Thursday, April 5, 2018

Homeless Response System Online Learning Clinic 2018 – Part VI: Dallas’ Homeless Response System in Action - 2017-2019

In 2015-2017, MDHA focused on building the necessary components of an effective unified homeless response system. In mid-2017, MDHA shifted its focus to utilizing the system to better house people quickly and permanently, while continuously improving the system. The Continuum of Care Strategic Work Plan 2017-2018[i] reflects this shift. Its goals are clear, and its objectives are bold.
 
Goals
 
        I.            Increase Access to Affordable Housing
      II.            End Chronic, Veteran and Elderly Homelessness
    III.            Improve Access and Coordination of Services and Emergency Housing
   IV.            Rapidly House Family Households with Children
     V.            Rapidly House Youth
   VI.            Drive Decision-making with HMIS Data
 VII.            Address Racial Disparities in Homelessness and Service Delivery
 
Objectives

        I.            Reduce the number of persons experiencing homelessness by 5%
      II.            Reduce the length of stay in homelessness by 10%
    III.            Reduce the number of chronic, veteran and elderly homeless by 50%
   IV.            Increase the number of unsheltered persons prioritized for housing to 500
     V.            Increase incomes for 20% of zero-income households on housing priority list
   VI.            Increase occupancy rates for all available shelter and housing beds to no less than 98.6%
 VII.            Increase housing stability in homeless housing programs to 96%
VIII.            Increase HMIS participation rates to no less than 86% of all beds and housing types

 Action

We report quarterly on our progress[ii], as a Continuum of Care, on 60 individual action items under the above seven goals. Here are just a few highlights of action we are taking to make homelessness rare, brief and nonrecurring:
 
·         Homeless Count – In January 2018, MDHA conducted the most extensive and technologically advanced Homeless Count in Texas history[iii], mobilizing more than 1,500 volunteers, and using the Counting Us app, from Simtech Solutions. Use of the app was helpful in making the Count easier and more accurate. By capturing the latitude and longitude of each encounter, it enabled MDHA to send out outreach teams the very next morning to aid individuals belonging to specific populations. MDHA provided the results of the Count at its annual State of the Homeless Address on March 21, 2018.
 
 

·         Homeless Response System Leadership Training and Strategic Planning Retreat – On March 28-29, 2018, we brought together all of the major “players”, in Dallas and Collin Counties, who can affect systems change, for a groundbreaking gathering, facilitated by OrgCode, led by pioneering world expert, Dr. Iain De Jong. With De Jong and former HUD Deputy Assistant Secretary, Ann Oliva, leading a team of facilitators, this retreat, with more than 65 senior leaders in attendance, was designed to usher in a more strategic community response to homelessness. Participating leaders spent two whole days of intense action-oriented participative and interactive hard work. They focused on the critical nature of collective impact, and how an effective system of care can bring about an end to homelessness in our community. Together, through a strategic planning journey, utilizing the Breakthrough Thinking approach, participants made the necessary decisions and vital commitments that will chart our course, as a community.

Ann Oliva
Former Deputy Assistant Secretary, HUD
·         Homeless Helpline – A key part of any homeless response system, it refers clients to several hubs: youth, domestic violence victims, families with children, single adults, Collin County residents, and general assistance, with each hub managed by a key CoC service provider. Lessons learned through the current soft-launch period of the helpline (which began in December 2017) will be incorporated into the public launch.

·         Housing “Challenges” - We challenge ourselves and our partners to house a specific group of people, during a specific time period. We have already concluded our first Top 50 Challenge; the idea is to house as many of the top 50 persons on the Housing Priority List, as possible. This challenge proved extremely successful, with over 80% of persons ending or on the verge of ending their homelessness! We will now run this challenge every other month, using the off months to learn and improve. We will soon run a Veterans Challenge, focusing on the 67 unsheltered veterans found in the Homeless Count. In the Spring, in collaboration with Dallas shelters, we will run an intensive Emergency Shelter Housing Challenge[iv].

