Usingdatatospursystemschange heading home hennepin minnesota
Transcript of Usingdatatospursystemschange heading home hennepin minnesota
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Presenters: Presenters: Cathy ten BroekeCathy ten BroekeMatthew AyresMatthew AyresLisa ThornquistLisa Thornquist
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Heading Home Hennepin• A community plan to end versus manage
homelessness• Specific plan with measurable benchmarks• City Council and County Board Approval –
December 2006• Implementation began January 1, 2007
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6 Goals of the Plan
• Prevention• Outreach• Housing• Service Delivery• Capacity for Self Support• Systems Improvement
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The Need for Evaluation
• One of the pieces of the plan is to evaluate the plan and report annually.
• The plan has dozens of initiatives, each designed to either prevent or end homelessness.
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Forging a relationship to produce evaluation
• Hennepin County is data rich.• U of M is student/faculty rich.• Hennepin offers U students and faculty
experience with administrative data, difficult analytical questions and real world issues.
• The U offers an independent analysis.
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The Hennepin University Partnership
• Hennepin County and the U of M have a standing agreement to provide academic expertise to issues facing the county
• The OEH work with faculty throughout the University to find common issues for evaluation.
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Major Projects in Collaboration with U of M
• Housing First evaluation• Single Adults in Shelter – Definition of LTH• Families in Shelter and Rapid Exit• Frequent Users Service Enhancement (FUSE)• Refugees• Collaboration capstones
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Other Research/Evaluation Projects
• Prevention Targeting• Highest Users of Single Shelter• Downtown 100• Group Residential Housing stability• Project Homeless Connect
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Capstone on Housing First (p. 23)
• Masters Level Public Policy students looked at participants in single adult Housing First compared to a match set of shelter users.
• We matched in health insurance coverage and criminal justice data.
• Students analyzed data as well as conducted interviews with program participants
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Capstone on Housing First: Finding
• HF participants’ shelter use dramatically declined compared to other shelter users.
• HF participants increased the number of days and continuity of health care coverage.
• HF participants had a reduction in CJ involvement, both as victims and perpetrators of crime, pre versus post and compared to other shelter users.
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Capstone on Housing First: Finding
• Interviews showed that housing had a positive impact on safety and well-being.
• Transition to housing posed challenges related to daily activities and social needs.
• Transportation was a significant barrier in housing and some participants changed housing after initial placement.
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Impact of the Research on Housing First
• Helped provide support for further funding – Currie Avenue Partnership.
• Told policy makers that this model works in OUR community.
• We greatly expanded our scattered site Housing First program.
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Capstone on Single Shelter Use and Definition of LTH (p. 5)
• Wanted to know when to intervene for single adults in shelter
• Stories of people being “stuck” in shelter for years.
• People staying in shelter waiting to meet the definition of long-term homeless to be eligible for programs.
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Capstone on Single Shelter Use
• Provided data from county data systems and HMIS for single adults in shelter from 2007-2009.
• First time we looked at whole single shelter system at once.
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Capstone on Single Shelter Use
• Evaluate dynamics of shelter use of single individuals in public and private shelters in Hennepin County
• Mixed Method Analysis using focus group interviews and analysis of administrative data
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Capstone on Single Shelter Use: Focus Group
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Capstone on Single Shelter Use• Fixed Window Method:
Count days of shelter for 12 mo. following shelter entry, for those who first entered shelter between 7/1/07 and 12/31/08• Cox Proportional Hazard Models
Estimate probability of ending a shelter spell in each month, given that you are still in shelter, for spells that start in the period 7/1/07-12/31/09
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Definition - homelessness spell
• Define beginning of spell as date first recorded shelter use
• Define end of spell as date in which individual leaves shelter and remains out of shelter for two weeks or longer
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Fixed Window Analysis
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Fixed Window Analysis
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Hazard Model Analysis
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Capstone on Single Shelter Use: Findings
• A large number of people stay in shelters for very short periods of time.
• Targeting people with long spells would reduce days in shelter more than targeting people with multiple spells
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Capstone on Single Shelter Use: Findings• Probability of exiting shelter declines rapidly from
months 6 to 12 and then levels off. This may reflect either:
--staying in shelters discourages exits
--less disadvantaged group leaves first
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Single Shelter Use: Policy Implications• Targeting people at 5 months for assessment into
housing programs• Ongoing discussions of efficacy of targeting at 5 months
versus 1 year – how are limited resources best spent.
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Frequent User Service Enhancement (FUSE) (p. 26)
• In 2007, Hennepin County found that 266 individuals used 70,000 nights of shelter, jail and detox over 5 years, costing taxpayers $4.2 million.
• The FUSE project began, targeting the highest users of both shelter AND jail.
• The intervention was housing, case management, and probation services.
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FUSE
• An examination of the first 6 program participants found that they used, on average, $95,000 in services prior to housing. After housing, they used $16,000 in services on average.
• This included jail bookings, jail days, detox, shelter, and Emergency Department use at Hennepin County Medical Center (HCMC)
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FUSE
• Sociology graduate students from the U of M conducted a more in-depth study of the first year of the program.
• The researchers compared FUSE participants to a similar cohort of high users of both jail and shelter.
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FUSE
• The program participants had a significantly larger decline in shelter use versus the comparison group.
• They found that both participants and the comparison group reduced their use of the criminal justice system.
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FUSE and other interventions
• The findings from the FUSE study lead to some interesting questions.
• We have so many interventions in downtown Minneapolis: FUSE, Downtown 100, Street Outreach, Currie Avenue Partnership.
