COACH (Clark County Outreach and Assistance to the Chronically Homeless) Program Evaluation and Policy Analysis Team Members Sandy von Wolffradt (State of Nevada) Kirk Medina (City of North Las Vegas) Tony Vibabul (City of North Las Vegas)
COACH A three-year HOPE grant from the Social Security Administration» $450,000» Supplemental Security Income» Social Security Disability Benefits
Outcome Evaluation Approvals 2004-2006 140 Clark County 120 100 80 60 40 20 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Agencies Approvals
Outcome Evaluation HOPE Enrollees vs. Approvals 140 Clark County 120 100 Approvals 80 60 Santa Cruz 40 White Bird Clinic 20 0 0 50 100 150 200 250 300 Enrollees Approvals Expon. (Approvals)
Outcome Evaluation SSA Cost per Application $80,000 Exceed $80,000 $70,000 $60,000 $50,000 $40,000 $30,000 $20,000 Clark County $10,000 $0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Agencies
Outcome Evaluation TOP PERFORMERS IN REGIONS 300 250 200 150 100 50 0 Boston New York Philadelphia Atlanta Chicago Dallas Kansas City Denver San Francisco Seattle Enrollees Approvals
Outcome Evaluation TOP 5 PERFORMERS 300 250 200 150 100 50 0 Clark County, NV Denver, CO Los Angeles, CA Santa Cruz, CA Roseville, MN Enrollees Approvals
Outcome Evaluation Benchmarking Top Five Performers Ranking Grantee Type of Organization Approvals SSA $ / App. 1 Clark County Social Services County Government 131 $2,672 2 Colorado Coalition for the Homeless, Denver Non-profit Corporation 93 $3,763 3 Volunteers of America, Los Angeles National Human Services Non-profit Organization 79 $4,430 4 County of Santa Cruz, CA County Government 74 $4,532 5 Salvation Army North, MN National Non-profit Organization 69 $5,072
Workflow Process Analysis Existing Staffing: One (1) supervisor (multi-programs) Two (2) full-time case workers Four (4) part-time assistants Areas of Concern Understaffing Communications With applicants Within agency - inconsistencies Southern Nevada Adult Mental Health Services (SNAMHS) Main reason for loss of contact with mentally-ill applicants Staffing (COACH to match SNAMHS increases )
Workflow Process Analysis Recommended Improvements Participate in One Stop Shop for homeless Utilize Technology Scanning equipment WESTAT (Private Data Agency) Improved Transportation Bus tokens vs unlimited passes Training Lack of cross-training Plan for attrition Outreach Practice Almost all outreach is through referrals
Workflow Process Analysis Strengths: Customer Service - Applicants Receive Full Assistance Documents Doctors visits Arrangements for housing assistance Food vouchers, personal transportation, etc. Exceptional staff accessibility Qualified Staff Very knowledgable Certified in the field (mental cases) Average approval time: 3-6 Months Strong Support From Other Agencies
Cost Analysis 2006 COACH Budget 1% 3% 3% 39% 11% 43% Staff Salary Contractural Supplies Staff Fringe Medical Records/ID's Travel
Cost Analysis Enrollees By Program Type and "Loss" Enrollees May 2004 - April 2006 Other Pending SSI SSD Loss Dis-Enrolled SSI SSD Loss Dis-Enrolled Reconsideration Pending Other Reconsideration
Cost Analysis Dollars Spent on Medical & Housing Assistance During Year Two of Grant Per Program Type $250,000 $200,000 $150,000 $100,000 $50,000 $0 Reconsideration SSI SSD Medical Assistance Services LOSS Pending Dwelling Assistance Services
Cost Analysis Volume of Work with Associated Expense By Type of Program Per Social Worker Number of Cases 45 40 35 30 25 20 15 10 5 0 Dis-Enrolled SSI SSD Reconsidered Pending Loss of Contact $200,000 $185,000 $170,000 $155,000 $140,000 $125,000 $110,000 $95,000 $80,000 $65,000 $50,000 $35,000 $20,000 $5,000 -$10,000 SNA CZA Expense
Cost Analysis Average Housing & Medical Assistance Paid for Enrollees By the County Pre- & Post-Enrollment 1700 1600 1500 1400 1300 1200 1100 1000 900 800 700 600 500 400 300 200 100 0 PRE Dwelling Assistance Services POST Medical Assistance Services
Viable Alternatives Description # Employees Cost/Yr Benefits Continue to fund program as is and seek additional SSA grant funding Continue to fund program but move to different department within the County Continue program only if additional grant funding can be obtained 4 to 8 FTE s Est. $300k SSA Benefits for 65 homeless per year 4 to 8 FTE s Est. $300k SSA Benefits for 65 homeless per year 4 to 8 FTE s N/A Only if funding is available / Program at risk. Discontinue program 0 N/A None, but more indirect costs in the long run Outsource program to private non-profit agency 0 $ More None, performance likely to decline
Recommendations Continue to fund program as is, even when grant funding is depleted (fiscal and social benefits far outweigh costs) Conduct comprehensive cost-benefit-analysis Keep program in Social Services Department where it has become the Top Performer in the nation Address staffing and technology needs Seek additional grant funding
Recommendations Shift a portion of program cost from contracted doctors to additional COACH staffing Create uniform reporting codes to monitor program (SSD, SSD-R, R-SSI) Identify the number of SSI/SSD enrollees (quarterly) from the County that were not enrolled through COACH program Implement a more corroborative method of patientrelease notification by SNAMHS Partner with other agencies (Homeless Coalition) to handle specific area of processing enrollees
Conclusion The Clark County COACH program is clearly the best performer in the Nation County will benefit by continuing to fund the existing program Additional information provided in documented program evaluation It has been our pleasure to work with County staff to prepare this evaluation