HomeMy WebLinkAboutIR 9210 INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 9210
To the Mayor and Members of the City Council March 9, 2010
!/ Page 1 of 2
SUBJECT: DIRECTIONS HOME HOMELESSNESS PLAN UPDATE
Attached for your review is a report from the University of Texas at Arlington on the third quarter of Program
Year I (PY-1 Q3) of the Directions Home plan. This Informal Report provides context for and highlights of the
major findings of the academic analysis and provides the Council with an update on other, notable activities and
funding in the effort to make homelessness, "rare, short-term and non-recurring."City staff works closely with
the United Way of Tarrant County, UTA and the Tarrant County Homeless Coalition to monitor, evaluate and
continuously improve the implementation of programs. The success of the Directions Home programs to date
has been a direct result of these professional collaborations and the hard work of service providers, community
volunteers, and especially, the women and men who are transitioning themselves out of homelessness.
Background
The Directions Home plan to end chronic homelessness was adopted by Council and incorporated into the
City's Comprehensive Plan in summer 2008. The plan includes 7 strategies and more than 90 action items to be
implemented by various community partners, including the City of Fort Worth. Funding was appropriated in FY
09 to launch a series of initiatives enumerated in the plan and prioritized by staff with the guidance of the
Mayor's Advisory Commission on Homelessness. City-funded action items include activities conducted by
City Departments and those that are contracted out to community- and faith-based partners through the United
Way of Tarrant County.
At no cost to the City, the United Way of Tarrant County recruited a Special Allocations Committee on
Homelessness and conducted a competitive bid process to select high-performing partner agencies to deliver an
array of targeted services. Following this selection, the program year for City-funded initiatives(including the
evaluation services of UTA) began in early spring 2009.
Funding
The FY 2010 budget appropriation for the Directions Home program administered by the Housing and
Economic Development Department(Program Year 11) included$2,556,042, of which$150,744 is for staff and
administration of the program. The remaining$2,393,356.00 will be distributed directly to the service providers
through the Program Year 11 United Way contract that is on the agenda for consideration at the March 9, 2010
City Council meeting. Additional funds from the State were acquired through the City's successful legislative
program in 2009 which provided $1.7 million in new funding from Austin for a"Homeless Housing and
Services Program"that is being administered by the Texas Department of Housing and Community Affairs.
Directions Home funding for Program Year 11 from the City of fort Worth is being counted towards the
required local match.atch. Money from this prograrn is also being awarded through the consolidated funding process
administered by the United Way and prograrri have e be_ n using these ° _ds during the first quarter of 2010.
e rt ffi hfl is fPY4 X31
The Third Quarter Update adds further evidence that Directions Horne-funded programs are performing as
expected: people are leaving the streets and shelters, moving into housing, keeping their housing and improving
their lives 265 individuals have been housed in the first 9 months of"Directions Home. Housing retention
among participants in The Directions m Voucher Pnlgrarn is '%,
%%
i A Zs dhs' "" ' '. .__ .ss?" sit ... _., 3, is w that tenants who have been placed in . j €rti9 housing
}p pear to bennefit substantially orn the supportive service s that are being o nre gauge a� rso s pro,
i
FORT WORTH, TEXAS
INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 9210
To the Mayor and Members of the City Council March 9, 2010
„f j , ► r�, Page 2 of 2
SUBJECT: DIRECTIONS HOME HOMELESSNESS PLAN UPDATE
from"crisis" to"thriving" frontline case managers work with tenants to complete a Self Sufficiency Matrix
when they enroll in the program and every three months thereafter. The Self Sufficiency Matrix measures
changes across numerous dimensions including income, employment, housing, safety, community involvement,
physical health, access to health care, and more. On average, participants in the Directions Home housing
program increased their self sufficiency scores by 48%.
Also in the first nine months of the programs, behavioral health care (substance abuse and mental health)was
offered to over 1,100 people and 48 entered outpatient or inpatient substance abuse treatment. In FY 09, the
Community Court dismissed 937 citations for 100 people who completed a self-improvement program and
court-ordered community service.
Notable Activities
The collection and analysis of data on homelessness programs is highly complex. Output and outcome
measures depend on the implementation of reliable data collection processes in challenging situations such as
crowded emergency shelters, scattered-site apartments and(literally) in the streets. The focus in this quarter has
been on establishing reliable means for interagency comparisons of outputs and outcomes. Attention to
quarterly reports has already enabled mid-stream course corrections in one contract to improve program
efficiency and outcomes.
The newest Directions Home program component has been the inclusion of a full-time street outreach team to
focus exclusively on the City of Fort Worth. This mobile team will go to various locations to engage
unsheltered homeless individuals to improve housing stability, health and quality of life by providing items to
meet emergency needs, crisis intervention, relocation assistance,needs assessment, and connection to housing
and resources that might not otherwise be available to those hesitant to seek services.
Data indicate that Tarrant County experienced a decrease of nearly 3% of the emergency sheltered and
transitionally housed homeless between 2009 and 2010. Given that unemployment for the lowest-income
Americans is upwards of 30%, this modest decline in the homeless population is a real tribute to the resilience
of Tarrant County residents and the hard work of the Continuum of Care to prevent and end homelessness.
The third annual "Project Homeless Connect" will be held on April 22 from 9:00— 1.30 at First Presbyterian
Church in downtown Fort Worth. Homeless Connect is a one day, one-stop fair where homeless people can
receive services and hospitality on the spat. Council members are welcome to drop by and tour the event or join
us for lunch.
If you need additional inform ation, please contact Jay Chapa or Otis Tho ton in the Housing and Economic
Development Department.
r
Date A% Fiss le , P,E.
City Manager
l l FORT WORTH, TA
2mmm�
Evaluating Directions Home: Ensuring
Accountability for Consumers, Funders, and ! ,
the Public
Third Quarter Update
(October 1-December 31, 2009)
21/19/2010
Authors:James Petrovich, PhD and Emily Spence-Almaguer, PhD
The authors wish to acknowledge the substantial contributions of Urne and effort by graduate school of
Social Work interns to the work products of the evaluation team. These students include.Lauren
Brueggemeyer,Jessica Godir� Kimberly Isbell, Currie Meyers, Patricia Rodriguez,Jonathan Salazar,
Rebecca alt s, and Vanessa Vaughter Weilage,
9' y is"I Aw ra i
al'i "I'an
Directions Home Third Quarter Update
���' Executive Summary
Summary of Strengths and Assets
Nine months into the ten year plan to make homelessness rare,short-term,and non-recurring in Fort Worth,
progress continues to be made.At the end of the third quarter, 157 individuals previously living in emergency
shelters or on the streets had a home as the result of Directions Home vouchers.People residing in emergency
shelters continued to access a higher level of care due to the addition of Directions Home-funded case manager
who were able to house an additional 1O8individuals.Combining these impressive efforts,265 individuals have
been housed in the first 9 months of Directions Home.Substance abuse and mental health services were offered
to over 1100 people while 48 entered outpatient or inpatient substance abuse treatment.
