Monday, October 30, 2017

Hard Conversations: Housing First Works… Just Look at Me!

What: Hear Joyce Grangent’s journey from homelessness to supportive housing to home ownership; from unemployment to employment to self-employment; from experiencing homelessness to becoming a nationally recognized expert on how to break the cycle of homelessness through supportive housing.
Who: Joyce Grangent is noted for her ability to help supportive housing providers expand and increase their program effectiveness and operational outcomes by enhancing individual and team leadership capacity among their staff. She gained her expertise, through both lived experience and professional experience over the last fifteen years. As such she brings a unique perspective to the fight to make homelessness, rare, brief and nonrecurring.                            
When and Where: Thursday, December 7, 2017, 12.30-2.00pm, J. Erik Jonsson Central Library (Auditorium – 1st Floor), 1515 Young St., Dallas, Texas 75201. Follow signs to underground parking on Wood St. Coffee and water provided. Attendees may bring a brown-bag lunch. Co-sponsored by the Dallas Public Library.

Thursday, October 19, 2017

CoC Strategic Work Plan Online Learning Clinic - End Chronic, Veteran and Elderly Homelessness

Why does our CoC Strategic Work Plan have an entirely separate goal for these populations? On one level the answer is rather simple: Opening Doors, the national strategic plan to end homelessness and the HEARTH Act of 2009 prioritize these (at least, the first two, explicitly). However, that doesn’t really answer the question, because then the question is, why did Congress, expressing the will of the nation, as a whole, prioritize these groups?
Cindy J. Crain, MDHA President and CEO, with Dennis Culhane
Prioritizing these groups follows an idea called progressive engagement. Dennis Culhane, one of the leading scholars of the modern homelessness crisis, and his colleagues discuss this at length. This graph, from their article, is very helpful in understanding what this approach is all about:

(Courtesy of Culhane, Metraux and Byrne)
As we explain in our playbook, before the HEARTH Act, the experimentation with Rapid Rehousing during the Great Recession, and the advent of the Housing First movement, Continua of Care and their grantees often served clients on a “first come, first served” basis, using a “one-size fits all” approach. This often meant that we served those who figured out how to best access the system, not those who needed the most help, and that we made everyone we served go through the exact same programs. This left our services, for everyone, lacking.
Using a progressive engagement approach, we serve each person, according to their needs, prioritizing those who need the most help. Not surprisingly, most people don’t need a huge amount of help, and those who do, vary by their level of vulnerability and scope of need. The greater the vulnerability and scope of need, the greater and more urgent the need for help is, and the greater the cost of that help.
Typically, the chronically homeless, veterans and the elderly will fall into those groups that are on right hand side of the graph. This does not always mean that that more intensive investment will come from the core of the homeless response system. As Culhane and his colleagues explain, and as the graph itself indicates, these may be provided by mainstream services aligned with the homeless response system. This is what this goal in our plan emphasizes too, particularly in action items 4, 7 and 10.
Prioritizing veterans also makes sense from an ethical standpoint. Veterans have given, of themselves, to our nation. We, as a nation, recognize that we have a heightened obligation to them, and so allowing veteran homelessness to continue would be a moral failure.

(Courtesy of USICH)
As a nation, we have proved up to the task. As the U.S. Interagency Council on Homelessness (USICH) tells us: “A growing list of 50 communities, including the entire states of Connecticut, Delaware, and Virginia, have proven that ending Veteran homelessness is possible and sustainable… (C)ommunities across 26 different states have proven that we can drive down the number of Veterans experiencing homelessness to as close to zero as possible… The national data tell the same story… We've reduced Veteran homelessness by 47% in this country between 2011 and 2016—including a remarkable 17% reduction during 2015 alone—and achieved a 56% reduction in Veterans experiencing unsheltered homelessness.”
Congress had an additional reason to prioritize veterans. They recognized that the movement to end all homelessness would be met with skepticism. And, so, what if we could demonstrate that we could end the homelessness of a specific group? Would that not go a long way to proving that ending all homelessness was not a pipe dream?

And so, by making such strides towards ending veteran homelessness, we have shown, as a nation, that ending homelessness is a realistic goal, if evidence-based best practices and systems thinking are applied to the problem. Now that we have proven it possible, the moral imperative of our nation’s social contract compels us to apply these to all types of homelessness. All that separates us from this goal, of ending chronic, veteran and elderly homelessness, and the general goal of making all homelessness rare, brief and nonrecurring, is the will to do it.

