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5.6 Katharine Gale
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5.6 Katharine Gale

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    5.6 Katharine Gale 5.6 Katharine Gale Presentation Transcript

    • Performance Improvement : Program and system-focused strategies to improve outcomes
      • National Conference on Ending Homelessness
      • Washington DC
      • July 14, 2011
      • Katharine Gale
      • Katharine Gale Consulting
      • & Focus Strategies
      • Berkeley, CA
      • (510) 710-9176, [email_address]
      • www.focusstrategies.net
    • Key to Community-Wide Performance Improvement
      • Thinking like a community/system:
      • We are working to end homelessness for all the people in our system vs. my agency is working to help our specific clients
      • We need to know how we are doing and target our scarce resources to the best solutions
      • To do this well, we must hold ourselves and each other accountable
      2
    • Mutual Accountability
      • Two examples of communities increasing mutual accountability
      • Alameda County – Performance measurement and contracting
      • Metro Area CoC (Omaha- Council Bluffs)
      • Housing Crisis Resolution through Coordinated Access system
      3
    • Performance Measurement: Alameda County
      • EveryOne Home (County’s 10- Year Plan) called for “Measuring Success and Reporting Outcomes”
      • Began outcomes development process in Fall 2009
      • Initial Outcomes and Benchmarks adopted in May 2010, and revised in Sept. 2010 with most recent data
      • First year report will be given July 25, 2011
      4
    • Process
      • Drafting Committee appointed: 6 providers, 3 jurisdictions and 1 private funder, plus EveryOne Home Director
        • Committee studied best practices around outcomes in other communities
        • Reviewed current metrics and recommended measures and benchmarks
        • Made process recommendations for time-frame for adoption and technical assistance
      5
    • Outcomes Selected
      • Obtain (or retain) permanent housing
      • Reduce exits to homelessness (negative exits)
      • Obtain permanent or interim housing
      • Exit with earned income
      • Those with no income exit with an income
      • Rate of return to system (“recidivism”)
      6
    • Efficiency/Process Measures Selected
      • Occupancy
      • Exit to “Known Destination”
      • Time from entry to Permanent Housing
      • Time to employment
      7
    • Establishing Benchmarks
      • To establish benchmarks Committee looked at
      • - current performance in the system where measures were available (i.e. exits to PH, exits with employment income, lengths of stay within programs)
      • - Other communities' goals where no local data available (example: returns to homelessness)
      8
    • Establishing Benchmarks
      • Where there was reasonably good data, basic benchmark established at 75 th percentile of current performance (rounded down to nearest 0 or 5 number.)
      • 25% of providers already exceeding goal, and another 25% close to goal.
      • Where no data, committee made a values-based decision
      • An improvement of 10% is considered having met the benchmark
      9
    • 9 Benchmarking Example: Transitional Housing Programs Exits to Perm. Housing
    • Alameda County Matrix of Outcomes for Whole System (Excerpt) 12
    • Implementation Process
      • Principles and benchmarks adopted May 2010
      • Base line report produced and reviewed September 2010, some adjustments made for better data
      • Funders (several cities, County Social Services and Housing and FEMA board) putting three year phase-in approach into contracts
      • EveryOne Home leading the way to resources for technical assistance and training
      12
    • Using HMIS for system and provider reports
      • System and component level reports generated from Countywide HMIS
      • Providers can generate their own program reports and compare their progress to the system and the goals
      • Iterative process – ongoing data cleaning, trouble shooting and adjustments being made
      • Performance Management Committee oversight
      13
    • Sample Alameda County Report: Emergency Shelters 14 Source: Alameda County HCD InHOUSE HMIS, 2/8/11 EMERGENCY SHELTERS Jan 1, 2010 - Dec 31, 2010 Dec 2010 Nov 2010 Jan 1, 2009 - Dec 31, 2009 GOAL People obtaining permanent housing 24.2% 26.2% 21.5% 21.3% {30%} Exiting to streets or shelter 15.3% 18.5% 23.4% --- {<30%} Exit with employment income 16.1% 17.9% 21.7% 15.6% {20%} Of adults entering with no income, an increase in those who exit with an income 4.4% 3.7% 3.6% 5.7% {15%} Return to homelessness in 12 months --- --- --- --- {N/A} Efficiency/ Process Measures Exit to Known Destination 67.7% 74.7% 71.8%        57.8% {85%} Obtain permanent housing within 60 days 58.1% 17.4% 0.00% 46.8% {50% <60 days}
    • Next step: system-assessment in process
      • HEARTH Academy held June 2011
      • Using NAEH Homeless System Evaluator Tool can see where system is bottle-necked or not cost effective. Includes:
        • Charts with exits rates/types by component
        • Cost per exit and cost per outcome
        • Returns to homelessness by component
      • Able to complete Evaluator because data now pretty good!
      15
    • Next step: system-assessment in process
      • Using system outcome and cost data to make system-improvement decisions including:
        • Expand coordinated intake approach beyond HPRP
        • Expand resources for rapid rehousing
        • Repurpose some transitional housing
      16
    • Commitment to System Coordination: Omaha and Council Bluffs Metro Area Continuum of Care (MACCH) 17
    • Commitment to System Coordination: MACCH
      • 10- year plan called for the implementation of systemic strategies that prevent the flow of individuals and families into homelessness.
      • In 2010 did assessment of prevention & rehousing system
      • Report “ Meeting the Effectiveness Challenge ”
      • found resources not well targeted and not well-coordinated
      18
    • Recommendations from Report
      • Develop a system of centralized access to the homeless prevention system and shelter resources with efficient referral to an agency/agencies who take responsibility for assisting clients through their crisis
      • Modify current funding streams or develop new financial assistance resources that are more flexible to address the crisis with an outcome of housing stability 
      • Improve program targeting and remove barriers to serving those with greatest need
      19
    • Result: Commitment to Develop a Coordinated Access System
      • Become a Housing-Crisis Resolution Focused System
      • Ensure clients get to the right place, get served appropriately, and exit the system without falling out
      • Be able to answer the question:
      • “ Who’s Got the Ball?”
      20
    • Vision
      • One Call and/or One Tool
      • Assessment and referral to an agency that can assist with the presenting housing crisis
      • Agency follows individual/household until crisis resolved OR “hands off” the client to someone else appropriate
      • MOU that holds agencies mutually accountable and data system that tracks this
      21
    • Steps to Implement
      • Identify assessment and referral point(s)
      • Develop common assessment tool and agency/program criteria
      • Assess technology needs and ensure data can be both collected and assessed to evaluate progress (including changes in outcomes!)
      • Develop MOU between parties to ensure mutual accountability for client outcomes
      22
    • More Information
      • National Alliance to End Homelessness
      • www.endhomelessness.org
      • Alameda County EveryOne Home www.everyonehome.org
      • Metro Area Continuum of Care (MACCH)
      • http://macchomeless.org
      • Me  email: [email_address]
      • www.focusstrategies.net
      23