Conceived as a comprehensive and integrated plan,Directions Home addresses the problem of homelessness on
multiple levels,Through its funding,Fort Worth police officers are working to ensure that the shelter area on East
Lancaster is safe for the people who live there and the surrounding community. Individuals seeking to improve
their lives are accessing a storage facility so they can secure their belongings while they work or keep important
appointments,Community and Homeless Court programs are offering a way to resolve the outstanding tickets and
warrants that represent barriers to escaping homelessness. In fiscal year 2009,937 citations were dismissed for
100 people who completed court-ordered community service. Directions Home is also supporting the work of
critical social service professionals who address the complex factors that contribute to and sustain homelessness.
With funding provided by the plan,the Tarrant County Homeless Coalition provides the training,innovative
resources,and advocacy needed to see the goal of Directions Home become a reality.
A key aspect of this update is the ability to analyze outcome-level data for people placed in Directions Home
IN supportive housing which is an assessment made possible by increases in the consistency of data collection by
voucher-linked supportive service programs. Using the Self Sufficiency Matrix(SSM),improvements are noted in all
the dimensions measured by this instrument including income,employment,housing,safety,community
involvement, physical health,access to health care,and more.On average,individuals increased SSM scores 48%
indicmtingadeartrajec1uryupw/ardfrom"crisis^to"thr(vinQ" VVhi|ethisisun|yuninida|assexsmentofoutcome'
!eve|data'itisencoumg|ngandhopedthatthistrendcontinues.
Opportunities for Continuous Improvement
In addition to the strengths and assets noted above,areas for improvement exist,Data obtained from Directions
Home quarterly reports,meetings with funded agencies,and the consumer advisory council indicate some housed
clients are struggling to transition into their new apartments,continue to require intensive mental health care, lack
social support,and struggle with substance abuse problems.Corroborating these assessments.,while the Self
Sufficiency Matrix indicates that improvement is noted for many people,it is clear others continue to struggle to
improve their life circumstances. Ultimately, it,is clear that while housing goes a long way in making homelessness
rare and short4erm,|t|m the intensive,ongoing supports offered by supportive service case managers and others
who will make homelessness non-pmmmrrimg.
Another critical concern|m that individuals placed|n supportive housing are being targeted bydrug dealers and
other predators, Discussed by members of the consumer advisory council and supportive service case managers,
is crucial the Fort Worth Police Department,supportive service programs, landlords,and clients themselves
collaborate to reduce this threat,Addit|ona/ky,the number of individuals housed by shelter-based case
2
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Directions Hume Third Quarter Update
lo�
fill management providers continues to impress all concerned stakeholders.However, it is unknown as to whether
y these individuals remain housed.
Review of Directions Horne-Funded Programs
The vision of Directions Home is that homelessness will be a rare,short-term,and non-recurring experience in
Fort Worth,Texas by 2018.Specific goals are that:
• Homelessness will be rare:every year fewer households will fall out of
housing and into homelessness.
• Homelessness will be short-term: no one will be homeless more than 12
months—ending chronic homelessness in our community.2
• Homelessness will be non-recurring:homelessness will be a once-in-a-lifetime
experience.
To realize this goal, Directions Home is built on 7 strategies:
1. Increase the supply of permanent supportive housing
1 Expand opportunities and services linked with accountability
1 Develop and operate a central resource facility
4. Coordinate and expand homelessness prevention initiatives
5. Support and strengthen existing public,private,and faith-based efforts
6. Mitigate the negative community impacts of homelessness
Vi
7. Lead,educate, and advocate for change
Vi
Multiple action items are specified for each of these 7 strategies. Each consists of a specific goal,target date,lead
entity/partners, possible funding sources,and proposed high,medium,and low funding levels. Programs or
initiatives funded through Directions Home are paid for by city and private funds.These programs are listed below
with the larger strategy identified in parentheses:
1. Supportive Housing(Strategy 1)
2. Voucher-linked upportive services(Strategy 1)
3. Integrated mental health and substance abuse services(Strategy 2)
4. Recruitment and placement specialist activities(Strategy 2)
5. Increased storage space(Strategy 2)
6. Critical document fund(Strategy 2)
7. Move-in fund(Strategy 2)
Additional job specialist personnel(Strategy 2)
Fund operations of Tarrant County Homeless eless Coalition(Strategy 2
10- Shelter-based case management (Strategy 5)
11, Home=ess system coordinator(Strategy 5)
12. Deploy additional Fort Worth Police Department resources in areas near shelters(Strategy 6)
11 Support establishment of Homeless Court(Strategy 6)
14. independent Evaluator(Strategy 7)
3
Directions Home Third Quarter Update
%/i
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���� implementing the plan,the United Way of Tarrant County agreed to oversee many of the programs identified
above. Municipal funding to support additional Police Department resources and the Homeless Court are managed
by various departments within City of Fort Worth.Programs overseen by the United Way are listed in Table 1
below:
Table 1:United Way-Funded Directions Home Programs
Related,,,
to"t catewy, Funded Age",
0"o
Supportive Services 1{1.1 1.4} • Catholic Charities{with HRA&Women's Center}
linked to housing • Texas ReEntry Services
vouchers • The Salvation Army
• Mental Health Mental Retardation of Tarrant County
{MHMR-TC}
• Fort Worth Housing Authority
• Presbyterian Night shelter{PNS}
Case Management 5{5.14} • Presbyterian Night Shelter
• Day Resource Center
• Salvation Army
Substance Abuse/ 2(2.3) • Recovery Resource Council{RRC}
�„ Mental Health Pilot
� �% Recruitment and 2{2.4—2.10,2.14, • Workforce Solutions of Tarrant County
,i
Placement Specialist 2.20}
Critical Document/ 2{11,2.11} • Day Resource Center
Move-In Fund • Presbyterian Night Shelter
• The Salvation Army
Fund Operations of 5(5.5) • Tarrant County Homeless Coalition
Tarrant County
Homeless Coalition J
Homeless System
' Coordinator i
Independent Evaluator i 7(7,8) [ • The University of Texas at Arlington
increased Storage 2{2.1 } Day Resource Center
Space
�
Other actions items specifier in the plan are considered essential to this comprehensive effort to address
homelessness in Fort`worth.These action items support strategies to.
