We Need to Tackle Grant Per Diem Funded Programs – NOW

If there is one pressing issue to be tackled from a policy and funding perspective in the pursuit of ending homelessness, it is grant per diem funding in any homeless services. While much of the spotlight has been on Veterans Affairs and its massive inventory of GPD funded beds, they are not alone. Other jurisdictions have wrestled with the concept of GPD funding in shelters for quite some time – and with little success. I say now is the time for tough change to get GPD aligned to the pursuit of ending homelessness.

If you don’t know what a GPD program is, in a nutshell it goes like this: as a service operator, you get a set fee for a head on a bed each night. Used in a sheltering context (which varies by jurisdiction, but can include things like transitional shelter, something resembling transitional housing, or emergency shelter…or in some antiquated models in the northeast something resembling a nursing home), the service provider most often provides some support services to the participants in this program.

In my experience and travels, these services are all over the map in terms of intensity, professionalism of delivery, and purpose. For example, in some instances I have seen highly qualified addiction counsellors provide a form of residential support and counselling to those striving for sobriety. But I have also seen too many poorly constructed life skills and budgeting classes, as well as terrible employment readiness programs. Some GPD programs offer around the clock access and supports. Others have periods of time where residents are expected to be out during the day. Some GPD programs require sobriety or meeting with a case manager within a certain number of days of entry or an employment plan. Others are much more low barrier. I guess my point is, people say “GPD” and make assumptions that they are all the same thing, when there is overwhelming diversity and a lack of quality assurance from city to city (or even within the same city). Country to country it is even more diverse.

What should bother us more than the diversity of programming though – and what I don’t get – is how any community or leader on the one hand can say they are all for housing first and then in the next breath support a GPD program. GPD, as it is most often delivered, is the epitome of housing readiness, which is the antithesis of housing first. The programs do not facilitate rapid access to permanent housing with supports wrapped around in the community.

GPD incentivizes homelessness. No service operator, from a financial perspective, wants to have people vacate their program until whatever imposed stay limit is exhausted. Why? They would have to find another head for the bed to ensure financial sustainability. Maybe this is not a concern in communities where there is considerable demand that outstrips supply, but the demand should not be what drives the program or its funding model in this instance. Should people stay homeless longer because it is in the financial best interest of the operator?

Those in the know will say GPD programs cannot and will not change until there is a legislative change, which steers the ship for providers. So what are we waiting for? If we know the answer, why is there little movement in most jurisdictions to rectify the matter? Is there a GPD lobby group so strong that it should overwhelm evidence and dare I say common sense? This is a classic example of a leadership void for a solution waiting to happen; an instance where popularity of a program and the fear of backlash trumps what is necessary.

Let me layout a funding transition plan that would get the ball rolling.

Offer each GPD provider guaranteed income of $25 per bed in their facility. Multiple that by 365 days. That should be enough to keep the place with a bare-bone staff and pay essential operating bills. In a 25 bed facility, that would equal $228,125.

Ensure GPD providers take people with the highest acuity first. So, the deeper the need on the part of the person that is homeless, the more likely they are to get access to the bed.

Then, offer an incentive of $500 for each person housed out of the GPD funded program. If the person does not return to homeless for three months, provide an additional $100. Do the same at 6 and 9 months. At the 12 months mark, if the person has not returned to homelessness, $1,500 bonus. If 100 people were housed through the program each year, this would actually result in the GPD funded program operator having a slightly greater annual budget (from GPD resources) than operating in the traditional manner – and it would move us all closer to ending homelessness. That would more than take care of all other staffing and building costs.

At the same time, ensure there is a financial disincentive for anyone that has a prolonged stay in a GPD program (perhaps with some exceptions for people that are palliative). So, for example, if someone has not had a positive housing destination within 6 months, the GPD provider only gets $15 for that person each night. If that reaches a year it is $10 for that person. If the person is still in GPD at 18 months, the provider only gets $5 in funding for that person.

That would work for the “traditional” GPD programs.

Then, if there is an appetite for service enriched programs like the professionally staffed addiction counselling and substance use recovery programming that I referenced earlier, call it something other than a GPD program. Give it block funding. Because really, a substance use recovery program is great (and needed for many people) but do NOT confuse a substance use recovery program with a homeless program. Homeless programs end homelessness through housing. Substance use recovery programs end the use of substances. They are NOT the same thing.

At the same time we need analysis on what the right size of GPD needs to be in each community. Some of this work has started, I know. If there has been such a HUGE investment in things like SSVF programs for veterans, and rapid rehousing in other jurisdictions where GPD is not limited to veterans, we should be seeing a reduction in GPD demand. As such, we should start decreasing the overall volume of GPD beds. With proper (and simple) analysis, this should be something that could be implemented over the next 12-18 months.

Now onto something I am going to say that will certainly be unpopular in some circles: until you have wrestled your GPD programs to the ground, do not make a claim that you have ended homelessness for veterans or any other population group for that matter. When, for example, any group doesn’t want to include GPD beds as people being homeless it is a misrepresentation of the true state of homelessness. When, for example, a community gets “cute” with how they name or classify their GPD beds in order to claim some sort of victory in getting an entire population housed, they are kidding no one and creating an overwhelmingly dangerous interpretation of what is actually happening on the ground. Out of sight does not mean out of mind. In fact, I will go so far as to say take any claim of ending homelessness with a grain of salt until there is a transparent answer on what is happening with its GPD beds. New Orleans did a good job of being transparent in this manner; but even then I would argue they should be called something other than a GPD bed.

As more and more communities start claiming “functional zero” in ending homelessness for veterans across the United States while having full GPD programs, it is a powder keg waiting to explode in the media and a public relations disaster waiting to happen. It doesn’t matter what any “takedown list” was, so long as people that are homeless continue to be served by GPD programs that are actually any variation of a shelter or transitional housing program, then let us have the courage to say: “They are still homeless and we are not done ending homelessness yet.”

Let me tackle the other argument that I hear a lot regarding any sheltering program that is funded through GPD. It goes something like this: “But, (insert name of population group like veterans, survivors of domestic or intimate partner violence, youth, people in recovery, people with concurrent disorders, recently hospitalized, etc.) NEED this GPD program in order to be successful in permanent housing.” What I think people are confusing is a mechanism for funding from a specific type of program. There are loads of great programs for different population groups. We know some work. We are still learning more about others. We know that other types of programs quite plainly fail. It is an injustice to suggest that a program that incentivizes a longer length of stay because of its funding source is a BETTER program.  I can think of no population group that has a better housed experience through a prolonged homeless experience.

So now is the time to take action. Now is the time to challenge what is occurring and demand that we do better. If we are serious about ending homelessness in any community (and I really hope we are), we have to get serious about changing the nature of GPD programs to get more people housed. In the meantime, we need to be counting people in GPD funded programs as homeless. Calling it anything else is not an honest representation of what is really happening.