Using Data in Santa Clara County · Santa Clara County Homeless Census & Surveyiii • Sheltered...

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USING DATA IN SANTA CLARA COUNTY’S SUPPORTIVE HOUSING SYSTEM

July 11, 2018 California Homeless Coordinating and Financing Council

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The “Perfect” System

Everyone is assessed for necessary housing services.

Completely reliable assessment tool to determine the appropriate housing interventions that are needed for each household.

All agree on how scarce housing resources are prioritized.

All programs only take referrals from the countywide system.

All programs adhere to common performance measures and record all information in a common data system.

We have consistent access to administrative data to support the assessment tools and to report on the impact of housing programs on safety-net systems.

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AGENDA

Office of Supportive Housing Data Sources

Coordinated Assessment System (CAS)

Performance Reporting and Outcomes

Office of the County Executive

Housing & Community Development

Permanent & Temporary Housing Programs

Continuum of Care

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l/) C

8,000

~ 6,000 L.. a,

(L

l/)

~ 4,000 a, E 0

I 2,000

Santa Clara County Homeless Census & Survey iii

• Sheltered • Unsheltered

7,067 7,631

6,556

7,394

0 ----------------------January January January January 2011 2013 2015 2017

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Typical Data Source: PIT / Census & Survey

Sheltered vs. Unsheltered

Demographics

Veteran Status and Special Populations

Jurisdictions / Locations

Causes of Homelessness

-Duration Out of the more than 100,000 people that experienced homelessness from 2007 through 2012, during those six years:

were

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homeless for 1 month

YEARS O F HOMELESSN ESS

were homeless. were homeless fo r2-6 • for7-11 months months

• were homeless for 1 year -23 months

2

were. homeless for 2 years • •

or more

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Home Not Found: Cost of Homelessness in Silicon Valley

Duration of Homelessness:

2017 PIT: 64% had been homeless one year or more

-$5,20 Ml ,LLION /YEAR

providing: s,ervices for homeless residents over the six-year study

~USTIC SYSTEM

THE LARGEST & MOST COMPREHENSIVE COST STUDY OF HOMELESSNESS IN THE USA 104,206 individuals in Santa Clara County over 6 years - between 2007 and 2012

HOUSING 1000

Pre-housing $62,473

Post-housing $19,767

--n.n

n.n

Reduction of $42,706

For the 103 homeless residents in the tenth cost decile who were housed through Housing 1000 program, the estimated average annual pre-housing public cost was $62,473. The estimated average post-housing cost was $19,767, a reduction of $42,706 annually.

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Costs and Cost-Avoidance

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= • � -= iiiiiiil ii • � - �

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Annual Agency Costs for Homeless Residents by Decile

$90,000 Cost data in 2011-2012,

Probation shown in 2014$ $80,000 Custody Mental Health

Custody Medical $70,000 Jail and Courts

80% received <$8,000 Foster Care $60,000

in benefits & services

Annu

al C

ost i

n 20

14 $

General Assistance

CalWORKs $50,000

Food Stamps Top, 10th Decile = 54%

of public costs $40,000 Homeless Services

Drug & Alcohol Rehab. $30,000 Emerg. Med. Transport.

Mental Health Outpatient

1st d

ecile

2nd

decil

e

3rd

decil

e

4th

decil

e

5th

decil

e

6th

decil

e

7th

decil

e

8th

decil

e

9th

decil

e

10th

dec

ile

Top

5%

$202

$952

$1,8

72

$6,1

89

$4,8

18

$3,8

85

$2,8

73

$46,

995

$7,6

72

$83,

083

Priv. Hosp. Inpatient & ER

$11,

294

$10,000

$20,000 Top 5% = 42% of public Mental Health Inpatient

costs VMC ER & Clinic

VMC Inpatient $0 Source: Economic Roundtable analysis; Source: Linked records for 96,857 individuals with costs in 2011 and/or 2012, presented in $2014.

