mary schwartz washington state department of commerce melissa ford shah

1DSHS | Research and Data Analysis Division ● MAY 22, 2014

Mary SchwartzWashington State Department of Commerce

Melissa Ford Shah Washington Department of Social

and Health Services

Conference on Ending HomelessnessYakima, Washington

MAY 22, 2014

Ending Homelessness In Washington State:

What The Data Tells Us

Getty Images, iStock


Roadmap1. Two Efforts to End Homelessness in Washington

State

2. DSHS-Commerce Research and Data Partnership

3. Informing the Chronic Homelessness Policy Academy

4. Data on the Ending Family Homelessness Pilot Project



PART 1

Overview of Two Efforts to End Homelessness in Washington State



MISSION STATEMENT

Promote sustainable housing as part of recovery for chronically homeless people

VISION

Ending chronic homelessness for most vulnerable high cost system users

FOCUS

Develop and implement a model for ending the experience of chronic homelessness for 3,000 people identified in 2013, and

replicate the model to a system-wide level by 2016

Chronic Homelessness Policy Academy:Housing 3,000 Subcommittee


Chronic Homelessness Policy Academy:Housing 3,000 Subcommittee

STEPS

1.End Chronic Homelessness in the State of Washington through targeted, solution-oriented approaches that can be scaled for efficacy around the State

2.Permanently house 3,000 people experiencing chronic homelessness in the State of Washington

3.Build a collaborative, integrated approach to identify and connect individuals who experience chronic homelessness with comprehensive services to support permanent housing


Washington State Policy Academy Process

WORKGROUP FOCUS NEXT STEPS

Expanding Housing

• Meet with key stakeholders to identify housing needs and opportunities

• Bring together Federal, State and County level agencies and stakeholders

Data • Integrate data to improve our understanding of the needs of homeless veterans

• Analyze medical and behavioral health costs for homeless Medicaid clients

• If awarded, a SAMHSA supplemental grant will fund an analysis of homeless veterans

• CSH and WLIHA finalizing a White Paper that includes a medical cost analysis for chronically homeless individuals

System Design • Configure the “pieces” of the overall Policy Academy activity to build a long term (and sustainable) solution to ending chronic homelessness in the State of Washington

• Working to add supportive services to Medicaid benefit

• Implementing BRIDGES grant, which provides behavioral health supportive housing services

Key Activities:


• In April 2013, five counties (Cowlitz, Mason, Snohomish, Spokane and Whatcom) implemented a pilot program involving:– Active coordination with local CSOs, WorkSource, and housing providers – Goal of moving homeless TANF families into permanent housing immediately while

connecting them to services so income could support that housing in 6 months

• January 2014: Pilot program was expanded under the consolidated homeless grant (CHG); continued partnership between Commerce, DSHS and ESD

• Statewide technical assistance being provided to EFH providers in partnership with Building Changes and the Gates Foundation

• Research being conducted by RDA on outcomes of 80+ households served in the pilot

Ending Family Homelessness (EFH): Rapid Re-housing for Homeless Families on TANF


PART 2

DSHS and Commerce Research and Data Partnership



School Outcomes Preschool – College

Washington State DSHS Integrated Client Database

Internal

Arrests Births

Deaths

Charges

Convictions

Incarcerations

Community Supervision

Dental ServicesMedical Eligibility Medicaid, State OnlyHospital Inpatient/ OutpatientManaged Care Physician ServicesPrescription Drugs

Hours

Wages

Housing AssistanceEmergency ShelterTransitional HousingHomeless Prevention and Rapid Re-housing Permanent Supportive Housing

