Homeless Response System Online Learning Clinic 2018 – Part IV: Building Dallas’ Homeless Response System – 2015-2017 – All Roads Lead to Housing

The entire system is oriented towards housing as the solution for homelessness, and this approach permeates every component of the system. There is a sense of urgency in getting everyone, and first and foremost those who are high on the Housing Priority List, into housing, as soon as possible, with as few barriers as possible. In the meantime, individuals, who need it, are offered temporary shelter, with the constant ever-present expectation that they be moved into housing as soon as possible.

Dr. Iain De Jong

(Courtesy of the Salt Lake Tribune)

Since 2015, MDHA has held regular policy discussions, trainings, lunch and learns, boot camps, and roundtables for case managers, program managers, agency leaders, and the public, to reorient every part of the Dallas homeless services ecosystem towards this thinking. Notably, in March 2017, MDHA asked pioneering world expert, Dr. Iain De Jong, of OrgCode, to conduct one of his international learning clinics on Being an Awesome Shelter, in Dallas. MDHA sponsored ten spots for Dallas shelters, to further facilitate a transformation in how Dallas shelters operate, as housing-oriented programs.
 
To further assist case managers in housing their clients, in 2015, in conjunction with United Way of Metropolitan Dallas, MDHA founded the MDHA Flex Fund[i]. This fund gives case managers an important tool to pay for hundreds of minor but impactful expenses, every year, that can help individuals resolve their homelessness, quickly and permanently. 

 

 

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[i] http://www.mdhadallas.org/the-mdha-flex-fund/

Introducing the Homeless Response System Online Learning Clinic 2018

The Metro Dallas Homeless Alliance (MDHA) leads the development of an effective homeless response system that will make the experience of homelessness in Dallas and Collin Counties rare, brief, and non-recurring. MDHA brings together more than 85 shelter, housing and supportive services programs in retooling homeless services into a crisis response system.

Over the course of 2015-2017, MDHA focused on building the necessary components of an effective unified homeless response system. Such a system helps those who can self-resolve do so, places those who cannot self-resolve into appropriate housing, is entirely oriented towards housing as the solution for homelessness, and practices full transparency, as a tool for learning and systems change.

In mid-2017, MDHA shifted its focus to utilizing the system to better house people quickly and permanently, while working with experts and innovators to continue to improve it. The system’s impact has been recognized by the local community, as well as lauded nationally.

This blog series, the Homeless Response System Online Learning Clinic 2018, is designed to walk the reader through our work, at MDHA, since 2015 to the present day, and as we move forward. It will follow this outline: 

Part I: From Managing to Ending Homelessness

Part II: The Need for a Homeless Response System
Part III: Building Dallas’ Homeless Response System – 2015-2017 – Diversion and Coordinated Access
Part IV: Building Dallas’ Homeless Response System – 2015-2017 – All Roads Lead to Housing
Part V: Building Dallas’ Homeless Response System – 2015-2017 – Data Transparency
Part VI: Dallas’ Homeless Response System in Action - 2017-2019

How Do We Know What We Know? - The Final Installment of the CoC Strategic Work Plan Online Learning Clinic

In this final installment of our Continuum of Care Strategic Work Plan, we touch on Goal V: Drive Decision-making with HMIS Data, zeroing in on Objective VIIII: Increase Homeless Management Information System (HMIS) participation rates to no less than 86% of all beds and housing types.
 
In a recent blog post we talked about the idea of ending veteran homelessness, and how more than fifty communities have achieved just that. Now, you might ask: Are you trying to say that there are no homeless veterans in any of those communities? Well, no, that is not what we are trying to say. Indeed, the quote from the U.S. Interagency Council on Homelessness (USICH) in that blog post talks about those communities bringing down the number of veterans experiencing homelessness not to zero, but as close as possible to zero. So, what is it? What do we mean by ending veteran homelessness?
 
USICH helpfully defines this for us in a document that is worth reading in full. Basically, it means that all veterans experiencing homelessness are and continue to be identified, that shelter is provided immediately to all who request it, that traditional transitional housing is rarely used, and instead all are offered and provided with permanent housing, as swiftly as possible. Most importantly, that community must not have done all of this on an ad hoc basis, but show that it, “has resources, plans, partnerships, and system capacity in place should any Veteran become homeless or be at risk of homelessness in the future.”


