1. Presenters: Cathy ten Broeke
Matthew Ayres
Lisa Thornquist

2. Heading Home Hennepin
• A community plan to end versus manage
homelessness
• Specific plan with measurable benchmarks
• City Council and County Board Approval –
December 2006
• Implementation began January 1, 2007

3. 6 Goals of the Plan
• Prevention
• Outreach
• Housing
• Service Delivery
• Capacity for Self Support
• Systems Improvement

4. The Need for Evaluation
• One of the pieces of the plan is to
evaluate the plan and report annually.
• The plan has dozens of initiatives, each
designed to either prevent or end
homelessness.

5. Forging a relationship
to produce evaluation
• Hennepin County is data rich.
• U of M is student/faculty rich.
• Hennepin offers U students and faculty
experience with administrative data, difficult
analytical questions and real world issues.
• The U offers an independent analysis.

6. The Hennepin University
Partnership
• Hennepin County and the U of M have a
standing agreement to provide academic
expertise to issues facing the county
• The OEH work with faculty throughout the
University to find common issues for
evaluation.

7. Major Projects in Collaboration
with U of M
• Housing First evaluation
• Single Adults in Shelter – Definition of LTH
• Families in Shelter and Rapid Exit
• Frequent Users Service Enhancement (FUSE)
• Refugees
• Collaboration capstones

8. Other Research/
Evaluation Projects
• Prevention Targeting
• Highest Users of Single Shelter
• Downtown 100
• Group Residential Housing stability
• Project Homeless Connect

9. Capstone on Housing First (p. 23)
• Masters Level Public Policy students looked
at participants in single adult Housing First
compared to a match set of shelter users.
• We matched in health insurance coverage
and criminal justice data.
• Students analyzed data as well as conducted
interviews with program participants

10. Capstone on Housing First:
Finding
• HF participants’ shelter use dramatically
declined compared to other shelter users.
• HF participants increased the number of
days and continuity of health care coverage.
• HF participants had a reduction in CJ
involvement, both as victims and
perpetrators of crime, pre versus post and
compared to other shelter users.

11. Capstone on Housing First:
Finding
• Interviews showed that housing had a
positive impact on safety and well-being.
• Transition to housing posed challenges
related to daily activities and social needs.
• Transportation was a significant barrier in
housing and some participants changed
housing after initial placement.

12. Impact of the Research
on Housing First
• Helped provide support for further funding –
Currie Avenue Partnership.
• Told policy makers that this model works in
OUR community.
• We greatly expanded our scattered site
Housing First program.

13. Capstone on Single Shelter Use
and Definition of LTH (p. 5)
• Wanted to know when to intervene for single
adults in shelter
• Stories of people being “stuck” in shelter for
years.
• People staying in shelter waiting to meet the
definition of long-term homeless to be
eligible for programs.

14. Capstone on Single Shelter Use
• Provided data from county data systems
and HMIS for single adults in shelter from
2007-2009.
• First time we looked at whole single shelter
system at once.

15. Capstone on Single Shelter Use
• Evaluate dynamics of shelter use of single
individuals in public and private shelters in
Hennepin County
• Mixed Method Analysis using focus group
interviews and analysis of administrative
data

16. Capstone on Single Shelter Use:
Focus Group

17. Capstone on Single Shelter Use
• Fixed Window Method:
Count days of shelter for 12 mo. following
shelter entry, for those who first entered
shelter between 7/1/07 and 12/31/08
• Cox Proportional Hazard Models
Estimate probability of ending a shelter spell
in each month, given that you are still in
shelter, for spells that start in the period
7/1/07-12/31/09

18. Definition - homelessness spell
• Define beginning of spell as date first
recorded shelter use
• Define end of spell as date in which
individual leaves shelter and remains out of
shelter for two weeks or longer

