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The Columbus Model: Quality Improvement
Toolkits | November 5, 2010
Files: PDF | 109 KB | 5 pages
Performance Evaluation Overview
Columbus's continuum operates through an outcomes-based funding model that uses measurable performance standards to monitor agencies and systems progress toward achieving community goals. The community evaluates 15 system-level performance measures and more than 30 client- and program- level measures. These performance standards reinforce an overall vision and strategy for improving the homeless services system and working toward the eventual elimination of homelessness.
A central component of Columbus evaluation process involves scoring individual providers as High, Medium or Low performers. Scores are based on achievement of overall program performance goals and outcomes that are developed by CSB in collaboration with the service provider and outlined in the agency's contract. In addition, Columbus evaluates each performance goal individually as Achieved (Yes/Y), Not Achieved (No/N), or Not Applicable (N/A). An Achieved Goal is defined as 90 percent or better of a numerical goal or within 5 percentage points of a percentage goal. Not Applicable is assigned when a performance goal was not assigned. A program that experiences repeated difficulty meeting performance goals is considered a program of concern. To learn more about Columbus's performance measurement and evaluation processes, click here.
System/Program Evaluation Ratings
Performance Incentives and Improvement
In order to drive overall system improvement and reductions in homelessness, Columbus uses a combination of approaches. CSB incentivizes a high level of performance by using performance-based contracts. In addition, CSB encourages agencies to perform well by making funding decisions and merit awards based on agencies’ annual evaluation and performance ratings. To view sample performance-based contracts, click here.
Quality Improvement Intervention Program
One of the most remarkable approaches used in Columbus to help agencies strengthen their performance is CSB’s Quality Improvement Intervention Program (QII). Programs rated as “Low,” identified as a “program of concern,” or that fail to comply with CSB’s Administrative and Program Standards go through the QII, which covers the following core areas:
Low performers are required to participate in the QII; however, if the low performing program and CSB cannot reach agreement on these core areas, the agency may appeal to the CoC Steering Committee for review and final recommendation.
Throughout the QII process, CSB conducts at least quarterly one-on-one dialogues with the troubled agency. Agencies may also submit monthly indicator reports to CSB and check-in regularly regarding specific action steps and timelines. The process may include organizational development opportunities such as training, peer-to-peer learning opportunities, and outside consulting or facilitation support. The QII may be as short a month or last up to 24 months and is tailored to each program’s needs. If a program is unable to deliver acceptable performance outcomes, it is defunded.
Columbus has a 100 percent success rate for improving organizations outcomes and helping them achieve system standards.
The following scenarios are based on case studies from organizations in multiple communities, not solely Columbus, OH. The information from these cases was altered to maintain the anonymity and privacy of the subject agencies.
The QII revealed that the organization’s service process is overly linear and lengthens clients’ stays in homelessness. Clients’ length of homelessness significantly impacts their housing outcomes. For example, the organization’s intake and assessment processes take only a couple of hours. However, this information is not reviewed or used to start addressing housing barriers (e.g. linking clients with benefits) until the next case team meeting. Team meetings only occur one time per week, and all the clients that entered the agency that week are discussed. The timing of the case meeting relative to a client’s intake and assessment accounts for approximately one week in length of stay variance.
Housing location for clients does not begin until nearly all the housing barriers (e.g., approval of benefits income, approval of relocation assistance) have been addressed, which takes 30 to 40 days. The housing location process takes an additional 3 to 4 weeks to complete. Many clients voluntarily leave the agency during this time but show up in another shelter program only a short time thereafter. Client interviews revealed that clients leave the program prematurely because they find shelter life stressful and they hear that other programs place clients in housing faster. Additionally, some clients are frustrated because they observe clients entering the program as much as 3 weeks later and placed into housing more quickly.
The QII found several areas where this agency could adjust its approach and become more cost-effective. These key areas include targeting practices, client programs, and client support services. Regarding targeting, this transitional program only accepts families with limited housing barriers and a strong likelihood of success. Often, the head of household has some employment history, limited history with substance use, at least six months of “clean time” where substance use has been an issue, and minor criminal history if any. Clients served in the program are required to participate in several classes and programs on topics such as parenting, health and nutrition, and financial management. Clients are also required to participate in a vocational, employment, or other education or training program, and they must demonstrate the development of specific life skills such as cleaning, improved social networks and skills (i.e., better friend choices, limited visitors, etc.), and cooking.
Clients in this transitional program demonstrate strong outcomes. However, review of client files shows that clients with similar profiles achieve the same outcomes when rapidly re-housed directly from shelter and
provided with short-term or no home-based case management. In fact, families with this client-profile obtain most of their income and social service resources while they are in shelter and can maintain housing with limited financial assistance in the form of a security deposit, back rent payment, and/or first month’s rent. Case management for these clients in a rapid re-housing program builds on client progress in shelter and
focuses on helping clients:
The transitional housing agency’s required programs and case management account for most of the difference in cost per household because they are financed only by the agency’s budget and do not leverage community resources. Further, the rapid re-housing programs serve a larger number of households in a fiscal term than the transitional program, which further decreases their cost per household. Finally, the majority of clients in the transitional housing program remain in the program until they obtain a permanent housing voucher. This makes the permanent housing voucher the primary driver of housing stability for this program’s clients and suggests that the programs and services are unnecessary to help the family access and maintain permanent housing.
The agency chose to become a short-term transitional housing program that takes clients with slightly higher housing barriers, making the resources expended more cost-appropriate for the client population served. The agency’s transition took 12 months and resulted in the following outcomes and changes:
Additional ResourcesCommunity Shelter Board Website