Post on 03-May-2018
Resources to Results
The Washington State
Pay for Success Symposium
November 18, 2015
#pfswa
Host Committee
Resources to Results
The Washington State
Pay for Success Symposium
November 18, 2015
#pfswa
Keynote
David Wilkinson Director
White House Office of
Social Innovation & Civic Participation
Life Cycle of Pay for Success
Moderator Caroline Whistler, Co-President and Co-Founder, Third Sector Capital Partners
Panel
§ Louis Chicoine, Exec. Dir., Abode Services § Brenda Van Gorder, Dir. of Title 1 Preschool
Program, Granite School District, Salt Lake City § Fraser Nelson, Dir. of Data and Innovation, Salt
Lake County § Greta Hansen, Lead Deputy County Counsel,
County of Santa Clara
© 2015, Third Sector Capital Partners, Inc. 6
Target Population
• 150-200 costliest chronically homeless individuals – 112 total housing units
Intervention • Delivered by Abode Services • Permanent supportive housing: Housing
First plus Modified Assertive Community Treatment
Funders & Grantors
• The Reinvestment Fund; CSH; The Sobrato Family Foundation; The Health Trust; The California Endowment; The James Irvine Foundation; Google.org; Laura & John Arnold Foundation (Evaluation Grantor)
• Palantir Technologies (Technology Partner)
Goal • Improve health and wellbeing of chronically
homeless individuals while reducing costs
Capital Structure • $6.9 million in upfront financing from
commercial and philanthropic funders
Project Budget
• $24M: $8M in possible success payments plus $17M in County-funded housing and mental health services
Success Payments Based on number of months of stable tenancy: • Lease plus verified tenancy in unit • Minimal time in jail or shelters
Project Overview Project Success Payments
Evaluation Evaluator: UCSF School of Medicine (M. Kushel and M. Raven) Evaluation Design: Randomized controlled trial to assess efficacy of project in reducing costs and improving wellbeing of target population (not tied to success payments)
Project Welcome Home
© 2015, Third Sector Capital Partners, Inc. 7
Target Population
• 250+ severely mentally ill adults who are frequent users of the County’s emergency and inpatient psychiatric facilities
Intervention
• Delivered by Telecare Corporation • Intensive Assertive Community Treatment • Housing support
Timing • 6 year project
Based on cost savings achieved by reducing County expenditures on: • Purchasing beds from non-County inpatient
psychiatric hospitals • Reduced/optimized utilization of emergency
and inpatient psychiatric facilities
Success Payments • Avoided utilization of emergency and
inpatient psychiatric services for clients enrolled in the program
Unique Characteristics
• First Mental Health PFS project
Project Overview Project Success Payments
Project Budget
Goal
• Improve health and wellbeing of severely mentally ill individuals while reducing costs
Evaluation Evaluator: Stanford School of Medicine Dept. of Psychiatry (K. Humphreys) Evaluation Design: Randomized controlled trial to assess efficacy of project in reducing costs and improving wellbeing of target population
Acute Mental Health Needs PFS Initiative
Utah High Quality Preschool Program
Project Overview
§ Financing to expand access to high quality preschool to district’s most impacted children to improve school readiness and long term academic performance
Popula@on Served
§ 5 cohorts of 3-‐ and 4-‐year old children who are low income and have other iden@fied risk factors.
