1. Presented by: Rachel Post, L.C.S.W., Public Policy Director
Transitional Housing: Performance Evaluation & Improvement
NAEH: July 19, 2017
Presented by: Rachel Post, L.C.S.W., Public Policy Director

2. Central City Concern’s Scope
Transitional Housing: Performance Evaluation & Improvement

3. Housing Choice: Different Housing for Different Needs
More than 1,700 units total
1,099 units recovery housing
604 units Housing First/low-barrier housing
300 scattered site Permanent Supportive Housing units
Transitional Housing: Performance Evaluation & Improvement

4. Transitional Recovery Community Housing
294 residents served in 95 short term units (200 exits)
74% exited to Permanent Housing (148 residents)
95% still housed and in recovery 12 months post exit
37% exit with employment
12% exit with other income
Permanent Recovery Housing: 89% remain 12 months or longer
37% employed and 44% with other income
Transitional Housing: Performance Evaluation & Improvement
Malcolm was a journalist and author before his life was diverted by addiction. Thanks to transitional recovery housing and a culturally responsive addiction treatment program, Malcolm is now employed as a director at the state food bank.

5. Transitional Housing: Performance Evaluation & Improvement
From detox to recovery
Clients who entered Recovery Housing after detox were:
3 times as likely to complete SUD treatment
10 times as likely to engage in primary care at OTC
Transitional Housing: Performance Evaluation & Improvement
Since Alycia became involved with CCC’s services, she has obtained her Certified Nursing Assistant (CNA) license and earned her Licensed Practical Nursing degree in May 2017.

6. Transitional Housing: Performance Evaluation & Improvement
TOTAL HEALTH CARE COST
Transitional Housing: Performance Evaluation & Improvement
Differences are statistically significant, but sample size is small; average cost for 12 calendar months following month of detox admission

7. Performance Reporting Quality Improvement Projects
Q.I. life cycle
Performance Reporting
Analysis
Quality Improvement Projects
Data Collection
Transitional Housing: Performance Evaluation & Improvement
Quality Improvement projects can be conducted not only with an aim to improve program outcomes, but also to improve data collection tools & processes themselves.

8. Transitional Housing: Performance Evaluation & Improvement
Data Universe
HMIS data feeds into:
Monthly KPI/outcomes reports reviewed by team (Excel)
Quarterly outcomes reports (Tableau)
Strategic Plan reports (Excel  Microsoft intranet)
Reporting transition in progress:
PSU Capstone Projects
Randomized Control Trial
Resident Satisfaction surveys
Resident History surveys
HMIS
Power BI
Data Warehouse
Transitional Housing: Performance Evaluation & Improvement
Power Business Intelligence (Microsoft reporting platform) helps us co-design more effective reports in real time
Analyze data in more meaningful and robust ways
Give department leadership easier and more timely access to reports

9. Transitional Housing: Performance Evaluation & Improvement
Staff involved with Q.I.
Quality Management (QM) Staff
QM Director
Quality Improvement Specialist – Housing & Employment Services
Senior Data Analytics Specialist
Supportive Housing & Housing Staff
Directors
Program managers
Front line staff
Data Warehouse
Transitional Housing: Performance Evaluation & Improvement

10. Program Improvements 2016-17
74% Permanent Housing Placements
Increased opportunities for resident engagement
51% Permanent Housing Placements
Changed staffing &
treatment models
MAT beds
Added Mentor positions
Transitional Housing: Performance Evaluation & Improvement
Sharon’s commentary on this slide: “In we were seeing really low completion rates (1-2 months were as low as 38%). We had moved away from zero tolerance but had gone to the complete opposite of the spectrum with people using and affecting community for long periods of time. We dug into the data including: Average length of stay at relapse and completion, time it took to get into treatment, connection to mental health services, connection to recovery support groups, and demographics of those completing and not completing. We worked with Program Management, Quality, Program Staff, and program participants to come up with needed improvements. “
Created a clear policy and process that allowed for personalized interventions for relapses
Intervention with CM and Counselor together
Opportunity to re-engage in recovery for those who have a goal to do so
Designated some NON A&D free units for people to exit to while waiting on permanent housing placement
Change Staffing Model and Treatment Models
Originally 2 Case Managers for 95 Units
Added 2 Peers by repurposing addiction treatment money due to ACA
Expanded Units for people doing MAT
Opportunities for engagement-adding weekly groups and activities with peers and case managers
Daily Check In Support while waiting for treatment to start
Case manager specific Housing Stability/Life Skills Group
Peer lead Recovery Support Groups
Peers helping people get to appointments
Began referring to CVC and EAC within in first 30 days
Refer to Housing Specialist within first 45 days
Meet bi-weekly with Employment and Clinical service provider
Game night
Peers taking people to community based recovery groups and events
Implemented personalized relapse interventions