ANNUAL REPORT

JULY 1, 2015 TO JUNE 30, 2016 Same identity, fresh perspective

The accomplishments that this report summarizes were inspired by and designed in support of our ambitious mission: to eliminate homelessness by ensuring comprehensive health care and secure housing for everyone. Each activity described here is an effort toward achieving our mission. Whether it is confronting barriers to care for transgender individuals without homes, helping health centers understand and maximize Medicaid resources, or training clinicians in cultural humility, each activity makes an intentional effort to ending homelessness while emphasizing human value and dignity.

To help us integrate this mission more intentionally into our daily work, the National Health Care for the Homeless Council describes our activities in terms of four key values: quality, access, justice, and community. It is our hope that these values reveal the breadth of the Council’s work and inspire you to learn more.

QUALITY ACCESS JUSTICE COMMUNITY Ensuring the best Eliminating Advancing public Creating solidarity in health care for the barriers to health policies that prevent the homeless health most vulnerable care and housing and end homelessness care movement Letter from the Executive Director INTRODUCTION

This Annual Report portrays our organization’s determined pursuit of a big and elusive goal: health care justice. The population we serve bears an extraordinary burden of injury, disease, trauma and stress, and is largely disenfranchised in the health care system. Increasingly, as this system evolves and as more people without homes gain Medicaid coverage through the Affordable Care Act, leaders in health care turn to the Council for the benefit of our rich experience. We are more than happy to share via our publications, webinars, consultations, conferences, and technical assistance, some of which is detailed herein.

In many instances, we can document our impact and count our results. In other cases, we cannot demonstrate that our efforts to train providers or shape public policy result in someone escaping the double trap of poverty and illness, but those victories of strong and resilient individuals are our most satisfying successes. They occur every day, throughout the nation, and the National Health Care for the Homeless Council helps to make it happen.

In the last year of my tenure as the Council’s executive director, I am proud to be retiring from an organization with an excellent staff, deeply involved membership, strong financials, and a profound commitment to human rights. Thank you for your investment in this organization, and for your support of our work.

Peace, John N. Lozier, MSSW Executive Director

Message from the President

It is an honor to present the Annual Report of the National Health Care for the Homeless Council. As the Council concludes its 30th year of supporting members and colleagues, we can all appreciate its contributions in identifying and advocating for issues that affect those without homes. These 30 years represent the production of hundreds of publications, the training of thousands of conference attendees, and innumerable hours of technical assistance. Most importantly, its members look to the Council as the best source for guidance and support. This mentorship can be difficult to measure, but it is the commitment of the Council’s members and extraordinary staff that keeps us all dedicated to ending the tragedy of our generation that is homelessness.

All committed to this work acknowledge there will be an end to homelessness in this country. The 3 National Health Care for the Homeless Council will perpetuate the understanding that housing is the prescription for good health care and poor health care is exacerbated by a lack of housing. The answer is simple but the road to get there is complicated. Your time to peruse this annual report and examine the work done by the Council is the first step in our advocacy to reach those who share the same care and concern our members do. I hope that your knowledge of this social determinant that we call homelessness is enriched by this report, and that it motivates you to become involved in the Council.

Kind regards, Doreen Fadus, MEd President 2015-2016 MEMBERSHIP As ofJune30, 2016: Membership 4,482 Total Individuals, Individuals, including including clinicians, clinicians, administrators, administrators, consumers, consumers, students, and and students, others who who others support our our support mission. 2,252 Clinicians’ Network 1,163 HCH Consumer Advisory Advisory National Board behalf of andincludingpeoplewithouthomes. individuals joinedourcause,strengthening ourcollective voice on individual andorganizational members:37organizations and801 Fiscal Year 2016wasthemostsuccessful termonrecord for both nhchc.org/join. investment that principally supportsouradvocacy. Learn more at while organizational membershipduesstartat just$500, amodest breathing life intoeverythingwedo.Individualmembershipisfree, organizations, theCouncil’smembersare thecore of itsidentity, homelessness. Witharapidlygrowing networkof individualsand other stakeholders addressing thenexusof poorhealthand for theHomelessgrantees,MedicalRespite providers, and The Councilisthemembershipassociation for HealthCare 1,067 Respite Care Providers’ Network Organizational Membership 199 151 48 Research Network Practice-Based Other stakeholders Grantees Health Care for the Homeless Organizations, andShelters Centers, National Advocacy Programs, Community Health Subcontractors, MedicalRespite CarePrimary Associations,HCH Puerto Rico 43 states, alongwith D.C. and Total organizations 53 61 across 28states andD.C. Homeless Grantees Health Care for the Total organizations

, including: representing

COMMUNICATIONS 5 Electronic Reach Electronic 564,239 total views of materials at www.nhchc.org at www.nhchc.org of materials views total 564,239 online visitors unique 196,367 fans Facebook 5,140 followers Twitter 1,290

