Scattergood Foundation - Progress and Expenditure Report

Final Report

for the Scattergood Foundation

Grant # 10-27 November 2010

Pathways is grateful for the vision of the Scattergood and Center City District Foundations in helping us to quantify and qualify the successful outcomes that we are seeing as we serve some of Philadelphia’s most vulnerable citizens.

As detailed in the grant proposal, the purpose of the grant was “to assess the effectiveness of its housing first approach in Philadelphia as compared to the traditional service model with a particular focus on the costs and benefits of each approach as measured across the publicly funded homeless, medical, behavioral health, and legal systems.” The result of the evaluation is a written report assessing the programmatic and cost-effectiveness of the housing first approach to chronically homeless individuals living on the street. As proposed in the grant application, Pathways engaged Fairmount Ventures, Inc. (Fairmount) to conduct the assessment and to produce the report.

Fairmount has met with representatives of the City of Philadelphia, Pathways to Housing, and representatives of the Scattergood and Center City District Foundations receiving input on the scope of this inquiry, the set of needed data, criteria which the evaluation should use, information each of these respective parties would want to see, etc. From these meetings, Fairmount and initial data analysis, developed a list of key indicators that the study employed to define and quantify success as related to the individual’s well-being and cost to the public sector. Fairmount also conducted a review of similar evaluations of how the housing first approach is working with similar populations in other cities to determine applicable “lessons learned” and any insights regarding how to approach the evaluation in Philadelphia.

Fairmount worked with Pathways to identify clients within the program that would serve as the study group for the evaluation and what data elements regarding housing, retention, and service usage would be collected and analyzed. Pathways provided Fairmount with de-identified data related to intake, admission, housing placement and retention for its entire program population. Fairmount analyzed the housing data to determine housing placement rates, the amount of time required to place people in housing and the length of time people remain in the program.

Pathways also provided de-identified service usage data for a subset of its population gathered from the City's CAIRS database that includes service usage (shelter episodes, shelter nights, mental health hospitalizations, etc.) for the year prior to entering the program and the year after entering the program. Fairmount analyzed this data and determined that Pathways’ clients decrease service usage as a result of participating in the Pathways program. Fairmount worked with the City and other sources to gather cost data related to these services to quantify the savings realized from the reduction in service usage by the broader publicly-funded service system.

Fairmount and Pathways worked with the City to gather data on service usage for a group of persons with similar characteristics who received differentinterventions and programmatic data on programs designed to serve similar populations. From the service usage data, Fairmount determined if there is a difference in pre- and post-intervention service usage between the Pathways population and those who receive other interventions. The programmatic data allowed for a comparison of the effectiveness of the different service models.

The draft report is complete. The draft was sent to Dr. Donald Schwarz, Deputy Mayor for Health and Opportunity, for feedback before it is made a public document.

A meeting to discuss the findings and there implication for Philadelphia’s special needs housing system is scheduled for Monday, November 15, 2010. In attendance will be Dr. Donald Schwartz, Deputy Mayor for Health and Opportunity; Paul Levy, Executive Director of the Center City District; Donald Kligerman, President of Fairmount Ventures; Joseph Pyle, President of the Scattergood Foundation for Behavioral Health; Sam Tsemberis, Founder of Pathways to Housing, Inc. and Christine Simiriglia, C.O.O. for Pathways in Philadelphia.

Highlights of the Draft Report

-  Pathways to Housing PA is less expensive per person than comparable programs serving the same population. Pathways is half the cost of other permanent housing programs for chronically homeless individuals and about two-thirds the cost of Residential Drug and Alcohol programs for chronically homeless mentally ill people.

-  The use of publicly funded services decreased for Pathways’ clients in every category:

·  Shelter episodes decreased by 88%.

·  Number of shelter nights decreased by 87%.

·  Crisis Response Center episodes decreased by 71%.

·  Mental Health Court episodes decreased by 11%t.

·  CBH hospitalizations episodes decreased by 70%.

·  CBH hospitalization days decreased by 46%.

·  Philadelphia Prison System episodes decreased by 50%.

·  Philadelphia Prison System days decreased by 45%.

-  Of the 128 people that Pathways attempted to engage and house, 117, or 92%, were successfully placed into housing over an 18-month period from October 2008 to April 2010. This rate is impressive, especially since this population of chronically homeless, dually diagnosed individuals are recognized as the most difficult to engage and hardest to house.

Implications

-  The people served by the program. i.e., seriously mentally ill people chronically living on the street, represent a discrete sub-set of the homeless population, who have been unable to accept services offered previously and, therefore, need a different approach to care.

-  The Housing First approach as employed by Pathways to Housing PA is consistent with national best practices and has been proven effective in other cities by a number of evaluations.

-  The Pathways to Housing PA approach to Housing First works well for chronically homeless mentally ill people, reduces costs across City service systems, and is an improvement over alternate approaches in terms of cost and outcomes for the people it serves.

-  In order to reduce the number of people living on the street, help get them the help they need sooner and in a more cost-effective manner than is currently provided, Philadelphia’s homeless policy should recognize that their trial program has been a success and consider expanding the Pathways to Housing PA approach to serve even more people who remain on the street.

Pathways to Housing Philadelphia 1 Final Report