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What could an outcomes-based Reaching Home look like?

October 28, 2018 - 8:03 pm / News

Canada’s new homelessness strategy Reaching Home represents a fundamental shift in federal homelessness policy that sets the stage for a major transformation in how Canadian communities respond to homelessness. At the heart of the new program is the goal of reducing chronic homelessness by 50% and shifting to a new “outcomes-based approach.” In this blog we explore some ideas for an outcomes-based federal homelessness program.

Through Reaching Home the government has set a very clear desired outcome: a 50% reduction in chronic homelessness. Any outcomes-based approach to preventing and reducing homelessness must centre on supporting communities to become outcome-oriented systems able to achieve this goal.  

Communities with outcome oriented homeless systems are resolutely focused on ending homelessness. They build data-driven systems, grounded in the Housing First philosophy, that are constantly improving performance toward achieving homelessness prevention and reduction outcomes. They can monitor system performance in real-time, use data to zero in on problems and can respond quickly to improve performance. These communities follow a Collective Impact approach with institutionalized processes led by key stakeholders (including people with lived experience of homelessness) that regularly give their community feedback on how they’re performing and set clear, timebound and measurable improvement goals to further reduce homelessness. 

So, what does this mean for the design of Reaching Home? Here are some of our thoughts on implementing Reaching Home’s ‘outcomes-based approach.’ 

Good data is the heart of performance improvement. Solving homelessness requires actionable, real-time, person specific data to ensure the right people get into the right housing at the right time and communities are armed with the data they need to assess performance and plan for improvement. Every community should have a Quality By-Name List. Gathering real-time person specific data on homelessness may seem like an overwhelming proposition, but there are already nine communities with Quality By-Name Lists in our 20,000 Homes Campaign and there will be at least 14 before Reaching Home launches in April. Find out more about building a By-Name List here. 

Set community level chronic homelessness reduction targets. The government has set a national goal to reduce chronic homelessness by 50%. The problem is we don’t have enough reliable data on homelessness now to know how many Canadians are experiencing chronic homelessness. The first outcome of Reaching Home should be to ensure a Quality By-Name List in every community. Once a community has quality real-time data, the number of actively chronically homeless individuals on that list becomes the baseline and the core community outcome becomes a 50% reduction from that baseline. This accomplishes three important things: it establishes a real number to work from, gets the data infrastructure in place quickly and sets the core housing outcome that local efforts can work toward.   

Have a limited number of outcomes. There’s a lot of truth in the statement “If you have too many priorities you have none.” Reaching Home should have a small set of outcomes that show progress to core chronic homelessness objectives (for example, achieving Quality By-Name Lists, achieving a Quality Coordinated Access System, chronic homelessness reduction). Too many outputs (e.g. number of people served) and too many outcomes will inevitably diffuse focus and dampen results.  

We need a clear definition of homelessness and chronic homelessness. Prioritizing chronic homelessness does not mean excluding other important sub-populations like women, youth or Indigenous People. The policy assumption behind the prioritization of chronic homelessness is that we’re prioritizing those in the greatest or most acute need first (like triage in hospital) and those who are the most expensive users of public systems (e.g. health care). However, the current federal definition of chronic homelessness has two key weaknesses: homelessness is not defined and therefore limited in a way that excludes many people who are not always in the homeless shelter system (e.g. women, youth); it is a definition based on length of homelessness and not necessarily acuity of need or vulnerability, which can mean very sick people get lower priority than those with less complex needs who have been homeless longer. Reaching Home needs an inclusive definition of homelessness along the lines of the Canadian Definition of Homelessness and a definition of chronic homelessness that includes vulnerability to ensure those with the greatest need are prioritized. This way we ensure those in the greatest need – across populations – are prioritized. 

Transparent and public performance monitoring. Outcomes-based programs work best if a system is in place to monitor performance to support improvement and there is an accountability for achieving the desired outcomes. Reporting monthly By-Name List data to a public website would create transparency and accountability. Community Solutions in the U.S. shows each participating Built for Zero community’s performance and progress toward zero by displaying their dashboards directly on their website. The dashboards show actively homeless numbers in each community over time, By Name List measures and can even project a community’s timeline to functional zero based on housing rates, number of actively homeless people, and inflow of new people becoming homeless. Our 20,000 Homes Campaign will be taking a similar approach, publishing monthly dashboards from campaign communities.  

A focus on continuous improvement. Communities who are achieving the greatest success in reducing homelessness can monitor system performance in real-time, use data to zero in on problems and can respond quickly using rapid cycle testing and human-centered design to improve performance. Community Entities play an essential leadership role in this process. Federal homelessness investments are important in funding interventions, but even with the doubling of that funding under the National Housing Strategy those investments will be not nearly enough and, in many communities – especially the larger cities – the federal government is a minority funder. Reaching Home should invest in the leadership capacity of Community Entities with investment to support leadership (e.g. administration), data systems, analysis, planning and performance improvement. 

Coaching and technical assistance. Everyone who has seen success in reducing chronic homelessness has had access to and used coaching, training and technical assistance. We’ve observed through our Training and Technical Assistance Program and the 20,000 Homes Campaign that Canadian communities are self-starting and highly motivated. Equipped with high quality, accessible, actionable ‘how-to’ resources they’ll run with it. Documenting the best practices, making those resources available, providing coaching and peer learning opportunities will accelerate the adoption of outcome-based homeless systems. 

Establish an Accelerator Fund: When communities develop outcome-oriented homelessness systems they will begin to achieve significant reductions in chronic homelessness but inevitably they will run into an obstacle or opportunity they don’t have the money to fix or exploit. The federal government could consider an Accelerator Fund to help communities accelerate progress in reducing chronic homelessness. The fund would be used to support 1- to 2-year investments in larger scale pilots (e.g. emergency shelter diversion) in communities that have a By-Name List and a Coordinated Access System, have shown progress in reducing chronic homelessness and have projects that could improve their community performance in reducing chronic homelessness. The money could also be used to scale a test (e.g. taking a one shelter diversion project out to three shelters in a large city) or to get a smaller community to functional zero (e.g. a small community may have to house 20 people to reach or sustain functional zero and a small federal grant could be all they need). This could be a powerful performance incentive.  

Have the flexibility to adapt and change. Building flexibility into Reaching Home is going to be really important. What we know today will be very different than what we know in 5 years or even next year. Flexibility (while staying firmly focused on the objective) is going to be important. Reaching Home will need to stay closely connected to community with visibility on how core elements of the program are evolving (e.g. coordinated access systems), what barriers communities are running into, respond to learnings from new data on chronic homelessness, or exploit opportunities that may present themselves. 

Reaching Home represents a fundamental shift in federal homelessness policy that sets up a major transformation in how Canadian communities respond to homelessness.

If the government is successful in helping communities build outcome oriented homeless systems, they will not only achieve a 50% reduction in chronic homelessness, they will set the stage for the elimination of homelessness in Canada.