Advance Care Planning for Individuals Experiencing Homelessness Individuals Experiencing Planning for Care Advance Experiencing Homelessness Individuals Case Management for of Vital Role Population: Serving the Homeless Providers Affected Medicaid Expansion How Has the ACA in the HCH Community Buprenorphine Treatment: Medication-Assisted Partners HCH Community & MCO Linking the and Homeless Populations: Managed Care for the HCH Community Resources Funds: Hospital Community Benefit Patients Homeless for Dental & Vision Care Coordination Care Angeles Los 10th Decile Project: Homeless: Houston the Chronically for Care Integrated 120 participants 209 participants participants 144 97 participants a. b. a. b. c. d. a. b. a. b. Recommendations & Resources (July 29,2015) & Resources Recommendations Engaging Youth: Homeless 2016) Partners (April 5, Linking the HCH Community and MCO Populations: and Homeless Managed Care Medicaid Expansion the ACA New Findings on the Impact of Serving Community: Homeless the 2016) (April 16, Foundation) (Kaiser Family 2016) (May 3, in UDS reports Technology of All Do IT: The Role We Homeless Populations to Meet the Needs of Resources Benefit Funding: Potential Community Hospital (July 12, 2016) In Focus: Briefs: Policy and Costs Coverage, Revenues, Analysis of Healing Hands: Permanent Supportive Housing on Profiles Project Diseases Within the Homeless Population to Infectious & Responses Sheet: Prevention Fact the Homeless Projects for Care in Health Satisfaction Patient Quick Guide: Addressing Is Defined and Managed in Rural East TN Model to Examine How Homelessness Using the Social Ecological Solutions Permanent to Advance Advocacy Strategies Emergency: of Homeless States & Services Practices Homeless: Core Who Are Engaging Youth Overview HCH Costing Toolkit Homeless the Chronically for Care Integrated and the Debt Ceiling, Budget Negotiations action alerts on topics including: Raising Five HCH Mobilizer Ending Sequestration. the HCH Community for Advocacy Areas & Homelessness: 16 Key Health Reform the HCH Community the Opioid Crisis: Priorities for Addressing Principles of Statement HCH Advocate the Homeless Community for the Health Care Priorities for Policy Requirements Comments on CMS Hospital Discharge Supportive Housing Services Permanent for Standards Comments on the Joint Commission’s Proposed Smoking in Public Housing of Prohibition Comments to HUD on Proposed Webinars Webinars • • • • • • • • • • • • • • • • • • • • • • • • Publications KEY ACCOMPLISHMENTS learning objectiveswere met. strongly agreed oragreed that 96% of evaluation respondents 96% Organizations Registrants App Users 352 998 514 organizational members Health Care for the Homeless Grantees, and125 Trinity Health System. supported by HRSA,17 supported by the generosity of Leadership Institute,16thSurgeon Generalof theUnitedStates: Founding Director andSeniorAdvisor, TheSatcher Health Keynote presentations by: 514 3,259.25 352 (43%) attendees first-time 434 998 Conference &Policy Symposium: National Health Care for the Homeless Joanne Guarino, Boston MA Art Rios,Portland OR Ellen DaileyConsumer Advocate Award presented to: SanFranciscoMichelle Schneidermann, CA Medical Respite Award for Excellence presented to: Elizabeth Salisbury-Afshar, Chicago IL Karen Rotondo Award for OutstandingService presented to: Jim O’Connell, Boston MA Inaugural PhilipW. BricknerNational Leadership Award presented to: Awards: 3 site visitlocationshosting Travel subsidiesprovided for Mercy HealthSystem /Trinity Health: Chief Accountable Care DevelopmentOfficer –Michigan,St. Joseph Dr. David Satcher New storytelling initiative: interviewed Exclusive performance by comedianPaula Poundstone producing 8hoursoffootage Portland, ORMay 31-June 3,2016 mobile app users produced 90,020 in-appactions organizations represented, including 126 total registrants, CMECredits claimed

180 66

Dr. Paul Harkaway consumers:49 registrants

33 storytellers

KEY ACCOMPLISHMENTS

Regional Trainings

Fall Regional Training: Philadelphia, PA: October 15-16, 2015

94 registrants representing 8 HCH grantees 213 CME hours awarded 99% of learning objectives met 10 consumer subsidies provided

Sessions included: Behavioral Health & Primary Care Integration; Building Successful Community & Academic Collaborations; Accessing Supportive Housing for Your Patients; Empowering the Voice of Consumers; Health Reform & Medicaid Expansion; Homeless Medical Respite; Advocacy 101: How to Affect Policy Change; Homelessness & Other Trauma Experienced in Childhood; Understanding the Current Status of Opioid Dependence in Homeless Populations; and Medical-Legal Partnership 101.

Spring Regional Training: Denver, CO: March 31-April 1, 2016

163 registrants representing 24 HCH grantees 165.5 CME hours awarded 95% of learning objectives met 10 consumer subsidies provided

Sessions included: Improving Outcomes through Cultural Humility; Building a Trauma-Informed Organization; Behavioral Health Integration; Advocacy, Policy Change, and the Health Care for the Homeless Community; Moving Forward & Keeping the Faith in Non-Medicaid Expansion States; Building Bridges with Law Enforcement; Engaging Consumer in Governance; Challenging Cases in Chronic Pain Management; Outreach to Homeless Populations Outside of the City; and Delivering Military-History- 7 Informed Care to Homeless Veterans. KEY ACCOMPLISHMENTS New AccessPoint Applications HCH Operations Trauma-Informed Care Consumer Governance Outreach Strategies Medical Respite Start-up Onsite TA Topics: Legal Entities:1% CarePrimary Associations:3% Government Entities:4% Educational Entities:4% Hospital/Medical Entities:6% Non-HCH Health Centers: 7% Non-Profits/Shelters: 14% Individuals/Other: 33% HCH Grantees: 28% FY15) over increase (21% 386 Technical Assistance (TA) Virtual: 1% Onsite: 3% In-Depth: 24% Direct Referral: 27% General: 42% TA Responses Research Individual ClientNeeds Medical Respite Care Administration Top TA Request Categories Region 7: 1.0% Region 1:3.3% Region 8:4.9% Region 2:5.7% Region 6:7.0% Region 10: 7.2% Region 3:10.3% Region 5:12.1% Region 4:19.0% Region 9:20.2% HHS Regions by NumberofRequests: total TA requests inFY16

FOCUS AREAS

Homelessness is a complex, multi-faceted problem, and the health care response to homelessness must contend with the human mind and body, and with the social and political contexts in which they exist. As such, the Council’s research, clinical and administrative guidance, and policy and advocacy work pertain to a range of topics all aimed to address the unique health needs of people experiencing homelessness and support the transition into permanent housing. Here we highlight a few significant foci of the Council’s work.

