3.2 Retooling the Crisis Response System


Published on

Published in: Business, Real Estate
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide
  • CSB is a public-private partnership organization working to end homelessness. We bring together many organizations to work together as a system focused on ending homelessness. We allocate over $13 million annually to support homeless programs and services at several provider agencies. Last year, these programs served more than 8,000 individuals.
  • Families seek shelter through a front door – the YWCA Family Center.
  • Prevention & diversion Single point of contact Minimize shelter stay/move to appropriate housing quickly We measure results and manage for outcomes
  • When a family calls or arrives at the YWCA Family Center, they are immediately triaged. First need to find out if they are still housed or not. If they are still housed, they are immediately referred to other services such as the Stable Families program which is focused on preserving current housing and provides rental assistance, case management etc. which is funded through CSB. Top prevention resources in addition to Stable Families are Columbus Impact (a community action agency), Legal Aid and Columbus Mediation Services. If they don’t have stable housing, we try to find another safe place for the family to stay versus coming into the shelter. We encourage them to take advantage of any opportunity to stay in any safe place versus coming into the shelter. Our goal is to divert 39% of the families who present for shelter. In the most recent quarter, 50% of families were diverted. We shelter all families in need of shelter. Assessment takes about 1½ hours. Comprehensive information is gathered and policies and expectations are discussed. Columbus Service Point is HMIS system. It is open database to all providers. Information is entered from assessment by next day.
  • One of the goals of HEARTH is a greater focus on prevention. We’ve added: Stable Families program To identify families who are at risk of literal homelessness and provide them with case management, supportive services and cash assistance if necessary to maintain housing; To maintain school stability so that students remain stable in school; and To increase the capacity of families to appropriately utilize community resources. Evaluation by the Strategy Team available on web site. Siemer Institute has been developed to replicate program in 5 other cities and has committed to 5 years of additional funding. Using HPRP funds to do additional family prevention at Gladden.
  • One of the goals of HEARTH is decreased length of stay. Some of the ways we achieve this: Family is scheduled to meet with their family advocate (to link with transportation, documents, housing, employment) and their child advocate (for school and child care linkages). Family Advocate completes goal plan with family within 24 to 48 hours of shelter entry. Intake assessment is so robust it gives Family Advocate good starting point. Within 5 days of completing goal plan-referral has to made to next step housing/services.   How does Y make decisions on where to refer/link families? Use document called “Next Step Housing Options” that helps drive decision making. Providers of next step housing and CSB staff meet weekly in a Program Administrators Meeting. The purpose is to staff families and decide what best option is. This is also the place where families with multiple barriers are staffed to problem solve getting them housed. Also have quarterly Family System Operations Workgroup Meetings with providers and CSB to deal with system issues that are affecting services. This is where processes etc are streamlined and made more efficient. Recent example: Issue with referrals. The FC would send referrals to VOA but then VOA would not accept the referral in a timely manner. The group came up with a receipt of referral form that clarifies when the agency received the referral, appointment time with family and who would be meeting with the family.
  • DCA – provides up to 3 mos. of rent/security deposit to help families move into new housing. Funded with both HPRP and non-HPRP funds. We are concerned about HPRP funds going away. Approximately $1.5 million of DCA is used annually from HPRP funds (we did $2.4 million DCA in total in FY11). Salvation Army Direct Housing – SA helps families move out of shelter and into housing – but they target families who need transitional support to be stable once housed. Case mgmt. is provided for typically up to 90 days. 212 households are served a year. Rolling Stock/Direct Housing – NEW – Traditionally families with multiple barriers that needed more time went to tier II providers that provided transitional housing that lasted about 100 days on average. Both of our Tier II shelters are transitioning into a direct housing model and will be completely converted by the end of 2011. This will be 70 units total (46 HFF, 24 VOA). Average length of participation is 104 days. Number households served per year is 199 (for FY12, HFF will serve 117 and VOA will serve 82) Job2Housing – NEW – HUD demonstration grant also funded by Chase. 6 months of rental subsidy & job training skills. We are finding this program challenging as so many of our heads of household are lacking HS diploma. USHS – NEW – Referrals to PSH have been done directly to providers of family PSH. Going forward through Unified Supportive Housing System, which is managed by CSB. This system allows us to manage vacancies system-wide as well as new lease ups. It assures that families & single adults most in need of PSH are prioritized and that all their eligibility requirements & paperwork is in order before they are referred to a PSH provider.