Governor Dan Malloy, of Connecticut,

discussing his state being the second to end veteran homelessness

(Courtesy of WNPR)

The importance of knowing that more than fifty communities have done this is, as we pointed out in that previous blog post, that this is doable. We often assume that what is, always was, and will always continue to be. Perhaps this is a result of our evolution, which before modern times granted us extremely short life spans. Indeed, the forty years of the modern homelessness crisis is longer than the life expectancy of our prehistorical ancestors roaming the African savannah. That is just it, though, this crisis is a new phenomenon in American Life.

What we aim to return to, through the development of effective homeless response systems across the country, is not full housing, with no one ever becoming homeless. What we aim to return to is a reality that existed in our country prior to the mid-seventies of the last century, when homelessness was rare, brief and nonrecurring. And so, when we speak of ending homelessness, what we really mean is bringing about an end to the modern homelessness crisis.

(Parenthetically, this is not to say that full housing is not a desirable outcome. As Dr. Barbara DiPietro pointed out in her visit mid-October, it is extremely desirable, and it too is very doable. However, this would require a realignment of resources, across our society on a much broader level. At the minimum, it would likely require that housing vouchers be made available to all who qualify for them, and that refusing to accept them as payment be outlawed across the land.)

But, how will we know when we get there? This might seem like a simple question. If only. In fact, one might ask a broader philosophical question, “How do we know what we know?” The study of how we know what we know, epistemology, has become extremely important, as our society further fractures and sources of information multiply. We are forced to ask ourselves, “What are the necessary and sufficient conditions of knowledge? What are its sources? What is its structure, and what are its limits?”

This is especially true regarding homelessness, where, “our failures are the most visible and our successes the most hidden." In this type of environment, it becomes difficult not to fall into the trap of assuming that data is just the plural of anecdote, and that the latest sensational headline negates evidence based practices.

The only hope for truly knowing what we know is the painstaking continuous and relentless collection and analysis of data in one shared open system, which everyone reports into. That word everyone is the crux of this proposition. As we mentioned in a previous post on this blog, “In early 2015, only 3%(!) of the shelter beds available to Dallas’ homeless population were reported into the (homeless management information) system… It was… analogous to Schrödinger’s Cat… the cat was 97% sealed within the box.”

 

We have come a long way since that 3% mark in 2015, partnering with PCCI and now Pieces Tech to develop and over the last few months implement, that single open state-of-the-art HMIS for Dallas, gradually and continuously increasing the number of beds in the system. We are determined under this plan to break that 86% mark, the minimum acceptable to the Federal Government, and keep on pushing until we get as close as possible to 100%. That alone is bringing us that much closer to achieving an end to not only veteran homelessness, but all types of homelessness, making this societal ill, once again, rare, brief and nonrecurring, and keeping it that way.

Schrödinger’s Homeless Cat*

The Thought Experiment

Perhaps the most famous quantum physics experiment is the thought experiment known as Schrödinger’s Cat. Erwin Schrödinger disagreed with a model of quantum mechanics. That model held that a particle exists in multiple states until observed. He used his thought experiment to disprove that model.

Imagine a sealed box containing a cat, a bottle of poison and a radioactive sample. The box is rigged, so once the sample has decayed, the bottle shatters, which kills the cat. Opening the box will allow us to detect if this has happened yet or not, but what about when the box is still sealed? According to the model Schrödinger was trying to disprove, the cat would be both alive and dead at the same time! Since that is obviously impossible, that model cannot be true. QED.

Now what remains true, and what undergirds the entire thought experiment, is that until we open the box, we don’t know if our furry feline friend is alive or dead. This is a perfect analogy for two different problems MDHA has been working on for the last two years.

(Courtesy of NobelPrize.org)

The Homeless Count

In early 2015, MDHA told the community, that regarding the number of unsheltered homeless persons counted in the annual homeless count, we had this type of Schrödinger’s Cat problem. We knew there were unsheltered homeless, and we were counting them every year, but we could not be confident we were finding everyone that could be found. We had what was, at least partially, a sealed box.

