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
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2DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
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3DSHS | Research and Data Analysis Division ● MAY 22, 2014
PART 1
Overview of Two Efforts to End Homelessness in Washington State
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4DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
5DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
6DSHS | Research and Data Analysis Division ● MAY 22, 2014
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:
7DSHS | Research and Data Analysis Division ● MAY 22, 2014
• 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
8DSHS | Research and Data Analysis Division ● MAY 22, 2014
PART 2
DSHS and Commerce Research and Data Partnership
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9DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
10DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
11DSHS | Research and Data Analysis Division ● MAY 22, 2014
PART 3
Identifying Chronically Homeless Individuals in Washington State
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12DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
13DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
14DSHS | Research and Data Analysis Division ● MAY 22, 2014
Characteristics of Washington’s Chronically Homeless PopulationDEMOGRAPHICS
TOTAL = 4,345*
n = 1,573 n = 699n = 359 n = 1,462n = 2,760
*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.
15DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
*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.
16DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
*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.
17DSHS | Research and Data Analysis Division ● MAY 22, 2014
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%
18DSHS | Research and Data Analysis Division ● MAY 22, 2014
PART 4
Data on the Ending Family Homelessness Pilot
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19DSHS | Research and Data Analysis Division ● MAY 22, 2014
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/
20DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
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/
21DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
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/
22DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
23DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
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/
24DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
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/
25DSHS | Research and Data Analysis Division ● MAY 22, 2014
Percent Homeless or Unstably Housed: April 2011-March 2012
2011 2012
EFH Parents
Other TANF Parents
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/
26DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
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/
27DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
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/
28DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
29DSHS | Research and Data Analysis Division ● MAY 22, 2014
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
http://publications.rda.dshs.wa.gov/1443/
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
http://publications.rda.dshs.wa.gov/1438/
30DSHS | Research and Data Analysis Division ● MAY 22, 2014
Permanent Options for Recovery-Centered Housing: Year 1 Annual ReportJUNE 2012 • Galvez, Lucenko, Black, Felver
http://publications.rda.dshs.wa.gov/1462/
Intensive Case Management within a Supportive Housing Facility
OCTOBER 2008 • Shah, Mancuso, Nordlund, Felver
http://publications.rda.dshs.wa.gov/1367/
Behavioral Health Risk among TANF Parents: Links to Homelessness, Child Abuse and Arrests
DECEMBER 2010 • Shah, Mancuso, He, Estee, Felver, Beall, Fiedler
http://publications.rda.dshs.wa.gov/1429/
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
http://publications.rda.dshs.wa.gov/1476/
31DSHS | Research and Data Analysis Division ● MAY 22, 2014
For more Information . . . .
Mary [email protected]
Melissa Ford [email protected]
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