Setting Your CoC / CQI Performance Targets 2011 Barb Ritter

CSIG Expectations for CoC Embed routine measurement of both “outputs” and “outcomes” in planning and evaluation activities. Routinely review performance on defined HMIS outcomes. Set measureable targets that reflect historical performance and industry standards. Adjust the targets based on: program type. client characteristics. Do Not Disadvantage the “Hardest to Serve.”

CSIG Guidelines Cont: ACT ON WHAT YOU LEARN!!!! Don’t forget to review basic measurement definitions and collection practices. Identify, document, and share successful practices / persistent problems / and opportunities to improve services. ACT ON WHAT YOU LEARN!!!!

Reporting to MSHDA Final Targets for ESG are due by 12/31/2011. The goal is for you to carefully assess your data to set those targets. The Progress Review form you will submit to MSHDA has three basic sets of data: Total families and singles, and homeless and at-risk served. Performance on ESG Provider Group Outcomes Performance on CoC Integrated Outcomes (covering all providers) MSHDA is evaluating your Grant against your ability to improve performance not against an arbitrary target. What you do to change will be important. Remember improvement is always possible. There will be a prize for the CoC demonstrating the most improvement

Comparison Groups: Understanding your performance meaning understanding how other “like” programs/CoCs perform. CoCs may elect to join together for the purposes of CQI to increase: options for comparison programs, the pool of resources that can be marshaled, and the pool of people with ideas. If your CoC would like data from an out-of- jurisdiction comparison group, you can make a request from MCAH / MSHMIS staff.

Strategy for Setting Targets MSHMIS published Statewide Performance by Region on all measures for all major types of programs. See 2010 Benchmarks Evaluate Integrated CoC – wide performance. Compare with Regional performance. Drill down to individual program performance. Are all programs performing in the same range (systems Issues)? Are there one or two outliers (training issue)? Is the “outlier” active in the CQI process?

Common definitions? Common basic discharge procedures?. If 1 & 2 are “yes”, assess needs of low performing program.

Look at the History of Performance Consider CoC’s history of performance? Is performance stable, increasing or decreasing. Select the best performance rate from the Quarterly rates.

Using Engagement Rates With regard to all types of programs, if there are a lot of “unknowns” – Engagement Rate – is low, consider setting a more ambitious target. There are known fixes.

Address “unknowns” in overnight shelters. Process steps to reducing the number of “unknowns”: Make sure the staff and clients talk / think about the exit throughout care beginning with the intake. Talk about it an entry, put exit forms about the facility, include an exit in the hotel check-out process, discuss exit in staffing meeting. Make sure that the staff who know where the client is going communicates that to the person entering data

Address the use of “other” In addition to marking “unknown”, providers often mark “other” rather than mapping the response to an appropriate HUD value. Other is not counted as a “success.” Avoid the use of “other” by providing staff a map..

Using the Discharge Destination to Process Improvement Ideas. Use the Discharge Destination Report to identify Service Delivery problems related to sub-populations. Within programs look for disparities between “Engagement Rates” for sub-population categories such as age ranges. Engagement rates should be approximately equal even if performance rates are not due to resource issues.

A Final Suggestion Look for outliers among your individual programs. Suppose your men’s shelter has lower outcomes than other shelters. Set program different targets for men’s & family shelters so that the targets are realistic for both. Look for/ request a benchmark target for men’s shelter so that you have a sense of the standards of practice. If the performance is below the comparison programs, do a CQI Process Review Monitor to look for solutions. If the issue relates to low engagement rates, problem – solve (see last slide) and set a more ambitious target. If it isn’t a data entry or an exit issue, be more conservative as the solutions will be harder.

Other Tools and Aids CQI Basics Curriculum CQI Advanced Curriculum – Moving to Evidence Based Practice Understanding Your Outcome Measures Training Setting Performance Targets CQI Curriculum – Coordinator Training Measuring Progress on 10 Year Plans Program Models – What are you and some suggested measures. Blank Forms and Tools Sample CoC CQI Guidelines (Kzoo) Sample CoC CQI Policy and Procedure (Kzoo)

Contact Information Barb Ritter (PIMIT): 517-853-3883, britter@mihomeless.org Training Schedules and Tools and Aids may be found at www.mihomeless.org