1. Ending Homelessness in Napa Mitch Wippern and Nui Bezaire, HHSA

2. Napa Has a Homeless Problem.
Here is Napa’s PITC – a snapshot of persons experiencing homelessness from 2011 to The second chart shows sheltered vs. unsheltered households. Because the trend was an increase in people experiencing homelessness, even though we were putting in a lot of effort, we knew we had to re-evaluate our whole system to better understand what was working and what wasn’t.
Some reasons: very difficult housing market, not a lot of rental stock, low vacancy, high rent.
Also, we learned that we were not trying to solve homelessness, we were managing it.

3. Napa’s Current Homeless Response System

4. The Current System is Not Effective.
Households are staying in shelters 180 days or longer.
Where are they going when they exit?
Shelters for single adults:
72% exited back to homelessness
Shelters for families:
34% exited back to homelessness
So what impact does this disjointed homeless response system have? Not a very positive one for single adults.
72 percent exited back into to homelessness, unknown destinations, or other non-permanent housing exits.
34  percent exited back into homelessness, unknown destinations, or other non-permanent housing destinations.
We also learned that..
People experiencing homelessness have difficulty accessing services and housing supports bECAUSE OUR SHELTERS HAVE STRICT ELIGIBILITY CRITERIA AND RULES THAT SCREEN THE MOST VULNERABLE OUT
SIGNIFICANT PORTION OF PEOPLE COMING FROM HOUSED SITUATIONS THAT MAY BE ABLE TO BE DIVERTED TO SAFE HOUSING SITUATION INSTEAD OF SHELTER
A SIGNIFICANT PORTION OF PEOPLE IN SHELTER RETURN TO HOMELESSNESS
DAY CENTER IS NOT EFFECTIVE IN RESOLVING PEOPLE’S HOUSING CRISES
HOUSING SUPPORT IS NOT CONNECTED TO SHELTER

5. City/County Joint System Re-Design
Employed consultants to find solutions
Analysis found that:
Resources are siloed.
Resources are not aligned.
There is a growing population of high-need vulnerable individuals in the County.
There is not enough available permanent housing inventory to meet the demand.
Usually communities take this in smaller pieces…we decided to look at system in totality and engaged consultants with national perspective, best practices, etc.
City and County came together to find a solution. We know the current ad hoc homeless response system in Napa is not effective in ending homelessness. Part of how we know this is because Napa contracted with the Corporation for Supportive Housing and the National Alliance to End Homelessness to analyze Napa’s current homeless system response and make recommendations for improvement.

6. Napa’s Re-Designed System
The overall goal of recommendations by both CSH and NAEH was to create a system that looked more like that, that created clear pathways to housing for vulnerable individuals. This is a very simple way or portraying a new system that would require various systems change trnansformation initiatives to realize. This type of systems change is a very large undertaking that is informed by national best practices and uses strategies that are new and innovative in the homeless systems change world. The recommendations for how to accomplish all of this follows….

7. Five Categories of Recommendations
Homeless & Housing System Redesign
Five Categories of Recommendations
Breaking Silos & Leveraging Resources
Cutting Costs & Realigning Resources
Prioritizing Housing Resources
Building Housing Capacity
Using Data
Identifying New Funding
These are the categories. We’ll cover the recommendations and status of them next.

8. Accomplishments Breaking Silos & Leveraging Resources
Funders Collaborative established
Homeless Program Coordinator hired
Flexible Housing Subsidy Pool created, Operator selected
Cutting Costs & Realigning Resources
Shelter system re-designed, new operator selected
Prioritizing Housing Resources
Coordinated Entry System to launch in Spring
System-wide Housing First approach
Building Housing Capacity
Landlord engagement, Housing Challenge
Using Data
System performance dashboard, data integration
Identifying New Funding
New System Grants, Whole Person Care

9. Napa’s WPC Program Lead Entity Napa County HHSA Launch Date
Award: ~$11.5M over 5 years
Napa County HHSA
Lead Entity
July 1, 2017
Launch Date
Homeless Medi-Cal beneficiaries who frequently use hospital, emergency departments and the shelter system
Target Population
Goal: Test community-based initiatives that coordinate health, behavioral health and social services for vulnerable Medi-Cal beneficiaries who are high users of multiple systems and have poor outcomes.
High-Utilizers: Repeated avoidable ED use or hospital readmissions
Vulnerable populations: Homeless, at-risk of homelessness and those being discharged into homelessness

10. Napa’s WPC Program: Partners
Care Coordination & Referrals
Partnership Health (MCO) - data
Ole Health (FQHC) – data and coordination
Catholic Charities (respite center) – services coordination
McAllister (detox & sobering center) – services coordination
Queen of the Valley (hospital) – data and coordination
Criminal justice partners
Housing Resources
Abode Services – housing matching and placement, tenancy care, services coordination
Napa Housing Authority – vouchers for housing
Landlords and housing providers – housing vacancies, housing placement
Flexible Housing Pool – housing subsidies and services $$

11. Napa’s WPC Program: Performance Measures
Outreach/Mobile Engagement
# of clients enrolled and served
Housing
# of clients placed in housing
# of clients who maintain housing
How long clients maintain their housing over grant term
Health
Reduction in suicidality
Reduce emergency department visits
Reduction in 30-day readmissions
Increased self-reported health status and quality of life
Increase initiation and engagement of drug and alcohol services
(105 over four years)
# of clients who maintain housing (85%)
Reduction in suicidality (20%)
Reduce emergency department visits (20%)
Reduction in 30-day readmissions (20%)
Increased self-reported health status and quality of life (20%)
Increase initiation and engagement of drug and alcohol services

12. Napa’s WPC Program: Status
Program Infrastructure & Data
Ongoing planning meetings with steering group
System design meetings with key partners
Data matching underway/ data integration platforms for client monitoring, tracking and outcomes reporting
Program Delivery
Outreach: lead organization under contract April 2017
Housing & Housing Support: launching Coordinated Entry system in Spring 2017, Abode Services to manage housing navigation, placement and support services
Program Evaluation & Compliance
Building evaluation plan with support from HHSA QM
ACO & HHSA Fiscal budget oversight
County internal evaluation staff and external evaluator RFP

13. Ending Homelessness: What’s Next?
Continue strong collaboration with City/Housing Authority
Change of government’s role from day-to-day system operations to:
Developing sustainable funding sources
Developing system-wide outcome evaluation and monitoring system that provides clarity on where to focus resources to end homelessness