Denver: And it is indeed a pleasure to welcome to the show one of the six finalists of the MacArthur Foundation’s 100&Change competition. She is Beth Sandor, a Principal at Built for Zero, which is an initiative of Community Solutions.
Welcome to The Business of Giving, Beth, and congratulations on being named one of the superlative six!
Beth: Thank you. It’s wonderful to be here.
Denver: Share with listeners just quickly the mission of Community Solutions and Built for Zero.
Beth: Yes, the mission of Community Solutions is a lasting end to homelessness that leaves no one behind. So that’s really what we’re trying to achieve with all of our work, and specifically with Built for Zero.
Denver: How many people are homeless in America on any given night, and what’s the impact on their health, their lifespan, and so on?
Beth: So right now, the numbers that we have are a little over half a million people are homeless on a given night. A large proportion of those folks are individuals but also almost 170,000 are families that make up that number and about 30,000 are youth. And so, we have a lot of families and youth still homeless in our communities.
The other important thing to note about the population it’s disproportionately, people of color compared to the general population. We can see that in Black Americans make up 13% of the general population, but 40% of the homeless population. And so, we’d see the disparities that exist in our communities generally show up in the homeless response system. And as you mentioned, it has huge impacts on people’s health, and mortality risk increases significantly when people are homeless. Being outdoors, being in unsafe situations, and as we’ve seen with COVID now with the public health crisis, we’ve seen the rest of people being in congregate settings, just make it more clear how important it is for people to be in homes.
Denver: And just on the issue of race that you mentioned, Community Solutions has really made a commitment to addressing that, which even included changing your mission statement, correct?
Beth: That’s right. In 2019, we changed our mission statement to be a lasting end to homelessness that leaves no one behind, to really hit home that homelessness mirrors the racism that pervades our society; and there’s really no path to an equitable future that doesn’t include ending homelessness and that we as leaders in the homeless response system really need to get serious about: What does it look like to end homelessness in equitable way? How can we use the information that we have in the homeless response system to hold institutions upstream accountable for outcomes, and also for racism?
Denver: I’m going to ask you to underscore one other point that you just mentioned and that is, I think, most people think about single men who make up the homeless population, and I think, in part, that’s because that’s what we see around. But you mentioned, women and children and families. Talk a little bit about that. That’s such an incredibly large number.
Beth: Yes, it is, and I think anyone being homeless is not good, no matter if you’re a single man or a family or a woman. But it is important to remember that just the visible homelessness that you see every day on the streets is not the whole story and that there are many people, especially youth in unsafe, unstable situations, and the hidden homeless population that we also need to make sure that we have solutions for. And so, it’s one of the most important things that a community can do is to really have their pulse on what homelessness looks like both on their streets, in their shelters, in doubled-up situations, on peoples’ couches so we have the full picture that includes women, children, individuals, everyone.
Denver: Beth, share with us Community Solutions’ approach to this homelessness challenge and how it has evolved over, let’s say, the past decade or so.
Beth: It’s evolved quite a bit, and I’ve been working with Rosanne Haggerty, who is our President for 20 years now, if you can believe that, and we’ve been on quite a journey together. We started as affordable housing developers with the mission to end homelessness because we really believed that the answer to homelessness is housing. And after doing that for a long time, building 3,000 units of housing, we realized there were still very vulnerable people on the streets outside of those buildings, and that we needed… if our mission was to end homelessness… we needed to get serious about understanding why that was.
And so our work evolved from focusing on permanent housing as the solution, to really trying to look at it as a systems problem. And when we started to talk to the people who were homeless on the streets, outside our buildings, what you saw and many people know is this very convoluted process for individuals and a very difficult process especially for people who are very vulnerable to move from the streets into permanent housing.
