Performance Improvement

Katie KitchinConsultant

Memphis, TN

Presentation OverviewThe Basics: How to start the process, what you

need, what to do with the information

Working in partnership with service providers to improve performance

Using financial incentives to drive performance

Governance structures that support system improvement

Beginning the ProcessQ: Who can drive a community to focus on performance improvement?

A: Anyone with access to the data.ConsultantGovernment officialNon-profit leaderAdvocacy group

Quantitative DataKey data sources: HMIS, AHAR, APRs

Key items to assess: Number who enter shelter and transitional housing

programsLength of stay Rate of annual turnover in PSHStatistically valid sample of participants; analysis

of recidivism (are there differences by program? Differences by setting?)

Cost per exit to permanent housing

Example

Source Data: AHAR and NAEH

Why do we care? Research on the impact of homelessness/trauma/chronic health conditions, etc.

Qualitative DataEligibility and tenant rules

Shadowing or assisting an applicant to the program

Standards of care; case monitoring

Exits to permanent housing including family and friends

Demographics of clients served (chronic or not, disabilities at program entry)

Comparing outcomes of different approaches with like population served

ExamplesAPR shows a program served 110 individuals; 56% exited to permanent housing

33% homeless at entry27% of exits were to permanent housing

excluding family and friendsAPR shows program served 27 families; 64% exited to permanent housing

6 exited to permanent housing excluding family and friends

Cost per permanent housing exit = $59,000+

Partnerships for Performance

Universal focus on outcome measures from all funders is motivating all agencies

Shrinking donor bases – must justify their existence and their cost effectiveness

National evaluations are easier to start with…

When goals are common/mutually accepted, start asking questions that prompt self-assessments…

Partnership ExampleComparing the outcomes and cost of rapid

rehousing and transitional housing…

Begin evaluating or assessing the effect of length of program stay on outcomes…

Experimenting with multiple sites, comparable population, and different program rules…

Truly partnering – not directing

Financial IncentivesDirect and indirect incentives

Require a particular approach (e.g. Chicago) Incent a particular approach with new funds

(HPRP)Educate funders, agency leadership, and board

members about evidence-based practices and the highly competitive nature of grantmaking

Governance Structure

Political leaders and

funders

Non-profit boards

Continuum of Care

Leadership

Academics and

Researchers

Tools: Mayors Office, Ten Year Plan entity, influential leaders of all kinds