* Develop and operate a central resource facility{Strategy 3}
* Coordinate and expand homelessness prevention activities(Strategy
Supporrand strengthen exisdi fir- private,and f a ith a efforts'Strategi 5
% '
Directions Home Third Quarter Update
f
• Mitigate the negative community impacts of homelessness(Strategy 6)
• Lead,educate,and advocate for change(Strategy 7)
For these action items,dialogue and cooperation between public,private,and faith-based partners is essential.
Leveraging current public interest in the problem of homelessness,ongoing activities of the larger Continuum of
Care,and the funded-activities of Directions Home, it is hoped that many of the initiatives and program expansions
identified in these action items will be realized.
Update on Progress
It continues to appear that movement is being made towards the overall goals of making homelessness rare,short-
term and non-recurring in Fort Worth,Texas. For the various initiatives funded by Directions Home, progress
continued to be noted in funded entities:
• Implementing programs
• Establishing and measuring program outcomes
• Meeting program capacity goals
• Providing contracted services
• Providing an appropriate level of service intensity
• Establishing and measuring program outcomes
• Reconfiguring programs as needed
As with previous summaries,larger Directions Home funded initiatives were assessed separately.While there
remains some concern regarding the reliability and consistency of data,documentation improvements initiated
during quarters one and two have continued in quarter three allowing for basic comparisons among programs.
Nonetheless,it is important to interpret any findings cautiously due to variations in program context and residual
documentation deficiencies. However,it is very positive to note that gaps in data reliability and consistency are
being minimized and the data appears able to support the outcome-oriented analyses expected at the end of
program year 1. It also appears that more refined comparisons between agencies will be possible in order to assess
whether programs differ meaningfully in terms of outputs,outcomes,and efficiency.
Considering the amount of funding allocated to Directions Home($2.9 million), it is worth noting the Independent
Evaluators activities have largely focused on funded Directions Home initiatives.Of these programs,it is important
to clarify even further that some direct service programs received much more attention than others.A substantial
amount of funding went to support new direct service programs(supportive housing vouchers,voucher-linked
supportive services,and integrated mental health and substance abuse services)and it was vital that program
output and outcome measures and data collection systerns were established and functioning properly. For
Directions Home funding that supports pre--existing services(shelter-based case manage=ment,the Tarrant County
Homeless Coalitions storage,and job specialists),similar challenges existed.Additionally,the evaluation approach
of continuo us im roverrent required that the Independent Evaluators remain attentive to and disseminate
information about agency and system-related implementation challenges to ensure course corrections could be
made in a timely manner_
5
Directions Home Third Quarter Update
�Ift
Supportive Housing Vouchers
A major strategy of Directions Home was to create/identify additional permanent supportive housing units
(strategy 1).By funding 100 rental vouchers and providing the services needed to utilize 100 existing federal
Shelter Plus Care vouchers,200 supportive housing units were created.This represents 361 of the goal of 544
units to be created by year 6(action item 1.2)and 181 of the overall goal of 1088 units by year 10 of Directions
Home(action item 1.4). In assessing progress towards these goals, it must be acknowledged that Directions Home
does not provide the resources needed to meet these goals alone. Ultimately,the ability of Fort Worth to offer
1088 homeless individuals safe housing with support services will be an ongoing and collaborative effort using
municipal,state,federal,and private funding.
Voucher-linked Supportive Services
Also linked to Directions Home strategy 1,voucher-linked supportive service agencies provide services to clients
placed in housing funded by Directions Home or Shelter-Plus-Care(action item 1.1). Programs were funded at a 1:8
(high intensity)or 1:20(medium intensity)case manager to client ratio or a combination of both.These ratios were
established under the assumption that clients present different levels of need requiring more or less intensive
services.However,the assignment of clients to case managers appears to be largely by the Vulnerability Index
which provides a score based on medical vulnerability.One cannot necessarily infer clients'needs for service
intensity based on their vulnerability scores.Thus,variations in caseload size are based only on different levels of
funding provided to agencies,rather than differences in client needs. in fact,the organization assigned a medium
intensity caseload of 20 clients to 1 case manager(Texas ReEntry)appears to have a client population that may
benefit from a more intensive level of monitoring and care since it appears they were assigned based on time
spent in prison or jail and may be a high-risk for relapse.Table 2 below indicates the agencies funded to provide
voucher-linked supportive services,the number of clients contracted to be serviced,and whether clients were
tR,
provided medium intensity case management,high intensity case management,or both.
At the end of the third quarter,reports provided by 5 of the 6 programs indicated they continued to be fully
implemented.One other program reported full implementation but also noted their case manager had been
terminated at the beginning of the third quarter and service provision had been compromised.Overall,supportive
service agencies had enrolled 196 clients in services at the end of the third quarter representing between 901 and
106%of each agency's total contracted caseload(figures over 1001 are due to attrition).According to these
programs,a total of 157 individuals were reported being housed through the end of quarter three which is 771 of
the 200 vouchers supported by Directions Home. However,agencies also noted that 11 individuals had left housing
at the end of the third quarter.This resulted in an excellent housing retention rate of 931,an outcome
unchanged from the second quarter.
Considering this retention rate,it continues to appear that,as a whole,supportive service programs are retaining
individuals in housing. However,some variation is observed bet ween agencies.As noted in Table 3 below, Catholic
Charities and the Fort Worth Housing Authori-ty reported no exits from housing at the end of the third quarter,
MHMR Addiction Services and the Presbyterian Night Shelter each reported three exits while the Salvation Army
reported 1 exit from housing.The final program,Texas ReEntry Services reported 4 clients had exited housing at
the end of the third quarter.While It is not possible to speak to the nature of these housing exits at this time,it is
important to mote that not all exits from housing should be considered a negative outcome,The individual may
have secured unsubsidized housing,relocated to be closer to family,and mare,During the fourth quarter,the
r depende t evaluators will;resat with agencies to discuss indivrJuals who f*housing to understand factOrs
c n.t tsuti to _1aei r exit ,b,`tf-fo."fs agencies made to s un"`vor,or,,.terr _ ar,exit ,,.v.._
f.�.„ .','�.. ro , s. whether
ether
r
3'`°.
Directions Home Third Quarter Update
1110 ^ programs have made adjustments to help avoid future housing exits.Considering retention it is also important to
note agencies were funded at different levels(based on whether agencies provide medium or high intensity case
management)and therefore the number of clients per case manager differs between agencies,This ultimately
means between program comparisons on retention and many other program level variables must be considered
cautiously.
Comparing Voucher-linked Supportive Services Outputs and Outcomes
The title given to this evaluation research project is Evaluating Directions Home:Ensuring Accountability for
Consumers,Funders,and the Public, Consistent with this focus on accountability,a crucial consideration of this
evaluation is to assess the effectiveness and efficiency of Directions Home-funded programs as a whole and|n
comparison toone another.
