oot Camps did lead to significant improvements in the housing placement process. However, while the improvements made the process less onerous for both tenants and providers, the number of people ultimately moving off the streets into permanent housing did not increase.
At the end of 2011, Margiotta commissioned Paul Howard, then of the Center for Urban Community Services, to conduct a study. She wanted to know how many people the Campaign was on track to house and, "by hell or high water, how we are going to get to 100,000." Howard had both bad and good news:
Bad News:The Campaign was on track to place 30,000 people.
Good News: By making some key changes, the Campaign could reach 100,000.
Becky Margiotta talks about pivoting to meet the Campaign goal (1:47)
Extend Campaign
By 1 year from July 2013 to July 2014
2.5% Monthly Target + 3 New Communities Per Month
Set monthly target for each community & systematically increase enrollment
Expand Target Population
Include people experiencing chronic homelessness who do not meet VI criteria
Redesign Boot Camp
Also focus on how to access and prioritize resources
Reorganize Campaign Team
Better help communities house people identified in Registry Week
Although team members had been excited that communities were signing on to the Campaign, a top priority was implementing additional structure and tools to guide those communities. At 18 months into a three-year initiative, communities had housed approximately 19,000 people.
One issue was that the Campaign had lost sight of McCannon's Primary Drivers. They needed to refocus on recruiting the 55 communities with 1,000+ chronic homeless population. It was accepting all interested communities, many of which had significantly smaller target populations, thus diverting the team's attention.
The Campaign also needed to address what Margiotta called Choose Your Own Adventure—communitieshoused whatever number of people they could and the Campaign was excited. Instead, communities needed to be systematically working towards their target with Campaign support.
Campaign Milestones
To get to 100,000 by July 2014, Howard determined that the Campaign had to hit these milestones:
Recruit 3 new communities per month (no hollow Easter bunnies)
Establish a target monthly housing placement rate of 2.5 percent (thus doubling the existing average rate of 1.2 percent)
Hollow Easter Bunnies
"That was our nickname for them. The couple of dozen communities where some really fired-up person enrolled them and then they just never did anything— they house zero people. We said it's just like Easter when you think you're going to get a really good chocolate Easter egg and it's just a hollow Easter bunny. It's nothing."
Quality Improvement & Inspiration
"The main tool was just clearer rules about how we would be measuring when a change was an improvement."- Beth Sandor, Director of Quality Improvement
On the recommendation of an advisor, Sandor took a six-month course on quality improvement (QI) at IHI. She assumed a new role for the Campaign, becoming director of quality improvement, and led the implementation of three key QI changes:
Run charts: Measure the shift in housing placement rates over time. Provide insight into whether changes communities made actually resulted in improved placement rates.
Frameworks: Will, Ideas, Execution Triangle (from IHI).3 You have to have the will to improve and ideas about alternatives to the status quo; then you have to make it real—execution.
Best practices: Analyze improvements in housing placement rates across communities to identify best practices.
The Housing Placement Rate run chart monitored progress against the 2.5 percent target and showed whether the Campaign was on track to achieve its overall goal of 100,000 placements.
While providing permanent housing for 100,000 chronic homeless people was the Campaign's primary goal, it was not the only goal. As Sandor became the QI expert for the team, she understood the long-term benefit of training communities in QI and providing them with the appropriate tools.
The 100,000 Homes Campaign took a number of steps to motivate and support partner communities:
To recognize communities making significant progress, the Campaign established the exclusive 2.5 Percent Club. Participants were admitted if they met the 2.5 percent target for three consecutive months. The Campaign also created the Fully Committed List to spotlight communities that regularly reported monthly placements rates, even if they were below 2.5 percent.
2.5 Percent Club Members Celebrating
By May 2014, 56 communities were in the 2.5 Percent Club and 107 were on the Fully Committed List.
