5.3 Using Data to Spur Systems Change

1,048 views

Published on

Published in: Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,048
On SlideShare
0
From Embeds
0
Number of Embeds
60
Actions
Shares
0
Downloads
25
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • Introduce ourselves, what we do with the plan
  • Cathy
  • cathy
  • cathy
  • Lisa
  • Lisa
  • Lisa
  • lisa
  • Lisa
  • Lisa
  • Matthew
  • Matthew and Cathy
  • Lisa
  • Lisa
  • Lisa
  • Lisa
  • Lisa
  • Lisa
  • Lisa
  • Lisa
  • Lisa
  • Lisa
  • Lisa
  • Matthew
  • Cathy
  • cathy
  • lisa
  • Lisa
  • Lisa
  • Cathy
  • Lisa
  • Lisa
  • Cathy
  • Cathy
  • Cathy
  • Cathy
  • Cathy
  • Cathy
  • Cathy
  • Cathy
  • Lisa
  • Lisa
  • Lisa
  • Lisa
  • 5.3 Using Data to Spur Systems Change

    1. 1. Presenters: Cathy ten Broeke Matthew Ayres Lisa Thornquist
    2. 2. Heading Home Hennepin <ul><li>A community plan to end versus manage homelessness </li></ul><ul><li>Specific plan with measurable benchmarks </li></ul><ul><li>City Council and County Board Approval – December 2006 </li></ul><ul><li>Implementation began January 1, 2007 </li></ul>
    3. 3. 6 Goals of the Plan <ul><li>Prevention </li></ul><ul><li>Outreach </li></ul><ul><li>Housing </li></ul><ul><li>Service Delivery </li></ul><ul><li>Capacity for Self Support </li></ul><ul><li>Systems Improvement </li></ul>
    4. 4. The Need for Evaluation <ul><li>One of the pieces of the plan is to evaluate the plan and report annually. </li></ul><ul><li>The plan has dozens of initiatives, each designed to either prevent or end homelessness. </li></ul>
    5. 5. Forging a relationship to produce evaluation <ul><li>Hennepin County is data rich. </li></ul><ul><li>U of M is student/faculty rich. </li></ul><ul><li>Hennepin offers U students and faculty experience with administrative data, difficult analytical questions and real world issues. </li></ul><ul><li>The U offers an independent analysis. </li></ul>
    6. 6. The Hennepin University Partnership <ul><li>Hennepin County and the U of M have a standing agreement to provide academic expertise to issues facing the county </li></ul><ul><li>The OEH work with faculty throughout the University to find common issues for evaluation. </li></ul>
    7. 7. Major Projects in Collaboration with U of M <ul><li>Housing First evaluation </li></ul><ul><li>Single Adults in Shelter – Definition of LTH </li></ul><ul><li>Families in Shelter and Rapid Exit </li></ul><ul><li>Frequent Users Service Enhancement (FUSE) </li></ul><ul><li>Refugees </li></ul><ul><li>Collaboration capstones </li></ul>
    8. 8. Other Research/ Evaluation Projects <ul><li>Prevention Targeting </li></ul><ul><li>Highest Users of Single Shelter </li></ul><ul><li>Downtown 100 </li></ul><ul><li>Group Residential Housing stability </li></ul><ul><li>Project Homeless Connect </li></ul>
    9. 9. Capstone on Housing First (p. 23) <ul><li>Masters Level Public Policy students looked at participants in single adult Housing First compared to a match set of shelter users. </li></ul><ul><li>We matched in health insurance coverage and criminal justice data. </li></ul><ul><li>Students analyzed data as well as conducted interviews with program participants </li></ul>
    10. 10. Capstone on Housing First: Finding <ul><li>HF participants’ shelter use dramatically declined compared to other shelter users. </li></ul><ul><li>HF participants increased the number of days and continuity of health care coverage. </li></ul><ul><li>HF participants had a reduction in CJ involvement, both as victims and perpetrators of crime, pre versus post and compared to other shelter users. </li></ul>
    11. 11. Capstone on Housing First: Finding <ul><li>Interviews showed that housing had a positive impact on safety and well-being. </li></ul><ul><li>Transition to housing posed challenges related to daily activities and social needs. </li></ul><ul><li>Transportation was a significant barrier in housing and some participants changed housing after initial placement. </li></ul>
    12. 12. Impact of the Research on Housing First <ul><li>Helped provide support for further funding – Currie Avenue Partnership. </li></ul><ul><li>Told policy makers that this model works in OUR community. </li></ul><ul><li>We greatly expanded our scattered site Housing First program. </li></ul>
