A History of the Continuum of Care

Dollars vs. Priorities

By Brian Davis

In the early 1990s, Cleveland was facing a homeless crisis. The emergency shelters were full, and there was a limited pool of resources to meet the growing demand for services. On top of this women and families were entering the system at an alarming rate. City Council President Jay Westbrook and County Commissioner Tim Hagen convened a Coordinating Council to study and make recommendations to answer the growing homeless problem locally. All the Foundations, service providers, some major businessmen, and the Coalition for the Homeless came to the table. Despite the somewhat contentious battles over philosophy and direction, the group produced a series of recommendations.

Along with the creation of more transitional housing programs, the Coordinating Council recommended the creation of the Office of Homeless Services to administer the goals outlined by the Council. This office was jointly funded by the City of Cleveland and Cuyahoga County. It was placed within the administrative structure of Cuyahoga County with broad goals of reporting to the Mayor of Cleveland and the County Commissioners once a year. It was governed by an Advisory Board made up of members of the original coordinating council. The Office of Homeless Services was given the task of coordinating the Supportive Housing Program (SHP) grant to HUD. They also administer the Emergency Shelter Grants from HUD, and act as coordinator of services locally.

The original goals of the Office of Homeless Services:

1.   End homelessness through empowerment

2.   Create an integrated service delivery system.

3.   Provide a continuum of services by establishing a Central Access Point for the homeless and those serving the homeless.

4.   Prevent additional people from becoming homeless by assisting them in maintaining their current housing.

5.   Provide decent temporary shelters to help people to acquire the ability to live independently.

6.   Provide an environment that combines housing and supportive services to enable the homeless to become self-sufficient.

7.   Increase safe, permanent, affordable housing opportunities for low income persons.

8.   Create an organizational capacity to perform multiple functions.

While some of the goals like ending homelessness were facetious and nearly impossible very few of the goals have been realized. OHS has taken the reigns in securing federal funds to serve the needs of homeless people. The key to securing funds is the planning, and OHS has tried various attempts to meet the HUD requirements. The grant is divided into a number of parts, which make sense from an academic stand point, but are totally impractical in Cuyahoga County.

What is the extent of the problem locally?

HUD asks that each community layout the extent of the homeless problem locally. They ask that each community certify the number of shelter beds, transitional housing beds and permanent housing units available. Then they ask what the need is for each of those beds and housing units. This is a reasonable request after all how can a community ask for more housing units if they cannot identify the gaps in service? Unfortunately, Cleveland does not have a central database to count the number of people who enter the system. No one collects the intake forms that shelters make every client complete. It is therefore impossible to demonstrate need except through anecdotal information. Every year, Cuyahoga County uses some numbers drawn from an attempted census done in 1993, but the numbers have very little basis in reality.

What is the timeline for planning locally?

The key to receiving the dollars from HUD is demonstrating on-going planning with regard to priorities and gaps in service. While there are some on-going discussions within the community regarding problems, the goal setting is wrapped around the grant. We traditionally begin the application in March or February with a deadline set by HUD for May or June. All of the planning locally takes place over three months every year. This compressed time frame makes it difficult to get into a philosophical discussion about extending shelter stays or developing programs that fill a major gap in services if no organization applies. There is little time to review all the projects seeking renewal funding, decide on the priorities for the year and submit the grant to HUD. Because the focus is on recovering federal dollars, the community planning process is a pursuit of dollars and not a pursuit of solutions.

What are the priorities in the community?

HUD asks that each community decide what are the greatest needs in the community, and then submit programs that address the highest priorities. Every year, Cuyahoga County under the guidance of OHS has attempted to come to a consensus of what the highest priorities are in the community. They have surveyed impartial groups (businesses, government, and foundations), service providers and homeless people and then tried to integrate all these recommendations. They have had the oversight committee for the grant make the recommendations. For the last few years they have just asked members of the community to come together in one large meeting to confirm the priorities from the previous years.

One of the conflicts within this system is that emergency services cannot be funded by the Continuum of Care SHP grant. Therefore many times emergency services are kicked out of the priority list. Also, many safety net services like a lack of entitlement income for adults are not able to be funded by the HUD SHP grant. One of the major concerns of homeless people was the deplorable overflow shelters, but this never made the priority list since it was not a HUD SHP funded program. In the end, the priorities for the community were decided in a one hour discussion at a meeting in March.

What programs should be renewed?

One of the biggest problems with the Continuum of Care funding is the cumulative impact of program funding. Each program is funded for three years, but the money is allocated in one year. So Transitional Shelter X may need $200,000 per year, but are forced to apply for $600,000 in the first year to cover the first three years of the program. The problem arises after three years when the program is up for renewal because every year more and more programs are up in need of renewal funding. Most every community is now at a point where just sustaining the programs funded over the last seven years takes most of the funding set aside for that community. In Fiscal Year 2000, Cuyahoga County faced a situation in which they had approximately $11 million allocated from HUD. If every project that was eligible received only one year of renewal funding, Cuyahoga County would spend $4.491 million. The permanent housing program called Shelter Plus Care needed nearly $7 million to maintain the current number of people housed.