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Odds Compared to All Homeless of Being in Different Cost Groups based on Individual Attributes

AGE 0-17 Years

18-24 Years 25-34 Years 35-44 Years 45-54 Years

55+ Years ETHNICITY

African American Asian

Euro. American Latino

Pacific Islander Other

SEX Female

Male OTHER FACTORS

Foreign Born Chronic Homeless Substance Abuse

Mental Illness Dual Diagnosed

Tri-Morbid Foster Youth

Bottom 95% of costs

Costs that spike into the top 5% and then drop

Top 5% with continuing high costs

0 1 2 3 4 5 6 Odds of Being in Different Cost Groups

(>1 = Higher Odds)

Odds Compared to All Homeless of Being in Different Cost Groups Based on Medical Diagnosis

Infectious Disease (001-139)

Neoplasm (140-239)

Endocrine Disorder (240-279)

Blood Disease (280-289)

Mental Disorder (290-319)

Nervous Sys. Disease (320-389)

Circulatory Diseases (390-459)

Respiratory Diseases (460-519)

Digestive Disease (520-579)

Genitourinary Disease (580-629)

Comp. of Pregnancy (630-679)

Skin Diseases (680-709)

Musculoskeletal Dis. (710-739)

Congenital Anomalies (740-759)

Perinatal Conditions (760-779)

Ill-Defined Conditions (780-799)

Injury and Poisoning (800-999)

Health Hazards (E & V codes)

Psychosis (290-299)

Schizophrenia (295)

Bottom 95% of costs

Costs that spike into the top 5% and then drop

Top 5% with continuing high costs

0 1 2 3 4 5 Odds of Being in Different Cost Groups

(>1 = Higher Odds) Source: 33,582 persons with complete cost data from all departments who were in Santa Clara County all years 2007-2012.

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-Total Permanently Housed ITOTALI 5,154

1,212 1201sltttttttttttt· 12m6lttttttttttttttttttt 120111tttttttttttttttttttt•

1,883 2,059

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Progress

As measured by biannual point-in-time counts: Continued reductions in chronic homelessness

Continued reductions in veteran homelessness

-Access Points Standard Assessment

~ Shelters

Outreach

fl>I Services

THP

Community Queue Housing Referrals

t -- - -- - -- - -- - --•

PSH

t -- ---- --- -----•

Moderate AcultV..,

--------,, t RRH

Refer to Other Services

---. ~

EAN ~ / ~ Public Benefits

Affordable Housing

TH

·----------------------------------------

~---------------------------------------~ I I I I I I I I I I I I I

·-----------------------------------------

Coordinated Assessment System

Permanent Supportive Housing

Score of 9+ for Families w/Children

Score of 8+ for Individuals

Rapid Rehousing Score of 4-8 for Families

w/Children Score of 4-7 for Individuals

Minimal Intervention Score of 0-3

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Acuity of assessed households over time

3500 60.0% 56.5%

Ded

uplic

ated

Firs

t Ass

essm

ents

0 2015 2016 2017 Projected 0.0%

2018 2015 2016 2017 2018 Calendar Year Acuity

19.2% 21.8%

18.1% 16.0%

47.3% 49.4%

47.2%

24.3%

30.9% 32.5% 36.9%

No housing intervention RRH PSH No housing intervention RRH PSH

3000

Perc

emt o

f H

ouse

hold

s A

sses

sed

50.0%

2500 40.0%

2000

1500 30.0%

1000 20.0%

500 10.0%

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For example: Acuity by gender

Trans Male

Trans Female

Gender Non-Conforming

Male

Female

No housing intervention RRH PSH

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0%

Female

16.1% 48.3% 35.5%

Male

24.0% 54.9% 21.1%

Gender Non-Conforming

0.0% 63.6% 36.4%

Percent oh Households Assessed

Trans Female

5.9% 49.0% 45.1%

Trans Male

22.2% 33.3% 44.4%

No housing intervention RRH PSH

\

15,296 VI-SPDATs Households

1,543 Families with

7 Justice Discharge

Nov 15, 2015 – Dec 31, 2017 12,138 Unduplicated

10,008 Individual 580 Youth Children Adults VI-SPDAT Type

-Referrals by intervention range over time

Refe

rral

s

1200

1000

800

600

400

200

0

815

238

PSH RRH

259 463

197

60

2016 2017 Jan-Apr 2018 Calendar Year

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Inflow Exceeds Housing Placements

