CORE partner feature: Council for the Homeless

Thursday, January 12, 2023

Learn how the Center for Outcomes Research and Education (CORE) partners with Council for the Homeless, a nonprofit providing community leadership, compelling advocacy, and practical solutions to prevent and end homelessness in Clark County, Washington.

Since its founding in 1989, Council for the Homeless (CFTH) has been the backbone of the Homeless Crisis Response System in Clark County, Washington. Like many communities, Southwest Washington faces a growing homelessness crisis. CFTH is responding with community-based and innovative solutions to help people remain in their homes, secure safe shelter, access basic needs, and more.

As one of CFTH’s measurement and evaluation partners, CORE has the honor of supporting some of their innovative and impactful work, particularly around collaborations with partners across the health care, behavioral health, and housing sectors. Read on to learn more.

"CORE’s research has played a valuable role in our work at Council for the Homeless, including helping inform my new role as systems integration manager by breaking down a seemingly impossible task into very understandable next steps. They’ve also helped identify where change is needed, where systems are doing well, and what we need to learn to better integrate, collaborate, and support the populations we serve. We truly appreciate our partnership with CORE!" - Heather Sheppard, Systems Integration Manager, Council for the Homeless

Enhancing Cross-Sector Collaboration

People experiencing homelessness face high rates of serious mental illness and chronic disease. Yet they often lack access to essential behavioral and physical health care services. That is why so much of CFTH’s work focuses on cross-sector collaborations between the housing, behavioral health, and healthcare sectors.

CORE supports this work through a variety of research and evaluation services, including surveys and interviews with CFTH’s cross-sector partners designed to help measure and enhance those collaborations. Our work helps CFTH understand perceptions and opportunities around collaboration between housing and healthcare organizations, with a goal of informing more effective strategies and partnerships that deliver better health and housing outcomes for those experiencing homelessness.

This work continued in 2022 through research on how relationships between housing and behavioral health organizations in the homeless crises responses had changed over the last two years. Survey findings revealed mutual appreciation, respect, and confidence between the two sectors and highlighted opportunities to deepen collaboration.

"In this community there are far fewer resources than there is need, and we have to figure out a way to leverage those resources. For that reason, there's a huge push for collaborative efforts." - CFTH partner (Housing Organization Executive)

Addressing Unmet Needs

Personal hygiene, housekeeping, meal preparation, and transportation to appointments are a key barrier to better outcomes for people transitioning out of homelessness. However, these needs often go unaddressed due to the existing Medicaid personal care services payment structure and eligibility process. In response, CFTH partnered with CDM Caregiving Services and the Vancouver Housing Authority to pilot expanded access to caregiving services, prioritizing seniors and people with complex health needs. They engaged CORE to help evaluate the pilot, with the goal of understanding staff and client perspectives and experiences with the personal care services pilot program.

Through interviews with staff and program participants, CORE found that the expansion of personal care services into the Homeless Crisis Response System helped clients establish more stability in CFTH clients’ day-to-day lives. And it contributed positively to their physical health, mental well-being, and housing security. We also identified opportunities for improvement, including a need for additional caregiver trainings, as well as the importance of greater flexibility and accommodations that respond to the challenging and emotionally demanding nature of caregivers’ work.

"[My doctor] couldn't believe how much better I'd been doing. Most of that, seriously, is thanks to [my caregiver] and her care and concern. She's very caring." - CFTH client

Advancing Innovative Solutions

In 2019, Southwest Washington Accountable Community of Health (SWACH) created the HealthConnect Hub to serve as a central care coordination system for the region. The Hub leverages an innovative model called Pathways, in which community-based care coordinators such as Community Health Workers (CHW) assist program participants with navigating health care, social services, and other systems to receive the care and support they need. CFTH is partnering with SWACH on this effort.

"It's never you, it's always we. [My CHW] includes herself into that category of, 'I'm not here telling you what to do, I'm here to take this path with you.'" - Pathways client

We recently completed an in-depth analysis exploring homelessness and housing concerns among Pathways participants. Our findings point to significant challenges faced by unhoused Pathways participants, who experience complex and interrelated issues related to their housing status. For example, unhoused Pathways participants have significant health needs and higher rates of basic needs such as food, clothing, and transportation. Unhoused participants were also more likely to use acute healthcare, such as the emergency room.

These findings highlight several key opportunities to improve housing stability and health for people exiting homelessness while reducing costly and ineffective uses of emergency healthcare.

Today, CFTH is working to strengthen the region’s Homeless Crisis Response System by integrating the Pathways program and CFTH’s personal care services program into that system, while expanding specialized access to physical and behavioral healthcare services for those experiencing or at risk of homelessness.

These are just a few of the ways CFTH is making a difference in their community, and just a few of the reasons we are so proud to partner with this impactful organization.

To learn more about CFTH, visit their website at https://www.councilforthehomeless.org/