Traverse City Community Conversation Day 1 · 141201 1...

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Crea%ng a Person-‐Centered Approach to Ending Homelessness

Tracy Flaherty-‐Willmo5 OrgCode Consul=ng, Inc.

About OrgCode Over 30 years assisting the non-profit, private, non-

governmental and governmental sectors

5 member team led by Iain De Jong

Blend of practitioners, researchers, educators, policy wonks, nerds, comics, analysts, advisors & leaders

Driven towards working on complex social issues especially homelessness

Creators of the SPDAT

Working in Canada, USA & Australia

1.  The Task of the Day

2.  The Current Landscape

3.  What We’ve Learned

4.  The Opportunity -‐ Breakthrough Thinking Sessions

5.  Strategic Priorities Operationalized

6.  Adjourn

Today’s Purpose

•  Leverage local knowledge and exper=se •  Create a forum for meaningful discussion •  Gather a broad range of input from mul=ple perspec=ves

•  Focus discussion on opera%onalizing the journey forward to end homelessness

•  Begin mapping an implementa%on strategy tailored to the local needs and reali=es.

Cogni=ve Dissonance •  Evidence is when there are facts that make an approach or

belief true. Opinion may or may not be aligned to evidence.

•  Cogni=ve dissonance occurs when opinions override evidence and sees an alternate approach as being true when there is not evidence to support it.

•  Common cogni=ve dissonance examples in ending homelessness: –  A belief that all types of homelessness can be ended or prevented;

–  A belief that local condi=ons are so unique that proven prac=ces from elsewhere will not apply locally;

–  A belief that anything other than housing will end homelessness;

–  Moral beliefs about behavior override what study shows.

Length of Time Homeless & Acuity

How do we identify who needs what intervention?

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Values & Opinions Impact Prac%ce

Values & Beliefs

•  Our own values and beliefs influence our prac=ce.

•  We are wired to have an emo%onal response to informa=on before a logical response.

Why do housing & homelessness programs exist?

•  Divert people away from the homeless service delivery system

•  Provide a rapid response to those that require an interven=on through progressive engagement

•  Put an end to chronic and episodic homelessness •  Ensure emergency/crisis responses func=on rela=ve to their original intent (short-‐term, infrequent)

•  Focus on the only know solu=on to homelessness – housing!

Why do homeless programs and services exist?

They exist to end homelessness. For some people this will mean a support program that comes with housing; others won’t require anything more than their

emergency needs being met.

Homeless programs and services don’t heal or fix people.

They house people.


•  Substance use can impact housing. But homeless programs are not substance use recovery programs.

•  Life skills can impact housing. But homeless programs are not life skills training programs.

•  Mental wellness can impact housing. But homeless programs are not psychiatric programs.


•  Kids can impact housing. But homeless programs are not paren%ng programs.

•  Physical health can impact housing. But homeless programs are not health programs.

•  Lack of employment can impact housing. But homeless programs are not employment programs.

•  Budge%ng can impact housing. But homeless programs are not money management programs.

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Homeless services exist to end homelessness. They don’t heal or fix people.

They house people.

Myths Impede Our Success •  Substance users need to achieve sobriety to be successful

in housing. •  People with mental health issues need to take their meds

and be connected to a psychiatrist to be successful in housing.

•  People need to be “housing ready”. •  Chronically homeless people choose to be homeless. •  People need to hit “rock bo5om” before they are ready to

make important life changes. •  Shelters need a lot of programming to prepare people for

success in housing. •  Our community is SO unique that prac=ces used

successfully elsewhere do not apply here.

An Example…

•  Let’s say the City of Super-‐Duper Good People has a Rapid Re-‐Housing & Housing First program for singles...

•  Last week there were 10 assessments completed amongst homeless persons

•  The scores (out of 60) were…

An Example… Scores

51 49 45 38 36 32 27 21 17 11

Good candidates for Housing First

Good candidates for Rapid Re-Housing

These folks should be encouraged to take care of themselves

An Example…

WAIT!!! There aren’t that many

open spaces on caseloads!

An Example…

Relax. Let’s say there are 2 open Housing First spots and 1

open Rapid Re-‐Housing spot...

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An Example… Scores

51 49 45 38 36 32 27 21 17 11

HF

RRH

•  Take the 51 and the 49 for the Housing First slots.

•  The others will have to wait and be considered next week compared to any other new assessments...

