Going Home: Programs Create New Housing Options for Rural Veterans

by Candi Helseth

Transitional housing took Desert Storm veteran Manny Alvarado, 44, off the streets and returned him to productivity. Medical foster care gave World War II veteran Rex McMahill, 88, a way out of spending the remainder of his life in a nursing home. Both programs are among various housing options supported by the Department of Veterans Affairs (VA) to help veterans of all ages live as independently as possible.

Alvarado participated in the North Coast Veterans Resource Center (No longer available online) (NCVRC) transitional living program in Eureka, Calif., as he climbed his way out of the pit that had become his life. Since 1998, NCVRC has helped homeless, unemployed or underemployed veterans become gainfully employed and establish permanent housing. The veterans, who live in NCVRC’s large, comfortably furnished Victorian Eureka House, are provided the basic physical essentials for daily living and given intensive case management support to find and get a job.

McMahill lived with his wife until she could no longer care for him. His advancing dementia made it unsafe for him to remain in their home. Medical Foster Homes (MFHs) provide a homelike option for veterans with major physical or mental disabilities who are unable to live independently. MFH care includes room and board, 24-hour supervision, medication management and assistance with daily tasks and personal care in a private home where caregivers are typically also the homeowners.

Medical Foster Homes Offers Family Setting

Medical Foster Home

Rex McMahill, a WWII veteran, enjoys sitting on the deck of his Medical Foster Home, run by Bill Olson and his wife, Marilyn, out of their own home.

McMahill can still recall details about his Navy service during World War II, such as not seeing land for 23 months, but may not remember what happened earlier that same day. In September 2011, he moved into a MFH in Cambridge, Iowa, a small town close enough to his previous home that his wife and son can visit regularly. Homeowners Scott and Marilyn Olson oversee McMahill’s needs.

“I’m happy here,” McMahill says. “They get me up in the morning, make me breakfast, have things to do that I can help with and they are careful not to let me do something I shouldn’t. They’re just like family, awfully good to me.”

The Olson home is one of nine MFHs under the VA Central Iowa Healthcare System, according to Jan O’Briant, MFH coordinator. While the VA has long provided placement for veterans with medical needs through its Community Residential Care (CRC) program begun in the 1950s, MFHs are a more recent development. Central Iowa’s first MFH opened in 2009; the VA Black Hills Health Care System in South Dakota is in the process of opening its first two MFHs.

One of the program’s strongest components is the VA Home Based Primary Care (HBPC) team that is part of every MFH, said Michelle Hough, Black Hills MFH coordinator. The team includes a variety of medical providers that provide primary care in the home, improving consistency of care and reducing health care-related travel for the veteran.

Rex McMahill Plays Checkers

Rex McMahill enjoys playing checkers at the Olsons’ dining room table.

“Most vets in these homes have major diagnoses—chronic diseases like diabetes or heart disease and mental health issues like PTSD and dementia,” Hough said. “The majority of them are on 12 or more medications. It’s very important they get consistent care.”

Marilyn Olson says they have found new purpose in the home that seemed too big after all their children left. As caregivers, the Olsons receive ongoing training and their home is regularly inspected. VA limits MFHs to having no more than three veterans at a time.

“We’ve been very blessed to get to know these World War II veterans and their families,” Marilyn commented. “It’s just amazing how much we get back out of it.”

The Black Hills and Central Iowa Health Care System services are part of the VA Midwest Health Care Network (or, Veterans Integrated Service Network 23), which serves more than 400,000 veterans in Iowa, Minnesota, Nebraska, North Dakota, South Dakota and portions of Illinois, Kansas, Missouri, Wisconsin and Wyoming.

Transitional Housing Gets Vets Back to Work

On the other end of the housing spectrum is transitional housing, which offers veterans temporary shelter with the goal of teaching them to live on their own. Last February NCVRC expanded the Eureka House to include 34 beds for male and female veterans. NCVRC Site Director Rob Amerman said the veteran population is relatively high in their rural area, and the recessive economy has contributed to increasing numbers of unemployed or underemployed veterans.

Eureka House

The Eureka House in Eureka, Calif., offers treatment and transitional housing for veterans who have nowhere else to go.

NCVRC’s three-step program begins with assessing and referring for treatment those residents whose addictions or mental health problems contribute to their inability to support themselves. NCVRC provides treatment support in cooperation with local mental health and addiction agencies. Residents commit to staying clean and sober and submit to random Breathalyzer and urinalysis tests.

Alvarado is grateful that NCVRC gave him a second chance. He relapsed following the death of two family members and has been sober again for two years.

“I used alcohol to chase away the bad dreams I had from my days in the service and the loss of my brother,” he said. “But they have helped me learn to deal with my loss and grief in better ways than going to the bottle. Now I’m helping other veterans and I understand where they’ve been.”

Alvarado is an NCVRC employee now, working with residents to help them with issues such as anger management, interpersonal skills, relationship building and relapse prevention. As veterans resolve their personal battles, they move through program steps that include job-specific training such as résumé writing and interviewing skills, then going to job interviews, and finally, getting a job and saving money. They can stay at the Eureka House up to two years, and must save 50 percent of their income toward permanent housing expenses.

“We offer a safe place to rest their head, take hunger off their minds with three good meals a day and teach them how to get a job,” Alvarado said. “You start seeing the pride coming back in their step. When they graduate, they want to come back and support other veterans through their process. We know that supporting each other makes all of us stronger.”

The Department of Veterans Affairs (VA), the Emergency Housing and Assistance Program (EHAP), and Community Development Block Grants from the State of California Department of Housing and Community Development funded the Eureka House expansion. NCVRC is a division of the nonprofit Vietnam Veterans of California (VVC), which has five regions in northern California.

Last fall, the Department of Veterans Affairs’ Supportive Services for Veterans and Families (SSVF) awarded VVC a $1 million grant that is assisting approximately 400 veteran families in northern California. Services include temporary financial assistance for expenses such as rent, utilities, moving, transportation, childcare and emergency supplies. Amerman said NCVRC also received a grant from SSVF to provide case management and financial assistance to stabilize families facing eviction and help homeless veterans and their families get into rental housing.

Additional Programs Provide Housing Support

Since 2009, VA and HUD have worked with more than 4,000 community agencies to successfully house 33,597 veterans in permanent, supportive housing with case management and health care access. Through SSVF, a homeless-prevention and rapid re-housing program, $100 million in housing-related grants is available in fiscal year 2012 to community agencies throughout the country.

“When we went into boot camp, asking for help was a sign of weakness,” Alvarado said. “We were trained to handle our own business, to be self-reliant. When vets come home, we don’t feel understood because people can’t really understand what combat is like. Now I tell the vets I work with, ‘You soldiered up for your country so you might as well veteran up for yourself.’ The more vets we can help get on their own two feet, the better off they are and all of us are. No veteran should be homeless.”


Veterans are one of the populations being targeted by the United States Interagency Council on Homelessness (USICH), which aims to create a national partnership at every level of government and with the private sector to reduce and end homelessness in the nation. The Council estimates that there are more than 70,000 veterans experiencing homelessness on any given night in the United States.

A summary of the Council’s five key areas for strategic action is available on the USICH Veterans page.


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