable housing unit. In  some instances, veterans were delayed in moving into their units because  of a lack of available funds to pay rental application fees, security  deposits for rent or utilities, and the first month’s rent. Such delays could  affect VA’s goal for placing veterans into housing within 100 days of being  accepted into the program.
The availability of resources to help veterans varied among locations, but  generally was more limited outside of larger cities. Two of the 10 locations  had a consistent source that could provide this type of assistance to  veterans. For example, New York City has a Department of Homeless  Services that provides a range of services to homeless individuals.  Through this entity, HUD-VASH veterans could receive assistance with  security deposits, first month’s rent, and household items. In Seattle,  HUD-VASH veterans could access a limited-term Human Services and  Veterans Levy that assisted veterans, military personnel and their  families, and others in need through a variety of housing and supportive  services. In other locations, VAMC and PHA staff told us that veterans  had relied on local public or nonprofit assistance and on Homeless  Prevention and Rapid Re-Housing Program funds that were temporarily  provided under the Recovery Act. Additionally, several said that they  hoped veterans would be able to use funds that would be provided under  the new Supportive Services for Veteran Families grant program.Homeless Prevention and Rapid Re-Housing Program funds are no  longer available and the other sources mentioned, according to the staff,  often were insufficient or were not guaranteed.
In some locations, the VAMC staff had developed other approaches to  mitigating this challenge for veterans. For example, at several facilities,  including Greater Los Angeles Health Care System, Black Hills Health  Care System in South Dakota, and Washington, D.C. VAMC, the staff  explained that they solicited landlords’ cooperation in waiving or  spreading out up-front fees. Additionally, staff at White River Junction  VAMC in Vermont had developed a handbook for veterans participating in  VA’s homeless programs that included a community resources guide.  They explained that the guide was included to assist veterans with  obtaining furniture, household items, and other resources they needed to  move into housing.
In April 2012, HUD released a best practices document that included  practices submitted by PHAs and VAMCs that administer HUD-VASH.  According to HUD, the purpose of the document is to share effective  strategies for administering HUD-VASH and highlight the efforts of  specific sites and other partners. According to HUD officials, VA was  involved in soliciting best practices from VAMCs and reviewed the  document that HUD developed. HUD intends to revise the document over  time. While the document was developed from the housing standpoint, it  includes information on strategies for carrying out procedures pertaining  to general PHA and VAMC management. More specifically, it describes  the ways in which individual sites have addressed specific challenges  such as those identified previously. For example, in addition to the Los  Angeles VAMC hiring a housing specialist, the document described other  facilities’ efforts to direct veterans to suitable housing by contracting with  a nonprofit housing referral organization, maintaining a list of potential  housing options in the VAMC’s service area, and conducting targeted  landlord outreach. Similarly, several PHAs had established a loan fund or  trust fund to assist veterans with move-in costs, and one PHA applied for  county Community Development Block Grant funds to assist veterans  with security and utility deposits.
section_title: Advocacy Organizations Generally Shared Positive Views of HUD-VASH and Also Suggested Program Improvements
paragraphs: Advocates for veterans and the homeless that we contacted generally  agreed that HUD-VASH was essential in helping homeless veterans to  access housing and long-term treatment. Representatives at one of the  organizations stated that the long-term housing HUD-VASH provides was  crucial to addressing the immediate and long-term needs of homeless  individuals and that combining case management with housing was  appropriate for veterans with the most significant problems. Additionally,  representatives at two organizations told us that HUD and VA sharing a  common strategic goal had been beneficial and that program  administrators had been responsive to the HUD-VASH community.  Moreover, they noted that the program’s administration had improved  over time. Specifically, they explained that VA had been willing to make  changes to improve HUD-VASH, including in terms of leadership.
The advocates offered suggestions for improving the HUD-VASH  program, including the following.
One advocate suggested that the program should continue to target  those with the greatest need for assistance and explore flexibility for  service delivery mechanisms, including having case managers  conduct more work in communities and outside of the traditional  VAMC appointment approach. Related to this point, recently the  Veterans Health Administration Homeless Program National Director  noted that VA was taking steps to have more of a presence in the  community. This included hiring HUD-VASH case managers living in  communities where veterans were being served and seeking more  opportunities to have case managers co-located with community- based organizations.
