Solutions to Family Homelessness and the Role of Assessment

February 25, 2014

HOME Conference

AGENDA

I. Introduction and Overview: the Process of Finding Solutions

II. Context and Some Guiding IdeasIII. Experiences With Rapid Re-Housing and Permanent

Supportive HousingIV. Adding Assessment and Better Coordination to the

Mix: Family Housing Solutions (FHS)V. Preliminary FHS Data, Lessons Learned So Far, and

Client FeedbackVI. Questions and Discussion

Context

What tools do we have to address family homelessness?ShelterTransitional housingPermanent supportive housing (PSH)Rapid re-housing (RRH)Diversion/preventionMainstream services (TANF, job training, health, mental

health, substance abuse services, etc.)Section 8 and other rental subsidy programsAffordable housing

Context

Less than 1 in 10 families living in poverty becomes homeless

Most families who do become homeless exit shelter and never return

Those who do stay in shelter do worse the longer they stay homeless, including:Higher incidence of substance abuseHigher incidence of mental health problemsHigher incidences of domestic violence and child-protective

services involvementLower school performance for children

Old Model

Shelter eligibility/

Assessment – Central Intake

Emergency Shelter

Long-term Shelter

Transitional

PermanentHousing?

Family Assessment

• Homelessness prevention, diversion, mediation• Connection to mainstream services

Temporary Housing

• Emergency shelter• Transitional housing•Connection to mainstream services

Permanent Housing

Emerging Model

• Permanent supportive housing•Rapid Re-Housing• Long-term affordable housing

Old Model (Graphic from Dennis Culhane)

Employmentassistance

Mental health/substance abuse services

Family supportservices

Housingplacement

Healthservices

Shelter

Emerging Model

Employment assistance

Mental health/substance abuse services

Family supportservices

HousingStabilization

Healthservices

Shelter

Rapid Re-Housing

Components: Assessing barriers to housing stability Housing search Supportive services (getting settled into housing,

understanding lease, connection to mainstream resources, employment services)

Financial assistance (move-in costs, first-month’s rent, security deposit, and rental subsidy)

Rapid Re-Housing

Characteristics of families served: Very low income First time or second time homeless Some barriers to housing stability, such as poor

rental histories, evictions, criminal and credit problem histories

May have disabilities, but not so severe as to preclude employment

Some recent work history

Rapid Re-Housing2013 Results

• 95% (52 of 55) of families that exited the program had not returned to DC shelter as of 12/31/13

• Average length of case management for exiters: 8.75 months

• 42% (23 of 55) of families who exited the program increased their income before exiting

• Average family size: 3.4• Average total cost per month: $2,100

Permanent SupportiveHousing

Components: Intensive case management (including case planning, and

coordination of services, connection to mental health services, medical care, and substance abuse recovery services)

Employment and education services, as well as advocacy to maximize public benefits

Health and wellness services Children’s services, including school advocacy, mentoring, and

developmental and social assessment Workshops and training opportunities Financial assistance (ongoing rental subsidy)

Permanent SupportiveHousing

Characteristics of families served: Very low income Long histories of homelessness, multiple episodes

of homelessness Multiple barriers to housing stability, including

little or no work history, significant documented disabilities (health, mental health, substance abuse), and greater levels of other trauma (e.g., domestic violence, PTSD)

Permanent SupportiveHousing 2013 Results

• 96% (136 of 142) of families and single adults remained stably housed in program or exited to another positive permanent housing destination

• 32% (46 of 142) of families and single adults served increased income

• Average family size: 3.6• Average total cost per month: $2,550

Overview of FHS Project

$1 million 1-year grant from Freddie Mac Foundation, supports: Services to support 100 rapid re-housing slots, and 50

permanent supportive housing slots Staffing – assessment specialists, case managers, housing

specialists, and employment specialists Technical assistance, training, and ongoing evaluation

delivered by OrgCode Consulting, Inc.DC Department of Human Services providing 100

temporary housing subsidies for rapid re-housing, and 50 permanent subsidies for permanent supportive housing

Goals & Philosophyof Grant

Permanently ending homelessness for 150 families in the homelessness assistance system

System change: piloting a uniform assessment and prioritization system, initially assessing at least 500 families “Right assistance, at the right time, for the right

family” Progressive engagement Coordination among private and public partners

Why The SPDAT?• Comprehensive

– Evaluates 20 components that contribute to housing stability• Quantitative and objective

– Scored 0-4 in each component based on level of acuity– Tallied scores fall within 3 ranges: one-time assistance, rapid rehousing, and

intensive supports• Research based

– Developed by academics, researchers, and practitioners– Used by over 10,000 individuals in 100 communities– Individual SPDAT has gone through 3 revisions

• Proven– Evaluation has shown that clients referred to programs through the SPDAT

assessment and case management have higher housing stability in the long term than clients that do not use the SPDAT because they were matched with appropriate level of services

