Systems Design For an Effective Crisis Response System to End Homelessness Kay Moshier McDivitt SENIOR TECHNICAL ASSISTANCE SPECIALIST Florida Institute on Homelessness and Supportive Housing November 2, 2017

Kay

System Design Workshop Workshop Overview Solutions and strategies to end homelessness Design a best practice crisis response system Working together to make homeless rare, brief, and non-recurring System Design Workshop AGENDA Crisis Response System Overview Core Elements of the Crisis Response System Implementing a Crisis Response System IMPROVE ABILITY TO Meet HEARTH Act Goals Prevent & End Homelessness Kay

Crisis Response System overview

What is a System? Inter-dependent parts Regularly interacting With a defined set of resources and practices Working together To achieve a common goal First, it might be good to define what we mean by “system”. A system brings together many inter-dependent parts. They aren’t all doing the same thing. They have different roles and responsibilities. In an effective system, the parts are working together within a defined set of resources and practices. The system knows where its boundaries are, what resources it has to work with, and what its primary methods and practices are. Those things are aligned and working together towards a common goal. In our case, the common goal is to house people who are experiencing homelessness quickly 72

An Effective Crisis Response System that Ends Homelessness Homelessness is rare, brief, and non-recurring Housing focused system: all interventions quickly end the episode of homelessness and move people to permanent housing Right mix of interventions that match the needs It is easily understood and navigated by persons experiencing homelessness

A Crisis Response System A Systemic Approach

To make homelessness rare, brief, and non-recurring An Effective Crisis Response System that Ends Homelessness and is Housing Focused Uses ONLY interventions that end homelessness as quickly as possible Allocates all resources (not just HUD) to most cost effective and efficient strategies that quickly re- house all homeless people Begins the conversation about re-housing as soon as someone becomes homeless Targets services to those with highest housing barriers Uses practices informed by data and research To make homelessness rare, brief, and non-recurring

Example of a Crisis Response System www.usich.gov

What is System Flow? An efficient and coordinated process that moves people from homelessness to housing as quickly as possible A description of the way a crisis response should move people from homelessness to housing as quickly as possible 73

A ”Stuck” System Unchanging or increasing number of unsheltered people Waitlist for shelter Long lengths of stay in shelter (more than 30 days) High percentage of exits from shelter back into homelessness Average length of homelessness is not decreasing Long waitlists for RRH, PSH No diversion strategy in place A system that does not have good system flow is stuck. A stuck system does not move people from the streets or shelter quickly into housing. A stuck system often looks like this: High unsheltered population Waitlist for shelter Long lengths of stay in shelter (more than 30 days) High percentage of exits from shelter back into homelessness Long waitlists for RRH, PSH No diversion strategy in place How many of you feel like your community has a “STUCK” system? (The animation on the next three slides will simulate this concept) 74

A “Stuck” System Unsheltered Sheltered Housed Animation (let it play for a few seconds): Here is a very simple representation of a system that doesn’t have optimal system flow – it is stuck. As you can see, on the left are people who are homeless and living on the street or in some type of unsheltered location. In the middle, we can see people who are in shelter beds. On the right are permanent housing units. The animation shows new people are becoming homeless. People are moving from the streets to shelter as well as to housing. And people are moving from shelter into housing when there are open spots. Some people may go back into homelessness, though this isn’t shown here. While there are some people who are getting housed, the overall number of people who are homeless is going up. On the bottom, you can see that the number of people experiencing homelessness is going up because the inflow of people becoming homeless is higher than the number of people that are getting housed. (People are becoming homeless at a faster rate than the system can house people.) Also, the people with the sad faces represent “long-stayers” – people who are stuck in shelter for long periods of time because they don’t have a way of getting out to housing. This system is stuck. 45 47 46 49 45 48 44 44 43 unsheltered + 30 sheltered = 78 77 79 74 74 76 75 75 73 75

