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HomeMy WebLinkAbout2020+FMCoC+CES+Evaluation_1 FMCoC CES Evaluation January 2020 – December 2020 O VERVIEW The Fresno-Madera Continuum of Care (FMCoC) conducts annual evaluations of its Coordinated Entry System (CES) to comply with HUD regulations and improve the quality of its intake, assessment, referral, and matching processes to benefit clients who are or h ave been experiencing homelessness. Different aspects of the system are covered in different years in order to build up a knowledge base that covers all aspects of CES. In 2019, the evaluation focused on staffing patterns and on the availability of physical access sites. For 2020, the evaluation will focus on the quality of CES data in the Homeless Management Information System (HMIS). The availability of the Real - Time Coordinated Entry Bed Opening Tracker in Google Sheets and the By-Name List maintained in Microsoft Excel to provide a useful opportunity to cross-check the quality of the CES HMIS data against related sources. HMIS D ATA On May 24, 2021, Homebase generated an APR for the “Coordinated Entry” project for the time period between 1/1/2020 – 12/31/2020. This APR should capture all clients who were in the Coordinated Entry project for any portion of calendar year 2020. The APR would include both clients who remained in the project at the end of 2020 (“stayers”) and clients who left the project sometime during 2020 (“leavers”). According to the APR, there were 2,966 clients served in the Coordinated Entry project. 740 of those clients had an entry, update, exit, or case note filed in HMIS during the last 30 days of 2020; this roughly corresponds to the number of clients that would be considered “active” on the by-name list. Of the 2,966 total clients, there were 2,252 stayers and 714 leavers. 2,361 of the clients were adults, and 602 were children under age 18. The total included 87 veterans, 583 people experiencing chronic homelessness, 412 people with a mental or behavioral health issue at entry, 328 people with a physical disability at entry, 194 people fleeing domestic violence, 1,410 males, 1,534 females, 14 transgender people, 226 people over the age of 62, 651 people who identified as Black or African-American, 124 people who identified as Native American, 1,509 people who identified as Hispanic, 66 people who identified as Asian or Pacific Islander, and 113 people who identified as multi-racial. The vast majority of the clients in the system entered the coordinated entry system from an emergency shelter (741) or a place not meant for human habitation such as streets, parks, and 2 tents (1,147). The next-most common origins were people who were staying with family (104), staying in a friend’s house (89), renting their own unit (50), or in a substance abuse facility (39). Most of the adults using the CES had no income (1,036). Of those who did have at least some income, the most common range was $500 to $1,000 per month (227). It was slightly more common for clients to report high income ($2,000 per month or more – 70 adults) than to report very low income ($150 per month or less – 41 adults). The most common sources of income were Supplemental Security Income (208 adults) and General Assistance (129 adults). No clients received an annual follow-up assessment of their income after staying in the coordinated entry program for a full year, even though 333 clients were due for such an assessment. Most participants in Coordinated Entry were never asked about their health insurance (1,774 clients), although of those whose health insurance status were recorded, it was more common for clients to have health insurance (983 clients) than to not have health insura nce (220 clients). However, the initial Coordinated Entry systems was never designed to capture health insurance data as it was meant to be determined by whatever agency the participant was referred to for services. Further, participants who are referred to diversion programs are not assessed using a VI-SPDAT and therefore not added to the by-name list and may not be properly closed out once their situation is resolved. The most common “length of participation” in the Coordinated Entry Program was 181 to 365 days (1,165 clients). Another 448 clients were recorded as being in the program for 1 to 2 years. 601 clients were recorded as exiting to permanent destinations such as a Rapid Re-Housing project or a rental by the client with no ongoing subsidy. 36 clients exited to temporary destinations such as motels or places not meant for human habitation. 12 clients exited to institutional settings such as substance abuse treatment centers. 