Think of the F-SPDATin 5 Domains

Wellness RisksSocialization

& Daily Functions

Housing History Family Unit

Wellness

Mental Health and Wellness & Cognitive Functioning

Abuse/Trauma Substance Use Physical Health & Wellness Medication

Risks

Harm

Interaction with

Emergency Services

Managing Tenancy

High Risk &

Exploitive Situations

Legal

Socialization &Daily Functions

Meaningful Daily Activities

Administration & Money

Management

Social Relations & Networks

Self-care & Daily Living

Skills

Family Unit

Needs of Children Child/Family Court Size of Family Stability/Resiliency Parental Engagement

SPDAT Example

• Abuse/Trauma (second component of the first domain, Wellness):

0 Parent does not report a past or present experience of abuse and/or trauma.

1 Parent has a history of abuse and/or traumatic events, but reports no serious consequences on present functioning and/or parental ability, or indicates resolution of past abuse through therapeutic means.

2 Parent has a history of abuse and/or traumatic events that are impacting present functioning and/or parental ability. Parent is currently engaged in therapeutic attempts at recovery, but does not consider self recovered.

3 Parent has a history of abuse and/or traumatic events that are severely impacting present functioning and/or parental ability. Parent has not attempted therapeutic recovery.

4 Parent is currently experiencing abuse or a traumatic event that is causing the current period of homelessness. No attempt at therapeutic recovery has been made.

SPDAT ScoringRange

Scoring Range Intervention0-26 One-time Assistance27-53 Rapid Re-Housing54-80 Permanent Supportive

Housing

F-SPDAT Process

Pre-Screening (1 day)

• The Assessment Specialist meets with shelter Case manager to conduct pre-screen and begin collecting documents. Pre-screen helps determine who to fully assess first in terms of priority.

Full Assessment (

1-2 Weeks

)

• The Assessment Specialist interviews clients at shelter, interviews shelter Case Managers and collects all supporting documents.

• Assessment Specialist scores the SPDAT based on all the information gathered.

Offer (7 days

after scorin

g)

• The Assessment Specialist meets with the client and the shelter Case Manager to discuss the findings and present the offer.

• The assistance offered is based on the SPDAT scores, possible service options include (Permanent Supportive Housing, Rapid Re-Housing and One-time assistance)

Preliminary FHS Data

698 pre-screened 524 assessed

80 (15%) scoring for one-time assistance404 (77%) scoring for rapid re-housing40 (8%) scoring for permanent supportive housing

130 housed So far, no families have become homeless

again

Preliminary FHS DataDOMAIN Avg. PSH

ScoreAvg. RRH Score

Avg. OTA Score

Out of a Possible

Wellness 3.29 2.00 0.46 5

Risks 2.35 0.97 0.03 4

Socialization & Daily functioning

3.53 2.65 1.33 4

History of Housing 1.0 0.93 0.76 1

Family Unit 3.82 1.95 1.08 5

TOTAL 14.00 8.50 3.90 19

EvaluationComponents

Basic demographic information; size of households; source and amount of income; history of housing and homelessness; physical health, mental health, addictions; involvement with emergency services; military service; history of incarceration; employment and education

Multiple self-reported quality-of-life indicatorsPerceptions of staff; interviews with clientsHow families do in their housing

Lessons Learned So Far

All the processes and timing within FHS are influenced by the functioning of the current system (e.g., LRSP, STI) Families moving out of shelter much slower than

anticipated Some families reluctant to accept RRH, though most offers

made by FHS staff have been accepted Hard to find affordable housing units – and lots of competition

for those units Coordination and communication among partners needs to be

explicit and consistent More training across providers needed for RRH and PSH to

ensure consistency of program outcomes

Clients’ Self-Reports

• Biggest improvements: physical health, mental health, and connection with kids

• Least improvements: stress level (27% reported greater stress now than when they were homeless), quality of food, and quantity of food

• 86% reported having somewhat or a lot of choice in where they lived

• Respondents had an average of $454 per month in income and $540 in food stamps; the majority reported under the table income (average $320), and 53% reported support from family members

Clients’ Self-Reports

• ER decreased 67%, ambulance calls decreased 60%• Rating of support received: 9.47 (out of 10)• Respondents were optimistic, but not confident, about their

future and likelihood of homelessness again• Readiness to move on scored at 5.5 out of 10, the importance

of moving on a 9 out of 10, and their confidence at 5.3 out of 10

• 75% said the type and frequency of supports were just right, 67% percent said the duration of supports was too short, and half said the intensity was too low while the other said it was just right

Questions and Discussion

• Possible expansion opportunities (single adults? Other populations?)

• System change opportunities (changes to prevention, shelter, and assessment system)

• Role of private funders• Next steps

Contact Information

Jamey BurdenDirector of Housing, Programs & PolicyCommunity of Hope, Inc.Phone: 202.407.7766E-mail: jburden@cohdc.orgwww.communityofhopedc.org

Community of Hope is the winner of the 2012 Washington Post Award for Excellence in Nonprofit Management.