Problems and Purpose

The Street Homeless Solutions (SHS) division of NYC Department of Homeless Services (NYCDHS) utilized a democratic policy co-creation process inspired by the vTaiwan engagement framework to create a comprehensive ‘Model of Practice’ outlining and ultimately tying together each of the three core service areas of HOME-STAT street outreach: Outreach, Safe Havens, and Drop-In Centers.

This first proposed ‘Model of Practice,’ focused on Safe Havens, was developed between November 2018 and June 2019 using this co-creation process.

Background History and Context

In 2016, the NYC Department of Homeless Services (DHS) [2] was merged with the Human Resources Administration (HRA) [3] to form the new Department of Social Services (DSS) [4]. As the Department of Homeless Services (DHS) transforms a haphazard shelter system that developed over decades, it has focused on raising the bar for client services, standardizing those services across its system, and strengthening delivery of services through clear outlines of expectations and more effective provision of training across the board, on all aspects of DHS services, roles, and responsibilities.

To that end, DHS set out to define consistent standards and set clear expectations for all service areas through the development of Models of Practice.

To that end, in 2018, DHS required all Program divisions to develop comprehensive Models of Practice defining and documenting each division’s core services, ensuring standardization across programs and offering all clients a high level of services across the board.

A DSS Model of Practice (MOP) documents programmatic standards, both “what must be done” and “how to do it well”. What must be done includes all service delivery actions from the time the client enters to the time they exit, who does them and when. How to do it well includes descriptions of how to complete each action with quality, with a client-centered, trauma-informed approach.

In service of these goals, the Street Homeless Solutions division embarked on a new type of policy co-creation process to create a Model of Practice for their first core service area: Safe Havens, building on work already underway to create standardization of service delivery across the division.

Safe Havens are transitional housing options dedicated to supporting New Yorkers experiencing unsheltered homelessness, with a focus on those experiencing chronic unsheltered homelessness. To be placed at a Safe Haven, unsheltered homeless individuals must be referred by outreach teams based on that outreach team’s assessment of the individual’s unique needs. Safe Havens are specialized spaces designed to serve unsheltered homeless individuals - who often face complex, layered challenges, and may be resistant to accepting services - by offering overnight beds, robust case management services, and physical and program characteristics more suitable for helping street homeless New Yorkers stabilize their lives in an effort to move them into permanent housing.

When the Safe Haven Model of Practice policy co-creation process started in November 2018, New York City was utilizing more than 1,000 Safe Haven beds citywide across more than a dozen different locations.

To create the Safe Haven Model of Practice, Joe Pressley, Deputy Commissioner of Street Homeless Solutions, and Tamara Benejan-Green, Associate Commissioner of Street Homeless Solutions, were interested in providing robust opportunity for input from all levels of program staff, both from staff at Safe Haven programs and from staff at Outreach programs that refer clients to Safe Havens.

Nathan Storey, an employee in the Street Homeless Solutions division, suggested a policy co-creation process for a Safe Haven Model of Practice inspired by the “vTaiwan” public engagement process that was developed in Taiwan after the Sunflower Movement of 2014 [5]. Mr. Storey had attended a 2-day training on the vTaiwan process held in NYC in 2018 [6]. Mr. Storey recommended a vTaiwan inspired process based on focused conversation methodology, incorporating the Polis tool to gather open ended feedback from a large group of people. Street Homeless Solutions leadership was enthusiastic about the vTaiwan consensus-based process that uses a participant-oriented agenda, open format, and mechanisms for rolling correction.

Organizing, Supporting, and Funding Entities

The Street Homeless Solutions division of the NYC Department of Homeless Services (DHS) organized the policy co-creation process. No specific funding was earmarked by DHS, but four DHS employees, Nathan Storey, Jennifer Wilcox, Erin Blaz, and Keesha Smartt, were chosen by the division leadership to organize the process. The policy co-creation process was used to generate stakeholder feedback needed to draft a new policy document called the Model of Practice which the agency is required to produce for all critical service areas. Polis provided access to the software free of charge for one pilot conversation.