Behavioral Health & Opioid Use forefront of advocating for persons experiencing This year saw important achievements in the homelessness as Congress shifts its focus towards Council’s advocacy for changes to the behavioral mental health reform. health system. The Council established five legislative policy priority areas, which included Examining Safety at HCH Sites behavioral health reforms that: reduce barriers The National Consumer Advisory Board (NCAB) to care, treat addiction and mental illness as a finished their biannual Consumer Participation disease, reduce stigma, and link services to housing Outreach Survey (CPO), a consumer-led research and employment. As Congress drafted legislation project designed to learn the concerns and needs addressing the opioid crisis, the Council educated of consumers. We use these data to improve members of Congress by producing three important practices and identify policy changes that would documents on behavioral health reform, addressing help us meet needs more effectively. This survey the opioid crisis, and medication-assisted treatment studied 537 consumers’ perceptions of safety at (MAT). Along with our strategic national partners, six different HCH projects, the results of which the Council’s Policy Team met with members of emphasized that respect is critical to people feeling Congress to advocate for: increased MAT patient safe, and a majority of participants (95%) did feel limits; expanded buprenorphine prescribing rights to they are treated with respect at their HCH project. Nurse Practitioners and Physician Assistants; treating The survey raised a number of important questions addiction as a disease, rather than a criminal activity; about how we define respect, and how we provide and ensuring that homeless populations be given training for staff to create safe environments for our priority consideration within the Comprehensive consumers. It also underscored the need to balance Addiction and Recovery Act of 2016. Complementing safe access for all clients with the reality that many our advocacy with training, the HCH Clinicians’ of our consumers are trauma survivors. NCAB is now Network developed a Healing Hands focusing working with an ad-hoc Safety Task Force comprising on substance use, trauma, mental health, and consumers, providers, administrators, and security 9 homelessness among youth. Moreover, the Council’s staff charged to continue examination of these issues Education Committee formed a Substance Use from a national perspective, cultivating resources for Disorder Work Group in order to assess the needs local HCH projects to apply these lessons to their of the Council’s members and to help develop communities and organizations. better trainings, resources, and other deliverables. Looking forward, the Council continues to broaden Medical-Legal Partnerships its partnerships, including the Mental Health Liaison Criminal and civil legal issues among populations Group, a coalition of more than 66 organizations, experiencing homelessness vary, and if left in order to ensure that the Council will be at the unaddressed, may prolong homelessness. These FOCUS AREAS costs, andadvanced care delivery. To supportthe in HCHandsupport improved outcomes, reduced role incare coordination, outreach, andenrollment Community HealthWorkers (CHWs) canplay a vital Health WorkersCommunity care onhealthcare quality andcost. meant todemonstrate theimpactof medicalrespite Now initssecond year, thisthree-year project is the Centerfor Medicare andMedicaidInnovation. through itsHealthCare Innovation Award fundedby is workingtohelpsustainmedicalrespite programs adhere tothesestandards. Additionally, theCouncil assistance tohelpexistingandnewprograms The Councilcontinues toprovide technical accreditation process for medicalrespite programs. accrediting bodyinaneffort toestablisha formal the standards complete, theCouncilnowseeksan seamlessly withlocalhealthcare systems.With to helpprograms operate safely, effectively, and program standards, whichserveasaframework national expertstodevelopandtestmedicalrespite quality services, theCouncilbrought together respite programs. To helptheseorganizations deliver communities astheyworktoestablishmedical training, andtechnicalassistance tosupport The Councilleadsthefieldinproviding resources, Medical Respite Care individuals experiencinghomelessness. in HCHsettingscanaddress thecivillegalneedsof study howmedical-legalpartnershipsestablished of these surveys,theCouncilwillpursuefundingto records asbarrierstohousing.Basedonthefindings discrimination, IDproblems, legalstatus, andcriminal including landlord issues,evictions,employment had experienced five or more civillegal needs, (40%) of theconsumer respondents stated they they hadexperienced whilehomeless.Fortypercent sample size of consumers aboutcivillegalneeds of theirpatients. Thesecond surveyasked asmall the legalissuesimpactinghealthoutcomes our HCHPractice-Based Research Networkabout health care providers whowere alsomembersof conducted twosurveys,thefirst of whichasked for individualsexperiencinghomelessness. We Agreement agency)toidentifythecivillegalneeds Legal Partnership(anotherNational Cooperative partnered withtheNational Centerfor Medical- an individual’swellbeing.TheCouncilhas Social Determinantsof Health,whichinfluence partners canbeveryhelpfulinaddressing the known ashealth-harmingcivillegalneeds.Legal rather legalneedsthat profoundly affect health, problems are nothealthcare problems perse,but Resource Guide for HCH Programs. HCH for Guide Resource Intersections Health Workers into Primary Care Practice: A A Practice: Care Primary into Workers Health is complemented byaseriesof podcastinterviews, media component totheresource, narrative material seeking toemployCHWs. Addingadynamic,multi- integration strategies that mayassistHCHprojects as wellsuccessful recruitment, supervision,and this guideexplores theresponsibilities of CHWs, themselves, andothersinvolvedintheproject, Incorporating feedback from supervisors,CHWs on theintegration of CHWs into12HCHprojects. Medicare andMedicaidInnovation, whichfocused demonstration project fundedbytheCenter for guide shares insightsfrom theCouncil’sthree-year experiencing homelessness. to care, andpatient experience of TGNC persons issues, unmethealthneeds, barriersandfacilitators pursue fundingtoassessphysical andmentalhealth on establishingandimproving TGNC services and vulnerable, theCouncilwillpublishaguideinFY17 increasing access andqualityof care for themost intersectionality of race. Withourcommitment to rural youthhomelessness,immigration, andthe lesser-known topicssuchasphysicalhealthissues, among LGBTQ homelessyouthandhighlighted resource provided anoverviewof health issues Fund andtheNational LGBTQ Task Force. This their supervisors. contributed toanonlineresource called services for TGNC persons.Inaddition,theCouncil steps toconsider whenestablishingandimproving a panelof transgenderproviders addressing the workshop at the2016National Conference featuring Based ontheseresults, theCouncil provided a implementation, andsustainabilityof theirprogram. to increase ourunderstandingof thedevelopment, specific service models for TGNC personsinaneffort interviewed homelessservice providers whouse this historicallyunderservedpopulation. InFY16we find themselvesunderprepared toadequately treat Council recognizes that healthcenters maystill have gainedmore attention inrecent years,the gender-nonconforming (LGBQ-TGNC) individuals bisexual, queer/questioning,transgenderand While theuniquehealthneedsof lesbian, gay, LGBTQ Homelessness Voices CHW online resource entitled programs, theCouncildevelopedacomprehensive integration of CHWs at HealthCare for theHomeless Over thepast 20years,womenhavebecome one Women Experiencing Homelessness , offering perspectivesfrom CHWs and incollaboration withtheTrue Colors Integrating Community Community Integrating Thisresource At the the At FOCUS AREAS

