Evaluation Of Fort Lyon SupPortive Residential Community .

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Illuminate Evaluation Services, LLC8005 22nd Ave NW, Seattle, WA 98117206.229.8530EVALUATION OF FORT LYONSUPPORTIVE RESIDENTI AL COMMUNITY:PRELIMINARY REPORTAUGUST 2017Prepared by Illuminate Evaluation Services, LLC

Legislative Audit CommitteeRepresentative Tracy Kraft-Tharp – ChairSenator Tim Neville – Vice-ChairSenator Kerry DonovanSenator Cheri JahnRepresentative Dan NordbergRepresentative Lori SaineSenator Jim SmallwoodRepresentative Faith WinterOffice of the State AuditorDianne E. RayState AuditorMonica BowersDeputy State AuditorMichelle ColinContract MonitorIlluminate Evaluation ServicesContractorInfinite Frontier ConsultingSub-ContractorAN ELECTRONIC VERSION OF THIS REPORT IS AVAILABLE ATWWW.COLORADO.GOV/AUDITORA BOUND REPORT MAY BE OBTAINED BY CALLING THEOFFICE OF THE STATE AUDITOR303.869.2800PLEASE REFER TO REPORT NUMBER 1671S WHEN REQUESTING THIS REPORTIlluminate Evaluation Services

TRANSMITTAL LETTERAugust 31, 2017Members of the Legislative Audit Committee:This report contains the preliminary results of the evaluation of the Fort Lyon SupportiveResidential Community Program (Fort Lyon Program). This evaluation was conductedpursuant to Section 24-32-725, C.R.S., which requires the State Auditor to retain acontractor to conduct a longitudinal evaluation of the Fort Lyon Program. This preliminaryreport presents a description of the Fort Lyon Program, a description of the evaluationmethodology and initial results, issues for further consideration, and a literature review.The work presented herein is based on data furnished by the Colorado Departments ofLocal Affairs, Health Care Policy and Financing, Human Services, and Corrections; theColorado Judicial Branch; and the Colorado Coalition for the Homeless. We gratefullyacknowledge the cooperation of all parties providing data, the Office of the State Auditor(OSA), the Department of Local Affairs, Fort Lyon Program staff, and the Fort Lyon StudyEvaluation Advisory Committee. Without this cooperation, the study could not have beencompleted.Respectfully submitted,Illuminate Evaluation Services, LLCCandace A. Gratama, Ed.D. Kari M. Peterson, Ph.D.Research ConsultantResearch ConsultantShawn D. Bachtler, Ph.D.Research ConsultantIlluminate Evaluation Services

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Report Highlights .1Chapter 1: Fort Lyon Program Description .3General Background . 3Fort Lyon Supportive Residential Community Program . 6Program Model . 8Program Access and Admission . 8Program Services . 9Program Options.11Program Completion .12Program Participation .13Program Funding .17Chapter 2: Methodology .17Scope of Project .18Year 1 and Year 2 Focus.18Methodology .19Data Sources .19Database Descriptions .19Analyses .20Chapter 3: Fort Lyon Costs and Benefits .21Cost and Benefit Results.21Program Costs .21Savings/Benefits .23Cost Analysis Study Sample .24Savings Due to Change in Community Services Costs Pre- to Post-Program .26Cost Analysis Summary .28Other Costs .30Other Benefits .30Overall Conclusion .31Chapter 4: Fort Lyon Outcomes .32Outcomes .32Other Outcomes .34Summary.36Chapter 5: Comparison to Other Similar Programs .38Comparison to Program Outcomes .38Harvest Farm.38Sobriety House .39Central City Concern .39Outcomes .40Comparison of Cost Studies .41Chapter 6: Issues for Further Consideration .43Best Practices In Use at the Fort Lyon Program .43Best Practices Under Development at the Fort Lyon Program .44Issues for Further Consideration .45Appendix A: Data Sources .46Database Descriptions .47Illuminate Evaluation Services

