An Evaluation of an Initiative to Improve Coordination and Service Delivery of Homeless Services Networks: Tables

Table 1:
Site Overviews
Site	Description
Broward County, Florida ~ HHOPE Program	The HHOPE program, a collaboration of the Broward County Human Services Department, Homeless Initiative Partnership Administration, provides scattered site housing and supportive services to severely and persistently mentally ill and chronically homeless individuals through Shelter Plus Care. The project is implementing a Housing First approach and using a modified ACT team. Their goal is to serve 80 individuals over the life of the project.
Chattanooga, Tennessee ~ The Collaborative Initiative	Chattanooga’s Collaborative Initiative, coordinated by the Fortwood Center, serves chronically homeless individuals in scattered site housing. The Initiative is implementing the Housing First approach and an ACT team to provide wrap-around services for clients in housing. The goal of the Initiative is to serve 50 individuals over three years, in housing subsidized through Shelter Plus Care.
Chicago, Illinois ~ ACT Resources for Chronically Homeless (ARCH)	Led by the Chicago Department of Human Services, ARCH targets chronically homeless individuals with mental health, substance abuse, and/or co-occurring disorders. They are using Shelter Plus Care vouchers to secure 59 tenant-based permanent housing units. The units are both scattered site and clustered. ARCH uses a Housing First approach and an ACT team. Their goal is to bring about significant expansion of permanent supportive housing, coordination and maximization of mainstream resources, and expansion of evidence-based service strategies to meet the complex needs of chronically homeless people.
Columbus, Ohio ~ Rebuilding Lives PACT Team Initiative (RLPTI)	RLPTI is led by Southeast, which contracts project management to the Community Shelter Board. The project serves chronically homeless individuals with severe mental disabilities or co-occurring substance abuse and mental illness. For this initiative, they have five clustered site housing units through a Supportive Housing Program grant and use a Housing First approach. They use a PACT model and have incorporated several evidence-based practices. One of RLPTI’s main goals is to increase the behavioral healthcare system in Franklin County, particularly by increasing Southeast’s capacity and treatment slots. In addition, they plan to increase income supports and entitlements for the chronically homeless. The goal of the RLPTI is to house and serve 108 individuals.
Contra Costa, California ~ Project Coming Home (PCH)	Led by the Contra Costa Office of Homeless Programs, PCH serves chronically homeless individuals using a Health, Housing, and Integrated Services Network (HHISN). Through Shelter Plus Care, PCH uses a housing first, scattered site model facilitated through partnerships with the housing authority and Shelter Inc. The goals of PCH include: increasing the effectiveness of integrated systems of care by providing comprehensive services and treatment, linked to housing; increasing the use of mainstream resources that pay for services and treatment; and supporting the development of infrastructures that sustain housing, services treatment, and inter-organizational partnerships beyond the federal initiative. Over a five-year period, they expect to contact 5,250 chronically homeless individuals and house 155 individuals.
Denver, Colorado ~ Denver Housing First Collaborative (DHFC)	DHFC, a Shelter Plus Care grant is a collaboration of agencies led by Colorado Coalition for the Homeless. It seeks to provide coordinated housing and treatment to chronically homeless individuals with disabilities, substance abuse, severe and persistent mental illness, co-occurring disorders, and/or chronic physical illness. DHFC uses a Housing First approach and an ACT team. Housing is both scattered site and clustered. DHFC aims to serve 100 clients in year one.
Los Angeles, California ~ Skid Row Collaborative	The Collaborative, which has a Shelter Plus Care Grant, is coordinated by the Skid Row Housing Trust, and seeks to serve chronically homeless and disabled persons. It uses the Health, Housing, and Integrated Services Network (HHISN) model. To reach their goal of assisting clients into permanent housing, the Collaborative is expanding mental health and co-occurring treatment services by adding a team of case manager specialists in mental health and substance abuse and peer advocates to provide outreach, engagement, support and recovery services/ treatment, and case management. They have a goal of housing and serving 62 individuals. The project has already had contact with 140 homeless individuals in its first year.
New York, New York ~ In Homes Now (IN)/Project Renewal	IN, a Supportive Housing grant, is coordinated by Project Renewal serves chronically homeless individuals who are active substance abusers in New York City. IN uses a Housing First approach and an Intensive Integrated Service Team to supplement existing programs (Continuum of Care and Pathways to Housing) for which active substance users are not eligible. The project’s goal is to house and provide comprehensive services for 40 individuals from the target population in scattered-site SRO apartments located in Manhattan and the Bronx.
Philadelphia, Pennsylvania ~ Home First	With the City of Philadelphia as the lead agency, Home First serves homeless individuals who have serious mental illness and/or co-occurring disorders and who have among the highest number of documented days in the city’s emergency shelter and residential behavioral health system. They use a Housing First approach and an ACT team. The project intends to serve approximately 85 chronically homeless individuals over the life of the Supportive Housing Program project.
Portland, Oregon ~ The Community Engagement Program (CEP III)/ Central City Concern	CEP III, which has a Shelter Plus Care grant, is coordinated by Central City Concern. The project focuses on the “hardest to serve” of Portland’s chronically homeless population – those with a significant disability (i.e., physical health, mental health, and/or substance abuse issues) and/or co-occurring disorders. Based on ACT and the Housing First approach, clients are housed in scattered site, clustered, or Shelter Plus Care units. The project’s main goal is to demonstrate an effective model in reducing chronic homelessness for people with co-occurring disorders. CEP III seeks to serve 100 clients in the first year and 150 over the life of the project.
San Francisco, California ~ Direct Access to Housing (DAH)	The San Francisco Department of Public Health is the lead agency for the Direct Access to Housing initiative, which has a Supportive Housing Program grant. They are creating 70 units of permanent supportive housing through an expansion of their DAH program at the Empress Hotel. DAH serves chronically homeless individuals with disabilities, using a supportive housing model.

