Homeless Response System Online Learning Clinic 2018 – Part III: Building Dallas’ Homeless Response System – 2015-2017 – Diversion and Coordinated Access

The linked infographic, developed by the equivalent to MDHA in Kansas City[i] a few years ago, is extremely useful in understanding how over the course of the last three years we built an effective unified homeless response system, here in Dallas. (It is helpful to consult it, while reading the next parts.) This system has four main attributes.

Diversion

It seeks to divert individuals from having to enter into or engage with the system. It recognizes that homelessness is not homogeneous; 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[ii]. In Dallas, Family Gateway[iii] and Austin Street Center[iv] stand out, as two partners, who over the course of 2017, put in place robust diversion protocols, to help clients end their homelessness, and avoid or shorten their stay in shelter. 

Coordinated Access
 
It assesses, prioritizes, and only then places individuals into housing. This is referred to by scholars and the Federal Government as Coordinated Assessment, or Coordinated Access. In the absence of such a system, homeless service providers each operate on their own, and when approached by an individual needing help, typically ask some version of this question, “Will this person be successful in our program?” This leads to those with lesser needs and lower vulnerability being served, while those with greater needs and vulnerability are turned away.[v]

In an effective coordinated system, the system as a whole asks, “What solutions best match the needs of this person, and will end their homelessness quickly and permanently?” The system has one (virtual) entry point only. No placements are made in any program without:
 

• Assessing – We objectively and uniformly assess each person, with an evidence-based tool[vi];
• Prioritizing – We prioritize each person for service, based on the level of their vulnerability and according to their specific needs. Each person is awarded a priority status or P number. The lower the number, the higher the priority.
• Placing – All clients go on to a unified Housing Priority List, and are housed based on their priority status and specific needs.

 
MDHA’s Housing Priority List (HPL) has been operational since early 2016. It represents the demand side of the housing equation. It is managed by the Documentation and Prioritization Status (DOPS) Coordinator, who ensures that the persons on it have not only been assessed and prioritized for service, but also have all necessary documents, so they may be housed without delay. Housing providers are expected to house those with a lower P number (indicating greater need and vulnerability) first. As of February 2018, there are about 750 individuals on the Housing Priority list, ready to be housed.
 
The Housing Inventory Chart (HIC) contains all beds funded through our Continuum of Care (CoC) program. It represents the supply side of the housing equation. It is managed by the Housing Resources Team, who ensure that when a unit becomes available, it is filled as soon as possible. The motto of the Housing Resources Team is “No Empty Bed”. All CoC program resources must be fully utilized, with every bed filled and every penny of federal housing dollars spent. The team also actively grows the supply of known housing, by finding housing units outside of the CoC program.
 
The CoC’s performance in this core area is constantly monitored by the CoC Performance Analyst, who produces the Housing Priority List Tracker, which aggregates all of the individuals on the Housing Priority List by priority status. The Analyst produces the quarterly[vii] Homeless Response System Community Dashboard[viii], through which MDHA tracks the community’s performance in housing individuals experiencing homelessness along five performance indicators on the demand side and five performance indicators on the supply side.
 

 

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[i] http://www.marc.org/Community/Homelessness-Task-Force/Assets/HTF-coordinated-intake-graphic-web.aspx

[ii] This idea is referred to as Progressive Engagement. See more on this concept, and its application to homelessness in A Prevention-Centered Approach to Homelessness Assistance: A Paradigm Shift? by Dennis Culhane, Stephen Metraux, and Thomas Byrne (2011), http://works.bepress.com/cgi/viewcontent.cgi?article=1105&context=dennis_culhane

[iii] http://www.mdhadallas.org/wp-content/uploads/2017/10/CoC-Family-and-DV-Services-Committee-Update-8-2017.pdf

[iv] http://www.austinstreet.org/ending-homelessness-through-prevention/

[v] See more at http://endinghomelessnessmdha.blogspot.com/2016/03/the-how-to-of-building-effective.html and http://endinghomelessnessmdha.blogspot.com/2016/03/coordinated-access-heart-of-effective.html

[vi] Our Continuum of Care, like many across the world, uses the VI-SPDAT and SPDAT from OrgCode Consulting – www.orgcode.com. 

[vii] See http://www.mdhadallas.org/wp-content/uploads/2015/06/MDHA-Homeless-Response-System-Community-Dashboard-3Q-July-September-2017.pdf for the latest report.

[viii] http://www.mdhadallas.org/wp-content/uploads/2017/02/MDHA-HRS-Community-Dashboard.docx

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!

