NCH Recommendation Re: Healthcare

National Coalition for the Homeless Recommends
Homeless Access to Recovery through Treatment Act

Background: The Homeless Access to Recovery through Treatment (HART) Act (H.R. 4129) is designed to increase access to mental health services and substance abuse programs to persons who are experiencing homelessness.

The HART Act would improve the state planning and implementation of the already existing programs to include preferences to those who are without housing and insure patient discharge from these programs systems into stable and appropriate housing. The bill would not make substantial changes to the programs, themselves. It would simply strengthen and expand federally funded programs that are currently working well, such as PATH and GBHI/THP, to be more inclusive of the needs of those without housing (including youth).

Status: Representatives Hilda Solis (D-CA), Julia Carson (D-IN), Jim Ramstad (R-MN) introduced the Homeless Access to Recovery through Treatment Act (H.R. 4129) in late 2007. The bill’s sponsors and advocates are seeking co-sponsors to establish a base of support for inclusion of the HART Act provisions within the larger Substance Abuse and Mental Health Services Administration (SAMHSA) reauthorization measure currently under development.

NCH, Recommendations: Ensure homeless people with addictions and mental illness receive the necessary treatment and assistance to help them recover and end their homeless conditions.

Recommendations to U.S. Representatives: Cosponsor the Homeless Access to Recovery through Treatment Act (HART Act, H.R. 4129).

Recommendations to U.S. Senators: Introduce or cosponsor a companion bill to the Homeless Access to Recovery through Treatment Act (HART Act, H.R. 4129).
.
NCH lists reasons that persons who are experiencing homelessness should be guaranteed access to recovery through treatment:

• Addiction and mental illness – frequently co-occurring – often lead to and prolong homelessness and tend to be exacerbated by the experience.

• Among surveyed homeless people, 39 percent have some form of mental health problem, and SAMHSA estimates that between 20 percent and 25 percent meet criteria for serious mental illness. In addition, 38 percent of surveyed homeless people have an alcohol problem, and 26 percent report problems with other drugs.

• In 2004, more than 175,300 admissions (13 percent) to substance abuse treatment facilities were homeless at the time of admission.

• A person experiencing homelessness is more than twice as likely to have had five or more previous treatment episodes as their housed counterparts.

• Untreated addictions and mental illnesses present serious barriers to employment and permanent housing, perpetuating an ever-worsening cycle of poor physical health, hospitalization, social dysfunction, incarceration, poverty, and homelessness. These are tragic outcomes for homeless persons and their families; burdens on healthcare, social service, and corrections systems; and costs to taxpayers.

• Homelessness presents serious barriers to treatment for behavioral health conditions. People experiencing homelessness are impoverished, uninsured or underinsured, and often alone. Lack of documentation, lack of transportation, and difficulty adhering to treatment regimens prevent many homeless individuals from succeeding in mainstream behavioral health care, including in the public behavioral health care safety net systems established for persons without insurance. Due to monetary constraints and limited understanding of homelessness, many mainstream behavioral health service providers are unable to offer the full range of care necessary to address the complex needs of people experiencing homelessness. People experiencing homelessness present complex challenges for which most mainstream providers are ill equipped or untrained.

• A helpful, but ultimately inadequate, work-around to these mainstream system failures has been two federal behavioral health care programs targeted to persons experiencing homelessness – Projects for Assistance in Transition from Homelessness (PATH) and Grants for the Benefit of Homeless Individuals/Treatment for Homeless Persons (GBHI/THP).


For further information on the public policy recommendations of the National Coalition for the Homeless, contact the NCH public policy staff at:

info@nationalhomeless.org or 202.462.4822

OR: visit www.nationalhomeless.org.