We needed to improve our count methodology, and we needed more volunteers. We explained that the experiences of other communities showed that you needed a ratio of 1:1, i.e. one volunteer per one unsheltered person, to find and count everyone.  We suggested that likely there were about 1,000 unsheltered persons in our jurisdiction, Dallas and Collin Counties.

Indeed, in 2016, in our first count conducted under our new counting regime, we had about 750 volunteers, and we found about 750 unsheltered homeless persons. (In 2015 we had found only about half as many.) We still were not able to cover all the routes we had carefully plotted in 2016, so we continued to suspect that we were not finding everyone who could be found.

In 2017, we set our target at 1,000 volunteers, and we ended up with about 1,375. We covered 99.5% of our routes, and we found 1,087 unsheltered persons. The box was unsealed, the cat was fully in view, and our two-year-old prediction had proven true. This is why in the 2017 State of Homeless Address we suggested that this number be the benchmark for our work moving forward.

 
The Homeless Management Information System

There was one more Schrödinger’s Cat problem we pointed out in early 2015. Communities in the United States are required under Federal Law to maintain Homeless Management Information Systems, commonly known as HMIS. Organizations like MDHA are tasked with operating these systems. Most organizations receiving Federal funding for housing programs for the homeless are required to report crucial data into these systems. This is not an issue of bureaucratic compliance. The only way we can and do help individual organizations and the community at large improve in our fight against homelessness is through collecting this data, analyzing it, and using it to drive improvement.

The problem was that in early 2015, only 3%(!) of the shelter beds available to Dallas’ homeless population were reported into the system. The data reported into the system from Federally funded housing programs is tremendously valuable, but it is data about the “back-end” of a person’s journey from homelessness to housing. The shelter environment is the “front-end” of homelessness, and we had very little data about it. It was more analogous to Schrödinger’s Cat, than the annual count ever was. In this regard, the cat was 97% sealed within the box.

 

 

During the last State of the Homeless Address, we had the audience go through our own thought experiment to drive this point home. We asked everyone to stand up to represent 100% of the homeless population. Then we gradually had sections of the audience sit down, leaving only a small section standing. We explained that we could not possibly, with a straight face, contend that the data we collect about the small section standing, was representative of the entire audience.

Already back in 2015, we stated that one of the most important things Dallas needed to do was move from 11(!) separate data systems to a single open state-of-the-art HMIS system, with at least 86% of shelter beds reported into it. The Federal Government does not really consider data from a system that does not have, at least 50%, to have any meaningful validity. Only at 86% does it consider the data to be comprehensive and reliable enough to award the community points on its collective grant application for homeless housing programs. The Federal Government cut the funding for homeless housing programs in Dallas twice over the last few years, because of this very problem. That cut did not affect the shelters; it affected the housing programs.    

 

We have been working on this problem for the last two years, early on partnering with PCCI and now Pieces Tech to develop that single open state-of-the-art HMIS for Dallas. In the meantime, we have increased the number of shelter beds reported into HMIS from 3% almost eleven-fold, but that is still just 32%. We are excited to be on the cusp of transitioning to the Pieces Tech HMIS, and even more excited that more service providers will be signing on to be a part of it. We are determined, this year, 2017, to break that 86% mark, and finally bid Schrödinger’s Cat adieu. We owe our homeless neighbors nothing less.   

* MDHA wishes to assure readers that no cats were harmed during the writing of this blog post, though one rabbit gave me a dirty look.

Our Homeless Friends’ Self-Advocacy Bears Fruit

Courtesy of DART

One of the forums that MDHA facilitates is the Alliance Homeless Forum. This is a monthly forum run by and for our friends, who are experiencing homelessness, or are formerly homeless. Shavon Moore, our Continuum of Care Resource Manager helps facilitate these meetings. Already back in 2014, our friends highlighted an acute need – public transportation. In their experience, having access to public transportation to utilize medical and social services, search for employment, and navigate housing solutions was a critical need. This access was impeded by the issue of cost. Though $5 a day might not seem like much for the average reader, this is not a cost most of our friends can afford.