A second advocate thought it would be useful to remove the section 8  limits on project-based housing under HUD-VASH to allow developers  to allocate portions of higher-quality, mixed-use developments for  project-based HUD-VASH vouchers. The representative explained  that this would be particularly helpful in locales with limited affordable  housing and in areas that are desirable (particularly for female  veterans with dependent children). HUD officials clarified that PHAs  can make the case to HUD to have funding for project-based HUD- VASH vouchers exceed the voucher budget authority limit of 20  percent. According to HUD officials, exceeding the limit must be tied  to effective administration of HUD-VASH, and HUD had not received  any such requests as of May 2012.
A third advocate expressed that VA should increase its outreach to  veteran service organizations to advertise to veterans who may not be  participating in VA programs. VA officials told us that VA has a  national outreach initiative under way that includes collaborating with  veteran service organizations to make information on HUD-VASH and  other VA programs more readily available.
Finally, a fourth advocate emphasized that sufficient resources  needed to be committed to HUD-VASH in support of the goal of  ending veteran homelessness. The representative explained that a  certain volume of vouchers needed to be in the system for it to be  successful and that inconsistent resources led to uncertainty among  service providers and veterans who need to access the program.
section_title: Agency Comments
paragraphs: We provided a draft of this report to the Secretary of Housing and Urban  Development, the Secretary of Veterans Affairs, and the Executive  Director of the U.S. Interagency Council on Homelessness. We received  comments from HUD, VA, and the Interagency Council that are  reproduced in appendixes II, III, and IV, respectively. HUD and VA also  provided technical comments, which we incorporated in the report as  appropriate. In their responses, HUD, VA, and the Interagency Council  generally agreed with our conclusions. HUD and VA noted that they were  committed to their partnership and the continued improvement of the  HUD-VASH program. The Interagency Council stated in its response that  VA and HUD work closely on local implementation through VA medical  centers and public housing agencies, and have improved lease-up rates,  enhanced data collection, and reduced the amount of time it takes to  house veterans in the HUD-VASH program.
We are sending copies of this report to appropriate congressional  committees; the Secretary of Housing and Urban Development; Secretary  of Veterans Affairs; and the Executive Director of the U.S. Interagency  Council on Homelessness. This report will also be available at no charge  on GAO’s Web site at http://www.gao.gov.
If you or your staff have any questions about this report, please contact  me at (202) 512-8678 or cackleya@gao.gov. Contact points for our  Offices of Congressional Affairs and Public Affairs may be found on the  last page of this report. GAO staff who made major contributions to this  report are listed in Appendix V.
section_title: Appendix I: Objectives, Scope, and Methodology
paragraphs: Our objectives were to examine (1) how the Department of Veterans  Affairs (VA) and the Department of Housing and Urban Development  (HUD) determine that veterans who participate in the HUD-VA Supportive  Housing (HUD-VASH) program meet the statutory eligibility criteria, (2)  what data VA and HUD collect and report on the HUD-VASH program  and the steps that VA and HUD take to help ensure the reliability of these  data, and (3) what is known about the performance of the HUD-VASH  program.
To address all three objectives, we reviewed VA and HUD documents to  determine the purpose of the HUD-VASH program and the agencies’  roles and responsibilities related to HUD-VASH. In addition, we reviewed  federal strategic plans that address veteran homelessness to obtain  information on VA’s and HUD’s goals related to reducing veteran  homelessness. We interviewed officials at the Veterans Health  Administration within VA and in HUD’s Office of Public and Indian  Housing and Office of Community Planning and Development. We  reviewed VA and HUD Office of Inspector General reports pertaining to  HUD-VASH and our previous reports. We selected a purposive, non- representative sample of 10 locations in which to interview management  and staff at VA medical centers (VAMC) and their partnering public  housing agencies (PHA) (see fig. 4). Results of these interviews cannot  be projected to other VAMCs or PHAs. We selected the 10 locations (9  states and the District of Columbia) based on several criteria, including a  significant presence of homeless veterans in and a large allocation of  HUD-VASH vouchers to the state, identified best practices or challenges  in administering the HUD-VASH program, and geographic diversity. To  obtain information on the presence of homeless veterans by state, we  reviewed the jointly developed veteran supplements to HUD’s 2009 and  2010 Annual Homeless Assessment Reports to Congress. We used  information from HUD on annual HUD-VASH voucher allocations by PHA  and partnering VAMC for fiscal years 2008 through 2010.
