Here’s to administration: How a wonky thing like backbone support is improving one county’s homeless response system

October 4, 2021 | CHRT News

connection“When the typical homeless client is entering a shelter, they’re probably having the worst day of their life,” says Andrew Kraemer,  Washtenaw County Continuum of Care (CoC) data and evaluation specialist. 

One new strategy that organizations in Washtenaw County are using to help clients on that worst day is diversion. 

Housing Access for Washtenaw County (HAWC) and the Shelter Association of Washtenaw County (SAWC) each brought on a diversion staff member in January 2021. These diversion specialists help people on the verge of entering a shelter find alternatives, like staying with family or friends or accessing other community resources.

“The whole idea [of diversion] is that we can help people calm down and consider their options,” says Kraemer. “A lot of people do have alternatives that maybe they’re not seeing in the moment because they’ve got that crisis tunnel vision.”

In the first three months, the program diverted 44 percent of the families who participated in diversion conversations and 37 percent of the individuals. Diversion took an average of four days, versus 137 days to get a client housed in 2020. And diversion cost only $73 per individual on average, compared to $85 for just one night in shelter.

While the sample size is small, the community is excited about the results. 

“This could be pretty impactful, especially if it takes under a hundred dollars to avoid homelessness,” says Kraemer.

Backbone support–behind-the-scenes and essential

Impactful programs like diversion aren’t easy to initiate. Coordinating organizations and finding funding is challenging when nonprofits and government agencies alike are already overloaded.

So the Center for Health and Research Transformation (CHRT), a health policy center at the University of Michigan that provides backbone support to collective impact initiatives, worked with local organizations to overcome the often-invisible challenges involved in improving the homeless system of care.

“One way to conceptualize a backbone organization is that its goal is not to work one-on-one with individuals or organizations, but to create a broader understanding of what a community needs and provide capacity to address those needs in the community,” says Nancy Baum, health policy director at CHRT. 

“Backbone work is accomplished working among multiple organizations in a community, rather than between two entities, as might occur in project management or traditional consulting work,” she continues.

“A backbone organization plays a critical role in bringing community partners together to achieve common goals,” adds Patrick Kelly, the senior analyst at CHRT who worked on the housing project.

In 2019, using infrastructure and relationships set up by CHRT’s work with the State Innovation Model (SIM) and the Washtenaw Health Initiative, CHRT brought together housing and homelessness partners to identify areas of need and develop activities to improve the homeless response systems in Livingston and Washtenaw counties.

The goal: to organize a large, multipronged project to support and champion the homeless response system.

Kelly explains that throughout this project, “CHRT served in a backbone role, facilitating conversations to prioritize and agree upon issues that could be addressed within funding timelines, and dispersing funds from the Michigan Department of Health and Human Services.”

The project, a systems change opportunity given to each of Michigan’s five State Innovation Model Community Health Innovation Regions, looked at Washtenaw and Livingston counties separately to develop responses tailored to each county’s needs. 

In Livingston County, the work was focused on a housing stock assessment, a coordinated entry system, and discharge planning. In Washtenaw County, the work focused on system modeling, discharge planning, and diversion. 

Laying the groundwork for new improvements

For Washtenaw County’s diversion initiative, CHRT supported a pilot program that trained frontline workers and support staff in implementing a diversion model. 

“As a result of the pilot starting conversations and gathering data, it was recognized that this could be a useful tool in our system of care,” says Amanda Carlisle, director of the Washtenaw Housing Alliance.

“Before, we were just so busy. We were always wanting to do diversion, but we didn’t always have the time or the resources,” says Kate D’Alessio, program director at SAWC. The pilot let the community try diversion and see how well it could work. 

Then, when CARES funding arrived from the federal government as part of the $2.2 billion Coronavirus Aid, Relief, and Economic Security Act, HAWC and SAWC used those resources to fund two new positions exclusively for diversion because of the pilot’s success.

“CHRT’s role in helping us marshall that funding and then get it out into the community was instrumental,” says Kraemer. “That was the first time we put any resources towards this idea of diversion beyond talking about it as something that we just wanted to do. I don’t think we’d have diversion funded now if we hadn’t already been on that track.”

The impact of data

As in the diversion pilot, CHRT often plays a background role, identifying funding, offering support, and organizing projects that otherwise may not have been possible.

One critical prerequisite to housing work is data, which is why in parallel to the diversion project, CHRT organized a system modeling report in Washtenaw County and a housing assessment in Livingston County to determine the needs in each area.

The system modeling in Washtenaw County, conducted in spring 2020 by the national nonprofit Corporation for Supportive Housing (CSH), used a gaps analysis to determine what was needed for temporary emergency shelter and permanent housing. 

The goal of the gaps analysis, says Carlisle, was to inform policy and funding priorities. The previous community housing goal was set in 2006, and out of date.

“We knew we had a shortage of affordable housing, and supportive housing in particular,” says Carlisle. “This report was instrumental in helping us to quantify that for the community and especially for policymakers and elected officials.” 

The system modeling report, which is not yet published, includes recommendations on how many and which types of housing units are needed as well as the estimated cost.

In addition, the results highlighted racial inequities related to the use of a state-mandated assessment tool, which is known to cause inequities. 

The Washtenaw Housing Alliance is now working to identify recommended actions to counter these inequities, and has partnered with agencies to do a diversity, equity, and inclusion assessment for nonprofits in this space. 

The full report will be presented publicly this November during National Hunger & Homelessness Awareness Week. But the results have already been used to support the affordable housing millage that passed in November 2020.

“We were able to convince the Ann Arbor City Council that some of the dollars from the millage could be used for [supportive housing] services,” says Carlisle. “That was because of the system modeling report.” In addition, supportive housing is being funded by the county’s Public Safety and Mental Health Preservation millage, as well.

Carlisle expects that the new report will continue to be used to develop recommendations for how to use federal resources like COVID-19 relief dollars.

“[The system modeling report] has the potential to have a big impact and inform a lot of the decisions that are made in the community about housing development and what is needed,” says Kelly.

“The administrative back end that people don’t get to see, but that really matters”

Carlisle at WHA says she wants to express “deep appreciation for CHRT being willing to take on the housing program funding and administer that.” 

She says that the county wouldn’t have been able to do the system modeling report or even really a test diversion initiative, without having those funds available. 

“They were instrumental in helping us move forward some of our work that we’ve been wanting to do for a long time.”

“[The millage funding for supportive housing] was able to be created because of that report and the millage work that we did. And we’ve been able to leverage other dollars to continue that diversion pilot and solidify it as a program in our community. 

“I really appreciate CHRT and all the work that they did to help us get those grants and manage the administrative back end that people don’t get to see, but that really matters.”

Story by Cleoniki Kesidis