Participant Recruitment and Selection

Participation in the Safe Haven Model of Practice policy co-creation process was limited to staff of the Street Homeless Solutions contracted Safe Haven and Outreach providers, and DHS staff who manage these programs. Future policy co-creation processes will include direct participation from clients. All contracted Safe Haven and Outreach providers participated in the process and conducted internal recruitment amongst their staff for participation.

For the first phase of the process (Objective Survey) only the directors of the Safe Havens were surveyed. For the second phase of the process (Reflective Survey) all staff from the Safe Haven and Outreach programs, as well as DHS staff who manage these programs were invited to participate. For the third phase of the process (Interpretive Focus Groups) Safe Haven and Outreach Directors, and the DHS staff who manage them were invited to participate. For the fourth phase of the process (Policy Co-Creation) DHS led the creation of a final policy document but checked in frequently with the Safe Haven and Outreach directors to make sure the document reflected the consensus of the group.

No stipends or other incentives were offered to any participants. DHS staff was required to participate as part of their job, and contracted provider directors likely felt compelled to participate due to the contractual relationship with DHS. However, many provider directors expressed interest in the process because they wanted to make sure they had a provide input, make suggestions, and weigh in on the development of a policy document that aims to summarize, clarify, define, and ultimately direct affect their work. Staff from the contracted providers were asked to participate in the Polis survey by their supervisors. Providers reported that some employees were excited to be given the opportunity to directly provide feedback about the programs they work on, while other employees did not want to participate.

Methods and Tools Used

The Safe Haven policy co-creation process used a methodology adopted from vTaiwan based on focused conversation methodology, incorporating the Polis tool to gather open ended feedback from a large group of people. The process also included facilitated discussion at Safe Haven directors meetings to interpret the meaning of various statements from the reflective survey. Insights from the reflective survey were also used as jumping off points for conversation at the Safe Haven directors meetings about topics not explicitly covered in the survey, such as the housing interview process and barriers to placement for long term stayers.

vTaiwan, the guiding methodology for the Safe Haven policy co-creation process, is a consensus-based process that uses a participant-oriented agenda, open format, and mechanisms for rolling correction. One methodology used in vTaiwan is the focused conversation methodology that is “a technique of deliberation meant to replicate the ‘natural’ thought process used to reflect on and address an issue.” [7] The focused conversation methodology calls for a four-phase process:

Phase 1: Objective – uncover facts

Phase 2: Reflection – uncover feelings

Phase 3: Interpretive – articulate meaning and significance

Phase 4: Decisional – make decision based on points of consensus in the group

The vTaiwan methodology introduced the use of the Polis tool as part of a process modeled after the focused conversation methodology. In the vTaiwan practice Polis is used to expand the scope of participation in the reflection phase.

Polis is an online “survey technology where the user clicks ‘agree,’ ‘disagree,’ or ‘pass’ in response to statements others have contributed. The user can also enter their own statement for others to take positions on. Pol.is clusters users who voted similarly into opinion groups using real-time machine learning (artificial intelligence), and visualizes those groups in real time. Polis visually defines and gives space to divergent opinion groups and breaks the community’s deadlock by identifying the points of consensus.” [8]

What Went On: Process, Interaction, and Participation

The Safe Haven Models of Practice policy co-creation process was initiated by the Street Homeless Solutions (SHS) division of the NYC Department of Homeless Services. Safe Haven providers are governed by the language in their contracts, but as part of DHS’ effort to clearly define and set expectations across the board, programmatic standards can be more comprehensive and more precise, including regarding what must be done and how to do it well. A Models of Practice document aims to clearly define “what must be done”, including all service delivery actions from the time the client enters to the time they exit, who does them and when. A Models of Practice document also aims to clearly define “how to do it well”, including descriptions of how to complete each action with quality, with a client-centered, trauma-informed approach.

In November 2018 SHS presented to its contracted Safe Haven providers an overview of the four phase policy co-creation process with the goal of generating stakeholder feedback to inform the drafting of a meaningful and democratic Models of Practice document. The process that was described was inspired by the vTaiwan framework, which utilizes a focused conversation methodology, with the Polis tool used to expand the scope of the reflective phase of the process. The Safe Haven policy co-creation phases were described as follows, with each phase having an organizing question:

                 Phase 1: descriptive survey

                 What do we know about how Safe Havens are operating?

