rapid rehousing evaluation · 2015-03-11 · simple rules retain information anyway you need to:...

Rapid ReHousing EvaluationAre you really doing Rapid ReHousing?

Flow Through Rate into Housing

Change in Household Acuity

Increase in Housing Retention

Qualitative Inputs

Shadowing and Coaching Staff

Simple Rules

✤ Retain information anyway you need to: notes, pictures, audio, video, doodling, texting, tweeting, posting.

✤ Use @orgcode with #naeh15 if tweeting about this.

✤ If you have a question, ask! If you don’t want to ask it out loud: ✤ Email me idejong@orgcode.com ✤ Text me: 416-432-0410

Sometimes we think we are so right when really we are so wrong

Are You Really Doing Rapid ReHousing?If you don’t define the program you have no idea what you are evaluating - especially if more than one organization is involved

Rapid ReHousing Logic in a NutshellInputs The money and staff that goes into delivering Rapid

ReHousing

ActivitiesWhat support workers/case managers do: financial assistance; home visits; connect to appointments; accompany to appointments; budgeting; acquire government benefits; etc.

Outputs

What it did - the volume of activities: o The number of people housed through Rapid ReHousing. o The number of people receiving financial assistance

through Rapid ReHousing.

Outcomes

How things changed - the difference it made: o changes in personal acuity o changes in personal quality of life o increase in flow-through rate to housing o increase in housing retention o decreases in returns to homelessness

What is Rapid ReHousing?

What is Rapid ReHousing?✤ Rapid re-housing is a support intervention.

✤ Time-limited case management and/or financial supports.

✤ Aligned to the philosophy and service orientation of housing first.

✤ Participants in a rapid re-housing program have moderate acuity – either across the board, or with higher acuity in a few select areas that impact housing stability and vulnerability, but not in others.

✤ Supports are provided in vivo.

✤ Professionally trained housing-based case managers deliver the supports.

✤ Approach is structured, documented, and strategic.

✤ Need identification is matched to facilitating resources to support the needs.

How Does RRH Relate to Housing First?✤ Philosophy:

✤ Move individuals/families into housing quickly without requiring treatment, rehabilitation or compliance first. Housing is attained before more intensive services are provided, and can even be provided before income is secured.

✤ Service orientation: ✤ Person-centred ✤ Strength-based ✤ Non-judgmental ✤ Harm reduction ✤ Solution-focused ✤ Intentional goal setting process driven through assessment ✤ Focus on greater independence ✤ No attempts to heal or fix people ✤ Community based & mobile ✤ Empowering ✤ Progressive engagement ✤ Objective-based interactions

People Must Get Housed for Rapid ReHousing to Work

Flow Through Rate Into HousingIf you assess people and assign people to rapid rehousing, but hardly ever house them, you have an administrative practice laden with waiting lists, not a housing program

Who Are You Housing?

No 59%

Yes 41%

Chronic Homeless Status of RRH/Outreach

Simple Output1 Adult 1 Youth 2 Adults 1 Adult, 1

Child2 Adult, 1

Child2 Adult, 2+ Children

1 Adult, 2+ Children

% Housed in Less than 30

Days13% 2% 20% 9% 36% 18% 8%

% Housed 31-90 days 29% 7% 21% 37% 32% 14% 19%

% housed 91-180 days 32% 19% 18% 17% 21% 15% 17%

% Housed 181-365 Days 11% 43% 22% 17% 1% 27% 26%

% Housed 366+ Days 8% 13% 12% 9% 2% 16% 11%

% of Active Clients Still

Waiting to be Housed

7% 16% 7% 11% 8% 10% 19%

While interesting, what this does NOT tell you about are things like:

variations across service providershow long it takes someone not homeless to find an apartment in the same community with identical household sizeanything about affordabilityany type of subsidy being provided or the availability of the subsidyanything about re-housing or returns to homelessness

The Ultimate Outcome

Change in Household AcuityMeasuring change from homelessness to housing

What Happens Over Time?Component Intake Move-in 30 Day 3 Month 6 MonthSelf Care & Daily Living Skills 2.1 2.1 2.3 1.7 1.4Personal Administration & Money Management 2.3 2.5 2.2 2.1 1.7Meaningful Daily Activities 2.9 3.1 3.0 2.7 2.1Social Relationships and Networks 2.6 2.6 2.9 2.9 2.5Involvement in High Risk/Exploitive Situations 1.1 1.0 1.0 0.8 0.6Legal Issues 0.8 0.8 0.8 0.7 0.5Risk of Personal Harm or Harm to Others 0.6 0.7 0.6 0.5 0.5Managing Tenancy 4.0 4.0 3.2 2.9 2.1Use of Emergency & Crisis Services 1.9 1.8 1.4 1.2 0.7Physical Health & Wellness 2.3 2.5 2.2 2.0 1.6Mental Health & Wellness and Cognitive 2.5 2.8 2.7 2.4 2.2Medication 1.5 1.6 1.4 1.3 1.3Experience of Abuse/Trauma 2.6 2.6 2.5 2.2 2.1Substance Use 1.2 1.4 1.6 1.5 1.2Parental Engagement 0.6 0.9 0.7 0.6 0.6Size of Family 3.1 3.3 3.3 3.2 3.0Needs of Children 4.0 4.0 3.2 2.9 2.8Stability/Resiliency of the Family Unit 0.5 1.1 1.3 0.9 0.6Involvement with Children Services/Family Court 0.9 1.1 0.8 0.9 0.7History of Homelessness 2.5 2.5 2.5 2.5 2.5

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Intake" Move"In" 30"Day" 3"Month" 6"Month"

Socializa:on"and"Daily"Func:ons" Risks"

Wellness" Family"Unit"

Doing it Right Trumps Doing it Quickly

Increase in Housing RetentionIt matters little how many people you housed. It matters a lot how many people stay housed.

Change in Overall Acuity

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Intake" Move"In" 30"Day" 3"Month" 6"Month"

Talk to the experts

Qualitative Inputs

The Most Accurate Measure is to Ask Program Participants

Self Reported Changes Once in RRH

45

67

89

1011

1314

VI-SPDAT Prescreen Scores and Average Acuity Markers

VI-SPDAT Prescreen Score Average Trips to the ER

Average Interactions with Police Average Trips to Hospital in an Ambulance

Hospitalized as an Inpatient

Without Operational Engagement You Will be Lose

Shadowing & Coaching StaffSeeing is Understanding

Internally or Externally

❖ Fidelity to practice

❖ Appropriate housing

❖ Appropriate household

❖ Documentation

❖ Data

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