  • Each next step provider has a written agreement with YWCA where all expectations of how referrals are made and time frames for service linkage are spelled out. This decreases instability & inconsistency when there is turnover in provider agency staff. For referral to market rate housing, the Family Advocate assists with the housing search, assures all documents needed are obtained & arranges transportation as needed for housing search & appts. Family Advocate fills out all paperwork related to obtaining DCA funds & submits to CSB for payment. FHC – CSB established this several years ago to streamline referrals and have providers act as a system of resources versus in silos. All providers have MOU with YWCA.
  • We shelter all families that need shelter. We have experienced a 5,220% increase in family overflow this year compared to last year. 2,445 nights/times families needed shelter when there were no beds in our regular shelter capacity, compared to 56 nights last year. The cost last year was $5,000 and this year it was $250,000. In order to help clear the family system, we added significant resources to our rapid re-housing programs – over $375K (CSS RRH, CHN RRH, CSB DCA, VOA DH).
  • Y’s performance over the past 5 years Outcome measures are: households served (goal is 660) average length of stay (goal 20) Successful housing outcome (only includes permanent exits, and they are a percentage of successful outcomes) Successful outcomes (includes exits to permanent housing and to tier II/rolling stock [goal 61%]) Average FHC transition time (goal 7 days). This is the amount of time before a family is linked to the providers for direct housing. We also track: nightly occupancy (tracked only) diversion (32%-tracked only)
  • We moved the family overflow management from various providers to the YWCA for more efficient handling. The Family Housing Collaborative manual was created to capture the roles and responsibilities of each partner. New measures were introduced to track the movement of families through the system to assure providers were moving families through quickly. We streamlined the next step housing practices using Six Sigma methods to focus on quick movement through the system. We introduced performance-based contracting to assure a focus on the outcomes we wanted to achieve. The performance-based contracts are based on the number of successful housing outcomes achieved (paid per SHO) and the number of direct client assistance applications submitted (paid by number of correct applications). Performance-based contracting has had a positive effect on providers working together. All providers are interested in each other’s success and work as a system to help each other achieve their goals and hold each other accountable. Many of the MOUs are built around performance-based contracting goals. This has reinforced housing first model and systematic thinking. Providers say they cooperate to all get their dollars versus feeling they are competing against each other for dollars.
  • CPOA – NEW Similar to the family system, we first attempt for the individual to be diverted from shelter. We identified a prevention need at the front door and with HPRP $s we established a prevention program for single adults that had good success. If the individual has to access shelter the CPOA makes the referral to the shelter. The referral is made electronically, through Columbus ServicePoint. Shelters then are able to assist the individual and provide services, including next step housing. With HPRP $s we also established a new rapid rehousing program for single adults and we are using the same HPRP $s to provide short-term rental assistance. In addition we have currently 965 units of permanent supportive housing dedicated to homeless and disabled individuals.
  • This triage and diversion step is also included in our homeless management information system, Columbus SevicePoint and all contacts are tracked in CSP along with minimal demographic information and the resolution of the contact. We are reporting out on the requests for shelter and diversion outcomes on a regular basis and I will show you some data as well.
