Summary: Although nearly all homeless people are extremely poor, it is generally the combination of poverty with other factors--lack of education or a job skills, severe mental illness, substance abuse, or lack of family and social supports--that results in homelessness. For these persons, homelessness is a chronic condition. Homeless people are often unable to access mainstream programs, such as food stamps and Medicaid, because of the inherent conditions of homelessness--transience, instability, and a lack of basic resources. Complying with mainstream programs' paperwork and communicating with agencies and service providers is difficult for someone without a permanent address or telephone. Furthermore, federal programs do not always include service providers with expertise, experience, or sensitivity in working with homeless people. Government assistance is highly fragmented, and it is difficult to develop an integrated approach to helping the homeless. An expert panel convened by GAO discussed strategies that could help homeless people's access to, and use of, federal programs. These included (1) improving the integration and coordination of federal programs, (2) making the process of applying for federal assistance easier, (3) improving outreach to homeless people, (4) ensuring an appropriate system of incentives for serving homeless people, and (5) holding mainstream programs more accountable for serving homeless people. Demonstration projects have developed effective approaches to serving the homeless in such areas as mental health, substance abuse treatment, primary health care, housing, and job training.
