Session 1.02: Understanding your System: Using Program and System-Level Performance Measures Selina Toy Lee Director of Collaborative Community Outcomes, San Mateo County Human Services Agency, California February 23, 2017

Presentation Overview Background San Mateo County Context Homeless System Changes HMIS System Performance Analysis Challenges Faced Homeless System Redesign Where Are We Now?

San Mateo County, California Santa Cruz

Fast Facts: San Mateo County, CA 758,581 Population HUD Fair Market Rent: $2,289 Average Market Rate: $2,980 2 Bedroom Rental Extremely Low 30%: $36,900 Very Low 50%: $61,500 AMI (4 person) 2 person: $86,150 4 person: $107,700 Median HH Income 4.4% Average Apartment Vacancy Rate

Collaborative Applicant Center on Homelessness HMIS Lead Strategic Plan Community Engagement CoC Coordinator Center on Homelessness (COH)

Homeless Services Continuum Prevention Rental Assistance Utility Assistance Legal Assistance Outreach and Engagement Homeless Outreach Teams Street Medicine Dignity on Wheels (mobile shower and laundry) Coordinated Entry and Assessment Shelter Diversion (begin in April 2017) Permanent Housing Rapid Re-Housing Permanent Supportive Housing Housing Locator Services Other Housing Vouchers Interim Housing Emergency Shelter Transitional Housing

Funding for Homeless Services County Funding ($9.8m) State Funding ($200,000) Federal Funding ($819,700) HUD CoC Funding ($8.2m) Total Funding in FY 16/17: $19 million

Homeless Count 2,281 2,149 1,796 1,772

Timeline of Homeless System Changes 2009 Late 2013 July 2014 Jan 2015 Nov 2015 June HEARTH Act HUD Policy Shift to System Performance Leadership Changes New Agency Director and New Branch Director County Priority Set County Manager set priority to end homelessness by 2020; local tax funding allocated; new HMIS implemented Board Study Session on Homelessness Board of Supervisors session on homelessness; requested HMIS analysis Begin Strategic Planning Process Begin Community learning and planning for homeless system redesign CoC NOFA Priority March 2016 HUD CoC Priority and Funding Shift focused on system and program performance Release New Strategic Plan Strategic Plan to Reach Functional Zero by 2020

Relationship with HMIS (circa 2013) COH Staff had limited access Providers Submit AHAR, APR Contractor Lead on Reports to HUD Limited Data QC Managed by IT Staff Compliance Based Initiated in 2005 HMIS (HOPE System)

Homeless System Performance Report Report Summary Hire Consultant Objectives Methodology Data Analysis To Learn! Who is being served in the system Funding Investments System Investments System Outcomes Program Outcomes Focus Strategies selected via RFP in Sept. 2014 Provider Communication and Data Collection Housing Inventory Count (HIC) HMIS data Program Budget Program Capacity PIT Count Base Year Performance Calculator (BYPC) Data Quality Project Costs Project Performance System and Program Level Presentation to Board of Supervisors, HOPE Interagency Council in March 2015 Individual Project Level Reports with Providers Webpage: http://hsa.smcgov.org/center-homelessness Links to Reports on the bottom

Key Findings: System Performance SYSTEM CAPACITY System Investment and Project Capacity is not proportional to the composition of homeless population. DATA QUALITY Excellent Very little missing data LENGTHS OF STAY Single Adults: 101 days Families: 107 days ENTRIES FROM HOMELESSNESS 44% entering Emergency Shelter were not literally homeless COST PER PERMANENT HOUSING EXIT FOR FAMILIES Emergency Shelter: $25,421 Transitional Housing: $18,329 Rapid Re-Housing: $4,190 RATE OF RETURN TO HOMELESSNESS Transitional Housing: Single Adults: 36% Families: 26% Rapid Re-Housing Single Adults: 9% Families: 10% RATE OF EXIT TO PERMANENT HOUSING Emergency Shelter: Single Adults: 19%, Families: 13% Transitional Housing Single Adults: 38%, Families: 68%