  • This workflow helps guide the staff at the CPOA with the data entry requirements into Columbus ShelterPoint. As you can see, if a diversion occurs it is captured in CSP and no further steps are needed. In case diversion is not possible, the intake is processed. During the intake, detailed client information and documentation is gathered and the shelter bed availability is checked. If a bed is available, the individual will have their bed reserved in Columbus ServicePoint for the shelter to know that somebody is assigned to their shelter. Our reservation list is using the ServicePoint reservation feature. If there is no bed available the individual is added to a waitlist, which currently operates on a first come first served principle. The waitlist is electronic and is set-up as a ServicePoint bedlist.
  • There are 3 scenarios possible. Once a bed becomes available the individual is sheltered, taken off the waitlist and a bed reservation is made for him or her. In the other two scenarios the individual will not receive a shelter bed – the individual either disappears or decides that he/she does not want or need the shelter bed.
  • During the intake process, all available client documentation is collected. In addition, the CPOA staff makes a preliminary determination of the individual’s homeless status – chronic homeless or rebuilding lives (which is the local eligibility definition for permanent supportive housing).
  • We have only one year worth of data for the CPOA and the numbers are shown here. We have a 25% rate of repeat contacts so far and 58% of the contacts are new to our system, which means they have not used the shelter system in the last 10 years. This % is lower than in the family system where more than 70% are new. Only 16% are diverted and we would like to increase this %. We are currently experiencing a waitlist for entry into shelter and we are working towards decreasing or eliminating this waitlist. Every day, we are making public the waitlist numbers for both men and women through our daily bedlist report that is issued to the community. We now have a very clear picture about the demand for shelter in our community. In a non-centralized environment it is not possible to do that so this is an additional benefit of the central intake process.
  • A bottleneck effect is occurring in the single adult shelters. Longer lengths of stay are causing capacity issues. We are also seeing a trend upward over the last 3 years of non-Franklin County residents using our shelters in the adult single system. Because of this and in preparation for full HEARTH implementation, we are making system-wide practice changes intended to decrease lengths of stay and increase positive housing outcomes in order to respond effectively to the increased demand.   The single adult shelter certification standards for FY12 have been changed to require goal plans with clients must be finalized within 5 days of entry to shelter, and a client has 20 days to make progress on their goal plan or be removed from shelter. If no progress, given 10 days more. If no progress, exited from shelter. Performance-based funding is being used. A portion of a shelter provider’s funding is dependent on meeting the 30-day average length of stay and 25% successful housing outcomes. Formed 2 ad hoc groups with key stakeholders to work on out-of-county issue and Transitional Age Youth.
  • CPOA has worked well but it’s very expensive – over $500K/year. Not sustainable. Looking at these questions: What should structure of front door be? Who should run it? What is its primary purpose? Current primary purpose is to get people into shelter. We want the primary purpose to be diversion. We want 30% diversion, but we are currently at 17%. Six Sigma black belt doing assessment of triage/intake process. Grange leadership team of 20 working on intake assessment.
  • Close relationship with VA, collaborating to help them develop their plan to end homelessness & integrate with our plan. They have been involved in our Outreach strategy. Appointed a designated contact person who can be called when a homeless vet presents for shelter. VOA/CHN RRH program – Goal is to rapidly re-house 200 homeless single adults living in emergency shelter or on the street, over approximately 20 months of funding availability. Each individual is provided with up to 6 months of rental subsidy and associated case management services. CHN RRH program – Housing facilitator for the single adult system that works to house those newly experiencing homelessness within 14 days to reduce shelter stay and likelihood of spiraling deeper into homelessness. One shelter is doing critical time intervention. Other shelter is doing clinical pathways in an intentional way.
  • Project partners: ADAMH Board, the Columbus Metropolitan Housing Authority and CSB. A thoughtful “system” for the way we use supportive housing, to make sure we place the most vulnerable of the homeless population into the most appropriate housing. Supportive housing is the answer to chronic homelessness but it’s a very precious resource. We must use it very wisely and with great care. This began as lease up of only the new units. Now we are managing vacancies for 590 units of supportive housing. 260 more units will come under our management over the next year (100 Chantry, 100 Third, 60 Inglewood).