• We also know there is a significant decline in downtown arrests. Who gets the credit?
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Implications of FUSE
• Shows targeting of specific populations can interrupt overuse of systems.
• This study, and others, let us know that targeting high users can greatly impact the overall system.
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Top 50 Users of Single Shelter
• Looked at highest users from Jan 2008 – April 2011
• Range from 737 days to 1413 days• Data in county go back to 1997 – 12 of
these top 50 were in shelter in 1997• Very little is known about these top users –
they are not high users in other systems
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Top 50 Users of Single Shelter
• Small group of county employees with access to all data systems.
• Included direct service staff from county and contracted shelters.
• Overall goal – to create a crack free system.
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Top 50 Users of Single Shelter
• 20 had social service activity in the county• 10 on General Assistance, 10 on RSDI/SSI• 12 had been to jail, 7 to detox• 11 engaged with the mental health system,
but twice as many were reported by staff to have mental health barriers
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Top 50 Users of Single Shelter
• Medical services were more prevalent– 29 received Healthcare for the Homeless
services– 38 got health care through Hennepin County
Medical Center (HCMC)
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Top 50 Users of Single Shelter Policy Implications
• No wrong door.• Rules and policies need to be flexible.• Onus on county workers to reach out to
people in shelter, to ensure they get services they are eligible for.
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Prevention Targeting
Rapid Exit has been a program in Hennepin County since 1993.
It focuses on early intervention in financial assistance where:-non-preventable, verifiable financial crisis
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Prevention Targeting
• Rapid Exit program started in 1993• Focus was on preventing homelessness for
families to reduce number of families entering shelter
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Prevention Targeting
• Eligibility:– Non-preventable, verifiable financial crisis– No other resources available– Prevention assistance will preserve housing– Goal was to reduce shelter admissions by 10%
and reduce length of stay by 10%
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Prevention Targeting
• Results:– 96% did not enter shelter within 1 year– 43% reduction in family shelter admissions
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Prevention Targeting
• After 17 years, time to re-examine the program.
• Used HMIS data and barrier assessments to compare characteristics of families who received prevention versus those who did not and ended up in shelter.
• If targeting well, families should look similar.
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Prevention TargetingPrevention Shelter
Incomes < $1000/mo 40% 94%
> 65% of income for
housing 45% 94%
homeless before 36% 63%
Head of hh < age 22 1% 33%
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Prevention Targeting
New criteria:• Families < 30% Area median income• Event is expected to result in housing loss
within 30 days• No resources or viable plan to resolve crisis• Reasonable expectation for sustained
resolution
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Prevention Targeting
Six month evaluation:• Data from May – Dec 2010• 436 households served• 7.4% returned to shelter within 6 months
(same as before)
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Prevention Targeting Policy Implications
• Change definition of success.• While a smaller percent of people who
receive prevention may avoid shelter, we may actually be preventing more homelessness.
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Refugees (p. 25)
• We partnered with the Center for Advanced Studies in Child Welfare for research on refugee experiences with homelessness.
• This led to findings to be incorporated into SSW learning modules.
• It also led to a dissertation currently being completed on refugee homelessness.
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Refugees• A graduate student conducted in-depth
interviews with 15 refugee families experiencing homelessness.
• We conducted a survey of 237 refugees in the Twin Cities asking about housing stability, ethnic identify and assimilation.
• A doctoral student is completing more in-depth interviews with refugee families in shelter.
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Refugees: Findings• Culture matters. While the barriers to
housing are similar to American-born families, specific cultural beliefs and values impact how families respond.
• Refugees who moved in with relatives first had less stability than those placed in their own apartment upon arrival.
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Refugees: Findings• Those whose current housing is unstable
have more mental health issues, less social capital or social networks, and use less public assistance.
• Larger families have more housing instability.
• Language continues to be a barrier.
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Refugees: Findings• A housing crisis pushes refugees to seek
more formal help both within their ethnic group and also with government agencies.
• Those with housing instability turned to public assistance and that assistance did stabilize housing for them.
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Refugees: A pilot• Hennepin County and the McKnight
Foundation funded a pilot to work with refugees at risk of homelessness.
• The intervention provided intensive case management and housing subsidies for a limited time.
• The focus was on housing stability, increased income and school engagement.
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Refugees: A pilot• Findings: 70 families were served. 98%
remained in housing during the program.• 83% increased their incomes due to an
increase in number of family members working.
• The families needed a rental subsidy for 6.3 months, on average.
• 97% reported positive engagement with their children’s school.
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Refugees: Policy Implications
Another example of targeting a population with special needs
The need for culturally specific services and service providers
Development of refugee-specific housing with cultural competency of landlords
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Project Homeless ConnectOngoing Evaluation
• Use HMIS data to track long-term trends, service needs, demographics.
• Allows us to craft each event to the needs of the guests, and fundraise for additional services
• Allows up to accurately report to funders, policy makers, and volunteers.
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Project Homeless Connect• Homeless status of guests served at event, comparison to previous events
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Project Homeless Connect
• Proportion of “doubled-up” clients, comparison to previous events
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Project Homeless Connect• Where PHC guests come from.
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Project Homeless Connect
• Main types of service sought by household
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What are the Implications of a Robust Evaluation Program?
• U of M more engaged in homelessness than ever before
• Hennepin County more committed to supporting research to better understand programs and outcomes
• Evaluation program builds on itself – it brings in money
• It builds community will
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For more information
• www.headinghomehennepin.org