Given that most Directions Hume programs have been funded for at least three program quartera,it is now
appropriate to begin examining differences in outputs(e.g., how many services were provided)and client
outcomes(e.g., impact of services). Initially this assessment will include the six organizations that received
voucher-linked supportive service funding. However,these comparisons must be made cautiously because while
programs may be providing very similar services,the amount of resources allocated per client(i.e., less money=
higher caseloads)differs between programs. Initially funded at "high intensity"or"medium intensity" levels,the
assumption was that high intensity clients will require and should receive a greater number of service units(e.g.,
more time,more home visits,more follow-up calls,more referrals,etc.).Thus,when we examine the average
number of home visits per client,we would expect to see more visits from high intensity case managers than
medium intensity case managers. Further complicating these comparisons is the fact that three of the six
OR
organizations receiving funds have mixed caseloads of both high and medium intensity clients.As a result,there is
40 significant variation among the six organizations along caseload sizes and fund ing-per-client levels.Therefore,we
have elected to employ a statistical technique(hereafter called the Voucher-linked Supportive Services[VSS)cost
index)that will allow us to draw comparisons between these six organizations,The best way to understand the
methodology of this VSS cost index is to use the same logic as community cost of living indices.
What is the Voucher-linked Supportive Services Cost Index?
Just as the cost-of-living index is computed for specific geographic areas to compensate employees living in higher-
cost regions,the Voucher-linked Supportive Services Cost Index is computed to help us compare services delivered
by organizations with differences in the amount of resources(i.e.,funding levels)they have been awarded per
client. Both types ofcost indices use a value of 100 to reflect the overall mean cost, For example, if you are living in
Fort Worth and receive a job offer in Chicago,you may want to consider that the cost of living index in Fort Worth
|m92(8%lower than the national average)and|n Chicago it|sI13(1]%higher than average and 2196 higher than
Fort Worth). In other words,a person earning S50,000 a year in Fort Worth would need to earn$60,sOo in
Chicago to enjoy the same standard mfliving,
What im the methodology behind the Voucher-finked Supportive Services Cost index?
For the first year of0r��|mnm Home,$76�250vvms budgeted for vouche�Unkedmuppo��e services, |fuUthings
were equal(|.e,nm medium mr high intensity levels offunding),this vsow}M mean that$3,841 dollars was budgeted
for each ofthe 200 clients to be housed($768,250-200),For the Voucher-linked Supportive Services Cost Ind ex
this average amount of$3,841 per client represents the starting p6nt1n our analysis comparing voucher-linked
supportive service programs.On the VSS cost index scale it,|s 100.Based mn this reference point,programs
providing only high Intensity services receive$5,44937_50 per dient and therefore have mVSS cmst index cf 143 since
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Directions Home Third Quarter Update
�' this amount|s43%higher than the average fundiugperdient.Theprogmmthatprovdesunlymediumintenyky
services has an index of 57 because their funding per client($2,195)is 43%lower than the mean funding level.
Figure 1 below illustrates the principles behind the VSS cost index while Table 2 below indicates the VSS Index level
for the G programs funded to provide voucher-linked supportive services:
Figure 1:Graphic Representation mfVSS Cost index
Evaluating this figure above,high intensity supportive service funding would need to be reduced by 43(143—43)
to achieve the VSS index of 100.Medium intensity supportive service funding would need to be increased by 43
(57+43)to achieve the vSS index nflOO.|f these adjustments are made,the scale would be balanced and the
amount of resources allocated to each client by each program would be comparable and,therefore,output and
outcomes would be comparable aawell.
Table 2:Variations in Funding levels and Voucher-linked Support Services Indices
Fort Worth Housing $5,487.50 143
Authority
Catholic Charities $5,48T50 143
Presbyterian Night Shelter $4,379 114
Salvation Army $3,150 82
MHMR Tarrant County $2,727 71
I Texas ReEntry Services $2,195 1 57
How is the Voucher-linked Swpport0meSerwces Cost Index Used toMake Comparative Adjustments of Service
Outputs?
Similar to the cost of living salary calculators one can find on the internet,we have used the VSS index to adjust
agency's service outputs(case management acti'vities)to allow"hem to be compared against,each other, For
example, let's say that a case manager who has 8 clients(e.g.,'high intensity!on their caseload spends 40 hours
each week assisting those clients,This would result in an average an average of 5 hours per client, A case manager
with 2O clients(e,g, "medium|ntewsity')who spends 40 hours each week assisting those clients would provide an
average mf2 hours per cUent, |nthi's context,when wveadjust the average hours using the VSS index,they become
nead��4u�}(�h�uU�htdi��nenmm results from nmunding when creating the VSSva|ums)�
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Directions Home Third Quarter Update
• High Intensity KSSl43>:Subtract 43%from S hours(5-2.15)=2.85
• Medium Intensity K/SSS7>:Add 43&to2 hours(Z+�86)=2.86
We use this adjustment technique to allow you to compare service outputs between voucher-linked supportive
service provider agencies. After the adjustments are made,any observable differences(i.e.,those not due to
rounding)should indicate true differences between agencies in the amount of effort being directed towards those
activities. It should be noted,however,that these differences do not necessarily indicate that one agency is
performing better than another or providing higher quality services. One case manager may routinely spend 2
hours with a client during home visits,while another spends 15 minutes,but makes daily follow-up calls. At this
juncture,we do not know which level of funding-per-client or which configuration of services rendered will result
in the best outcomes. Ultimately,we will be able to answer some of these questions once we obtain a large
enough sample of valid and reliable client outcome and output data.
Table 3:Assessment of Supportive Service Program Capacity(Year to Date)
lj �11
)J EAVEE
Charities
Army
Total all 1 1&13 i 200
Programs
Because an emphasis of Directions Home was to provide a sophisticated and comprehensli've model of supportive
services,voucher-linked supportive service programs were expected to complete a battery mf assessments, make
referrals as needed,and provide ongoing resources necessary bm escape homelessness. |n order to assess the
intensity ofoemioes provided,Directions Home uu",oMiwe service prmgrammmpnmvided anaccmuntngmfvMeir
N��� 9
Directions Home Third Quarter Update
1`231111�" programmatic activities.Table 3 below provides a year to date aggregation of selected supportive service activities
including the Tier two universal assessment,service plan,housing application,referral,and follow-up meetings).
Whether examining real figures nr those adjusted using the VSS index itis clear that there are significant variations
between these organizations,the majority of which result from differences in the numbers of follow-up contacts.
As noted in table 3 below, it is evident that Salvation Army provides the highest intensity ufactivities. Catholic
Charities provides the next highest level of activities,though when adjusted using the VSS Index,one can see that
the Texas ReEntry case manager spends a greater proportion of her time on these activities.
