Runaway and Homeless Youth Act: Current Issues for Reauthorization Adrienne L. Fernandes-Alcantara Specialist in Social Policy October 23, 2014 Congressional Research Service 7-5700 www.crs.gov R43766 Runaway and Homeless Youth Act: Current Issues for Reauthorization Summary The Runaway and Homeless Youth program is authorized by the Runaway and Homeless Youth Act, and funds organizations throughout the country to provide services to youth who have run away and/or experience homelessness. The program, which is administered by the U.S. Department of Health and Human Services (HHS), includes three components: (1) the Basic Center program (BCP), which provides outreach, temporary shelter, and counseling for up to 21 days to youth under age 18 who have run away or are homeless; (2) the Transitional Living program (TLP), which supports residential services and services to youth ages 16 through 21 for up to 18 months; and (3) the Street Outreach program (SOP), which provides street-based outreach and education—including treatment and referrals—for runaway and homeless youth who have been subjected to sexual abuse and exploitation or are otherwise on the street. Funding authorization for the programs expired on September 30, 2013. The federal government, led by an independent agency known as the U.S. Interagency Council on Homelessness (USICH), has developed a plan for ending youth homelessness. In 2010, USICH released Opening Doors, which included goals of ending chronic homelessness and homelessness among youth and other specified populations. An amendment to the plan in 2012 specifically introduced the Federal Framework to End Youth Homelessness, which includes improved data collection on these youth and developing and testing effective intervention models. This plan is consistent with the 2008 reauthorization of the Runaway and Homeless Youth program, which directed HHS to estimate the number of youth who have run away or are homeless and to assess the characteristics of these youth. Congress may wish to determine whether actions taken by HHS and its partners are addressing the data requirements in the law. Related to this, little is known about the outcomes of youth who participate in programs funded under the act. Congress may also be interested in the extent to which the Runaway and Homeless Youth program should more actively engage the families of runaway and homeless youth. Family conflict is a primary reason why youth leave home or are forced to leave home. The Runaway and Homeless Youth Act addresses family relationships primarily through the BCP. Some providers have models for helping build stronger connections between youth and their families. Another issue that may be of interest is demand. The programs serve a small fraction of the overall number of youth believed to be runaway or homeless, and the number of youth turned away from the BCP and TLP due to a lack of capacity has ranged from about 9,000 to 11,000 annually. Advocates assert that additional funding is needed to serve more youth, particularly because other federal funding sources for homeless service are believed to be limited. For example, the Continuum of Care (CoC) program directs homeless service providers to coordinate with runaway and homeless youth providers; however, CoC funding may not be available to some Runaway and Homeless Youth program grantees that are already not CoC funded. Finally, runaway and homeless youth tend to have multiple challenges. Congress may consider the role that the Runaway and Homeless Youth Act could play in meeting the specific needs of youth who identify as lesbian, gay, bisexual, transgendered, or questioning (LGBTQ); youth who are sex trafficked; and youth who are or were engaged in foster care or the juvenile justice system. For example, recent research on LGBTQ youth suggests that some RHY providers have difficulty identifying this population and could benefit from technical assistance for serving them effectively. In addition, runaway and homeless youth appear to be vulnerable to sex trafficking and some have a history of such victimization. The act could be amended to ensure that training and technical assistance is available to RHY providers to assist particular groups of youth. Congressional Research Service Runaway and Homeless Youth Act: Current Issues for Reauthorization Contents Introduction...................................................................................................................................... 1 Background ...................................................................................................................................... 2 Federal Efforts to Address Preventing and Ending Youth Homelessness ........................................ 4 HHS Report to Congress ........................................................................................................... 5 U.S. Interagency Council on Homelessness: Opening Doors ................................................... 5 Estimates and Demographic Information on Runaway and Homeless Youth ................................. 8 Background................................................................................................................................ 8 Point-in-Time Estimates ............................................................................................................ 9 Coordinating Existing Data Systems ....................................................................................... 11 National Study on Prevalence of Youth Homelessness ........................................................... 13 Youth Connection with Their Families .......................................................................................... 13 Program and Youth Outcomes ....................................................................................................... 16 Current Evaluation of the Program.......................................................................................... 16 Evaluation of Interventions Generally ..................................................................................... 17 Access to Funding.......................................................................................................................... 18 Program Funding Over Time ................................................................................................... 19 Continuum of Care (CoC) Program Funding .......................................................................... 21 Vulnerable Populations .................................................................................................................. 23 LGBTQ Youth ......................................................................................................................... 23 Sexually Trafficked Youth ....................................................................................................... 25 High-Risk Youth ...................................................................................................................... 28 Interaction with Child Welfare and Juvenile Justice Systems ................................................. 29 Figures Figure 1. Overview of the Three Major Programs Authorized Under the Runaway and Homeless Youth Act ..................................................................................................................... 3 Figure 2. United States Interagency Council on Homelessness (USICH) Data and Capacity Strategies for Ending Youth Homelessness by 2020 ..................................................... 7 Figure 3. Total Funding for the Runaway and Homeless Youth Program ..................................... 21 Tables Table 1. Number of Youth Turned Away at Basic Center Program and Transitional Living Program, FY2007-FY2013 ......................................................................................................... 19 Table 2. Runaway and Homeless Youth Program Appropriations, FY2001-FY2014 (as enacted)....................................................................................................................................... 20 Table A-1.Proposed Performance Standards for the Runaway and Homeless Youth Program ...................................................................................................................................... 31 Congressional Research Service Runaway and Homeless Youth Act: Current Issues for Reauthorization Appendixes Appendix. Proposed Monitoring and Outcomes for the Runaway and Homeless Youth Program ...................................................................................................................................... 31 Contacts Author Contact Information........................................................................................................... 32 Congressional Research Service Runaway and Homeless Youth Act: Current Issues for Reauthorization Introduction The Runaway and Homeless Youth program is the largest targeted federal program that provides assistance to youth under age 23 who are homeless or have run away. The program was established by the Runaway Youth Act as Title III of the Juvenile Justice and Delinquency Prevention Act of 1974 (JJDPA; P.L. 93-415), and has since been amended nine times. Amendments to the act in 1977 (P.L. 95-115) renamed the act the Runaway and Homeless Youth Act, which was expanded to include homeless youth. The act was most recently authorized, from FY2009 through FY2013, by the Reconnecting Homeless Youth Act of 2008 (P.L. 110-378).1 As currently enacted, the program includes three components: the Basic Center program (BCP), which provides short-term services for youth under age 18; the Transitional Living program (TLP), which provides housing and supports for youth ages 16 through 22; and the Street Outreach program (SOP)—referred to in statute as the Sexual Abuse Prevention program—which serves youth living on the streets and provides referral services. In FY2014, appropriations for the program totaled $114.1 million. The House Committee on Education and the Workforce and the Senate Judiciary Committee have exercised jurisdiction over the RHY program. Bills were introduced in the 113th Congress to amend the Runaway and Homeless Youth Act. One of the bills, the Runaway and Homeless Youth Trafficking Prevention Act (S. 2646), would reauthorize the act. On September 18, 2014, the Senate Judiciary Committee reported the bill out of committee.2 The bill would reauthorize the act from FY2015 through FY2019 and make other changes. This report provides background on the federal response to runaway and homeless youth (RHY), including steps taken by federal agencies to end youth homelessness. Following this discussion is an overview of issues that may be relevant if Congress takes up reauthorization of the act. These issues are grouped as follows: • demographic and other data on runaway and homeless youth; • effectiveness of programs that serve this population; • efforts to connect RHY with their families; • access to and funding for the program; • supports for vulnerable RHY populations, including youth who are lesbian, gay, bisexual, transgendered, or questioning (LGBTQ); those who have been victims of sex trafficking or are at risk for sex trafficking; and those who have other risk factors; and • interaction between the RHY system and child welfare and juvenile justice systems. 1 The program has been reauthorized five times, and is codified at 42 U.S.C. §5701 et seq. In the September 18, 2014 markup of the bill, the Senate Finance Committee approved amendments that separately amend other laws, including (but not limited to)—Section 404(b) of the Missing Children’s Assistance Act; Section 3702 of the Crime Control Act of 1990; Sections 1591, 1594, and 2516 and Chapter 201 of Title 18 of the U.S. Code; Sections 103(10), 107(f), and 203 of the Trafficking Victims Protection Act of 2000; and Section 212 and Section 214 of the Victims of Child Abuse Act. As of the publication date of this report, two other bills have been introduced that would amend the Runaway and Homeless Youth Act: the Runaway and Homeless Youth Inclusion Act of 2013 (H.R. 2955) and the Enhancing Services for Runaway and Homeless Victims of Youth Trafficking Act of 2014 (H.R. 5076); and Runaway and Homeless Youth and Trafficking Prevention Act (S. 2646). 2 Congressional Research Service 1 Runaway and Homeless Youth Act: Current Issues for Reauthorization The Appendix provides an overview of accountability standards that have been drafted as part of a proposed rule for the Runaway and Homeless Youth program.3 The report is a companion to CRS Report RL33785, Runaway and Homeless Youth: Demographics and Programs, which provides detailed information about the program. Background Since at least the Great Depression, the federal government has responded to the needs of youth who were homeless or transient in some capacity. Depression-era programs for vulnerable youth focused on providing employment services, primarily through the Civilian Conservation Corps program; employment centers; and aid in the form of housing and basic provisions.4 Separately, the Social Security Act of 1935 (P.L. 74-231), as Definitions of Homelessness and Related Terms Under originally enacted, authorized the Runaway and Homeless Youth Program indefinite funding for states “Homeless Youth” (for purposes of the BCP): An individual under age to establish and expand 18 (or an older maximum age if the BCP center is located in a state or services under the Child locality with a law or regulation that permits a higher maximum age in Welfare Services program compliance with licensure requirements for child- and youth-serving facilities) “for the protection and care for whom it is not possible to live in a safe environment with a relative and who has no other safe alternative living arrangement. of homeless, dependent, and neglected children, and “Homeless Youth” (for purposes of the TLP): An individual age 16 through 21 (or older so long as the participant entered the TLP prior to children in danger of reaching age 22) for whom it is not possible to live in a safe environment with becoming delinquent.” This a relative and who has no other safe alternative living arrangement. law and others addressed “Runaway Youth”: An individual under age 18 who leaves home or a place youth running away from of legal residence without the permission of a parent or legal guardian. home; however, they did not focus on providing services, “Street Youth:” Runaway youth or youth who are indefinitely or intermittently homeless and spend a significant amount of time on the street or did so on a limited basis. or in other areas that increase the risk to these youth for sexual abuse, The Runaway Youth Act, sexual exploitation, prostitution, or drug abuse. enacted in 1974, was the first Source: Section 387 of the Runaway and Homeless Youth Act. law to authorize dedicated funding to runaway youth. As currently enacted, the three programs under the Runaway and Homeless Youth program—the Basic Center program, Transitional Living program, and Street Outreach program—target distinct but overlapping populations and serve youth in different settings. Each of these programs competitively awards grants to nonprofit organizations. 