Performance Improvement Clinic
Community planners now have a great new tool to evaluate changes to their communities’ homelessness assistance system. With the newly released Performance Improvement Calculator, developed by Focus Strategies, you can use your community’s HMIS and budget data to see the impact a proposed change has on the rate of permanent housing exits and average costs.
It is easy to experiment with the Calculator because it comes preloaded with sample data, although you’ll get the best results if you complete the Calculator with your own communities’ data. I wanted to see, for example, what the impact would be if I reduced the average length of time adults and families stay in transitional housing programs by 30 days. I reduced the length of stay, and then checked the summary tab to see what the effect would be. The charts on the left of this post show my result – I’ve increased my permanent housing exits by three percent and cut the average cost per permanent housing exit by six percent.
Other things you can experiment with, either independently or all together, include:
- Changing the average permanent housing placement rates for different kinds of programs (typically shelter, transitional housing, rapid re-housing, and permanent supportive housing),
- Changing the rate at which people return to the homeless system after being housed,
- Moving funding from one type of intervention to another, and
- As I did above, changing the average length of program stays.
The following was originally posted by The Connecticut Coalition to End Homelessness. We have reprinted it here with their permission. You can find the original blog here. Katharine Gale is a frequent trainer at the Alliance’s Performance Improvement Clinics.
Three Key Things with Katharine Gale
Key steps for making the transformation to a housing crisis resolution system.
Commit to using local data for change. Use information from HMIS and from grant and program budgets to understand system performance and cost. We need to learn what outcomes we are buying with our current mix of funding and programs and ask how we can more closely match our collective resources to the unmet need. While our efforts would certainly benefit from increased funding, the greatest resources our communities are likely to be able to direct to the problem soon are the ones we already have. Making sure that the data we have to work with is of high quality so we can trust it to inform our decision-making is everyone’s responsibility. (It also better positions us to expand our resource base in the future as more funders ask us to demonstrate return on their investment.)
Expand the range of reality-based housing solutions. Look at the lives of our clients, what their realistic housing options are and where they go when they leave us. Most of the people our system works with do not escape being low-income through our efforts, even when we invest significantly in them at the expense of others we do not serve. Most can, however, regain housing with our help, even if deep subsidies are in short supply. We can rehouse more people, and continue to assist them with other resources, or connect them to other services (if they want them) that support further progress, by focusing our rehousing efforts on the right next step that resolves this housing crisis, instead of the forever solution. We shouldn’t stop advocating for long-term affordability, but we must also recognize that it is not reality now for many people who are just like the households we serve, but who have housing.
Work as a system with shared responsibility. Everyone should be clear (clients, providers and funders) about how people can access help from the programs that make up our system. If we currently distribute most of our support based on luck or persistence, we need to fix that; if there are people who no program will take we need to fix that. In setting up a coordinated front door, our responsibility is not just to make sure that agencies get the clients they will serve, it’s to get clients the support they need. Knowing who gets in and who goes unserved will help us refine programs and services to better meet the combined need. The importance of working more collaboratively to increase impact applies to funders as much as to programs. As one director I know puts it “we need to fix our relationships for the sake of our clients.”
Katharine Gale is an independent consultant from Berkeley, California with 20 years experience in the fields of homelessness and special needs housing. She provides services to public and non-profit agencies including community-wide planning, new program development, data analysis, research and evaluation. Ms. Gale helped design and delivers the Alliance’s Performance Improvement Clinics. In 2011, she co-founded Focus Strategies, a joint venture dedicated to helping communities use local homeless data to prepare for HEARTH and make effective system change. Prior to consulting, she worked for seven years as a manager and Deputy Director for Alameda County Housing and Community Development Department.
Today we bring you another voice of a Performance Improvement Clinic (an intensive one-and-a-half day clinic that helps communities prepare for changes made by the HEARTH Act ) trainer, Iain De Jong. We ask Iain the question: Why should my community conduct a Performance Improvement Clinic?
The plural of “anecdote” is not – and never has been – “data.” Each community has a narrative to pull together on the great work that they are doing to end homelessness. But we need to move beyond samples sizes of one, good stories and intuition to prove to policy makers, funders and the general public that what we do makes a difference. In an era of limited resources, we also need to be sure that we are investing our precious time and money into those interventions that improve the system as a whole, not just a particular project.
