The city of Seattle, Wash, has been changing the way they deal with homeless populations, and gathering data to drive some evidenced-based solutions. Now, with clear incentives and data collection, employees have a path forward for helping the homeless. But will it work? Journalist Rebecca Gale investigates.

 

Homelessness was on the rise in Seattle. In 2015, the mayor declared the problem a state of emergency. Even as the city increased its budget for homeless services — from $29m in 2005 to $50m in 2016 —  homelessness rates continued to rise. Myriad possible causes contributed, including Seattle’s expensive housing market and a marked increase in the opioid epidemic.

But Seattle was motivated to do something different. With a new mayor in Seattle, there was a chance to innovate.

“We had a blind spot,” said Jason Johnson, the Interim Director for the Seattle Human Services Department, who was Deputy Director at the time.“This was an intentional effort to understand what our homeless investments were.”

Seattle’s Human Services Department was sent a fellow, Christina Grover-Roybal, overseen by the Harvard’s Government Performance Lab as part of the Bloomberg Philanthropies What Works Cities Initiative, to study the inner workings and challenges of the city’s homeless services. Procurement (the way the city contracts with other nonprofits to shelter and resettle homeless populations) was flagged as a likely target for improvement.

Grover-Roybal and Johnson convened a working group to come up with consistent data-driven metrics which they could enforce across all contractors working with the region’s homeless population. The Human Services Department lacked reliable information about how services impacted homeless individuals and families, including data about moves to stable housing — the primary measure of success of all homeless programs. There was a wide disparity in the amount of money spent on very similar activities (shelters, for example).  And even though the contractors were “mission-driven” as Johnson describes, they lacked built-in incentives to meet such metrics.

Johnson and his team came up with five crucial performance metrics: exit to permanent housing, average length of stay in a homeless shelter, the effectiveness rate to keep people from returning, utilization rate of the shelter, and making sure the correct population was being served, i.e. are they people coming to the shelter homeless?

Next, they restructured the procurement process to tie three percent of the contract value to hitting the performance metrics, which required all providers to input data into the Homeless Management Information System, an online database which would then be analyzed quarterly. As of first quarter 2018, the first quarter such systems are in place, over 3000 households transitioned to stable housing, an increase of more than 1200 than had done so in the first quarter of 2017, without the data-driven metrics and new contracts.

But implementing the change has not been easy. “Providers are struggling to be data-focused in the way we want them to be. To spend their days mired in the details of a contract isn’t their usual orientation,” said Johnson. Many need time to update and train staff and adopt a new work culture which includes data input as a crucial part of the job.

“A big part of the change management here is helping the city help [contractors] understand if they can show that the data helps increase the ability to do their work,” said Johnson.

“The whole effort that Seattle is doing is taking the results-driven process to the next level,” said Peggy Bailey, director of health integration at the Center on Budget and Policy Priorities. “I do think what they are doing can be a model; people will definitely learn from what they are doing.” Bailey anticipates that other communities are likely to follow — having hard data on outcomes would help in applying for federal funding for homelessness programs from HUD.

Hanna Azemati, program director at the Government Performance Lab at the Harvard Kennedy School, who oversaw the fellow for Seattle’s HSD office, clarifies that even if the data shows an improvement, it’s hard to attribute that to one cause, especially in cities like Seattle that are doing so much already to combat the problem of homelessness.  “The relationship with providers is critical,” she said, “And having the right data to inform that relationship is key.”

Johnson, too, points to other areas of change that he thinks contribute to the rise of exits to permanent housing, including investing more in rapid-rehousing and diversion (a rapid, accessible cash-assistance program to help get people into housing), and keeping the shelters open 24 hours a day, instead of just overnight.

But not all providers feel that the new change is without drawbacks. Janet Pope, Executive Director of Compass Housing Alliance, one of the nonprofit homeless services contractors, agrees that showing ways in which tax dollars are being spent on homeless services is crucial. Compass manages over 250 emergency shelter beds;   three percent of their annual contract payment will come when they are able to hit the metrics Seattle has provided for them, and found permanent housing for a requisite number of people in the shelter.

But as with any complex issue, focusing on a handful of metrics mean that other critical services are left out. Compass Housing Alliance also run two hygiene centers, where people can come for a shower and laundry. “People line up to take a shower with a work uniform to change into when they’re done,” said Pope. “These are people who cannot afford an apartment in Seattle — a two bedroom is going for $2200 a month.”

Since hygiene centers, “band-aid programs” as Pope called them, don’t contribute to the metric of finding permanent housing, and therefore were not eligible for city funding and will need to close by the end of the year.

But cutting hygiene centers leads to outbreaks of hepatitis and lice. “You’ll have a public health crisis on your hands,” said Pope. “Until you see all the ripple effects among the different institutions, cutting one thing creates a different problem.” She felt the providers aren’t brought into the conversation often or early enough. “We could have predicted this pretty quickly.”

This Seattle project was the first with What Works Cities + the Government Performance Lab to tackle a results-driven contracting project, and Azemati believes it was the compelling topic of homelessness and the cooperation of the city that made this a good example for other cities to follow.  HSD in Seattle has trained a majority of its staff in Results Based Accountability and continues to identify population-level results across all of its investment and service areas. The Government Performance Lab now has a new staffer in Seattle examining results driven contracts as an option for other community services, including a youth violence prevention initiative.

“The way we were able to break down the problem and get the city to get behind change, we were really lucky in terms of our timing,” said Azemati. “Performance-based payment approach can be risky, but the city wanted to test it out.”

This article is part of Rise Local, a project of the New America National Network.