What We Learned Homeless System Service Providers COH Staff Current system was set up to serve clients to move through programs Data did not always line up with anecdotes highlighted by providers Some Programs Were Still Working Towards Housing First System and Program Measures Service Providers Providers had varying knowledge and understanding of their own HMIS data Providers had never analyzed cost data or provided full budgets Non-literally homeless clients were enrolled into homeless programs Providers measure success through program participation & completion COH Staff Data Quality Checks were Ad Hoc System Level coordination of all programs is needed for change Limited ownership of system or provider performance results Need to increase depth and knowledge of homeless systems

Quality Improvement Plan Training and Technical Assistance Program Reviews Data Validation HMIS Users Group Work closely with System Admin Data Integrity Checks Quality Improvement Plan

Timeline of Homeless System Changes 2009 Late 2013 July 2014 Jan 2015 Oct 2015 June HEARTH Act HUD Policy Shift to System Performance Leadership Changes New Agency Director and Division Director County Priority Set County Manager set priority to end homelessness by 2020; local tax funding allocated; new HMIS implemented Board Study Session on Homelessness Board of Supervisors session on homelessness; requested HMIS analysis Begin Strategic Planning Process Begin Community learning and planning for homeless system redesign CoC NOFA Priority March 2016 HUD CoC Priority and Funding Shift focused on system and program performance Release New Strategic Plan Strategic Plan to Reach Functional Zero by 2020

Challenges Faced A. B. C. Alignment? Using Data Promoting Change Where to Begin? Alignment? Using Data Promoting Change A. Not all at once Gaining Trust with Community and Providers Selling “Change” as Positive Proving Best Practices can and will work B. Tough Discussions Some existing Programs not aligned with HUD/best practices Decisions and Visions become “personal” Provider Autonomy Funding Priorities C. Ready for Action Data Integrity belongs to everyone Balancing data driven decisions with reality of operations

Strategic Plan to End Homelessness VISION KEY GUIDING PRINCIPLES Text Here Systems Orientation In the next five years, homelessness will be a rare, brief, and one-time occurrence. End all Homelessness by 2020. Create System to End Homelessness End Veteran Homelessness End Family Homelessness End Youth Homelessness Individuals Exiting Institutions will not Discharge to Homelessness Context Specific and Aligned with Best Practices Housing First Data Driven Client Centered

How We Will Create the System Shift to a Housing First Approach for all Funding 1 Transform existing set of programs into housing crisis resolution system 2 Develop and Implement Shelter Diversion/Housing Counseling 3 Develop and Implement a Coordinated Entry System for Homeless Svcs 4 Right Size Interim Housing 5 Expand Rapid Re-Housing Services 6 Maximize Permanent Supportive Housing 7 Use Data for Continuous Quality Improvement 8

Moving Forward: Changing Our System Public Accountability for System Outcomes New Systems Require New Thinking Hire Staff Who Are Data Curious and Flexible New RFPs include Guiding Principles and Intended Outcomes Revise Contractor Performance Measures Data Dashboard and Data Spotlights at Meetings

Data Spotlight: Households Requesting Food

Data Spotlight: HUD System Performance HUD System Performance Measures (SPM) System Performance Measure Federal FY 14-15 (10/1/14-9/30/15) FY 16-17 Q1 &Q2 Preliminary for discussion (7/1/16-12/31/16) 1a. Average Length of time homeless in ES and TH 105 days 94 days 1a. Median Length of time homeless in ES and TH 76 days 67 days 2. Persons who exit homelessness to permanent housing destinations who return to homelessness within 6-12 months (exited from ES, TH, RRH, or PSH and returned to ES or TH within 6-12 months) 3% 2.50% 4.6. For CoC Funded Programs, Percentage of adults who exited programs with increased total income (both earned and non-employment income) 21% 22% 7b.1. Percentage of exits to permanent housing destinations for persons exiting from ES, TH , & RRH 43% 53%

Thank You and Questions Selina Toy Lee Email: SToy-Lee@smcgov.org Web: http://hsa.smcgov.org/center-homelessness (Links to Reports at Bottom) Twitter: @SelinaToyLee