·         Youth Homelessness – The MDHA CoC Youth Committee conducted, “See Us Now” the most extensive youth outreach survey to date, among and with the help of homeless youth. The qualitative and quantitative data collected, once analyzed, will help service providers better understand the needs of homeless youth, and serve them accordingly. This effort will be capped off with a “See Us Now” event in April 2018.

·         Collin County – MDHA expanded its assistance to Collin County providers, with an MDHA team member officing out of the Assistance Center of Collin County three days a week, and assisting multiple clients with housing navigation and placement. 

·         Housing Resources – MDHA conducted Housing Resource Clinics for the staff of six different emergency shelters, to give them additional tools to house their guests. We expanded housing search tools for case managers. As part of the Emergency Shelter Housing Challenge, we will conduct Housing Planning Clinics for clients, and encourage every client to build a “My Housing Plan” framework to end their homelessness. An MDHA authored New Tenant Resource Guide, is now available to all CoC member organizations. It is distributed to individual clients upon housing.

·         Harvey ReliefMDHA, the City of Dallas, the Dallas Foundation and Catholic Charities of Dallas joined forces to provide housing, services and case management to 200 non-FEMA eligible families, rendered homeless by Hurricane Harvey.

·         Faith-Based Organizations – The Salvation Army is now using HMIS for 100% of their programs. Discussions have begun with the Samaritan Inn to join HMIS. We will seek to add other faith-based organizations to HMIS with funding from the City of Dallas. A new CoC Faith-based Collaborations Committee now meets monthly, to help faith-based organizations do their part to help end homelessness.

·         Street Outreach – MDHA provides support to the City of Dallas’ expanded street outreach eorts, with resources and training, and in solidifying inclusion in the Housing Priority List, as a standard practice for street outreach.

·         Racial Equity – MDHA is committed to ensuring that racial equity permeate its work, as one of six communities working with the Center for Social Innovation’s SPARC project. MDHA has begun publishing a Homeless Response System Community Dashboard Race Addendum[v], to highlight racial disparities in homelessness and service delivery. An MDHA delegation participated in the Center for Social Innovation’s first-of-its-kind national summit on Racial Equity and Homelessness, in partnership with the Raikes Foundation and the Bill & Melinda Gates Foundation. MDHA will soon conduct a survey of the demographic make-up of the senior management and board officers of all federally funded service providers, with the goal of increasing the diversity of these groups, so they better reflect the homeless population.

 

Tuesday, April 3, 2018

Homeless Response System Online Learning Clinic 2018 – Part V: Building Dallas’ Homeless Response System – 2015-2017 – Data Transparency

All homeless service providers must practice full transparency, by reporting all data into the Homeless Management Information System (HMIS), the federally-mandated community wide database, that drives improvement of homeless services programs, without exception (barring issues of safety). Reporting into HMIS is not simply an issue of bureaucratic compliance. This is the only way we know if and how much progress our community is making. More importantly, this is the only way we can improve and self-correct, where we are not[i].
 
In the last three years, Dallas made huge strides, specifically, in this area. For instance, as late as 2014, no emergency shelter beds were reported into HMIS. It is impossible to assess system performance, in the absence of data on the point of entry into homelessness. Therefore, communities that do not have that data in their HMIS are routinely penalized for it, as Dallas was. However, unlike the housing programs, funded through the Continuum of Care (CoC) Program, MDHA cannot simply require shelters to enter their data. MDHA methodically worked with each of the major shelters, and over the last three years brought most of them into the system. As of December 2017, with the Salvation Army adding all of their 700 beds into the system, 57% of shelter beds are now entered into HMIS. In 2018, we will meet and exceed the standard set by the Federal Government, 86%.
 
These simple numbers, important as they are, bely a more fundamental shift in the HMIS, here in Dallas. In early 2015, MDHA and its partners began a discovery process that led the Continuum of Care (CoC) to adopt a new HMIS system, built from the ground up, by a non-profit founded by the Parkland Health and Hospital System, PCCI[ii], and its for-profit affiliate, Pieces Tech[iii]. This system was designed to be part of a larger ecosystem tracking individuals as they move through the healthcare system and social service organizations, Pieces Iris.