Table 2:
Four-Factor Solution to a Factor Analysis of 15 Dyadic Integration/Coordination
Items from the Network Participation Survey
Burden Item	Factor Loading
Factor 1: Joint Planning and Cooperation
Send clients to or receive homeless clients from this agency	.831
Co-locate staff and/or services in the same location with this agency	.594
Cooperate in serving clients	.912
Communicate clearly with this agency in serving clients	.894
Agree on goals with this agency for serving clients	.780
Cooperate with this agency in planning	.526
Communicate clearly with this agency in planning	.558
Send information to or receive information from this agency for coordination, control, planning, or evaluation	.539
Have written documents (e.g., MOUs) or flow charts specifying working relationship with this agency	.452
Factor 2: Trust and Respect
Trust this agency	.903
Respect this agency	.905
Factor 3: Send Funds to or Influence Flow of Funds to Other Agency
Send funds to this agency	.920
Influence flow of funds to agency	.889
Factor 4: Receive Funds From or Influences Flow of Funds to Your Agency
Receive funds from this agency	.910
To what extent does this agency influence the flow of funds to you	.906

Table 3:
Two-Factor Solution to a Factor Analysis of 8 Housing Emphasis Items
from the Network Participation Survey
Burden Item	Factor Loading
Factor 1: Current Housing Emphasis by CICH network
Emergency Shelter	.749
Transitional Housing	.829
Affordable Housing	.645

Factor 2: Change in Housing Emphasis by CICH Network
Emergency Shelter	-.659
Transitional Housing	-.728
Permanent Supported Housing	.578

Table 4:
Descriptive Characteristics: System-Level Measures Across All Time Points
Variable Groups	Variables	N	Mean Scores	SD	Range
System Connectedness And Integration	Integrative Practices	215	2.08	.52	0-3
	Coalition Involvement	187	2.25	.72	0-3
	Working Together	210	2.66	.51	0-3
	Involvement of Local Organizations: Number	211	7.65	2.42	0-12
	Dyadic Joint Service Planning and Coordination	1,366	1.82	.87	0-3
	Dyadic Trust and Respect	1,369	2.64	.60	0-3
Emphasis On Providing Housing Services And On The Associated Goal Of Ending Homelessness	Emphasis on Transitional, Emergency, and Affordable Housing as Contrasted with Permanent Supported Housing	206	2.23	.72	0-3
	Change in Emphasis from Emergency Shelter and Transitional Housing to Permanent Supported and Non-supported Housing	208	2.12	.52	1-3
Development Of Homeless Services Management Information System	Client and Services Information Available	208	.84	.29	0-1
	CICH Management Information System Exists	199	1.51	1.01	0-4
Use of Evidence-Based mental health Practices	Use of Evidence Based Practices	208	2.30	.44	.11-3
Funds Transfer and Influence	Fiscal Relationship Exists	1,355	.31	.46	0-1