421 460

380 416

395

449 425 433 422

348 385

367

161 181

139 178

143 152 124

146 134 128 162 148

Households Entering the Coordinated Assessment System and the Number of

Households Housed

Households who took the VI-SPDAT Assessment for the First Time

Households Placed in Housing

73 79 66 66 77 83 74 78 81 57 59 73

208 209 194 200 195 218 228 238 212 169 193 160

140 172

120 150 123

148 123 117 129

122 133 134

421 460

380 416 395

449 425 433 422

348 385 367

Number of Households Entering the Coordinated Assessment System at Each Level of Intervention

PSH, RRH, Minimal Intervention

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System-wide Housing Placements

Annual Housing Placement Trend (Households Housed in Current Month + Prior 11 Months)

2,500

2059 2063 2088 2077 2059 19662033 20142,000 2009 2008 1920

1,500

1,000

500

0 JUN-17 JUL-17 AUG-17 SEP-17 OCT-17 NOV-17 DEC-17 JAN-18 FEB-18 MAR-18 APR-18

-iiii Iii - - - - - -

,'I " ,'I ,'I ,eo ,eo ,eo ,eo ,'I ,'I ,'I ~ '<~- ~ ~

,'I ,.__, ~- u ~ ~ ~ .:i>'v 0' ~- oc; ~o <:)'¢ --,'?'

4.' ~ ~'<) ~ ~

,<o ,<o ,<o ,<o ,'I ,'I ,'I ,'I ,'I ,'I ,'I " ~ '<~ ~ ~ ,.__, ~- u

~ ~ .:i>'v 0' ~- ,;)'¢ --,'?' 4.' ~ q:; oc; ~o ~ ~ ~

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Housing Placements by Program Type

Permanent Supportive

Housing

Rapid Rehousing

48 60

50

76

42 40 31 36 32 29

41 44

Number of Households Housed Monthly via a Permanent Supportive Housing (PSH) Program

53 66

60 51 47

37 48

41

26 34 34

47

Number of Households Housed Monthly via a Rapid Re-Housing (RRH) Program

Note: PSH placements include Veterans placed in housing with VASH vouchers

576 590 579 595 590 582 577 573 567 569 551 529

0

200

400

600

800

Annual PSH Placement Trend (Current Month + Prior 11 Months)

542 578 600 615 625 625 631 615 587 568 543 544

0

200

400

600

Annual RRH Placement Trend (Current Month + Prior 11 Months)

-- - - - - - - - - -

- -- - - - - - - -

Housing Placements by Program Type

22 22 21

34

22 27 24

18 23 19

11 11

Number of Households Exiting a Transitional Housing (TH) Program to Permanent Housing (PH), by Month

Annual Housing Placement Trend from TH to PH (Current Month + Prior 11 Months)

400 336 332 326 335 333 340 335 317 306 294 284 254

200

0

Transitional Housing

30 24 25 36 35

47 38

49 44 37

68

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Number of Households Exiting an Emergency Shelter (ES) Program to Permanent Housing (PH), by Month

464 448 444 434 431 443 440 449 457 457 474 481

0

200

400

600

Annual Housing Placement Trend from ES to PH (Current Month + Prior 11 Months)

Emergency Shelter

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System Performance Measures

Returns to Homelessness After exiting to Permanent Housing Destinations, the Percentage of People who Return to Homelessness in less than 6 Months, 1 Year, and 2 Years (N = Exits to PH between

05/2015 to 4/2016)

6 Months 1 Year 2 Years 20%

10%

0%

8%

1% 3%

8% 11%12%

3% 6%

13% 17%18%

6%

11%

19% 23%

SYSTEM (N=1929) PERMANENT HOUSING RAPID REHOUSING TRANSITIONAL EMERGENCY SHELTER (N=88) (N=526) HOUSING (N=592) (N=709)

Benchmarks:

6 -12 Months 12% 2% 2% 4% 10%

2 Years 12% 2% 2% 6% 15%

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1System Performance Measures (cont.)