Appendix B: Cost Benefit Analysis Literature Review .49Appendix C: Cost Analysis Study – Full Sample .54Savings Due to Change in Community Services Costs Pre- to Post-Program.55Cost Analysis Summary .59Appendix D: Data from Outcomes Analysis .60Appendix E: Homelessness Outcomes Research/Best Practices Literature Review .64Coordinated Assessment and Outreach Systems.64Dual Focus on Addiction and Homelessness .65Trauma Informed Approach .67Peer Mentoring/Social Support .68Comprehensive and Integrated Services .69Programmatic Flexibility and Client Choice .69Use of Data .70Illuminate Evaluation Services

REPORTHIGHLIGHTSFORT LYON SUPPORTIVE RESIDENTIAL COMMUNITYIlluminate Evaluation Services, LLCPRELIMINARY EVALUATION REPORT, AUGUST 2017ENTITY 2KEY INITIAL RESULTS BACKGROUNDThe average annual per participant cost of the Fort Lyon Supportive ResidentialCommunity Program (Fort Lyon Program) from Fiscal Years 2014 through 2016,was about 18,000 based on a 250-person capacity.Of the 600 participants exiting the Fort Lyon Program as of December 13, 2016,39.7 percent completed the Program by meeting their goals (234 of 590 withcomplete data) and 38.6 percent exited to permanent housing (200 of 518 withcomplete data).Costs per participant decreased 27 percent for physical and behavioral healthcare and 66 percent for the judicial system (i.e., incarceration and probation) frompre-enrollment in the Fort Lyon Program to post-enrollment in the Program forparticipants who had 1-year of post-enrollment data and who received Medicaidboth pre- and post-enrollment. These results are consistent with the results of coststudies conducted of other similar programs, although the cost reduction at FortLyon is less for than other programs.The more days a participant stays in the Fort Lyon Program, the greater the oddsof completing the Program and exiting to permanent housing. In contrast, aparticipant’s drug and alcohol use history, behavioral health concerns, andparticipation in vocational, educational, or employment programs were notsignificant predictors of completing the program or exiting to permanent housing.Participants reported significant improvements in their levels of anxiety,depression, and overall quality of life after entering the Fort Lyon Program.A benefit cost analysis performed for the Bent County Development Foundationon the Fort Lyon Program estimated that economic activity at Fort Lyon generated119 jobs and approximately 10.3 million of financial activity in the Bent Countyarea in 2015- 2016.Of the three comparison programs reviewed, the Fort Lyon Program had thelowest costs, and a similar average length of stay as two of the three programs. The Fort Lyon Program’s primarypurpose is to provide transitionalhousing and facilitate peer-basedrecovery from substance use forhomeless and at-risk individualsfrom across Colorado with apriority on homeless veterans. Funding for the Fort LyonProgram comes from stategeneral funds, which averagedabout 3.1 million annually, andmortgage settlement funds whichaveraged 1.7 million annually,for Fiscal Years 2014 through2016. Between September 2013, whenthe Fort Lyon Program began,and December 13, 2016, theProgramhasserved798individuals. Participation levelsare set at an average of 250 permonth. The average age of Programparticipants was 49 years, about82 percent were male, and about21 percent were veterans. Ofthe798individualsparticipating in the Fort LyonProgram, 600 (75 percent) hadexited the Program as ofDecember 13, 2016.Illuminate Evaluation Services