3 On April 14, 2014, HHS issued a proposed rule on performance standards. It also includes other proposed changes to the regulations. U.S. Department of Health and Human Services (HHS), Administration for Children and Families (ACF), “Runaway and Homeless Youth Program; Proposed Rule,” 79 Federal Register 71, April 14, 2014. See proposed changes to §1351.1, §1351.10, and §1351.19. (Hereinafter HHS, ACF, “Runaway and Homeless Youth Program; Proposed Rule,” 79 Federal Register 71, April 14, 2014.) 4 Eric Beecroft and Seymour Janow, “Toward a National Policy for Migration,” Social Forces, vol. 16, no. 4 (May 1938), p. 477. Congressional Research Service 2 Runaway and Homeless Youth Act: Current Issues for Reauthorization • The BCP is available to youth under age 18 and provides short-term shelter and other assistance to both youth and their families. BCP grants are awarded by a formula that distributes funding based on child population in each state and territory. • The TLP provides assistance to youth ages 16 through 21 with longer-term residential and other services. • The SOP engages runaway and homeless youth who live on or frequent the streets by providing counseling and referrals. See Figure 1 for further detail. The Runaway and Homeless Youth program also supports a tollfree hotline so that runaways can learn about services in their communities; grants for services in rural communities; research and evaluations; and training and technical assistance. The program is administered by the Family and Youth Services Bureau (FYSB) in the U.S. Department of Health and Human Services’ (HHS) Administration for Children and Families (ACF). Figure 1. Overview of the Three Major Programs Authorized Under the Runaway and Homeless Youth Act Source: Congressional Research Service (CRS), based on the Runaway and Homeless Youth Act. Congressional Research Service 3 Runaway and Homeless Youth Act: Current Issues for Reauthorization The Reconnecting Homeless Youth Act of 2008 (P.L. 110-378) most recently reauthorized the Runway and Homeless Youth program through FY2013 (September 30, 2013). The law amended multiple provisions including those that address funding for the program, requirements for grantees that receive BCP and TLP grants, and accountability of programs and activities authorized under the Runaway and Homeless Youth Act. • Funding: P.L. 110-378 increased the authorization of appropriations for FY2009. The law also increased the authorized annual minimum levels of BCP funding available to organizations in each state and territory. It further required HHS to reallocate unused BCP funds from one state to other states. • Requirements: P.L. 110-378 specified that youth may remain in a program funded under the BCP and TLP longer than they were able to under the prior law, although the law imposed additional criteria for youth who stay longer at TLPfunded programs. The law also changed the definition of “homeless youth” to permit youth over age 18 and age 21 to stay in BCP- and TLP-funded programs, respectively, but only under certain circumstances. Another change made by the law specified that in funding grants for research and other projects related to runaway and homeless youth, HHS is to give priority to applicants that serve diverse youth and represent diverse geographic regions of the United States (the term “diverse” was not defined). • Accountability: P.L. 110-378 required HHS to promulgate regulations that specify performance standards for public and nonprofit entities that receive BCP, TLP, and SOP grants. (See the Appendix for an overview of standards that have been proposed by HHS.) The law further required HHS to periodically submit to Congress an incidence and prevalence study of runaway and homeless youth, as well as the characteristics of a representative sample of these youth. HHS must consult with the U.S. Interagency Council on Homelessness in developing the study. The law also directed the Government Accountability Office (GAO) to evaluate the process by which organizations apply for BCP, TLP, and SOP, including HHS’s response to these applicants.5 Federal Efforts to Address Preventing and Ending Youth Homelessness Congress and the Obama Administration have taken steps in recent years to address preventing and ending youth homelessness. Two notable efforts include an HHS report to Congress on ending youth homelessness and a strategy put into place by the U.S. Interagency Council on Homelessness (USICH) to end youth homelessness by 2020.6 5 GAO completed this report, and all but one of seven recommendations made by GAO have been implemented. U.S. Government Accountability Office, Runaway and Homeless Youth: Improvements Needed in the Grant Award Process, GAO-10-33, May 10, 2010, http://www.gao.gov/products/GAO-10-335. 6 USICH is an independent executive branch agency consisting of 19 cabinet secretaries and agency heads. Its mission is to coordinate the federal response to homelessness. The strategy engages the Runaway and Homeless Youth program and other federal programs. Congressional Research Service 4 Runaway and Homeless Youth Act: Current Issues for Reauthorization HHS Report to Congress The 2003 reauthorization of the Runaway and Homeless Youth Act (P.L. 93-415) required HHS, in consultation with USICH, to prepare a report to Congress on promising strategies to end youth homelessness. HHS submitted the report to Congress in 2007.7 It explained that there was little information in the research literature about the effectiveness of interventions for homeless youth, and that the few studies on interventions were not based on rigorous experimental or quasiexperimental research designs. For this reason, the report incorporated information about interventions in related fields for high-risk youth, including family interventions to prevent child abuse and neglect, interventions to reduce juvenile violence, and interventions that support successful transitions from juvenile detention and foster care. Based on these approaches, the report described the ways in which providers and others can intervene in the lives of homeless youth. The report acknowledged that solutions to prevent and ameliorate youth homelessness will not be easily accomplished, and that no single approach exists to solve its problems; however, the report emphasizes that certain policy options may prevent and end youth homelessness. These options include (1) providing targeted education and support services to high-risk families with youth who may become homeless; (2) providing enhanced services to support youth as they transition from the juvenile justice and foster care systems because these youth are particularly vulnerable to becoming homeless; (3) providing a continuum of services, including “gateway” services for youth who are newly homeless to long-term supportive housing programs for youth who may not have the option to live with their families; and (4) helping to coordinate programs and services for youth who are homeless or are at-risk of becoming homeless. The report cites USICH as a coordinating body that can assist in these efforts. USICH and other federal agencies have taken steps to address youth homelessness overall. U.S. Interagency Council on Homelessness: Opening Doors In addition to authorizing multiple programs to address homelessness, the 1987 Stewart B. McKinney Homeless Assistance Act (P.L. 100-77) also established USICH. The HEARTH Act, enacted in 2009 as part of the Helping Families Save Their Homes Act (P.L. 111-22), charged USICH with developing a National Strategic Plan to End Homelessness.8 In June 2010, USICH released this plan, entitled Opening Doors.9 The plan sets out four goals: (1) ending chronic homelessness by 2015; (2) preventing and ending homelessness among veterans by 2015; (3) preventing and ending homelessness for families, youth, and children by 2020; and (4) setting a path to ending all types of homelessness. 7 HHS, ACF, Administration on Children, Youth and Families (ACYF), Family and Youth Services Bureau (FYSB), Promising Strategies to End Youth Homelessness, Report to Congress, 2007. (Hereinafter HHS, Promising Strategies to End Youth Homelessness, Report to Congress.) 8 The HEARTH Act specified that the plan should be made available for public comment and submitted to Congress and the President within one year of the law’s enactment. USICH convened working groups made up of members of federal agencies to discuss ending homelessness among specific populations: families, youth, persons experiencing chronic homelessness, and veterans. USICH, Federal Strategic Plan to Prevent and End Homelessness Overview. The council then held regional meetings to get feedback from various stakeholders, and it accepted public comments on its website during March 2010. For public comments, see http://fsp.uservoice.com/forums/41991-how-can-the-localcommunity-contribute-to-the-visi. 9 USICH, Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, June 2010. Congressional Research Service 5 Runaway and Homeless Youth Act: Current Issues for Reauthorization In September 2012, USICH amended Opening Doors to specifically address strategies for improving the educational outcomes for children and youth and assisting unaccompanied homeless youth.10 The strategies for preventing and ending youth homelessness include (1) obtaining more comprehensive information on the scope of youth homelessness; (2) building an evidence base of the most effective interventions for different subsets of youth; and (3) improving access to emergency assistance, housing, and supports for historically underserved groups of youth, including those with histories in the child welfare system, LGBTQ youth, pregnant or parenting youth, and youth with mental health needs. In February 2013, an interagency working group to end youth homelessness developed a guiding document for ending youth homelessness by 2020. Known as the Framework to End Youth Homelessness, the document outlines a data strategy (to collect better data on the number and characteristics of youth experiencing homelessness) and a capacity strategy (to strengthen and coordinate the capacity of federal, state, and local systems to work toward ending youth homelessness). These strategies are outlined and discussed further in the following two sections. The framework specifies activities in each of these areas that can begin immediately, activities that will require new resources, and longer-term activities that build on earlier efforts and may require new resources and/or new legislative authority. Through these activities, USICH ultimately intends to improve outcomes for youth in four areas: stable housing, permanent connections, education or employment options, and socio-emotional well-being.11 10 USICH, Opening Doors: Federal Strategic Plan to Prevent and End Homelessness Amendment 2012, September 2012, http://usich.gov/opening_doors/amendment_2012.(Hereinafter USICH, Opening Doors: Federal Strategic Plan to Prevent and End Homelessness Amendment 2012.) See also, U.S. Interagency Council on Homelessness, Council Meeting, presentation by Bryan Samuels, Commissioner, Administration on Children, Youth and Families, June 12, 2012. Unaccompanied youth includes those on their own, youth who are parents and their children, adolescent siblings, and other groups composed of only youth. 11 USICH, Framework to End Youth Homelessness: A Resource Text for Dialogue and Action, February 2013. (Hereinafter USICH, Framework to End Youth Homelessness: A Resource Text for Dialogue and Action.) Congressional Research Service 6 Figure 2. United States Interagency Council on Homelessness (USICH) Data and Capacity Strategies for Ending Youth Homelessness by 2020 Source: Congressional Research Service (CRS), based on the U.S. Interagency Council on Homelessness, Framework to End Youth Homelessness: A Resource Text for Dialogue and Action, February 2013. CRS-7 Runaway and Homeless Youth Act: Current Issues for Reauthorization The remainder of this report discusses issues that may be relevant if Congress considers reauthorization of the Runaway and Homeless Youth Act. These issues include (1) estimates and demographic information on homeless and runaway youth; (2) program and youth outcomes; (3) funding for the Runaway and Homeless Youth program; and (4) serving vulnerable populations. Estimates and Demographic Information on Runaway and Homeless Youth This section provides background on federal efforts to estimate the number and characteristics of youth who are homeless and/or have runaway. As Congress considers reauthorization of the Runaway and Homeless program, it may wish to (1) determine if HHS’s efforts (underway with USICH) are adequate in addressing the data reporting provisions that are specified in the Runaway and Homeless Youth Act; (2) determine whether the act provides adequate direction to HHS about its role in carrying out data collection efforts in coordination with the U.S. Department of Housing and Urban Development (HUD), which administers multiple programs for homeless individuals; and (3) the extent to which funding should be appropriated through new funding or by reallocating funds, such as through existing funding within the Runaway and Homeless Youth program,12 for the studies required by the law and/or new activities to improve data collection. Background Estimates of the number of youth who are homeless or runaways and their demographic characteristics are not necessarily straightforward. The accuracy of estimates depends on how counts take place, and may depend on the capacity of researchers and communities to conduct counts and use statistical sampling methods. Estimates also depend on which definitions of homelessness and runaway are used. Some research includes only selected runaway and homeless youth populations (homeless youth; runaway youth; or unaccompanied youth, which encompasses both runaway and homeless youth). Further, studies on the number and characteristics of runaway and homeless youth are dated.13 Concerns over the lack of data are not new. For instance, testimony in the 110th Congress suggested that a lack of data impairs policy making and that a comprehensive study is needed on estimates of runaway and homeless youth.14 Congress subsequently passed the Reconnecting 12 The Runaway and Homeless Youth Act authorizes funding for three sets of activities: (1) the BCP, TLP, national communication system, coordination, training, research, other activities, and general provisions; (2) Street Outreach Program; and (3) the periodic estimates of the runaway and homeless youth population. Congress has appropriated funding for the first two sets of activities. 