Strategy on the Streets: Improving Los Angeles Homeless Services Authority’s Outreach Program

Homelessness by the Numbers

  • According to the 2019 Homeless Count results, homelessness is up 12% in L.A. County and 16% citywide.
  • L.A. reported 42,500 unsheltered people — the highest number in the U.S.
  • There are only 15,600 shelter beds, but only 80% are filled on a given night.
  • One in four homeless individuals suffer from serious mental illness and one in seven have a substance abuse disorder.
  • African Americans (19,000) and Latinos (20,504) represent 70% of the homeless population.
  • In 2018, 918 homeless people died on the streets — a 76% increase from 2014.

Photo / Los Angeles Homelessness Services Authority

 

The Los Angeles Homeless Services Authority (LAHSA) — a City-County joint powers authority — is the lead agency for homelessness in the region.

LAHSA is governed by a 10-member commission appointed by both the City of Los Angeles (Mayor and City Council) and County of Los Angeles (Board of Supervisors), and operates with a $300 million annual budget comprised of federal, State, County and City funds. For the 2019-2020 fiscal year, the City of Los Angeles allocated $35 million to LAHSA.

Responsibilities:

  • Implementing a coordinated entry system to connect homeless people to housing and services.
  • Administering data collection and performance measurement.
  • Coordinating and performing street outreach to connect people to organizations.

LAHSA did not achieve five of its City outreach goals in FY 2018-2019.

Achieved:

  • 6,634 people contacted (Goal: 6,500)
  • 5,710 direct services provided (86% — better than 85% goal)
  • 4,199 coordinated entry system assessments (63% — better than 50% goal)

Not achieved:

  • 20% of people engaged referred to bridge housing (Actual: 598 people, 14% success)
  • 10% of people engaged moved to permanent supportive housing (Actual: 167 people, 4% success)
  • 25% of people engaged with substance abuse problems referred to treatment (Actual: 39 people, 6% success)
  • 25% of people engaged with mental health conditions connected to services (Actual: 56 people, 4% success)
  • 95% of data quality in Homeless Management Information System (Not represented in chart; no outcomes reported)

To address LAHSA’s achievement gaps, Controller Ron Galperin offers the following recommendations:

  • Create “HomeSTAT,” a statistically-driven performance management system that would fundamentally reshape LAHSA’s outreach program by using real-time data on homelessness to evaluate performance and make informed decisions about resource allocation.
  • Work with City and County partners to define a unified set of clear and consistent goals, specific metrics and accurate reporting on outreach activities throughout the greater L.A. area.
  • Focus on a proactive outreach strategy to reach a greater number of homeless people for the first time.
  • Enhance LAHSA transparency and accountability by geo-based mapping of outreach activities.

Read the full report and recommendations below.

Cover Letter

 

August 28, 2019

Honorable Eric Garcetti, Mayor
Honorable Michael Feuer, City Attorney
Honorable Members of the Los Angeles City Council

Re: Strategy on the Streets: Improving Los Angeles Homeless Services Authority’s Outreach Program

There is no issue more pressing and no challenge more daunting than homelessness in Los Angeles today. Homelessness climbed 16 percent over last year in the City of Los Angeles and the greater area reported the highest number of unsheltered people in the United States. While those sleeping on our streets suffer most acutely, the crisis touches all Angelenos and comes at a great cost. This year’s City budget allocated nearly a half-billion dollars to house and serve the most vulnerable in our communities. 

The entity tasked with connecting the homeless to housing and services in the region is the Los Angeles Homeless Services Authority (LAHSA), a joint powers authority of the City and County of Los Angeles. Operating with a $300 million annual budget provided by federal, State, County and City funds, one of LAHSA’s core functions is street outreach to the homeless population, ensuring they receive resources, shelter and eventually permanent housing. The City and County have spent more than $54 million funding outreach efforts over the past two years, with the City paying $10.3 million to LAHSA out of its general fund.