Public HousingHousing Choice VouchersMulti-Family Project-Based Vouchers

External

Administrative Office

of the Courts

Employment Security

DepartmentDepartment

of HealthDepartment

of CorrectionsWashington State Patrol

Department of Commerce

Health Care Authority

Housing and Urban

Development Public Housing

Authority

WASHINGTON STATEDepartment of Social and Health Services

INTEGRATED CLIENT DATABASE

WASHINGTON STATEDepartment of Social and Health Services

INTEGRATED CLIENT DATABASE

Nursing Facilities

In-home Services

Community Residential

Functional Assessments

Case Management

Community Residential Services

Personal Care Support

Residential Habilitation Centers and Nursing Facilities

Medical and Psychological Services

Training, Education, Supplies

Case Management

Vocational Assessments Job Skills

Child Protective Services

Child Welfare Services

Adoption

Adoption Support

Child Care

Out of Home Placement

Voluntary Services

Family Reconciliation Services

Institutions

Dispositional Alternative

Community Placement

Parole

Food Stamps

TANF and State Family Assistance

General Assistance

Child Support Services

Working Connections Child Care

DSHS Juvenile

Rehabilitation

DSHS Economic Services

DSHS Aging and Long-

Term Support

DSHS Developmental

Disabilities

DSHS Vocational

Rehabilitation

DSHS Children’s Services

Child Study Treatment Center

Children’s Long-term Inpatient Program

Community Inpatient Evaluation/ Treatment

Community Services

State Hospitals State Institutions

Assessments

Detoxification

Opiate Substitution Treatment

Outpatient Treatment

Residential Treatment

DSHS Behavioral Health and Service

IntegrationMental Health and Substance Abuse Services

Education Research Data

Center

De-identified


The vast majority of housing clients in HMIS have been DSHS clients•In State Fiscal Year (SFY) 2013, 78 percent of HMIS housing recipients gave consent and had sufficient information for linkage to DSHS records (71,652 of 91,524)

•91 percent of those who could possibly be linked were found in the DSHS Integrated Client Database (64,974 of 71,652)

HMISALL Housing

Assistance Recipients

n = 91,524

Gave consent and had sufficient information for linkingn = 71,652

DSHS-HMISHMIS Linked to DSHS

Integrated Client Databasen = 64,974

HMIS Housing Program Clients with DSHS Service History SFY 2013


PART 3

Identifying Chronically Homeless Individuals in Washington State



Data on chronic homelessness is missing for four counties in Washington because it is not part of the HMIS data standards

THURSTON

GRAYS HARBOR

MASON

JEFFERSON

CLALLAM

WHATCOM

SAN JUAN

ISLAND

KITSAP

SKAGIT

SNOHOMISH

KING

PIERCE

LEWISPACIFIC

WAHKIAKUM COWITZ

CLARK

SKAMANIA

YAKIMA

KLICKITAT

KITTITAS

CHELAN

DOUGLAS

OKANOGAN FERRY STEVENS PEND OREILLE

GRANT

BENTON

FRANKLIN

WALLA WALLA

ADAMS

LINCOLN

SPOKANE

WHITMAN

GARFIELD

COLUMBIA

ASOTIN

Everett

Tacoma

Spokane


Proportion of homeless population meeting criteria for chronic homelessness

*NOTE: This data represents all HMIS entries in the state in CY 2012, with the exception of Clark, Pierce, Snohomish, and Spokane counties. These records are not unduplicated at the client level.

Chronically Homeless, January 2013 Point in Time Count

TOTAL HOMELESS IN STATE = 17,775

Chronically Homeless, CY 2012 HMIS Entries*

TOTAL CY 2012 ENTRIES IN HMIS = 22,158

Chronically Homeless12%n = 2,219

Chronically Homeless*

20%n = 4,345

Homelessnot chronically88%n = 15,556

Homelessnot chronically80%n = 17,813


Characteristics of Washington’s Chronically Homeless PopulationDEMOGRAPHICS

TOTAL = 4,345*

n = 1,573 n = 699n = 359 n = 1,462n = 2,760



Characteristics of Washington’s Chronically Homeless PopulationHOMELESS EPISODES

TOTAL = 4,345*

Continuously Homeless83%n = 3,627

Frequently Homeless

48%n = 2,076

Both Continuously and Frequently

Homeless31%n = 1,358



Characteristics of Washington’s Chronically Homeless PopulationHEALTH AND BEHAVIORAL HEALTH CONDITIONS