13 For further information about research on the number of runaway and homeless youth, see CRS Report RL33785, Runaway and Homeless Youth: Demographics and Programs, by Adrienne L. Fernandes-Alcantara. 14 U.S. Congress. House. Committee on Education and Labor. Subcommittee on Healthy Families and Communities. Runaway, Homeless, and Missing Children: Perspectives on Helping the Nation’s Vulnerable Youth. Hearings. 110th Congress, 1st session, July 24, 2007, http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname= 110_house_hearings&docid=f:36729.pdf. See testimony of Ernie Allen, National Center for Missing and Exploited Children; Steven Berg, National Alliance to End Homelessness; Beth Alberts, Texas Center for the Missing; and Sue Krahe-Eggelston, Our Family. U.S. Congress. Senate. Committee on the Judiciary. Living on the Street: Finding (continued...) Congressional Research Service 8 Runaway and Homeless Youth Act: Current Issues for Reauthorization Homeless Youth Act of 2008 (P.L. 110-378), which, in part, addressed concerns about data on runaway and homeless youth. It added a new section to the Runaway and Homeless Youth Act that requires HHS, in consultation with USICH, to prepare a report to Congress that includes estimates of the incidence and prevalence of the runaway and homeless youth population ages 13 to 26. The act also directed HHS to assess the characteristics of these youth. In addition, HHS is required to conduct a survey of and direct interviews with a representative sample of homeless youth ages 13 to 26 to determine (1) past and current socioeconomic characteristics; (2) barriers to obtaining housing and other services; and (3) other information HHS determines useful, in consultation with states and other entities concerned with youth homelessness. The 2008 act does not specify the methodology for carrying out the studies, except to say that HHS should make the estimate based on the best quantitative and qualitative social science research methods available. The law specifically authorized such sums as may be necessary for the study for FY2009 through FY2013. As mentioned, the USICH framework for ending youth homelessness includes a data strategy for collecting information about homeless youth specifically. This strategy has four components: (1) developing better strategies for counting youth in point-in-time (PIT) counts of homelessness; (2) coordinating federal data systems that collect information on youth experiencing homelessness and their receipt of services; (3) launching a national study on the prevalence and characteristics of youth homelessness; and (4) using this national study to make periodic estimates of youth homelessness over time. USICH has articulated that better data on youth homelessness can help social service agencies and other stakeholders advocate for the appropriate resources to support youth experiencing homelessness and allow social agencies to tailor resources to the specific needs of youth.15 These components are discussed in the following sections. Point-in-Time Estimates USICH and its federal partners are working with communities to develop better estimates of youth experiencing homelessness through what are known as point-in-time (PIT) counts. HUD requires Continuums of Care (CoC)—typically cities, counties, or combinations of both that organize and deliver housing and services for homeless individuals in each community—to collect information in each community on the number and characteristics of individuals and families experiencing homelessness on a single day in January (during the last 10 days) in at least every other year (odd calendar years). PIT counts differ from HUD’s Homeless Management Information Systems (HMIS), which include data on homeless individuals collected by homeless service providers that receive HUD funding. These providers report the data to their local CoC and these data are used to derive national estimates of homelessness over a one-year period. USICH and other federal agencies are increasingly using data from the PIT counts as a source to track trends and progress in eliminating homelessness. HUD requires communities to collect information on unaccompanied youth under age 18. This includes youth on their own, youth who are parents and their children, adolescent siblings, and other groups composed of only youth. Beginning in 2013, HUD required that PIT counts include unsheltered youth. Youth under age 25 (...continued) Solutions to Protect Runaway and Homeless Youth. 110th Congress, 2nd session, April 29, 2008. Written testimony available at http://judiciary.senate.gov/hearing.cfm?id=3312. 15 USICH, Framework to End Youth Homelessness: A Resource Text for Dialogue and Action. Congressional Research Service 9 Runaway and Homeless Youth Act: Current Issues for Reauthorization who meet the definition of homeless16 under the McKinney-Vento Act (the major act that authorizes homelessness programs) are included in the count.17 This encompasses sheltered youth in runaway and homeless youth programs (including those that may not be funded under the federal program). Also since 2013, CoCs have been required to specifically identify the number of youth ages 18 or 18 to 24. Previously, these youth were included in a larger category of young adults ages 18 to 30. In addition, CoCs are required to count younger youth in a larger category of children under age 18. PIT counts can capture information on youth who interact with RHY or other homeless service providers, as well as those who do not (i.e., sheltered and unsheltered youth). These counts do not provide a confident estimate of youth experiencing homelessness across the country.18 Counting sheltered and unsheltered unaccompanied youth is a challenge because they often do not use homeless residential services or develop relationships with local homeless services providers who can ensure that each youth is counted. Further, unsheltered youth may congregate in different places and at different times than other homeless individuals, and thus may not be brought to the attention of enumerators who conduct the PIT counts.19 In response to these concerns, HUD has provided specific guidance on counting youth who are unsheltered. HUD recommends that CoCs coordinate with multiple entities—RHY service providers, homeless liaisons for local education agencies (i.e., school districts), and selected social service organizations—to assist with a comprehensive count of children and youth.20 HUD also encourages communities to recruit currently or formerly homeless youth to assist with the count, and to hold “magnet events” that include food and other appropriate incentives to draw in youth who typically do not use shelters and services. In addition, CoCs are encouraged to survey locations during multiple times throughout the day of the count and use social media to raise awareness and outreach. This guidance has been informed by an initiative, known as Youth Count!, to improve data collection on youth as part of PIT counts.21 With philanthropic support, USICH (and its partner agencies) provided technical assistance to nine communities to improve 16 For sheltered individuals, this includes those “living in a supervised publicly or privately operated shelter designed to provide temporary living arrangements (including congregate shelters, traditional housing, and hotels and motels paid for by charitable organizations or by federal, state, or local government programs for low-income individuals on the night of the count).” For unsheltered individuals, this includes those “with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping group on the night designated for the count.” U.S. Department of Housing and Urban Development (HUD), “Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH): Defining “Homeless” Final Rule,” Federal Register 75994, November 2011. Youth who are homeless by another federal definition on the night of the count, may still be counted for CoC planning purposes, just not reported to HUD as part of the unsheltered PIT count. See, HUD, “PIT Methodology Guide,” September 2014, https://www.hudexchange.info/resources/documents/PIT-Count-Methodology-Guide.pdf. (Hereinafter, HUD, “PIT Methodology Guide.”) 17 HUD, “2013 Housing Inventory Count and Point-in-Time Counts of Homeless Persons: Supplemental Guidance on Counting Homeless Youth,” Version 1.0, December 2012, https://onecpd.info/resources/documents/ 2013HICandPITGuidance_Youth.pdf. (Hereinafter, HUD, “2013 Housing Inventory Count and Point-in-Time Counts of Homeless Persons: Supplemental Guidance on Counting Homeless Youth.”) The law (42 USC §11386a(b)(3)) limits the categories of those defined as homeless that the Secretary can require to be counted. 18 U.S. Interagency Council on Homelessness, Framework to End Youth Homelessness: A Resource Text for Dialogue and Action, p. 6. 19 HUD, “PIT Methodology Guide,” p. 61. 20 Ibid, and HUD, “2013 Housing Inventory Count and Point-in-Time Counts of Homeless Persons: Supplemental Guidance on Counting Homeless Youth.” 21 USICH, Youth Count!, http://www.usich.gov/population/youth/youth_count/. Congressional Research Service 10 Runaway and Homeless Youth Act: Current Issues for Reauthorization data collection on homeless youth as part of the 2013 PIT.22 The initiative was intended to aid the nine communities in developing and implementing strategies to reach unaccompanied youth experiencing homelessness and document lessons learned. The CoC agency was the lead entity for the Youth Count! in each of the nine communities. The agency partnered with other stakeholders, including homeless youth service providers, to implement the count.23 The Runaway and Homeless Youth Act directs HHS, as appropriate, to consult with HUD to ensure coordination of programs and services for homeless youth.24 As Congress considers reauthorization of the act, it may want to determine the extent to which the act should specify the role of HHS and RHY grantees in participating in HUD’s point-in-time counts. Coordinating Existing Data Systems HHS and HUD are taking steps to coordinate the data collection system for the Runaway and Homeless Youth program—known as NEO-RHYMIS (National Extranet Optimized Runaway and Homeless Youth Management Information System)—with HMIS. Currently, data on youth served in the BCP and TLP, and the number of contacts made in the SOP, are collected from grantees via NEO-RHYMIS twice during the fiscal year. Specifically, the data system collects information on the basic demographics of the youth, the services they received, and the status of the youth (i.e., expected living situation, physical and mental health, and family dynamics, etc.) upon exiting the programs. Since approximately 2004, the system has received routine data submissions from nearly all BCP, TLP, and SOP grantees. Separately, HMIS is a locally administered data system used to record and analyze client, service, and housing data for individuals and families who are homeless or at risk of homelessness in a given community. Service providers report the data to their local CoCs. HUD uses data from a sample of participating HMIS jurisdictions to derive a national-level estimate of the number of individuals who are homeless over a one-year period. This estimate is included in HUD’s Annual Homelessness Assessment Report (AHAR), which provides Congress with detailed data on individuals and households experiencing homelessness across the country each year. In April 2013, HUD issued a notice to change data elements within HMIS, including data on youth who have run away and/or are homeless.25 In May 2014, HUD and HHS (along with the Department of Veterans Affairs) released the 2014 HMIS Data Dictionary and 2014 HMIS Data Manual, which revise the HMIS data standards. These new standards went into effect on October 1, 2014. They are intended to provide guidance for HMIS vendors and administrators to collect 22 These sites were Boston, MA; Cleveland, OH; Hennepin County, MN; Houston, TX; Los Angeles, CA; New York City, NY; Seattle, WA; Washington State; and Winston-Salem, NC. These sites were selected because of local leadership around youth homelessness, efforts of CoCs to include youth in the PIT counts, commitment of local education agencies, and presence of RHY providers. In addition, these sites represent a mix of urban, suburban, and rural sites. 23 HHS contracted with the Urban Institute to conduct a process study of the count in the nine communities. Their report identified promising practices at the pilot sites (i.e., engaging youth service providers and LGBTQ partners, involving youth in the counts, magnet events, and measuring homelessness) and areas that need improvement (i.e, expanding coverage to other areas, engaging schools, designing and administering surveys, improving de-duplication and integration with the overall PIT county, and improving training). Michael Pergamit et al., Youth Count! Process Study, Urban Institute, July 2013. 24 Section 341(3) of the Runaway and Homeless Youth Act. 25 HUD, Draft Homelesss Management Information Systems (HMIS) Data Standards, April 2013, https://www.hudexchange.info/resource/2917/2013-draft-hmis-data-standards/. Congressional Research Service 11 Runaway and Homeless Youth Act: Current Issues for Reauthorization HMIS data in a way that meets the data submissions requirements of each applicable federal program, including the Runaway and Homeless Youth program. The HMIS standards include the data collection questions that are in NEO-RHYMIS, along with new data elements. For example, new elements include information on income and sources of income (for TLP and demonstration projects); health insurance status (all programs); whether the youth has specified disabilities (all programs); whether the young person is at risk for or is a victim of commercial sexual exploitation (all programs); whether family reunification was achieved (all programs except SOP); information about the youth’s employment status at entry and exit (all programs except SOP); the types of programs to which the youth was referred (all programs); and the extent of transitional, exit, and aftercare plans for youth (all programs except SOP). It also specifies new categories for the issues identified by the youth and program staff (for BCP and TLP), and revises categories for types of referrals (for BCP and TLP) and whether youth completed the program (for all programs except SOP).26 HHS expects that Runaway and Homeless Youth program grantees will begin training grantees on the new system in late 2014 and grantees will likely begin reporting in late 2015.27 According to HHS, the department has informed grantees about the initiative through a series of speaking engagements and workshops conducted at national homelessness conferences over the past year. HHS also conducted listening sessions in which grantees had the opportunity to provide feedback about the initiative.28 Also according to HHS, approximately half of Runaway and Homeless Youth program grantees that were surveyed by the department’s technical assistance provider are HUD grantees, and therefore these grantees enter data on the youth they serve into both information systems.29 Stakeholders like the National Alliance to End Homelessness (NAEH), an organization representing the interest of groups devoted to ending homelessness, supports incorporating NEO-RHYMIS data measures into HMIS, as a way to reduce the time that grantees input data.30 NEO-RHYMIS includes individuals participating in the Runaway and Homeless Youth program, which serves only a fraction of the youth believed to be experiencing homelessness. On the other hand, HMIS generally includes unduplicated counts of all individuals experiencing homelessness, including unaccompanied children and youth under age 18 and youth ages 18 to 24. Merging the two systems may help to better assess the size and nature of homelessness among youth, while reducing the burden of Runaway and Homeless Youth grantees that input data into both systems. The Runaway and Homeless Youth Act specifies that BCP and TLP providers are required to submit to HHS information about the number and characteristics of the youth they serve.31 As part of reauthorization of the act, Congress might consider whether the act should include additional direction on the participation of HHS and grantees in the new data collection process. 