41 clients left the project without completing an exit interview. B Y -N AME L IST D ATA The by-name master list is intended to capture all people who have been identified as experiencing homelessness by the Coordinated Entry System. There were 401 clients added to the by-name list between 1/1/2020 and 12/31/2020. Homebase gathered data on these clients based on the most recent available version of the by-name list as of the time this report was being written, which was dated 5/27/2021. Of the 401 clients who joined the by-name list during the 2020 calendar year, 142 clients were considered “active” records, i.e., records where there was at least some contact with the client within the last 90 days. On average, it has been 366 days – a full year – since clients who were added during 2020 were recorded as having contact with the Coordinated Entry System. This does not include 70 clients for whom no date of last contact was recorded. Even among the active clients who were added in calendar year 2020, the average time since last contact is 86 3 days – several clients are listed as active despite having as many as 175 days with no contact with the system. Most clients are being added to the by-name list shortly after they are identified as homeless. In 2020, the average delay was 15 days. All clients who were added to the by -name list in 2020 have a recorded VI-SPDAT score, with a mean score of 7.03 and a standard deviation of 2.69. This means that most people on the list have a VI-SPDAT score between 4 and 10. For clients within this range, 36% were matched to a particular project or priority list, and 50% had an exit to permanent housing. Clients with higher VI-SPDAT scores (11 or above) were more likely to be matched but less likely to succeed; 46% of them were matched to a particular project or priority list, but only 41% had an exit to permanent housing. Clients with lower VI-SPDAT scores (1, 2, or 3) had somewhat better results, with 48% matched to a particular project or priority list, and 76% exiting to permanent housing . All 483 of the active clients on the by-name list (including both clients who joined the by-name list in 2020 and clients who joined the by-name list in other years) have been assigned a navigator. There were 28 navigators in the by-name list who had 3 or fewer active clients, compared to only 16 navigators who had 10 or more active clients, suggesting that there is either a problem with updating the names of navigators, or that many navigators are only occasionally participating in the Coordinated Entry System. R EAL -T IME B ED O PENING T RACKER D ATA The FMCoC rolled out a real-time bed opening tracker for the Coordinated Entry System in February 2020. The first few months of data are somewhat unreliable because agencies were still learning how to use the new system. However, a ll CoC-funded agencies as well as Centro La Familia and Selma Com used the Google Sheet to enter the number of openings they ha d in each program each week during the period from 8/3/2020 through 12/31/2020. Where available, the number of openings is given in terms of the total number of beds in the relevant programs; e.g., 4.29 out of 22 means that the programs were funded to have 22 beds, and an average of 4.29 of those beds were open in any given week. ES, TH, Bridge Housing, and other Programs Availability RRH Availability PSH Availability Cap Madera n/a Accepting an unknown number of referrals 4.29 out of 22 4 Centro La Familia n/a 0.5 out of 15 n/a Fresno Economic Opportunity Commission 4.8 0.6 out of 36 0 out of 63 Marjaree Mason Center 9.31 8.58 out of 39 n/a Fresno Housing Authority n/a 8 out of 25 27.92 out of 158 Mental Health Systems 0.75 n/a 0.22 out of 15 Selma Com 0.5 4 out of 15 n/a Turning Point of Central California 3.4 Accepting an unknown number of referrals 0 out of 106 WestCare 3.43 0.58 0 out of 15 TOTAL 22.19 22.26 out of 130 (17%) 32.43 out of 379 (8%) As shown in the table above, there were a higher share of openings in RRH projects than in PSH projects. In fact, many PSH projects reported 0 openings throughout the entire measurement period. Although PSH often has limited turnover, it is possible that the rows of zeros represent either an error in data entry or an agency prac tice of filling some openings outside the Coordinated Entry System. Within any given agency, the bulk of openings were often concentrated in a single project, suggesting that those projects may be experiencing unusual barriers to filling their beds. If those projects continue to have concentrated openings in 2021, it may be appropriate to target those projects with technical assistance. Agencies have been encouraged to report a specific number of openings even for RRH projects, and so far, the 2021 data suggests increased compliance on that topic. 5 Taken as a whole, the rate of openings is somewhat high and suggests that there is work to be done to improve (a) the willingness of projects to accept referrals for all of their beds, and/or (b) the efficiency of the assessment, matching, and referral process. Because the FMCoC region still has over 2,000 people experiencing unsheltered homelessness, most housing opportunities should be filled very shortly after they become available. ACCESS SITES AND SPECIAL POPULATIONS Through most of 2020, the only physical access sites were in downtown Fresno: MAP Point at Poverello House, Naomi’s House, Golden State Triage Center, and The Welcome Center. Although street outreach teams and phone hotlines help provide broader geographic coverage, it is also important for clients