                 Phase 2: reflective survey

                 How do Safe Haven practitioners feel about how their service models are working?

                 Phase 3: interpretive focus groups

                 What would minimum standards mean for Safe Haven providers?

                 Phase 4: policy creation

                 What minimum standards for Safe Havens are feasible to implement?

Phase 1 consisted of a descriptive survey that was open to Safe Haven directors to fill out between November 15, 2018 and November 30, 2018. The survey, administered through Google Forms, focused on gathering objective facts about the operating models of each Safe Haven. Most of the questions were structured and factual. Sample questions include:

• Who leads intake?
• How soon after intake is your next communication with Outreach?
• How many case management staff do you have?

The descriptive survey also included a few open ended questions that asked Safe Haven Directors which aspects of their service model were most essential to successful operations and outcomes. All 17 Safe Haven sites completed the survey. Summaries of the descriptive survey were sent to the Safe Haven directors and SHS staff. The policy co-creation team also used the answers from the descriptive survey to create the seed statements for the reflective survey (phase 2).

Phase 2 consisted of a reflective survey that was open from December 15, 2018 to January 15, 2019 to all Safe Haven staff, all Outreach staff, and all DHS staff who manage Safe Haven or Outreach programs. The survey, administered through the Polis tool, focused on gathering opinions and feelings about the safe haven operating models. The reflective survey consisted of short statements that the respondents could click “agree”, “disagree”, or “pass”. All responses to the survey were anonymous. The initial 42 “seed” statements were prepared by the SHS policy co-creation team. The seed statements were chosen based on insights from the descriptive survey as well as from consultation with other SHS staff members. After participants in the reflective survey had responded to all of the statements, they were invited to add their own statements—and to return to the survey later to respond to statements submitted by other users. Functioning in real time, the Polis tool divided participants into groups based on similar voting patterns and then visualized the statements that had the most similar answers for each group. The reflective survey was launched at a regularly-scheduled Safe Haven directors meeting, during which the directors took the survey. The Safe Haven directors then disseminated the survey link and instructions to their staff. Periodically, the SHS policy co-creation team reminded Safe Haven directors to encourage staff participation at all levels (including case managers, supervisors, security guards, and building maintenance staff), and to encourage staff to return to the survey to vote on new statements. At a regularly scheduled Outreach directors meeting the reflective survey was introduced and similarly disseminated to Outreach staff.

Using the Polis tool allowed the policy co-creation team to efficiently deliver a survey that reached 301 participants [based on final report form Pol.is survey]. SHS saw a high level of engagement with the reflective survey, with 286 of the 301 participants being grouped based on 31,935 votes cast on 373 statements (42 seed statements and 331 statements submitted by participants). Participants voted on an average of 106.10 statements and made 3.52 statements per statement author. SHS chose 14 statements to designate as “metadata”. These statements helped to ensure that the survey included a wide cross section of roles (executive staff, case managers, residential assistants, clinicians, security, building maintenance, housing specialist). Metadata statements also helped to interpret the groupings of participants. For the Safe Haven reflective survey, the metadata factor that most distinguished the two groupings of participants was whether the participant worked for a Safe Haven provider or for an Outreach provider.

Phase 3 consisted of internal analysis and a series of interpretive focus groups with stakeholders. First, the SHS policy co-creation team spent time analyzing the data from the Polis survey. Some statements, such as statements about the need for specific types of trainings, were widely agreed upon. Other statements, such as statements about the need for specific types of security protocols, resulted in differences of opinion between Group A, which consisted of mostly Outreach workers, and Group B, which consisted of mostly Safe Haven workers. Additionally, some statements revealed differences of opinion between executive leadership and line-level staff. Working with other SHS staff members, the SHS policy co-creation team identified five statements that needed additional interpretation to understand these differences in opinions between the various groups. In separate meetings with the Safe Haven directors and the Outreach directors, the SHS policy co-creation team led facilitated discussions to help interpret the differences. In an additional meeting with Safe Haven directors, the directors were asked to write on sticky notes the policy areas that they felt most needed to be addressed in a Safe Haven Model of Practice. The SHS policy co-creation team then grouped the sticky notes by policy theme, asking follow-up questions about the themes that received the most comments. A similar sticky note exercise was repeated with SHS staff.