§ 6 programs involved: 2 Public School Districts, 1 Charter School, 1 non-‐profit and 2 for-‐profit child cares
Success Indicator(s)
§ Payment trigger – special educa@on assignment § Other successes measured: school readiness, proficiency on statewide
assessments, other longitudinal data
Ini@al Investment
$7 million
Investors Goldman Sachs; J.B. Pritzker
Salt Lake County
Project Overview
§ A porYolio approach to address three cri@cal issues related to the county’s priority of criminal and social jus@ce reform: Recidivism, homelessness, maternal and child health
Popula@on Served
§ Individuals at high risk of recidivism § Persistently homeless individuals § Low income mothers and infants
Success Indicator(s)
§ Reduc@on in recidivism/use of jail beds; stable housing; maternal/child health; income
Ini@al Investment
§ Development fund of $1.2M; have not begun raise fund for projects
Investors § CRA banks, philanthropy, NFF grant, loans
Project Welcome Home
Project Overview
§ Permanent supportive housing for 150-200 of the costliest chronically homeless individuals in Santa Clara County, CA using 112 units/year
Population Served
§ Chronically homeless individuals who are the most “frequent users” of county services
Success Indicator(s)
§ Increased months of stable tenancy in permanent supportive housing
§ Improved health § The well-being of acutely chronically homeless individuals
Initial Investment
§ $6.9 million
Investors
§ The Reinvestment Fund, Corporation for Supportive Housing, Sobrato Family Foundation, California Endowment, Health Trust, James Irvine Foundation, Laura and John Arnold Foundation, Google.org, Abode Services
Serves 4,400+ adults and children each year
Strong fiscal and management infrastructure
Proven ability to lead large, mul@-‐agency collabora@ons
Ongoing commitment to evidence-‐based prac@ces and measurable impact
$29 million agency
Overview of Abode Services
Housing First Model
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• Housing First -‐ Proven, effec@ve, cost-‐saving approach for people experiencing chronic homelessness.
Building Systems through Pay for Success
David Willis Director
Division of Home Visiting and Early Childhood Systems, Health Resources and Services
Administration
U.S. Dept. of Health and Human Services
Emerging Opportunities
Moderator Megan Golden, Dir. of Pay for Success Financing, Institute for Child Success
Panel
§ David Willis, Dir. of Division of Home Visiting and Early Childhood Systems, Health Resources and Services Administration, US Dept. of Health and Human Services
§ Nathan Johnson, Chief Policy Officer, Washington State Health Care Authority (Project Representative)
HVSA and Pay for Success
Feasibility Study • Will determine if Pay for Success
funding model can significantly expand, strengthen and sustain proven home visiting programs statewide
By spring 2016, study will tell us: • How we can strengthen and continue to build our entire
home visiting system. • If the Pay for Success model could be a good fit to support
Washington state’s home visiting work. If yes, our state will then need to decide if we should use it.
• Created by state Legislature in December 2010. Brings together state, federal and private dollars to support a porYolio of high-‐quality proven and promising home visi@ng programs – and make sure they deliver results.
About
• More than 2,000 children and their families in some of our state’s most vulnerable communi@es have access to these programs.
Popula@on Served
• Voluntary, early and proven interven@on • Pairs professionals with expec@ng and new families to work together on a regular basis in the home
• Strengthens families and gives children best start possible: Improve maternal/child health, family bonds and self-‐sufficiency, and school readiness.
Why A Strong Investment
• $11.6M Current Budget
Home Visiting Services Account
The Health Care Authority’s PFS Feasibility Study
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• Houses 75 homeless individuals w/ chronic alcohol addiction
• Low-barrier; harm reduction; housing-first
• Journal of the American Medical Association:
• Average health and social services cost savings of 53 percent per resident
• Saved taxpayers over $4 million in first year of operation
Success Story: 1811 Eastlake (DESC)
*hlp://www.desc.org/documents/DESC_1811_JAMA_info.pdf Better Health, Better Care, Lower Costs
The HCA PFS model
Better Health, Better Care, Lower Costs
• Scope is critical – PFS is an opportunity to support effective,
innovative services for specific, high-needs populations
• Communication is key – Because PFS is a relatively new concept, it is
easily misunderstood
• Now is the Opportunity – Community support is strong and
policymaker support is growing
Key lessons learned so far
Better Health, Better Care, Lower Costs
Join the Healthier Washington Feedback
Network: healthierwa@hca.wa.gov
Learn more:
www.hca.wa.gov/hw
Better Health, Better Care, Lower Costs
Role of Funders & Investors
Moderator Ian Galloway, Senior Research Associate, Federal Reserve Bank of San Francisco
Panel
§ Annelise Grimm, Program Officer, The James Irvine Foundation
§ Deborah Kasemeyer, Senior Vice President, Northern Trust
§ Andrea Phillips, Vice President, Goldman Sachs Urban Investment Group