of the fastest-growing groups within the homeless adversities, including: family rejection, neglect, population, constituting more than one third of and abuse; economic hardship; and difficulties sheltered homeless adults. Though homeless accessing homeless services. Youth experiencing women struggle with high rates of substance use and homelessness are at significant risk of diseases, co-occurring mental and physical health problems, injuries, and developmental delays that can impair systems of care are usually structured to support their functioning, potentially for their entire lives. This men and often leave women out. Confronting this year the Council developed multiple resources to disparity, the Council partnered with the University of help providers engage and serve youth experiencing Massachusetts Medical School (UMMS) to conduct homelessness. Our resource Engaging Youth a national study of women accessing primary care Experiencing Homelessness: Core Practices and in eleven Health Care for the Homeless grantees Services examines practices and services that HCH across nine states. The study confirmed a high grantees have found to be helpful in engaging youth prevalence of substance use and co-occurring experiencing homelessness. To build on this work, mental health problems among women experiencing we dedicated an issue of In Focus, our quarterly homelessness and identified the unique challenges in research review, to behavioral health among youth accessing behavioral health services. We concluded experiencing homelessness. In our home state of that the care delivery necessitates targeted substance Tennessee, we conducted intensive outreach and use treatment services that also address psychiatric education through our TennCare Shelter Enrollment co-morbidities, physical and sexual violence, Project, which is an effort to ensure that children and domestic violence, risky sex behaviors, child care, youth living in shelters have health care coverage and social support services. Having presented these and receive appropriate health care screenings results at the 2016 National HCH Conference, the and primary care. We also expanded our reach by Council has also accepted an invitation to present partnering with the School-Based Health Alliance them at the 9th Annual International Women’s and and National Network for Youth to educate a Children’s Health and Gender Group Conference. broader constituency on the health needs of youth Using the data from this study, we will develop a experiencing homelessness. 11 special issue fact sheet and pursue a larger grant with UMMS to develop and implement an intervention for Medicaid Managed Care substance use disorders within this population. The Council made significant strides in addressing the implications of Medicaid Managed Care Youth Experiencing Homelessness on Health Care for the Homeless, primarily by Youth without homes represent one of the largest developing strategic partnerships with MCOs. We subgroups of the overall homeless population collaborated with UnitedHealthcare, for example, to in the US. In addition to their experiences with publish a policy brief and host a webinar describing unstable housing, most have faced a number of managed care plans and illustrating the shared 12 FOCUS AREAS supportive housing. aimed tostrengthen theintersectionof healthand several trainingshostedby CSHandtheCouncil on theidentifiedservice gaps.Thiswasone of populations andasubsequenttrainingbased Health CenterinvolvementinservingOlmstead also includedaNeedsAssessmentmeasuring the core. TheCouncil’spartnershipwithCSH housing-first model,withhealth centers at community hasincorporated healthintotheir promising practices, andevaluation plans.Each with housingfirstprograms todiscusschallenges, exchange bringingtogetherfour communities area, CSHandtheCouncilcreated avirtualpeer engage healthcenters ineachother’sworkthis have impactedtheircommunities. To more closely resources, thepartnersinvolved,and how they and Orlandowere initiated, theirapproach and initiatives inLos Angeles,Houston, AnnArbor, provide anoverviewof howfrequent user partnerships around thecountry. Theprofiles project profiles highlightinghealthand housing the CouncilandCSHproduced aseriesof four Housing (CSH).Inthiscontinued collaboration, subcontractor for theCorporation for Supportive This wastheCouncil’ssecond yearasa Permanent Supportive Housing assessments. social determinantsof healthare includedinrisk capacity for services isdetermined,andhow care, howreimbursement rates are set,how to howmanagedcare covers institutional managed care; ourchallengestoCMSpertained and MedicaidServices’ draft regulations of to submitcomments on theCenterfor Medicare the Counciltookadvantageof theopportunity our services for peoplewithouthomes.Finally, finding common ground andenhancing all of this gathering wasanunprecedented steptoward presumed tocontradict oneanother, andthus interests of thesestakeholders are sometimes including hospitalsandotherpolicymakers. The HCH leaderswere joinedbyotherstakeholders and otherworkshopsinPortland where MCO and conversation at afull-dayPreconference Institute housing). TheCouncil’spolicyteamexpandedthis management, medicalrespite care, andsupportive and healthoutcomes (e.g. investmentsincase local level,ultimately yielding better-qualitycare collaborations willfoster closerrelationships at the goals of HCHprograms. We anticipate these celebrations of survival andresilience, andthe This year, three HCHprojects hostedsuch struggle for justice. draw inspiration from themaswecontinue inthe fitting timetohonortheir accomplishments andto The SummerSolstice, adayfilledwithlight,is housing that allowsthemtoreclaim theirlives. incredible hurdles, findingaccess