1. Performance Improvement Katie Kitchin Consultant Memphis, TN

2. Presentation Overview The Basics: How to start the process, what you need, what to do with the information Working in partnership with service providers to improve performance Using financial incentives to drive performance Governance structures that support system improvement

3. Beginning the Process Q: Who can drive a community to focus on performance improvement? A: Anyone with access to the data. Consultant Government official Non-profit leader Advocacy group

4. Quantitative Data Key data sources: HMIS, AHAR, APRs Key items to assess: Number who enter shelter and transitional housing programs Length of stay Rate of annual turnover in PSH Statistically valid sample of participants; analysis of recidivism (are there differences by program? Differences by setting?) Cost per exit to permanent housing

5. Example Source Data: AHAR and NAEH Why do we care? Research on the impact of homelessness/trauma/chronic health conditions, etc.

6. Qualitative Data Eligibility and tenant rules Shadowing or assisting an applicant to the program Standards of care; case monitoring Exits to permanent housing including family and friends Demographics of clients served (chronic or not, disabilities at program entry) Comparing outcomes of different approaches with like population served

7. Examples APR shows a program served 110 individuals; 56% exited to permanent housing 33% homeless at entry 27% of exits were to permanent housing excluding family and friends APR shows program served 27 families; 64% exited to permanent housing 6 exited to permanent housing excluding family and friends Cost per permanent housing exit = $59,000+

8. Partnerships for Performance Universal focus on outcome measures from all funders is motivating all agencies Shrinking donor bases – must justify their existence and their cost effectiveness National evaluations are easier to start with… When goals are common/mutually accepted, start asking questions that prompt self-assessments…

9. Partnership Example Comparing the outcomes and cost of rapid rehousing and transitional housing… Begin evaluating or assessing the effect of length of program stay on outcomes… Experimenting with multiple sites, comparable population, and different program rules… Truly partnering – not directing

10. Financial Incentives Direct and indirect incentives Require a particular approach (e.g. Chicago) Incent a particular approach with new funds (HPRP) Educate funders, agency leadership, and board members about evidence-based practices and the highly competitive nature of grantmaking

11. Governance Structure Tools: Mayors Office, Ten Year Plan entity, influential leaders of all kinds