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HEARTH Academy: System Assessment

by National Alliance to End Homelessness on Dec 02, 2010

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The HEARTH Academy webinar PPT from the 10-27-2010 online presentation.

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Welcome to the HEARTH Academy’s webinar on System Assessment and Design. The webinar will consist of two parts. The first part is on tools you can use to assess how well your system is working. This part takes approximately 20 minutes. The second part is on how to design an effective homelessness assistance system. This will take approximately 25 minutes.
Understanding how well your system works is a difficult process. Evaluation usually focuses on providers. and providers of homelessness assistance are pressured to perform from a number of directions. They must focus on the requirements of their funding sources. They also have to respond to the needs of consumers of their services, partner organizations, community and political leaders, and other stakeholders. But assessing how well your system works requires a deliberate strategy that steps back from the provider level and focuses on how well the entire process works, from before the time a person becomes homeless to after they exit and have achieved stability. The Alliance is developing a set of tools, both qualitative and quantitative to assist with the assessment process, and we’ll introduce you to some of those tools in this presentation.
Surveying the various stakeholders in your community can generate a wealth of information about how well homelessness assistance works in your community. Asking the right questions is critical. Consumer surveys should focus on a consumer’s needs and whether they were met. Survey questions should focus on what kinds of assistance consumers needed to prevent and end their homeless episodes, what services were provided, and whether they received assistance that was effective and empowering. Surveys of direct service providers should focus on whether consumers are appropriately prioritized for assistance based on need, training of direct service provider staff, access to resources, and an emphasis on continuous improvement. Executive directors, local officials, and other community leaders should be asked about how funding decisions are made, whether good performance is rewarded, and whether landlords are successfully engaged in re-housing efforts.
The Alliance is developing sample survey tools for consumers of homelessness assistance, service providers, and community leaders along with helpful hints about how to analyze the results. The slide is a screenshot from one of those tools, which will be published in the next several weeks.
You have many options to quantitatively measure the outcomes of your community’s efforts to prevent and end homelessness. There are numerous data sources, particularly HMIS, at your disposal. The key is to identify the right things to measure. The best strategy is to take your cue from the performance measures included in the HEARTH Act. They will help you create a system performance measurement strategy so you can better assess your performance on HEARTH Act measures and make progress toward your goal of preventing and ending homelessness.
As a reminder, the three key measures from the HEARTH Act are-- Reducing new episodes of homelessness—this measure will help you assess the effectiveness of your community’s prevention and diversion efforts. Reducing lengths of homeless episodes—this is one of the most challenging measures, it will help you determine if your system helps people move quickly into permanent housing. The HEARTH Act sets a federal goal of ensuring that everybody who becomes homeless moves into permanent housing within 30 days. This goal creates an ambitious target for your community’s rapid re-housing efforts. Reducing returns to homelessness—most people who are re-housed will not return to homelessness, however, your community should have the stabilization services in place to support people who will need additional assistance even after they exit homelessness. Let’s take a look at some of the keys to measuring these outcomes.
One of the key data elements for HEARTH Act measures and for measuring system performance generally is the housing status indicator. One of the challenges is knowing where a person exited to—did they exit to permanent housing? another homeless program? the streets?—and when did they exit. Many programs don’t carefully track what happens when a person exits their program. Programs are not necessarily required to update the housing status field in real time. Consequently, they may know that at one point in time a person was homeless, and several months later, the person was housed, but they may not know exactly when the person moved to housing. The better you can address these challenges, the more precisely you will be able to measure system performance. As you prepare for changing over to the HEARTH Act, examine what you can do to improve data quality. For example, look at programs that record a high number of “other/don’t know” for housing status. Also, change your policies to require that changes in housing status are recorded with the specific date they happened.
Tracking Length of stay is a challenge. The goal is to identify the average length of time between the time a person becomes homeless to the time the same person exits homelessness. This is especially challenging because a person may stay in several programs or no programs at all. Let’s look at an example of a homeless stay and identify what the length of stay is for this individual. The individual becomes homeless by entering a shelter and stays there 16 days. Then there is a 5 day gap where the person was not in any shelter or program. When the person exited, the housing status was listed as “unknown.” The person reenters a different shelter and stays for 21 days. During that shelter stay, the person is referred to a rapid re-housing program. After 21 days in the shelter, the person moves into permanent housing. The person receives 2 months of rental assistance and continues to receive case management after entering permanent housing.