While the HEARTH era expects communities to work as systems rather than a collection of projects, making the shift to do so has greater benefits than just meeting requirements of HEARTH. It makes good sense and it is in the best interests of the people we serve. A Performance Improvement Clinic provides the right forum to assist communities in taking increased strides towards a system-based approach to service delivery. This type of thinking helps ensure that the right person gets to the right organization for the right type of intervention at the right time. It leverages the strengths across the entire community.
With increased attention paid to data and performance in the delivery of human services, both “data” and “performance” are dirty words to some. Some well-intentioned people have overly complicated both rather than making them easily understood and useful in operations and decision-making from the frontline level right on up to management. We need to reclaim “data” and “performance” as a reflection of our efforts and hard work. We need to make them meaningful to everyone in an organization and across the entire community. And we need to know how to make the right decisions from the information to better serve homeless people by helping them access and maintain housing.
Simply put, what gets measured gets done. A community that conducts a Performance Improvement Clinic can count on having the tools in place to more easily understand and improve performance in an ongoing and sustainable way, making the best possible choices and investments for the people within their community, and explaining to one and all – including the end users of services – why performance matters.
Iain De Jong is the President & CEO of OrgCode Consulting and a long-time conference presenter at National Alliance Conferences. He will be making at least two presentations at the conference, and looking forward to learning much more from the other presenters and attendees. You can learn more about Iain at www.orgcode.com or www.facebook.com/orgcode or follow him on Twitter @orgcode.
If your community would like to learn more about the Performance Improvement Clinic, contact us at email@example.com.
On our new weekly blog series, Field Notes, we have talked about the experiences of Alameda County and Whatcom County with our Performance Improvement Clinics (previously called the HEARTH Implementation Clinic). Today I wanted to share the experiences of the people who conduct these Clinics. Katharine Gale, an independent consultant from Berkeley, California with 20 years experience in the fields of homelessness and special needs housing, helped design the Performance Improvement Clinic and has presented at a number of clinics in communities large and small. Below are Katharine’s words about why she enjoys being a part of these clinics.
I enjoy being part of the Performance Improvement Clinic team because the give and take is always so great and I learn so much. The Clinic helps communities grapple with the importance of a performance measurement perspective, and it supports them to make concrete plans to work together to improve outcomes across the system. Some of this work is a little scary because it’s a different framework than most of us are used to — one in which we are holding ourselves and each other accountable for our combined impact on the problem. But I find that everyone is pretty excited and willing to engage in lively debate!
Working with communities across the country has given me a great opportunity to see what we all share and where we face different challenges. It’s interesting to me how often people think their community has so much less housing than anywhere else or much more troubled people. That feeling seems to be universal – which makes me glad that we are learning how to rehouse people quickly and securely without having to wait for permanent subsidies for most of them. On the other hand, communities face unique realities around funding, politics and historic relationships which mean each place has different potential paths to improvement. Communities that make progress identify where they have inroads to build on: some have developed strong relationships with mental health services, some with their public housing authority, some with the education system. They see that to transform to a housing crisis resolution system means lightening our touch and relying more on other systems of care to do their jobs.
I think our field is at an important crossroads – we have much better information about what works and we finally have the local data to begin to ask what outcomes we are achieving and how can we deploy available resources to improve them. But we also have existing infrastructure, agencies, programs and experience and we don’t want to throw the baby out with the bathwater! Identifying how to use our data, our existing resources and our historic infrastructure strategically is what is going to move us all forward. Everywhere I go I find amazing local players who are quietly doing what it takes to change their organizations and their systems, and I am fortunate to get to go and share their stories with others.
Over the past year, the Alliance has been presenting an intensive one-and-a-half day clinic to help communities prepare for changes made by the HEARTH Act. The clinic focuses on improving community performance by analyzing community data and shifting to strategies that better achieve the HEARTH Act’s performance expectations.
We will continue to offer these clinics, although we’re changing the name to the Performance Improvement Clinic (we used to call them HEARTH Implementation Clinics). The name change reflects the fact that the clinic mostly focuses on the performance aspects of the HEARTH Act and also to distinguish it from the many other types of HEARTH Act assistance that will be available from HUD and other organizations over the coming months.
The Performance Improvement Clinic will continue to include group discussions, system design and modification planning sessions, and presentations on best practices. Clinic participants will also receive hands-on technical assistance with data analysis and system assessment in preparation for the Clinic and follow-up support. While the overall goals and structure of the clinic are the same, it is constantly updated with new information and customized to the conditions in each community.