Friday, October 13, 2017

CoC Strategic Work Plan Online Learning Clinic - Improve Access and Coordination of Services and Emergency Housing and Rapidly House Family Households with Children

Some of the most important systems change work in our Continuum of Care (CoC) is done on the committee level. The Family and Domestic Violence Services Committee’s work over the last few months is a great example of this. Back in August, the two committee co-chairs, Ellen Magnis, CEO of Family Gateway and Blake Fetterman, Executive Director of the Salvation Army Carr P. Collins Social Service Center, treated us, at the CoC General Assembly, to a fascinating progress report on how they are working through various elements of Goals III and IV of the CoC Strategic Work Plan.
In this installment of the CoC Strategic Work Plan Online Learning Clinic, we will zero in on specific points they discussed in this presentation. We encourage you to carefully review the entire PowerPoint presentation from Ellen and Blake’s progress report, as well as Goals III and IV, to understand the full context of the discussion.
Ellen Magnis
The first part of the presentation focuses on system mapping and alignment of rules and procedures of different shelters. Why is it important to map a system of care, especially to the level of specificity that Ellen and Blake exhibit on page 2 of their presentation? Why is it important to align the rules of different shelters? Simple: Without doing this work, there is no system; there is only an uncoordinated environment. That hurts those experiencing homelessness, and hampers the work of those trying to help them.

In an uncoordinated environment, the National Alliance to End Homelessness explains, “families with housing crises may end up going to multiple agencies that cannot serve them before they get to the one most appropriate for their needs.” And when each agency has different rules and procedures, this ends up, “slowing down families’ receipt of assistance.” Furthermore, “extra staff, time, and money are spent doing intake and assessment, taking time away from other, more housing-focused tasks, such as case management, housing location, and landlord negotiation.” This type of environment is detrimental to those who need our help the most, as, “research suggests that, in many systems, resources are being conferred on a small subset of families whose needs may primarily be economic, while those with more significant challenges (co-occurring disorders, complete lack of a social support system, etc.) are falling through the cracks.”

Laura Zeilinger
Indeed, as we have shared before, former Executive Director of USICH, Laura Zeilinger, argues that the essence of transforming homeless services into an effective homeless response system may be summed up in the right entity asking the right question: An effective homeless response system is one where individual programs no longer ask, "Will this person be successful in our program?" Rather, the system as a whole asks, “What solutions best match the needs of this person or household, and will end their homelessness quickly and permanently?"  
This focus on solutions rather than programs is what drives another important idea Ellen and Blake reiterate, the cardinal importance of diversion. As we explain in our playbook (pg. 8), “An effective homeless response system, counterintuitively perhaps, seeks to divert individuals from having to enter into or engage with the system. It recognizes that homelessness is not homogeneous, rather it is on a continuum. Many of those who seek our help have the capacity to self-resolve, with the help of mainstream resources, or ‘light touch’ one-time assistance.”
A recent excellent piece on the Austin Street Center website elaborates on this, and is worth quoting at length:
It’s easy to think that anyone who seeks services at a homeless shelter is actually homeless and in need of a safe place to stay for the night. However, according to Austin Street’s Executive Director, Daniel Roby, that’s not always the case, ‘Sometimes people come to us in shock, having just been kicked out of their apartment. They often haven’t had the time to think through what other options might be available to them. They are just thinking, ‘I need shelter tonight.’”
According to Director of Programs, Dustin Perkins, “Diversion allows us to have a comprehensive understanding of a person’s true needs. When you’re overwhelmed, when something traumatic has happened, sometimes it’s hard to see when you do really have options. We can help with that.”

Dustin Perkins
Diversion is better for the individual or family in crisis, and it is better for the system as a whole. After all, diverting an individual or family, who can self-resolve, eases the pressure on the limited resources of the system, allowing us to serve those who cannot self-resolve and cannot be diverted. This is why both Austin Street Center and Family Gateway have made significant investments in diversion.

By the end of this month, we will tackle the remaining two goals we have not covered yet in this Online Learning Clinic: End Chronic, Veteran and Elderly Homelessness and Drive Decision-making with HMIS Data. Stay tuned!

Saturday, October 7, 2017

Does it Matter Where People Experiencing Homelessness in Dallas Come From?

Our mission statement at MDHA is very specifically worded: 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. That language is directly derived from the 2009 Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act, and Opening Doors, the national strategic plan to end homelessness, established under the Act.