In this case, the length of this person’s homeless episode is 42 days. The fact that they continued to receive assistance through a rapid re-housing program after they entered permanent housing does not affect the length of of the episode. There are many decisions to be made when tracking length of homeless episodes. Many people have gaps in their episodes. At what point do you treat gaps as separate episodes? (30 days?) What do you do about people who have exits to unknown? How do you integrate street outreach into your calculations?
If for some reason you can’t track the entire duration of a homeless episode, there are alternatives. One is to look at the duration of individual program stays for shelter and transitional housing and then supplement it by looking at the number of people who use multiple programs. For example, take a single shelter program, and track the average length of stay within that program, and then look at all users of that shelter program to see how many used multiple shelter or transitional housing programs. By reducing both the average length of stay in individual programs and the rate at which people are using multiple programs, you will be reducing lengths of homeless episodes.
Measuring returns to homelessness requires identifying a cohort of people who exited a program or set of programs and then identifying how many of them became homeless again during some follow up period. In the graphic on the slide, the rate of returns to homelessness would be calculated by looking at a group of people who exited homelessness during a period of time. For example, let’s say you were looking at people who exited homelessness last September and there were a thousand people. Then you would look at your data to see which of those thousand people had an additional spell of homelessness within some period of time, we’ll use 12 months, of their exit. Let’s say that’s a hundred people. Your rate of returns to homelessness would be 10 percent (100 divided by 1,000)
Assessing the extent of repeat episodes of homelessness also requires decisions. One of the main choices is deciding how long a period to follow up. A shorter follow up period—perhaps 90 days—will help you focus your homelessness assistance on interventions that solve immediate housing crises. A longer follow up period-something like 12 months—will assess whether your system is helping people with longer term stability. There are tradeoffs. A focus on shorter periods will encourage your system to house people more rapidly and more directly measures things that are in the control of your system, but will discourage efforts to promote longer term stability. Longer follow-up periods will discourage rapid re-housing, and focus more on longer-term stability, but that stability is often outside of the control or influence of your system. A few additional points. You want to be sure to only count a return to homelessness if the person becomes homeless again, not if they simply come back for more assistance. Continued engagement and assistance for people is a sign of a healthy system. You just don’t want people to re-experience homelessness. You may want to use different returns to homelessness measures in different ways. For example, if you are using the measure to assess individual program performance, you may want to use longer follow-up periods for programs intended to help people make more progress toward self-sufficiency or for programs providing longer term support.
A thorough assessment of your community’s homelessness assistance will require an assessment of where and how you are investing your resources and comparing cost per outcome relative to the needs of the person you are serving. In general, you want to have a lot of interventions that are relatively inexpensive and serve people with relatively few needs, and you want to provide fewer interventions that are expensive and reserve them for people with greater needs. You can do a very simple assessment of cost effectiveness in two steps. 1. Assess how many exits to permanent housing the different parts of your homelessness system is achieving—for example, how many people exit shelter, transitional housing, and rapid re-housing for permanent housing. Look at the total budgets for each of those systems and divide by the number of people who exit to permanent housing. 2. Adjust for the difficulty of the people being served. For example, programs serving people with zero income and more barriers to housing (previous evictions, disabilities, criminal records) would expect to have a higher cost per permanent housing exit than programs serving people with fewer barriers. As you gain experience with this kind of assessment, you’ll want to look at more factors. For example, if an intervention is reducing or increasing costs to other parts of your system or other mainstream systems. You will also want to look at how people use programs in combination. The point of focusing on costs is not just that you make your system more efficient and effective. In many ways costs are a proxy for real trauma and suffering that you are trying to reduce. Lengthy shelter stays are both costly and traumatic, and reducing those costs by reducing shelter stays is a benefit.
These analyses of your homelessness system will allow you to compare different interventions within your community. For example, should we do more rapid re-housing and less transitional housing? More shelter diversion and less shelter? The cost per exit will not be the only factor you will consider, but it should be an important factor. Understanding the cost effectiveness of different interventions in your homelessness system will help you decide where to invest any increases in funding or to decide whether to transition programs to different types. On the slide, the interventions have dramatically different costs per outcome. Is that because they actually serve people with different levels of barriers, or is it because some are more effective than others?