    13. 13. Capstone on Single Shelter Use and Definition of LTH (p. 5) <ul><li>Wanted to know when to intervene for single adults in shelter </li></ul><ul><li>Stories of people being “stuck” in shelter for years. </li></ul><ul><li>People staying in shelter waiting to meet the definition of long-term homeless to be eligible for programs. </li></ul>
    14. 14. Capstone on Single Shelter Use <ul><li>Provided data from county data systems and HMIS for single adults in shelter from 2007-2009. </li></ul><ul><li>First time we looked at whole single shelter system at once. </li></ul>
    15. 15. Capstone on Single Shelter Use <ul><li>Evaluate dynamics of shelter use of single individuals in public and private shelters in Hennepin County </li></ul><ul><li>Mixed Method Analysis using focus group interviews and analysis of administrative data </li></ul>
    16. 16. Capstone on Single Shelter Use: Focus Group
    17. 17. Capstone on Single Shelter Use <ul><ul><li>Fixed Window Method: </li></ul></ul><ul><li>Count days of shelter for 12 mo. following shelter entry, for those who first entered shelter between 7/1/07 and 12/31/08 </li></ul><ul><ul><li>Cox Proportional Hazard Models </li></ul></ul><ul><li>Estimate probability of ending a shelter spell in each month, given that you are still in shelter, for spells that start in the period 7/1/07-12/31/09 </li></ul>
    18. 18. Definition - homelessness spell <ul><li>Define beginning of spell as date first recorded shelter use </li></ul><ul><li>Define end of spell as date in which individual leaves shelter and remains out of shelter for two weeks or longer </li></ul>
    19. 19. Fixed Window Analysis
    20. 20. Fixed Window Analysis
    21. 21. Hazard Model Analysis
    22. 22. Capstone on Single Shelter Use: Findings <ul><li>A large number of people stay in shelters for very short periods of time. </li></ul><ul><li>Targeting people with long spells would reduce days in shelter more than targeting people with multiple spells </li></ul>
    23. 23. Capstone on Single Shelter Use: Findings <ul><li>Probability of exiting shelter declines rapidly from months 6 to 12 and then levels off. This may reflect either: </li></ul><ul><li>--staying in shelters discourages exits </li></ul><ul><li>--less disadvantaged group leaves first </li></ul>
    24. 24. Single Shelter Use: Policy Implications <ul><li>Targeting people at 5 months for assessment into housing programs </li></ul><ul><li>Ongoing discussions of efficacy of targeting at 5 months versus 1 year – how are limited resources best spent. </li></ul>
    25. 25. Frequent User Service Enhancement (FUSE) (p. 26) <ul><li>In 2007, Hennepin County found that 266 individuals used 70,000 nights of shelter, jail and detox over 5 years, costing taxpayers $4.2 million. </li></ul><ul><li>The FUSE project began, targeting the highest users of both shelter AND jail. </li></ul><ul><li>The intervention was housing, case management, and probation services. </li></ul>
    26. 26. FUSE <ul><li>An examination of the first 6 program participants found that they used, on average, $95,000 in services prior to housing. After housing, they used $16,000 in services on average. </li></ul><ul><li>This included jail bookings, jail days, detox, shelter, and Emergency Department use at Hennepin County Medical Center (HCMC) </li></ul>
    27. 27. FUSE <ul><li>Sociology graduate students from the U of M conducted a more in-depth study of the first year of the program. </li></ul><ul><li>The researchers compared FUSE participants to a similar cohort of high users of both jail and shelter. </li></ul>
    28. 28. FUSE <ul><li>The program participants had a significantly larger decline in shelter use versus the comparison group. </li></ul><ul><li>They found that both participants and the comparison group reduced their use of the criminal justice system. </li></ul>
    29. 29. FUSE and other interventions <ul><li>The findings from the FUSE study lead to some interesting questions. </li></ul><ul><li>We have so many interventions in downtown Minneapolis: FUSE, Downtown 100, Street Outreach, Currie Avenue Partnership. </li></ul><ul><li>We also know there is a significant decline in downtown arrests. Who gets the credit? </li></ul>