They researched the issue, and discovered that Dallas Area Rapid Transit (DART) already had well publicized programs in place, that allowed for 50% reduced fares for certain classes of people, e.g. persons with disabilities, seniors and students. They researched the issue further and found that a little-known program existed, where those receiving Temporary Assistance for Needy Families (TANF) were eligible for such a 50% reduced fare too. Perhaps since qualifying for TANF in Texas is extremely difficult, this program was not being utilized.

Shavon and our friends approached DART, and suggested that it would make more sense to convert this existing unutilized program into a program that would address their needs. DART agreed to run a pilot program, in collaboration with MDHA for the months of March-August 2016, that would enable our friends to pay a 50% reduced fare. Following this successful pilot, DART agreed to renew the program for all of 2017!

To be eligible for this program, a person must be literally homeless or actively enrolled in a program through safe haven, permanent housing, transitional housing or emergency shelter for at least ten days, and he or she must be have an active record in the MDHA’s Homeless Management Information System.

If such a person and his or her case manager identify transportation as a need, the case manager submits a request to MDHA. MDHA then verifies the person’s housing status and provides a letter of certification to the case manager. The person then submits the letter to the DART Store, and purchases a DART Reduced ID card.

The DART Reduced ID card allows persons to purchase 50% discounted passes at the DART Store, ticket vending machines and on buses. They must show the ID when presenting a DART pass to a bus operator or a train fare enforcement officer. 2-hour passes, day passes and 31 day passes are available. The MDHA Flex Fund can further pay for the ID and/or the remaining 50% of a monthly pass, if needed.

One of the most important lessons of this story is one that should be obvious, but is all too often forgotten. When it comes to discovering the needs of those experiencing homelessness, one of the most important things to do is… ask those experiencing homelessness! There is simply no substitute for true lived experience.

Housing and Shelter Targets Exceeded as Haskell Encampment Closes; Street Outreach and Case Management Continues

Haskell Encampment, Dallas, Texas – Yesterday, October 24, 2016, the Metro Dallas Homeless Alliance (MDHA) and the Street Outreach Initiative, closed out an intensive week of case management and engagement, reviewing options with the remaining thirty-seven individuals, living at the Haskell Encampment, who had not moved yet. The encampment area located between S. Hill and Haskell Avenues under I-30 is in the process of being formally closed today, October 25, 2016.                                          


Street Outreach Initiative

Team Mobile Office

The site was slated for closure after a joint meeting with City Officials on September 29, 2016, when MDHA and collaborative partners agreed that the Street Outreach Initiative could reasonably house half of the then population of eighty-two encampment residents. The closure guidelines were developed by MDHA in consultation with the City of Dallas, following the clearing of Tent City in April-May of this year. As of yesterday, 45 persons have been placed, just above the goal of 41. 


Over the course of the last few weeks, in fact, MDHA and its partners from the City of Dallas, CitySquare, Nexus Recovery Center, Turtle Creek Recovery Center, The Bridge, Austin Street Center, the Salvation Army and Metrocare Services, were able to find and place forty-five residents into shelter, treatment, rapid rehousing, permanent private housing, and group homes or help them reunite with their families.



“Consistent and persistent case management, patiently undertaken by seasoned professionals, trained in trauma-informed care,  and armed with a toolbox of evidence-based solutions, is the only way we can end unsheltered homelessness in Dallas,” said Cindy Crain, President and CEO of MDHA. “The success of this effort could not be accomplished without strategic interagency collaboration, which has been developing over the course of 2016 into a true crisis response system, where we all work together, breaking down silos, and securing the best possible outcome for every individual,” she added.   

Yesterday, as case managers and volunteers helped the remaining residents pack up, they were joined by five formerly unsheltered homeless from prior tent encampment closures who are now permanently housed.

Crain reflected, “Their presence gave residents a glimpse of hope and possibility of the results of accepting shelter, housing, treatment and services. Seeing is believing, and is critical to motivating and working through the ever present trauma enforced fear and uncertainty of accepting assistance. The Street Outreach team gets better every day at the hard work that they do.”