Adding More Shelter Capacity Unsheltered Sheltered Housed Animation (let it play) When you have a lot of people who are homeless in your system, it is common to think that adding more shelter will help the problem. As you can see here, the number of homeless people still increases. Why? Because if you don’t increase housing capacity, people who are in shelter still have no way to exit out of homelessness. Add shelter capacity 45 28 31 30 30 32 34 30 29 29 33 unsheltered + 30 45 sheltered = 79 78 76 74 75 77 73 74 75 76

Adding More RRH Capacity Unsheltered Sheltered Housed Animation (let it play) This system has added more RRH capacity. This allows there to be more people flowing through to housing and at a faster rate. Also, because RRH is a short-term crisis intervention, it is important to note that these “units” will open up every 6-12 months so new people can get that housing assistance. This creates good system flow. People are no longer getting stuck in literal or unsheltered homelessness for long periods of time because they have ,more adequate resources to help them exit more quickly. Imagine what could happen if there were more permanent housing resources to match the need of people experiencing homelessness. Add RRH capacity 41 45 34 39 40 41 42 43 42 41 40 36 38 38 34 37 32 40 38 39 34 36 33 32 33 35 36 38 unsheltered + 30 sheltered = 71 70 72 73 75 70 72 69 71 71 62 68 64 68 66 64 70 68 67 63 69 66 66 68 65 64 63 62 77

Characteristics of an Effective Crisis Response System With Good System Flow Prevention of or diversion from homelessness when possible Rapid identification and engagement of people experiencing unsheltered homelessness to connect them to crisis services Quick, accessible pathways to shelter and other crisis services with short stays in shelter Rapid connection to permanent housing for all sheltered and unsheltered people, with priority on most vulnerable In an effective crisis response system, each part should play a specific role focused on the overall goal of stabilizing people experiencing homelessness in housing as quickly as possible. Here are characteristics of an effective crisis response system with good system flow. This helps to reduce system “blockage” and bottlenecks where people get stuck in homelessness with no or little support in getting out. 78

Characteristics of an Effective Crisis Response System With Good System Flow Enough rapid re-housing and other housing interventions to match the needs of people in a community to decrease number of people experiencing homelessness and the average length of homelessness across the system Utilization of long-term and intensive resources like PSH and vouchers reserved only for small number of people who most need those to exit homelessness Strong connections to internal and external system partners, services, and mainstream agency benefits and networks to promote longer-term housing stability (Continued from last slide) Enough RRH is key to helping increase system flow. No other interventions work as well to house more people quickly and create the kind of flow your system needs to actually reduce the number of people who are experiencing homelessness. We will talk more about how to target more intensive resources like PSH and vouchers and longer-term and intensive resources like TH for those who need it when we discuss a progressive engagement strategy across the system. To make RRH and other housing interventions work to keep people housed, strong connections are needed internally and externally. We will talk more about this later when we discuss bringing RRH to scale. 79

Key Elements of a Homeless Response System

An Outcomes Focused System PSH Stabilization Prevention Targeted Prevention Diversion Rapid Re-Housing Length of Episodes Repeat Episodes New Entries

Elements of an Effective Systemic Response Housing First Orientation Coordinated Entry that includes outreach, diversion, and prioritization Emergency/Crisis Housing and Crisis Services Quick Return to Housing with Rapid Re-Housing, Permanent Supportive Housing, and Mainstream Housing Options Access to Stabilization Supports

Housing First Orientation Housing First is a paradigm shift from the traditional housing ready approach. It follows a basic principle—that everyone is ready for housing, regardless of the complexity or severity of their needs. Housing First is not a ‘program’, it is a system- wide orientation and response.