tostable poverty. Yet someindividualssurmountthese programs, allcomplicated bypoorhealthand to lowwagesandinadequate publicassistance systemic barriers,from thehighcost of housing homelessness. People withouthomesface many homeless, yetitisnoeasytasktobreak outof We knowthat itisfartooeasytobecome can endhomelessnessfor everyone. homelessness, andtoaffirm that asasocietywe those whohaveovercome theirindividual longest dayof theyear),theybegantocelebrate Thus, onJune21(thefirstday of summer and but rather thehopethat we canendinjustice. that our fight for justice comes notfrom despair, counterpoised eventencouraging ustoremember Care for theHomelessinNewYork organized a while enduringhomelessness.Afew yearsago, has honored individualswhohavelosttheirlives tradition occurring onthewintersolstice that Homeless Person’s MemorialDay, a20-year Most intheHCHcommunity are familiarwith and Resilience Solstice: HonoringSummer Strength STORIES OF IMPACT Its HCH Pioneers , an ongoing video series that debuted video series that , an ongoing HCH Stories HCH Movement the Chronicling the Council in June 2016, Conference At its National a half-day session called organized allowing participants to claim and communicate their their communicate claim and to participants allowing transformative on the reflecting while experiences and lives, perspectives, the field on their of influence health. the foundation formed stories have These powerful of online on HCH Day, August 10th, with a tale of tragedy 10th, with a tale of August online on HCH Day, is It New York. Calvin Alston from from and recovery these video vignettes that the Council the hope of personal perspectives participants’ will not only share the critical of but also help build awareness on HCH, experiencing people lives of HCH in the impact of homelessness. purpose was to document the 30-year history of history of purpose was to document the 30-year to its seminal according the Homeless for Health Care the on where leaders, with additional reflections filmed the session movement is headed. The Council a every moment and inform for to account in order document. proceedings professionally-composed by punctuated discussions were Roundtable first HCH the for those responsible from presentations example, the most For the country. across programs described her “pioneer” Marianne Savarese tenured St. Vincent’s Philip Brickner at tutelage under the late the for Brickner is credited Dr. Hospital in New York; still informs that care the HCH model of of inception at which he was honored for practices, present-day Leadership new National with a the 2016 Conference ranks as these from Marianne rose in his name. Award in HCH program a nurse and now leads the exemplary New Hampshire. Manchester, presentations—with After rich discussion and more young people in a hearteningly high number of took to the podium to Lozier attendance—John adjourn the meeting. But logistics gave way to as the of his tenure as John took stock reflections pointing to his Director, Executive Council’s founding on his As he reflected 2016. in December retirement (having peace for desire perpetual and foundational Viet to Agent Orange poisoning in lost his brother Nam), John was uncharacteristically moved to tears, His in the room. dry eyes remained which few after and ovation met with a rousing were closing words a new scholarship leaders of Board from presentation in his name. It was a deeply meaningful way to mark conference. John’s achievements and his final HCH explore the past and address the future of HCH. In moving sessions— stories told through smiles and In moving sessions— stories told through journeys personal related tears alike—participants treating homelessness to housing, tales of from consumers, of and bearing witness to the resilience of the 19-city the first days from and reminiscences HCH Trust Memorial Johnson/Pew Wood Robert The empowering video Program. Demonstration HCH, the power and values of interviews illustrated The Power of Storytelling of Storytelling The Power a is the story of the Homeless for Health Care to thousand stories, and the Council endeavored HCH National 2016 its at tales those of few a illuminate In a unique digital Symposium. & Policy Conference Consumer assisted by the National storytelling initiative Storytelling Committee, HCH Stories, Advisory Board service administrators, the Council invited consumers, their personal stories to share and advocates providers, of the Homeless. Over the course for Health Care of the United States across from two days, 33 attendees on-camera with Council their experiences shared to contribute Manager Rick Brown Communications HCH. to the oral history of Council supported the event for the first time through the first time through Council supported the event for The Council communications. our nationwide these events as important opportunities to perceives those who have overcome highlight the stories of us the hope homelessness despite the odds, giving to create together we can find the strength that everyone. for the political will to end homelessness all HCH grantees and organizational encourage We the next Summer Solstice! members to celebrate FINANCES $2,812,251 $2,697,066 Programs 80.9% 76.8% Grants Membership Advocacy $118,035 $164,675 3.4% 4.7% Dues Total Expenses: $3,477,324 Total Revenue: $3,510,266 Individual Gifts Membership $66,306 $48,218 Corp & Corp 1.9% 1.4% Program Income Development $104,401 $569,710 16.2% 3.0% Administration $394,419 $12,509 11.3% 0.4% Other DONORS The advocacy and operations of the National Health Care for the Homeless Council were supported by the generosity of these individuals and institutions. Thank you! Gifts made between July 1, 2015 and June 30, 2016.