26 HUD, 2014 HMIS Data Standards: HMIS Data Dictionary, version 2.1, August 2014, and 2014 HMIS Data Standards Manual: A Guide for HMIS Users, CoCs and System Administrators, version 2.1, August 2014, https://www.hudexchange.info/hmis/hmis-regulations-and-notices. 27 HHS, ACF, ACYF, FYSB, Report to Congress on the Runaway and Homeless Youth Programs Fiscal Years 2012 and 2013, August 2014, http://www.acf.hhs.gov/programs/fysb/resource/congress-rhy-2012-2013. (Hereinafter HHS, Report to Congress on the Runaway and Homeless Youth Programs Fiscal Years 2012 and 2013.) 28 Based on correspondence with HHS, ACF, ACYF, FYSB, September 2014. 29 Ibid, September 2014. According to HHS, the response rate was not 100%. 30 National Alliance to End Homelessness, “Merging RHYMIS and HMIS,” Federal Policy Brief, April 9, 2012. 31 Section 312(b)(12)(C) and Section 322(a)(9) of the Runaway and Homeless Youth Act. Congressional Research Service 12 Runaway and Homeless Youth Act: Current Issues for Reauthorization National Study on Prevalence of Youth Homelessness The Federal Framework to End Youth Homelessness includes a strategy to design and implement a national study to estimate the number, needs, and characteristics of youth experiencing homelessness. The study will include “coordinated approaches, such as building on an existing nationally-representative household survey and an enhanced national youth strategy for the HUD PIT count.” According to USICH, the study will commence in 2015 if funding is available. UISCH and its federal partners intend to estimate the prevalence and characteristics of youth experiencing homelessness over time, also pending available funds.32 These plans appear to be consistent with the requirements in the Runaway and Homeless Youth Act for a national incidence and prevalence study of youth. HHS has requested funds for the study as part of the budget request for FY2014 ($3 million) and FY2015 ($2 million).33 HHS has also been developing a sampling methodology that will help inform the design of this study.34 No funds have been appropriated for this purpose. The Runaway and Homeless Youth and Trafficking Prevention Act (S. 2646), a bill to reauthorize the Runaway and Homeless Youth Act, would authorize $2 million for the study for each of FY2015 through FY2019 (the current authorization is such sums as necessary). The National Network for Youth (NN4Y), a nonprofit organization representing the interests of RHY providers, and its partners recommend requiring Runaway and Homeless Youth program grantees to collect specific additional data that are not already specified in the law. Such data could incorporate information on trafficking victimization; whether youth identify as LGBT; pregnancy and parenting; and current or past involvement in either or both the child welfare system and juvenile/criminal justice system.35 S. 2646 includes similar requirements, except that it would not specify data collection on LGBT status. It would also require collection of data on youth beginning at age 12 rather than 13 as in current law. Further, the bill would require HHS to collect data on barriers to youth receiving mental health services and education and job training. Youth Connection with Their Families Youth most often cite family conflict as the major reason for their homelessness or episodes of running away. A literature review of youth experiencing homelessness suggests that a youth’s relationship with a step-parent, sexual activity, sexual orientation, pregnancy, school problems, and alcohol and drug use were strong predictors of family discord.36 Among youth in the Runaway and Homeless Youth program, most cite family dynamics as a major concern when exiting the program. In FY2013, over 30,500 youth exiting the BCP and over 2,000 youth exiting 32 USICH, Framework to End Youth Homelessness: A Resource Text for Dialogue and Action. HHS, ACF, Fiscal Year 2014 Justification of Estimates for Appropriation Committees and Fiscal Year 2015 Justification of Estimates for Appropriation Committees. 34 This is based on CRS correspondence with HHS, ACF and Office of the Assistant Secretary for Planning and Evaluation, September 2014. 35 National Network for Youth, No More Homeless Youth in America: RHYA 2013 Reauthorization Working Group’s Recommendations for 2013 Reauthorization, 2013. 36 Paul A.Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches,” Toward Understanding Homelessness: The 2007 National Symposium on Homelessness Research (2007). (Hereinafter, Paul A.Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches.”) 33 Congressional Research Service 13 Runaway and Homeless Youth Act: Current Issues for Reauthorization the TLP cited this concern (it was the most frequently cited issue for BCP youth and the second most frequently cited issue for TLP youth).37 The 2007 HHS report to Congress on strategies to end youth homelessness emphasized the importance of family relationships. It said that “to address the risk factors that lead to youth leaving and staying away from their homes, intervention approaches must emphasize strategies to strengthen and support families. Families, whether immediate or extended, are resources for homeless youth and should be actively involved in adolescents’ transition to independence and adulthood.”38 The Runaway and Homeless Youth Act specifies that the BCP is intended to provide services as an alternative to involving youth who are runaways and/or homeless in the child welfare system (and other specified systems). The act requires BCP grantees to develop “adequate plans for contacting the parents or other relatives of the youth and ensuring the safe return of the youth according to the best interests of the youth.”39 In addition, BCP grantees are directed to provide “individual, family, and group counseling, as appropriate … and may include home-based services for families with youth at risk of separation from the family.”40 Most (71%) of youth exiting the BCP in FY2013 return to their parents’ house. In addition, 15% to 17% of youth served by BCP grantees receive preventative services that can include mediation and family and individual counseling. According to HHS, most of those young people remain at home and do not stay at the center.41 The statute does not address family support and reunification for the TLP and SOP. This may be due to the relatively younger age of youth served in the BCP and their living situations upon exiting. The TLP provides longer-term support to youth ages 16 to 21. Fewer than one out of five (16%) of youth in FY2013 went on to live with their parent(s) upon exiting the program. The SOP provides services to youth who live on the street, and presumably many of these youth have limited or no contact with their parents (HHS does not collect information on these youth). The regulations to accompany the Runaway and Homeless Youth Act specify that all grantees should ensure they have “plans for meeting the best interests of the youth involving, when possible, both the youth and the family” and that such plans include contacts with family within 24 hours (and not more than 72 hours) after the youth’s admission into the program.42 In addition, HHS’s proposed regulations for the program emphasize the importance of permanent connections for young people in programs funded under the Runaway and Homeless Youth Act. 37 Congressional Research Service analysis of FY2013 NEO-RHYMIS data provided by the U.S. Department of Health and Human Services, Administration for Children and Families. 38 HHS, Promising Strategies to End Youth Homelessness, Report to Congress, p. 43. 39 Section 312(b))(3) of the Runaway and Homeless Youth Act. 40 Section 311(a)(2) of the Runaway and Homeless Youth Act. Home-based services encompass “counseling and information to youth and the families (including unrelated individuals in the family households) of such youth, including services relating to basic life skills, interpersonal skill building, educational advancement…and referrals to sources of other needed services” (Section 312(d)). In addition, BCP grantees are required to keep records of youth and family members whom it serves, and annually report to the HHS Secretary on statistics about youth who have run away or are homeless, including “youth at risk of family separation” (Section 312(b)). It also defines “youth at risk of separation from their families” if they are under the age of 18; have a history of running away from their families; and whose parents are not willing to provide for their basic needs, or who are at risk of entering the child welfare or juvenile justice systems as a result of the lack of services available. 41 HHS, Report to Congress on the Runaway and Homeless Youth Programs Fiscal Years 2012 and 2013, p. 12. 42 42 C.F.R. §1351.18. Congressional Research Service 14 Runaway and Homeless Youth Act: Current Issues for Reauthorization The extent to which all providers with Runaway and Homeless Youth Act funds, or even BCPfunded programs, provide family interventions has not been fully examined. According to the 2007 HHS report to Congress, “shelters that place a strong emphasis on stabilizing youth and reunification with families or other appropriate long-term placements are critical in preventing prolonged episodes of homelessness among this population. Providers report that younger youth and those experiencing their first episode of homelessness are more likely to reconcile with families, if early intervention is available.”43 A 2007 report, coordinated by multiple federal agencies, emphasized that more attention should be paid to prevention and intervention strategies that focus on youth. The report goes on to say that such strategies could involve improving communication, developing conflict resolution skills, and increasing understanding of adolescent development.44 The National Alliance to End Homelessness defines family intervention along a spectrum that involves strategies such as family reunification, family connection, family finding, and aftercare services.45 Examples of these strategies can include support groups for parents and parenting skills classes. Some interventions have been assessed, though not necessarily through rigorous evaluation or specifically for youth who have run away or are homeless. One such approach is multisystemic therapy (MST) in which families are provided with intensive, home-based services facilitated by a therapist who empowers parents to better manage their adolescent’s behavior and also coordinates services and supports for the family. Randomized controlled trials have shown that MST can reduce antisocial behavior; however, again, these evaluations have not focused on the RHY population in particular.46 Another promising model—used by a runaway and homeless youth provider, Project Safe, in Washington—provides phone consultation, support groups or workshops, and a resource library to parents or caretakers. The goal is to prevent teen homelessness and promote healthier family functioning. Outcome data from these interventions showed a significant decrease in the parental perception of the youth needing to leave the home.47 Further, some intervention models focus on families separated because their teens identify as LGBT. These models draw on findings that seek to strengthen families by informing them of the negative impacts and risks that “rejecting” behaviors can have on their child.48 43 HHS, Promising Strategies to End Youth Homelessness, Report to Congress. Paul A. Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches.” 45 Andre C. Wade, Tania Pryce, and Dr. Norweeta G. Milburn, Family Intervention: Building Relationships and Increasing Stability for Runaway and Homeless Youth, National Alliance to End Homelessness, webinar, June 18, 2012. As articulated by NAEH, “family reunification” refers to the process of returning youth to their family of origin, and should involve the youth in decisionmaking and include ongoing assessments of safety. “Family connection” refers to connecting a youth with his or her family to facilitate an emotional reunification if a physical reunification is not possible. “Family finding” refers to a model used in child welfare to identity and engage extended family, including individuals whom the young person identifies as family. In addition, “aftercare services” can be a form of family intervention that is provided to a youth and his or her family after the youth has exited a program. 46 Paul A. Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches,” pp. 6-14. 47 Ibid. Similarly, Eva’s Initiative’s Family Reconnect Program, a program in Canada for runaway and homeless youth, provides case management for youth and their families. The program has demonstrated positive outcomes in terms of relations between youth and their families, mental health issues, and housing and other material supports. For further information, see Daphne Winland, Stephen Gaetz, and Tara Patton, “Family Matters - Homeless Youth and Eva’s Initiatives “Family Reconnect” Program,” The Homeless Hub Research Report Series, The Canadian Homelessness Research Network , 2011. 48 The Family Acceptance Model, “Family Services,” http://familyproject.sfsu.edu/family-services. 