    30. 30. Implications of FUSE <ul><li>Shows targeting of specific populations can interrupt overuse of systems. </li></ul><ul><li>This study, and others, let us know that targeting high users can greatly impact the overall system. </li></ul>
    31. 31. Top 50 Users of Single Shelter <ul><li>Looked at highest users from Jan 2008 – April 2011 </li></ul><ul><li>Range from 737 days to 1413 days </li></ul><ul><li>Data in county go back to 1997 – 12 of these top 50 were in shelter in 1997 </li></ul><ul><li>Very little is known about these top users – they are not high users in other systems </li></ul>
    32. 32. Top 50 Users of Single Shelter <ul><li>Small group of county employees with access to all data systems. </li></ul><ul><li>Included direct service staff from county and contracted shelters. </li></ul><ul><li>Overall goal – to create a crack free system. </li></ul>
    33. 33. Top 50 Users of Single Shelter <ul><li>20 had social service activity in the county </li></ul><ul><li>10 on General Assistance, 10 on RSDI/SSI </li></ul><ul><li>12 had been to jail, 7 to detox </li></ul><ul><li>11 engaged with the mental health system, but twice as many were reported by staff to have mental health barriers </li></ul>
    34. 34. Top 50 Users of Single Shelter <ul><li>Medical services were more prevalent </li></ul><ul><ul><li>29 received Healthcare for the Homeless services </li></ul></ul><ul><ul><li>38 got health care through Hennepin County Medical Center (HCMC) </li></ul></ul>
    35. 35. Top 50 Users of Single Shelter Policy Implications <ul><li>No wrong door. </li></ul><ul><li>Rules and policies need to be flexible. </li></ul><ul><li>Onus on county workers to reach out to people in shelter, to ensure they get services they are eligible for. </li></ul>
    36. 36. Prevention Targeting <ul><ul><li>Rapid Exit has been a program in Hennepin County since 1993. </li></ul></ul><ul><ul><li>It focuses on early intervention in financial assistance where: </li></ul></ul><ul><ul><li>-non-preventable, verifiable financial crisis </li></ul></ul>
    37. 37. Prevention Targeting <ul><li>Rapid Exit program started in 1993 </li></ul><ul><li>Focus was on preventing homelessness for families to reduce number of families entering shelter </li></ul>
    38. 38. Prevention Targeting <ul><li>Eligibility: </li></ul><ul><ul><li>Non-preventable, verifiable financial crisis </li></ul></ul><ul><ul><li>No other resources available </li></ul></ul><ul><ul><li>Prevention assistance will preserve housing </li></ul></ul><ul><ul><li>Goal was to reduce shelter admissions by 10% and reduce length of stay by 10% </li></ul></ul>
    39. 39. Prevention Targeting <ul><li>Results: </li></ul><ul><ul><li>96% did not enter shelter within 1 year </li></ul></ul><ul><ul><li>43% reduction in family shelter admissions </li></ul></ul>
    40. 40. Prevention Targeting <ul><li>After 17 years, time to re-examine the program. </li></ul><ul><li>Used HMIS data and barrier assessments to compare characteristics of families who received prevention versus those who did not and ended up in shelter. </li></ul><ul><li>If targeting well, families should look similar. </li></ul>
    41. 41. Prevention Targeting 33% 1% Head of hh < age 22 63% 36% homeless before 94% 45% > 65% of income for housing 94% 40% Incomes < $1000/mo Shelter Prevention
    42. 42. Prevention Targeting <ul><li>New criteria: </li></ul><ul><li>Families < 30% Area median income </li></ul><ul><li>Event is expected to result in housing loss within 30 days </li></ul><ul><li>No resources or viable plan to resolve crisis </li></ul><ul><li>Reasonable expectation for sustained resolution </li></ul>
    43. 43. Prevention Targeting <ul><li>Six month evaluation: </li></ul><ul><li>Data from May – Dec 2010 </li></ul><ul><li>436 households served </li></ul><ul><li>7.4% returned to shelter within 6 months (same as before) </li></ul>
    44. 44. Prevention Targeting Policy Implications <ul><li>Change definition of success. </li></ul><ul><li>While a smaller percent of people who receive prevention may avoid shelter, we may actually be preventing more homelessness. </li></ul>