Housing First Orientation An effective homeless crisis response system places a systemic focus on helping individuals and families access permanent housing as quickly as possible when a housing crisis occurs. Service participation is client driven and voluntary Crisis and permanent housing interventions are low demand, and targeted to those with the highest need All programs screen in those with highest needs, not out

Coordinated Entry: Goals Move to a more streamlined and transparent system of access to crisis and permanent housing Fair and equal access to crisis housing and services Standardized assessment and referral Prioritize and allocate resources more effectively Client-centered approach Ensure quick matching to permanent housing

Coordinated Entry: After HUD Webinar 3.17

Coordinated Entry: Outcomes Reduce first time homelessness Reduce average length of homelessness Increase exits to permanent housing Decrease returns to homelessness “Coordinated Entry requires changes throughout your whole system”…

Homelessness Diversion Diversion is a strategy that prevents homelessness by helping people experiencing a housing crisis and seeking shelter to preserve their current housing situation or make immediate alternative arrangements without having to enter shelter Diversion is NOT a separate “program” but rather part of the entire system Diversion is problem solving and solution focused Diversion should always be safe and appropriate for the client.

Outreach Overall goal of street outreach is to assist people to move off the streets and into housing as quickly as possible. Street outreach is mobile housing work Strength based and individualized Relational and engaging People who say “no” to shelter does not mean they will say “no” to housing-if they do say no, keep asking Build community partnerships

Emergency/Crisis Housing Safe, appropriate, and immediate temporary low-barrier shelter, for people who have no viable alternatives, that serves as a first step to being quickly and permanently re-housed

Kay The 5 key elements to effective emergency shelters: Having a Housing First Approach Practicing safe and appropriate diversion Ensuring your shelter provides immediate and low-barrier access Making your shelter housing-focused, with rapid exits TO HOUSING services And using your data to measure your shelter’s effectiveness and make shelter design decisions

Quick Return to Permanent Housing Rapid Re-Housing Best Practice Major component of the crisis response system portfolio, not just a “program” System-wide policies and procedures Not a “one size fits all” model Embraces the 3 core components of Rapid Re- Housing Short-term, individualized, shallow subsidy Rapid re-housing is rapid

Quick Return to Permanent Housing Permanent Supportive Housing Uses system-wide policies and procedures Prioritizes chronically homeless people Reserved for those with highest housing barriers who need it the most Screens people in, not out – low demand Practices a Housing First approach for all units

Access to Stabilization Supports Best Practice Access to stabilization supports helps people further stabilize in housing, resolve future crisis, connect to community supports, prevent eviction and avoid returns to homelessness.

Local Implementation data matters

Restructuring to a Crisis Response System Next Steps What does your system look like? What do you need to change to quickly move people to permanent housing? What do we have vs. what do we need? How do we need to restructure our community system?

Why Data? Good data is essential to plan an end homelessness, evaluate programs, and properly (re-)allocate resources. Point-in-time (PIT) and Housing Inventory Count (HIC) data System - wide data Program Level Data

Use Data Get monthly data to measure performance of each strategy and programs within each strategy Reallocate from low performing strategies to effective strategies Make sure your “pie” is cut correctly Engage all funders in your strategy Measure and adjust Make sure you have the right interventions and programs…working as a system

Restructuring to a Crisis Response System Identify the specific needs of those experiencing homelessness within the CoC Define what and how much of each intervention is necessary to meet those needs Determine how resources (including reallocation) are used the implement the strategies to best meet those needs through a crisis response system Set systemic measures that are analyzed regularly Adjust as necessary to reach the goal of ending homelessness

REMEMBER An Effective Crisis Response System that Ends Homelessness Means: Homelessness is rare, brief, and non-recurring A housing focused system: all interventions quickly end the episode of homelessness and move people to permanent housing The right mix of interventions that match the needs It is easily understood and navigated by persons experiencing homelessness

Next Steps What is one thing you will do in the next week around restructuring your homeless response system?

Thanks! Kay Moshier McDivitt kmoshiermcdivitt@naeh.org Twitter @60_kay National Alliance to End Homelessness www.endhomelessness.org Twitter @naehomelessness