Resources to Results - Thrive Washington · Resources to Results The Washington State Pay for...
Transcript of Resources to Results - Thrive Washington · Resources to Results The Washington State Pay for...
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Resources to Results
The Washington State
Pay for Success Symposium
November 18, 2015
#pfswa
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Host Committee
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Resources to Results
The Washington State
Pay for Success Symposium
November 18, 2015
#pfswa
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Keynote
David Wilkinson Director
White House Office of
Social Innovation & Civic Participation
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Life Cycle of Pay for Success
Moderator Caroline Whistler, Co-President and Co-Founder, Third Sector Capital Partners
Panel
§ Louis Chicoine, Exec. Dir., Abode Services § Brenda Van Gorder, Dir. of Title 1 Preschool
Program, Granite School District, Salt Lake City § Fraser Nelson, Dir. of Data and Innovation, Salt
Lake County § Greta Hansen, Lead Deputy County Counsel,
County of Santa Clara
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© 2015, Third Sector Capital Partners, Inc. 6
Target Population
• 150-200 costliest chronically homeless individuals – 112 total housing units
Intervention • Delivered by Abode Services • Permanent supportive housing: Housing
First plus Modified Assertive Community Treatment
Funders & Grantors
• The Reinvestment Fund; CSH; The Sobrato Family Foundation; The Health Trust; The California Endowment; The James Irvine Foundation; Google.org; Laura & John Arnold Foundation (Evaluation Grantor)
• Palantir Technologies (Technology Partner)
Goal • Improve health and wellbeing of chronically
homeless individuals while reducing costs
Capital Structure • $6.9 million in upfront financing from
commercial and philanthropic funders
Project Budget
• $24M: $8M in possible success payments plus $17M in County-funded housing and mental health services
Success Payments Based on number of months of stable tenancy: • Lease plus verified tenancy in unit • Minimal time in jail or shelters
Project Overview Project Success Payments
Evaluation Evaluator: UCSF School of Medicine (M. Kushel and M. Raven) Evaluation Design: Randomized controlled trial to assess efficacy of project in reducing costs and improving wellbeing of target population (not tied to success payments)
Project Welcome Home
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© 2015, Third Sector Capital Partners, Inc. 7
Target Population
• 250+ severely mentally ill adults who are frequent users of the County’s emergency and inpatient psychiatric facilities
Intervention
• Delivered by Telecare Corporation • Intensive Assertive Community Treatment • Housing support
Timing • 6 year project
Based on cost savings achieved by reducing County expenditures on: • Purchasing beds from non-County inpatient
psychiatric hospitals • Reduced/optimized utilization of emergency
and inpatient psychiatric facilities
Success Payments • Avoided utilization of emergency and
inpatient psychiatric services for clients enrolled in the program
Unique Characteristics
• First Mental Health PFS project
Project Overview Project Success Payments
Project Budget
Goal
• Improve health and wellbeing of severely mentally ill individuals while reducing costs
Evaluation Evaluator: Stanford School of Medicine Dept. of Psychiatry (K. Humphreys) Evaluation Design: Randomized controlled trial to assess efficacy of project in reducing costs and improving wellbeing of target population
Acute Mental Health Needs PFS Initiative
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Utah High Quality Preschool Program
Project Overview
§ Financing to expand access to high quality preschool to district’s most impacted children to improve school readiness and long term academic performance
Popula@on Served
§ 5 cohorts of 3-‐ and 4-‐year old children who are low income and have other iden@fied risk factors.