•  And you’d take on the 32 for Rapid Re-Housing, with the 27 and 21 waiting until next week and compared against other new assessments.

Pathway to Housing

Presents for Shelter

Diversion Attempted

Shelter Admission if Diversion Unsuccessful

Minimal Service (encouragement) for 14 days

Housing Triage

Acuity Determined

1. Housing First/PSH 2. Rapid Re-Housing 3. No Housing Assistance

Prioritization Determined

Client Notified of Priority Status

Assigned Case Manager

Prep for Housing

Housing Search

Lease Signing

Move in!

Case Management Begins in Earnest

Goal Setting Linked to Higher Acuity Areas

Monitor Results

Pathway to Housing

WAIT!!! What about people

that return to shelter?

Pathway to Housing

Returns to Shelter

Diversion Attempted

Shelter Admission if Diversion Unsuccessful

Minimal Service (encouragement) for 7 days

Housing Triage

Acuity Determined





Prep for Housing

Housing Search

Lease Signing

Move in!



Monitor Results

Pathway to Housing

WAIT!!! What about long-‐term shelter stayers or people

living outdoors?

Pathway to Housing

Start Here

Housing Triage

Acuity Determined





Prep for Housing

Housing Search

Lease Signing

Move in!



Monitor Results

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FOOD FOR THOUGHT… Successful Elements In Strategies To

End Homelessness Learning from the experiences (and

mistakes) of others…

Food for Thought… Unified Housing &

Homelessness System •  Shii from funding driven, independent programs to an integrated service model that is outcome-‐based and dedicated to maintaining housing stability

•  Op=mize service pathways to effec=vely and efficiently end homelessness

•  Formalized collabora=on and alignment among the sectors that impact homelessness and community based agencies

•  Resul=ng in reduced system costs, improved demand management and higher quality service provision

System Transforma=on

•  System approaches: – Generate a Shared Vision and Guiding Principles – Help services be great, doing the thing they say they do

–  Coordinated access, assessment, service priori=za=on, referrals and focus of case management

– Don’t expect each service provider to be all things to all people

–  Let’s the system coordinate & navigate service access, not individual providers

Food for Thought… Preven=on & Diversion

•  Closing the front door into homelessness •  Assistance provided to prevent housing loss •  Diversion is oien a strategy that is missing in communi=es… – Diversion is not a refusal for service, it is the most important service!

–  Inves=gate the 9 Steps of Diversion

Homelessness Preven=on Research

•  Historically much of the preven=on investment has been going to the wrong households.

•  US Research found that without targeted use of preven=on funds, up to 80% of investments go to households that never would have become homeless.

•  The best investment of preven=on resources is targeted for those households that most closely resemble the exis=ng chronically homeless popula=on.

•  Without improved data and an effec=ve assessment and priori=za=on tool, targeted preven=on ac=vi=es are unlikely to have the desired benefits.

The Role of Diversion •  Diversion occurs at the “front door” of homeless services before people are admi5ed to shelter

•  Majority of shelter guests exit within a very short period of =me, sugges=ng that they may not have needed shelter at all

•  Evidence from diversion programs in North America and the U.K. suggest that between 30-‐50% of people seeking emergency shelter can be diverted.

•  The goal of diversion is to find a housing solu=on – even if temporary -‐ that stabilizes their housing without shelter access. Concurrently, long term housing stability is promoted.

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Diversion Services •  Family reunifica=on/Accessing family help •  Landlord media=on •  Access to housing lis=ngs •  Access to phone and computer •  Assistance accessing other community-‐based supports and resources

•  Naviga=ng other systems of supports •  Very short term case management/problem solving

•  Very shallow assistance (i.e. grocery gii card)

Food for Thought…

Enhancing Housing Op=ons •  Housing is the only known solu=on to

homelessness. •  No solu=ons to homelessness can exist without a focus on guaranteeing a sufficient supply of safe, permanent, affordable and adequate housing op=ons.

•  People do be5er in housing and stay housed longer when they have choice, not placement.

•  There is more than one housing solu=on. •  The op=ons must be explored – under-‐performing porrolios, conversions of exis=ng stock, partnerships, etc.

Food for Thought… Enhancing Housing & Supports

•  Opening the back door out of homelessness… Housing First – Everyone is housing ready – Housing First is NOT Housing ONLY – Why HF?

•  Higher housing reten=on rates •  Lower returns to homelessness •  Significant reduc=ons in the use of crisis services and therefore COST SAVINGS in the long term

Housing First...

