Through many studies and many site visits, the authors have identified the critical importance of having one or more people facilitating, coordinating, stimulating, reminding, organizing, assessing progress, bringing in new players, and keeping the many actors moving in the right general direction. As mentioned in the framework, creating this position represents a change in power to support system change efforts. The THCH project clearly demonstrates this finding (Burt & Anderson, 2006). THCH funds have supported these essential functions in every THCH site. Key informants consistently stressed how vitally these functions have contributed to progress and the role and effects of coordination were obvious everywhere and at every level of system change observed. The basic phrase heard repeatedly was, it wouldnt have happened without [insert name of key THCH coordinator]. Without it, even a community with a dedicated council, committee, task force, or other mechanism that in theory could assume leadership runs up against the reality that committee members have other jobs to do. With the best will in the world, they cannot take on the coordinating function.
In all likelihood providing someone to mind the store is the key way that THCH has been able to have such a strong influence in many of its communities in such a short period of time the grant pays the salary of someone whose job is to pay attention. The THCH evaluation also addressed the issue of where a coordinator should be located to be most effective. Some THCH site coordinators were employees of government agencies, while others operated from independent CSH offices, two of which were newly created for THCH. So the lever of change in some THCH communities was internal to government and thus subject to government changes in direction and policy, while in others it was external to government and had a primary and continuing mission to promote system change.
The decision to place the THCH project within or outside government was not random, which complicates analysis. Four sites had government agencies that were very ready for change and had also taken significant steps of their own toward investing in interventions to end long-term homelessness. These are the sites with coordinators internal to government, as there was an obvious governmental home eager to receive and support them. However, governments change, so it is especially telling to note what happened in the one or two THCH communities where the coordinator role was not as strongly realized, or not realized as quickly or at the highest levels. System change in these communities happened more slowly, or did not happen at all, because political or administrative changes (changes in power) occurred soon after THCH began, and hampered the coordinative function.
Two sites in which the THCH grant went to government agencies, Maine and Kentucky, began their grant period with their state housing finance agencies well positioned to involve other state agencies in expanded commitments to PSH development. A change of governors in Kentucky greatly reduced the potential coordinating function that THCH was able to play because agency priorities changed from ending homelessness to fostering recovery from substance abuse for people with housing. The Council on Homeless Policy, with its complement of state agency, provider, and advocate representatives, continued to meet, but operated mostly at the communication level, with some minimal coordinating activities. Each representative of a government agency operated in the context of his or her agency practices to facilitate PSH development. No one fulfilled a strong coordinator position urging new mechanisms, streamlined mechanisms, joint funding options, or changed policies and practices to stimulate even more PSH. Perhaps the time was not right in Kentucky for even the strongest coordinator or facilitator to pursue a PSH agenda with state agencies, and perhaps the results would have been the same whether someone was trying to fulfill this role from inside or outside of government. But the fact remains that without a strong coordinating influence the need for system change was not recognized or acted on.
The Maine State Housing Authority also had a commitment to PSH when THCH began, in a state that had already made significant commitments on paper to ending homelessness in the form of a statewide Action Plan. For various reasons unrelated to THCH, steps to endorse and then implement the Action Plan stalled. THCH stepped into these difficult circumstances; state housing finance agency staff proceeded to create an important multi-agency work group focused on PSH production. This group of mid-level government officials, working below the radar screen of agency heads but with their knowledge, made significant headway in moving projects toward realization through the commitment of new public resources (additional capital from the housing authority and Medicaid to pay for services from the Department of Human Services). When the state-level process began moving again and the new governor endorsed the Action Plan, THCH staff were in position to continue and expand their coordination activities. The governor also created a cabinet-level Director of Homeless Initiatives, making Maine the only state in the country to elevate the issue of homelessness to the cabinet level. This significant shift in power is leading to shifts in money and ideas.