§ 6 programs involved: 2 Public School Districts, 1 Charter School, 1 non-‐profit and 2 for-‐profit child cares
Success Indicator(s)
§ Payment trigger – special educa@on assignment § Other successes measured: school readiness, proficiency on statewide
assessments, other longitudinal data
Ini@al Investment
$7 million
Investors Goldman Sachs; J.B. Pritzker
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Salt Lake County
Project Overview
§ A porYolio approach to address three cri@cal issues related to the county’s priority of criminal and social jus@ce reform: Recidivism, homelessness, maternal and child health
Popula@on Served
§ Individuals at high risk of recidivism § Persistently homeless individuals § Low income mothers and infants
Success Indicator(s)
§ Reduc@on in recidivism/use of jail beds; stable housing; maternal/child health; income
Ini@al Investment
§ Development fund of $1.2M; have not begun raise fund for projects
Investors § CRA banks, philanthropy, NFF grant, loans
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Project Welcome Home
Project Overview
§ Permanent supportive housing for 150-200 of the costliest chronically homeless individuals in Santa Clara County, CA using 112 units/year
Population Served
§ Chronically homeless individuals who are the most “frequent users” of county services
Success Indicator(s)
§ Increased months of stable tenancy in permanent supportive housing
§ Improved health § The well-being of acutely chronically homeless individuals
Initial Investment
§ $6.9 million
Investors
§ The Reinvestment Fund, Corporation for Supportive Housing, Sobrato Family Foundation, California Endowment, Health Trust, James Irvine Foundation, Laura and John Arnold Foundation, Google.org, Abode Services
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Serves 4,400+ adults and children each year
Strong fiscal and management infrastructure
Proven ability to lead large, mul@-‐agency collabora@ons
Ongoing commitment to evidence-‐based prac@ces and measurable impact
$29 million agency
Overview of Abode Services
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Housing First Model
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• Housing First -‐ Proven, effec@ve, cost-‐saving approach for people experiencing chronic homelessness.
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Building Systems through Pay for Success
David Willis Director
Division of Home Visiting and Early Childhood Systems, Health Resources and Services
Administration
U.S. Dept. of Health and Human Services
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Emerging Opportunities
Moderator Megan Golden, Dir. of Pay for Success Financing, Institute for Child Success
Panel
§ David Willis, Dir. of Division of Home Visiting and Early Childhood Systems, Health Resources and Services Administration, US Dept. of Health and Human Services
§ Nathan Johnson, Chief Policy Officer, Washington State Health Care Authority (Project Representative)
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HVSA and Pay for Success
Feasibility Study • Will determine if Pay for Success
funding model can significantly expand, strengthen and sustain proven home visiting programs statewide
By spring 2016, study will tell us: • How we can strengthen and continue to build our entire
home visiting system. • If the Pay for Success model could be a good fit to support
Washington state’s home visiting work. If yes, our state will then need to decide if we should use it.
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• Created by state Legislature in December 2010. Brings together state, federal and private dollars to support a porYolio of high-‐quality proven and promising home visi@ng programs – and make sure they deliver results.
About
• More than 2,000 children and their families in some of our state’s most vulnerable communi@es have access to these programs.
Popula@on Served
• Voluntary, early and proven interven@on • Pairs professionals with expec@ng and new families to work together on a regular basis in the home
• Strengthens families and gives children best start possible: Improve maternal/child health, family bonds and self-‐sufficiency, and school readiness.
Why A Strong Investment
• $11.6M Current Budget
Home Visiting Services Account
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The Health Care Authority’s PFS Feasibility Study
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• Houses 75 homeless individuals w/ chronic alcohol addiction
• Low-barrier; harm reduction; housing-first
• Journal of the American Medical Association:
• Average health and social services cost savings of 53 percent per resident
• Saved taxpayers over $4 million in first year of operation
Success Story: 1811 Eastlake (DESC)
*hlp://www.desc.org/documents/DESC_1811_JAMA_info.pdf Better Health, Better Care, Lower Costs
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The HCA PFS model
Better Health, Better Care, Lower Costs
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• Scope is critical – PFS is an opportunity to support effective,
innovative services for specific, high-needs populations
• Communication is key – Because PFS is a relatively new concept, it is
easily misunderstood
• Now is the Opportunity – Community support is strong and
policymaker support is growing
Key lessons learned so far
Better Health, Better Care, Lower Costs
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Join the Healthier Washington Feedback
Network: [email protected]
Learn more:
www.hca.wa.gov/hw
Better Health, Better Care, Lower Costs
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Role of Funders & Investors
Moderator Ian Galloway, Senior Research Associate, Federal Reserve Bank of San Francisco
Panel
§ Annelise Grimm, Program Officer, The James Irvine Foundation
§ Deborah Kasemeyer, Senior Vice President, Northern Trust
§ Andrea Phillips, Vice President, Goldman Sachs Urban Investment Group