To identify what distinguished communities with high monthly rates of housing placement
from the rest, Community Solutions developed the community self-assessment tool (SAT). Preliminary analysis revealed five factors that correlated with
success and separated the high-performing communities:
Implementing Housing First on a system-wide basis
Creating and continuously updating a prioritized, by-name list of homeless neighbors
Setting eligibility criteria for Permanent Supportive Housing at the community level rather than the provider level
Using shared data to drive decision making around housing
Implementing a concrete plan to tap Medicaid and Community Development Block Grant funds
Once identified, the Campaign shared these best practices as widely as possible and encouraged other participating communities to adopt them.
Margiotta found that one of the best ways to motivate both her team members as well as volunteers was to compile and share the notes of appreciation that she received. This type of feedback allowed Campaign members to understand just how their efforts were making a difference and inspired them to keep at it.
Alice - Santa Barbara
It’s been intense, but so rewarding, and SO worth it. I can hardly wait for Boot Camp, Registry Week, and handing over keys to our homeless neighbors. (I think this might be my new religion, Becky!)
Fred Karnas - Special Assistant to HUD Secretary
100,000 Homes is the most refreshing and hopeful approach to ending long-term homelessness EVER. It has taken way too long to bring the laser-like focus you brought to ending chronic and veteran homelessness. But we are getting there thanks to the work you have done and will continue to do.
Laura - Nashville
You gave us hope and inspiration. Now we know that we are not alone. There are others out there just like us who feel our pain and are able to do great things in spite of the status quo. Maybe someday we will do something great, too, and you can tell the world for us.
The Campaign was also able to demonstrate that permanent housing made financial sense. Liana Downey and Associates conducted an analysis that estimated total taxpayer savings from housing 100,000 chronically homeless Americans at more than $1.3 billion annually. The chronically homeless accounted for 12 to 15 percent of the homeless population in U.S. communities, yet consumed more than 70 percent of all public dollars spent on homelessness. This reflected the high use of emergency services, such as the ER or psychiatric hospitals, where a single night’s stay by a homeless person often could cost more than a full month’s rent in permanent housing.4
Rosanne Haggerty emphasized, "Study after study confirms that it is cheaper to end homelessness than to let it persist." She dismissed complaints about costs, noting that "Fiscal concerns are no longer an acceptable excuse for failing to end homelessness. Permanent housing with services, targeted to chronically homeless Americans, is the smartest, most cost-effective way to do the right thing."5
The Goal is to be a Chicken F'er
"You are not harnessing people, you are trying to keep up with them."
- Becky Margiotta, Campaign Director
At the Registry Week in Santa Monica, Margiotta and Sandor observed that the person who was supposed to lead was not truly doing so. Several of her staff members, who also supported the Campaign, approached Margiotta and Sandor saying, "You've got to tell her to just take charge and do this."
Margiotta, pulling from her army experience, described the unique way in which she began having these conversations:
Margiotta Explains the Concept of Chicken F'er (2:03)
After witnessing Margiotta give her talk, the staff members gave their leader a rubber chicken. Encouraging a leader to step up became a common need and as Margiotta and Sandor interacted with more communities; in fact, it got to the point where Sandor would just look at Margiotta and say, "We're going to have to give the chicken f'er talk, you know."
Margiotta and Sandor did not anticipate the impact of what they had started. At a friendly competition that the Campaign had organized, the team from Omaha, Nebraska, showcased their successes and proudly summarized by saying, "Now we are chicken f'ers!"Even though Margiotta and the Campaign team had only used the term informally, everyone at the competition knew that it was a badge of honor and "the room went bananas."
Top Secret Award
The chicken f'er honor evolved into a top secret rooster award. Each month, the Campaign team selected 10 to 15 members from partnering communities around the country and sent them a rooster figurine (to represent a chicken f'er) and an unpublished video link with a special message.
Secret Video Sent to Chicken F'ers (1:45)
In 2014, as the Campaign was entering its last six months, Margiotta and her team wanted to ensure that the Campaign came across the finish line strong. The goal was "to surprise
and delight and really have these people, with us all along, feel like they’re
part of something really special." They arranged a celebration at the White House for when the 100,000 goal was hit and invited the chicken f'ers to attend.