    45. 45. Refugees (p. 25) <ul><li>We partnered with the Center for Advanced Studies in Child Welfare for research on refugee experiences with homelessness. </li></ul><ul><li>This led to findings to be incorporated into SSW learning modules. </li></ul><ul><li>It also led to a dissertation currently being completed on refugee homelessness. </li></ul>
    46. 46. Refugees <ul><li>A graduate student conducted in-depth interviews with 15 refugee families experiencing homelessness. </li></ul><ul><li>We conducted a survey of 237 refugees in the Twin Cities asking about housing stability, ethnic identify and assimilation. </li></ul><ul><li>A doctoral student is completing more in-depth interviews with refugee families in shelter. </li></ul>
    47. 47. Refugees: Findings <ul><li>Culture matters. While the barriers to housing are similar to American-born families, specific cultural beliefs and values impact how families respond. </li></ul><ul><li>Refugees who moved in with relatives first had less stability than those placed in their own apartment upon arrival. </li></ul>
    48. 48. Refugees: Findings <ul><li>Those whose current housing is unstable have more mental health issues, less social capital or social networks, and use less public assistance. </li></ul><ul><li>Larger families have more housing instability. </li></ul><ul><li>Language continues to be a barrier. </li></ul>
    49. 49. Refugees: Findings <ul><li>A housing crisis pushes refugees to seek more formal help both within their ethnic group and also with government agencies. </li></ul><ul><li>Those with housing instability turned to public assistance and that assistance did stabilize housing for them. </li></ul>
    50. 50. Refugees: A pilot <ul><li>Hennepin County and the McKnight Foundation funded a pilot to work with refugees at risk of homelessness. </li></ul><ul><li>The intervention provided intensive case management and housing subsidies for a limited time. </li></ul><ul><li>The focus was on housing stability, increased income and school engagement. </li></ul>
    51. 51. Refugees: A pilot <ul><li>Findings: 70 families were served. 98% remained in housing during the program. </li></ul><ul><li>83% increased their incomes due to an increase in number of family members working. </li></ul><ul><li>The families needed a rental subsidy for 6.3 months, on average. </li></ul><ul><li>97% reported positive engagement with their children’s school. </li></ul>
    52. 52. Refugees: Policy Implications <ul><li>Another example of targeting a population with special needs </li></ul><ul><li>The need for culturally specific services and service providers </li></ul><ul><li>Development of refugee-specific housing with cultural competency of landlords </li></ul>
    53. 53. Project Homeless Connect Ongoing Evaluation <ul><li>Use HMIS data to track long-term trends, service needs, demographics. </li></ul><ul><li>Allows us to craft each event to the needs of the guests, and fundraise for additional services </li></ul><ul><li>Allows up to accurately report to funders, policy makers, and volunteers . </li></ul>
    54. 54. Project Homeless Connect <ul><li>Homeless status of guests served at event, comparison to previous events </li></ul>
    55. 55. Project Homeless Connect <ul><li>Proportion of “doubled-up” clients, comparison to previous events </li></ul>
    56. 56. Project Homeless Connect <ul><li>Where PHC guests come from. </li></ul>
    57. 57. Project Homeless Connect <ul><li>Main types of service sought by household </li></ul>
    58. 58. What are the Implications of a Robust Evaluation Program? <ul><li>U of M more engaged in homelessness than ever before </li></ul><ul><li>Hennepin County more committed to supporting research to better understand programs and outcomes </li></ul><ul><li>Evaluation program builds on itself – it brings in money </li></ul><ul><li>It builds community will </li></ul>
    59. 59. For more information <ul><li>[email_address] </li></ul><ul><li>[email_address] </li></ul><ul><li>[email_address] </li></ul><ul><li>www.headinghomehennepin.org </li></ul>

    ×