  • 3.2 Retooling the Crisis Response System

    1. 1. Retooling the Crisis Response System Michelle Heritage Executive Director Community Shelter Board www.csb.org National Conference on Ending Homelessness Washington, DC July 14, 2011
    2. 3. Our Family Shelter System
    3. 4. YWCA Family Center
    4. 5. Franklin County Family Emergency Shelter System <ul><li>First contact between YWCA Family Center and family: </li></ul><ul><li>Triage </li></ul><ul><li>Referral </li></ul><ul><li>Assessment </li></ul><ul><li>Services </li></ul><ul><li>Guidance </li></ul>Permanent housing, usually with Transition assistance (CSB) Referral to direct housing: Family Housing Collaborative (Salvation Army, Homeless Families Foundation, Volunteers of America, CSB) Diversion: Helping families stay in the housing they’re in, with support from community programs, social service agencies, family and friends, and other community agencies. Welcome to the Family Center Referral to Tier II shelter (Homeless Families Foundation, Volunteers of America) Referral to transitional housing (Amethyst) Referral to permanent supportive housing (Community Housing Network, Amethyst, Volunteers of America, Maryhaven, Columbus AIDS Task Force) Permanent housing Treatment programs for severe issues (ADAMH agencies) RA-TA/Program Planning-Development/Family System Planning/Front door slide with provider names 5.6.10 5/6/10
    5. 6. Comprehensive Assessment <ul><li>Family immediately triaged to see if diversion is possible </li></ul><ul><li>Referred to prevention if still housed </li></ul><ul><li>Eligibility - must have minor children </li></ul><ul><li>Intakes done 24/7 </li></ul><ul><li>Assessment takes 1.5 hours </li></ul>
    6. 7. Prevention Stable Families
    7. 8. Coordinated Client Linkage Housing plan completed within 24-48 hours
    8. 9. Program Referrals <ul><li>Direct client assistance for rent/security deposit </li></ul><ul><li>Direct housing </li></ul><ul><li>Job2Housing program </li></ul><ul><li>Permanent supportive housing </li></ul><ul><li>Market rate housing </li></ul>
    9. 10. Program Referrals <ul><li>Direct client assistance for rent/security deposit </li></ul><ul><li>Direct housing </li></ul><ul><li>Job2Housing program </li></ul><ul><li>Permanent supportive housing </li></ul><ul><li>Market rate housing </li></ul>
    10. 11. Waitlists & Occupancy 5,220% increase in family overflow
    11. 12. Outcomes   Households Served Nightly Occupancy Average Length of Stay (Days) Successful Outcomes Successful Housing Outcomes Average FHC Transition Time (Days) YWCA Goal (#) Actual (#) Outcome Achieve ment Capacity Actual Goal Actual Outcome Achievement Goal (#) Actual (#) Outcome Achievement Goal (%) Actual (%) Outcome Achievement Goal (#) Actual (#) Outcome Achievement Goal (%) Actual (%) Outcome Achievement Goal Actual Outcome Achievement FY2010 660 688 √ 50 38 20 21 √ 427 487 √ 70% 76% √ 260 333 √ 61% 68% √ 7 14 ≠ FY2009 660 653 √ 50 39 20 22 √ 427 451 √ 70% 74% √ 333 257 N/A 78% 57% N/A 7 19 N/A FY2008 660 726 √ 50 47 20 24 ≠             427 495 √ 70% 72% √       FY2007 660 701 √ 50 44 20 23 ≠             427 440 √ 70% 66% √       FY2006 660 696 √ 50 44 20 23 ≠             427 442 √ 70% 68% √      
    12. 13. Other Ways we’ve Re-tooled <ul><li>Overflow management handled by front door provider </li></ul><ul><li>Manual to capture roles of each partner </li></ul><ul><li>Streamlined next step housing practices </li></ul><ul><li>Performance-based contracting </li></ul>
    13. 14. Our Single Adult Shelter System