•  As a philosophy it is the belief that homeless individuals should be assisted in accessing housing as quickly as possible with supports delivered in community

•  As an interven%on it is the delivery of direct supports through Asser:ve Community Treatment or Intensive Case Management, inten=onally working with those people that have most acute needs first

Before and Aier •  Before Housing First:

–  oriented towards emergencies and crises

•  services and investment of resources reflect this

–  emphasis on determina=on of how ready a person is seen for housing

•  less “risk” seen as a good fit for housing

–  program volume heavy within the emergency service system

–  many rules or requirements for accessing housing and supports

•  lots of compliance

•  Aier Housing First: –  oriented towards housing and

case management services in housing

•  services and investment of resources reflect this

–  emphasis on iden=fying and serving the person with highest acuity

•  more “risk” seen as a good fit for housing

–  program volume heavy within housing services

–  few rules or requirements for accessing housing and supports

•  not compliance based

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Criteria of a Housing First or Rapid Re-‐Housing Interven=on...

People do NOT have to… þ …complete any mandatory programming prior to moving into housing

þ …have a source of income prior to moving into housing

þ …be sober prior to moving into housing þ …graduate from transi:onal housing to be considered for housing

þ …par=cipate in mental health programming


Supports are delivered… þ …based upon acuity levels and presen=ng issues þ …in the person’s home, not an office þ …according to an INDIVIDUALIZED service plan þ …with no inten:on to “heal” or “fix” people

þ Par=cipants are priori:zed for par=cipa=on based upon acuity

þ Every person supported in housing has a crisis plan and a risk assessment completed

þ The work on other life goals occurs only aOer housing stability is well established


If people lose their housing… þ …they do NOT lose their supports þ …re-‐housing them is an immediate priority þ …they are not punished for making “mistakes” or losing their housing

þ People exit the program once housing and life stability are achieved

Case workers… þ …do NOT act like crisis workers þ …have a caseload no more than 1:20 for Housing First and 1:35 for Rapid Re-‐Housing

Food for Thought… Use of Evidence & Data to Guide and Monitor

•  Across the world, communi=es with reduc=ons in homelessness have insisted on using data to guide and inform decisions.

•  Many =mes, what we think and what we know are different things.

•  Correc=ve ac=on comes from monitoring. Improved data is necessary to enhance func=oning at program and system levels

Data, Outcomes & Public Messages •  Shelter data and calls for assistance with housing provide

an indicator, but not the whole picture, which can result in a misunderstanding about the incidence of homelessness and the needs of homeless individuals and families.

•  A commitment to improve data collec=on methods for all homeless programs and services will be essen=al.

•  An investment in a comprehensive Homeless Management Informa=on System (HMIS) that provides informa=on on unique individuals and outcomes from all relevant services provide the founda=on for future strategic planning, policy making and program improvements.

•  Enhanced informa=on on Current Reali=es & Impact Narra=ves provide valuable public messages that need to be communicated.

Data Points to Dig Deeper On •  How many individuals and families presented for shelter services but were diverted as a direct result

of your system’s efforts?

•  What is the average length of =me it takes individuals/families to get out of shelter and not return to homelessness?

•  Using a consistent assessment tool, what percentage of these individuals/families that did not get out of homeless may be classified as high acuity, moderate acuity, low acuity?

•  What is the average number of =mes an individual/family re-‐enters a shelter within a six month period?

•  Using a consistent assessment tool, what percentage of these individuals/families that return three or more =mes may be classified as high acuity, moderate acuity, low acuity?

•  How many individuals/families are living outdoors or any place not fit for human habita=on?

•  Using a consistent measurement, what percentage of these individuals/families may be classified as high acuity, moderate acuity, low acuity?

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Your Work Begins Now… •  5 Topics for Small Group Discussions:

–  Create a Unified Housing & Homelessness System –  Increase Housing Op=ons –  Enhance Housing Interven=ons –  Improve Homelessness Preven=on –  Improve Informa=on Systems: Data and System Knowledge

•  Each group will require a designated facilitator & recorder

•  You will work through a set of ques=ons designed to opera=onalize the journey forward

Next Steps

•  Imperfect Ac=on Always Trumps Perfect Planning

•  What will be accomplished in the next 90 days?

•  A commitment to ac=on.

@orgcode

facebook.com/orgcode 416-698-9700

orgcode.com

[email protected] orgcodemobile

Traverse City Community Conversation Day 1 · 141201 1...

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