In the work that we did, in analyzing what that system looked like, what we saw is on average, it could take an individual 300 days to navigate the steps of the process, and that process could have up to 40 steps. And if you’re a person who’s been sleeping on the street, you’re cognitively impaired because you don’t sleep well, you may have major health issues. And that kind of process, it would be difficult enough for anyone to navigate, and let alone someone who has a high QD level of health or mental health needs. And so, that was a wake-up call for us to say, “Okay, what would it take to design the housing placement system around the most vulnerable individuals in our communities? And if we could do that, then the system would work better for everyone.”
And so, we launched in 2010 a national initiative called the 100,000 homes campaign where 186 communities across the country came together to figure out how to redesign their systems to accelerate their housing for the most vulnerable people. And over four years, those communities housed 105,000 of the most vulnerable people. It was incredible to see what they achieved, on average, increased their housing placement rate of vulnerable people by 286%.
And we learned a lot during that time, but we had to continue to hold ourselves accountable for what we said our mission was. Were we ending homelessness? And our theory was: if you got faster and better at housing people, that that would result in fewer people in the homeless system, and we just didn’t see that happen. And so, in 2015, we took what we have learned from that four years and designed Built for Zero to answer the question: How do you move away from counting up to housing placements and instead count down to zero homelessness?
Denver: How does your approach and how did your mindset change when you started counting down instead of counting up?
Beth: Well, things got a lot more complicated. I think we were a little naïve to how difficult it was going to be to answer that question, but we were lucky enough. We’ve had a decades-long partnership with the Institute for Healthcare Improvement, and our work and our partnership has really informed our approach.
And so, we knew a couple of things going into Built for Zero. One was how important it was to know people by name and to really have your pulse on who is experiencing homelessness and have that information updated in real-time. And so we knew that, and we had seen what had happened in healthcare when they had imbedded a quality improvement methodology into the work and healthcare.
And so, our shift was really moving away from treating homelessness as a technical problem that just needed… if we just had more housing, if we just had more money, if we just had – if we just instituted best practice that we would solve it to instead say, “What new problem-solving skills would we need as a sector if we were going to respond to homelessness in a dynamic way?” Homelessness is always changing every day in communities, and there are factors in society that are making that change every day. And so, if we see it as a systems problem, as a data problem that can only be solved by individuals working together differently, how would we approach it? And so, we got serious about embedding quality improvement in how our team worked and how local community teams are working. We got serious about moving away from static data to dynamic data that really helps people understand in real-time what’s happening, and then using this iterative framework of testing ideas and learning into the solutions, rather than assuming we had all the solutions upfront.
Denver: Yes. I love what you said a moment ago about knowing the person’s name because when I think about this problem, it changes the way I think about it… because if I were thinking about, I think of the homeless… or many of us do as a population, of a demographic or something like that. But when it becomes “sue or build,” it’s really the way a doctor would treat somebody as an individual and not as a population that you need to fix or challenge or something like that.
Well, how many communities across the country are part of the Built to Zero initiative?
Beth: We are lucky enough to work with 81 communities across the US, and when we say community, I think that sometimes, it’s unclear what it means. So, what we’re talking about is usually a county or a multi-county jurisdiction. And we’re working with the leaders who touch housing, services, the homelessness response system– usually city-county agencies, non-profits who all have to come together in a different way to hold themselves accountable for population-level reduction. So, are the enrolled numbers dropping every month? Are there fewer people experiencing homelessness this month than last month? And it’s amazing to have these leaders and implementers from across the country who are willing to raise their hand and say: We’re going to hold ourselves accountable for this and figure this out.
The communities we work with range from big cities like Washington D.C., which has a very high number of people experiencing homelessness, to world communities like Gulf Coast Mississippi where we have a six-county region that’s largely rural and is making enormous progress on ending homelessness, not just for individuals, but really for everyone.
Denver: And looking at those communities, too, I think it’s another myth we have about homelessness is that it’s a big city problem and that’s it. But that’s not the case is it?