To simplify the process of assessing your homelessness interventions, you can create a hybrid measure that combines various different features. For example, the Alliance is developing a system assessment tool that uses “Quality Exits” as an indicator. The indicator combines length of Homeless episode and returns to homelessness in one measure. Quality exits is calculated by taking all of the people who exited homelessness during a given period of time AND who exited within 60 days of becoming homeless and subtracts the number who exited a year ago and who became homeless again in the subsequent year. You can further refine such a measure by looking at the cost of each quality exit produced by an intervention, and then by adjusting for the level of housing barriers among people served by that intervention.
Now is a good time to mention that the Alliance is developing a tool to help analyze system performance. The tool is being field tested now and will be released in late November. The tool will provide a simple way to analyze your homelessness assistance based on the concepts we discuss in this presentation, including exits to permanent housing, cost effectiveness, lengths of homeless episodes, returns to homelessness, and quality exits.
For the next part of our presentation, we’ll look at how to modify and redesign your community’s homelessness assistance so that it better achieves the results of preventing and ending homelessness. We’ll start by looking at the main functions of a well designed homelessness assistance system. Then we’ll describe some examples of successful strategies for preventing and ending homelessness. We’ll look at how to stitch together different programs into a coordinated system. And finally, we’ll discuss how to plan and transition to a new system in your community.
So we’ll start with the basic functions of a homelessness assistance system. While there are many activities that homelessness assistance organizations perform, there are three that are essential for everybody who experiences a crisis and becomes homeless—prevention, shelter, and re-housing—every homelessness system in every community should be trying to perform these three functions for everybody they can. The first is to attempt to prevent homelessness or divert people who are about to become homeless. The homelessness assistance system should have the tools and resources necessary to address a crisis quickly enough that a person who is about to become homeless, even if that person might become homeless that night, can remain in their housing or find other housing without having to become homeless. The second is to protect and shelter or temporary housing for people who become homeless. Lastly homelessness assistance has to help re-house people as quickly after they become homeless as possible. In many cases re-housing also means providing or linking with additional supports or permanent supportive housing to ensure that people don’t become homeless again. These are the key things that all homelessness assistance systems should be striving to provide, and there are many approaches to performing these functions. Let’s quickly look at a couple of examples of practices.
One of the most effective strategies for prevention of homelessness is the use of shelter diversion strategies. This slide highlights results for a pilot project in Boston, Massachusetts, known as the Dudley Diversion Project. The Dudley Square neighborhood had seen an increase in family homelessness, and this pilot was a response. Each family seeking shelter was offered diversion assistance. Of the 69 families who participated, 29 were diverted from shelter, many stabilizing in their original housing or moving in with family or friends. Obviously, when somebody is coming to shelter for assistance, their situation is bad. Diversion programs basically work on both an immediate plan and a medium term plan. The immediate plan is to find a way to salvage the person’s current housing situation even if only for a short period of time. This can be done by making appeals to the landlord or family member with whom the person was staying and letting them know that you will help the person quickly find a new place to live. Sometimes an offer of financial assistance, to help pay rent for example will help. Next the program provides housing assistance and supportive services designed to help stabilize that housing situation or to help the person move to a new, more stable housing situation. More information about the Dudley Diversion Pilot: http://www.endhomelessness.org/content/article/detail/2208
By now, most of you are probably familiar with rapid re-housing strategies. I’m going to give you just one quick example of the impact rapid re-housing can have when it’s implemented broadly. In Hennepin County, MN, which includes the city of Minneapolis, the implementation of rapid re-housing across their family homelessness system reduced the average length of stay in shelters by 47% and bed-nights of shelter by 71 percent. We highlight Hennepin a lot because they were one of the first to implement rapid re-housing on a broad scale, but many other communities have had success as well. More information: www.hudhre.info/documents/HennepinCounty.pdf
Now we’ll take a look at what a very basic model of an effective homelessness system looks like. We should stop and recognize that there are many different types of communities, different geographies, different histories, and different housing markets that can all affect how homelessness and homelessness assistance looks like. However, this basic model will work in almost any community.