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

Courtesy of www.stephencovey.com

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.

Faith, Hope and Home II

Rev. Jonathan Grace, CitySquare
leading an opening prayer

On March 30, 2017, we held our second Faith Hope and Home event, in Austin Street Center's beautiful chapel. The evening was led by our very own Rebecca Cox. It featured: Josh Cogan of Outlast Youth, Teresa Keenan of Incarnation House, Rev. Heather Mustain, of Wilshire Baptist Church, Leah Parker, of St. Paul United Methodist Church, and Mark Pierce, of the Dallas Independent School District.

Mark Pierce, DISD

Mark, Teresa, and Josh talked about the evolution of school and out of school time drop in centers, how helpful they have been to youth, and the need for more such centers. Rev. Heather and Leah shared how their congregations participate in the Room in the Inn program. This program allows congregations to host pre-screened persons experiencing homelessness in their house of worship for a night, break bread with them, practice fellowship, and help them become part of the community. They encouraged other congregations to follow in their footsteps. A vigorous and informative Q&A session followed. Charletra Sharp, of the City of Dallas, closed out the evening, inviting those who wanted to roll up their sleeves and continue this work on the systems level, to join the MDHA CoC General Assembly's new Faith Collaborations Committee.

 

Is your congregation ready to engage in work that not only helps the homeless, but will really move the needle on ending homelessness? Contact us or any of the above speakers, and we will hook you up! (If you don't know how to contact one of them, we can help with that too.)

The MDHA Flex Fund - A Powerful Tool for Unsung Heroes Ending Homelessness

When our family moved into an apartment in 2007, the apartment complex was running a special, and so we did not have to pay a deposit or a move-in fee. That meant that we saved the whopping sum of $69! For us, and likely for most of the people reading this, paying those $69 would not have been an issue, much less a deal breaker. Not paying it was just a nice perk. Not so for many of our homeless neighbors.


Take Kisha*, a young single mother, with two boys, aged two and three, who was staying at Dallas Life. With the help of her City of Dallas case manager, Mirka, she found an apartment, and enrolled in a program, that would pay her rent and even her deposit. The apartment complex required two types of fees, before she could move in, an administrative fee and an application fee, totaling $95. Now, you might assume that if the City of Dallas is paying for her rent and her deposit, which are much greater sums, they could pay these fees for her. Not so. The rules of the grant that funds the City of Dallas program, does not allow it to pay these types of fees. Kisha would have been happy to pay the $95 herself, but her only income, child support, had not arrived on time. So, Kisha and her boys were stuck.

Marsha, of Family Gateway, an Unsung Hero

Or take Sarah and her daughter Carol, who were staying at Family Gateway. With the help of Marsha, their case manager, Sarah had obtained a housing voucher, and had found an apartment complex that would take it. Sarah was excited to have a place to call home, and it would be much easier to care for Carol, who has a disability, in an apartment of their own. However, the apartment complex required payment of an administrative fee of $149, before they could move in. With their only income being inconsistent child support, and SSI (Supplemental Security Income), there was no way they could afford this. Sarah and Carol too were stuck.

Or take Laura, an Austin Street Center guest. Working with her case manager, Niki, she too had received a voucher and found an apartment. Unlike Kisha or Sarah, Laura had only herself to worry about. Therefore, with her SSI and Social Security benefits, though it would be “tight”, she would be able to pay her portion of the rent and even her application fee. However, the apartment complex needed her to put down a $200 deposit, and that she could not afford. I think you can see the pattern here already. Laura too, you guessed it, was stuck.

Prior to September 2015, Kisha and her boys’ story, Sarah and Carol’s story and Laura’s story, would all have ended there. They would have been stuck, and unable to move on. They would have remained homeless because of $95, $149, and $200, respectively. And these three cases are just examples of countless others.

So, what happened in September 2015? With the help of United Way of Metropolitan Dallas, MDHA launched the MDHA Flex Fund. It was designed as a fund of last resort, to pay for minor, but impactful expenditures, that can help folks, just like Kisha, Sarah and Laura, end their homelessness.

Niki, of Austin Street Center, an Unsung Hero

All Mirka, Marsha and Niki had to do was fill out a simple one page form. On the form, they each stated the need of the client, how fulfilling it would help that client end her homelessness, and why there was no other resource to pay for it. They and their supervisors signed the forms, and along with documentation to back them up, they each emailed their forms to Shavon, at MDHA.

