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| Continuums of Care (CoC) | |
|---|---|
| Name | Continuums of Care (CoC) |
| Type | Programmatic network |
| Established | 1994 |
| Jurisdiction | United States |
| Parent agency | United States Department of Housing and Urban Development |
Continuums of Care (CoC) are regional planning bodies and coordinated networks that organize local strategies to address homelessness in the United States Department of Housing and Urban Development system. They link municipal, county, and tribal stakeholders with nonprofit providers, philanthropic organizations, and federal programs to prioritize housing, supportive services, and rapid rehousing. CoCs operate alongside landmark policies and initiatives shaped by laws, federal agencies, and national coalitions.
Continuums of Care were designed to coordinate resources from entities such as the United States Department of Veterans Affairs, Centers for Disease Control and Prevention, Federal Emergency Management Agency, Social Security Administration, and Department of Labor to reduce homelessness among populations served by National Alliance to End Homelessness, The Salvation Army, Catholic Charities USA, United Way Worldwide, and local public housing authorities including New York City Housing Authority and Los Angeles Housing Department. Their purpose aligns with statutes and programs like the McKinney–Vento Homeless Assistance Act, the Housing First model promulgated by advocates including Dr. Sam Tsemberis and institutions such as Pathways to Housing and policy analyses from Urban Institute, Brookings Institution, Kaiser Family Foundation, Harvard Kennedy School, and RAND Corporation. CoCs facilitate coordinated entry systems, point-in-time counts linked to research by Princeton University, Columbia University, University of California, Los Angeles, Johns Hopkins University, and data systems interoperable with platforms used by Centers for Medicare & Medicaid Services.
CoCs emerged after enactment of the McKinney–Vento Homeless Assistance Act and were formalized under rulemaking by the United States Department of Housing and Urban Development during administrations including Clinton administration and subsequent policy adjustments under the George W. Bush administration, Obama administration, and Trump administration. National movements such as efforts led by Coalition for the Homeless (New York City), National Coalition for the Homeless, National Law Center on Homelessness & Poverty, and research from Urban Institute and Brookings Institution influenced design. Major events shaping CoC practice included federal funding shifts after the Great Recession, programmatic expansions under initiatives like Continuum of Care Program (HUD) revisions, and legal decisions referenced by litigators at organizations such as ACLU and National Homelessness Law Center.
Each CoC is typically organized by a lead entity such as a municipal government, county agency, or nonprofit consortium including examples like Los Angeles County Department of Health Services partnerships with Los Angeles Homeless Services Authority and collaborations modeled after networks in New York City or Chicago. Governance involves a board or council comprised of representatives from local public housing authorities, hospital systems like Mount Sinai Health System or Kaiser Permanente, faith-based providers such as The Salvation Army and Catholic Charities USA, and academic partners including Columbia University or University of Chicago. Oversight and compliance relate to regulations promulgated by United States Department of Housing and Urban Development and reporting expectations tied to federal entities like the Office of Management and Budget and inspector general reviews similar to those affecting Department of Veterans Affairs programs.
CoCs coordinate an array of interventions including emergency shelter operated by agencies like Red Cross (American) affiliates and transitional housing run by providers modeled on Women in Need (WIN)],] supportive housing initiatives influenced by Pathways to Housing, permanent supportive housing funded under HUD rules, rapid rehousing aligned with Veterans Affairs Supportive Housing and Supportive Services for Veteran Families, and eviction prevention services partnering with legal aid organizations such as Legal Services Corporation grantees. They connect to workforce programs from Department of Labor grantees, health services through Centers for Medicare & Medicaid Services partnerships, behavioral health referrals used by Substance Abuse and Mental Health Services Administration, and veteran-focused coordination with United States Department of Veterans Affairs regional offices.
Major funding streams include HUD CoC Program awards administered competitively, Emergency Solutions Grants allocated by Department of Housing and Urban Development, and supplemental funding from congressional appropriations influenced by committees such as the United States Senate Committee on Banking, Housing, and Urban Affairs and the United States House Committee on Financial Services. Philanthropic support from foundations including Bill & Melinda Gates Foundation, Robert Wood Johnson Foundation, Ford Foundation, and MacArthur Foundation supplements federal grants, alongside state and local appropriations from legislatures like the California State Legislature and municipal budgets in jurisdictions such as City of Seattle. Resource allocation decisions are informed by data from HUD Exchange reports and analyses by research centers like Urban Institute and Center on Budget and Policy Priorities.
CoCs use metrics including reductions in chronic homelessness, length of shelter stay, housing placement rates, and returns to homelessness tracked via the Homeless Management Information System and point-in-time counts conducted under HUD guidance. Outcome evaluation draws on studies by Urban Institute, RAND Corporation, Harvard University researchers, and federal program evaluations by Government Accountability Office and Congressional Research Service. Performance targets reflect objectives in federal strategic plans and cross-agency frameworks used by Interagency Council on Homelessness and are adjusted based on evidence from randomized trials and cohort studies published in journals associated with Harvard Medical School and Johns Hopkins Bloomberg School of Public Health.
CoCs face critiques regarding fragmented coverage across jurisdictions exemplified in debates involving Los Angeles County and New York City, competition among providers for scarce HUD awards, equity concerns raised by advocates from National Low Income Housing Coalition and National Alliance to End Homelessness, and administrative burdens described by municipal officials in cities like Detroit and Baltimore. Challenges include data quality issues in HMIS noted by researchers at University of Michigan and University of Pennsylvania, gaps in affordable housing stock highlighted by analyses from Congressional Budget Office and Lincoln Institute of Land Policy, and tensions between federal compliance and local innovation cited in hearings before the United States Senate Committee on Banking, Housing, and Urban Affairs.