For a person with a housing crisis, their first encounter with the homelessness assistance system might be when they are losing their housing and need shelter—that first contact with the point of entry into your homelessness system. There are several basic tasks of a point of entry system. The first of these is to attempt to prevent the homeless episode through diversion. If diversion is not possible, the point of entry should be assessing the households immediate barriers to housing. This assessment should focus on what it will take to quickly re-house the household. The exact nature of the assessment will depend on what programs are available in your community. However, it should be able to identify a few basic categories: Severe housing barriers such as combinations of disabilities, long histories of homelessness, substance use, etc that indicate that the household should move into permanent supportive housing. Less severe barriers that indicate that the household should begin immediately to work on their re-housing. Special conditions (veterans, domestic violence, etc) where a referral to a particular program or service system is most beneficial. The assessment should NOT be comprehensive. It is not a complete psycho-social evaluation, and it is not intended to develop a service plan. It should only ask for as much information as is necessary to make referrals to the appropriate intervention. There are various different formats for a point of entry. They include: Single physical location. Multiple locations. Virtual Location (phone or web-based) Combined with other service agencies (TANF/Food Stamps) There are advantages and disadvantages to each of these structures. The key for all of them is that they have these attributes: Easily accessible for people who need immediate assistance Uniform so that people get the same assessment and assistance no matter when or where they make first contact Have resources (either directly or through referral) immediately available to prevent a homeless episode
Even while somebody is in shelter however, re-housing is the ultimate goal. Re-housing programs are one of the most challenging but important aspects a homelessness assistance system. There are several keys to an effective re-housing intervention. Rapid Re-housing programs should scale assistance based on need—people who have more barriers to obtaining housing should receive more assistance. Programs should strive to provide “just enough” assistance to obtain housing. This will stretch resources further and enable the program to assist more people. Services should first be focused on obtaining housing and then on maintaining housing. Services should be home-based, voluntary, and focused on connecting consumers with mainstream service providers. Comprehensive information about planning and developing rapid re-housing resources can be found at: www.endhomelessness.org/content/article/detail/2450
Part of an overall homelessness assistance strategy is to know what level of assistance will resolve a housing crisis. The amount of assistance it takes can vary dramatically. And it’s really hard to tell just how much people are going to need. Progressive engagement is a simple strategy to enable you to target your resources effectively. Progressive engagement simply refers to a strategy of starting with a small amount of assistance for a lot of people and then adding more as needed. Here is an example of how it works in practice. I want to stress that this is just one example of how it can be structured. You would want to tailor the specific interventions to the needs of people in your community. For every household who becomes homeless in your system, you provide a basic level of re-housing assistance, which we’re calling Rapid Re-Housing 1. This could include: a list of rental vacancies, tips about how to find an apartment, help negotiating with landlords or friends or family members a person could live with, and some financial assistance for application fees, deposits, etc. If it becomes clear that the household will not quickly exit homelessness with only this much assistance (for example if they have no prospects after 5-7 days of searching), then you provide additional assistance, which might include short-term rental assistance and case management—Rapid Re-Housing 2. At this point, a household should be re-housed, but the job may not be over. If at the end of 3 months, or even earlier, it is clear that the person is going to be evicted, then additional assistance can be provided, such as a medium-term or long-term rental assistance, and more intensive case management and supportive services. At some point, it may even become clear that the person will never be able to achieve even modest housing stability, in which case you may want to provide a housing voucher (if the issue is primarily economic) or you may look at permanent supportive housing (if the person would not be able to maintain housing even with a voucher). In a progressive engagement approach, these programs—RRH 1, RRH 2, and RRH 3—don’t have to be different programs. They can just be different levels of assistance provided by the same program. Also there’s no reason to have 3 levels as opposed 2 or 4 or 5. The benefits of this progressive engagement approach are many. You don’t have to be able to predict beforehand how much assistance a person will need to be re-housed. You can also stretch your limited resources farther. It prevents disruption for the household. They are not literally moving from program to program, or even using different caseworkers. From their perspective, they stay a short period of time in shelter, then are assisted to move into permanent housing. Their level of assistance may be increased or decreased, but their living situation is stable. This approach also has challenges. It means that as a community, you have to find ways to make your assistance fit around the people you are serving. For example, you will have to figure out how to set aside permanent rental subsidies for people that need them. You don’t want to put everybody on the waiting list at the beginning of the process. You want to have a pool of vouchers waiting for those for whom smaller amounts of assistance didn’t work. This also requires that the caseworkers are trained and can recognize when a person has achieved enough stability or when they will need further assistance. This progressive engagement approach is described in more detail in a supplemental document to the US ICH Federal Strategic Plan to End Homelessness: http://www.ich.gov/PDF/OpeningDoors/DennisCulhane_PrevCentApproHomelessnessAssist.pdf
Another approach to allocating your resources is a Triage approach. Under a triage approach, a person receives an assessment of their housing barriers. The assessment focuses on things that will directly impact their ability to quickly obtain housing, such as income, credit history, and other factors that a landlord would likely consider when deciding whether to rent to somebody. Based on this assessment, which happens when a person first becomes homeless, a referral is made to an intervention. People with fewer barriers are referred to relatively “light” interventions such as the RRH 1, while people with multiple barriers are referred to more intensive interventions like RRH 2 and 3 or perhaps permanent supportive housing.