On this critical front, LAHSA is falling short of its City goals. In 2018-2019, LAHSA failed to meet five City outreach targets — in some cases reporting four or six percent success — and reaching only dozens of people in need. Currently, the goals themselves are ill-defined and do not align with the benchmarks established by the County, leading to an uncoordinated approach to outreach and data collection. In addition, at least two-thirds of LAHSA’s City outreach is reactive, focusing on complaint-driven encampment cleanups.

LAHSA’s insufficient street outreach performance is matched by its loose review and reporting procedures on these activities. All of this hinders the agency’s ability to make data-driven decisions and impairs its ability to deploy resources in a way that will most effectively combat homelessness.

Smart strategy will improve outcomes

The accompanying report and recommendations outline ways to address LAHSA’s achievement gaps, offering a more strategic approach to homeless outreach that will better serve Angelenos in need: 

  • Create “HomeSTAT,” a statistically-driven performance management system to inform LAHSA’s outreach goals. HomeSTAT would fundamentally reshape LAHSA’s outreach program by using real-time data on homelessness to evaluate performance and make informed decisions about resource allocation.
  • Work with City and County partners to define a unified set of clear and consistent goals, specific metrics and accurate reporting on outreach activities throughout the greater L.A. area.
  • Focus on a proactive outreach strategy to reach a greater number of homeless people for the first time.
  • Enhance LAHSA’s transparency and accountability by geo-based mapping of street outreach activities.


If we hope to make real progress on homelessness, the City must look soberly at every action it takes and every program it funds to determine what is working and what is not. This report provides an opportunity to address an area where dramatic improvement is possible. I urge City leaders to adopt these recommendations and work closely with LAHSA on implementation. Doing so will ensure taxpayer dollars are spent more effectively to reduce homelessness and improve outcomes for the tens of thousands of people living on L.A.’s streets.

Respectfully submitted,

RON GALPERIN
L.A. Controller

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Executive Summary

 

Perhaps no challenge in Los Angeles today is more troublesome and more critical than the magnitude of the homeless crisis.[1] The 2019 point-in-time count estimated that the number of people experiencing homelessness grew to 56,000 in the Los Angeles Continuum of Care (CoC) of which 42,500 people were considered unsheltered at the time of the count. This represented the largest number of unsheltered people in any of the nation’s major CoCs and the City of Los Angeles (City), itself, was home to most of the unsheltered cases. Overall, the City experienced a 16% rise from the prior year’s count to 36,000 individuals.

The Los Angeles Homeless Services Authority (LAHSA) is a joint powers authority of the City and County of Los Angeles; and is governed by a 10-member commission that is appointed by the City Council/Mayor and County Board of Supervisors. LAHSA, today, manages an approximate annual budget of $300 million in federal, State, County, and City funds for programs that provide shelter, permanent housing, and services to people experiencing homelessness.

A critical service LAHSA provides is street outreach (outreach).  Outreach is the process by which a representative of a homeless services agency contacts people experiencing homelessness in our public spaces in order to help connect them to resources, shelters, and eventually permanent housing—sometimes with supportive services.  Over the last two fiscal years, the City allocated a combined $10 million for outreach services, while the County provided the largest amount, totaling $44 million.[2]

Our Office sought to determine how well LAHSA performed City outreach, and we offer recommendations for much needed improvements to its performance and reporting. This review focused on City funded outreach for two fiscal years as approved in a contract between the Housing and Community Investment Department and LAHSA.

In fiscal year (FY) 2017-18, LAHSA failed to meet seven of nine citywide outreach goals, which the agency attributed to data quality issues associated with a new system. As a result, our Office also reviewed LAHSA’s outreach performance in FY 2018-19—for the period when its data challenges should have been resolved—and the results did not improve.

LAHSA failed to meet the following five citywide outreach goals in fiscal year (FY) 2018-19:

  1. Individuals who were placed into a shelter or bridge housing.

Goal: 20%, LAHSA reported 14%.

  1. Individuals assessed who were placed in permanent housing.

Goal: 10%, LAHSA reported 4%.

  1. Individuals who self-identified a substance abuse disorder and obtained treatment.

Goal: 25%, LAHSA reported 6%.

