HealthCare and Housing (H2) Systems Integration Initiative Wisconsin
Introduction
HealthCare and Housing integration is a critical strategy for addressing homelessness, particularly for vulnerable populations with complex medical and social needs. In Wisconsin, the HealthCare and Housing (H2) Systems Integration Initiative provides a roadmap for providers to navigate the fragmented landscape of federal and state resources.
By understanding the interplay between medical support and stable shelter, professionals can better serve clients experiencing homelessness. This article analyzes the key components of the HealthCare and Housing framework in Wisconsin, detailing funding streams, voucher programs, and local initiatives that drive successful outcomes.Understanding the HealthCare and Housing Landscape in Wisconsin
The core premise of the HealthCare and Housing initiative is that financial support for low-income individuals generally falls into two categories: "hard" costs and "soft" costs. Hard costs include construction and rehabilitation of physical structures, while soft costs cover flexible needs such as rental vouchers, operating expenses, and supportive services.
The HealthCare and Housing document emphasizes that resources are often targeted at specific populations, including people with disabilities, those living with HIV/AIDS, veterans, and individuals experiencing chronic homelessness.
For HealthCare and Housing providers, understanding these distinctions is vital. The document serves as a primary reference for health care providers, offering a general overview of federal resources available for affordable housing and supportive service providers.
It also aims to provide context for discussions on gaps in needed housing and services that support housing stability. By aligning HealthCare and Housing strategies, stakeholders can identify where systems overlap and where critical gaps remain.
Federal HUD Resources for HealthCare and Housing Stability
The U.S. Department of Housing and Urban Development (HUD) offers a variety of resources that are foundational to the HealthCare and Housing ecosystem in Wisconsin. These programs are designed to provide access to affordable housing or facilitate its development.
Housing Choice Vouchers and Special Purpose Vouchers
The Housing Choice Voucher (HCV) program, commonly known as Section 8, is a cornerstone of HealthCare and Housing assistance. It provides tenant-based rental assistance, allowing low-income households to rent private apartments that meet program guidelines.
Additionally, project-based rental assistance ensures subsidies stay with specific buildings. In Wisconsin, 123 Public Housing Authorities (PHAs) administer these programs. Of these, 27 administer only HCVs, 58 administer only public housing, and 38 administer both.
Within the HealthCare and Housing framework, Special Purpose Vouchers are invaluable for people with disabilities. These vouchers are set aside exclusively for this population, ensuring they remain available even when reissued. Two key types include:
- Five-Year Mainstream Housing Opportunities for Persons with Disabilities: Funded through the Section 811 program, these vouchers are targeted exclusively at people with disabilities.
- Rental Assistance for Non-Elderly Persons with Disabilities (NED): Over 55,000 of these vouchers have been awarded nationally. In Wisconsin, PHAs in Milwaukee, Kenosha, Marshfield, Waukesha, and West Bend hold significant allocations of NED and Mainstream vouchers.
However, HealthCare and Housing providers must note that waiting lists for these vouchers are often substantial and may close when wait times become unreasonable.
HOME Investment Partnerships Program
Created in 1990, the HOME Investment Partnerships Program is a formula grant given to states and localities, known as participating jurisdictions (PJs). Since 1992, Wisconsin PJs have received over $592 million in HOME funds.
These funds are crucial for HealthCare and Housing development, as they can be used to build, buy, and renovate rental housing; finance homeownership; repair homes for accessibility; and provide rental subsidies.
As of December 2014, Wisconsin had 12 participating PJs, including major entities like Milwaukee, Madison, and Dane County.
The data indicate that while cumulative funding is high, the number of tenant-based rental assistance vouchers actively utilized varies significantly by jurisdiction.
For HealthCare and Housing planners, this highlights the importance of local capacity in deploying federal funds effectively.
National Housing Trust Fund (HTF)
The National Housing Trust Fund (HTF), created in 2008, began allocating funds in 2016. It is a formula grant focused on producing and preserving rental housing for extremely low-income households.
States must use at least 80% of HTF grants for rental housing. For HealthCare and Housing advocates, the HTF represents a dedicated stream for the most vulnerable populations, with funds usable for new construction, acquisition, rehabilitation, and limited operating costs.
Continuum of Care and Emergency Solutions in HealthCare and Housing
The Continuum of Care (CoC) Program is essential for coordinating HealthCare and Housing services. Wisconsin has four active CoCs: Wisconsin Balance of State, Milwaukee City and County, Racine City and County, and Madison/Dane County.
In January 2014, Wisconsin had 6,504 year-round beds dedicated to homeless persons. Approximately 54% were in emergency shelters or safe havens, while 46% were in transitional housing.
Crucially for HealthCare and Housing integration, the state had 3,093 permanent housing inventory units, including permanent supportive housing (PSH) and rapid re-housing (RRH). Milwaukee City and County held the largest share of permanent housing inventory, with 1,297 units, underscoring the urban concentration of HealthCare and Housing resources.
