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Youth Homelessness: HUD and HHS Could Enhance Coordination to Better Support Communities

GAO-21-540 Published: Sep 30, 2021. Publicly Released: Nov 01, 2021.
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Fast Facts

In the U.S., about 1 in 10 young adults and 1 in 30 minors under age 18 experience homelessness without a parent or caregiver over the course of a year. Homelessness is higher among some groups, such as youth of color and transgender youth.

Although the Departments of Housing and Urban Development and Health and Human Services provide grants to local organizations to operate programs, like shelters or transitional living programs, many youth who are homeless may not be receiving services they may be eligible for.

We recommended that HUD and HHS provide more guidance to local programs on how to help youth who are homeless.

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Highlights

What GAO Found

The Departments of Housing and Urban Development (HUD) and Health and Human Services (HHS) have taken steps to coordinate their programs that serve youth experiencing homelessness. These programs include HUD's Continuum of Care program, which funds housing and homelessness services for people of all ages in nearly all communities across the country, and HHS's Runaway and Homeless Youth program, which funds emergency shelters, transitional housing, and supportive services for youth in a few hundred communities. For example, HHS was involved in the development of HUD's Youth Homelessness Demonstration Program, which provides grants to several dozen communities to address youth homelessness. In addition, the agencies integrated data collection for the Runaway and Homeless Youth program into local data systems operated under the Continuum of Care program to help program providers better coordinate client services at the local level.

GAO's review of documents and interviews with local program providers, agency officials, researchers, and advocates identified several challenges in serving youth experiencing homelessness, including both young adults and minors (those under 18). For example:

Under the Continuum of Care program, communities must establish a process, known as coordinated entry, for prioritizing who receives limited housing resources. Many providers of homelessness services reported that their community's process tends to prioritize young adults lower than older adults. This is partly because these processes, following HUD guidance, give higher priority to those who have been homeless longer and who have documented disabilities. HUD has provided some information to communities on serving youth through coordinated entry, but this information largely has not addressed how to ensure that young adults are not consistently prioritized below other groups for housing.

Most providers GAO interviewed reported that minors experiencing homelessness unaccompanied (without a parent or caregiver) do not participate in the coordinated entry process, with several noting there are limited housing options that can serve minors. Some providers and other stakeholders discussed challenges coordinating between the homelessness and child welfare systems to serve this group. However, HUD and HHS have provided limited information about or examples of how providers could coordinate to better serve unaccompanied minors.

Although HUD and HHS have taken some steps to coordinate the Continuum of Care and Runaway and Homeless Youth programs, providers of these programs reported challenges in coordination and communication, including a lack of understanding of one another's programs and a need for more strategic planning on services for youth.

HUD and HHS have acknowledged a need for additional information related to serving youth. Additional support from HUD and HHS in the areas identified above could help to improve coordination and the delivery of services to both young adults and minors at the local level.

Why GAO Did This Study

Youth homelessness is a widespread problem, with one recent study estimating that one in 10 young adults experience some form of homelessness over the course of a year—such as living on the streets or in a shelter or temporarily staying with others. GAO was asked to study youth homelessness. This report examines, among other things, HUD's and HHS's coordination to address youth homelessness and challenges communities face in serving youth through HUD and HHS programs.

GAO analyzed federal agency documents related to homelessness efforts; conducted structured interviews with a nongeneralizable sample of 24 local homelessness providers, selected to reflect communities of different sizes and with different types of programs for youth; and interviewed other local program staff, youth homelessness researchers and advocates, and federal officials.

Recommendations

GAO makes 10 recommendations to improve services for youth experiencing homelessness, including that HUD work with HHS to provide additional information or examples to local communities in the following areas: serving young adults through coordinated entry processes, coordinating to serve unaccompanied minors, and coordinating their programs. HUD generally agreed with four recommendations. HUD neither agreed nor disagreed with two recommendations, but described intended plans to help address these areas. HHS agreed with GAO's recommendations.