  1. Individuals who self-identified a mental health need and obtained treatment.

Goal: 25%, LAHSA reported 4%.

  1. Program data is complete and accurate.

Goal: 95% of data. LAHSA chose not to report on this goal.

In light of these outcomes, we also sought to determine why LAHSA reported that there were 21,000 housing placements in 2018, and whether improvements have been achieved.  We found that the 21,000 placements reflect:[3]

    • Results for several agencies in the Greater Los Angeles area – Including all people assisted within the Greater Los Angeles area (not just the City) by LAHSA, the U.S. Department of Veterans Affairs, the Housing Authority of Los Angeles (HACLA), and over 100 provider agencies.
    • Repeated placements for the same individuals or families in a year – Repeated housing placements for the same person or family falling in and out of homelessness during a year are included in the figure.[4]

 

Recommendations

 

This report includes eight recommendations to address LAHSA’s achievement gaps and provide improved homeless services to the people of Los Angeles.  Key recommendations include:

Employ a Data Driven Approach to Homelessness

LAHSA indicated that its outreach outcomes in fiscal year 2017-18 may be a reflection of incomplete and inaccurate information resulting during a period of time when the agency transitioned to a new Homeless Management Information System (HMIS) and its staff and contractors had not yet been trained to properly collect and record data.  Although that was part of the problem, outcomes did not improve in fiscal year 2018-19 when the data issues should have been resolved. Moreover, LAHSA also lacked a holistic performance review process for its outreach activities in order to make data-driven decisions about the deployment of resources to address the region’s rising homelessness crisis.

In the early 2000s, cities across America recognized the need for real-time data by adopting performance-management frameworks.  For example, “CompSTAT,” short for Computer Statistics, has enabled police departments to analyze and compare statistics in a timely manner to make decisions about resource deployments.

This approach also made its way into social services, including behavioral health, economic security, and homelessness to gather more accurate and timely data while also seeking to rapidly deploy resources and provide follow up assessments.

We recommend that City and LAHSA adopt a performance-based process for outreach and homelessness services. Through a “HomeSTAT” like approach—LAHSA and any City department involved in monitoring outreach will need to use accurate data to evaluate performance, and make informed decisions to effectively respond to the City’s homelessness crisis.

Reassess and Clarify the Goals of Outreach

In 2018, 80% of nearly 15,600 shelter beds estimated for a point in time in the Greater Los Angeles region were filled by someone experiencing homelessness. With the lack of shelter beds and permanent housing at this time, LAHSA’s housing first goal should be supported with short-term solutions to immediately help people experiencing homelessness, until permanent housing is made available.  LAHSA, the City, and County partners should work to identify short-term immediate resources (restrooms, showers, storage facilities, waste services) to address needed improvements to the street living conditions for unsheltered individuals.

Unclear Metrics, Results, and Terminology

Achieving clarity starts with outreach metrics and targets, which are based on percentages of people to be served rather than absolute numbers that can be easily understood and measured.

As noted in the example metric and target:

“LAHSA’s City contract specified that 25% of individuals engaged who identify with a substance abuse disorder would be connected to appropriate treatment options by outreach workers.”

This metric supplies no indication about what the 25% target represents. LAHSA’s outreach in FY 2018-19 yielded the following results for the example metric:

  1. LAHSA contacted 6,634 individuals experiencing homelessness.
  2. 4,199 individuals contacted were engaged in the City; engaged meaning they were assessed or provided a housing plan.
  3. 668 of the 4,199 individuals engaged disclosed a substance abuse disorder.
  4. 39 of the 668 (6%) obtained treatment as a result of an outreach referral.


Even if LAHSA had met its 25% target, only 167 of 668 individuals would have received substance abuse treatment.

Given the enormity of our homelessness crisis and public perceptions that there are plenty of individuals that need urgent assistance for substance abuse disorders, this metric and target yielded minimal results. Emphasis should be placed on goals to provide more:

    • hygiene kits to stem the spread of typhus and hepatitis A.
    • access to toilets and mobile showers, like those deployed by Lava Mae or through the City’s Mobile Pit Stop Program, should be expanded throughout the City to promote better living conditions.
    • temporary shelter beds while permanent housing is developed.