HUD did allocate additional resources to communities facing a dramatic shortfall in need versus federal share of the SHP funds. For example in 1999, Cuyahoga County had a $10.5 million share, but was given over $17 million to meet the renewal needs of the community. This burden of renewal program has led to a moratorium on the funding of new programs. There is just not room in the allocation for new programs without reducing funding or de-funding programs. This is the heart of the problem in Cuyahoga County. There has never been a reduction in any programs funding, and every program has been renewed every year. Even those programs not performing are renewed. There is no outside oversight body reviewing the programs operating in Cleveland and determining their effectiveness.

Only within the last year were the programs even reviewed to assure compliance with standards locally. In fact, an independent consultant was hired in 2000 to evaluate the 1999 grant application, and she found that "There is not much in the way of program evaluation," and [Cuyahoga County] is limited in its ability to deal with projects that have performance problems. The SHP funds are billed by HUD as helping to "develop housing and related supportive services for people moving from homelessness to independent living." In Cuyahoga County very few of the organizations are effectively moving people into independent living. Many programs spend $20,000 to $30,000 for each person that they move into housing.

Who makes the recommendations for the grants?

An ongoing controversy in Cuyahoga County is who makes the recommendation for what agencies are submitted to HUD for funding. Social service providers have an expertise on how to serve homeless people, but they also have a bias to maintain funding for their organization. Homeless people know what works, but they also have an affinity for the programs that have helped them out of their situation. The government entities have an interest in not rocking the boat in order to not to politicize the grant application. The local government also has a close relationship with social service providers who they rely on to stem the tide of homeless people.

One year a survey of all the programs seeking renewal funding was sent to all the other social service providers in the community. This was to solicit expert testimony about colleagues. One provider who requested that his identity be kept confidential confirmed that providers called each other that year to solicit positive reviews. Our source said, "I got a call saying if you give me a good score, I will rate your program with a high score." Another service agency was given a high score and they were not even operational. They had never housed one individual, but were given a favorable review by the other social service agencies.

The Coalition for the Homeless regularly surveyed homeless people about programs that were seeking renewal funding. These surveys were not given much weight. The opinions of homeless people did not lead to any changes in the funding of programs that were not performing. The Coalition stopped doing the surveys two years ago out of frustration.

Who sits on the oversight committee?

A community meeting of a broad constituency that sets the priorities in the community takes place at the end of the winter every year. The Office of Homeless Services has an advisory board that sets the schedule for the how the grant is prepared. It also approves the final grant and is involved in the application process, but who manages and oversees the application. This has for years been a fine line to walk. There is the issue of conflict of interest that makes it difficult to pick an oversight body. There is a great deal at stake for the social service providers, and should social service providers sit on the oversight body? Some of these programs are $1 million dollar organizations and employ scores of people. The decisions made by the oversight body mean the continued existence of some of the programs or it means that private organizations will have to be tapped to continue the funding.

The OHS advisory board empanels a committee to shepherd the federal grant to completion. The grant oversight organization was called the "ad hoc committee" or the "OHS review and ranking committee." They met three or four times during the grant application process to rank order the programs that are seeking renewal funding and to review new programs and put them in the order of priority for the community. Aside from the lack of objectivity on this committee and the high scores the agencies received, the committee never really looked at the impact the organization was making in the community. While the committee checked to assure that the organization had adequate fire extinguishers they never looked at the organization moving their clients toward housing stability.

The other problem with this committee is the final decisions are not conducted by secret ballot. The committee is supposed to make the recommendations regarding, which programs are provided renewal funding and then which new programs should go forward. For the past two years, the renewal funding used all the resources available to Cuyahoga County, and therefore there were no new programs. In voting on recommendations for renewal funding a chart was produced with the names and vote from each committee member. This makes it difficult to vote not to recommend renewal funding. Every committee member has to be aware of the backlash against the people who voted against a social service provider that may not be performing, but is serving a politically popular constituency like women and children or homeless people with a mental illness. That social service provider could use media and other leaders in the community to castigate the committee members that voted to "throw children back onto the street," or "recklessly close the few safe places for mentally ill people in our community."

In looking broadly at the Continuum of Care system, Cuyahoga County has seen a tripling of the resources from the federal government over the last ten years. We have at the same time seen the number of homeless people experiencing a bout of homelessness during the course of the year also triple during that time. We have institutionalized homelessness transforming it from a short term lack of housing to a chronic condition. There is no accurate assessment of the number or profile of the people entering the system to say nothing of future or emerging populations. There is no plan in place and there is effort to use the dollars to better serve the needs in the community. The consultant hired by the County to look at the Continuum of Care funding process summarized the problem by recommending, "refocusing the community discussion from dollars to priorities."

Copyright NEOCH and the Homeless Grapevine, Issue #45 -  2001