Based on analysis of the Polis data, comments in focus group sessions about the Polis data, and the sticky note exercises, the SHS policy co-creation team produced a summary of the policy co-creation process at that point, which included a list of policy development priorities. This presentation was presented at a Quarterly Directors meeting attended by both Safe Haven and Outreach providers. During this meeting the directors participated in a small-group breakout session (each group consisted of staff from Safe Havens, Outreach, and SHS). In the breakout session, participants took turns explaining how they would respond to a hypothetical scenario that involved interconnected issues of Harm Reduction, Security, Referrals, Transfers, Training, and Staffing – all issues identified as policy development priorities. First, a Safe Haven director explained how they would respond to an incident. Then, an Outreach director explained how they would respond. Then, the rest of the group asked follow up questions. Then,a third person reported back to the larger group about the similarities and differences in the proposed responses to the hypothetical scenario.

Phase 4 consisted of drafting a Safe Haven Model of Practice document guided by feedback and insights received from stakeholders throughout the other three phases of the process. Jennifer Wilcox, a member of the SHS policy co-creation team, outlined and developed the document based on the policy priorities identified. As much as possible, text was drawn from consensus positions, or else it addressed concerns brought up in interpretive focus groups about conflicting perspectives or positions. Text was also annotated by the policy co-creation team as part of this process. Annotations served to provide additional context to the document, including, for example, if legal or resource constraints may prohibit the ability to immediately implement a consensus idea. Some sections were included as a priority area in the document but were left blank with an indication that another, more specific policy development process was needed to address the priority. Some sections not fully developed are being addressed by other Agency-wide policy development processes. Other sections not fully developed were identified for further development by SHS. The annotated draft of the document was shared with SHS staff and Safe Haven and Outreach provider directors to allow them to verify that the final document aligned with their understanding of the groups’ consensus. Comments were incorporated into a final document that was sent to the DHS Executive team to fulfill the mandate for producing a Model of Practice for the Safe Haven program, with the belief that this is a living document that can and will be enhanced and continually strengthened as new policies are developed or revised, including by future policy co-creation processes.

Influence, Outcomes, and Effects

The Safe Haven Model of Practice policy co-creation process had the intended outcome of producing a final policy document that was reflective of stakeholder input, based on participation by staff at all levels of the outreach effort, from DHS SHS leadership to Safe Haven and Outreach frontline staff. While the goal of this process was to produce a democratic document to guide the practice of contracted service providers utilizing feedback from contracted service provider practitioners, future SHS policy co-creation processes are envisioned to integrate direct client participation.

Analysis and Lessons Learned

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See Also

vTaiwan

Polis

Focused Conversation

References

[1] vTaiwan: https://participedia.net/method/4678

[2] NYC Department of Homeless Services: https://www1.nyc.gov/site/dhs/index.page

[3] NYC Human Resources Administration: https://www1.nyc.gov/site/dss/hra/hra.page

[4] NYC Department of Social Services: https://www1.nyc.gov/assets/home/downloads/pdf/reports/2016/90-day-homeless-services-review.pdf

[5]: vTaiwan and the Sunflower movement: https://civichall.org/civicist/vtaiwan-democracy-frontier/

[6]: vTaiwan / g0v training: http://training.g0v.network/

[7]: Focused conversation methodology: https://participedia.net/method/4652

[8]: Polis: https://participedia.net/method/4682

External Links

NYC Department of Homeless Services Street Homeless Solutions webpage: https://www1.nyc.gov/site/dhs/outreach/street-outreach.page

NYC Ending Street Homelessness Action Plan: http://www.nyc.gov/html/endinghomelessness/downloads/pdf/actionbooklet.pdf

Notes