44 Congressional Research Service 15 Runaway and Homeless Youth Act: Current Issues for Reauthorization Reauthorization of the Runaway and Homeless Youth Act may provide an opportunity to examine the role of youth connection to their families. For example, the National Network for Youth has suggested that the act could extend family intervention and reconnection services to TLP participants when safe and appropriate.49 The Runaway and Homeless Youth and Trafficking Prevention Act (S. 2646), introduced in the Senate in July 2014, would add that BCP providers may implement services for assessing family engagement in supporting the youth and reunifying them with their families, and providing services to family members or (if appropriate) individuals identified as family by the youth. In addition, it would require that TLP applicants agree to provide counseling to youth who are homeless and to encourage, if appropriate, counseling that involves parents, legal guardians, or individuals that the youth identifies as family. Program and Youth Outcomes This section first describes how HHS currently assesses whether grantees receiving Runaway and Homeless Youth program funds are meeting the needs of youth who have run away and/or are homeless, and how HHS determines whether the Runaway and Homeless Youth program is effective overall. It then discusses the research literature on interventions for this population and the potential role of the Runaway and Homeless Youth Act in testing interventions. Current Evaluation of the Program The Family and Youth Services Bureau (FYSB) evaluates each grantee through the Runaway and Homeless Youth Monitoring System. Staff from regional Administration for Children and Families (ACF) offices and other grant recipients (known as peer reviewers) conduct an onsite review of the program, which involves interviewing grantee staff, reviewing case files and other agency documents, and conducting entry and exit conferences. The monitoring team then prepares a written report that identifies the strengths of the program and areas that require corrective action. The protocols used to conduct the onsite review generally follow the BCP Performance Standards, and are adapted for the TLP and SOP.50 The performance standards relate to how well the needs of youth who have run away and/or are homeless and their families are being met, and not the outcomes of services provided. Nine of these standards address service components (e.g., outreach, individual intake process, and recreational programs, etc.) and six focus on administrative functions or activities (e.g., staffing and staff development, reporting, and individual client files, etc.).51 On April 14, 2014, HHS issued a notice of proposed rulemaking (NPRM) that seeks to implement new performance standards and other requirements for Runaway and Homeless Youth program grantees. These proposed performance standards are outlined in the Appendix. For example, BCP and TLP grantees would be required to maintain at 90% or higher the proportion of youth who exit to safe and appropriate settings.52 49 No More Homeless Youth in America: RHYA 2013 Reauthorization Working Group’s Recommendations for 2013 Reauthorization, p. 2. 50 HHS, ACF, ACYF, FYSB, Onsite Review Protocol: Runaway and Homeless Youth Programs, April 11, 2012, http://www.acf.hhs.gov/programs/fysb/resource/onsite-review-protocol. 51 HHS, ACF, ACYF, FYSB, Basic Center Performance Standards, http://www.acf.hhs.gov/programs/fysb/resource/ bcp-performance. 52 HHS, ACF, “Runaway and Homeless Youth; Proposed Rule,” 79 Federal Register, April 14, 2014. See proposed changes to §1351.30 and §1351.31. Congressional Research Service 16 Runaway and Homeless Youth Act: Current Issues for Reauthorization Separately, BCP and TLP grantees collectively are expected to meet certain outcomes. This is distinct from the performance standards and onsite review for determining whether individual grantees are meeting the needs of youth and families. Grantees are required to report outcome data through the NEO-RHYMIS reporting system, which includes multiple data elements.53 HHS uses the NEO-RHYMIS data to calculate four outcome measures in particular for the entire program: • Maintain the proportion of youth who are prevented from running away as a result of BCP non-shelter, preventative services. The FY2013 target was 96% and the result was 94.2%.54 • Increase the proportion of youth living in safe and appropriate settings after exiting TLP services. The FY2013 target was 86% and the result was 87.7%. • Increase the percentage of youth who complete the TLP by graduating or who leave ahead of schedule based upon an opportunity. The FY2013 target was 58% and the result was 63.5%. • Increase the percentage of TLP youth participants who are engaged in community service and service learning activities while in the program. The FY2013 target was 39.8% and the result was 36.9%. Evaluation of Interventions Generally As discussed in the 2007 HHS report to Congress and other research, multiple interventions have been developed to assist youth who have run away and/or are homeless, but they have not been evaluated to determine whether they are effective.55 Researchers have pointed out that closing this gap in research “will require methodologically sound studies that include control (or at least comparison) groups in experimental (or at least quasi-experimental) research designs.”56 To this end, efforts are underway at HHS to learn more about the long-term outcomes of youth who are served by the TLP using a rigorous research design. HHS has contracted with Abt Associates, a policy research organization, to conduct an evaluation of the TLP at select grantee sites. The study seeks to describe the outcomes of youth who participate in the program and to isolate and describe promising practices and other factors that may contribute to their successes or challenges. The study will examine delivery approaches, youth demographics, socio-emotional wellness, and life experiences. The study will also include an impact evaluation, with youth randomly assigned to the treatment (i.e., entry into TLP) and control groups to determine whether the TLP leads to different impacts for enrolled youth than for those who did not enroll. The evaluation is in its early stages, and is expected to conclude in FY2017.57 53 Section 312(b)(7) and Section 322(a)(12) of the Runaway and Homeless Youth Act. HHS, Administration for Children and Families Justification of Estimates for Appropriations Committees, FY2015, pp. 114-115. 55 HHS, Promising Strategies to End Youth Homelessness, Report to Congress; and Paul A.Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches,” pp. 6-14. 56 Paul A. Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches.” 57 HHS, ACF, FY 2015 Justification of Estimates for Appropriation Committees, Children and Families Services Programs, p. 114. 54 Congressional Research Service 17 Runaway and Homeless Youth Act: Current Issues for Reauthorization Separately, HHS and other federal agencies are moving ahead with disseminating an intervention model that draws on evidence-based tools and practices for assisting youth who are homeless. This model is the main component of the capacity building strategy that is part of USICH’s Framework to End Youth Homelessness (outlined in Figure 2). The intervention model emphasizes that providers should use valid and reliable screening and assessment tools to understand each youth’s strengths and needs. It also specifies that intervention strategies should be based on scientific evidence for improving outcomes, provide culturally appropriate supports that account for the specific characteristics and needs of the youth, and emphasize settings and relationships where young people can heal and thrive. The framework envisions using federal and other resources to put the intervention model into practice and evaluate which approaches are most effective. Federal agencies would then disseminate and scale-up screening and assessment tools and effective interventions.58 Since the model was disseminated, FYSB has modified requirements for Runaway and Homeless Youth grantees to help ensure their efforts align with the model. For example, FYSB has begun to require that grantees use appropriate screening and assessment tools to determine whether young people entering programs have a history of trauma and other issues. In addition, organizations applying for funding under the Runaway and Homeless Youth program have recently been required to ensure that case planning takes into account the youth risk and protective factors and their goals. Further, FYSB has provided training and technical assistance on specific practices that have some effectiveness, and has enhanced efforts to monitor the performance of grantees.59 The Runaway and Homeless Youth Act currently authorizes HHS to make grants to carry out research and evaluation, and requires that in making such grants, HHS gives priority to certain types of projects.60 One type of project appears to be most germane to examining effectiveness of a program—“providing programs, including innovative programs, that assist youth in obtaining and maintaining safe and stable housing, and which may include programs with supportive services that continue after the youth complete the remainder of the programs.” The reauthorization process could involve examining the role of evaluations, such as whether the law should place greater emphasis on testing promising intervention models or whether HHS might provide technical assistance to individual grantees about conducting more rigorous evaluations of their programs. The reauthorization process might also involve examining the goals of the TLP in particular because of the program’s outcomes. Notably, approximately one-third (36.3%) of youth completed the TLP in FY2013. The remaining two-thirds did not complete the program: 27.2% did not complete the program because of other opportunities, 16.2% did not complete the program and had no other plans, and 20.3% were expelled or involuntarily discharged from the program.61 Access to Funding A related issue that may be of interest to Congress is youth access to the Runaway and Homeless Youth Act programs. Estimates of youth who have run away or are homeless exceed 1 million, 58 USICH, Framework to End Youth Homelessness: A Resource Text for Dialogue and Action. HHS, Report to Congress on the Runaway and Homeless Youth Programs Fiscal Years 2012 and 2013, pp. 5-6. 60 Section 343(b) of the Runaway and Homeless Youth Act. 61 CRS analysis of NEO-RHYMIS data. 59 Congressional Research Service 18 Runaway and Homeless Youth Act: Current Issues for Reauthorization and the program provides services to just a fraction of these youth. In recent years, the BCP has served approximately 35,000 to 52,000 youth annually and the TLP has served 3,300 to 4,400 youth annually.62 In a January 2014 analysis, HHS provided estimates for the number of beds available at HHS-funded BCP and TLP grantees.63 The analysis estimated that in FY2012, there were an average of 10 beds per BCP grantee, for a total of 3,102 beds across all grantees; and that in FY2013, there were 11 beds per TLP grantee, for a total of 1,635 beds across all grantees. The estimated total number of beds for these two programs was 4,737. The number of youth served does not correlate with the number of beds, as youth in both programs generally stay less than three weeks (for the BCP) and less than six months (for the TLP). Table 1 shows the number of youth who were turned away from the BCP and TLP due to a lack of bed space from FY2007 through FY2013. Overall, between 7,000 and 11,000 young people were turned away each year from the BCP and TLP—with the greatest number of youth turned away in FY2010. Data for the SOP are collected only on the number of contacts that organizations made with youth, and not the actual number of youth served. Table 1. Number of Youth Turned Away at Basic Center Program and Transitional Living Program, FY2007-FY2013 Fiscal Year Basic Center Program Transitional Living Program Total Turned Away for BCP and TLP 2007 5,111 4,466 9,577 2008 2,629 5,159 7,788 2009 2,964 6,446 9,410 2010 4,431 6,720 11,151 2011 2,784 6,647 9,431 2012 3,006 5,100 8,106 2013 2,025 4,957 6,982 Source: Congressional Research Service (CRS), based on U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Family and Youth Services Bureau, NEO-RHYMIS Data. Program Funding Over Time Advocates assert that funding is needed for the Runaway and Homeless Youth program to meet the needs of this population. They have recommended that funding be increased to $300 million.64 Table 2 shows appropriation levels for the major components of the program from 62 CRS Report RL33785, Runaway and Homeless Youth: Demographics and Programs, by Adrienne L. FernandesAlcantara. 63 HHS, ACF ACYF, Office of Data, Analysis, Research and Evaluation, “Runaway and Homeless Youth Bed Capacity,” January 17, 2014. The Street Outreach Program requires service providers to have access to shelter beds for youth they encounter who are willing to leave the streets; however, because these programs shelter with local providers and may not provide housing directly, they are not included in the estimates. 