Office of the State Auditor.2 Illuminate Evaluation ServicesReport Highlights

Office of the State AuditorChapter 1CHAPTER 1: HOMELESSNESS AND THE FORTLYON PROGRAMGENERAL BACKGROUNDThe U.S. Department of Housing and Urban Development (HUD) defines homelessnessunder four broad categories to qualify for grants and programs. The categories include: Literal Homelessness: People who are living in a place not meant for humanhabitation (e.g., car), emergency shelter, transitional housing, or hotels paid for by agovernment or charitable organization. This also includes individuals exiting aninstitution where he/she resided for 90 days or less and who resided in a shelter orplace not meant for habitation prior to entering the institution.Imminent Risk of Homelessness: Individuals or families who will lose theirprimary residence within 14 days, no subsequent residence has been identified, andhave no other resources or support networks to obtain housing.Homeless Under Other Statutes: Unaccompanied youth under age 25 or familieswith children who do not meet the other categories or are homeless under otherfederal statutes, have not had a lease or permanent housing in 60 days, have movedtwo or more times in the last 60 days, and are likely to remain homeless because ofspecial needs or barriers.Fleeing Domestic Violence: Individuals or families who are fleeing or attempting toflee domestic violence, have no other residence, and lack resources and supportnetworks to obtain permanent housing.In this report, we refer to homelessness in a general sense, which includes individualsacross all categories, unless otherwise stated.The homeless population is also categorized as sheltered or unsheltered. The shelteredhomeless population includes homeless persons residing in an emergency shelter,transitional housing, or safe havens, which are semi-private long-term housing for peoplewith severe mental illness. The unsheltered homeless population refers to individualswhose primary residence is a public or private place not designed for regular sleeping (e.g.,street, vehicle, parks).HUD has produced the Annual Homeless Assessment Report (HUD Homeless Report) on ayearly basis since 2007. The reports include Point-in-Time estimates of “literalhomelessness,” which provide a snapshot of both sheltered and unsheltered individuals ona single night for particular populations. Exhibit 1.1 shows the number of peopleexperiencing homelessness nationally from 2007 to 2016, according to the 2016 HUD3 Illuminate Evaluation Services

Office of the State AuditorChapter 1Homeless Report. During that time, there was a 15 percent decrease in the number ofpeople experiencing homelessness. While the number of sheltered persons has remainedrelatively unchanged over the years, the percentage of unsheltered persons has declined.EXHIBIT 1.1NATIONAL: PEOPLE EXPERIENCING HOMELESSNESSBY SHELTER STATUS, 2007 - 2016All Homeless PeopleSheltered PeopleUnsheltered 122013SOURCE: Annual Homeless Assessment Report: Point-in-Time Data, 2016.The HUD Homeless Reports also provide data for those defined as literal homeless for eachstate. From 2007 thru 2012, Colorado’s homeless population increased 15.2 percent.Between 2013 and 2016 it increased 7.5 percent. According to the Colorado Coalition forthe Homeless (CCH), in 2013 the methodology changed for counting unsheltered homelessindividuals based on HUD direction and definition. This change did not represent a changein the actual number of homeless persons, just a reduction in the number reported (seeExhibit 1.2). The total number of sheltered persons has fluctuated over time, but there is ageneral upward trend in the number of sheltered persons in Colorado.4 Illuminate Evaluation Services

Office of the State AuditorChapter 1EXHIBIT 1.2COLORADO: PEOPLE EXPERIENCING HOMELESSENESSBY SHELTERED STATUS, 2007-2016All Homeless 316,2376,451Sheltered People16,76815,116Unsheltered 95310,5507,1347,6112,8192,93920152016SOURCE: Annual Homeless Assessment Report: Point-in-Time Data, 2016.A 2015 benefit cost analysis prepared for the Bent County Development Foundationanalyzed the increase in homelessness through 2012 and found a strong relationshipbetween unemployment rates in Colorado and the unsheltered populations. The findingssuggest the effects of the recession from 2007 to 2009, the economy, and highunemployment rates likely contributed to the increase in homelessness through 2012. Thestudy acknowledged that other known factors, such as mental illness and substance abusealso explain who becomes homeless.HUD also identifies several subpopulations of homeless persons. Exhibit 1.3 shows asummary of the number of homeless persons in Colorado by subpopulation. The largestsubpopulation within Colorado is the chronically homeless. According to HUD (24 CFRParts 91 and 578 [Docket No. FR–5809–F–01] RIN 2506–AC37):A ‘‘chronically homeless’’ individual is defined to mean a homeless individualwith a disability who lives either in a place not meant for human habitation, asafe haven, an emergency shelter, or an institutional care facility if theindividual has been living in the facility for fewer than 90 days and had beenliving in a place not meant for human habitation, a safe haven, or anemergency shelter immediately before entering the institutional care facility.In order to meet the ‘‘chronically homeless’’ definition, the individual alsomust have been living as described above continuously for at least 12months, or on at least four separate occasions in the last 3 years, where thecombin

on the Fort Lyon Program estimated that economic activity at Fort Lyon generated 119 jobs and approximately 10.3 million of financial activity in the Bent County area in 2015- 2016. Of the three comparison programs reviewed, the Fort Lyon Program had the lowest costs, and a similar average length of stay as two of the three programs.

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