Table 4:Aggregated Voucher-based Supportive Service Activities(Year to Date)
_Wiin Activities
Agency and,kftrW*,Index, Totat"', t f0tai,61r1o, Mev�awn per"
ro
En It Client JYTDl',,' Adjusted wing,
CA=:O_� theVSS,Index
MHMRTC(71) 546 51 10.7 13.8
Salvation Army(82) 986 35.2 41.5
Texas ReEntry(57) 364 17.3 24.7
Catholic Charities(143) 630 34 1&5 10.5
Total All Agencies(100) 3,042 1 196 1 15.5 15.5
For clients who have been housed,supportive service agencies also documented the number of times they met
with clients through face-to-face home visits or via telephone during the previous two program quarters:
Table 5:Client Contacts(Year tmDate)
Total, mean Home
Horne,, Mean Totat
Vwts pet 00dacts,Per",
Client YTO'
entY
AdjU
Salvation 23 308 322 630 13A(15.8) 27.4(32,33)
Army(82)
Texas ReEntry 13 109 185 294 8,4(12.0) 226(323)
Catholic 32 751 1 292 1,043 1 23,5(114) 32,6(18,6
Chaidlities(143)
Tables 3 and 4 combined demonstrate that programs continue to vary in the number of services provided to
chents and the frequencycit contacts with dients after they are housed,Whether this impacts dient-level
mucconnea(Le,housing retentimn'redomt{mnmfidentified barriers, increased work activities,|ncnmaued,income,and
%O
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Directions Home Third Quarter Update
,w increased access to mainstream benefits)remains to be seen.Currently,this assessment is planned for the annual
report when there will be sufficient longitudinal data to support this analysis.
The Self-Sufficiency Matrix
Another key outcome measure,the Self-Sufficiency Matrix{SSM}was expected to be administered at baseline and
every 90 days thereafter. This instrument is a key measure of client level outcomes as it evaluates clients on 19
different dimensions(income,employment,housing,family support,legal challenges,etc.)providing an
assessment of each dimension and an overall self-sufficiency score.At the end of the third quarter, 116 individuals
(59%of 196 enrolled)had completed baseline and the first follow-up SSM in the proper timeframes.Seventy-eight
individuals had completed baseline,3 month follow-up,and 6 month follow-up SSM's in the proper timeframe.
This is 74%of the 105 individuals who have been enrolled in a supportive service program long enough to allow for
a baseline and two follow-up SSM's.Considering the importance of the SSM in evaluating client-level outcomes,
agencies were assessed for their compliance with SSM timelines.Table 6 provides this overview with"eligible
clients"being those who had been enrolled in supportive services long enough to allow for the initial baseline and
two follow-up SSM's."Clients within timelines"includes those clients who had a baseline and two follow-up SSM's
that were completed within the appropriate timeframes:
Table 6:Agency Contribution of Valid Baseline and 2 Follow-Up SSM Scores
ct
1 c i t ft i * r + r € �..
.P
t� "ttttt ry tiiiittriyiis.
Catholic Charities 30 25 83%
10011 v Fort Worth Housing 2 1 50%
Authority
MHMR Addiction Services 28 25 89%
Presbyterian Night Shelter 23 11 47%
The Salvation Army 16 11 68%
Texas ReEntry Services 6 5 83%
A significant issue affecting the ability of agencies to contribute to this analysis included baseline SSM's completed
after individuals were housed.This practice was identified in the first quarter and agencies began administering
baseline SSM's at the time of program enrollment versus housing.The concern was that overall and item scores
would be inflated and not provide true representations of an individual's life circumstances at the time they
enrolled in supportive services.Therefore,8 individuals were excluded from this analysis.
While a more in-depth analysis of this instrument will be completed for the yearend report,a descriptive overview
is possible and supports an overall assessment that,on average,clients are benefiting from their participation in
srectior s floe supportive housing and supportive servo:es.Overa'l,clients averaged 2,37 on the initial SS
administered at their enrollment in supportive senv ices.On the first fo€low-up SSM administered at 3 months,
average overall scores increased to 3.30,an increase of 39%.Average overall scores cores for the second follow-
up,administered at 6 months,were 3.53 which represented a 48`3° increase over baseline, individual item scores
are presented in Table 5.In interpreting these statistics,an average of 1,00 would be considered"in severe crisis"
while a 5 s considered'thriving".
r�
Directions Home Third Quarter Update
jfX'Vr ,
Table 7:Voucher-Linked Supportive Service Self-Sufficiency Matrix Assessment
Item, Baseline Man Score - 3 month Follow-Up 6 month, Mean- Percent
(number of Scare Follow:Up Difference Change
respondents) (number of Score from (Baseline to 6:.
respondents)` (number of' Baseline to month follow-
respondents)e 6 month Up
Follow-up,
Income 1.67(78) 2.08(78) 2.29(77) 0.62 37%
Employment 1.10(78) 1.27(78) 1.35(77) 0.25 23%
Shelter 1.08(78) 3.69(78) 3.96(78) 2.88 267%
Food 1.29(78) 2.38(78) 3.08(77) 1.79 139%
Childcare 2.00(2) 2.00(4) 3.00(3) 1 50%
Child Education 5.00(2) 5.00(2) 5.00(2) 0 0%
Adult Education 2.64(78) 2.88(78) 3.06(78) 0.42 16%
Legal 3.67(75) 4.32(77) 4.53(76) 0.86 24%
Health Care 2.82(77) 3.99(77) 4.21(77) 1.39 49%
ro° Life Skills 2.31(78) 3.01(78) 3.35(78) 1.04 45%
Mental Health 3.43(76) 4.16(77) 3.91(77) 0.48 14%
Substance Abuse 4.03(73) 4.54(76) 4.41(75) 0.38 9.4%
Family Relations 1.99(72) 2.72(76) 188(75) 0.89 45%
Mobility 2.58(77) 3.74(78) 3.97(78) 1.39 54%
Community 2.47(78) 3.54(78) 3.82(77) 1.35 55%
Involvement
Safety r 128(78) 4.65(78) 4.83(78) i 2.55 112%
I i €
Parenting Skills
2,67(6) 2.75(4) 4,88(8) 2,21 831
I �
Physical Health i 2,99(77) 1 3.42(77) 3.78(76" 039 26
i support Network 1 1.38(77) 190(77) 1 3.00(75) 1_Pr2 0%
In addition to the improvement indicated by most item and overall mean scores,other item analyses indicated
clients are experiencing positive changes in their-liven
l/j% 12
Directions Home Third Quarter Update
Id-
r • 24% (19)of individuals reported adequate and stable income at 6 month follow-up versus 8%%(6)at
baseline
6(8%)individuals moved into"full time employment"or"full-time permanent employment"at 6 month
follow-up versus 1(01.3%)at baseline
• At baseline,all 78(100%)individuals reported being"homeless or in transitional,temporary or
substandard housing"while only 1(1.3%)individuals reported this housing situation at 6 month follow-up
• 25(32%)individuals can"meet basic food needs without assistance"or"choose to purchase and food
household desires"at 6 month follow-up while 0(0%)individuals reported these levels of self-sufficiency
at baseline
• Only 4 of 78 individuals(5%)reported"current outstanding tickets or warrants or other serious
unresolved legal issues"or"current charges/trial pending;noncompliance with probation or parole"
versus 17(22%)at baseline
• The number of clients reporting they are"able to get medical care when needed but may strain budget"
or"are covered by affordable,adequate medical insurance"more than doubled from 27 of 122(35%)at
baseline to 65(83%)at 6 month follow-up
• 68%(53)of individuals report mental health symptoms are"absent"or"minimal"at follow-up versus 45%
(35)at baseline
• At the 6 month follow-up,79%(62)stated transportation"is generally accessible to meet basic travel
needs"or"transportation is readily available and affordable;car is adequately insured'versus 19.2°%(15)
at baseline
• At baseline,only 1 of 122(1.31)individuals reported their housing was"safe and stable"versus 61(78%)
at follow-up
W • The number of individuals reporting they are"able to identify need for assistance in managing ongoing
��s
medical condition"or"there are no immediate or on-going medical problems"increased from 11(14%)to
50(64.1%)
Ultimately, it does appear that for most items,a trend exists of clients moving towards higher levels of self-
su€ficiency. However,analyses continue to illustrate the challenges that exist even after people are placed in
housing:
• 461 continue to report"no income"
• 74%continue to report they have"no job"
• 57.7%still report"no food or means to prepare it"and continue to rely on other sources of free or low-
cost food or on food stamps
0 42%lack"necessary support from family/friends"or"family/friends may be supportive, but lack financial
resources to help"
Who Has Been Housed?
