At a time when the Department of Veterans Affairs has its hands full combating the opiate epidemic among veterans; walking a tightrope on medical cannabis research; chipping away at its claims backlog; and ending veterans suicide, it’s struggling to find time and resources to end veteran homelessness.

For the first time in seven years, the number of homeless veterans has increased in the United States. There were 585 more homeless veterans in 2017 than the year prior — the first time that number has risen since 2010, when then-President Barack Obama set the goal of ending veteran homelessness by 2015 — a deadline that obviously was not met.

The VA and the Department of Housing and Urban Development — the two federal agencies taking lead on that front — have made considerable gains in the last seven years, with vet homelessness dropping overall by 46%. But watchdogs worry that efforts to shelter more than 40,000 veterans still living on U.S. streets are stalling.

“It seems to us there is no longer an emphasis and determination to get every veteran off the streets,” Stephen Peck, the president of U.S. VETS, a nonprofit that provides housing and employment assistance to homeless veterans, said at a Jan. 18 congressional hearing on veteran homelessness. “This is no time to be taking our eye off the ball.”

Here’s what you need to know about the challenges facing the Department of Veterans Affairs as it seeks to end this longstanding problem.

It’s not just about housing

Since 2010, when the VA rolled out its plan to end veteran homelessness, more than 480,000 veterans and their families have been permanently housed, quickly moved into new homes, or otherwise prevented from becoming homeless through various federal programs, according to a statement by HUD last month.

Housing programs provide sunny metrics for administrators, but they don’t get at a lot of root causes for homelessness.

“I think it’s important we look at the entire continuum,” Peck said at the hearing. “There has been a tendency to look for a single fix — Housing First was the answer there for a while — but I think it’s critical that we provide those more intensive services.”

Here’s what else is required

Housing takes care of homeless veterans’ most immediate need, but it doesn’t get at the root causes of homelessness. That requires a broader approach “so that veterans coming in from off the street get the services they require, whether it be mental health, substance abuse, education, or whatever it may be,” Peck said.

Related: Federal Agencies See No End In Sight For Veteran Homelessness »

On the ground, this could mean pairing homeless veterans with social workers; getting those who need it into substance abuse programs; assisting veterans in finding gainful employment; and childcare service for veterans with children.

Women veterans face nearly twice the risk of homelessness as male peers

Women veterans face a greater risk of becoming homeless — 2.4% — compared to male vets, who face a 1.4% risk. Contributing factors include post-traumatic stress disorder; loss of employment; dissolution of marriage; and a lack of gender-specific support, according to a Jan. 18 Veterans of Foreign Wars’ statement. Additionally, one-fifth of homeless female veterans have dependent children, which places added emphasis on the need for support services like child-care.

Minority veterans, urban dwellers, and those suffering from substance abuse are at the highest risk

The majority of homeless veterans are single; live in urban areas; suffer from mental health, substance, and/or alcohol abuse disorder; and account for roughly 11% of the adult homeless population, according to the National Coalition for Homeless Veterans. Roughly 45% of all homeless veterans are African American or Hispanic, even though those groups only make up about 30% of the active military ranks. Homeless vets are younger on average — compared to the entire vet population — and nearly half of all homeless veterans served during the Vietnam War, and a third of all homeless veterans served in a war zone. A further 1.4 million veterans are considered “at risk” of homelessness, due to a lack of support, poverty, overcrowded and substandard housing.

Housing and support programs require significant funding

In December, Politico reported that the VA planned to pull $460 million specifically set aside for the HUD-Veterans Affairs Supportive Housing (or HUD-VASH) program, which provides vets with housing vouchers. The plan was to redirect those funds to local VA hospitals, where individual directors could determine how the money was used. That proposal prompted an outcry from veteran advocates and lawmakers who feared funds would go to other uses, and the VA backtracked on the decision.

Advocates continue to worry about VA cuts to homeless programs

“While VA has backed away from this decision for the time being, this could’ve dramatically reduced case management for vulnerable veterans,” Kathryn Monet, chief executive officer of the National Coalition for Homeless Veterans said at Thursday’s hearing. “To remove it would be catastrophic to the housing stability of veterans using these vouchers.”

At a Senate Committee on Veterans Affairs hearing Jan. 17, VA Secretary David Shulkin stated that any changes to changes to veteran homelessness programs would bring more resources to bear on the problem. “We need to do this better,” Shulkin said. “We have to rethink our effort. We need to double down on things that work and come up with a fresh approach here. I’m not satisfied with the progress we’re making.”

It’s not entirely clear where veteran homelessness stands as a VA priority

The obstacles facing veteran homelessness don’t boil down to funding alone, but resources play a major role. They also serve as an indicator of the Department of Veterans Affairs’ priorities.

“Our feeling is that they’ve either given up thinking this is going to work, or they have other priorities,” Peck told Task & Purpose. “Secretary Shulkin has five priorities, but homelessness is not one of them.” Indeed, Shulkin told lawmakers last May that his priorities are greater health care choices for vets, modernizing VA, increasing efficiency, improving timeliness, and ending veteran suicide — all laudable, but not directly addressing homelessness.

“One of the things we’ve heard is that he wants more money to use for those five priorities,” Peck said.

When asked for a comment, VA Press Secretary Curt Cashour said in an email: “We have a dedicated team of more than 5,000 staff across the country focusing on Veteran homelessness as their primary responsibility every day. But there are limits to what VA can do affect the supply of affordable housing, which is more dependent on state and local policies and community involvement.”

VA’s spokesman says the main culprit is expensive big cities

The high rate of homelessness in urban centers like Los Angeles— which saw a 26% increase in overall homelessness since 2016 — is closely tied to rising housing costs, and a workaround requires coordination between city, county, and state organizations and the federal government, but there’s only so much the VA can do alone, Cashour said. “An inadequate supply of affordable housing and major increases in rental costs, particularly in Seattle and Los Angeles, are the top challenges, considering that those two cities are where we’ve seen the largest uptick in Veteran homelessness recently.”

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