    14. 15. Franklin County Adult Crisis Response <ul><li>First contact between Centralized Point of Access and single adult: </li></ul><ul><li>Triage </li></ul><ul><li>Referral </li></ul><ul><li>Services </li></ul><ul><li>Guidance </li></ul>Permanent housing, usually with Transition assistance (CSB) Diversion: Helping individuals stay in the housing they’re in, with support from community programs, social service agencies, family and friends, and other community agencies. Welcome to the Centralized Point of Access Referral to transitional housing (Amethyst, Friends of the Homeless, Volunteers of America of Greater Ohio) Referral to permanent supportive housing (Community Housing Network, Amethyst, Volunteers of America of Greater Ohio, Maryhaven, National Church Residences, Columbus AIDS Task Force) Permanent housing Treatment programs for severe issues (ADAMH agencies) RA-TA/Program Planning-Development/Adult System Planning/Adult System Slide 4.5.11 4/5/11 Admission to: FM on 8 th , FM on 6 th , FM Nancy’s Place, FoH Men’s Shelter, FoH Rebecca’s Place, VOA Men’s Shelter. Referral to inebriate shelter (Maryhaven Engagement Center) Referral to the Unified Supportive Housing System for placement in permanent supportive housing (Community Housing Network, Southeast Inc. National Church Residences, YMCA of Central Ohio, YWCA Columbus) Referral to Rapid Re-housing programs (Volunteers of America of Greater Ohio / Community Housing Network Rapid Re-housing, Community Housing Network In-reach Single Adults)
    15. 16. Triage and Diversion <ul><li>Complete Triage/Diversion Form; </li></ul><ul><li>Enter data in CSP </li></ul>Refer to Prevention Services Is adult facing eviction/ foreclosure? Single Adult presents at CPOA Is adult self caring? Refer to Hospital, Mental Health Provider, shelter for public inebriates Does adult have any other option? Assist adult in making alternate arrangements Complete Shelter Intake Yes No Yes Yes No No
    16. 17. Diversion Workflow Chart
    17. 18. Waitlist Workflow Chart
    18. 19. Front-Door Intake <ul><li>Collect all available client documentation </li></ul><ul><li>Complete client intake paperwork </li></ul><ul><li>Determination of Rebuilding Lives or Chronic Homeless status </li></ul><ul><li>Data entry into CSP </li></ul><ul><li>Upload of intake documentation into CSP </li></ul><ul><li>Intakes done 24/7 </li></ul>
    19. 20. One Year Outcomes <ul><li>Individuals served </li></ul><ul><ul><li>5,348 individuals, 36% female, 64% male </li></ul></ul><ul><ul><li>6,662 contacts (25% repeat contacts for the year) </li></ul></ul><ul><ul><li>58% new to shelter (within 10 years) </li></ul></ul>
    20. 21. New Measurements <ul><li>Client goal plans within 5 days of shelter entry </li></ul><ul><li>Client must show some progress within 20 days </li></ul><ul><li>Portion of shelter funding dependent on: </li></ul><ul><ul><li>meeting 30-day average length of stay </li></ul></ul><ul><ul><li>25% successful housing outcomes </li></ul></ul>
    21. 22. Looking Forward <ul><li>What should the structure of the front door be? </li></ul><ul><li>Who should run it? </li></ul><ul><li>What is its primary purpose? </li></ul>
    22. 23. Getting to Housing <ul><li>Veterans Administration </li></ul><ul><li>Rapid Re-housing programs </li></ul><ul><li>Critical time intervention; clinical pathways </li></ul>
    23. 24. Unified Supportive Housing System <ul><li>Placing the right person </li></ul><ul><ul><li>In the right unit </li></ul></ul><ul><ul><ul><li>At the right time </li></ul></ul></ul><ul><ul><ul><ul><li>At the right cost </li></ul></ul></ul></ul>
    24. 25. Questions?