Noted earlier, 157 individuals were housed by Directions Hone voucher-linked supportive service programs since
being funded on April 15,20-09.Of these, 118(75%)were identified as chronically homeless, based on having a
disability and being homeless for at least one year or more than 4 tunes in 3 years.The median length of
homelessness was 2.3 year and ranged from 4 months to lust over 40 years.Almost one-"third of the group(29%)
reported they had been homeless for over 5 years-
OR=s
Directions Home Third Quarter Update
M. Other analyses indicated the average age of those housed was 50 years old and ranged from 23 to 78.As with the
previous two quarters, males continue to be housed more frequently(641)than females(361).Also consistent
with the two quarters, Black j African-Americans(n=78,471)and Caucasians(n=77,461)were housed most
often.Thirty(191)of the 157 housed identified themselves as veterans of United States military service.Overall,
the distribution of these variables remains comparable to national assessments of people who are homeless.
Consistent with the goals of Directions Home,individuals housed also represented the most medically vulnerable
of those who are homeless in Fort Worth.All 157 individuals were determined to be medically vulnerable using the
Vulnerability Index(VI)which service providers began administering in October 2008.
Other factors indicate individuals housed during the previous three quarters continue to represent a population in
need.lust over 491(72)of all individuals housed reported being admitted to the hospital a total of 189 times in
the year prior to taking the VI.The average number of visits was 2.6.In the 90 days prior to completing the VI,97
(621)of the 157 individuals reported visiting the ER 291 times in the previous 90 days.The average number of
visits for these individuals was 3.0.
Given these striking statistics,a more in-depth analysis of health care service use is warranted.The forthcoming
cost effectiveness conducted by the UTA Independent Evaluation team will provide this assessment by evaluating
the use of health care services before and after individuals enter supportive housing. In the meantime however,
the overall improvement in physical health noted by the Self Sufficiency Matrix is encouraging and may result in
less health care utilization.Other positive findings related to health-care are that,on average,individuals report
greater access to consistent and adequate medical care and medical insurance.As anecdotal evidence suggests
people who are homeless often use the ER for non-emergency medical needs,greater access to consistent care
and insurance may impact non-emergency ER utilization.
Shelter-Based Case Management Programs
During the second quarter,three Directions Home shelter-based case management programs continued to
outreach and engage people who are homeless in case management services.Consistent with the second quarter,
one program(Salvation Army)indicated it was fully implemented while case management programs at the Day
Resource Center for the Homeless(DRC)and the Presbyterian Night Shelter(PNS)were reported as partially
implemented. Providing more detail,PNS noted that they were unable to input child Tier 11 assessments into HMIS
despite efforts to resolve this issue.Ultimately,this is not considered to be a significant program barrier.The DRC
reported that barriers to full implementation included continued inconsistencies in staff coverage and the burden
of documenting case management activities in HMIS. Unlike PNS,this was considered a significant challenge to
service provision. For these two partially implemented programs,adjustments are being to ensure that programs
are fully implemented and functioning property. PNS has relocated its shelter-based case management program
from the Lowden-Shutts women and children's shelter to the main emergency shelter.The DRC reports that it is
working closely with subcontracted agencies to ensure that the personnel provided to their shelter-based case
management program are able to uphold roles and spo. s6i s required by the program
o€ � rear rz }�°� err
As with the supportive service programs discussed previously,case management programs contracted to provide
services to a minimum annual number of clients and employ a sophisticated model of case management.Table 8
provides an assessment of program capacity year to date and the number of clients housed by these programs:
r 1
Y;
Directions Home Third Quarter Update
Table 8:Assessment ofShelter-Based Case Management Program Capacity(Year tmDate)
Army
Programs
As noted in Table 8 all programs appear on track to meet annual enrollment goals and continue to play a vital role
in making homelessness rare,short-term,and non-recurring in Fort Worth.At the end of the third quarter these
programs reported housing a total of 108 clients.Compared to supportive service programs-who housed 157
households—this continues tobea considerable accomplishment.Coupling the outstanding results of these two
initiatives,265 individuals were housed by Directions Home through the end of the second quarter.
In the midst of this finding however,the issue of housing retention must be acknowledged.Noted previously, 11
individuals have left Directions Home supportive housing resulting in a 93%overall retention rate,At this time,it is
unknown whether any of the 108 individuals housed by case management programs have left housing.Since
���� Directions Home shelter-based case managers work with ind�idua|sresiding in shelters and likely dn not have the
��
resources to provide supportive services to individuals after they are housed,evaluating whether these individuals
remain housed iy considered critical. As more case managers are added tu these programs in the coming year,it
maybebepeficia|toindude|onDeptermfuUow-upandasdytanceaapartoftheirsemicede|iverypmcess.