This slide is an example of how your system would look different if focused much more on diversion and rapid re-housing. We’re going to take a simple forecasting model and build it out. Keep in mind that this is only an example. You should look at your community’s data and circumstances. The numbers used here, are roughly based on national data regarding patterns of homelessness. There are many assumptions used in this model, and we won’t discuss them all today. The Alliance is happy to work with your community if you are interested in doing a more involved version of this kind of forecasting. We’ll start by looking at an example of data about a fictional community. The first thing we have to decide is what data is going to be relevant. For the purpose of this discussion, we won’t separate families from individuals (we’ll just call them households), but when you do this in your community, you should do separate analyses for individuals and families. One of the most helpful data sources to use to design your system is the patterns of homelessness, particularly the length of time people are homeless. So at the left side of the chart, you can see an example of patterns of homelessness for a typical community. We’re looking at the entries over the course of a year. If you were to look at it at a point in time, the system would look much different, much more heavily weighted to the longer term stayers. In this community, nearly a third of homeless people are homeless for less than a week, while similar numbers are homeless between a week and a month and between one month and three months. A smaller number are homeless for more than six months or they experience multiple episodes of homelessness. Now we’ll forecast how people would flow through a rapid re-housing system similar to the one we described in our progressive engagement example earlier. To make the math easier, we’ll assume that we’re looking at what happens to 100 people who enter the system over the course of a year. The first group of 30 people would have been homeless for less than 7 days, and a robust diversion program could divert about half of them, while the other half would receive our lightest rapid re-housing intervention, which we’re calling RRH 1. Under the old system those 30 people would account for about 120 shelter nights over the course of a year, while under the new system, they would account for about half that. The next group, 1 week to 1 month, accounts for 25 people. A few of them (5) can be diverted, while most receive either the light or moderate version of rapid re-housing. You can see that the number of shelter nights for this group declines because rapid re-housing programs are helping them move out of homelessness quicker. The third group 1-6 months, are people for whom diversion is unlikely to be successful. RRH 1 may help a few exit homelessness, but most will be served by RRH 2 and some with RRH 3, which will involve longer term subsidies. This is the group for which rapid re-housing starts to create larger reductions in the number of shelter nights. At the same time, it’s also the group for which you are starting to invest a lot of rapid re-housing resources. Last is the group of people who get stuck in the system. They are homeless 6 months or more, or have multiple episodes. These are the major beneficiaries of a rapid re-housing focused system. For this group, diversion is still possible but unlikely. Most of the work is done by the moderate and intensive rapid re-housing approaches. This is also the group in which you will find some people for whom rapid re-housing doesn’t succeed, and for whom you will need permanent supportive housing. In general, you will probably find a higher percentage of your singles population needing Permanent Supportive Housing than of your families. The results of this approach are to reduce entries into homelessness by 20 percent (that’s the group we were able to divert), and to reduce the average length of episodes from 78 days to 28 days.
