Ensuring Your Transitional Housing Program Meets HUD Performance Standards Martha Kenton, MSW, MUP Senior Consultant, Training & Consulting Services Center for Urban Community Services Rebuilding Lives, Sharing Knowledge, Shaping Systems
A special thank you for the support of FRANCES L. & EDWIN L. CUMMINGS MEMORIAL FUND
Introductions What is your name? What agency and program are you from? Name one positive thing you hope to achieve today In this training or in general
Training Objectives By the end of this training you will have an understanding of 1. What HUD expects from your program and from the NYC Continuum of Care 2. The impact of not meeting HUD performance expectations 3. What data HUD uses to measure performance 4. How to use sample tools to track process and outcome indicators 5. A framework for Continuous Quality Improvement (CQI) that can help your programs to achieve performance targets
Agenda Part I: NYCCoC and HEARTH Goals What is the NYCCoC? Overview of HEARTH Performance Measures under HEARTH Community level Program level APR Impact of performance Exercise Break
Agenda Part II: Performance Management Staff concerns that arise when using data to measure performance Benefits of using data to measure performance The CQI Cycle and sample tools Technology Culture Shift Wrap Up
Part I: HEARTH & NYC Coalition on the Continuum of Care 7
NYC Coalition on the Continuum of Care (NYC CoC) What is the Continuum? Annual competitive process for McKinney-Vento Homeless Assistance programs: Supportive Housing Program, Shelter Plus Care (S+C), and Section 8 Moderate Rehabilitation program (SR0) What does the Continuum require? Development of a CoC system to address homelessness through a coordinated community-based process Formation of a lead decision making group Data entry into a Homeless Management Information System What is the NYC Coalition on the Continuum of Care? The mission of the NYCCoC is to provide a leadership role in the prevention and eradication of homelessness in New York City. It is a broad-based coalition of homeless housing and shelter providers, consumers, advocates, and government representatives, working together to shape citywide planning and decision-making.
Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Homeless Emergency Assistance and Rapid Transition to Housing HEARTH provides communities with streamlined resources and better tools to prevent and end homelessness.
HEARTH Overview HEARTH aligns existing programs within a single Federal Strategic Plan To end chronic homelessness To prevent homelessness within identified vulnerable populations e.g. mentally ill adults, veterans, families, youth and children Supporting the pathway forward to end homelessness nationally HEARTH shifts performance measures emphasis By focusing on the entire homeless service system Through targeted attention on stated performance measured outcomes With reporting requirements streamlined through HMIS
HEARTH Overview: Changes to CoC Programs McKinney-Vento Continuum of Care 3 programs 1. Permanent Supportive Housing Program (SHP) 2. Shelter Plus Care 3. Section 8 Moderate Rehabilitation HEARTH Collaborative Applicant One CoC program Incorporates all previous program eligible activities More flexibility for mix/match eligible activities Up to 10% funding for administrative costs New measures require evaluating performance of ENTIRE homeless service system not just CoC funded programs
HEARTH Overview: Performance Measures HEARTH Act Community Level Performance Measures: Reduce average length of time persons are homeless Reduce returns to homelessness Improve program coverage (includes geographic and HMIS coverage) Reduce number of families and individuals who are homeless Improve employment rate and income amount of families and individuals who are homeless Reduce number of families and individuals who become homeless (first time homeless) Prevent homelessness and achieve independent living in permanent housing for families and youth defined as homeless under other Federal statutes
NYC CCoC 2011 Exhibit One: Performance Measures Program Level 2011 HUD Performance Measure 2011 HUD Goal 2011 NYC CoC Performance Difference between Target and Actual Percent of PSH participants remaining in PSH >6 Months Percent of exited TH participants who exited to permanent housing Percent of exited participants (all CoC funded projects) with employment income at exit > 77% 90% +13 > 65% 51% -14 > 20 23% +3 McKinney-Vento funded CoC projects only
HEARTH Overview: Key Performance Measures At least 65% of all exits from Transitional Housing programs must move into Permanent Housing Exits to PH will remain a HEARTH performance indicator for TH (HUD may change %) Permanent Housing Includes: Permanent Supportive Housing (e.g. Shelter + Care, SHP if permanent, VASH, Section 8 Moderate Rehab) Home ownership Rental (subsidized or unsubsidized) Shared living arrangements (if permanent)
Annual Performance Report (APR) How does HUD calculate our TH to PH placement performance? (Total Permanent Destinations 29a1+ Total Permanent Destinations 29a2) (Total Leavers 29a1 + Total Leavers 29a2)
Impact of Placement Performance What are the benefits of increasing placements to PH? What happens if you don t meet the HUD criteria?
