Illustration by Andrew Colin Beck
Veterans have historically been overrepresented within the adult homeless population. While homelessness of any kind is tragic, veteran homelessness is particularly poignant because of the deep sacrifices these men and women made for their country. The US Department of Housing and Urban Development (HUD) estimates that in 2010, there were more than 76,000 veterans experiencing homelessness in the country, approximately a third of whom were considered chronically homeless.
In November 2009, President Barack Obama, along with Secretary Eric Shinseki of Veterans Affairs (VA) and Secretary Shaun Donovan of HUD committed to ending homelessness among veterans. In the years that followed, significant resources were directed toward this goal, and the numbers of veterans experiencing homelessness in much of the country decreased steadily. By the end of 2012, there was an 18 percent decrease nationwide. During that period, progress in large metropolitan areas lagged slightly behind other areas: In 25 of the largest US cities by population, which accounted for 40 percent of the total number of veterans experiencing homelessness in the country, the rate decreased by 16 percent.
In 2012, the VA and HUD, with support from the US Interagency Council on Homelessness (USICH), shifted their approach to veteran homelessness, particularly in large metropolitan areas, in two profound ways. First, they moved away from national programs with prescribed solutions and toward a bottom-up approach that invested in solutions emerging in each city and that used local experience to adapt and adjust the national programs. Second, they shifted away from efforts that were driven and coordinated by the VA staff at the national network of VA Medical Centers and toward a community-led effort in which VA staff working on homelessness became equal partners with other stakeholders in their communities.
Starting in mid-2012 and over the 30 months that followed, progress on veteran homelessness picked up dramatically, especially in the 25 cities. These demonstrated a 47 percent decline in veterans experiencing homelessness from 2012 to 2014, compared with a 27 percent reduction of veteran homelessness in the rest of the country. This experience not only has demonstrated tremendous impact on a difficult social problem but also provides a model for doing government differently. It suggests that federal agencies need to shift away from topdown methods of technical assistance, communication, and program structures, and toward strategies that foster local empowerment and emergent, bottom-up solutions.
Local Answers
The prime motif of this new approach was the “100-Day Challenge,” in which participants set unreasonably ambitious 100-day goals related to helping individuals experiencing homelessness move into permanent housing. The focus was on veterans and on individuals experiencing chronic homelessness, 30 percent of whom were veterans.
The new effort began with an e-mail from Becky Margiotta, director of the 100,000 Homes Campaign for Community Solutions—a national campaign to house 100,000 individuals experiencing chronic homelessness—to the Rapid Results Institute (RRI) headed by co-author Nadim Matta. Margiotta noticed a New York Times article about 100-Day Challenges that RRI was conducting in several African countries, to help communities tackle a variety of issues ranging from HIV/AIDS prevention to school attendance. She suspected that similar 100-Day Challenges could supplement the Campaign’s efforts to help US communities tackle homelessness.
In May 2012, a joint RRI and Campaign team organized the first 100-Day Challenge pilots in five cities, with support from philanthropic foundations. Each challenge was organized by a “launch” workshop with teams convened by the VA, HUD, and USICH. Each team of 10 to 20 participants comprised mid-level managers or front-line staff from agencies and organizations involved in providing services to veterans and other individuals experiencing homelessness. Typically, a representative from the mayor’s office was also involved.
These workshops provided a structured venue for teams to have honest conversations about the systems of care for the homeless individuals in their cities, the systems they wanted to build, the targets they wanted to set during the 100 days that followed, and the plans they would put in place to meet these targets. The day after each workshop, the 100-day countdown started for the participating cities, and the teams went to work.
“Once I saw how community teams got fired up by the 100-Day Challenges and the results that they were achieving, I knew this was a model we needed to amplify,” recalls Mark Johnston, then deputy assistant secretary at HUD. A series of 100-Day Challenges, organized in multi-city Boot Camps, and funded by HUD, followed. Some participating cities doubled and some even tripled their housing placement rates in 100 days.