Beth: No. The communities we work with range from big cities like Washington D.C., which has a very high number of people experiencing homelessness, to rural communities like Gulf Coast Mississippi where we have a six-county region that’s largely rural and is making enormous progress on ending homelessness, not just for individuals, but really for everyone. And so, it’s a problem in every type of community, and we have to have the opportunity to work across that spectrum.
Denver: So what happens in one of these communities? You’ve sort of painted a little bit of a picture, but when you go in there, what’s the approach? How do you go about doing this work? And what is the role that Built for Zero/Community Solutions plays in it?
Beth: Well, to be clear, really the local team are the ones that are doing the heavy lifting there, and we’re just really there to support them. So, the first thing we do is make sure there is that political will across that community to commit to a population level reduction, and I think why that’s important is that historically, in our sector, the incentives are set up, and the way the work is set up is to run really excellent programs for people and get good outcomes for people, which is obviously very important. But the additional question we need to ask: Are all of those investments and all of that activity adding up to cure people experiencing homelessness every month? And that we need to hold ourselves accountable to that too.
So, the first step is, is there the political will for that level of accountability? And once that there’s that shared aim around looking at reductions as the measure of progress, then the first thing that we work with the community on is getting to comprehensive quality data across that county on: Do we know everyone experiencing homelessness by name to do what you were talking about? One, to make homelessness non-anonymous, like these are real people with stories and histories that many, most of which lived and worked and went to school in our communities before. So, getting to know those people individually and making sure that we’re bringing the services and support to end their homelessness that’s best for them as people. But then, also to know: Are all of these things we’re doing working at scale on the aggregate?
And so, that is the foundation. Without that information, a community is doing a lot of activity but has no way to measure they’re making progress. So, that’s the first step. And on average, that takes a community about six months to get to a place where they have credible data that everyone feels confidence and that they can use to try…
Denver: So Beth, let me ask you a question about that, if I can, because we kind of talk about this political will and bringing the people to gather around the table. I have worked with and in a lot of organizations, and we can’t take collaboration inside the organization itself. And as you’re talking about this, I’m thinking about the mayor’s office. I’m thinking about the health services, mental health, non-profit, veteran’s administration. How are you able to get them working, all pulling in the same direction? You know, you were saying that, but you know, a lot of people are saying, “Wow! How do you achieve that?”
Beth: Yes, no, well, I’ll say that the communities in Built for Zero are a coalition of the willing. They are communities who have chosen to participate. And so, we’ve seen them as kind of the leading edge of this work. But, no matter, what you said is exactly right. Because no one entity in any community is accountable for any homelessness; lots of agencies are; everyone has to agree. And one of the challenges is that over time, some of the leaders that agree leave, and new leaders come in, and you have to now convince them again that this is still what we want to be doing.
And so, that’s why I started with it because I think sometimes we skip that, that how important that will building is and how much institutional players in the private and public sector can make a difference in creating that atmosphere of accountability and can really change what’s happening in communities. We have a strategic partnership with Kaiser Permanente, and their partnership over the last two years has made an enormous difference in helping to build will at the local level in communities because they are an anchor institution in those communities and have a vested interest in what happens. And so, them coming to the table and supporting those players to build that will has really been a game-changer, and so I think we often underestimate what some players that aren’t involved in the homeless system can do to help us build that will.
Denver: And then continuing on, what happens next after you get that will?
Beth: So, you get the will; you get the good data and the good information that’s helping you not only end homelessness for people but also understand if you’re driving overall reductions. And then you go into the hard part which is testing your ideas, and so you’re using that information… and to make it a little more concrete, the kind of information people are getting is: How many people are becoming homeless every month? And are those people, people we knew and helped and fell out of housing, which means the right strategy there is: How do we get better at retention in housing and supporting people? Or, are they people completely new toy us? We’ve never seen them before and are coming into the system. If that is happening, how do we partner upstream with other institutions?