Perhaps one of the most important words in our mission statement is “system”. Housing is the only solution that can end homelessness. Effectively and efficiently delivering any resource, especially a scarce one, like housing for those experiencing homelessness, cannot be done without a well-oiled delivery system.
That is why systems thinking is so central to what we do. I was, personally, first introduced to systems thinking, when I was studying for my Texas school principal certification. Perhaps that is why I really like this concise straightforward explanation from the Waters Foundation: “Systems thinking utilizes habits, tools and concepts to develop an understanding of the interdependent structures of dynamic systems. When individuals have a better understanding of systems, they are better able to identify the leverage points that lead to desired outcomes.”
One of my favorite aspects of systems thinking is that it, a la Stephen Covey, begins with the end in mind. It first asks what the desired outcomes or outputs are. Once you have figured that out, it backs up, and asks what inputs are needed to deliver those outputs. Any suggested input, however attractive, must be rejected, if it does not lead to the desired output. Covey rightly points out that one must be ruthless in doing this, because, “If your ladder is not leaning against the right wall, every step you take gets you to the wrong place faster.”

Stephen Covey
Recently, Cindy J. Crain, MDHA’s President and CEO addressed a question in a way that illustrates this idea very well. The question was, “Where do people experiencing homelessness in Dallas come from?” There is an honest misconception in many communities that those experiencing homelessness are not from that community. In fact, when this was measured in Dallas homeless counts, the numbers indicated that the vast majority of our homeless friends became homeless in Dallas. This number seems to be in line with other locales’ past homeless counts too.
The Department of Veterans Affairs (VA) actually conducted a long-term study on this very issue. Their findings not only back up what we knew already, but answer a question communities seldom wonder about: How many natives of our community are experiencing homelessness elsewhere? They arrived at this not surprising result: “In-migration roughly balanced out-migration. For most (communities) there was a small net impact of migration on homeless population size. In (communities) with larger numbers of homeless, the net impact of migration attenuated towards zero (emphasis mine-DSG).”

Now, Crain did mention this misconception and the facts on the ground in passing, but she did not dwell on them. Instead she explained that there is very little utility in answering this question on a macro level. The answer would not and should not cause MDHA and its partners to do anything differently in the effort to make homelessness rare, brief and nonrecurring in our community. There are data points that are very important on the macro level, such as age, gender identity, veteran status, race and more, because they have utility in the systems thinking frame. This data point, on the other hand, simply does not, which is probably why the U.S. Department of Housing and Urban Development removed it from its guidelines regarding annual homeless counts.

What utility do these other data points have? Let’s take an issue we just blogged about, as an example, the overrepresentation of African Americans in the homeless population. The current output is that 60-70% of those experiencing homelessness in Dallas County are African American. Ideally, one would hope their percentage would roughly equal their percentage in Dallas County’s population at large, about 13%. So, what inputs do we need to change on the system level to get that desired output, is a very important question, which we seek to address.

Crain did explain that on the micro or individual level, the question of where the person comes from is tremendously important, and is a routine part of best practice case management. Why? Because, as we point out in our playbook (pg. 8), the first step in engaging an individual person seeking services in the homeless response system should be diversion. One of the easiest ways to divert, is to help the person reunite with family, if possible. This is true regardless of where the person is from. A great example of this is our story from about a year and a half ago, Solomon’s Ticket out of Homelessness. An incredible example of this, is the story of Gershon Campbell, who with the help of Austin Street Center returned to his home 5,600(!) miles away.

Gershon Campbell
(Courtesy of KHOU)
Once again, this goes back to systems thinking. Imagine, you are a case manager, and you are approached by an individual person experiencing homelessness. The desired output is that they be housed. Can their origin be a useful input? You don’t know yet, because you need to know more about them. If they are from Dallas, for instance, their family moved away to Rhode Island, has invited the individual to join them, and the individual so desires, then the fact that the individual is from Dallas is not a useful input at all. It would be a dereliction of duty to insist the person stay homeless in Dallas, and not join family and be housed in Rhode Island!

Conversely, in Leonard’s case, which we wrote about exactly a year ago, even though he had no intention of returning to Florida, where he was from, this data point was a very relevant input. Why? Because, Leonard wanted to self-resolve his homelessness. His plan was to return to his career as a truck driver, which would enable him to obtain housing, the desired output of our system. He had a Commercial Driver's License or CDL, but alas it was from Florida, not from Texas. The necessary additional input was to transfer the license from Florida to Texas, with the help of Austin Street Center and MDHA.

In summary, does it matter where people experiencing homelessness in Dallas come from? On the macro level, because it does not contribute to our desired output, housing, not really. (Parenthetically, the vast majority are from here, anyway, and in-migration vs. out-migration attenuate to zero.) On the micro level, when helping individuals experiencing homelessness, it depends on the client, so one should always ask. The answer should be factored as an input into the system, but only if it can help our desired output, the housing of that individual.