National Health Care for Homeless Council

What it reported doing in 2024

The national health care for the homeless council provides national, state and local-level training related to the unique features and needs of homeless populations to the 1,400+ federally qualified health centers with a focus on 300 health centers that specifically serve homelss populations, 150+ medical respite programs and other safety net programs that provide care to more than one million homeless patients per year. Program services include: virtual trainings, communties of practice and a national conference, plus site-specific trainings and technical assistance from peer experts in the field. The council maintains a compreshensive website of health care for the homeles information and regular publications. The nhchc is a national training and technical assistance partner of the health resources and services administration. In fy25, nhchc responded to nearly 150 technical assistance requests. The top three categories were medical respite, quality improvement and clinical practice. In addition to responding to requests, the council prepares and distributes issue briefs, fact sheets, and reports, as well as newsletters. Topics included supporting older adults experiencing homelessness, end of life care in medical respite care programs, mortality and homelessness, pathways into and out of family homelessness and more.the national institute for medical respite care (nimrc) is a special program of the council created to help expand and advance medical respite care. In the past year, the council has helped more than 50 medical respite programs get started, expand services, or improve operations through training, technical assistance, and conducting learning communities. We also provided input to several state governments that are in various stages of including medical respite as a benefit in their state medicaid plan. We were privileged to disburse more than $9m to support medical respite programs since the launch of nimrc in july 2020. In april 2025, nimrc launched a first of its kind national certification process for medical respite care programs. Nimrc has designed a voluntary certification process built on robust stakeholder input and a nationally recognized framework for medical respite care programs. Over 60 programs applied for certification in april 2025 representing about 25% of the field. Nimrc is on track to certify over 100 programs in the first 3 years.

Financial Efficiency

• Mission deployment rate: 65.7%; rating input score 66
• Program expense ratio: 78.6%; rating input score 79
• Fundraising efficiency: $50.48 raised per $1 spent on fundraising; rating input score 78; 78th percentile among comparable filings

Transparency & Controls

• Consistency checks: 93.3%; rating input score 93; 17th percentile among comparable filings
• Pay-setting controls: 3 of 6 controls in place; rating input score 50
  • Compensation committee: Pass
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Pass
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: 95.8%; rating input score 96; 30th percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 100%; rating input score 100; 63rd percentile among comparable filings
• Governance controls: 7 of 9 controls in place; rating input score 78
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Fail
  • CEO compensation review process: Pass
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 17%; rating input score 73; 73rd percentile among comparable filings
• Total-asset coverage ratio: 0.63; rating input score 23; 23rd percentile among comparable filings
• Liabilities to assets ratio: 0.3; rating input score 34; 34th percentile among comparable filings
• Officer compensation ratio: 12.3%; rating input score 24; 24th percentile among comparable filings

Growth

• Program expense growth: 11.8% per year; rating input score 100; 70th percentile among comparable filings
• Revenue growth: 12.9% per year; rating input score 100; 77th percentile among comparable filings
• Asset growth: 17.3% per year; rating input score 100; 79th percentile among comparable filings