Adele Cohen Edwin Dellert Kristin Hasson Patricia Jassak Alexis Weinstein Elizabeth Buck Lara Shew Patricia Post Alfonsina Truchan Elizabeth Swann Laurie Haworth Patrick Cavanaugh Alice Brickner Erica Kruse Lee Carroll Patrick Perri Amber Roth Erin Schwarz Leslie Tallyn Pearline Byrd AmeriCares Eve Wilson Leticia Bresnahan Philip Dombrowski Amy Grassette Evelyn Calhoun Lily & Jay Catalano Pooja Bhalla Amy Pisman Frances Isbell Linda Baer Rachael Hunsucker Amy Romanoff Frank Berry Linda Masiello Raj Chablani Amy Sparks Fred Karnas Linda Stone Randal Pinnelli Andrea Harshman Friederika Poulos Lindsay Nelson Randall Jacobs Anne Grupe Gail Triggs Lisa Navracruz Rebecca DeVivo Annie Mcalmon Gary Cobb Loretta Aloi Reece Pierce Annie Nicol Gayla Bruner Lynne Callea Rhonda Hauff Ansell Horn Gordon Bonnyman Marcia Jackson Rhonda Mendoza Apatow Mann Family Gregory Morris Margaret Farkas Rhonda Metzler Foundation Greselda Butler Margaret Hobbs Rick Brown Arthur Sutherland Gretel Greenhouse Maria Elisa J Obias Robert Oermann Association for Continuing Education in the Health Heidi Nelson Marian Pena Robyn Snyder Professions Henry Kumpf Marianne Savarese Roland Arthur Avik Chatterjee Howard Angela Marion Scott Rose Dunn Barbara Conanan Iris Pressman Marita Rice Rosemary Shugar Barbara DiPietro Janet Schultz Mark Casanova Roxanne Bolinger Barbara Huffman Janey Mcgarry Mark Fox Ruth Cohen Barry Bock Jean Hochron Mark Giese Sabrina Edgington Bob Donovan Jeff Singer Marlene von Friederichs- Samantha Williams Bobby Watts Jennifer Alessi Fitzwater Sandra Mohr Bonnie Bixler Jennifer Hyvonen Mary Ales Sara Fagerlie Brian Bickford Jennifer Metzler Mary Ellen Benzik Sarah Anderson Brooks Ann McKinney Jennifer Nelson-Seals Mary Grantner Scott Orman Carla Brink Jeri Foley Mary Lowe Sharon Cathcart Carol Murphy Jerri Davis Marybeth Shinn & David Sharon Popielewski Carrie Fields Jessie Gaeta Krantz Sheila Crowley Chauna Brocht Jim Torres Maureen Neal Sigrid Olson Chiara Marin Joanne Rolls Meera Beharry Siobhan Joan Dolan Community Foundation of Joceline Lemaire Melissa Carter Stacey Davidson Middle Tennessee John Gilvar Melville Charitable Trust Steven Casebeer Concept Technology John Lovejoy Michael Durham Steven Folstein Conrad Hilton Foundation John Lozier Michael Porter Steven Hurdle Crissy Zitka John Prendergast Michelle Nance Sue McGuinness Curtis Stauffer Joseph Benson Monica Moore Suzanne Ziemnik Cynthia Cisneros Joseph Mega Monique Johnson Ted Amann Damon Marquis Judith Ribble Monique Lemaire Thomas Fontana David Modersbach Julia Zur Nakisha Kinlaw Thomas Hanson Dean Beals Julie Kozminski Nancy Elder Timothy Holder Dean Parry Julie Loomis Nancy Hanson Timothy Johnson 15 Debbian Fletcher-Blake Julie Tagliareni Nancy Hostetter Tina Hayes Deborah Walsh Justin Gorinson Nancy Klingle Tom & Andrea Tatlock Debra Mahan Karen Batia Neil Donnelly Tom Andrews Destry Sulkes Kathleen Orsetti Nicholas Apostoleris Trinity Health Diane Murad Keith McCormish Noyah Natural Cosmetics Valarie Dowell Diane Simmons Kevin Lindamood Odette Spencer Victor Hatcher Dion Richetti Kevin Nagengast Pamela Atkinson Vincent Keane Doreen Fadus Kimberle Morrison Pamela Mason Wayne Anderson Doug Van Ramshorst Kimberly Corbin Pamela Root Will Cheek Ed Stellon Kresge Foundation Patricia Deshields 16 ORGANIZATIONAL MEMBERS In good standing as of June 30, 2016 Peak VistaCommunity HealthCenters: Metro CommunityProvider Network: Englewood Colorado Coalitionfor theHomeless: Denver Association of GospelRescue Missions: Ascending toHealthRespite Care: ColoradoSprings Colorado West CountyHealthCenters:Guerneville Ventura CountyPublic Health:Ventura Venice Family Clinic:Venice Tom Waddell HealthCenter:SanFrancisco St. John’sWell Child&Family Center:Los Angles Fairfield Solano CommunityHealth&SocialServices Dep.: Shasta CommunityHealthCenter:Redding Share OurSelves:CostaMesa Santa CruzCo.HomelessPersons Health Project: Santa BarbaraCo.PublicHealthDepartment: San Mateo MedicalCenter:SanMateo San Francisco CommunityClinicConsortium: Sacramento Sacramento Co.HealthCare for theHomeless: Ritter Center:SanRafael Petaluma HealthCenter:Petaluma Northeast Valley HealthCorporation: SanFernando National HealthFoundation: Los Angeles Mendocino CommunityHealthClinic:Ukiah Marin CityHealthandWellness Center:Sausalito Los Angeles ChristianHealthCenters:Los Angeles JWCH Institute:Los Angeles Illumination Foundation: Irvine Homeless HealthCare Los Angeles:Los Angeles Health toHopeClinics:Riverside Gardner Family HealthNetwork:Alviso Family HealthCentersof SanDiego:Diego Elica