So for example, you see in some communities a hundred veterans a month becoming homeless. That is an indication that we’re failing upstream. Right? our veteran community. And so the answer isn’t always in the homeless response system. Sometimes it’s upstream with these other partners, and that’s really the hard work of how to bring in those players, how to create that accountability and partnership upstream. But the information is driving that people are getting every month about: Do we need to accelerate their housing placements? Do we need to work on inflow? Is driving the strategies that they’re testing on the ground, and those strategies are driving policy change or resource allocation. And then it’s just continually iterative. Like when we did these things over the last three months, did we see the numbers drop? If we did, then let’s double down. If we didn’t, what else can we try? And so, it’s really about how quickly can we learn? And how quickly can we respond to the information in front of us?
Denver: As they say, let the work teach you.
Denver: And that’s essentially what you’re doing. You just…
Beth: Absolutely. I couldn’t have said it better.
…where we start is not that the solution needs more money. Where we start is: How do we optimize the resources we have to address this problem? And what we see is we know what it costs to keep someone homeless; it costs us about $35,000 a year and that by housing them, we save almost 40%…
Denver: Now, a lot of people are going to wonder about the cost of all this. I mean, many communities, want to address homelessness, but they just don’t have the resources to do it. Share with us what’s going on in terms of the cost and the cost differentials in trying to end this problem in communities.
Beth: Yes, well, we are spending a fortune already on this problem, and so in the communities we work with, where we start is not that the solution needs more money. Where we start is: How do we optimize the resources we have to address this problem? And what we see is we know what it costs to keep someone homeless; it costs us about $35,000 a year, and that by housing them, we save almost 40% and so, there is a huge upside to ending homelessness in our communities. And obviously, there’s a moral imperative to do it as well. And so, I think it shouldn’t all be driven by cost, but I think people forget that we are spending a lot of money to have systems that keep a lot of people in homelessness and that we design those systems, and we can design systems that don’t do that and then end homelessness in our communities. And that’s what gives me hope is that these are systems we designed, and we are smart enough to figure out how to redesign these systems to work for people in a different way.
Denver: What is the most impactful lesson you’ve learned about systems change?
Beth: I think it is to really be comfortable with failing forward a lot. I think when we moved away from these ideas of mapping a 10-year, 5-year plan to end homelessness and instead say: If we can get clear on the end state, what it means to end homelessness and how we’d know we’re doing that, and then be willing to learn our way into it, that is the game-changer. That has been the game-changer in my work. And I think the hard thing for a lot of, I’ll say, electeds and a lot of the people in positions of authority is that isn’t something we have communicated to the public yet. We’ve, in our messaging around homelessness, have treated homelessness as a static problem. Right? We’ve said, “There are this many people experiencing homelessness in our community, and if only we have this much housing, we can solve the problem.” And actually, homelessness is very dynamic. It’s changing all the time. And what we need is to be dynamic in the response. And so, how can we start to message the problem differently that will allow the community to understand that we are going to get a lot of things wrong before we get them right, but the commitment is to that end state, and as long as that exists, we can do this work.
Denver: Well, I was thinking about that end state: 81 communities are part of Built for Zero. Has anybody achieved that end state? And if so, tell us a little bit about it.
Beth: Yes. So, we have 13 communities that have ended homelessness for veterans or chronically homeless individuals and then…
We have 13 communities that have ended homelessness for veterans or chronically homeless individuals… and about 40 of our communities are seeing measurable reductions every month, and that’s an indication to us that we’re moving in the right direction with where communities are going.
Beth: Thank you. Congratulations to them. About 40 of our communities are seeing measurable reductions every month, and that’s an indication to us that we’re moving in the right direction with where communities are going. And the reason that we started with veterans or chronic homelessness is for communities to learn: What does it take to end all homelessness? And we have a cohort of about 10 communities that have already done it for veterans or chronic or both who are now working on applying the method that has gotten them there to everyone. And I have to say, one of the most exciting things is: we think, in the next year, we will have a couple of communities who’ve ended homelessness across their whole county for everyone – women, children, adults, everyone. And I think that is really the vision we have is that we live in communities that don’t allow people to experience homelessness, and if they have to, then it’s very rare.