64 The National Network for Youth, Youth Homelessness in America: The Current Status and the Way Forward,” Policy Brief, March 17, 2014 . (Hereinafter, The National Network for Youth, Youth Homelessness in America: The Current Status and the Way Forward.) The National Network for Youth, “RHYA 2013 Reauthorization Working (continued...) Congressional Research Service 19 Runaway and Homeless Youth Act: Current Issues for Reauthorization FY2001, when funding totaled $84.1 million, through FY2014, when funding totaled $114.1 million. Over this period, funding for the program has increased twice—from FY2001 to FY2002 and from FY2007 to FY2008. The first increase was due to the doubling of funding for the TLP. Although the TLP authorized services for pregnant and parenting teens prior to FY2002, the Bush Administration sought funds specifically to serve this population and Congress provided the increased funds to enable these youth to access TLP services. In FY2003, amendments to the Runaway and Homeless Youth Act (P.L. 108-96) authorized TLP funds to be used for services targeted at pregnant and parenting teens at TLP centers known as Maternity Group Homes. The second funding increase may have been due in part to heightened attention to the Runaway and Homeless Youth program, as Congress began to consider legislation in FY2008 to reauthorize the act. Funding was $114.1 million for FY2014. Table 2. Runaway and Homeless Youth Program Appropriations, FY2001-FY2014 (as enacted) Dollars in thousands Year BCP TLP SOP Total 2001 $48,338 $20,740 $14,999 $84,127 2002 48,288 39,736 14,999 103,023 2003 49,473 40,505 15,399 104,202 2004 49,171 40,260 15,302 104,733 2005 48,786 39,938 15,178 103,902 2006 48,265 39,511 15,017 102,793 2007 48,298 39,539 15,027 102,864 2008 52,860 43,268 17,221 113,349 2009 53,469 43,765 17,721 114,955 2010 53,744 43,990 17,971 115,705 2011 53,637 43,902 17,935 115,474 2012 53,536 43,819 17,901 115,256 2013 50,097 41,004 16,751 107,852 2014 53,350 43,650 17,141 114,141 Source: HHS, ACF, Justification of Estimates for Appropriations Committees, FY2003-FY2015. Note: BCP and TLP funds are appropriated together under what is known as the Consolidated Runaway and Homeless Youth program. SOP funds are appropriated separately. Appropriations law sometimes refers to the SOP as Prevention Grants to Reduce Abuse of Runaway Youth. Figure 3 shows the amount of funding appropriated for each of FY2001 through FY2013 in nominal dollars and FY2013 dollars (real dollars). FY2013 is the most recent year for which the (...continued) Group.” Congressional Research Service 20 Runaway and Homeless Youth Act: Current Issues for Reauthorization Current Price Index (CPI) is available to examine these trends. In real dollars, funding ranged from a high of $133.4 million in FY2002 to a low of $107.9 million in FY2013. Figure 3.Total Funding for the Runaway and Homeless Youth Program In nominal and real (2013) dollars $160,000,000 $133,047,054 $140,000,000 $129,159,796 $115,571,803 $119,590,096 $120,000,000 $115,256,000 $110,660,494 $100,000,000 $107,852,000 $104,733,000 $113,349,000 $84,127,000 $80,000,000 $60,000,000 $40,000,000 $20,000,000 $2001 2002 2003 2004 2005 2006 Nominal Dollars 2007 2008 2009 2010 2011 2012 2013 2013 Dollars Source: Congressional Research Service (CRS), based on analysis of the 2013 Consumer Price Index for All Urban Consumers (CPI-U). Note: FY2013 dollars are used because FY2013 is the most recent year for which CPI-U are available on an annualized basis. Continuum of Care (CoC) Program Funding On a related point, providers of services to youth who have run away or are experiencing homelessness may have limited access to funding from the major program through which HUD supports homeless services providers, known as the Continuum of Care (CoC) program. Funds for the CoC program are made available to local communities, which are also called Continuums of Care. Nearly every community in the country has become part of a CoC, with more than 400 CoCs, including those in the territories, covering most of the country. Homeless youth providers, including RHY providers, compete for CoC funding. Local communities establish CoC advisory boards made up of representatives from local government agencies, service providers, community members, and formerly homeless individuals who meet to establish local priorities and strategies to address homelessness in their communities. The CoC plan that results from this process is meant to contain elements that address the continuum of needs of homeless persons: prevention of homelessness, emergency shelter, transitional housing, permanent housing, and supportive services provided at all stages of housing. HUD distributes these funds through an annual Congressional Research Service 21 Runaway and Homeless Youth Act: Current Issues for Reauthorization competition. Funds for a CoC can be awarded based on a preliminary need amount (which is based on a formula) or on the CoC’s Annual Renewal Demand (ARD) amount, whichever is higher. Due to lower funding levels in recent years, all CoCs have been limited to the ARD amount even if the preliminary need amount is higher. Project applicants serving individuals who are homeless in a community (e.g., nonprofit organizations, units of government, etc.) submit a project application that is subsequently submitted by the CoC lead entity, otherwise known as the collaborative applicant.65 HUD issues an annual notice of funding that sets the criteria for the type of projects and priorities that will be funded in a given year. CoC program funds may be used to serve youth who are defined as homeless under the HUD definition of homelessness.66 The most recent funding announcement (for FY2013-FY2014) was the first to specify that CoCs may score points in the application process in relation to serving youth. Up to 2 points (out of 150) were available to CoCs that could demonstrate current efforts to address youth homelessness, including a description of services and housing from all funding sources that are available within the CoC for this population, and the extent to which resources are available for all youth or only specifically for youth ages 16 to 17 or 18 to 24.67 An additional 1 point was available to CoCs that clearly demonstrated coordination with federal, state, local, private, or other entities serving the homeless. Each CoC was required to describe how it participated in and/or coordinated with other funding sources that include the Runaway and Homeless Youth program. The majority of CoC program funds are used to renew existing grants. However, even if a CoC has very few or planned projects to respond to youth experiencing homelessness, providers may still be able to access funds. The funding process allows CoCs to reallocate funds from an existing project to a new one if they decide that a new project would be more beneficial than an existing one. The FY2013-FY2014 round of CoC funding allowed CoCs to reallocate funding to projects for the chronically homeless, which could include youth ages 18 to 24, and homeless households with children. HUD has encouraged CoCs to partner with Runaway and Homeless Youth program grantees. In guidance to HUD grantees, HUD emphasized the need for such coordination: “Homeless youth are more multi-jurisdictional than any other homeless population and may interact with adults from educational, child welfare, juvenile justice, and/or homelessness systems. It is therefore critical that CoCs collaborate with schools, child welfare agencies, juvenile justice systems, and, if applicable, projects funded under HHS’ Runaway and Homeless Youth Program.”68 Some leaders in the runaway and homeless youth community have suggested the ways that RHY providers can play a more active role in the CoC process even if they are not competing for funds, such as by reading and rating the local applications for CoC funding each year. These stakeholders assert that such participation can help providers understand the CoC’s priorities and 65 For further information about the CoC program, see CRS Report RL33764, The HUD Homeless Assistance Grants: Programs Authorized by the HEARTH Act, by Libby Perl. 66 Up to 10% of funds for a CoC could be used to provide housing and services to individuals that meet the definition of homeless under other federal definitions, including the Runaway and Homeless Youth Act. This is only if the CoC has explicitly requested and received approval by HUD to do so. To date, no CoCs have met the standard required to receive HUD approval. This is based on correspondence with HUD, September 2014. 67 U.S. Department of Housing and Urban Development, “Notice of Funding Availability (NOFA) for the Continuum of Care Homeless Assistance Program,” December 20, 2013. 68 HUD, HUD Exchange, SNAPS Weekly Focus, “Considering the Needs of Families and Youth,” August 6, 2013, https://www.hudexchange.info/homelessness-assistance/snaps-weekly-focus/. Congressional Research Service 22 Runaway and Homeless Youth Act: Current Issues for Reauthorization the extent to which youth are served. They posit that RHY providers could work together closely to improve the chances that youth services will be funded in the CoC: “One or two strong, collaborative or multi-agency endorsed applications to [the] CoC can have a much greater chance at winning a funding award than many competing applications from a variety of youth providers.”69 Stakeholders have further suggested that RHY providers could collaborate with homeless service providers who work with young adults under age 25 that compete for CoC funding, such as by providing targeted services to this population or contracting to train their staff about the needs of this population.70 The preamble to the proposed regulations for the program, issued in April 2014, notes that HHS strongly encourages grantees to collaborate with their local CoC, with the goal of ending youth homelessness.71 The National Alliance to End Homelessness, an organization representing the interest of groups devoted to ending homelessness, has articulated that HHS should explicitly encourage and incentivize this coordination by including it as a factor that is assessed as part of the grant review process for the Runaway and Homeless Youth program.72 Vulnerable Populations Certain groups of youth are vulnerable to running away or becoming homeless. These include lesbian, gay, bisexual, transgendered, or questioning (LGBTQ) youth; those involved in foster care and the juvenile justice system; and youth who are sex trafficked. These groups of youth are not mutually exclusive, and have many of the same underlying issues—stemming, in part, from a lack of family support—that can contribute to their becoming homeless. The amendment to Opening Doors in 2012 emphasized the need for supporting these groups in particular.73 Policy makers could consider the role of the Runaway and Homeless Youth Act in strengthening assistance to these vulnerable populations and ensuring that RHY providers are equipped to address their sometimes unique circumstances. LGBTQ Youth LGBTQ youth appear to be overrepresented in the homeless population, often due to being forced out of their homes when they come out to their families about their sexuality. In five studies of unaccompanied youth in mid-size and large cities, between 20% and 40% of respondents identified as gay or lesbian.74 In addition, a nationwide survey of 354 organizations serving youth 69 Valerie Douglas and Melinda Giovengo, “5 Things Every Homeless Youth Program Should Know When Working with Their HUD Continuum of Care (CoC),” presentation at National Network for Youth National Summit on Youth Homelessness, Washington, DC, March 24, 2014, http://www.nn4youth.org/system/files/ NN4Y%20Summit%205%20Things%21%20Handout.pdf. 70 Ibid. 71 HHS, ACF, “Runaway and Homeless Youth Program; Proposed Rule,” 79 Federal Register 71, April 14, 2014. 72 National Alliance to End Homelessness, Letter regarding 45 CFR 1351, RIN 0970-AC43, June 13, 2014. 73 U.S. Interagency Council on Homelessness, Opening Doors: Federal Strategic Plan to Prevent and End Homelessness Amendment 2012. The amendment also emphasized supports for pregnant and parenting youth and youth with mental health needs. 74 Nicholas Ray, Lesbian, Gay, and Transgender Youth: An Epidemic of Homelessness, National Gay and Lesbian Task Force and National Coalition for the Homeless, 2006, pp. 12-14, http://www.thetaskforce.org/downloads/reports/ reports/HomelessYouth.pdf. See also Andrew Cray, Katie Miller, and Laura E. Durso, Seeking Shelter: The (continued...) Congressional Research Service 23 Runaway and Homeless Youth Act: Current Issues for Reauthorization who were homeless in 2011 and 2012 found that LGBTQ youth make up about 40% of their clients.75 The survey further found that nearly half (46%) of youth who identified as LGBTQ ran away because of family rejection of sexual orientation or gender identity. The survey also found that 40% of providers did not provide services that address the most commonly cited factor that contributes to their LGBTQ clients’ homelessness—family rejection.76 Many providers who were surveyed stated that they had a “great deal of experience” working with LGBT youth, but some did not. Providers identified a range of issues that were barriers in improving their efforts to prevent or address LGBTQ youth homelessness, including lack of funding (32% to 36%, depending on the funding source); difficulty in identifying the population (20%); the fact that serving these youth is not central to their mission (14%); and a lack of information and training on LGBTG youth (9%). Efforts are underway at FYSB to assist this population by awarding funding under a three-year cooperative agreement in September 2013 to build the capacity of TLPs in serving LGBTQ youth. The grant seeks to develop information about serving the LGBTQ youth population experiencing homelessness, such as through efforts to identify innovative intervention strategies, determining culturally appropriate screening and assessment tools, and better understanding the needs of LGBTQ youth served by RHY providers.77 In addition, HHS’s proposed regulations for the program specify that grantees must provide training that is sensitive to “complex social identities” of youth, including their gender identity and expression and sexual orientation.78 The Runaway and Homeless Youth Act does not specifically address LGBTQ youth issues. Congress may consider whether reauthorization of the act should include such provisions and whether current efforts are adequate. For example, some stakeholders have identified concerns that the act does not require grantees to adopt nondiscrimination policies to protect the well-being of LGBTQ youth, or explicitly require training expressly targeted at these youth.79 In 2009, the (...continued) Experiences and Unmet Needs of LGBT Homeless Youth, The Center for American Progress, September 2013, pp. 4-5, http://www.americanprogress.org/issues/lgbt/report/2013/09/26/75746/seeking-shelter-the-experiences-and-unmetneeds-of-lgbt-homeless-youth/. 75 Laura E. Durso and Gary J. Gates, “Serving Our Youth: Findings from a National Survey of Service Providers Working with Lesbian, Gay, Bisexual, and Transgender Youth who are Homeless or At Risk of Becoming Homeless,” The Williams Institute with True Colors Fund and The Palette Fund, 2012, http://fortytonone.org/wp-content/uploads/ 2012/06/LGBT-Homeless-Youth-Survey-Final-Report-7-11-12.pdf. (Hereinafter, Laura E. Durso and Gary J. Gates, “Serving Our Youth: Findings from a National Survey of Service Providers Working with Lesbian, Gay, Bisexual, and Transgender Youth who are Homeless or At Risk of Becoming Homeless.”) 76 The survey did not distinguish between whether this was an issue for youth under age 18 compared to youth age 18 or older; however, 75-80% of providers who served clients under the age of 18 said they do family acceptance-related work, compared to about half of providers who serve youth age 18 and older. Laura E. Durso and Gary J. Gates, “Serving Our Youth: Findings from a National Survey of Service Providers Working with Lesbian, Gay, Bisexual, and Transgender Youth who are Homeless or At Risk of Becoming Homeless.” 77 HHS, ACF, FYSB, “Runaway and Homeless Youth Capacity Building for Lesbian, Gay, Bisexual, Transgender and/or Questioning Youth Populations, Grant Announcement,” HHS-2013-ACF-ACYF-CX-0638. 