Emergency Solutions Grants (ESG)
The Emergency Solutions Grant (ESG) Program provides funds for emergency shelter, transitional housing, and permanent housing solutions. ESG funds support street outreach, homelessness prevention, and rapid re-housing assistance.
In 2014, four grantees in Wisconsin received over $5 million in ESG funds. These grants are flexible tools for HealthCare and Housing providers to address immediate crises while working toward long-term stability.
Housing Opportunities for Persons with AIDS (HOPWA)
The HOPWA program provides housing assistance and supportive services for persons living with HIV/AIDS. In 2014, Wisconsin received two formula awards totaling $1.05 million, allocated to Milwaukee and the state-wide balance.
HOPWA funds are vital for HealthCare and Housing integration because they explicitly link medical needs with housing stability. Data from 2013 shows that hundreds of households were served through short-term rent assistance and transitional facilities, demonstrating the program's role in preventing homelessness among those with chronic health conditions.
Veteran-Specific HealthCare and Housing Programs
Veterans represent a significant population within the HealthCare and Housing initiative. Two primary federal programs address their needs:
VA Supportive Housing (VASH)
VASH is a joint project between the Department of Veterans Affairs (VA) and HUD. It combines HUD housing vouchers with intensive case management provided by the VA for five years.
From 2008 to 2015, 842 VASH vouchers were awarded to nine PHAs across Wisconsin. This program is a prime example of successful HealthCare and Housing integration, directly linking medical case management with rental assistance to transition veterans from homelessness to permanent housing.
Supportive Services for Veteran Families (SSVF)
The SSVF Program awards grants to nonprofit organizations to provide supportive services to very low-income veterans. In 2014, four organizations in Wisconsin received SSVF awards totaling over $3.1 million. These services promote housing stability and are a critical component of the broader HealthCare and Housing safety net for veterans.
State-Level Initiatives and Local Health Care and Housing Models
Wisconsin has developed several state-specific resources to complement federal programs. The Interest-Bearing Real Estate Trust Accounts (IBRETA) Program generates approximately $200,000 to $300,000 annually from real estate broker trust accounts. These funds augment emergency and transitional homeless programs, providing a unique state-level revenue stream for HealthCare and Housing initiatives.
Additionally, the Low-Income Housing Tax Credit (LIHTC) program, administered by the Wisconsin Housing and Economic Development Authority (WHEDA), is a major driver of affordable housing development.
In 2014 alone, LIHTC reservations supported the creation of 1,133 affordable units across 25 developments. For HealthCare and Housing developers, LIHTC is often the primary financial tool for building supportive housing.
Successful Local HealthCare and Housing Implementations
Several local organizations exemplify best practices in HealthCare and Housing integration:
- Thomas H. Wynn, Sr. Memorial Veterans Manor: This Milwaukee development provides 52 permanent supportive housing units for veterans. Its success, marked by low turnover, highlights the effectiveness of combining location convenience with supportive services.
- Guest House of Milwaukee: Serving over 300 individuals, this organization uses one-on-one case management and Recovery Support Specialists to help clients maintain housing while managing mental health and substance abuse issues.
- AIDS Resource Center of Wisconsin (ARCW): ARCW tailors its HealthCare and Housing programs for people with HIV/AIDS, offering rent assistance and counseling to reduce behaviors that threaten housing stability.
- Tellurian UCAN: In Dane County, Tellurian operates transitional and permanent housing for individuals with mental illness and chemical dependence. Their "Start on Success" project and Community Intervention Team demonstrate the value of assertive outreach in HealthCare and Housing models.
- Community Action Coalition (CAC): CAC’s "Home for Good" and "SHIFT" programs provide long-term housing and intensive case management in South Central Wisconsin, focusing on self-sufficiency and employment.
The Role of SOAR in HealthCare and Housing Access
The SSI/SSDI Outreach, Access, and Recovery (SOAR) program is a critical link between HealthCare and Housing and income support. Nationally, only 15% of initial SSI/SSDI applications from homeless individuals are approved.
However, when using the SOAR model, approval rates rise to 93%. Wisconsin supports SOAR through PATH and Mental Health Block Grant funds, helping homeless persons with mental illness access benefits that enable housing stability.
With five local SOAR leads and ten trainers statewide, this program is a vital tool for HealthCare and Housing providers seeking to secure long-term income for their clients.
Conclusion
The HealthCare and Housing (H2) Systems Integration Initiative in Wisconsin offers a comprehensive framework for addressing homelessness through coordinated care and resource allocation.
By leveraging federal programs like HUD vouchers, HOME funds, and VASH, alongside state initiatives like IBRETA and LIHTC, providers can create a robust safety net.
Local models such as Veterans Manor and Guest House of Milwaukee demonstrate that integrating medical, mental health, and housing services leads to better outcomes.
As the landscape evolves, the principles outlined in this document remain essential for researchers, policymakers, and practitioners committed to advancing HealthCare and Housing solutions for Wisconsin’s most vulnerable residents.