St. Cloud, Minnesota Enhanced-Use Lease Questions and Answers
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Mental Health Residential Rehabilitation Treatment Program (MH RRTP) — What are the characteristics of the persons who enter the Mental Health Residential Rehabilitation Treatment Program (single/person with family, male/female, income level, age, geographic home, etc?)
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Mental Health Residential Rehabilitation Treatment Program (MH RRTP) — What percent of program participants are homeless upon entry?
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Mental Health Residential Rehabilitation Treatment Program (MH RRTP) — What are the destinations of persons who leave the program (e.g., move back home, VASH voucher, Al Loehr complex, MACV Transitional Living, Salvation Army Grant and Per Diem Program, Section 8, private market rental housing)?
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Mental Health Residential Rehabilitation Treatment Program (MH RRTP) — What do program staff see as the greatest unmet housing need for veterans leaving the treatment program?
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VA Grant and Per Diem (GPD) Program — What are the characteristics of the men referred to this program? (Income, history of sobriety, barriers)
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VA Grant and Per Diem (GPD) Program — What is the homelessness history of veterans who apply for or enter the per diem program?
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VA Grant and Per Diem (GPD) Program — What is the percentage of Veterans who complete the program?
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VA Grant and Per Diem (GPD) Program — What do program staff see as the greatest unmet housing need for veterans successfully leaving the per diem program?
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Health Care for Homeless Veterans Program — Who is the coordinator?
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Health Care for Homeless Veterans Program — What does this program do?
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Health Care for Homeless Veterans Program — What are the characteristics of the veterans in the HCHV program?
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Health Care for Homeless Veterans Program — What are the needs of the veterans who apply to the HCHV program?
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Health Care for Homeless Veterans Program — What are the housing situations of veterans in the program?
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Health Care for Homeless Veterans Program — What are the housing needs of veterans in the program?
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VASH — What are the demographic characteristics of veterans who receive VASH vouchers?
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VASH — What is the homelessness history of veterans who apply for or receive VASH vouchers?
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VASH — What are the referral sources for VASH vouchers?
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VASH — What service eras are represented by the veterans who apply for or receive VASH Vouchers? (i.e. what percent served in Vietnam? What percent served in the Persian Gulf?)
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VASH — How many people are on the waiting list?
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General EUL Site Information
The vast majority of Veterans admitted to the St. Cloud VA HCS MH RRTP are male (97%). Most are white (77%) and the average age is approximately 48 years. Many admissions are homeless (41.0%). Given the St. Cloud VA MH RRTP receives a high percentage of referrals from its Acute Psychiatric Unit (approximately 55% of all Acute Psychiatric Unit discharges are to MH RRTP), Veterans served are typically very complex and suffer from a multitude of psychiatric disorders. 99.1% of Veterans served at the St. Cloud VA MH RRTP suffer from a psychiatric diagnosis (substance use or mental health disorder). Most Veterans suffer from multiple diagnoses and receive treatment for these disorders concurrently during programming. Marital status is not a demographic characteristic that is tracked for MH RRTP admission. Approximately 5% of all admissions receive a non-service connection pension, 20% are service connected at a level of 50% or less, and 28% receive a service connection of 50% or higher. Approximately 50% of all referrals come from the St. Cloud Healthcare System’s catchment area (Central MN). The remaining 50% come from other areas within VISN 23 (Minnesota, North Dakota, South Dakota, Iowa, Nebraska, and small areas of several other states).
Current data indicates that 41% of all admissions from the prior year were identified as homeless.
All resources mentioned above are utilized. Other sources include State Veteran Homes, half-way housing, Group Residential Home funding (GRH), Board and Care facilities and any other solution required to meet the needs of the Veteran.
Known gaps in the homeless continuum of care:
- Homeless Veterans requiring a longer-term supportive setting but who do not require the intensive services of an MH RRTP (residential treatment)
- Female homeless Veterans
- Homeless Veterans with families (male and female)
- Homeless Veterans with felonies and other legal histories that preclude them from most other transitional services
- Homeless Veterans with serious mental illness
- Homeless Veterans with substantial credit issues or poor rental history
- Sobriety requirements that often preclude admission to housing.
The GPD program at the Salvation Army is targeted to single, male homeless Veterans (for the purposes of GPD, the definition of “Veteran” is “a person who served in the active military, naval, or air service, and who was discharged or released under conditions other than dishonorable”). There are no income guidelines for the Salvation Army program but it is expected that income is a barrier to independently obtaining or maintaining permanent housing. Many Veterans who enter the Salvation Army GPD program have histories of substance use disorders and/or mental health concerns including Post Traumatic Stress Disorder. Veterans may be experiencing legal concerns, credit difficulties, poor rental histories, and other barriers related to securing housing that are consistent with those in the general homeless population.
The homelessness history of Veterans entering the program is varied. Many meet the HUD definition of chronic homelessness; however, this is not required. Some are also newly homeless or experiencing their first episode of homelessness ever.