Now, we have all filled out forms for various things in life, only to then have to wait, and wait and wait. That is not how Shavon operates. In each case, she carefully reviews each form, and if everything is in order she quickly approves the request. She then has Wayne, our CFO, cut a check to the vendor (in these cases the apartment complex), and notifies the case manager that the check is ready. The case manager swings by MDHA to pick the check up, and delivers it to the apartment complex. This whole process usually takes only 24-48 hours.

One of the most attractive aspects of the program is how it empowers the unsung heroes of our homeless response system, case managers. It gives them a powerful and readily accessible tool, with which they can end a client’s homelessness quickly and permanently. Since September 2015, using this tool, case managers like Mirka, Marsha and Niki have helped hundreds of clients, just like Kisha, Sarah and Laura, rebuild their lives. And you really can’t put a price on that…  

*All client names have been changed to protect their privacy.

On the Road Again – with the Help of Austin Street Center and the MDHA Flex Fund

An effective homeless response system is one where we always ask, “What solutions best match the needs of this person or household, and will end their homelessness quickly and permanently?" In asking this open-ended question, we acknowledge that a one-size-fits-all approach to homelessness is never the right one. Solutions must match the needs of the person, more than one solution might be needed, and a progressively “lighter touch” should be preferred.

Sometimes, the answer to that question is simpler than you might think.  Take Leonard (name changed to protect his privacy), for instance, an Austin Street Center guest. Though experiencing homelessness, Leonard is a healthy 58 year old, who has made his living driving a truck. Unemployed, homelessness for this road warrior was just a bump in the road. With the help of Austin Street Center’s job program, E2, Leonard was ready to get back on the road, figuratively and literally!

An “inside look” at Austin Street Center

(Courtesy of Austin Street Center)

As you may know, they don’t just let every Tom, Dick and Harry drive a truck, or as it is technically referred to a Commercial Motor Vehicle or CMV.  The Federal Government requires that one have “a higher level of knowledge, experience, skills, and physical abilities than that (sic) required to drive a non-commercial vehicle.” Every truck driver must obtain and maintain a Commercial Driver's License or CDL. Now, though the Federal Government makes the rules, it does not issue the licenses. That is left to the states, and one must obtain one’s license from one’s state of residence. As Leonard’s CDL was from Florida, he could not use it, and so could not begin looking for a job, that could then help him resolve his homelessness. 

Fortunately, Leonard could transfer his CDL from Florida to Texas. However, because of the higher standards involved in maintaining a CDL, he would have to undergo a full Department of Transportation (DOT) physical examination by a physician. The cost of the examination is $60, which Leonard did not have. If you think about it, this is the classic example of a Catch 22. If Leonard had a job, he could probably afford the $60 examination. But, of course, he couldn’t even begin looking for a job, if he didn’t have the Texas CDL. He was stuck!

Leonard explained his situation to Dulari, an Austin Street Center program manager. She told him that though Austin Street Center could not pay for the DOT examination, she did have another tool in her tool box, that could help her quickly resolve this predicament – the MDHA Flex Fund. The MDHA Flex Fund was designed by the Metro Dallas Homeless Alliance (MDHA) and United Way of Metropolitan Dallas to address minor but impactful expenditures, just like this one, that can help clients resolve their homelessness.

Dulari helped Leonard find a physician who could perform the examination, and issue the necessary documents. The physician’s office manager made Leonard an appointment, and sent over a confirmation email, including the $60 cost. Dulari then pulled up a simple one page form, available in the guidebook on MDHA’s website. On the form she explained how this expenditure would help Leonard, and she certified that there was no existing resource, that could pay for it. She ran all of this by her supervisor, Laura, they both signed the form, and submitted it to Shavon, at MDHA, for approval. Shavon reviewed all of the details of Leonard’s case, approved the request, and asked Wayne, at MDHA, to issue a check written out to the specific physician, who would perform the examination. Dulari was then able to pick up the check, and give it to Leonard, to take to his appointment. (The MDHA Flex Fund never hands over cash to a client or a case manager.) Leonard was able to transfer his CDL, and embark on his job search. He was now one step closer, much closer, in fact, to resolving his homelessness and becoming once again self-sufficient.

Laura, one of Austin Street Center’s “Superheroes”

(Courtesy of Austin Street Center)

And, in getting Leonard the help he needs, Dulari and Laura not only helped Leonard. Once Leonard has a steady paycheck, he will be able to move into an apartment, leaving Austin Street Center behind. This will enable Austin Street Center, who is forced to turn folks away every night, due to lack of space, to take in and help one more person. And all of that, for just $60. Not a bad return on investment…