Dr. Steve Miff, PCCI

Pieces Iris was born out of the recognition that limited communication between the healthcare system and social service organizations, may cause vital information to slip through the cracks. The idea was to create a seamless system that connects healthcare and community-based organizations, allowing for smart sharing of information that makes a tangible difference in the lives of the most vulnerable populations[iv]. As PCCI President and CEO, Dr. Steve Miff, told the Becker Hospital Review[v], in September 2017, “Up to 50 percent of clinical outcomes are driven by social, economic or environmental factors, and not necessarily related to the direct care the individual received. That has basically set the stage and created the need for this solution to connect communities, and through that, to drive personalized medicine."

Over the course of the last three years, MDHA, PCCI and Pieces Tech worked hand in hand to launch the new HMIS, which went live in mid-2017. As Politico Magazine[vi] wrote in December 2017, Pieces Iris is already, “having a powerful impact on overwhelmed homeless organizations in Dallas… The availability of data showed… that homeless people were 167% more likely to have emergency room visits than the non-homeless population, and that from 300 to 400 homeless were arrested in Dallas each month. Neither of these pieces of information was shocking, but they gave [MDHA President and CEO, Cindy J.] Crain data she could take to officials to try to influence policy on homelessness. If she could show that housed people needed fewer EMS transports, ER visits and less time in jail, then, she reasoned, ‘I can make a business case to say, it’s not only the moral thing to bring housing to these homeless, mentally ill people. It’s going to save you money. If you don’t serve these people they’ll die in the street or eat you alive with these public response systems.’”

Finally, one glaring fact that “jumps out” at anyone who analyzes the data on homelessness in Dallas, is the overrepresentation of African Americans in the homeless population. Since late 2016, with the support of the United Way of Metropolitan Dallas[vii] Unite Dallas Relief Fund[viii], we are partnering with six other cities, towards establishing more racial equity in homeless services, through SPARC (Supporting Partnerships for Anti-Racist Communities)[ix], a new research and action program from the Center for Social Innovation (C4)[x].

Saturday, March 31, 2018

On the Rise of Homelessness in Urban America, and Our Next Steps to Address It Here in Dallas

During her State of the Homeless Address on March 21, 2018, Cindy J. Crain, MDHA President and CEO, shared the results of the 2018 Homeless Count in Dallas and Collin Counties. The numbers showed an increase in homelessness, in general, and unsheltered homelessness, specifically, accompanied by drops in chronic and veteran homelessness. That same week, the Collin County Homeless Coalition published its report, which showed a drop in the number of those experiencing homelessness in that county. Not surprisingly, it takes the U.S. Department of Housing and Urban Development (HUD) many more months to report on the results for the entire country.
 
In the meantime, we do have the 2017 numbers, which came out fairly recently, this last December, with HUD’s submission of Part I of its 2017 Annual Homeless Assessment Report (AHAR) to Congress on Point-in-Time Estimates of Homelessness. HUD reported that, “Homelessness increased for the first time in seven years. The number of people experiencing homelessness increased by a little less than one percent between 2016 and 2017.” Interestingly, though, this aggregate number reflects two separate phenomena: “This increase reflected a nine percent increase in the number of people experiencing homelessness in unsheltered locations, which was partially offset by a three percent decline in the number of people experiencing homelessness in sheltered locations.”
 
More importantly, HUD emphasized that this is primarily an urban problem: “Recent increases in homelessness were driven mostly by specific changes happening within cities. Increases in the numbers of unsheltered individuals in the 50 largest cities accounted for nearly all of the national increase…  The number of all people experiencing homelessness increased in major cities and decreased elsewhere between 2016 and 2017… More specifically, increases in unsheltered homelessness in major cities drove the national increase…”


One of our homeless friends at an encampment in 2017
(Photo taken by award winning photographer, B.J. Lacasse)


Why is this? What is going on in our cities?