Table 5:
Correlations of All Measures at Agency Level
Variables	1	2	3	4	5	6	7	8	9	10	11	12
1=Integrative Practices (N=215)	1.00
2=Coalition Involvement (N=187)	.39 (.0001)	1.00
3=Working Together (N=210)	.53 (.0001)	.25 (.001)	1.00
4=Involvement of Local Organizations: Number (N=211)	.35 (.0001)	.28 (.0001)	.33 (.0001)	1.00
5= Dyadic Joint Service Planning and Coordination (By Rating Agency) (N=217)	.47 (.0001)	.07 (.35)	.23 (.001)	.23 (.0009)	1.00
6=Dyadic Trust and Respect (By Rating Agency) (N=221)	.45 (.0001)	.11 (.13)	.26 (.0001)	.30 (.0001)	.52 (.0001)	1.00
7= Emphasis on Transitional, Emergency, and Affordable Housing as Contrasted with Permanent Supported Housing (N=206)	.27 (.0001)	.008 (.91)	.23 (.0012)	.29 (.0001)	.20 (.0035)	.29 (.0001)
8= Change in Emphasis from Emergency Shelter and Transitional Housing to Permanent Supported Housing (N=208)	-.084 (.23)	-.14 (.059)	-.216 (.0019)	-.036 (.61)	-.014 (.84)	0.12 (.083)
9=Client and Services Information Available (N=208)	.32 (.0001)	.21 (.004)	.26 (.0002)	.22 (.0014)	.27 (.0001)	.05 (.47)	.105 (.14)	-.053 (.45)	1.00
10=CICH Management Information System Exists (N=199)	.25 (.0005)	.13 (.085)	.20 (.0052)	.20 (.0053)	.24 (.0009)	.15 (.038)	-.004 (.96)	.13 (.071)	.28 (.0001)	1.00
11= Average Degree Evidence Based Practices Used (N=208)	.66 (.0001)	.23 (.002)	.56 (.0001)	.33 (.0001)	.38 (.0001)	.46 (.0001)	.24 (.001)	-.031 (.66)	.22 (.0002)	.20 (.004)	1.00
12=Funds Transfer and Influence (N=215)	.20 (.0029)	-.008 (.91)	.11 (.12)	.16 (.023)	.49 (.0001)	.28 (.0001)	.13 (.07)	.14 (.043)	.12 (.09)	.20 (.004)	.16 (.02)	1.00

Table 6:
System Integration Over Time
Measures of System Connectedness and Integration	N	Mean Scores	Time Comparison
Wave 1	Wave 2	Wave 3	Percent Change (Wave 1 to Wave 3)	P*	Pairwise Comparison**
Integrative Practices	204	1.94	2.06	2.23	14.9%	.003	W3>W1
Coalition Involvement	187	2.36	2.09	2.29	-3.0%	.049	W1>W2
Working Together	210	2.59	2.70	2.69	3.9%	.30	None
Involvement of Local Organizations: Number	203	7.34	7.73	8.21	11.9%	.12	W3>W1
Dyadic Joint Service Planning and Coordination	1,366	1.63	1.85	2.04	25.2%	.0001	W3>W2>W1
Dyadic Trust and Respect	1,369	2.58	2.68	2.67	3.5%	.005	W3>W1, W2>W1

