Audit of Homeless Screening Clinical Reminder Process

With a requested fiscal year 2026 budget of about $3.5 billion for homelessness programs, the Veterans Health Administration (VHA) is committed to preventing and ending veteran homelessness. VHA’s Homeless Programs Office uses a required screening process to identify veterans who are experiencing or at risk of homelessness and need assistance. Medical facilities must complete screenings for veterans under their care, have a process for positive screenings, and ensure staff respond to requests for services within seven business days. Follow-up action must occur within 30 days.

From January through June 2024, VHA screened over 2.4 million veterans and identified 31,149 who reported either experiencing or being at risk of homelessness. About 59 percent (18,250) requested to be referred to social work or homelessness program staff for further assistance. At 42 of 140 facilities, 25 to about 71 percent of veterans (depending on the facility) who wanted to be referred for additional assistance during the screening did not receive follow-up action within 30 days.

The audit team evaluated screening reminder processes at four medical facilities and found weaknesses in the referral and follow-up processes that put veterans at risk of not receiving assistance after they indicated they were experiencing or at risk of homelessness. Deficiencies in the process occurred, in part, because facilities did not establish written local policies and procedures in accordance with federal internal control standards and VHA policy. In addition, the Homeless Programs Office did not ensure facilities had an effective mechanism to monitor follow-up action. The VA Office of Inspector General made four recommendations to improve controls over referral, follow-up, and monitoring processes to ensure veterans’ needs are addressed after positive homelessness screenings. VHA’s under secretary concurred with three recommendations and concurred in principle with one recommendation.