19. Fixed Window Analysis

20. Fixed Window Analysis

21. Hazard Model Analysis

22. Capstone on Single Shelter
•
Use: stay in shelters for very short
A large number of people
Findings
periods of time.
• Targeting people with long spells would reduce days in
shelter more than targeting people with multiple spells

23. Capstone on Single Shelter
• Use: Findings
Probability of exiting shelter declines rapidly from
months 6 to 12 and then levels off. This may reflect
either:
--staying in shelters discourages exits
--less disadvantaged group leaves first

24. Single Shelter Use:
• Targeting people at 5 Implications
Policy months for assessment into
housing programs
• Ongoing discussions of efficacy of targeting at 5 months
versus 1 year – how are limited resources best spent.

25. Frequent User Service
Enhancement (FUSE) (p. 26)
• In 2007, Hennepin County found that 266
individuals used 70,000 nights of shelter,
jail and detox over 5 years, costing
taxpayers $4.2 million.
• The FUSE project began, targeting the
highest users of both shelter AND jail.
• The intervention was housing, case
management, and probation services.

26. FUSE
• An examination of the first 6 program
participants found that they used, on
average, $95,000 in services prior to
housing. After housing, they used $16,000
in services on average.
• This included jail bookings, jail days, detox,
shelter, and Emergency Department use at
Hennepin County Medical Center (HCMC)

27. FUSE
• Sociology graduate students from the U of
M conducted a more in-depth study of the
first year of the program.
• The researchers compared FUSE
participants to a similar cohort of high
users of both jail and shelter.

28. FUSE
• The program participants had a
significantly larger decline in shelter use
versus the comparison group.
• They found that both participants and the
comparison group reduced their use of the
criminal justice system.

29. FUSE and other
interventions
• The findings from the FUSE study lead to
some interesting questions.
• We have so many interventions in
downtown Minneapolis: FUSE, Downtown
100, Street Outreach, Currie Avenue
Partnership.
• We also know there is a significant decline
in downtown arrests. Who gets the credit?

30. Implications of FUSE
• Shows targeting of specific populations can
interrupt overuse of systems.
• This study, and others, let us know that
targeting high users can greatly impact the
overall system.

31. Top 50 Users of Single Shelter
• Looked at highest users from Jan 2008 –
April 2011
• Range from 737 days to 1413 days
• Data in county go back to 1997 – 12 of
these top 50 were in shelter in 1997
• Very little is known about these top users –
they are not high users in other systems

32. Top 50 Users of Single Shelter
• Small group of county employees with
access to all data systems.
• Included direct service staff from county
and contracted shelters.
• Overall goal – to create a crack free
system.

33. Top 50 Users of Single Shelter
• 20 had social service activity in the county
• 10 on General Assistance, 10 on RSDI/SSI
• 12 had been to jail, 7 to detox
• 11 engaged with the mental health system,
but twice as many were reported by staff to
have mental health barriers

34. Top 50 Users of Single Shelter
• Medical services were more prevalent
– 29 received Healthcare for the Homeless
services
– 38 got health care through Hennepin County
Medical Center (HCMC)

35. Top 50 Users of Single Shelter
Policy Implications
• No wrong door.
• Rules and policies need to be flexible.
• Onus on county workers to reach out to
people in shelter, to ensure they get
services they are eligible for.

36. Prevention Targeting
Rapid Exit has been a program in
Hennepin County since 1993.
It focuses on early intervention in financial
assistance where:
-non-preventable, verifiable financial
crisis

37. Prevention Targeting
• Rapid Exit program started in 1993
• Focus was on preventing homelessness for
families to reduce number of families
entering shelter

38. Prevention Targeting
• Eligibility:
– Non-preventable, verifiable financial crisis
– No other resources available
– Prevention assistance will preserve housing
– Goal was to reduce shelter admissions by 10%
and reduce length of stay by 10%

39. Prevention Targeting
• Results:
– 96% did not enter shelter within 1 year
– 43% reduction in family shelter admissions

40. Prevention Targeting
• After 17 years, time to re-examine the
program.
• Used HMIS data and barrier assessments
to compare characteristics of families who
received prevention versus those who did
not and ended up in shelter.
• If targeting well, families should look
similar.