Impact of Placement Performance Individual Level Impact: Most clients want a permanent place to live Placements to PH are more stable for clients Churning of clients through non PH settings could result in fewer transitional beds available for persons transitioning from the street or shelter Program Level Impact: Staff want to feel successful at placing clients in PH Failure to achieve HUD performance standard could result in monitoring findings, awards conditions, and/or recapture of funds
Impact of Placement Performance Continuum of Care Level Impact The reason we are all here and the purpose of the CoC is to get homeless people housed HUD considers anyone in these locations still homeless: Unsheltered, Emergency Shelter, Transitional Housing, Safe Havens Exits to PH locations will help performance on these HEARTH measures: Reduce average length of time persons are homeless Reduce returns to homelessness Reduce number of families and individuals who are homeless
Impact of Placement Performance Continuum of Care Level Impact NYCCoC competes for funds each year with other Continua nationally A lower overall score puts at risk HUD funds Bonus Funds: $6M for new housing annually Renewal Funds could also be at risk depending on appropriations
Pre-Training Assignment Review 22
Break 23
Part II Performance Management 24
Agenda Part II : Performance Management Concerns that arise when using data to measure performance Benefits of using data to measure performance Continuous Quality Improvement (CQI) cycle Performance Definition System Design Review of Sample Tools Data Management Evaluation and Analysis Adjustments Technology Creating a performance focused organizational culture
Performance Management: Creating the Link Provider Agency & Staff Goals Consumer Goals HUD & CCoC Goals
Question. Name the things that concern staff about using data to measure performance. What are the benefits?
Common Staff Concerns & Reactions Tracking data takes time away from working with clients You can t measure what we do We don t have the resources or technology we need We care more about people than numbers Data are often wrong What if the data make me/my program look bad I m not good at or I don t like math
Why Use Data to Support Performance? 1. We think we know things we don t 2. We think we should know things that we shouldn t 3. We don t know, what we don t know Anecdotal and impressionistic knowledge is often wrong. Clinician s illusion Outlier effect First/formative impressions Bias against disconfirmatory evidence Clarity/immediacy of most recent experience Organizational filtering 29
What is Performance Management? 30
Performance Management is NOT about. 1. Forms needed in triplicate 2. Spreadsheets no one looks at 3. Useless reports that are out of date before they are printed 4. Targets set by people removed from the action
Performance Management IS really about 1. Setting expectations and program goals 2. Clearly communicating expectations through performance management tools (e.g. dashboards, tracking tools, etc.) 3. Developing an ongoing process to review and refine program goals as programs grow and change 4. Making fiscal and programmatic decisions based on fact verses speculation 5. Building a strategy for improvement
How Do We Know What Indicators to Measure? Meaningful Should be consistent with core purpose. Should tell us something important or valuable about the effectiveness of our services. Measurable Should be quantifiable, or able to be represented with numbers. Manageable Staff must be able to obtain and use it without engaging in an overwhelming amount of work.
Continuous Quality Improvement Cycle 1. Performance Definition 2. System Design 3. Data Management 4. Evaluation and Analysis 5. Adjustments
Performance Definition: Other Factors to Consider in Choosing Indicators Always select at least one outcome indicator for each defined outcome: Outcome indicators are the ultimate measure of program performance Process indicators should be tracked, as well, when: The outcome isn t immediately measurable and you need an immediate way to track progress and make course corrections. They are known predictors of outcomes and will be useful in figuring out what is going right or needs to be adjusted.
Performance Definition: Outcome Indicator Core purpose: to permanently house homeless people Performance targets: HUD: At least 65% of all exits from Transitional Housing programs must move into Permanent Housing Program specific: Place at least x people into permanent housing each month.
Performance Definition: Process Indicators Core purpose: to support program goal of exits into permanent housing Process indicators used in monitoring progress: Identification Documents Current Medications Active Benefits Housing Documents Current Psycho-Social Psych Evaluation Status Letters PSH Application
Continuous Quality Improvement Cycle 1. Performance Definition 2. System Design 3. Data Management 4. Evaluation and Analysis 5. Adjustments
System Design: Building the System for YOUR Agency Structures for Tracking Placements into Permanent Housing Data tracking tools Policies & procedures for who will collect the data, enter the data, check data quality Quality assurance and regular internal audits Structures for Reporting on Performance Who needs to see the information? What information is needed at each level (Exec, Program Management, Staff)? Who is responsible for developing and disseminating reports?