On our weekly blog series, Field Notes, we have talked about the experiences of Alameda County and Whatcom County with the clinics, and the work they are doing to improve their homelessness assistance system as a community. In the next few weeks we will continue to bring you their stories and lessons learned, as well as the voices of our staff and consultants who have conducted clinics. For more information about the Performance Improvement Clinics in the meantime, please email the Center for Capacity Building at firstname.lastname@example.org.
The HEARTH Act will significantly change the way the U.S. Department of Housing and Urban Development (HUD) funds homelessness assistance. Communities will be expected to work towards the federal goal that no one remains homeless for longer than 30 days. Additionally, performance on new outcomes will be measured, including reducing lengths of homeless episodes, and reducing new and returning entries into homelessness.
How can your community encourage homelessness programs to perform better on these outcomes? I recently spoke with Elaine de Coligny, Executive Director of EveryOne Home in Alameda, on the unique incentive they have devised – a prize.
EveryOne Home, a community-based nonprofit that coordinates Alameda County, California’s plan to end homelessness, has recently announced the 2012 Outcomes Achievement Awards. Programs that make the most progress on key community-wide outcomes will now be rewarded with one of two prizes.
The idea for the awards came to Elaine during a Performance Improvement Clinic (formerly called the HEARTH Academy) the Alliance held with Alameda County stakeholders in June of last year. She then approached a funder EveryOne Home had a previous relationship with, the Y&H Soda Foundation, about the idea. Elaine says the Y&H Soda Foundation was excited to support the initiative, and generously funded two achievement awards. The first award for $10,000 will be given to the highest achieving program, and the second for $5,000 will be given to the most improved program. Awards will be made to programs that have the highest rate of exits out of homelessness to permanent housing in the shortest time from program entry.
One of the most exciting aspects of the award is that programs do not need to fill out a single application form. The outcome data used to determine the achievement of programs will come directly from the information they enter into HMIS. This way, programs can concentrate on moving people to permanent housing rather than filling out paperwork. This is possible because of the work Alameda County has done to make their HMIS system generate reports and data that they can use strategically to measure success on key outcomes.
Elaine hopes that these awards, which will be given out in early 2013, will energize the approximately 50 programs in Alameda County eligible for the awards to improve their outcomes. If so, she says, there may be more awards available in the future.
Last week I discussed how Whatcom County, Washington, is preparing for the HEARTH Act by launching a coordinated entry system. The HEARTH Act aims to streamline and modernize the McKinney-Vento Homeless Assistance Grants and help communities create more efficient, more effective homeless assistance systems.
Whatcom County is one community taking a few steps to move in that direction. (Go Whatcom County!)
In addition to implementing a coordinated entry system, the county is also working on a prevention targeting and diversion initiative. They’re modeling theirs after one currently in existence in Hennepin County, MN (a model the Alliance has highlighted) and the goal is of the initiative is to better target their homeless prevention resources to people most likely to become homeless.
Not only that, Whatcom County hosted one of the Alliance’s Performance Improvement Clinics (formerly called the HEARTH Academy) last year and based on what they learned, the county has added diversion assistance to their menu of homeless interventions. Diversion is a strategy that redirects people seeking shelter and helps them identify immediate, alternate housing arrangements. If necessary, diversion assistance also connects these people and families with services and financial assistance to help them return to permanent housing. Case management staff had already been providing diversion assistance informally for some time in Whatcom County, but the new diversion process has become formal and deliberate. Case managers are now trained to see friends and family members of a household as “informal landlords.”
I asked Greg Winter of the Whatcom Homeless Service Center to discuss his experience with the Alliance’s Performance Improvement Clinic and specifically, I asked him a question we receive often from communities interesting holding their own Performance Improvement Clinic: who should we invite?
Greg encouraged communities to seek a representative sample of the types of homelessness programs in their communities. Additionally, he felt that having the local housing authority, local governmental officials, or whoever is in charge of funding housing programs in the community. Whatcom also has a history of strong collaboration between housing providers and domestic violence providers, and he felt that their participation in the Performance Improvement Clinic was very important.