to be able to physically travel to an access site to receive services and participate in intake. HUD Notice CPD-17-01 allows for separate access points and variations in assessment processes to the extent necessary to meet the needs of the following five populations: 1) Adults without children 2) Adults accompanied by children 3) Unaccompanied youth 4) Households fleeting domestic violence, and 5) Persons at risk of homelessness. In addition, although CoCs may not establish a separate access point for veterans, the coordinated entry process may allow Veterans Administration (VA) partners to conduct assessment and make direct placements into homeless assistance programs in collaboration with the CoC. To date, the only separate access points or variation in process that has been extensively employed by the FMCoC’s Coordinated Entry System is the one for households fleeing domestic violence. Survivors of domestic violence are served by two dedicated DV Bonus Grants that fund coordinated entry services, including DV-specific street outreach, a parallel by-name list for DV survivors, a parallel database for tracking outcomes, and a variety o f DV-specific shelters, transitional living facilities, and rapid re-housing programs. Program managers for Marjaree Mason Center, the largest DV-specific provider in the region, work closely with the management of the Coordinated Entry System to provide maximum flexibility for DV survivors without compromising their safety. The CoC also collaborates with the local VA office to assist with referrals for VA vouchers and with the placement of homeless veterans. Clients are assessed and referred by the Coordinated Entry System with an awareness of their family status in order to match them with programs that will best meet their needs, but there are no separate access sites for adults, families, or unaccompanied y outh. Instead, all types of households are served at all access sites. Similarly, people at risk of homelessness are welcomed at ordinary CES access sites; one of the first steps in the assessment process for all 6 households is to determine whether the household is homeless, at risk of homelessness, or neither. As a result, services for people at risk of homelessness are an organic part of the primary Coordinated Entry intake procedure. ANALYSIS AND RECOMMENDATIONS There were significant discrepancies between the by-name master list kept in Microsoft Excel and the Annual Performance Report based on HMIS data. For example, the by -name list showed 1,974 total clients from all years, of which only 486 were coded as ‘active’, but the HMIS report showed 2,966 total clients from all years, of which only 186 were coded as ‘active’. Of these 186 active records, only 123 matched a name on the by-name list. 773 of the 2,966 total clients had been assessed using the VI-SPDAT, VI-FSPDAT, or TAY-VI-SPDAT. The Coordinated Entry Committee discusses whether there were enough VI-SPDAT trained assessors in the CoC and wanted to look into this during future discussions. Moreover, 227 of the entries on the by -name list for 2020 had no HMIS ID associated with them, even though most of those 227 entries had a full name and a full birthdate in the by - name spreadsheet. The caseload assignments for navigators would require them to work with many clients at a time, but most of the navigators in the by -name list are only officially assigned to 3 or fewer clients. To resolve these discrepancies, more staff time will need to be dedicated to data entry, data cleaning, and data analysis. Much of this work has traditionally been done on a volunteer basis, with staff donating their time to improve the quality of the data on an ad hoc basis, as and when their other job duties permit it. However, this volunteer work has fallen significantly behind the community’s needs. As the Coordinated Entry System continues to grow, there is an increasingly strong need for professional, full-time data management. The FMCoC is currently considering the selection of a management entity that can fulfill this role. Another opportunity for improvement is to try to merge the by -name list into HMIS, eliminating the need for double-entries. This will require both adding additional features to the HMIS platform (so that it can deliver most or all of the functionality of the current by -name list) and increasing the availability of training and licenses for HMIS, so that the broadest possible cross- section of the community will still be able to contribute data to the by -name list. In terms of access sites, the community needs to continue to work on adding new physical access points outside downtown Fresno. New access si tes have opened in the less-dense towns of Selma and Sanger, and CAP Madera has committed to operating an access site in the City of Madera. These are important signs of progress, but more work is needed: access sites should be opened in additional locations to provide truly complete geographic coverage. Moreover, the new access sites should be fully supported so that they can provide high -quality intake services throughout their hours of operation.