7. VA Grant and Per Diem (GPD) Program — What is the percentage of Veterans who complete the program?
From March 2010-February 2011, the program reports that 58% of Veterans completed the program and transitioned into permanent housing. Some Veterans transitioned out with a planned discharge to a higher level of care (i.e., treatment).
Rental opportunities based on income; appropriate/safe/sober housing for low-income individuals; and permanent supported housing such as HUD-VASH.
(Staff have identified “harm reduction” housing with rent based on income as the need for persons who need to leave the program because they can't maintain sobriety.)
Supportive services/housing for those struggling with substance use and/or mental health symptoms in a manner that keeps them engaged in treatment is encouraged as a model for future care. Absolute sobriety and stable mental health symptoms is at times an unrealistic expectation for some. Unfortunately, many Veterans are excluded from services without these conditions.
9. Health Care for Homeless Veterans Program — Who is the coordinator?
Ellen Dinsmore LICSW — Homeless Coordinator
10. Health Care for Homeless Veterans Program — What does this program do?
St. Cloud VA HCS’s Healthcare for Homeless Veterans (HCHV) Program is designed to reach out to Veterans experiencing homelessness, those at risk of becoming homeless, and to those needing assistance connecting with services. The HCHV Program provides the following services to Veterans.
- Provide assistance in finding housing, including emergency shelter, transitional or permanent housing
- Assistance in connecting to VA services, including medical, mental health, and substance use treatment
- Assistance in accessing basic needs items such as food, clothing, and footwear
- Referral to services in the community
Many Veterans have histories of substance use disorders and/or mental health concerns including PTSD. Veterans may be experiencing legal concerns, credit difficulties, poor rental histories, and other barriers related to securing housing that are consistent with those in the general homeless population. However, it should be noted that Veterans characteristics vary drastically. Some Veterans have no substance use or mental health history and essentially are struggling due to the economy or job market.
Veterans seeking assistance in the Healthcare for Homeless Veterans Program generally are experiencing homelessness, are at risk of becoming homeless, or need assistance connecting with services.
Most Veterans engaged in the HCHV Program are homeless, and the verge of homelessness, or need assistance staying in their current home.
14. Health Care for Homeless Veterans Program — What are the housing needs of veterans in the program?
Rental opportunities based on income (transitional and permanent); appropriate/safe/sober housing for low-income individuals; and permanent supported housing such as HUD-VASH.
15. VASH — What are the demographic characteristics of veterans who receive VASH vouchers?
The majority of participants are males. At this time, no families are participating in the program. Ages range from 28-69 years old.
16. VASH — What is the homelessness history of veterans who apply for or receive VASH vouchers?
90% of the participants meet criteria for being chronically homeless (as defined by the McKinney Act and HEARTH ACT with at least 12 consecutive months of being homeless or 4 episodes in the past 3 years). The majority of veterans are from the St. Cloud area with a fewer number wanting to “start over” following their treatment at this facility.
17. VASH — What are the referral sources for VASH vouchers?
The majority of referrals are self-referred. Other referral sources include the HCHV staff from the St. Cloud VA HCS, other VA staff including MH RRTP, MH Care Coordinators, community partners (Social Services, VSO).
Currently, there are Veterans that have served in Viet Nam, post-Viet Nam, the other peace-keeping operations (Lebanon, Panama, Somalia, Bosnia, Kosovo), Persian Gulf War (Operation Desert Storm), Afghanistan, and Iraq (Operation Iraqi Freedom). Exact percentages of each era are unknown.
19. VASH — How many people are on the waiting list?
There are currently 13 Veterans on the interested list for the Al Loehr facility.
20. General EUL Site Information
- The St. Cloud VA Medical Center campus is zoned under an institutional Planned Urban Development (PUD). As such, setbacks from the external borders of the property will need to be respected by the Enhanced-Use Lease (EUL) project. Setback distances internal to the campus will have more flexibility.
- In addition to local, State, and Federal requirements, the St. Cloud VA Health Care System will require the subject project to be designed and constructed to meet the National Fire Protection Association (NFPA) 101, Life Safety Code, 2012 Edition.
- The EUL property and associated construction will be required to be physically separated from the Medical Center campus by a security fence.
- A requirement of the project will include arrangements for law enforcement services through the St. Cloud Police Department.
- A requirement of the project will include arrangements for fire protection services through the St. Cloud Fire Department.
- The location of utilities servicing the campus were reviewed and discussed. Specific note was made to the location of the campus sanitary sewer. The proposed project will not include any interconnection with VA utility systems. A utility drawing depicting approximate utility system locations was reviewed.
- The subject EUL project site is bordered by another EUL, the Al Loehr Veterans and Community Housing Complex. The existing lease does include provisions for connecting to the existing curb cut accessing 12th Street North as necessitated by future projects.
- The VA acknowledged that the proposed project site was comprised of significantly less than the estimated 6 acres indicated within the RFP. A survey of the proposed site has been ordered, however, had not been accomplished prior to the site visit.