Exits to Permanent Housing Destinations Of Persons in ES, TH, and RRH who Exited, the Percentage of Successful

Exits to Permanent Housing

05/01/16-04/30/16 05/01/16-04/30/17

05/01/17-04/30/18

Permanent Housing Retention 4 Percentage of People in Permanent Housing Programs (excluding Rapid Rehousing) Retaining Housing during the Reporting Year

(Benchmark = 95%)

33%

64% 58%

18%

32%

70%

55%

17%

40%

72%

55%

24%

96.5%

92.6%

97.9%

SYSTEM RAPID TRANSITIONAL EMERGENCY (40%) REHOUSING HOUSING SHELTER (30%)

(95%) (75%) 05/01/15- 05/01/16- 05/01/17-04/30/16 04/30/17 04/30/18

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Utilization Outcomes for PSH Programs (excluding PWH) 21

Outpatient Mental Health Service Encounters 12000

10000

8000

6000

4000

2000

0 25-36 mos. 13-24 mos. 0-12 mos. 0-12 mos. 13-24 mos. 25-36 mos.

Outpatient Drug/Alcohol Service Encounters 5000

4500

4000

3500

3000

2500

2000

1500

1000

500


Pre Housed Post Housed Pre Housed Post Housed

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Utilization Outcomes for PSH Programs (cont.) 22

County Emergency Room Admits

900

800

700

600

500

400

300

200

100


County Inpatient Hospital Stays

1000

900

800

700

600

500

400

300

200

100


Pre Housed Post Housed Pre Housed Post Housed

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Utilization Outcomes for PSH Programs (cont.)

Admits to Emergency Psychiatric Services

350

300

250

200

150

100

50


Pre Housed Post Housed

Psychiatric Inpatient Service Days

200

180

160

140

120

100

80

60

40

20



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Utilization Outcomes for PSH Programs (cont.) 24

Number of Arrests

700

600

500

400

300

200

100



Number of Days Incarcerated

9000

8000

7000

6000

5000

4000

3000

2000

1000



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...... ...... ...... ...... ...... ......

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Healthcare Costs

Healthcare Costs: Pre- and Post-Housing- ED, VMC Inpatient,BAP, EPS, Contract Hospitals, and MH Programs

$5,000,000 $4,500,000 $4,000,000 $3,500,000 $3,000,000 $2,500,000 $2,000,000 $1,500,000 $1,000,000

$500,000 $0

ED Costs VMC Inpatient EPS BAP Contract Hospital MH OP and Residential

-

1 0

70

30

0

Top Services Breakdti n

'VMCTICU • zzVMCJR, .. e VMC EtlP. ,3

• VMC B .·p __ _

• · MC 2.A ••• • V. iC !ICC • VMC SA ... • :Z2VMCT,f::_ ..

VM . 4$U .. . e VMC 6A .. .

VM [) • Z-ZVMCii •• • -v C ~SU __ _

• VMC EPS

e VMC E:D

f'ER l:�D

rnonth.;..

F~L'fER SE~ VICES

V.M·C. ijA ~ IJ

V."11,C ~P4� 0 lC

VM'C !ED X

VM'C TICU X

. C ,EflS \t'M:C iMICC

ZLV~CJR B X

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Project Welcome Home after 36 months

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What’s Missing? Next Steps

Augmenting Coordinated Assessment Utilization Tool for Project Welcome

Home

High Users of Multiple Systems (HUMS)

Silicon Valley Triage Tool

Specialized Outreach and Programs

Randomized Controlled Trials

Automation

System Impact for non-PSH Programs

Coordinated Assessment 2.0 Emergency Shelter & Transitional

Housing System

New/Better VI-SPDAT

More access points

DV System / Emergency Assistance System

Homelessness Prevention SPDAT

Homelessness Prevention using risk factors among safety-net populations

An end to homelessness means that every community will have a systematic response in place that ensures homelessness is prevented whenever possible or is otherwise a rare, brief, and non-recurring experience.

Moving on all Fronts Parkside Studios, Sunnyvale, CA Charities Housing Development Corporation

Using Data in Santa Clara County · Santa Clara County Homeless Census & Surveyiii • Sheltered...

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