It is important to note that between-agency comparisons are challenging for shelter-based case management
programs. Each was implemented within a unique service context and/or can be considered to serve different
populations of people who are homeless.The Day Resource Center is a day-time drop in center serving males and
females.The PNS Lowden-Schutts program is a residential shelter and their reported figures include only women
and children. Finally,the Salvation Army shelter-based case management program operates within an overnight
emergency shelter serving men and women who are homeless. However,each of these programs documented the
number of service activities conducted with each client.As with the supportive service programs above,selected
activities were aggregated for this summary and included completed Vulnerability Indices jier It Assessments,
initial service plans, housing applications,and follow-up/evaluation meetings-Due to programmatic differences in
how referrals are made between these programs,they are listed separately(see Table 7 below).
���N�� 15
Directions Home Third Quarter Update
�g %! Table 9:Aggregated Case Management Activities(YTD)
T l A Ctl rltl Mean, Completed, Mean Referrals
lulled'(; Act1vIeS per Enrolled,
per Enrolled,,,, � �Cl n
Gent
a,
I
Salvation 58 402 6.9 I 230 4
Army
DRC 1 55 377 6.8 29 .5
PNS 94 357 3.7 1286 13.7
Total All 207 1,136 5.5 1 1545 7.5
Agencies
Integrated Substance Abuse and Mental Health Program
Acknowledging the disproportionate number of people who are homeless who suffer from substance abuse and
mental health problems, an integrated services program was funded by Directions Home. Third quarter reports
indicated this program was fully implemented. As with other programs, annual outreach and enrollment goals
were established for this program and are illustrated in Table 10.
Table 10:integrated Services Program Capacity(Year to Date)
,�j/,,
�
j
Recovery 2.75 375—Enrolled 136.4/1 207(55%) 3(1.4%)
Resource Council
In addition to enrolling clients in services,the program also proposed to outreach 625 clients,which was exceeded
at the end of the second quarter(n=653).At the end of the third quarter,the program reported outreaching 1188
people who are homeless.As with the supportive service and shelter-based case management programs,the
Integrated Services program was also expected to conduct a variety of basic assessments in order to identify and
prioritize client needs.These included the Vulnerability Index and Tier II universal assessment. However, unlike the
supportive service and shelter-based case management programs discussed previously,many of the clients seeking
services from this program had these assessments completed by referring agencies.Therefore,no meaningful
information can be gleaned by comparing the number of these assessments completed versus the number of
individuals enrolled in services. It is informative to evaluate the number of clients screened and assessed for
substance abuse or mental health problems,the number screened as having these proWerns,and the number who
were able to be limed to treatment services.At the end of the second quarter,the Integrated Services program
reported-.
95 individuals were screened for a substance abuse problem
* Of those 95,66(69%)indicated a substance abuse problem
+ Of those 66,62(94%)participated in a secondary substance abuse assessment to determine their
treatment creeds
* Of those 62,44(71%)were =.ace on a waibng hst f inpatient substance abusee treatment
i
/ j: 1
Directions Home Third Quarter Update
V1 � • Of those 44,25(57%)individuals entered inpatient treatment
It is also notable that 23 individuals entered outpatient substance abuse treatment for a total placement of 48
individuals or 731 of the 66 individuals who screened as having a substance abuse problem.In addition to these
activities,341 counseling sessions were conducted with 83 individuals(mean of 4.1 sessions per client). Pre-paid
services were also provided to 295 individuals,contracted services through Texas ReEntry were provided to 64
individuals,and peer intervention specialists outreached 535 individuals.
In the midst of these outputs and activities,the agency funded to create this program, Recovery Resource Council
(RRC),noted that it was struggling to meet the number of clients it projected to enroll and that proposed mental
health services were not implemented.At the time of the writing of this report, RRC has proposed a new
integrated mental health and substance abuse services program that focuses on the provision of higher-level
mental health and substance abuse services versus generalist case management,will seek to support shelter-based
case managers more directly,and will incorporate a robust mental health program. Ultimately,it does appear this
reconfiguration acknowledges the lessons learned in the previous three quarters and will be much more consistent
with the original intent of the program.Considering that course corrections like these can be difficult,the ability of
RRC to identify that its program was underperforming and assertively address its inadequacies is commendable.
Homeless System Coordinator
Understanding that the activities of Directions Home are inexorably linked to the larger homelessness Continuum
of Care in Tarrant County,funding was provided to the Tarrant County Homeless Coalition(TCHC).A portion of the
funding went to support the addition of a Homeless System Coordinator to facilitate training,case manager
A ft roundtable meetings,general TCHC meetings,and more.Through the third quarter program activities are largely
on track or have exceeded annual performance goals.Table 11 provides an overview of these activities:
Table 11:Homeless System Coordinator Activities
ll is Tmeetings Aimust�:Professional Development 241!0(12 hours)
Service Provider Roundtables � 751(12 meetings)
TCHC General Meetings 751(12 meetings)
Newsletters 19 newsletters 791(24 newsletters)
Individualized HMIS Training i 6 trainings 251(24 trainings)
Individualized CoC Tech Assistance ' 25 meetings 208%(12 meetings)
In addition to these program outputs,outcome measures were identified through the 2008 Case Manager Needs
Assessment and Included-
Increasing the stock of expene? ceo case managers working with people who are horneies
Increasing the rate of interagency collaboration
Ensuring that case managers increase their knowledge of the services other agencies offer
* Satisfaction with opportunities for training
* Rate of client information sharing
x
17
Directions Home Third Quarter Update
r
It is important to note that the individual hired to serve as the Homeless System Coordinator(HSC)resigned and
the program was reconfigured during the second quarter.Acknowledging that basic outputs discussed above
(professional development hours,roundtable meetings,general meetings,etc.)are part of the traditional activities
of the Tarrant County Homeless Coalition,it was proposed that TCHC staff could continue to provide these
valuable services but redirect Directions Home funding towards other needed resources.After presenting this
reconceptualization to representatives from the United Way of Tarrant County and the City of Fort Worth,the
contract was amended to allow for these new activities which included the development of an internet-based
system to help clients obtain critical documents.
At this time,updates regarding this program reconfiguration have not been submitted.
Storage Facility
The inability to safely store personal belongings has been previously identified as an obstacle faced by people who
are homeless.Having to carry all of their belongings with them makes traveling to work or appointments a difficult
proposition and can ultimately undermine efforts to escape homelessness.At the end of the second quarter,the
storage facility funded by Directions Home and located at the Day Resource Center for the Homeless.However,the
ability to track whether individuals using the facility were enrolled in case management was still unresolved.
During second quarter meetings with program representatives, it was discussed that the equipment needed to use
Homeless Management Information System(HMIS)to track utilization of the storage facility and case management
had been purchased but not installed. At the writing of this update,quarter three reports have not been
submitted and it is unknown if this system is operational.