78 HHS, ACF, “Runaway and Homeless Youth Program; Proposed Rule,” 79 Federal Register 71, April 14, 2014. See proposed changes to §1351.1, §1351.10, and §1351.19. 79 The most recent BCP, TLP, and SOP grant funding announcement (issued between September 2013 and February 2014) requires applicants to submit a certification that they have or will establish and publicize policies prohibiting discrimination on race, sexual orientation, gender, gender identity (and expression), religion, and national origin. It further requires grantees to provide staff with initial and ongoing training on LGBT youth issues. One federal law, the Violence Against Women Act (VAWA, as amended by P.L. 113-4 in 2013) prohibits discrimination expressly on the basis of sexual orientation or gender identity. Congressional Research Service 24 Runaway and Homeless Youth Act: Current Issues for Reauthorization American Bar Association (ABA) and the National Network for Youth (NN4Y) developed a model state statute that seeks to ensure that homeless youth service providers adopt inclusive, nondiscrimination policies for LGBTQ youth. The model provides guidance on adopting nondiscrimination policies, including on the basis of gender identity and expression.80 Recent research has also suggested that HHS could provide more extensive training and technical assistance on meeting the needs of LGBTQ youth. A 2014 study funded by HHS examined the strategies of four grantees receiving BCP, TLP, and/or SOP funding for identifying and serving LGBTQ youth. The study identified that RHY providers would likely benefit from “specification, dissemination, and evaluation of models for serving LGBTQ youth effectively.” The report also specified that technical assistance or training on LGBTQ issues would help agencies in areas without access to local LGBTQ resources, or establishing a forum for providers to share information.81 The ABA/NN4Y model state statute and other publications outline the types of training topics that could be covered by runaway and homeless youth providers in serving LGBTQ youth, such as approaches to working with families of LGBTQ youth and how to communicate sensitively with youth about sexuality, sexual orientation, and gender identity.82 Legislation introduced in the 113th Congress (H.R. 2955 and S. 2646) would amend the Runaway and Homeless Youth Act to include a statement of nondiscrimination on the basis of sexual orientation and gender identity or expression (and other characteristics). Also under H.R. 2955, BCP grantees would be required to provide family assessment, intervention, and resources for families of “sexual and gender minority youth.” Sexually Trafficked Youth Runaway youth are particularly vulnerable to becoming victims of sex trafficking and other forms of sexual exploitation.83 Runaways may be perceived as easy targets for traffickers because they often cannot go home and have few resources.84 A federally funded study found that 80 The model state statute refers to the term “gender identity and expression” as having or being perceived as having gender-related characteristics, appearance, mannerisms, or identity, whether or not stereotypically associated with one’s assigned sex at birth. Amy Horton-Newell, Katie Meyer, and Casey Trupin, eds., Runaway and Homeless Youth and the Law, American Bar Association, Commission on Homelessness and Poverty and National Network for Youth, 2009, pp. 53-64, http://www.americanbar.org/content/dam/aba/publications/division_for_public_services/ ABA_Runaway_eBook.authcheckdam.pdf. 81 Andrew Burwick et al., Identifying and Serving LGBTQ Youth: Case Studies of Runaway and Homeless Youth Program Grantees, Final Report, Mathematica, February 14, 2014. 82 Lambda Legal et al., National Recommended Best Practices for Serving LGBTQ Homeless Youth, 2009, pp. 9-10. See also Lamba Legal and Child Welfare League of America, Tools to Support LGBTQ Youth in Care: Recommendations for Training & Education on LGBTQ Youth Issues. 83 Federal law does not define sex trafficking per se; however, the Trafficking Victims Protection Act (TVPA), as amended, defines the term “severe forms of trafficking in persons” to include trafficking. “Severe forms of trafficking in persons” refers (in part) to “sex trafficking in which a sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age. “Commercial sex act” means “any sex act, on account of which anything of value is given to or received by any person.” For further background on and definitions of child sexual exploitation and sex trafficking, see CRS Report R41878, Sex Trafficking of Children in the United States: Overview and Issues for Congress, by Kristin Finklea, Adrienne L. Fernandes-Alcantara, and Alison Siskin. 84 Heather J. Clawson and Lisa Goldblatt Grace, Human Trafficking Into and Within the United States: Review of the Literature, U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, August 2009. (Hereinafter Heather J. Clawson and Lisa Goldblatt Grace, Human Trafficking Into and Within the United States: Review of the Literature.) Congressional Research Service 25 Runaway and Homeless Youth Act: Current Issues for Reauthorization approximately 1.7 million youth under age 18 had run away from home or were forced to leave their homes at some point in 1999.85 While away from home, an estimated 38,600 (2.2%) of these youth were sexually assaulted, were in the company of someone known to be sexually abusive, or were engaged in sexual activity in exchange for money, drugs, food, or shelter. The Dallas Police Department also found a strong correlation between sex trafficking and runaway status: the more times a child runs away, the greater the likelihood that he or she will be victimized.86 Other research, including studies examining prostitution in Boston, Chicago, and San Francisco, has found that the majority of prostituted women were runaways.87 Shelter and services for trafficked victims who are transitioning from “the life” of prostitution appear to be available on a limited basis. As background for a 2012 colloquium on supports for child victims of sex trafficking, a working group surveyed organizations that provide residential and other services to victims.88 Over 50 organizations responded to the survey, and together they reported having the capacity to provide specialized services for 1,684 child victims and shelter for 226 child victims. Given that the number of child victims is believed to be much higher, the shelter and services that are available may only reach a fraction of children needing supports. In 2012, the President’s Interagency Task Force on trafficking (established by the Trafficking Victims Protection Act ) coordinated a strategic plan on services for victims in the United States. The plan specified that runaway and homeless youth providers are part of a broader response to sex trafficking that involves multiple sectors and organizations.89 Some runaway and homeless youth providers have long served youth who are victims of sexual exploitation. Amendments to the Runaway and Homeless Youth Act in 1994 (P.L. 103-322) first specified a role for providers in responding to youth sexual exploitation. These amendments created the Grants for Prevention of Sexual Abuse and Exploitation program, which is now referred to in law as the Sexual Abuse Prevention program and commonly called the Street Outreach program (SOP). As currently enacted, the program seeks to provide street-based services to youth “who have been subjected to, or are at risk of being subjected to, sexual abuse, prostitution, or sexual exploitation.”90 In addition, BCP and TLP providers can often offer immediate support to youth without some of the 85 Heather Hammer, David Finkelhor, and Andrea J. Sedlak, “Runaway/Thrownaway Children: National Estimates and Characteristics,” U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention, OJJDP NISMART Bulletin, October 2002. These are the most recent survey data available. 86 Linda A. Smith, Samantha Healy Vardaman, and Melissa A. Snow, “The National Report on Domestic Minor Sex Trafficking: America’s Prostituted Children,” Shared Hope International, May 2009. 87 Heather J. Clawson and Lisa Goldblatt Grace, Human Trafficking Into and Within the United States: Review of the Literature. 88 ECPAT USA and Shared Hope International, National Colloquium: 2012 Final Report: An Inventory and Evaluation of the Current Shelter and Service Response to Domestic Minor Sex Trafficking, May 2013. (Hereinafter ECPAT USA and Shared Hope International, National Colloquium: 2012 Final Report.) Twenty percent of organizations providing shelter reported providing such shelter for seven days or less. 89 President’s Interagency Task Force to Monitor and Combat Trafficking in Persons, Coordination, Collaboration, Capacity, Federal Strategic Action Plan on Services for Victims of Human Trafficking in the United States 2013-2017, Phase I: Initial Framework, April 2013. (Hereinafter President’s Interagency Task Force to Monitor and Combat Trafficking in Persons, Coordination, Collaboration, Capacity, Federal Strategic Action Plan on Services for Victims of Human Trafficking in the United States 2013-2017.) In the same vein, the National Academy of Sciences asserted in its 2013 report on child sexual exploitation and sex trafficking in the United States, that commercial sexual exploitation must be addressed through multiple sectors. Ellen Wright Clayton, Richard D. Krugman, and Patti Simon, eds., Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States, National Academy of Sciences, 2013. 90 Section 351(a) of the Runaway and Homeless Youth Act. Congressional Research Service 26 Runaway and Homeless Youth Act: Current Issues for Reauthorization same barriers of other residential options. For example, they have the ability to accept youth in the middle of the night and can offer longer-term placements to boys and transgendered youth who might otherwise have difficulty finding places to stay.91 Nonetheless, the capacity for runaway and homeless youth agencies to respond to the needs of sex trafficking victims is believed to be limited. These settings are often not equipped to provide intensive services for victims or recognize the trauma they have experienced. They also often have time restrictions imposed by funding sources on the length of stay, which, given their unique needs, makes serving victims of sex trafficking difficult. RHY providers and other providers may not recognize the signs of sex trafficking. Even if providers do recognize these signs, youth may choose to leave, given that shelter providers are required to report suspected abuse and neglect, including sexual exploitation.92 The federal strategic plan calls for greater supports for RHY and other social service providers in aiding victims of trafficking. The plan articulates that these providers “need training and support to expand their screening protocols to identify those who are trafficking victims and to provide appropriate services and referrals.”93 The plan also lays out action steps that HHS can take to prepare RHY providers in responding. HHS is currently working on such efforts. With support from HHS/ACF, four Runaway and Homeless Youth program grantees have collaborated with the FBI on its Innocence Lost initiative to recover victims of child sex trafficking.94 These grantees developed a set of standards for working with victims of trafficking that have been used to provide training and technical assistance to grantees.95 Separately, HHS/ACF issued a grant announcement in June 2014 for approximately three cooperative agreements to implement demonstration projects to provide coordinated case management and direct victim assistance to domestic victims of a “severe form of trafficking in persons.”96 Case management can include service plan development, counseling, monitoring and developing services, monitoring and evaluating client progress, and ensuring clients’ rights are protected. Direct victim assistance involves the development of individualized service plans that are tailored to meet the victims’ needs. 91 ECPAT USA and Shared Hope International, National Colloquium: 2012 Final Report. See also HHS, ACF, ACYF, “Guidance to States and Services on Addressing Human Trafficking of Children and Youth in the United States,” September 13, 2013. (Hereinafter, HHS, ACF, “Guidance to States and Services on Addressing Human Trafficking of Children and Youth in the United States”.) 93 President’s Interagency Task Force to Monitor and Combat Trafficking in Persons, Coordination, Collaboration, Capacity, Federal Strategic Action Plan on Services for Victims of Human Trafficking in the United States 2013-2017 94 U.S. Department of Health and Human Services, Administration for Children and Families, Family and Youth Services Bureau, “A Federal Partnership Brings Justice to Sexual Exploiters While Protecting Runaway and Homeless Youth.” 95 HHS, ACYF, “Guidance to States and Services on Addressing Human Trafficking of Children and Youth in the United States;” and HHS, Report to Congress on the Runaway and Homeless Youth Programs Fiscal Years 2012 and 2013, p. 6. 96 This refers to “sex trafficking in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age;” or the “recruitment, harboring, transportation, provision or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.” 22 U.S.C. 7102(9). “Sex trafficking” means the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act, per 22 U.S.C. 7102(10). 