Table 7:
Comparisons Over Time of Other System Characteristics
Variable Groups	Variables	N	Mean Scores			Time Comparison
Variable Groups	Variables	N	Wave 1	Wave 2	Wave 3	Percent Change (Wave 1 to Wave 3)	P*	Pairwise Comparison**
Emphasis On Providing Housing Services And On The Associated Goal Of Ending Homelessness	Emphasis on Transitional, Emergency, and Affordable Housing as Contrasted with Permanent Supported Housing (Factor Score)	206	2.33	2.21	2.15	-7.7%	.32	None
	Change in Emphasis from Emergency Shelter and Transitional Housing to Permanent Supported Housing (Factor Score)	208	2.12	2.07	2.18	2.8%	.47	None
Development Of Homeless Services Management Information System	Client and Services Information Available	208	.75	.86	.90	20.0%	.0009	W3>W1, W2>W1
	CICH Management Information System Exists	199	1.23	1.47	1.90	54.5%	.0006	W3>W1, W3>W2
Use of Evidence-Based mental health Practices	Use of Evidence Based Practices (Mean Rating)	204	2.12	2.35	2.41	13.7%	.0002	W3>W1, W2>W1
Funds Transfer and Influence	Fiscal Relationship Exists	1,355	.29	.32	.33	13.8%	.52	None

*Proc mixed used in which autocorrelation controlled for with respect to site for those measures based on key informant observations (site and ID for those based on relationship characteristics)

**Only those comparisons with significance in which p<.05 reported

Table 8:
Comparison of Measures by Site and Agency Type
Variable Groups	Variables	N	Site Comparison (All Time Points)		Agency Type Comparison (All Time Points)
Variable Groups	Variables	N	Interaction Effect — Site and Time	Sites that Showed Significant Change Over Time	Interaction Effect — Agency Type and Time	Types of Agencies that Showed Significant Change Over Time
System Connectedness And Integration	Integrative Practices	215	(p=.49)	NA	(p=.85)	NA
	Coalition Involvement	187	(p=.91)	NA	(p=.57)	NA
	Working Together	210	(p=.70)	NA	(p=.83)	NA
	Involvement of Local Organizations: Number	211	(p=.96)	NA	(p=.91)	NA
	Dyadic Joint Service Planning and Coordination	1,366	(p=.02)	Los Angles (p=.0001) Columbus (p=.0001) Fort Lauderdale (p=.0007) San Francisco (p=.0015) Portland (p=.0195)	(p=.06)	Lead (p=.0045) Housing (p=.0087) Mental Health (p=.0017) VA (p=.0001) Other (p=.0005)
	Dyadic Trust and Respect	1,369	(p=.28)	NA	(p=.11)	Lead (p=.0046)
Emphasis On Providing Housing Services And On The Associated Goal Of Ending Homelessness	Emphasis on Transitional, Emergency, and Affordable Housing as Contrasted with Permanent Supported Housing	206	(p=.72)	NA	(p=.86)	NA
	Change in Emphasis from Emergency Shelter and Transitional Housing to Permanent Supported Housing	208	(.97)	NA	(p.=62)	NA
Development Of Homeless Services Management Information System	Client and Services Information Available	208	(p=.73)	NA	(p=.81)	NA
	CICH Management Information System Exists	199	(p=.60)	NA	(p=.17)	NA
Use of Evidence-Based mental health Practices	Use of Evidence Based Practices	208	(p=.49)	NA	(p=.74)	NA
Funds Transfer and Influence	Fiscal Relationship Exists	1,355	(p=.74)	NA	(p=.25)	NA

Table 9:
Funds Transfer Relationship and Measures of Integration
Variables	N	Mean Scores			Presence of Fiscal Relationship	Interaction Effect — Fiscal Relationship and Time
Variables	N	No Relationship	Relationship Exists	Percentage Difference	Presence of Fiscal Relationship	Interaction Effect — Fiscal Relationship and Time
Dyadic Joint Service Planning and Coordination	1,326	1.55	2.41	55.5%	(p<.0001)	(p=.10)
Dyadic Trust and Respect	1,322	2.57	2.79	8.6%	(p<.0001)	(p=.95)

An Evaluation of an Initiative to Improve Coordination and Service Delivery of Homeless Services Networks:

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