So what we’ve described here is a very basic homelessness assistance system. But what about all the other stuff that’s part of homelessness assistance? Transitional housing programs, employment programs, substance use treatment, health clinics, etc. As your community works on implementing the HEARTH Act, you may want to evaluate which of these programs are valuable and which you may want to consider converting or restructuring. Let’s take an example of one type of program, transitional housing, and look at some of the options.
Transitional housing comes in many forms. The key to evaluating your transitional housing is to look at the assets in your transitional housing programs and evaluate whether those programs fit into how you want to design your community’s homelessness assistance and if not, how you can put those assets to work in your new system. For example, if you have a transitional housing program with a fixed building, you probably don’t want to give up that building. Options for utilizing that building include converting the program into a shorter term program, such as a shelter, that helps people exit homelessness quickly, or converting to permanent supportive housing that serves chronically homeless individuals and families. Similarly, the program may have services such as case management, assistance with locating housing, employment, mental health, substance use counseling, etc. Can those same services be delivered in a home-based setting, consistent with the housing first approach? Another option for transitional housing is a transition in place approach. Transition in place involves a transitional housing program leasing scattered site units, moving in homeless households who co-lease or sublease, providing short or medium-term subsidies and services, and then at some point, the household completely takes over the unit, while the transitional housing program finds a new unit to lease. Interim housing is another model that’s used in Chicago. It combines elements of shelter and rapid re-housing. Communities may also consider using transitional housing programs for special populations.
The change process is challenging, but it offers a great opportunity to improve homelessness assistance in your community for homeless people and other stakeholders. This slide outlines the steps you will be going through to improve your homelessness assistance. As you get ready to embark on this transition, we hope we’ve given you some tools to make it easier and more productive, and we’ll be producing more tools in the weeks and months to come. We’ve described how to analyze your data, focusing on key data elements like lengths of homeless episodes. We’ve also covered several concepts for analyzing your programs and how they should fit together. This information will help you identify the gaps and underserved populations in your community, particularly the ones who get stuck in your homelessness system. One of the big challenges going forward will be to prioritize and act on decisions. There are always numerous changes that would make your system function better, and far too few resources to make them all happen. You will have to work with other stakeholders in the community to develop a shared vision and priorities for moving forward and to generate enough enthusiasm and shared sense of responsibility to make that happen.
To help with the process, we will post a sample tool we used in one community to help them prioritize and organize their transformation of their family homelessness assistance. You can see screen shots of that document here. The document will be posted, along with numerous other materials, at our HEARTH Academy page: http://www.endhomelessness.org/section/training/hearthacademy
The HEARTH Academy has three major components: A 1.5 day clinic where 6-10 leaders from each of several communities will come together to assess their communities performance and create an action plan to implement cost effective strategies that will help their communities reduce homelessness and better meet the goals of the HEARTH Act A series of preparation and implementation webinars and tools covering a range of topics: An overview of the HEARTH Act and its implications Using performance measures to improve outcomes Designing a cost effective homelessness assistance system Individualized consulting for communities interested in receiving customized assistance
If you want more information about the HEARTH Academy, you can visit the link on our website. http://www.endhomelessness.org/section/training/hearthacademy The HEARTH Academy is not sponsored by or affiliated with the Department of Housing and Urban Development (HUD) or any other federal agency. The HEARTH Academy is a project of the National Alliance to End Homelessness.

HEARTH Academy: System Assessment Presentation Transcript

The HEARTH Academy System Assessment and Design
- October 2010
How well does your system prevent and end homelessness?
- Survey consumers, service providers, and community leaders
Consumer Survey What services or assistance do you or did you need the most to get permanent housing? What services or help were you offered to help you get housing? Was it easy for you to find services to help you when you became homeless. To get help, were you sometimes asked to do things that you didn't want to do. Do you feel that you got to "call the shots" about when and how you received services.
Estimated release mid-November
Use data to measure outcomes from your homelessness assistance system.
Reduce new episodes of homelessness Reduce lengths of homeless episodes Reduce returns to homelessness HEARTH Measures
Measuring exits to permanent housing is the key!