92 Congressional Research Service 27 Runaway and Homeless Youth Act: Current Issues for Reauthorization Whether Congress wishes to address sex trafficking in the Runaway and Homeless Youth Act may depend on how it envisions the role of providers in responding. For example, if it envisions a broader role, it could specify that BCP and TLP providers can or should provide shelter to sexually trafficked youth, or require the programs to coordinate with other entities in the community to respond. Some stakeholders have suggested that the term “prostitute” should be struck from the authorizing language for the SOP, and replaced with a term reflecting that youth are forced or coerced into providing sexual acts.97 This is consistent with federal trafficking laws that treat children involved in commercial sex acts as victims.98 The Enhancing Services for Runaway and Homeless Victims of Youth Trafficking Act of 2014 (H.R. 5076), passed by the House in July 2014, would direct HHS to give priority to proposed research and related projects that include staff training in the effects of and responses to severe forms of trafficking in persons involving youth who have run away and/or are homeless. In addition, it would amend the BCP to specify that the program provides services for street youth who are victims of severe forms of trafficking. Similarly, the Runaway and Homeless Youth and Trafficking Prevention Act (S. 2646), introduced in July 2014 and passed by the Senate Judiciary Committee in September 2014, would make multiple amendments to the law to address trafficking. For example, it would require BCP and TLP applicants to develop “an adequate plan” for runaway and/or homeless youth who are victims of trafficking in persons or sexually exploited, and require applicants to annually report to HHS on the number of youth served who are victims of a severe form of trafficking in persons (as defined under TVPA) or sexual exploitation. High-Risk Youth Youth experiencing homelessness appear to be at elevated risk for a variety of negative outcomes, including problems in school, mental health and behavior disorders, and engaging in high-risk behaviors such as drug use, risky sexual behavior, and criminal activity.99 Some TLP providers may not want to admit “hard-to-serve” youth because they lack the specialized services and supports to serve this population.100 Stakeholders have asserted that this can amount to providers serving only those youth who have the fewest needs and therefore can more readily transition to school, work, or other productive pathways.101 In comments to HHS about the proposed rule, the National Network for Youth (on behalf of the organizations they represent) raised concerns about the 90% rate that was set for safe and appropriate exits from the BCP and TLP. They suggested that 80% of BCP and 60% of TLP exits should be to safe and appropriate settings because “if the outcome measure is set too high, programs would be dissuaded from serving extremely high-risk runaway and homeless youth.... These programs often have wait lists because the need for services is larger than the capacity of existing programs (due to limited resources) and many 97 The National Network for Youth, “RHYA 2013 Reauthorization Working Group,” no date. For further information, see CRS Report R41878, Sex Trafficking of Children in the United States: Overview and Issues for Congress, by Kristin Finklea, Adrienne L. Fernandes-Alcantara, and Alison Siskin. 99 Paul A.Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches.” 100 HHS, Promising Strategies to End Youth Homelessness, Report to Congress, p. 54. 101 Ibid. 98 Congressional Research Service 28 Runaway and Homeless Youth Act: Current Issues for Reauthorization programs could choose to serve the lower-risk runaway and homeless youth in order to increase their likelihood of meeting the proposed (unrealistic) outcome measures.”102 Interaction with Child Welfare and Juvenile Justice Systems The Runaway and Homeless Youth Act specifies that services provided by BCP grantees are intended to be an alternative to involving runaway and homeless youth in the law enforcement, child welfare, and juvenile justice systems. Still, some of these youth are served by Runaway and Homeless Youth program providers while involved with foster care or juvenile justice or upon leaving those systems, and runaway and homeless youth advocates have raised concerns that Runaway and Homeless Youth program programs receive “little to no funding or recognition” for doing so.103 Some stakeholders have raised concerns that these other systems do not fully address the needs of some young people, who are then served by the runaway and homeless youth system. As noted in the 2007 HHS report to Congress, youth transitioning from the juvenile justice and foster care systems are particularly vulnerable to becoming homeless. In recent years, about 7% of youth in the BCP reported having spent some time in foster care and 6% of youth had been in the juvenile justice system at some point in their lives. About 20% of TLP youth have spent time in foster care and nearly 10% have been in the care of the juvenile justice system at some time in their lives.104 In addition, youth who run away often have a history of involvement in the foster care system. On the last day of FY2012, states reported that almost 5,000 foster children (1% of all foster children) had a current placement of “runaway.”105 A study of youth in Illinois who ran away from foster care between 1993 and 2003 found that the average likelihood of an individual running away from foster care placements increased over this time period.106 Research on youth who emancipate from foster care suggests a nexus between foster care involvement and later episodes of homelessness. Estimates of homeless youth who are reported as having been in foster care range from 21% to 53%.107 In an often-cited study of youth who had emancipated from foster care in three states, over one-third had experienced homelessness between the time they left care and age 26.108 The research literature has similarly documented a connection among juveniles and young adults released from secure detention or correction facilities and becoming homeless, although the data on this population are not as reliable.109 Some studies have found that 102 National Network for Youth, Runaway and Homeless Youth Proposed Rule - Document #2014-08178, June 13, 2014. See also, National Alliance to End Homelessness, Regarding 45 CFR 1351, RIN 0970-AC43, June 13. 2014. 103 Ibid. 104 CRS analysis of NEO-RHYMIS data. Data are available online by state, region, and grantee organization at https://extranet.acf.hhs.gov/rhymis/custom_reports.html. 105 HHS, ACF, ACYF, Children’s Bureau, Adoption and Foster Care Analysis and Reporting System Report #20 (Preliminary Estimates for FY2012), November 2013. 106 Mark E. Courtney et al., “Youth Who Run Away from Out-of-Home Care,” University of Chicago, Chapin Hall Center for Children, Issue Brief no. 103 (March 2005), p. 2. 107 Paul A.Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches,” Toward Understanding Homelessness: The 2007 National Symposium on Homelessness Research (2007). (Hereinafter, Paul A.Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches.”) 108 Amy Dworsky, “Predictors of Homelessness During the Transition From Foster Care to Adulthood,” University of Chicago, Chapin Hall Center for Children, Inside the Research, no date. 109 Paul A.Toro, Amy Dworsky, and Patrick J. Fowler, “Homeless Youth in the United States: Recent Research Findings and Intervention Approaches.” Congressional Research Service 29 Runaway and Homeless Youth Act: Current Issues for Reauthorization homeless adults had high rates of prior incarceration, including while they were juveniles. Further, research has identified a number of challenges that youth are likely to confront when reentering the community, including problems with family and living arrangements. Young people who are homeless also have relatively high levels of involvement with the juvenile justice system.110 The National Network for Youth has articulated that given scarce resources, RHY providers should receive greater financial support on behalf of the youth they serve from these systems.111 In its April 2014 proposed regulations for the Runaway and Homeless Youth Program, HHS provides guidance on coordinating services for these other populations. For example, the rule would add provisions that grantees are not required to provide services that substitute for those provided by juvenile justice, child welfare, or other systems that are legally responsible to youth who are under their supervision. As discussed in the preamble to the proposed rule, the purposes of these provisions is to provide a clear demarcation between services that are the legal and financial responsibility of other programs, and services that are the responsibility of the Runaway and Homeless Youth Program. Because the availability of federal funds varies among programs, and where Federal funds are available the matching rates usually vary, other State and local agencies have financial incentive to blur these lines. We strongly encourage grantees to take steps [to] prevent other programs from displacing their costs on these programs while also providing continuous service to youth.112 Policy makers might consider the extent to which the act should reflect language that is similar to the regulations, or whether RHY providers should coordinate with child welfare and juvenile justice agencies. Current child welfare policies address youth who have run away and/or are homeless. The Child Abuse Prevention and Treatment Act (CAPTA) directs states that receive CAPTA state grant funds to prevent and respond to child abuse to certify that CAPTA-funded programs and training address the unique needs of unaccompanied homeless youth, including access to enrollment and support services. In addition, CAPTA community-based grants allow funds to be used for resources, opportunities, and prevention services for these youth.113 Separately, HHS is providing child welfare funding for a grant to develop interventions for youth who have a history of child welfare involvement and are at-risk of homelessness. Grantees— including child welfare agencies and at least one runaway and homeless youth provider—can use these funds to test an intervention model that will help young people in or aging out of care make a successful transition at home, at work, in school, in the community, and in adulthood.114 These outcomes are consistent with the goals of USICH’s Framework to End Youth Homelessness. 110 U.S. Department of Health and Human Services, Promising Strategies to End Youth Homelessness, Report to Congress. 111 National Network for Youth, National Summit on Youth Homelessness, March 24-25, 2014, Washington, DC. 112 HHS, ACF, “Runaway and Homeless Youth Program; Proposed Rule,” 79 Federal Register 71, April 14, 2014. See proposed changes to §1351.20. 113 See Section 106(b)(2)(F) and Section 201(b)(1)(E) of the CAPTA. “Unaccompanied homeless youth” means an individual who is referenced in Section 725 of the McKinney-Vento Homeless Assistance Act. Specifically “homeless children and youths” are those lacking a fixed, regular, and adequate nighttime residence; and includes those who are (1) sharing housing with other persons due to loss of housing or economic hardship; (2) living in hotels or motels, trailer parks, or campgrounds due to lack of alternative arrangements; (3) awaiting foster care placement; (4) living in substandard housing; and (5) children of migrant workers. The term “unaccompanied youth” also includes a youth not in the physical custody of a parent or guardian. 114 U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth, and Families, “Planning Grants to Develop A Model Intervention for Youth/Young Adults With Child (continued...) Congressional Research Service 30 Runaway and Homeless Youth Act: Current Issues for Reauthorization Appendix. Proposed Monitoring and Outcomes for the Runaway and Homeless Youth Program The Reconnecting Homeless Youth Act of 2008 required that within one year after its enactment (i.e., October 8, 2009), HHS issue rules that specify performance standards for public and nonprofit entities that receive BCP, TLP, and SOP grants. In developing the regulations, HHS was to consult with stakeholders in the runaway and homeless youth policy community. The law further required that HHS integrate the performance standards into the grantmaking, monitoring, and evaluations processes for the BCP, TLP, and SOP. On April 14, 2014, HHS issued a notice of proposed rulemaking (NPRM) that seeks to implement new performance standards and other requirements for grantees receiving funds under the Runaway and Homeless Youth program. According to the NPRM, FYSB undertook a process for consulting with a wide range of stakeholders about the performance standards. The proposed rule includes 10 proposed performance standards, which are outlined in Table A-1. The NPRM also specifies that the grantmaking process will give priority to providers that (in past years) have demonstrated high performance under these standards. Table A-1.Proposed Performance Standards for the Runaway and Homeless Youth Program Proposed Performance Standards Basic Center Program • Grantees must contact the parent(s), legal guardian, or other relatives of each participant within 72 hours of the youth entering the program to inform them that the youth is safe. The grantee should determine on a case-by-case basis if it is in the best interests of the youth to notify the parent(s) or legal guardian about the location of the youth until further information has been gathered to assure safety. • Grantees shall maintain at 90% or higher the proportion of youth transitioning to safe and appropriate settings when exiting BCP services. • Grantees shall ensure that youth receive counseling services that match the individual needs of each participant. Data shall be reported by each grantee on the type of counseling each youth received (individual, family and/or group counseling), the participation rate based on a youth’s service plan or treatment plan, and the completion rate based on a youth’s service plan or treatment plan, where applicable. • Grantees that choose to provide street-based services, home-based services, drug and/or alcohol abuse education and prevention services, and/or testing for sexually transmitted diseases (at the request of the youth) shall ensure youth receive the appropriate services. Data shall be reported on the completion rate for each service provided based on the youth’s service or treatment plan. Transitional Living Program • Grantees shall maintain at 90% or higher the proportion of youth transitioning to safe and appropriate settings when exiting Transitional Living Program services. (...continued) Welfare Involvement,” April 11, 2013. Congressional Research Service 31 Runaway and Homeless Youth Act: Current Issues for Reauthorization Proposed Performance Standards • Grantees shall maintain at 40% or higher the proportion of youth who are engaged in community service and service learning activities while in the program. • Grantees shall ensure youth are engaged in educational advancement, job attainment skills, or work activities while in the program. • Grantees shall ensure and report that youth receive health care services as determined within their health care referral plan. • Maternity group home grantees shall ensure and report that youth receive consistent prenatal care, well-baby exams, and immunizations for the infant while in the program. Street Outreach Program • Grantees shall contact youth who are at risk of homeless or runaway status on the streets, in numbers that are reasonably attainable for the staff size of the project. Grantees with larger staffs will be expected to contact larger numbers of youth in approximate proportion, as determined by HHS, to the larger number of staff available to provide this service. Source: U.S. Department of Health and Human Services, Administration for Children and Families, Family and Youth Services Bureau, Basic Center Performance Standards. Author Contact Information Adrienne L. Fernandes-Alcantara Specialist in Social Policy afernandes@crs.loc.gov, 7-9005 Congressional Research Service 32