Recommendations for Executive Action

Agency Affected Sort descending Recommendation Status
Department of Health and Human Services HHS's Assistant Secretary for Planning and Evaluation, in coordination with USICH and HUD's Office of Special Needs Assistance Programs, should establish a timeline for developing and disseminating information, such as an interactive decision-making tool, to help providers accurately identify the federal homelessness assistance programs for which individuals seeking services are eligible. (Recommendation 5)
Open
HHS agreed with this recommendation from GAO-21-540 (September 2021) and has taken steps to share information and resources about federal homelessness assistance programs (including HHS programs and other agencies' programs) on a dedicated webpage. HHS noted that the webpage was updated in May 2022 to ensure that homelessness assistance programs across the federal government were included. HHS added that it will continue to work with USICH and HUD to disseminate information developed by USICH member agencies and to review federal homelessness definitions as part of the effort to implement the federal strategic plan to prevent and end homelessness. However, since our report was issued, USICH has determined that the development of an interactive decision-making tool is not a priority. USICH and its member agencies are not currently pursuing the development of a tool or other resource to help service providers identify the federal homelessness assistance programs for which individuals seeking services are eligible. To close this recommendation as implemented, HHS should coordinate with USICH and HUD to establish a timeline for disseminating information (which could be an interactive tool or a non-interactive written resource) that would help service providers understand and apply the different eligibility criteria for federal homelessness assistance programs. Financial or other benefits have not been attained. Implementing this recommendation could help ensure that individuals seeking services are appropriately referred to the programs for which they are eligible.
Department of Health and Human Services HHS's Associate Commissioners for the Family and Youth Services Bureau and for the Children's Bureau, in coordination with HUD's Office of Special Needs Assistance Programs, should develop information for local providers that includes examples of how communities have addressed the needs of unaccompanied minors experiencing homelessness, including the role of the CoC program and other entities (such as RHY providers and child welfare) in serving this population in these communities. (Recommendation 7)
Open
HHS agreed with this recommendation from GAO-21-540 (September 2021) and has taken some steps towards implementing it. FYSB said it has held several meetings with FYSB, the Children's Bureau (CB), and HUD to discuss ways to gather information from communities about how they have addressed the needs of unaccompanied minors experiencing homelessness, including the role of the CoC program, RHY providers, and child welfare agencies, and to identify best practices. HHS said that in 2022 and 2023, FYSB convened several meetings with FYSB, and the Department of Housing and Urban Development's Office of Special Needs Assistance Programs (HUD) to strengthen its focus and understanding of ways that communities have addressed the needs of unaccompanied minors experiencing homelessness, including the role of the CoC program and other entities such as RHY providers and child welfare agencies in serving this population in these communities. FYSB added that FYSB and HUD are working together to identify organizations that receive funding from both the RHY and CoC programs, with the goal of better understanding ways of leveraging funding to support minors. FYSB also stated that it has begun discussions with HHS's Administration for Children and Families (ACF) to potentially update ACF's 2014 memorandum on providing services for minors who run away from foster care. To support this work, FYSB said that FYSB and the Children's Bureau are planning to conduct joint site visits in communities in fall 2023 to discuss the roles of child welfare and RHY programs in serving this population. HHS said that in October 2023, FYSB and CB provided feedback and edits to a joint CB-FYSB-HUD Technical Assistance brief focused on consideration for serving unaccompanied minor youth. They said the brief reviews the policies, laws, and programmatic considerations that communities and agencies should consider when developing and implementing projects to serve unaccompanied minor youth experiencing homelessness. They expect the brief to be finalized and distributed to RHY, CB, and HUD partners in the first quarter of 2024. To close this recommendation as implemented, FYSB and the Children's Bureau should coordinate with HUD to develop specific and available information for local providers that includes examples of how communities have addressed minors experiencing homelessness. Financial or other benefits have not been attained. Implementing this recommendation could help communities identify ways to better coordinate services for this population.
Department of Health and Human Services HHS's Associate Commissioner for the Family and Youth Services Bureau, in coordination with HUD's Office of Special Needs Assistance Programs, should provide communities with additional information on strategies and promising practices for coordinating their CoC and RHY programs' efforts to address youth homelessness. (Recommendation 9)
Open
