Presented by: Rachel Post, L.C.S.W., Public Policy Director Transitional Housing: Performance Evaluation & Improvement NAEH: July 19, 2017 Presented by: Rachel Post, L.C.S.W., Public Policy Director

Central City Concern’s Scope Transitional Housing: Performance Evaluation & Improvement

Housing Choice: Different Housing for Different Needs More than 1,700 units total 1,099 units recovery housing 604 units Housing First/low-barrier housing 300 scattered site Permanent Supportive Housing units Transitional Housing: Performance Evaluation & Improvement

Transitional Recovery Community Housing 294 residents served in 95 short term units (200 exits) 74% exited to Permanent Housing (148 residents) 95% still housed and in recovery 12 months post exit 37% exit with employment 12% exit with other income Permanent Recovery Housing: 89% remain 12 months or longer 37% employed and 44% with other income Transitional Housing: Performance Evaluation & Improvement Malcolm was a journalist and author before his life was diverted by addiction. Thanks to transitional recovery housing and a culturally responsive addiction treatment program, Malcolm is now employed as a director at the state food bank.

Transitional Housing: Performance Evaluation & Improvement From detox to recovery Clients who entered Recovery Housing after detox were: 3 times as likely to complete SUD treatment 10 times as likely to engage in primary care at OTC Transitional Housing: Performance Evaluation & Improvement Since Alycia became involved with CCC’s services, she has obtained her Certified Nursing Assistant (CNA) license and earned her Licensed Practical Nursing degree in May 2017.

Transitional Housing: Performance Evaluation & Improvement TOTAL HEALTH CARE COST Transitional Housing: Performance Evaluation & Improvement Differences are statistically significant, but sample size is small; average cost for 12 calendar months following month of detox admission

Performance Reporting Quality Improvement Projects Q.I. life cycle Performance Reporting Analysis Quality Improvement Projects Data Collection Transitional Housing: Performance Evaluation & Improvement Quality Improvement projects can be conducted not only with an aim to improve program outcomes, but also to improve data collection tools & processes themselves.

Transitional Housing: Performance Evaluation & Improvement Data Universe HMIS data feeds into: Monthly KPI/outcomes reports reviewed by team (Excel) Quarterly outcomes reports (Tableau) Strategic Plan reports (Excel  Microsoft intranet) Reporting transition in progress: PSU Capstone Projects Randomized Control Trial Resident Satisfaction surveys Resident History surveys HMIS Power BI Data Warehouse Transitional Housing: Performance Evaluation & Improvement Power Business Intelligence (Microsoft reporting platform) helps us co-design more effective reports in real time Analyze data in more meaningful and robust ways Give department leadership easier and more timely access to reports

Transitional Housing: Performance Evaluation & Improvement Staff involved with Q.I. Quality Management (QM) Staff QM Director Quality Improvement Specialist – Housing & Employment Services Senior Data Analytics Specialist Supportive Housing & Housing Staff Directors Program managers Front line staff Data Warehouse Transitional Housing: Performance Evaluation & Improvement

Program Improvements 2016-17 74% Permanent Housing Placements Increased opportunities for resident engagement 2013-14 51% Permanent Housing Placements Changed staffing & treatment models MAT beds Added Mentor positions Transitional Housing: Performance Evaluation & Improvement Sharon’s commentary on this slide: “In 2013-14 we were seeing really low completion rates (1-2 months were as low as 38%). We had moved away from zero tolerance but had gone to the complete opposite of the spectrum with people using and affecting community for long periods of time. We dug into the data including: Average length of stay at relapse and completion, time it took to get into treatment, connection to mental health services, connection to recovery support groups, and demographics of those completing and not completing. We worked with Program Management, Quality, Program Staff, and program participants to come up with needed improvements. “ Created a clear policy and process that allowed for personalized interventions for relapses Intervention with CM and Counselor together Opportunity to re-engage in recovery for those who have a goal to do so Designated some NON A&D free units for people to exit to while waiting on permanent housing placement Change Staffing Model and Treatment Models Originally 2 Case Managers for 95 Units Added 2 Peers 2014-16 by repurposing addiction treatment money due to ACA Expanded Units for people doing MAT Opportunities for engagement-adding weekly groups and activities with peers and case managers Daily Check In Support while waiting for treatment to start Case manager specific Housing Stability/Life Skills Group Peer lead Recovery Support Groups Peers helping people get to appointments Began referring to CVC and EAC within in first 30 days Refer to Housing Specialist within first 45 days Meet bi-weekly with Employment and Clinical service provider Game night Peers taking people to community based recovery groups and events Implemented personalized relapse interventions