VA Homeless Programs
Grant and Per Diem (GPD) Low Demand Model
Grant and Per Diem (GPD) Low Demand Model
Low Demand Homeless Programs have played an important role in ending homelessness among our nation's Veterans. Low Demand Programs provide an effective alternative to Veterans who cannot stay clean and sober, or Veterans who have difficulty being fully compliant with their mental health care. Low Demand Homeless Programs are recovery programs that:
- Provide supportive housing and rely on harm reduction practices
- Serve hard-to-reach and hard-to-engage chronically homeless Veterans diagnosed with severe mental illness and/or substance use disorders
- Do not require sobriety or compliance with treatment for admission or continued stay
- Serve Veterans who have not been able comply with other homeless programs that require being clean and sober for admission and continued stay and full compliance with mental health care
In August 2014 the VA National Center on Homelessness among Veterans and the national Grant and Per Diem Office established a new low demand model development initiative among Grant and Per Diem Programs. The GPD Low Demand Program now has eighty operational programs. GPD-LD housing programs utilize a harm reduction framework to accommodate chronically homeless Veterans who were either unsuccessful in traditional housing programs, or did not participate in them, due to treatment participation and sobriety requirements for admission to and/or continued stay in the programs. In GPD Low Demand Programs, the demands are kept to a minimum; the environment of care is non-intrusive as possible to foster trust between staff and residents; rules focus on staff and resident safety; and case management, education, and treatment services are offered and highly encouraged, but not a condition of admission or continued stay.
GPD Fact Sheet (September 2019)
GPD OEND Presentation (5/1/2018)
VA has the following training modules available on the GPD Low Demand web site:
Low Demand Model Training - Introduction to the Core Values of Low Demand Homeless Programs
Low Demand Model Training - Transitioning a GPD Facility to GPD Low Demand
Low Demand Model Training - Targeting Veterans Who Need Low Demand Programs
Low Demand Model Training - Programing Offered in Low Demand Programs
Low Demand Model Training - Low Demand Program Best Practices
Low Demand Model Training - Measuring the Fidelity of Your Program to the Low Demand Model
Low Demand Model Training - Helping Your Staff Practice the Model
Low Demand Model Training - Assisting Veterans with Financial Management and Fiduciary Services
Low Demand Model Training - Evidence Base and Evaluation
Motivational Interviewing Training - April 2017
Programming for Low Demand Housing Programs
Practicing the Low Demand Model with Your Staff
Helping Homeless Veterans with Financial Problems
GPD Low Demand Module - Fidelity 2019
Best Practices and Helpful Practices from the Fidelity Reviews
GPD - Low Demand Fidelity Review - Feedback - Lessons Learned
GPD - Low Demand Fidelity Review - Feedback - Challenges
GPD - Low Demand Fidelity Review - Summary (F-1)
Researchers at the University of Michigan's Center for Local, State, and Urban Policy published a Policy Report that reviewed the literature on housing and housing arrangements for homeless populations (Gerber, Haradon, & Phinney, 2008). The report cited 65 articles and technical reports, concluding that low-demand programs demonstrate outcomes pertaining to substance use and participation in mental health services comparable with traditional housing programs that require abstinence and treatment compliance.
In 2016, the National Center measured the effectiveness of the GPD Low Demand Model Initiative and found that of those Veterans exiting the program, over 60% were characterized as positive. Upon exit, nearly half (49.7%) were characterized as stably housed. Consistent with the intent of a Low Demand model, only 2.1% exited due to alcohol or drug use, and only 1.4% exited due to curfew violations. It also found that the fidelity data indicated that the Low Demand model was implemented as intended.
Tsai, J., Kasprow, W. J., & Rosenheck, R. A. (2014). Alcohol and drug use disorders among homeless veterans: Prevalence and association with supported housing outcomes. Addictive Behaviors, 39, 455-460.
Schinka, J. A., Casey, R. J., Kasprow, W., and Rosenheck, R. A. (2011). Requiring sobriety at program entry: Impact on outcomes in supported transitional housing for homeless Veterans. Psychiatric Services, 62(11), 1325–1330.
Gerber, E. R., Haradon, S., & Phinney, R. (2008). Reforming the system of care: A review of the literature on housing and service arrangements for homeless populations. University of Michigan Center for Local, State, and Urban Policy. Policy Report, 12, 1–12.
The VA periodically issues a Notice of Funding Availability (NOFA) to renew existing grants and to recruit new grantees in the Grant and Per Diem Low Demand Program. The program operates in almost all states, and VA has experienced a high demand for this program.
The low demand GPD beds must comply with all GPD requirements in addition to the following specific low demand/GPD guidance provided by the VA National Center on Homelessness among Veterans and the national GPD office:
- Serve hard-to-reach homeless persons with severe mental illnesses who are on the streets and have been unable or unwilling to participate in supportive services
- Provide and encourage use of supportive services with a primary focus of preparing the Veteran to transition successfully to permanent supportive housing
- Offer private or semi-private accommodations
- Operate as a low demand facility where participants have access to needed services but are not required to utilize them
- In keeping with low demand/harm reduction approached, does not require sobriety or treatment compliance as a condition of admission or continued stay
- Be willing to retain Veterans in the program if they commit minor rule violations (e.g., curfew, substance use)
- The program must maintain a primary focus of transitioning and providing the bio-psychosocial support to move the veteran to permanent supportive housing.
No available resources
The following resources were made available for GPD-Low Demand Technical Assistance:
- Grant and Per Diem - Low Demand Program Model FAQ's
- GPD Low Demand Fidelity Self-Assessment Survey
- GPD Low Demand Initiative HHSPM-V Process Measure
- A Quick Guide to Assist Homeless Veterans with Financial Management and Fiduciary Services
- Disaster Preparedness to Promote Community Resiliency - Fact Sheet
- Low Demand Presentation - NCHV Conference
- Managing Contraband and Use of Amnesty Boxes in Low Demand Programs
- Safe Room Sober Lounge Presentation
- Safety Practices for Low Demand Programs
- US Surgeon General EVZIO Announcement - Press Release
- Ward Family Foundation Report 2005: Safe Haven Programs; Analysis of Strategies and Operating Practices
POC
For information on the GPD Program contact GPD National Program Office / GPDgrants@va.gov.
For information on the GPD Program Low Demand Model contact Roger Casey, PhD / Roger.Casey@va.gov,Scott Young, PhD / SYoung1@usf.edu,or Paul Smits/ psmits@usf.edu.
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