HHS generally agreed with this recommendation from GAO-21-540 (September 2021) and has taken some steps towards implementing it. HHS said that steps it has taken include convening regular and ongoing meetings with HUD to identify ways to provide communities with additional information on strategies and promising practices for coordinating their CoC and RHY programs, and that HHS and HUD are identifying ways to learn about strategies and promising practices in communities that have strong CoC and RHY coordination. HHS said that FYSB and HUD announced new awardees receiving RHY funding and YHDP funding, and it will complete a cross-walk to better understand organizations that leverage both funding opportunities. HHS said that HUD, with FYSBs support, is developing a training and technical assistance resource to share ways communities have leveraged RHY programs to support implementation of HUD's YHDP. Once this resource is finalized, HHS said FYSB will publicize it on their website and distribute it to all RHY programs. Additionally, HHS said that HUD presented to RHY programs on promising practices and lessons learned from communities that have implemented the YHDP with partnerships with RHY programs during the November 2022 Runaway and Homeless Youth Training and Technical Assistance National Training. HHS said that FYSB invited HUD to participate in the 2023 Runaway and Homeless Youth Training and Technical Assistance National Training. Additionally, in coordination with HUD and CB, HHS said that FYSB is developing guidance to RHY grant recipients regarding HUD's Foster Youth to Independence Voucher Program and how to ensure eligible youth experiencing homelessness, who have previously been in foster care, gain access to these resources. HHS said when the guidance is completed, it will be shared across FYSB, CB, and HUD partners. To close this recommendation as implemented, HHS should produce specific and available information with strategies and promising practices for coordinating CoC and RHY programs' efforts to address youth homelessness. Financial or other benefits have not been attained. Implementing this recommendation could help communities who face challenges in working together to create a cohesive and integrated local service system for youth experiencing homelessness to implement a more unified approach.
Office of Special Needs Assistance Programs HUD's Deputy Assistant Secretary for Special Needs, in coordination with HHS's Family and Youth Services Bureau, should develop additional information for homelessness providers on how the coordinated entry process can more effectively serve youth. This information should address (1) how to help ensure that youth are not consistently prioritized below older adults for housing and services in coordinated entry systems and (2) how CoCs can work with RHY providers and other stakeholders to serve youth who are not prioritized for housing or are not eligible for housing under CoC program rules. (Recommendation 1)
Open
HUD neither agreed nor disagreed with this recommendation from GAO-21-540 (September 2021) and has taken limited steps towards implementing it. HUD said that it has published several resources related to collaborations to better serve youth experiencing homelessness and that it is currently developing additional publications, including on the topic of combining resources from the RHY program and HUD's Youth Homelessness Demonstration Program (YHDP) to support stronger youth systems. HUD added that it plans to develop additional technical assistance resources that address prioritizing youth in coordinated entry systems, including examples from YHDP communities. To close this recommendation as implemented, HUD should coordinate with HHS to produce specific and available information on how CoCs can more effectively serve youth through coordinated entry systems, including how they can help ensure that youth are not consistently prioritized below older adults and how they can coordinate to serve youth who are not prioritized or not eligible for CoC resources. Financial or other benefits have not been attained. Implementing this recommendation could help communities better ensure that youth experiencing homelessness are able to access the assistance they need through the coordinated entry system.
Office of Special Needs Assistance Programs HUD's Deputy Assistant Secretary for Special Needs should provide additional information to CoCs to clarify how they could meet the standards outlined in regulation for serving people in Category 3 of HUD's definition of homelessness. This information should include examples that illustrate specific ways that CoCs could demonstrate that use of funds to serve these youth and families meets Category 3 requirements, including methods CoCs could use to develop estimates of cost-effectiveness. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Office of Special Needs Assistance Programs HUD's Deputy Assistant Secretary for Special Needs, in coordination with USICH and HHS's Office of the Assistant Secretary for Planning and Evaluation, should establish a timeline for developing and disseminating information, such as an interactive decision-making tool, to help providers accurately identify the federal homelessness assistance programs for which individuals seeking services are eligible. (Recommendation 4)
Open
HUD generally agreed with this recommendation from GAO-21-540 (September 2021) and stated that the effort to develop an interactive tool should be coordinated by USICH, given USICH's expertise as a coordinating agency. Since our report was issued, USICH has determined that the development of an interactive decision-making tool is not a priority. HUD stated that, because the effort to create such a tool is an interagency function, HUD does not believe this work will go forward. However, HUD noted that it plans to participate with USICH and other agencies in reviewing federal homelessness definitions as part of the effort to implement the federal strategic plan to prevent and end homelessness. To close this recommendation as implemented, HUD should coordinate with USICH and HHS to establish a timeline for disseminating information (which could be an interactive tool or a non-interactive written resource) that would help service providers understand and apply the different eligibility criteria for federal homelessness assistance programs. Financial or other benefits have not been attained. Implementing this recommendation could help ensure that individuals seeking services are appropriately referred to the programs for which they are eligible.
Office of Special Needs Assistance Programs HUD's Deputy Assistant Secretary for Special Needs, in coordination with HHS's Family and Youth Services Bureau and Children's Bureau, should develop information for local providers that includes examples of how communities have addressed the needs of unaccompanied minors experiencing homelessness, including the role of the CoC program and other entities (such as RHY providers and child welfare) in serving this population in these communities. (Recommendation 6)
Open