To address our first objective, we reviewed eligibility requirements in the  HUD-VASH statute to assess how VA and HUD are to determine that  veterans who participate in HUD-VASH meet the statutory eligibility  criteria. We also reviewed requirements specific to VA in the Veterans  Health Administration’s HUD-VASH handbook and a HUD-VASH  resource guide developed by the National Center for Homelessness  among Veterans. To obtain specific information on how VA screened  veterans to determine if they were eligible for the program, we  interviewed VAMC management and staff in the selected 10 locations.  The centers are responsible for screening and evaluating veterans for  acceptance into HUD-VASH, referring veterans to partnering PHAs, and  coordinating veterans’ case management under HUD-VASH. Similarly, to  obtain more specific information on how PHAs (following HUD’s  procedures) screened veterans referred by partnering VAMCs, we  interviewed management and staff at PHAs that partner with the 10  VAMCs to assess veterans and also manage various aspects of the  housing process. In our interviews with VAMC and PHA staff, we asked  about their general procedures for administering HUD-VASH, including  how they made eligibility determinations based on VA’s requirements and  HUD’s guidelines, respectively. We also discussed cooperation at the  local level between partnering VAMCs and PHAs.
To address our second objective, we reviewed program manuals and  guidance on data that VA and HUD collect on HUD-VASH, their data  collection mechanisms, and reliability controls. We interviewed VA and  HUD officials to determine what HUD-VASH information the agencies  report and the systems they use for collecting and reporting the related  data. We obtained and reviewed selected monthly Dashboard-based  reports that VA provided to Congress during fiscal years 2011 and 2012  to identify the data elements typically reported for HUD-VASH; we  reviewed VA program data through March 2012. While VA provides  monthly voucher utilization reports to Congress, HUD reports to Congress  on HUD-VASH only upon request. To identify the steps that VA takes to  help ensure the reliability of its data, we interviewed knowledgeable VA  officials about the purpose, structure, and quality controls used to capture  or report HUD-VASH program data using VA’s Dashboard and HOMES.  We reviewed VA documentation, including the HOMES user manual,  HUD-VASH data entry forms, and data validity checks. In interviews with  VAMC staff at the 10 selected locations, we asked about data collection  and reporting, and any related challenges. In addition, we observed a  demonstration of VA’s reporting mechanism for HUD-VASH on-site.  Finally, we compared VA’s data collection and reporting procedures to  standards for internal control in the federal government. To identify the  steps that HUD takes to help ensure the reliability of its data, we  interviewed knowledgeable HUD officials about the purpose, structure,  and relevant quality controls for HUD-VASH data, including information  captured in HUD’s Voucher Management System (VMS) and Public and  Indian Housing Information Center (PIC). We also interviewed PHA staff  at the 10 selected locations about data collection and reporting, and any  related challenges. We reviewed relevant documentation, including the  information systems’ user guidance and HUD’s documented analysis of  comparisons between VMS, PIC, and VA data.
To address our third objective, we reviewed performance-related  information reported by VA such as monthly Dashboard-based reports on  HUD-VASH voucher utilization and a more descriptive report submitted to  Congress in October 2011. In addition, we interviewed representatives of,  and gathered documentation from, HUD and VA headquarters; the U.S.  Interagency Council on Homelessness (Interagency Council); and veteran  and homeless advocacy organizations, including the National Coalition for  Homeless Veterans, the National Coalition for the Homeless, the National  Alliance to End Homelessness, and Vietnam Veterans of America. In  interviews with VA and HUD officials, we asked about performance  measures the agencies were monitoring for HUD-VASH. In interviews  with representatives of advocacy organizations, we discussed their  perspectives on HUD-VASH administration and the program’s  performance. We also asked VAMC and PHA staff for their perspectives  on HUD-VASH performance, potential ways to measure program  success, and opportunities for improvement.
We conducted this performance audit from September 2011 through June  2012 in accordance with generally accepted government auditing  standards. Those standards require that we plan and perform the audit to  obtain sufficient, appropriate evidence to provide a reasonable basis for  our findings and conclusions based on our audit objectives. We believe  that the evidence obtained provides a reasonable basis for our findings  and conclusions based on our audit objectives.
section_title: Appendix II: Comments from the Department of Housing and Urban Development
section_title: Appendix III: Comments from the Department of Veterans Affairs
section_title: Appendix IV: Comments from the U.S. Interagency Council on Homelessness
section_title: Appendix V: GAO Contact and Staff Acknowledgments
subsections: section_title: GAO Contact
section_title: Staff Acknowledgments
paragraphs: In addition to the contact named above, Marshall Hamlett (Assistant  Director), Bernice Benta, F. Chase Cook, Pamela Davidson, Cynthia  Grant, John McGrail, Marc Molino, and Barbara Roesmann made key  contributions to this report.