National Academies Press: OpenBook

Homelessness, Health, and Human Needs (1988)

Chapter: Appendix A: Legislative Efforts to Aid the Homeless

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Suggested Citation:"Appendix A: Legislative Efforts to Aid the Homeless." Institute of Medicine. 1988. Homelessness, Health, and Human Needs. Washington, DC: The National Academies Press. doi: 10.17226/1092.
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Suggested Citation:"Appendix A: Legislative Efforts to Aid the Homeless." Institute of Medicine. 1988. Homelessness, Health, and Human Needs. Washington, DC: The National Academies Press. doi: 10.17226/1092.
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Suggested Citation:"Appendix A: Legislative Efforts to Aid the Homeless." Institute of Medicine. 1988. Homelessness, Health, and Human Needs. Washington, DC: The National Academies Press. doi: 10.17226/1092.
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Suggested Citation:"Appendix A: Legislative Efforts to Aid the Homeless." Institute of Medicine. 1988. Homelessness, Health, and Human Needs. Washington, DC: The National Academies Press. doi: 10.17226/1092.
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Page 166
Suggested Citation:"Appendix A: Legislative Efforts to Aid the Homeless." Institute of Medicine. 1988. Homelessness, Health, and Human Needs. Washington, DC: The National Academies Press. doi: 10.17226/1092.
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Page 167
Suggested Citation:"Appendix A: Legislative Efforts to Aid the Homeless." Institute of Medicine. 1988. Homelessness, Health, and Human Needs. Washington, DC: The National Academies Press. doi: 10.17226/1092.
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Page 168

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APPENDIXES

A Legislative Efforts to Aid the Homeless In 1983, Congress appropriated $100 million for emergency food and shelter to be funneled to community groups through the Federal Emer- gency Management Agency (FEMA). Since then it has appropriated $320 million more for this purpose and has made changes in federal housing assistance, food stamps, Medicaid, mental health, Aid to Families with Dependent Children (AFDC), Supplemental Security Income (SSI), vet- erans, job training, and other programs primarily to make them more accessible to the homeless. A brief summary of measures enacted since 1983 follows. P.L. 98-8: With passage of the Emergency Jobs Appropriations Act of 1983, Congress appropriated $100 million for emergency food and shelter to be channeled to community-based groups through FEMA. Half of the funds were disseminated by a national board of volunteer organi- zations and the other half were allocated to the states as formula grants. The act also provided $125 million to the U.S. Department of Agriculture to purchase ($75 million) and distribute ($50 million) surplus food com- modities to the needy. The new program was named the Temporary Emergency Food Assistance Program (TEFAP). P.L. 98-94: The 1984 Department of Defense Authorization Act permitted military installations to make facilities available for shelters. P.L.'s 98-151, 98-181, and 98-396: Various appropriations measures passed in 1984 gave FEMA an additional $110 million to be allocated for emergency food and shelter. P.L. 98-181 also provided $60 million for an emergency shelter program to be administered by the U.S. Department of Housing and Urban Development (HUD); however, these funds were 165

166 APPENDIX A never expended. HUD testifies that Community Development Block Grant money was being used for the same purpose. P.L. 98-288: The Domestic Volunteer Service Act Amendments of 1983 authorized the use of Volunteers in Service to America (VISTA) in projects to aid the homeless. P.L.'s 99-88 and 99-160: Two appropriations acts passed in 1985 gave FEMA an additional $90 million to be allocated for emergency food and shelter. P.L. 99-129: The Health Professions Training Assistance Act of 1985 directed the secretary of the U.S. Department of Health and Human Services (HHS) to arrange with the National Academy of Sciences for an Institute of Medicine study of the delivery of inpatient and outpatient health care services to homeless people. P.L. 99-167: The 1986 Military Construction Authorization Act per- mitted military installations to make surplus bedding available to shelter operators. P.L. 99-198: The Food Security Act of 1985 required state welfare offices to develop ways to issue food stamps to people with no permanent address. It also reauthorized TEFAP through fiscal year 1987 (FY87) again providing $50 million per year for distribution costs but imposing a cost-sharing requirement on distribution activities run at the state government level. P.L. 99-570: As part of the Anti-Drug Abuse Act of 1986, Congress enacted the Homeless Eligibility Clarification Act that (1) removed the bar to food stamp eligibility for shelter residents and permitted the homeless to use food stamps to buy prepared meals from soup kitchens and shelters; (2) required the federal agencies responsible for Medicaid, AFDC, and SSI to develop methods to assess eligibility for, and make aid available to, people who do not have fixed home or mailing addresses; (3) prohibited the denial of veterans' benefits because of the lack of a mailing address; (4) required the Social Security Administration (SSA) to make regular visits to facilities for the homeless to take SSI and food stamp applications, and required SSA and the U. S Department of Agriculture to develop procedures to take SSI and food stamp applications from people about to be discharged from medical, penal, and other institutions; and (5) explicitly made the homeless eligible for state and local job training programs authorized by the Job Training Partnership Act and required that their job training be coordinated with education, training, and assistance available under other public programs. The Veterans Administration and the U.S. Department of Agriculture have promulgated and adopted the mandated regulatory frameworks. They are effective retroactively to October 1986. SSA has issued revisions to its program operating manual; the Health Care Financing Administra-