Improved metrics should:

    • Use terminology that is understandable (avoiding technical terms).
    • Specify a target based on the total number of people expected to receive assistance through outreach (avoiding percentage-based targets).
    • Distinctly measure one activity: For example, the agency could establish one metric for the number of assessments, another for referrals, and a separate metric for successful referrals resulting in service. Each should have its corresponding target.
    • Measure substantive outcomes, such as the number of individuals that maintained housing after being touched by outreach, or individuals that achieved sobriety, etc.

These are just some examples, but metrics should be modified to align with those established in the County and those in the City’s Comprehensive Homeless Strategy, where it makes sense, to provide a consolidated view of outreach across the entire Greater Los Angeles area. This would bring consistency to our measures and provide a common way to evaluate observed trends, so that outreach can be adapted to meet the needs of people experiencing homelessness.

LAHSA, the Housing and Community Investment Department (HCID) and the City Administrative Officer (CAO) must work with all relevant City entities and County partners to establish clear and consistent goals, specific metrics and targets, and appropriate reporting for outreach activities throughout the Greater Los Angeles area.

Engage in Proactive Versus Reactive Outreach

LAHSA estimated that approximately 67% of its time is dedicated to outreach reacting to City encampment cleanups, working side by side with the Bureau of Sanitation. In many cases, they are required to talk with people that are already working with homeless service providers.

Leading research suggests that outreach achieves its greatest impact when organizations proactively seek people experiencing homelessness according to a strategy or plan, instead of responding to service calls. Through proactive outreach, LAHSA would have more autonomy to find people that are experiencing homelessness for the first time, or visit encampments where there are people that have yet to accept services.

To address these issues, we recommend the City rethink its outreach policies and more sufficiently find a balance between a proactive and reactive outreach strategy.

Hold LAHSA Accountable for Performance

LAHSA performed outreach without much oversight, as the City’s contract administrator, HCID, noted that it accepted LAHSA’s recommended outreach goals/targets without scrutiny. HCID representatives noted that, at the time of this review, its role was limited to monitoring expenditure of City funds; not LAHSA’s overall performance towards contracted outreach goals.

During this review, HCID made some changes by executing a new contract with LAHSA for fiscal year 2019-20 that requires LAHSA to provide more information in its reports to HCID on the total number of people that were served through outreach. The contract also requires LAHSA to submit narrative explanations for any significant deviation in targets, deemed to be 20% or more.

Our Office notes that although some improved reporting requirements have been included in the new contract, LAHSA’s outreach goals and related targets are still based on percentages of individuals engaged rather than total number of people served. We believe that transparency should be provided both at the start of the contract year, and also during reporting, by providing exact targets that are measurable. Moreover, accountability will still need to be improved, as the new contract’s compliance provisions are focused on deficiencies in reporting, rather than LAHSA’s overall performance towards its outreach goals and targets.

To address these issues, the Housing and Community Investment Department (HCID) and the City Administrative Officer (CAO) must monitor LAHSA’s outreach performance and work with the agency to address any mid-year shortfalls, including holding LAHSA accountable for not meeting expected performance targets.

Click here to read the full report.

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[1] Throughout this report, Greater Los Angeles Area or region is consistent with LAHSA’s defined jurisdiction for continuum of care and refers to all cities in the County–except Pasadena, Glendale, and Long Beach.

[2] Fiscal years 2017-18 and 2018-19.

[3] LAHSA Press Release Dated June 4, 2019 “Greater Los Angeles Homeless Count Shows 12% Rise In Homelessness”: <https://www.lahsa.org/news?article=558-greater-los-angeles-homeless-count-shows-12-rise-in-homelessness>

[4] LAHSA de-duplicates individuals or families falling in and out of homelessness during the same month and will count such instances once.  However, subsequent placements occurring in other months are counted again towards annual totals.

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