NAEH Conference: Effective Crisis Response Systems

August 05, 2015

By Jackie Janosko

The National Conference on Ending Homelessness started strong in the Systemic Response to Homelessness Track with a workshop titled Building an Effective Crisis Response System. The session included information on what makes an effective system; what interventions are necessary and the best practices for each; and how to analyze the system to be sure it is meeting the needs of those accessing it.

Effective crisis response systems must adhere to four main standards: an episode of homelessness is rare, brief, and non-recurring; the system is housing focused; it is right sized with the appropriate mix of interventions for those in need; and is easy to navigate. When we as part of the state, a Continuum of Care (CoC), a Coordinated Access Network (CAN), a community, or an agency take a moment to think about these standards, do we have what we need to meet or exceed them? The foundation of that answer comes from careful analysis of data and then setting system-wide measures that stakeholders review regularly.

A good system needs to have the four interventions: coordinated entry with diversion, crisis response housing and services, rapid rehousing, and permanent supportive housing. Each of these interventions should include adherence to best practices. The best practices for coordinated entry include:

  • Written standards for eligibility and prioritization
  • Robust diversion efforts
  • People are prioritized based on their level of need
  • Fully integrated with HMIS
  • Increases exits to permanent housing
  • Closes all of the side doors
  • Includes prevention resources

Crisis response housing and services are a necessary part of the system. Think of these as “crisis beds,” rather than “shelter beds.” This slight shift in the nomenclature helps recalibrate our thinking in terms of providing crisis services to people for whom diversion is not possible. Stability services come after housing. Best practices for crisis housing are:

  • Accessible to people 24 hours per day, not just an overnight place to sleep
  • Crisis beds are in low demand
  • Includes street outreach efforts
  • Has a connection to emergency health resources and other crisis beds

Rapid Rehousing is another critical component to an effective crisis response system. Best practices for this intervention are:

  • Rapid Rehousing is a major component of the available housing portfolio
  • Short term, shallow subsidies offered
  • Must be RAPID and individualized for each household
  • Use progressive engagement
  • Adhere to system wide policies and procedures
  • Follow a Housing First approach

In addition to adhering to system wide policies and procedures and following the principles of housing first, Permanent Supportive Housing should also:

  • House the most vulnerable
  • Prioritize chronically homeless
  • Be in low demand
  • Screen people in, not out

How do we know if all of these efforts are working? We need to actively monitor the data that informs every aspect of the crisis response system from coordinated entry through exits to permanent housing. System analysis must be done for those who are experiencing homelessness now. Assess what existing systems are accomplishing and identify what’s working and what needs improvement. This also includes determining how much of available interventions need to change. The most critical crisis response system performance measures are system capacity relative to the need, bed/unit utilization rates, where people came from when entering the system, how long people are homeless, rates of exit to permanent housing from all project types, and the cost effectiveness of the program. The cost per permanent housing exit is key, not the cost per unit or per bed. This should happen in a standardized way and include all funding sources for a project—donor dollars count!

It is also important to remember that all outcomes are good: positive, negative and unexpected. Focusing just on the positive exits causes some projects to selectively enroll clients who will succeed and that antithetical to an effective crisis response system. Negative outcomes also provide valuable information in that they inform what we need to be doing differently.

Communities should monitor their system continuously and document the performance results. The data should drive decision making, not just to learn. There should be a clear feedback mechanism across the system.

As a rule, change is difficult and slow. Our systems were designed to operate as individual programs focused on individual results. Now, the focus is on the entire community’s ability to prevent and end homelessness. By applying the best practices in an effective crisis response system, we can achieve an end to homelessness as we know it sooner than we ever thought possible.