HealthCenters:Sacramento Contra CostaCountyHealthServices: Martinez Clinica DeSaludDelValle DeSalinas:Salinas Center for theVulnerable Child:Oakland Care Link,CommunityMedicalCenters:Stockton Oakland Alameda CountyHealthCare for theHomeless: Adventist Health–CentralValley Network:Hanford California Maricopa CountyDepartmentPublicHealth:Phoenix Circle theCity:Phoenix Arizona Whatley HealthServices: Tuscaloosa National AidsHousingCoalition:Birmingham Franklin Primary HealthCenter:Mobile Community Wellness Coalition: Montgomery Alabama Regional MedicalServices: Birmingham Alabama Colorado Springs Colorado Springs Santa Cruz Santa Barbara San Francisco Tulane Drop-In Health Services: NewOrleans Health Care for theHomeless:NewOrleans Louisiana Mountain Comprehensive Care Center:Paintsville Richmond Kentucky RiverFoothillsDevelopmentCouncil: Kentucky MountainHealthAlliance: Hazard Family HealthCenters—Phoenix:Louisville Bluegrass CommunityHealthCenter:Lexington Kentucky Grantham UniversityCollegeof Nursing:Lenexa Kansas Community HealthCare, Inc.:Davenport Iowa Regional MentalHealthCenter:Hammond LifeSpring HealthSystems: Jeffersonville HealthNet: Indianapolis Indiana The Boulevard: Chicago Lawndale ChristianHealthCenters:Chicago Heartland HealthOutreach: Chicago Central CountiesHealthCenters:Springfield Aunt Martha’sYouth Service Center: Aurora Illinois Dirne HealthCenters:Coeurd’Alene Idaho Mercy Care: Atlanta JC Lewis PrimaryHealthcare Center:Savannah First Choice PrimaryCare: Macon Georgia Tampa Family HealthCenters:Tampa Neighborhood MedicalCenter:Tallahassee IM SulzbacherCenterfor theHomeless:Jacksonville Genesis CommunityHealth:BoyntonBeach Community Healthof SouthFlorida:Miami CL BrumbackPrimaryCare Clinics:PalmSprings Camillus HealthConcern: Miami Broward Health:FortLauderdale Brevard HealthAlliance: Melbourne Florida Unity HealthCare National Low Income HousingCoalition Christ House District of Columbia Community HealthCenter, Inc.:NewHaven Columbus House:NewHaven Charter OakHealthCenter:Hartford Generations Family Health Center:Willimantic Connecticut ORGANIZATIONAL MEMBERS Mississippi Health Center: Jackson-Hinds Comprehensive Jackson Missouri Kansas City Health Services: Swope Montana Helena Association: Montana Primary Care Riverstone Health: Billings Nevada Reno Community Health Alliance: Reno Northern Nevada HOPES: New Hampshire Bow Association: Primary Care Bi-State Portsmouth Seacoast: the Greater First of Families Harbor Homes: Nashua Manchester the Homeless: for Health Care New Jersey Atlantic City Health Services: Atlanticare Amboy Perth Foundation: Jewish Renaissance Health & Community Wellness: Newark Dep. of Newark Hope: Camden Project New Mexico the Homeless: for Health Care Albuquerque Albuquerque Health: Espanola Family El Centro Albuquerque Community Healthsource: First Nations the Homeless: Santa Fe for Health Care La Familia Albuquerque Association: Primary Care New Mexico Santa Fe Medical Services: Presbyterian Clinic: Las Cruces Health Care St Luke’s Minnesota Hennepin County: Minneapolis St. Paul Community Health Services: Side West Michigan Advantage Health Centers: Detroit Cherry Health: Grand Rapids Detroit Covenant Community Care: Central City: Detroit Detroit Flint Genesee Health System: Network: Pontiac Healthcare Oakland Integrated Health: Livonia Trinity Massachusetts Bridgewell: Lynnfield Needham Social Innovation: Center for Community Health Connections: Fitchburg Community Healthlink: Worcester Duffy Health Center: Hyannis Lexington Eliot Community Human Services: Health Center: Lawrence Family Lawrence Greater Homeless Program: the for Boston Health Care Boston Boston Without Walls: Health Care the Homeless: for Medical Health Care Mercy Springfield Maryland Inc.: Baltimore the Homeless, for Health Care Services: Health & Human Montgomery Co. Dep. of Rockville Community Health Centers: Assn of National Bethesda Maine Sanford Nasson Health Care: Community Health Center: Portland Portland 18 ORGANIZATIONAL MEMBERS Migrant HealthCenterWestern Region: Mayaguez Puerto Rico Public HealthManagement Corporation: Philadelphia Project HOME: Philadelphia Primary Care HealthServices: Pittsburgh Desales Free Clinic:CenterValley Pennsylvania Wallace MedicalConcern: Portland Outside In:Portland Central CityConcern: Portland Coast CommunityHealthCenter:Bandon Oregon Community HealthCenters,HealingHands: Oklahoma Samaritan HomelessClinic:Dayton PrimaryOne Health:Columbus Cincinnati HealthNetwork:Cincinnati Center for Respite Care: Cincinnati Care Alliance HealthCenter:Cleveland Ohio