This makes sense. In order for interventions like coordinated entry, diversion, and prevention to be effective and efficient, the whole homeless assistance system has to be on board. The best way to have a significant, positive impact on people experiencing or at risk of experiencing homelessness is to provide deliberate, concerted service as one cooperative community.
The Alliance is working with communities like Whatcom County across the country. Learn more about homeless assistance strategies and holding a Performance Improvement Clinics of your own on our website.
Last week I had the opportunity to interview Greg Winter of Whatcom County, Washington about how his community is preparing for the HEARTH Act. Because I discussed using an existing 211 service to start a coordinated entry system in your community last week, I wanted to contrast Whatcom’s coordinated entry process.
Whatcom has been developing a coordinated entry system since 2008, when they formed the Homeless Service Center at the Opportunity Council, the local community action agency. There, they established a coordinated entry system with five service providers in the county. The community was familiar with going to the Opportunity Council’s resource center for help, so running the coordinated entry system out of this single, physical location was a good fit for Whatcom. Additionally, other people in the community are trained to complete the intake process, including a street outreach team run by a local volunteer organization, social workers based in a local hospital, and some staff in the local jail.
In 2011 the Alliance held a Performance Improvement Clinic (formerly called the HEARTH Academy) with Whatcom, which encouraged them to further develop their coordinated entry system. Data sharing agreements were signed with providers to allow better coordination between agencies. They adopted a philosophy of services based on vulnerability, rather than first-come first-served. Some organizations that participate in the coordinated entry system no longer run their own waiting lists. Instead, the Homeless Service Center keeps one central “housing interest pool.” Providers have found that this lessens their administrative burden, and helps them concentrate on their housing focused services. Finally, Whatcom adopted Hennepin County, Minnesota’s prevention targeting tool (more on this next week).
The next step for Whatcom is to continue adding service providers in a gradual and deliberate way to their coordinated entry system, and to continue evaluating and improving their system.
Stephanie Reinauer from the Whatcom Homeless Service Center, recently gave a presentation at our February conference on becoming a coordinated homelessness assistance system. Find the slides from her presentation on our website. For more information on Coordinated Entry, read our brief “One Way In: The Advantages of Introducing System- Wide Coordinated Entry for Homeless Families.”
Our Capacity Building Team is at it again!
This fall, the Alliance’s Capacity Building Team is off again conducting their Performance Improvement Clinic (formerly called the HEARTH Academy) clinics in communities across the country. Armed with the tools, models, and trainings they develop right here at the Alliance, the CAP Team helps local communities measurably improve the outcomes of their homeless assistance systems and prepare for the implementation of the HEARTH Act. The HEARTH Act, signed into law in 2009, will take significant steps to modernize and streamline the McKinney-Vento Homeless Assistance Grants. While HEARTH won’t kick into effect until next year, it’s never too early to get prepared.
In the next few months, the CAP Team will be in Oregon, Maryland, New Hampshire, and Arizona. They’ll be taking with them the training tools, including the Homeless System Evaluator and the Qualitative Assessment Tools – both of which gauge the performance of local homeless assistance systems. Working together, the CAP Team and the local community can improve the way homeless people are served by the system and move towards preventing and ending homelessness.
For more information about the Capacity Building Team or the Performance Improvement Clinics, please check our website.
In fact, we have this great little department called the Center for Capacity Building. And lately, they’ve been really busy with a project called the Performance Improvement Clinic (formerly called the HEARTH Academy).
Refresher: In 2008, Congress passed the HEARTH Act which was intended to streamline and modernize the McKinney-Vento Homeless Assistance Grants. You can find out more about the HEARTH Act on our website.
The Performance Improvement Clinic is designed to prepare communities for the HEARTH Act, which is going to change the way communities both apply for federal funding under the McKinney-Vento Homeless Assistance Grants and they way that money can be applied within communities. Moreover, the HEARTH Act asks communities to change some of the ways they operate and measure the progress of their efforts to end homelessness and meet specific, numerical goals.
The Center for Capacity Building (CAP Team) is traveling to help communities prepare for the new legislation with an arsenal of new tools to help communities evaluate their systems and implement systems change. You can find these tools, including the Homeless System Evaluator Tool, as well as webinars, briefs, and resources on our website.
So far, the CAP Team has been to Mississippi, Iowa, Washington, Connecticut, Missouri, North Carolina, and Texas. This week, our intrepid capacity builders are in California before they hit West Virginia next week.