TOTAL ENTRIES = 4,345*

n = 612 n = 2,089n = 1,702 n = 1,968n = 3,037



Identifying Chronically Homeless Population with the ICDB: Medical assistance clients meeting HUD definition

Homeless in June 2012n = 10,532

52%Yes. Got Assistance

12% n = 2,445

No. Did not receive HMIS-Recorded Housing Assistancen = 8,087

40%

Total Medical Assistance PopulationSFY 2012 = 1.5 million Met HUD

definition of Chronically

Homeless in SFY 2012

n = 20,174

1.3%

Homeless in SFY 2012 but not in June 2012n = 9,642

48%


PART 4

Data on the Ending Family Homelessness Pilot



Monthly EFH Enrollment Trends by Pilot CountyAPRIL – SEPTEMBER 2013

Whatcom n = 30

Mason n = 20

Cowlitz n = 37

Snohomish n = 64

Spokane n = 94

35

128

167

235249

TOTAL = 277

245

SOURCE: The Ending Family Homelessness Pilot: Rapid Re-Housing for TANF Families, Ford Shah, et.al., DSHS Research and Data Analysis Division, January 2014.http://publications.rda.dshs.wa.gov/1498/


Average Monthly EFH Costs per HouseholdAPRIL – SEPTEMBER 2013

Average cost per month of program participation for all heads of household with reported EFH costs . . .

Average cost per service user per service month . . .

RENTn = 71

SECURITY DEPOSITn = 71

UTILITY DEPOSITn = 71

MOTEL/HOTEL COSTn = 71

ALL COSTSn = 71

$636 $180 $37 $36 $889

RENTn = 70

SECURITY DEPOSITn = 60

UTILITY DEPOSITn = 16

MOTEL/HOTEL COSTn = 8

ALL COSTS

$688 $592 $207 $800 n/a



Prior Living Situation Recorded in HMIS for EFH Recipients

Emergency Shelter

67% n = 75

57% n = 158

19% n = 13

65% n = 24

64% n = 23

96% n = 23

Place not meant for human habitation

All others

22% n = 25

38% n = 105

78% n = 53

35% n = 13

36% n = 13

4% n = 1

11% n = 12

5% n = 14

3% n = 2

TOTAL = 277

TOTAL = 112

TOTAL = 68

TOTAL = 37

TOTAL = 36

TOTAL = 24



Three-Year Shelter Use History for EFH Participants:Chronic, Temporary, and Episodic Homelessness

10%n = 29

14%n = 38

No Prior Shelter

42%n = 115

Episodic Homelessness2%n = 6

TOTAL CASES = 277

Chronic Homelessness

Temporary Homelessness

Prior Shelter Not Recorded in HMIS*32%n = 89

74%n = 204

*Program staff in the five pilot counties confirmed that these 89 individuals with prior shelter not recorded in HMIS were either 1) entering EFH from shelters not required to report into HMIS or 2) fleeing domestic violence when served in shelter.

Three-Year History: EFH Clients with Prior Shelter Use in HMIS

Temporary(n = 38)

Episodic(n = 6)

Chronic(n = 29)

TOTAL (n = 73)

Average number of shelter episodes 1 2.3 1.1 1.1Average number of days in shelter 9.8 6.3 89.1 41.0Average number of days per episode 9.8 3 86.6 39.8


Issues Identified in the Comprehensive Evaluation: EFH Parents Compared to Other TANF Parents

EFH EFH

EFH

EFH

EFH

TANFOther

TANFOther

TANFOther

TANFOther

TANFOther

0n = 24 of 105

8,725 of 55,505

n = 23 of 105

4,578 of 55,505

n = 38 of 105

8,217 of 55,505

n = 22 of 105

5,962 of 55,505

n = 45 of 105

20,542 of 55,505



Pregnancy and Ages of Children in the Household: EFH Parents Compared to Other TANF Parents