Family Healthcare Center:Fargo North Dakota Western NCCommunityHealthServices: Asheville Piedmont HealthServices: Carrboro National Centerfor HomelessEducation: Lincoln CommunityHealthCenter:Durham Haywood Street Respite: Asheville Asheville Appalachian MountainCommunityHealthCenters: North Carolina Urban Pathways: NewYork The Institutefor Family Health:NewYork Cornwall The Greater HudsonValley Family HealthCenter: The Bridge:NewYork Project Renewal: NewYork NYU LutheranFamily HealthCenters:Brooklyn New York Children’s HealthProject: NewYork Neighborhood HealthCenter:Buffalo Janian MedicalCare: NewYork Harlem United:NewYork Daman Family Care Centers:Briarwood Corporation for SupportiveHousing:NewYork Comunilife: NewYork Care for theHomeless:NewYork Brightpoint Health:NewYork New York Oklahoma City Browns Summit Wyoming PrimaryCare Association: Cheyenne Casper Community ActionPartnership of Natrona County: Wyoming Partnership CommunityHealthCenter:Menasha Outreach CommunityHealthCenter:Milwaukee Wisconsin Yakima NeighborhoodHealth:Yakima Neighborcare Health:Seattle Seattle Health Care for theHomeless NetworkKingCounty: Cowlitz Family HealthCenter:Longview Washington Southeastern Virginia HealthSystem: NewportNews The DailyPlanet:Richmond Virginia Community HealthCentersof Burlington:Burlington Vermont Mountainlands CommunityHealthCenter:Provo Midtown CommunityHealthCenter:Ogden Fourth Street Clinic:SaltLake City Association for UtahCommunityHealth:SaltLake City Utah True Worth: FortWorth Metro DallasHomelessAlliance: Dallas JPS HealthNetwork:FortWorth Heart of Texas CommunityHealthCenter:Waco Health Care for theHomeless–Houston:Houston Harris HealthSystem: Houston Harmony House:Houston El Centro DelBarrio:SanAntonio Communitycare: Austin Bee BusyWellness Center:Houston Texas Tennessee PrimaryCare Association: Nashville Safe HavenFamily Shelter:Nashville Neighborhood Health:Nashville Hamilton CountyHealthDepartment:Chattanooga Christ CommunityHealthServices: Memphis Cherokee HealthSystems: Knoxville Tennessee Community HealthCenter:SiouxFalls Community HealthCenterof theBlackHills:RapidCity South Dakota South Carolina PrimaryHealthCare Assn:Columbia New Horizon Family HealthServices: Greenville South Carolina 2016 BOARD OF DIRECTORS Kevin Lindamood, MSW MSW Lindamood, Kevin PRESIDENT-ELECT the for Health Care Inc. Homeless, MD Baltimore, MSW Ann McKinney, Brooks Mission Hospital Asheville, NC MPH Jennifer Metzler, TREASURER for Care Health Albuquerque the Homeless NM Albuquerque, David Modersbach, BA Alameda County Health Care the Homeless Program for Oakland, CA Heidi Nelson, MHSA Duffy Health Center Hyannis, MA MSHRM Jennifer Nelson-Seals, The Boulevard Chicago, IL BSN RN, Marianne Savarese, the for Health Care Homeless - Manchester NH Manchester, EdD Linda Son-Stone, Community First Nations Healthsource NM Albuquerque, MA, CADC MS, Ed Stellon, Heartland Health Outreach Chicago, IL MPH MD, Barb Wismer, Urban Waddell Tom Health Clinic CA San Francisco, Mark Fox, MD, PhD, MPH PhD, MD, Mark Fox, School Oklahoma of University Medicine Community of OK Tulsa, MDiv Bill Friskics-Warren, Neighborhood Health Nashville, TN Jessie Gaeta, MD the for Boston Health Care Homeless Program Boston, MA NP Dana Gamble, MPH, Santa Barbara County Public Health Department of Santa Barbara, CA Amy Grassette Health Center Family MA Worcester, MBA MD, Paul Gregerson, Institute JWCH Angeles, CA Los Reginald Hamilton, JD Advantage Health Centers MI Detroit, Iacino B.J. Colorado Coalition for the Homeless CO Denver, Isbell, MA Frances SECRETARY the for Health Care Homeless - Houston Houston, TX PHN Paul Leon, RN, Foundation Illumination Irvine, CA Francis Afram-Gyening, MPH, MPH, Afram-Gyening, Francis MBA, FACHE Alliance Care OH Cleveland, RN Amann, MPH, Ted Central City Concern OR Portland, MBA PhD, Nicholas Apostoleris, PRESIDENT PAST IMMEDIATE Health Center Mountain Area PhD Batia, Karen Associates Health Management Chicago, IL Joseph Benson, CHW the for Health Care Homeless - Houston Houston, TX RN Pooja Bhalla, MSN, the for Boston Health Care Homeless Program Boston, MA Gary Cobb Central City Concern OR Portland, MS Barbara Conanan, RN, NYU Lutheran Community Medicine Program NY New York, Brandon Cook, BA Family New Horizon Health Services SC Greenville, MEd Fadus, Doreen PRESIDENT Medical Center Health Mercy the Homeless for Care Springfield, MA National Health Care for the Homeless Council PO BOX 60427 Nashville, TN 37206 office (615) 226-2292 • fax (615) 226-1656

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