The Source for Housing Solutions Targeting and Prioritization: Best Practices for Serving the Most Vulnerable Kim Walker Senior Program Manager, CSH September 22, 2014

Our Mission Improve lives of vulnerable people Maximize public resources Build strong, healthy communities Advancing housing solutions that:

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Agenda  Coordinated Assessment: A Tool for Targeting  Prioritization Standards  Targeting Example: FUSE

Coordinated Assessment Process to Determine Housing Exit Strategy Shelters Rapid Re-Housing Permanent Supportive Housing Homelessness Prevention Community Supports Coordinated Access Processes

Systemwide Targeting with Coordinated Assessmen t  Clear definitions and parameters for all interventions  Data-informed decisions and targeting  Housing First system orientation  Commitment to low-barrier entry to programs

Progessive Engagement…

Assessment Tools: Qualities Barriers related to housing Length of homeless episodes Referrals correspond to prioritization standards and community priorities Success or failure of previous interventions

Diversion “Where did you stay last night? Could you safely stay there again?” “Why did you have to leave where you stayed last night?” “Is there anyone else you could stay with for a few days while we work with you?”

HUD Prioritization Guidance  For chronically homeless households (and CoC CH PSH beds)  Longest history of homelessness + most severe service needs  Longest history of homelessness  Most severe service needs  All other CH households  For non-chronically homeless households (and CoC non- CH PSH beds)  Households with disabilities + most severe service needs  Households with disabilities + long period/episodic homelessness  Households with disabilities coming from PNMFHH, Safe Havens, or emergency shelter  Households with disabilities coming from TH

What is FUSE? F REQUENT U SERS S YSTEMS E NGAGEMENT TThousands of people with chronic health conditions cycle in and out of hospitals, jails, detox, and homelessness - at great public expense and with limited positive human outcomes. TTargeted supportive housing for the most vulnerable and costly of this group can reduce costs while getting better outcomes FFUSE program serves as a catalyst for system change at the local level

FUSE & High Utilizer Initiatives Re-entry FUSE – Operating Re-entry FUSE – Significant planning Health FUSE – Operating Health FUSE – Significant planning Douglas Co, NE FUSE King Co FACT KCC/SIF SIF+FUSE/Ert Just in Reach 2.0 Project 25 Maricopa Co FUSE Hennepin Co FUSE Bexar Co High Utilizers- TBD Washtenaw FUSE/SIF Detroit FUSE Chicago FUSE Columbus BJA FUSE Wash. DC FUSE NYC FUSE CT SIF CT FUSE Rhode Island FUSE Richmond FUSE MeckFUSE Denver FUSE Travis Co BJA Louisville ACT Frequent user program totals 17 re-entry FUSE programs 8 health high utilizer programs Approx people housed Approx. 825 to be housed

The FUSE Blueprint Data-Driven Problem-Solving Cross-system data match to identify frequent users Track implementation progress Measure outcomes/impact and cost-effectiveness Policy and Systems Reform Convene interagency and multi-sector working group Troubleshoot barriers to housing placement and retention Enlist policymakers to bring FUSE to scale Targeted Housing and Services Create supportive housing and develop assertive recruitment process Recruit and place clients into housing, and stabilize with services Expand model and house additional clients

Evaluation Results: FUSE Reduces Recidivism  40% fewer jail days  91% fewer shelter days  50% fewer psychiatric inpatient hospitalizations (not shown) Results from Columbia University’s evaluation of the New York City FUSE program, released in November 2013

The Source for Housing Solutions Kim Walker