In one community that ended veteran homelessness, Gulf Coast, Mississippi, when they ended it, what that meant was that if you were a veteran who became homeless, that community could house you in 11 days. And so, that is incredible. And as someone whose brother is an army veteran, I have to say, to know that you live in a community that does not allow people who served our country to experience homelessness is what we’re all striving for, right? And so, that’s the vision… is that it may happen to folks, and it’s awful when it does. But it’s not going to be a 20-year experience. It’s going to be an 11-day experience.
Denver: And I know one other thing your organization is so good at is making success visible to inspire others, and that really is wonderful. What has been the impact of COVID-19 on both those who are homeless and also the work that you are doing?
Beth: Yes. Well, you know in March, what we saw in communities is that people working on ending homelessness had to pivot hard actually to be frontline workers in a public health crisis and think about how were we going to protect the people living on our streets and the congregate shelters from getting COVID? How do we protect them long-term? And so, for about three months there, all the work was focused on how to stand up in emergency response to a public health crisis. And then, now what we’re working on with communities is: How do we, as quickly as possible, move these people from temporary accommodation that got stood up because of COVID into permanent housing? And, a lot of new resources were brought to bear in communities that allowed them to do it. And now the trick is: How do we not keep going as business as usual but use those resources and that inflection of urgency because we are in the middle of a public health crisis, to see homelessness as part of the problem, and that if people were housed, there wouldn’t be that risk? And so, the COVID-19 is now just part of the work. Right? It is a factor that we’re all focused on. It has definitely slowed down a little bit, the focus on population level reduction because people are having to pivot to public health response often. But they are dedicated to keep that momentum going, and it feels like, you know, it’s even clearer now more than ever, that we should be focused on getting to zero on homelessness.
Denver: What are the experts saying, Beth, about the prospect of additional homelessness because of the pandemic and all the job losses that are coming about as a result of it?
Beth: I think everyone’s expecting to see a very large influx of new people coming into the homeless response system. I think we’re all holding our breath right now. The good news, I think, is that the communities that we’re working in have monthly data on inflow. So, they are able to see what’s happening, to see as that’s starting to increase, and they have their line of sight into that problem to start to get ahead of it. And so we know many of them are already starting to work and partnering with upstream systems on addiction prevention work, on how do we support people so they don’t come into the system. So, inflow has become a huge focus of our work in the last year, and is a huge focus of what’s happening on the ground in communities.
Denver: Let’s turn our attention to the $100 million award that will be given by the MacArthur Foundation to one of the six finalists. If you are fortunate enough to be declared that winner, how will you use the $100 million, and what will it allow you to do that you can’t do otherwise?
Beth: First, I’ll just say we are thrilled to be a finalist in this competition. It is a testament really to the work in these communities, and I think it has become, for us, a validation that ending homelessness is possible, that it is happening, that we need to collectively focus on how to scale that work. And so that is really what it would accelerate for us, is the ability to go from 13 communities having ended homelessness in their community to 75 in the next six years, and to scale the work and start to become a normal experience for communities to end homelessness. So, it’s going deeper in communities and increasing the number of proof points of communities ending homelessness, and then going wider in scaling both policy and practice change so that there’s a clear roadmap for everyone in the country to end homelessness in their community.
Denver: Well, Beth, I want to thank you for being with us today. Tell us about your website and some of the things visitors will find there.
Beth: Yes. Go to www.community.solutions or joinbuiltforzero.org. Either one of those, you will find information about Community Solutions work generally, about our work in Built for Zero, about the methodology and approach. And you can also see all the communities, the names of all 81 communities that participate in this work and the names of our partners that have supported this work to-date.
Denver: Very cool. Well, best of luck to you and your team and the MacArthur Foundation’s 100&Change competition. It was really a pleasure to have you on the program, Beth.
Beth: Pleasure to be here. Thank you!
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