In late 2013, there was a seamless transition of sponsorship of these 100-Day Challenges from HUD to the VA. The VA, in turn, decided to focus the 100-Day Challenge support on the 25 largest cities in the country.
Several rounds of 100-Day Challenges ensued in each of the cities. Along the way, many effective practices and strategies emerged. At the heart of these were structured ways to coordinate community efforts to tackle homelessness. These took different shapes in each community, but they often included creating and managing a single list of individuals (including veterans) experiencing homelessness, and adopting community-wide methods and tools for assessing, prioritizing, and matching individuals on this list with available housing resources and services in the community.
The 100-Day Challenges became a venue for spreading these practices across communities, primarily through peer sharing. The 100-day goals set by teams in each city also provided a natural impetus for mainstreaming the shift toward a “housing first” strategy, which prioritizes housing as a necessary intervention to begin to stabilize the ancillary conditions that are associated with homelessness, such as substance abuse and mental health issues.
The 100-Day Challenge’s work with the 25 cities involved modest facilitation and coaching support to community leaders and teams, but it did not come with extra program funding or traditional technical assistance. However, starting in 2010, the VA and HUD supplemented programs for homeless and atrisk veterans across the country with large increases in funding and staffing resources. The VA also introduced performance measures that enabled communities around the country to assess and track their own progress and compare it with national benchmarks.
Although 100-Day Challenges generated significant results in each community, the effort was on the whole incremental. There was no grand design, overarching theory of change, or master plan. From the vantage of national VA and HUD leaders, it was a grassroots way to tackle the hugely ambitious challenge of ending veteran homelessness.
Take, for example, the team in Washington, D.C. They participated in their first 100-Day Challenge on veteran homelessness in August 2013. The effort resulted in 207 veterans experiencing homelessness moving into stable housing in 100 days. Prior to this, the average placement rate of veterans was about 30 per month. This initial 100-Day Challenge led to the emergence of a group of leaders, Veterans Now, that combined service providers, city agencies, and representatives from the local VA. Veterans Now, which has continued to meet every two weeks to review progress, proceeded to organize three subsequent rounds of 100-Day Challenges in 2014 that resulted in housing another 504 veterans. A new performance norm was established—almost doubling the average monthly placement rate prior to the 100-Day Challenges.
A New Model of Government
The traditional power relationship between national program leaders and field staff was temporarily suspended during the 100-Day Challenges. “Leaders of the national VA and HUD programs would listen to our discussions at our 100-Day Challenge workshops,” recalls Chris Dollard, director of Healthcare for Homeless Veterans at the VA Boston Healthcare System. “Curiously, federal leaders offered ideas but did not impose specific solutions. Instead they asked questions—and specifically they asked us what we needed in order to get the job done.”
The Boston team struggled with losing case managers, because they were hired on a temporary contractual basis, Dollard says. This problem, in turn, undermined the trust of the veterans they were trying to serve. Previous attempts to raise this problem went nowhere. But this time, federal leaders were clearly listening.
“I was really surprised when I got a call a week later informing me that seven of our temporary case managers could be converted to long-term employment,” says Dollard. “This made a huge impact on our ability in Boston to achieve the goal of ending chronic homelessness for veterans.”
This alternative approach of empowering communities and their leaders does, however, require investment and commitment by federal agencies. This, in turn, must include investment in federal staff resources to work with philanthropic organizations and local leaders to utilize the intellectual and financial resources available to each community, and to help the community use federal funding as effectively as possible.
The 100-Day Challenges provided a safe space for honest dialogue among stakeholders at the local and national levels. This created trust and fostered a shift in mind-set toward more openness for experimentation, more flexibility, higher tolerance for mistakes, more humility about what one party could do on its own, and, paradoxically, a stronger belief and confidence that the problem could actually be solved. Other government efforts, throughout the world, can learn from this model.