Funds for Critical Documents and Client Move-in Expenses
v4 More than for any other Directions Home funded initiative, monies provided for move-in expenses and critical
documents proved to present the most challenges in Quarter 1.Initially,it was not widely known that these funds
existed to assist people who are homeless.However, moving into the second quarter the agencies holding the
majority of the funds,the Presbyterian Night Shelter and Salvation Army,created processes whereby other
agencies were able to access these funds.
At the end of the second quarter,the majority of these funds had been spent.Pending the implementation of
additional direct service funds provided to the Tarrant County Homeless Coalition,agencies are leveraging other
resources to provide for critical documents and move-in assistance.
Law Enforcement and Criminal Justice Initiatives
Programs facilitated by the City of Fort Worth City Attorney's Office,Code Compliance, Municipal Courts,and the
Fort Worth Police Department(F ttPD)were also funded under Directions Howie.At the time of this update,data
provided by the FB PD indicated that funding provided to support Special Operations Division Narcotics Section
operations was yielding results.Table 12 below identifies Narcotic Section-related activity in the police beats
bordering the area where shelters and other homeless assistance providers are located on Fast Lancaster Avenue"
8
Directions Home Third Quarter Update
lmy INN/
</ Table 12:FW RD Narcotic Section Activities in Shelter Area on East Lancaster
1 w
All 2 t 16 ( 8 i 74 � 29 i 14 ; 143
i 1���� � i 2 3 2 3 32 10 6 53
I lr1 (fuii �,, $2,718 $394 $6,472 $61,387 i $202,248 $2,833 $174,952
Other activities supporting Directions Home Strategy 6 include regular police patrols in the shelter area on East
Lancaster.From January 1-October 31,2009,the FWPD reported 822 public intoxication arrests, issued citations
or arrested 254 individuals for alcohol within 1000'of a shelter and arrested 137 homeless individuals for violent
offenses.These numbers were tracked from reports where the person lists one of the shelters as a home address
so there is likely arrests were not included if they listed a separate address as a home address.
Staff from the Homeless Court indicated that for fiscal year 2009,238 people appeared in court for arraignment.
Of those 238,100(42%)defendants completed probation with 937 citations dismissed{mean of 9.4 citations per
defendant.Additionally,clients were referred by 64 case managers from 32 agencies.Of these,7 case managers
were employed by 5 Directions Home programs at the Presbyterian Night Shelter,MHMR of Tarrant County,
Catholic Charities,Texas ReEntry Services,and Recovery Resource Council. Homeless court staff conducted client-
level outreach activities in 14 different agencies over the course of FY 2009.
The program more than exceeded the goal of having at least one citation per defendant per month dismissed,The
program also exceeded its goal of engaging at least one new agency referral source per month with 34 agencies
referring clients to the program in FY 2009.Finally,the program also surpassed its goal of engaging with 18 case ME
managers to make use of the program identifying that 64 case managers referred client for help with ongoing
�� criminal justice concerns. Data from the first quarter of FY 2010(October 1—December 31)is pending.
Central Resource Facility
A key strategy in Directions Home's efforts to make homelessness rare,short-term,and non-recurring is the
development of a central resource facility(Strategy 3: Develop a Central Resource Facility),At the end of the
second quarter, it was understood that land to be used for this facility had been purchased by John Peter Smith
Health Network but that no other progress has been noted on this strategy.
Existing Community Efforts Supporting Directions Home
At the writing of this update,agencies,organizations,and programs including the Tarrant Area Community of
Churches,The T,Travelers Aid,Guardianship Services,and Room in the Inn continue to provide voluntary
representative payee services,educational opportunities,shelter during extreme weather,and transportation
assistance.At the time of this report,most reported no significant changes in their programs,
Independent Evaluator
"through the end of the third quarter,the evaluation team was aided by the addition of 7 graduate U`IA School of
Soul Work interns. Students have assisted with the Directions Horne evaluation by helping to develop the
evaluation websi e jw w_uta du d re do shornej,developing an interactive asset map using Geograp# is
Information Systems(GI to help case managers connect their voucher-based clients with neighborhood
resources,serving as liaison and support to Direions Home funded organizations,analyzing and extracting data
from HN41S,organizing the onssur r Adv so rx Council,assisting t the transfer of responsibilitles
// 1
Directions Home Third Quarter Update
r
the Vulnerability Index data,and numerous other activities. The creativity, motivation and hard work of the
student interns provide a value-added boost to the evaluation team.
During the third quarter,progress continued to be noted in the cost effectiveness study proposed for individuals
placed in Directions Home supportive housing.Regulatory concerns have largely been addressed with the only
pending issue being final approval from the UTA Institutional Review Board(IRB)and modifications to MHMR and
John Peter Smith Health Network(JPS)IRB protocols allowing for the inclusion of new student interns added in the
Spring 2010 semester.
Consumer Advisory Council
The Directions Home Evaluation Consumer Advisory Council has continued to hold monthly meetings and engage
members in telephone conversations between meetings. One significant observation that has transpired over
these past few months is that they have moved past the'honeymoon'period of being housed and are now
struggling with the pressures of seeking self-sufficiency,loneliness and isolation,and working to avoid some of the
pitfalls that contributed to their earlier homelessness. While they generally report feeling hopeful and upbeat,it
was evident that the holidays were difficult for some and they are straining to keep moving forward.
They expressed numerous positive comments about the role of support groups and case managers in staying
connected and engaged in a community.Sensing a purpose in their work,especially when helping or mentoring
others,seems to be incredibly powerful in helping the some members get through the hard moments and days.
Those members without diverse ties missed meetings,trended toward previous negative behavior patterns and
have had difficulty maintaining the gains made since receiving housing. These problems have been exacerbated by
lapses in medication management and predators in their apartment communities.For clients who struggle with
r✓ mental illness,consistent access to medications is critical to their well-being,so attention must be paid to
VON scheduling of psychiatric appointments and when medications need to be refilled. Furthermore,the advisory
members seemed concerned about the targeting of new residents by established drug dealers in apartment
complexes.They raised concerns about Direction Home clients who are trying to stay clean and are faced with
temptation to use,as well as enduring physical threats. They reported awareness of dealers"borrowing"clients'
apartments to make their transactions and being bribed with significant financial offers to help them infiltrate the
complex.
Conclusion
As evidenced by this report,quarter three data showed definitive progress towards meeting the goals of Directions
Home. Concerns raised in earlier quarterly updates have been resolved or continue to be addressed,thus the
continuous improvement model appears to effective in promoting better service delivery to people who are
homeless. As we move toward the end of the this first year,it will be necessary to begin raising larger questions of
how the homelessness services sector should change in structure and function as our community becomes more
effective in reducing homelessness, These issues will be discussed in the year-end report,and recommendations
will be made based on the 0 quarter results.
k.r
20