- Record housing status at exit
- Update housing status real time
Track Length of Episodes Shelter 1 16 days Shelter 2 21 days Rapid Re-Housing 90 days Gap 5 days Permanent Housing
Track Length of Episodes Shelter 1 16 days Shelter 2 21 days Rapid Re-Housing 90 days Gap 5 days Permanent Housing Length of Stay 42 days
More Strategies for Tracking Lengths of Episodes Track average stays in individual programs. Look at how many people use multiple programs.
Reduce Repeat Episodes People who exited homelessness during a period of time Of the group that exited, how many experienced an additional episode of homelessness within a period after exiting. 1,000 100
Reduce Repeat Episodes Short Follow-Up Period Long Follow-Up Period Focus on rapid re-housing, and things more within the control of homelessness system Focus on self sufficiency, and things more affected by job markets and mainstream systems
Perform a Simple Cost Analysis 1. Calculate how much is spent on an intervention for each permanent housing exit. 2. Adjust for the fact that interventions serving higher barrier people will likely cost more for each exit to permanent housing.
Compare Interventions Intervention A – $1,000 per exit to PH Intervention B – $5,000 per exit to PH Intervention C – $20,000 per exit to PH
Quality Exits The number of people who exit to permanent housing within 60 days of becoming homeless minus the number who exited homelessness one year ago and since returned to homelessness.
Field testing now. Estimated release late November System Performance Tool
How do you make your system work better?
Functions of Homelessness Assistance Shelter Re-house Prevent
Diverting People From Homelessness Dudley Diversion Pilot, Boston, MA
Rapid Re-Housing Hennepin County, MN In one four‐year period, when internal County funding and staffing changes were implemented to support rapid re‐housing, shelter admissions declined by 42%, average length of stay by 47% and the total number of purchased “bed‐nights” was reduced by 70%. (Community Spotlight: Rapid Re‐Housing—Rapid Exit Program in Hennepin County, MN from the HUD HRE website)
Put the Pieces Together
First Contact Point of Entry Stabilize current housing Immediate re-housing Assess barriers Refer to shelter and/or re-housing
Exit Strategy Point of Entry Permanent Housing Shelter Re-Housing
Example of Progressive Engagement Point of Entry Housed RRH 1 $ RRH 2 $$ RRH 3 $$$ PSH $$$$
Example of Triage Point of Entry Housed RRH 1 $ RRH 2 $$ RRH 3 $$$ PSH $$$$ Assessment of Barriers to Housing High: Evictions Substance Use Medium: Inconsistent work No supports Low: Service engaged Income None: Rental history Support network
Forecasting a New System Current System New Interventions Shelter nights Days homeless # of entries Diversion RRH 1 RRH 2 RRH 3 PSH Old Design New Design 1-7 30 15 15 0 0 0 120 60 8-30 25 5 10 10 0 0 475 300 31-180 30 0 6 18 6 0 3,150 1,080 181+ * 15 0 0 5 5 5 4,050 765 Total 100 20 31 33 11 5 7,795 2,205 *including multiple episodes Average Length of Episodes 78 28
What about all the other programs? Employment Transitional Housing Services
Assets Buildings Housing location Stabilization Service coordination Employment Options Shelter Interim Housing Rapid Re-Housing Convert to PSH Transition in Place Specialize Opportunities for Transitional Housing
Making the Transition 1. Analyze your data. 2. Analyze your programs. 3. Identify gaps and underserved populations. 4. Prioritize changes. 5. Assign timelines, benchmarks, responsible entities. 6. Start transforming!
Making the Transition
Implementing proven strategies to end homelessness Presented by the National Alliance to End Homelessness HEARTH Academy Implementation Clinic Participants in this 1.5 day clinic will assess the performance of their homelessness assistance and implement community-wide strategies to better achieve the goals of the HEARTH Act. Individualized Consulting The Alliance’s Center for Capacity Building and other expert consultants will be available to provide customized assistance. Webinars and Tools Webinars, tools, and training materials will help communities prepare for the Implementation Clinic and learn about and implement the strategies that help prevent and end homelessness.
Aisha Williams Center for Capacity Building National Alliance to End Homelessness [email_address] 202-942-8298 If you are interested in participating in the HEARTH Academy or would like more information, please contact: Note: The HEARTH Academy is not sponsored by or affiliated with the Department of Housing and Urban Development (HUD) or any other federal agency. The HEARTH Academy is a project of the National Alliance to End Homelessness.