System Design: Client Level Process Indicators Please take out Caseload Tracking Form, Sorted by Worker
System Design: Client Level Placement Projections Projected Future Permanent Exits As Of: January 31, 2012 February March April May, June & July 1 Maria P. 1 James K. 1 Tyrone D. 1 Anita F. 2 Jackson F. 2 George T. 2 Eric S. 2 Debra C. 3 Lou F. 3 Tanya C. 3 Robert W. 3 Laura L. 4 Lonnie D. 4 Anthony T. 4 George H. 4 Mary V. 5 Dawn M. 5 Courtney W. 5 John H. 5 Graham G. 6 Jenny M. 6 Robin L. 6 Mike G. 6 Martin M. 7 Lance G. 7 Tess B. 7 Will K. 7 Harry P. 8 Rick F. 8 Bakar W. 8 Carol L. 8 Louis B. 9 Aaron B. 9 Lauren P. (etc. should have 10 Emily C. 10 Erick S. approx. 30 names) Total Exits to Permanent Housing Total Exits (current month) Total Anticipated (next month) Total Targeted Exits to Permanent Housing 5 Monthly 5 10 Annual 60 Total Anticipated ( three months) 28
Systems Design: Client Level Outcomes Client Exits Month Client Name Permanent Setting Exit Destination Summary Temporary Setting Institutional Setting Other Jan Client 1 1 Jan Client 2 1 Jan Client 3 1 Jan Client 4 1 Jan Client 5 1 Jan Client 6 1 Jan Client 7 1 Jan Client 8 1 January Total 8 5 2 1 0 Feb Client 1 1 Feb Client 2 1 Feb Client 3 1 Feb Client 4 1 Feb Client 5 1 Feb Client 6 1 Feb Client 7 1 Feb Client 8 1 February Total 8 2 3 2 1
Systems Design: Management Dashboard Exit Destination Summary HUD Targets Program Targets Month Target Permanent Placements Actual Permanent Placements Actual Temporary Placements Actual Institutional Placements Other Total Percent Placed Percent Placed Monthly Into YTD into PH PH Percent Monthly Placement Target Achieved Percent YTD Placement Target Achieved January 5 5 2 1 0 8 63% 63% 100% 100% February 5 2 3 2 1 8 25% 44% 40% 70% March 5 5 0 1 2 8 63% 50% 100% 80% April 5 4 2 0 0 6 67% 53% 80% 80% May 5 1 1 0 2 4 25% 50% 20% 68% June 5 3 0 1 0 4 75% 53% 60% 67% July 5 3 1 0 0 4 75% 55% 60% 66% August 5 3 1 0 0 4 75% 57% 60% 65% September 5 2 0 2 0 4 50% 56% 40% 62% October 5 6 0 1 2 9 67% 58% 120% 68% November 5 1 0 0 0 1 100% 58% 20% 64% December 5 5 1 0 1 7 71% 60% 100% 67% Monthly Total 60 40 11 8 8 67 Percent Placed Annually into Permanent Housing 60% 16% 12% 12% 100%
Continuous Quality Improvement Cycle 1. Performance Definition 2. System Design 3. Data Management 4. Evaluation and Analysis 5. Adjustments
Data Management: Day-to-day Execution of the System You Built Data Management Who collects data? Where does the data come from? Who enters it? Who checks it for accuracy?
Continuous Quality Improvement Cycle 1. Performance Definition 2. System Design 3. Data Management 4. Evaluation and Analysis 5. Adjustments
Evaluation and Analysis Four steps to incorporate performance management into your everyday practice: 1. Review Performance Reports and Compare to Targets Staff at all levels: Exec, Program Management, Line Staff 2. Identify Opportunities for Improvement 3. Analyze Opportunities for Improved Performance 4. Hypothesize Factors Limiting Current Performance
Continuous Quality Improvement Cycle 1. Performance Definition 2. System Design 3. Data Management 4. Evaluation and Analysis 5. Adjustments
Adjustments It s not a useless report if you use it! Brainstorm as many ideas as possible with your team about how to change factors to improve performance Decide which things are most likely to be manageable and effective Implement change
Adjustments It s not a useless report if you use it! Monitor how the changes are impacting performance Adjust practice to keep making progress. Adjust targets when you are unable to generate change proposals that can improve performance sufficiently or you are meeting or exceeding the target and you think you can do even better! Celebrate success!
Technology 52
Technology & Training A simple spreadsheet can improve your ability to track and analyze process and outcome indicators HUD reporting requirements place significant focus on electronic submissions Job expectations for staff at every level should require use of data tracking tools Ongoing support of staff to learn the principles and mechanics of performance and data management will improve the overall program Reducing reporting errors, expanding internal capacity
Shifting Culture 54
Wrap Up: Cultural Shifts May Be Necessary Move Away From Data is collected for external reports Data as a burden Move Towards Data for internal improvement Data as a useful tool Only the manager knows Sharing knowledge across staff Culture of blame and excuses Culture of shared accountability
Wrap Up: Cultural Shifts May Be Necessary Move Away From Functional or program silos Move Towards Cross-function teams Focus on barriers not in your control That is not relevant to my job Fear of breaking rules and patterns Focus on things you can change to strengthen your performance How can I help us reach our team goal? Support for making mistakes and trying new strategies Adapted from Good Stories Aren t Good Enough by Martha A. Miles
Wrap Up 57
Where to Go for Further Support HUD Homeless Resource Exchange www.hudhre.info http://www.hudhre.info/index.cfm?do=viewshpdeskguidec National Alliance to End Homelessness http://www.endhomelessness.org/section/_2011conferencepresentations/_he arthact
Follow Up Consultation Application Deadline for Consultation Services February 24 th General Eligibility Criteria The program applying for technical assistance is a Transitional Housing Program provider. The program applying for technical assistance receives SHP funds through the NYC Coalition on the Continuum of Care. The program applying for technical assistance has experienced consistent low performance in the last two reporting years (i.e., <65% placement to PH in FY10 and FY11). A senior staff member (e.g. program director or similar) has attended the half day training on Continuous Quality Improvement (CQI) provided by CUCS on either February 10th or 14th.
Thank You! For further information regarding materials discussed in the training please contact: Martha Kenton, Senior Consultant (212) 801-3363 or martha.kenton@gmail.com