MDHA and its partners will continue to work with these and other unsheltered individuals to get as many of them as possible off the streets and into shelter and housing. The overall impact of the successful, peaceful and housing-oriented closing of three encampments since the beginning of May 2016, will not be fully known before the annual Point-in-Time Homeless Count, which will be led by MDHA on the night of Thursday, January 26, 2017.

In the last Count, conducted on the night of Thursday, January 21, 2016, MDHA counted 539 unsheltered homeless individuals in Dallas. In order to conduct a full and accurate count of the unsheltered homeless, this coming January, MDHA will need 1,000 volunteers, registered as teams of 3-5 persons. Registration will open mid-November. Those wishing to receive notification of such, should text keyword MDHA to 22828 to join MDHA’s mailing list.

Supportive Services and Assessments Increased at Haskell Homeless Encampment – Racial Inequities Must be Addressed

On Tuesday, September 6, 2016, beginning at 9:30 am, the Metro Dallas Homeless Alliance and representatives from several homeless service providers will increase supportive services and client needs assessments for residents of the homeless encampment located at I-30 and Haskell in Dallas, Texas. 

Street outreach workers primarily from City Square, Austin Street Center, The Stewpot and Turtle Creek Recovery Center will embark on a “blitz” to methodically assess each person, and document their homelessness, in preparation for moving them into housing, as soon as feasible.

Effective evidence-based street outreach assumes that all persons have strengths and assets, enters into dialogue, figuratively and literally where clients are, and starts the conversation immediately, with a specific question, “What is your housing plan?” Persons are assessed using evidence-based tools, with an eye to facing the practical housing barriers the person faces. The attitude brought to such outreach is key: We are aware, that nearly all persons living unsheltered come from a position of trauma, and are coping with antisocial, destructive and avoidant behaviors. Therefore, we do not judge.

It is important to identify each person’s collateral and most immediate and achievable need, in order to build trust. Case workers must be mindful of the fact that change comes in stages: Some people can move quickly, while others require thoughtful motivational interviews and conversations. Persistence and consistency are key: Follow up, follow up, follow up, with that same question, “What is your housing plan?” Deadlines can be helpful, serving as antagonists to create bias for action, however, the best results depend on the resources available, including time.

To be effective, a ratio of one case manager to ten households is a must, since there is much to do for each person. Case managers must initiate contact, assess and prioritize for service, connect persons with services, staff each case with other relevant agencies, facilitate the development of a housing plan, follow up on said plan, directly assist with barriers to the plan, advocate for the person with other agencies, and document all of this in the Homeless Management Information System.   

It is this type of methodical work that was able to lower the estimated number of individuals experiencing homelessness in the largest encampments in Dallas’ urban core from about 300 to 200 individuals, since the May 2016 closure of the Tent City under the I-45 Bridge. Specifically, 57 persons were housed by CitySquare, 4 moved out of Dallas, 4 others were housed by other entities, 13 entered emergency shelter, and 18 have been fully assessed and prioritized, and are ready to be housed immediately, once housing units open. 

Doing this work, Dallas must come to terms with one more important fact: The persistence of racial inequality stands out in the area of homelessness. African Americans make up 13% of the population, both in the US and Dallas. Across the country, on average, African Americans make up 40% of the homeless population, and 28% of the unsheltered homeless population, which is troubling, in and of itself. However, in Dallas, African Americans make up 67% of the homeless population, and 70% of the unsheltered homeless population! And, unfortunately, true to Chief David Brown’s words on July 8, 2016, this too is one more “societal failure we put… off on the cops to solve.”

As we continue the ongoing work with the unsheltered homeless population, MDHA and its partners will seek to tackle this overrepresentation of African Americans in the homeless population. While no single initiative can end structural racism across all systems, we believe that it is possible to create positive change in attitudes and behaviors that will begin to close the racial gap that has led to the disproportionate prevalence of homelessness among African Americans. We will work to make that happen.

History of Encampment Tent Population Estimates in 2016:  

2016	Jan (PIT)	Feb	March	Apr	May	June	July	Aug	Sept
I45	181	237	221	204	77	0	0	0	0
Haskell	21	22	34	56	62	73	86	92	82
Coombs	24	28	26	41	84	82	73	14	14
Total Tents	226	287	281	301	223	155	159	106	96