APPENDIX A 167 lion published a new policy statement in February 1987 that implemented the provisions of P.L. 99-570. P.L. 99-591: As part of a continuing appropriations measure, $15 million was given to HUD to allocate in FY87 (under the title of the Homeless Housing Act of 1986J for housing demonstration projects affecting the homeless. The measure also gave FEMA an additional $70 million to be allocated for emergency food and shelter. P.L. 99-660: As part of an omnibus health care bill, Congress gave the National Institute of Mental Health (NIMH) specific authority to award grants for demonstration projects affecting the homeless mentally ill. P.L. 100-6: Congress passed a measure reallocating $50 million in disaster relief funds to programs aiding the homeless. So that these funds would be of some relief during the winter months, Congress passed H.J. Res. 102, a supplemental appropriations act permitting $45 million of the previously reallocated funds to be used for FEMA's emergency food and shelter program and the other $5 million to be used by the Veterans Administration (VA) to provide services to homeless mentally ill veterans. The administration initially opposed the transfer, arguing that it might jeopardize the disaster relief program and that the money would not reach the homeless in time to meet winter needs. The resolution also included language rejecting the administration's proposed deferral of $28.6 million for distribution costs under the U.S. Department of Agriculture's surplus food distribution program (TEFAP). Although considerable controversy emerged over the resolution after the Senate added language rejecting an imminent congressional pay raise, the resolution passed both houses of Congress and was signed into law on February 12, 1987. P.L. 100-77: The major homeless aid bill of the 100th Congress, H.R. 558, the Stewart B. McKinney Homeless Assistance Act of 1987, was signed into law on July 23, 1987. In a parallel action taken by Congress, a supplemental appropriations bill authorizing most of the funds for P.L. 100-77 was passed and signed into law on July 11, 1987. The following are some highlights of this particular piece of legislation. · Authorization of $200,000 for FY87 and $2.5 million to establish a 3-year Interagency Council on the Homeless, composed of most cabinet secretaries and the heads of several independent agencies. · Authorization of $15 million for FY87 (in addition to funds already appropriated) and $124 million for FY88 for FEMA's emergency food and shelter program, which had been operating by way of appropriation language for the previous 4 years. · Authorizations, with regard to HUD, for (1) $100 million in FY87 and $120 million in FY88 for state grants for emergency shelter and $80

168 APPENDIX A million in FY87 and $100 million in FY88 for a supportive housing demonstration program (of which at least $20 million would be earmarked for projects that serve homeless families with children and at least $15 million for projects providing permanent housing for handicapped home- less people); the amounts that would be authorized for FY87 for both programs are in addition to the $15 million already appropriated under the FY87 continuing resolution, P.L. 99-591; and (2) an additional $35 million each for FY87 and FY88 for Section 8 assistance for the rehabilitation of single room occupancy (SRO) dwellings to be used solely to house the homeless. · Authorizations, with regard to HHS, for (1) $50 million in FY87 and $30 million in FY88 for new grants to provide outpatient health care to the homeless; (2) $35 million in FY87 and such sums as may be necessary in FY88 for new state block grants to provide outpatient mental health services to the homeless chronically mentally ill; (3) $10 million in FY87 for new alcohol and drug abuse treatment demonstration projects for the homeless to be conducted by community-based public and nonprofit entities; and (4) $40 million for each of FY87 and FY88 for emergency community services grants for the homeless under the community services block grant program. · Authorizations, with regard to the Department of Education, for (1) $7.5 million in FY87 and $10 million in FY88 for new state grants to develop literacy programs for homeless adults; (2) $5 million for each of FY87 and FY88 for state grants to establish an Office of Coordinator of Education of Homeless Children and Youth in each state to ensure that homeless children have access to public education; and (3) $2.5 million in FY88 for new grants to state and local education agencies for exemplary programs that successfully address the needs of homeless elementary and secondary school students. · With regard to the Department of Agriculture, the bill will, among other things, (1) allow related families with children who live together to be treated as separate households for the purpose of obtaining food stamps, and (2) prohibit third-party payments on behalf of households residing in temporary shelter that lack adequate cooking facilities from being counted as income for the purpose of obtaining food stamps, thereby increasing benefits for those in certain welfare hotels.

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There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.

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