The two remaining THCH sites with coordinators internal to government, Portland/Multnomah County and Seattle/King County, are prime examples of how far a person whose job is system change can move a system from a platform inside a government agency. Even when the system was ready to be moved, far less would have happened, in the opinion of key stakeholders, without the facilitation offered by the THCH coordinator. Having THCH money and someone in the coordinator position facilitated bringing everyone together, including politicians, agency heads, middle management, providers, and the clients in need of PSH units. With coordinators in place, these communities moved to establish one or more working groups. The groups had some common charges, including bringing more agencies to the table, finding more money for PSH, and smoothing the process of putting together PSH funding packages. In these communities, the agency responsible for mental health and substance abuse services was a primary target for inclusion, and both succeeded in bringing these very important agencies and their service-oriented resources on board. Law enforcement is also an important new partner in Portland.
Multi-agency groups in both communities have made great progress in identifying and committing public resources. These include completely new funding sources (e.g., Washingtons bill 2163), more funding and redirected funding from existing sources (e.g., use of state and local mental health dollars as service matches for PSH), and more streamlined funding mechanisms. They have also reduced bureaucratic entanglements that can slow the process of PSH development. Finally, these two THCH communities established new procedures for assuring that the hardest-to-serve long-term homeless adults were most likely to become tenants of new units.
The THCH sites in Los Angeles and Rhode Island were structured with coordinators in new CSH offices external to government because local government was not active in seeking solutions to homelessness. There was thus no obvious place to locate an internal coordinator. The external THCH coordinators initial goals in these communities were to educate relevant stakeholders about PSH and demonstrate to public agencies that PSH could help them fulfill their own agency objectives. Working from their nongovernmental platforms, THCH staff in both sites sought a foothold in the most relevant committees, councils, or task forces and proceeded from there. They were also able to capitalize on activities of their affiliated CSH offices (California and Southern New England) to help mobilize these new communities.
In Los Angeles THCH resources were used to staff the Special Needs Housing Alliance (a task force of county agencies charged with assessing and then augmenting available special needs housing, including housing for homeless people). This staffing provided coordination and technical assistance to help the Alliance articulate its agenda, complete a countywide inventory of special needs housing, develop a strategic plan, and see important components of that plan funded by the County Board of Supervisors, including a new position of housing and homelessness coordinator under the countys Chief Administrative Officer several firsts for Los Angeles County that in turn are leading to new developments and partnerships. In Rhode Island, THCH intervention helped make PSH a recognizable concept to key stakeholders (change in ideas), leading to a new state agency with a housing and homelessness portfolio that gathers most of the states housing and homelessness-related funding streams into one coordinating office (change in power), staff to make it happen, a re-established interagency council, a partnership of philanthropy and government, and a first-ever public-private funding commitment for new units of PSH (change in money).
In the remaining THCH community, Connecticut, a good argument could be made that Connecticut had already achieved system change before THCH. But THCH staff in Connecticut see system change as an ongoing process and one that will always need some level of tending. Systems can always be improved, new agencies and populations brought in, service approaches expanded and made more effective, new provider teams created, prevention tackled, and real public understanding and commitment to ending homelessness secured. Connecticut used its THCH resources to many of these and other ends. It is the best example within THCH, so far, of what might be called a self-renewing system one that regularly reflects on where it is and where it wants to be and keeps moving forward. As the nongovernmental entity whose eyes are always on the PSH prize, THCH and CSH in Connecticut still find significant roles in promoting the means to end homelessness for people with disabilities who are unlikely to be able to manage on their own.
The issue of the most effective location for a coordinator as change agent has no simple answer. Internally placed coordinators may be extremely effective in communities where at least some agencies and providers are ready for and interested in change. However, they are vulnerable to alterations in political support, and if support shifts substantially, their internal position may make it difficult for them to continue facilitating and advocating for system change. An externally placed coordinator may remain single-focused through all political changes, but has no official clout to wield in the process of gaining peoples attention and beginning to influence their choices. Further, an externally placed coordinator must have a home somewhere, so an external organization must create and sustain that home. To be most effective, the external organization should be seen as neutral or nonpartisan but politically savvy, able to contribute expert knowledge and technical assistance, respectful of all parties, and good at listening and facilitating.