41. Prevention Targeting
Prevention Shelter
Incomes <
$1000/mo 40% 94%
> 65% of
income for
housing 45% 94%
homeless
before 36% 63%
Head of hh
< age 22 1% 33%

42. Prevention Targeting
New criteria:
• Families < 30% Area median income
• Event is expected to result in housing loss
within 30 days
• No resources or viable plan to resolve crisis
• Reasonable expectation for sustained
resolution

43. Prevention Targeting
Six month evaluation:
• Data from May – Dec 2010
• 436 households served
• 7.4% returned to shelter within 6 months
(same as before)

44. Prevention Targeting
Policy Implications
• Change definition of success.
• While a smaller percent of people who
receive prevention may avoid shelter, we
may actually be preventing more
homelessness.

45. Refugees (p. 25)
• We partnered with the Center for Advanced
Studies in Child Welfare for research on
refugee experiences with homelessness.
• This led to findings to be incorporated into
SSW learning modules.
• It also led to a dissertation currently being
completed on refugee homelessness.

46. Refugees
• A graduate student conducted in-depth
interviews with 15 refugee families
experiencing homelessness.
• We conducted a survey of 237 refugees in
the Twin Cities asking about housing
stability, ethnic identify and assimilation.
• A doctoral student is completing more in-
depth interviews with refugee families in
shelter.

47. Refugees: Findings
• Culture matters. While the barriers to
housing are similar to American-born
families, specific cultural beliefs and values
impact how families respond.
• Refugees who moved in with relatives first
had less stability than those placed in their
own apartment upon arrival.

48. Refugees: Findings
• Those whose current housing is unstable
have more mental health issues, less
social capital or social networks, and use
less public assistance.
• Larger families have more housing
instability.
• Language continues to be a barrier.

49. Refugees: Findings
• A housing crisis pushes refugees to seek
more formal help both within their ethnic
group and also with government agencies.
• Those with housing instability turned to
public assistance and that assistance did
stabilize housing for them.

50. Refugees: A pilot
• Hennepin County and the McKnight
Foundation funded a pilot to work with
refugees at risk of homelessness.
• The intervention provided intensive case
management and housing subsidies for a
limited time.
• The focus was on housing stability,
increased income and school engagement.

51. Refugees: A pilot
• Findings: 70 families were served. 98%
remained in housing during the program.
• 83% increased their incomes due to an
increase in number of family members
working.
• The families needed a rental subsidy for
6.3 months, on average.
• 97% reported positive engagement with
their children’s school.

52. Refugees: Policy
Implications
Another example of targeting a population
with special needs
The need for culturally specific services and
service providers
Development of refugee-specific housing with
cultural competency of landlords

53. Project Homeless Connect
Ongoing Evaluation
• Use HMIS data to track long-term trends, service
needs, demographics.
• Allows us to craft each event to the needs of the
guests, and fundraise for additional services
• Allows up to accurately report to funders, policy
makers, and volunteers.

54. Project Homeless Connect
• Homelessstatus of guests served at event,
comparison to previous events

55. Project Homeless Connect
• Proportion
of “doubled-up” clients,
comparison to previous events

56. Project Homeless Connect
• Where PHC guests come from.

57. Project Homeless Connect
• Main types of service sought by household

58. What are the Implications of a
Robust Evaluation Program?
• U of M more engaged in homelessness
than ever before
• Hennepin County more committed to
supporting research to better
understand programs and outcomes
• Evaluation program builds on itself – it
brings in money
• It builds community will

59. For more information
• Cathy.ten.broeke@co.hennepin.mn.us
• Matthew.ayres@co.hennepin.mn.us
• Lisa.thornquist@co.hennepin.mn.us
• www.headinghomehennepin.org