EFH

EFH

EFH

EFH

EFH

TANFOther

TANFOther

TANFOther

TANFOther

TANFOther

0n = 8

of 1055,719 of

55,505n = 55 of 105

25,491 of 55,505

n = 32 of 105

17,737 of 55,505

n = 25 of 105

11,974 of 55,505

n = 0 of 105

973 of 55,505



Percent Homeless or Unstably Housed: April 2011-March 2012

2011 2012

EFH Parents

Other TANF Parents



Behavioral Health and Medical Risk IndicatorsAMONG THOSE WITH MEDICAL COVERAGE

EFH

EFH

EFH EFH

EFHTANFOther

TANFOther TANF

Other

TANFOther

0n = 26 of 105

8,575 of 55,505

n = 20 of 105

4,436of 55,505

n = 52 of 105

20,579 of 55,505

n = 52 of 105

19,374 of 55,505

n = 16 of 105

4,958 of 55,505

EFH

EFH

TANFOther

n = 29 of 105

11,525 of 55,505

n = 24 of 105

6,853 of 55,505

Alcohol and/or Other Drug (AOD) Use

24-month baseline period

Mental Health 24-month baseline

period

Medical Indicators12-month baseline period



Foster Care Placement In 12-Month Baseline Period

EFH children were less likely to have had a foster care placement and more than twice as likely to experience poor health conditions

IN BASELINE YEAR

Proportion with Poor Health StatusAmong those with Medical Coverage

EFH

TANFOther

n = 4 of 145 4,156 of 104,899

EFH

TANFOther

n = 6 of 145 2,164 of 104,8990 0



Coming Attractions . . .

• Youth at Risk of Homelessness (YARH) Planning Grant Predicting homelessness among youth exiting foster care

• Vulnerable Families Partnership and TANF PRISM Predicting homelessness among TANF households and providing information to

caseworkers on key risk factors

• Ending Family Homelessness (EFH) Evaluating the impact of the program on key outcomes for EFH participants

compared to a statistically matched comparison group of their peers

• Housing and Essential Needs (HEN) Evaluating the impact of HEN on key outcomes for recipients compared to a

statistically matched comparison group of their peers


Identifying Homeless and Unstably Housed DSHS Clients in Multiple Service SystemsAPRIL 2012 • Shah, Black, Felver

http://publications.rda.dshs.wa.gov/1457/

The Housing Status of Individuals Discharged from Behavioral Health Treatment Facilities

JULY 2012 • Shah, Black, Felverhttp://publications.rda.dshs.wa.gov/1460/

Impact of Housing Assistance on Short-Term HomelessnessAmong TANF, Disability Lifeline, and Basic Food recipients with recently recorded spells of homelessnessSEPTEMBER 2011 • Shah, Estee, Mancuso, Black, Felver


A Profile of Housing Assistance Recipients in Washington State: History of Arrests, Employment, and Social and Health Service Use

MARCH 2011 • Shah, Estee, Albrecht, Yette, Felver



Permanent Options for Recovery-Centered Housing: Year 1 Annual ReportJUNE 2012 • Galvez, Lucenko, Black, Felver


Intensive Case Management within a Supportive Housing Facility

OCTOBER 2008 • Shah, Mancuso, Nordlund, Felver


Behavioral Health Risk among TANF Parents: Links to Homelessness, Child Abuse and Arrests

DECEMBER 2010 • Shah, Mancuso, He, Estee, Felver, Beall, Fiedler


Washington State’s Housing and Essential Needs ProgramImpacts on Housing Status, Use of Food Assistance, Arrests, Incarcerations, and Health OutcomesJANUARY 2013 • Mancuso, Ford Shah, Black, Felver



For more Information . . . .

Mary [email protected]

Melissa Ford [email protected]


mary schwartz washington state department of commerce melissa ford shah

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