HUD generally agreed with this recommendation from GAO-21-540 (September 2021) and has taken some steps towards implementing it. HUD stated that it has met with FYSB and the Children's Bureau several times to identify best practices and intersections between HHS and HUD programs to serve minors experiencing homelessness. Based on these meetings, HUD determined that it would develop products on this topic. HUD provided a draft of a document that addresses serving minors, which HUD said it was editing before its release. HUD added that it has already published a number of articles that include examples of how communities have used Youth Homelessness Demonstration Program (YHDP) and other funding to better serve youth experiencing homelessness (however, these products are not specific to minors). HUD noted that it is also planning to develop a "best practices" series that will focus on lessons learned for serving youth at risk of or experiencing homelessness. To close this recommendation as implemented, HUD should coordinate with FYSB and the Children's Bureau to develop specific and available information for local providers that includes examples of how communities have addressed minors experiencing homelessness. Financial or other benefits have not been attained. Implementing this recommendation could help communities identify ways to better coordinate services for this population.
Office of Special Needs Assistance Programs HUD's Deputy Assistant Secretary for Special Needs, in coordination with HHS's Family and Youth Services Bureau, should provide communities with additional information on strategies and promising practices for coordinating their CoC and RHY programs' efforts to address youth homelessness. (Recommendation 8)
Open
HUD generally agreed with this recommendation from GAO-21-540 (September 2021) and has taken some steps towards implementing it. HUD said that steps it has taken include HUD staff working with HHS colleagues to develop technical assistance products that highlight how youth providers can develop partnerships to enhance the services offered to youth. HUD said that in December 2022 it published the first four of these products, and provided drafts of additional documents in the editing stage which address topics such as combining RHY and Youth Homelessness Demonstration Program resources to support stronger youth systems. To close this recommendation as implemented, HUD should produce specific and available information with strategies and promising practices for coordinating CoC and RHY programs' efforts to address youth homelessness. Financial or other benefits have not been attained. Implementing this recommendation could help communities that face challenges in working together to create a cohesive and integrated local service system for youth experiencing homelessness to implement a more unified approach.
Office of Special Needs Assistance Programs HUD's Deputy Assistant Secretary for Special Needs, in coordination with HHS's Family and Youth Services Bureau, should develop a set of optional youth-specific performance measures that CoCs could use to assess their local efforts to address youth homelessness. HUD should also provide CoCs with information on how they might track these measures. (Recommendation 10)
Open
HUD neither agreed nor disagreed with this recommendation from GAO-21-540 (September 2021) and has taken limited steps towards implementing it. HUD said that it has been working through collecting data on well-being measures, but these are for the entire homeless population and not specific to youth. HUD also said that it is considering publishing lessons learned from the Youth Homelessness Demonstration Program, where it mandated that grantees use additional data elements that are currently collected in the RHY programs. HUD said that it plans to publish guidance in spring 2023 regarding using RHY data elements, which it hopes will help non-YHDP-funded youth providers consider additional data elements that they could collect to better serve youth. To close this recommendation as implemented, HUD will need to coordinate with HHS and take actions that directly demonstrate efforts to develop optional youth-specific performance measures and provide CoCs with information on how they might track the measures. Financial or other benefits have not been attained. Implementing this recommendation could help communities better monitor the performance of local programs that serve youth.
United States Interagency Council on Homelessness The Interim Executive Director of USICH, in coordination with HUD's Office of Special Needs Assistance Programs and HHS's Office of the Assistant Secretary for Planning and Evaluation, should establish a timeline for developing and disseminating information, such as an interactive decision-making tool, to help providers accurately identify the federal homelessness assistance programs for which individuals seeking services are eligible. (Recommendation 3)
Open
USICH agreed with this recommendation from GAO-21-540 (September 2021) but does not currently plan to implement it. In a May 2022 report to Congress, USICH stated that it had reassessed the feasibility and utility of developing an interactive tool and had determined that the utility of such a tool would be limited in comparison to the resources needed to create and maintain it. As of February 2023, USICH still does not intend to develop an interactive decision-making tool. However, USICH noted that it plans to coordinate with other federal agencies to review their various definitions of homelessness as part of the implementation of the federal strategic plan to prevent and end homelessness. To close this recommendation as implemented, USICH should coordinate with HUD and HHS to establish a timeline for disseminating information (which could be an interactive tool or a non-interactive written resource) that would help service providers understand and apply the different eligibility criteria for federal homelessness assistance programs. Financial or other benefits have not been attained. Implementing this recommendation could help ensure that individuals seeking services are appropriately referred to the programs for which they are eligible.

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Assistance programsCommunitiesHomelessnessHousingHousing programsMinorsPerformance measurementYouth servicesYouthAdults