An earlier HUD report, Worst Case Housing Needs – 2017 Report to Congress, may help us understand:

Worst case housing needs are a national problem. Such severe housing problems have expanded dramatically during the past decade and were exacerbated by the economic recession and associated collapse of the housing market, which reduced homeownership through foreclosures and tight lending and increased demand for renting. The slight improvements observed since 2011 offer cause for hope, but the failure to sustain the more promising trends observed in 2013 is sobering… The latest resumption of worsening housing problems among the nation’s very low-income renters is attributable primarily to demographic and economic factors—especially a notable shift from homeownership to renting—that grew the number of households susceptible to worst case needs. Uneven housing market responses that increased the proportion of unassisted very low-income renters with severe rent burdens played a secondary yet substantial role.


Even with rental assistance, 6 of 10 extremely low-income renters and 4 of 10 very low-income renters do not have access to affordable and available housing units. Among very low-income renters in 2015, only 25 percent of households had rental assistance and an additional 43 percent had worst case needs for assisted or other affordable housing. In other words, only a small share of very low-income renters—32 percent—avoided severe housing problems in the unassisted private rental market in 2015.  

And where is this problem most pronounced? “Central cities were home to most (9.51 million) very low-income renters, followed by suburbs (7.23 million) and nonmetropolitan areas (2.49 million).” The report emphasizes that the main culprit in this crisis is the lack of affordable rental housing in the nation’s urban centers.
 
Arguably, what we have is not a homelessness crisis, but an acute affordable housing crisis, and the epicenter of that crisis is in our cities, including Dallas and other urban communities in Texas. As we wrote, about a year ago, “Housing is the key… Local governments must act now to create affordable housing… We need more permanent supportive housing, more second chance housing, and more affordable housing in the 0-30% AMI (Area Median Income) range.” And HUD’s prescription is clear: “A broad strategy at the federal, state, and local levels is needed to continue to rebuild the economy, strengthen and realign markets, and provide assistance to those families most in need.”


Two of our formerly homeless friends
(Photo taken by award winning photographer, B.J. Lacasse)


The emphasis on the federal level is well warranted. The current level of federal funding for the Continuum of Care Program, just over $2 billion, is essentially a rounding error in a $4 trillion Federal Budget. We can’t expect to end homelessness, with this level of investment. As we wrote in December: “Especially over the last decade, we have become extremely skillful at building systems that maximize the impact of these $2 billion. However, as a nation, we have not explored the idea of significantly adding to that funding. We have accepted… that around $2 billion, in 2017 dollars, is enough to defeat a social ill that has been with us for forty years and counting.”


Ann Oliva
Former Deputy Assistant Secretary, HUD

However, we do need to do our part here in Dallas and Collin Counties, and specifically the urban core of Dallas, to address this affordable housing crisis, that is driving the increase in homelessness. This is why on March 28-29, 2018, we brought together all of the major “players”, in Dallas and Collin Counties, who can affect this type of change on the local level, for a Homeless Response System Leadership Training and Strategic Planning Retreat. This groundbreaking gathering was facilitated by OrgCode, led by pioneering world expert, Dr. Iain De Jong. With De Jong and former HUD Deputy Assistant Secretary Ann Oliva, leading a team of facilitators, this retreat, with more than 65 senior leaders in attendance, was designed to usher in a more strategic community response to homelessness.


Dr. Iain De Jong
(Courtesy of the Salt Lake Tribune)

Participating leaders spent two whole days of intense action-oriented participative and interactive hard work. They focused on the critical nature of collective impact, and how an effective system of care can bring about an end to homelessness in our community. Together, through a strategic planning journey, utilizing the Breakthrough Thinking approach, participants made the necessary decisions and vital commitments that will chart our course, as a community.

We look forward to sharing the report OrgCode will produce to help our community flesh out the next steps. Then, united in vision and purpose, we will act on those decisions, and fulfill those commitments. That is how, working together, as a community, we can and will make homelessness in Dallas and Collin Counties, rare, brief and nonrecurring.