In The Solution

    BACKGROUND:  According to the National Alliance to End Homelessness, in 2020, there were over half a million people experiencing homelessness on our streets and in shelters in America.  Seventy percent were individuals, and the remaining 30 percent were families with children.  They lived in every state and territory, and they include people from every gender, racial and ethnic group.  However, some groups are far more likely than others to become homeless.  In the same year, The U.S. Department of Housing and Urban Development Annual Homeless Assessment Report to Congress revealed that African Americans are overrepresented in the population of people experiencing homelessness compared to their share of the overall US population.  A recent report by the Chicago Coalition for the homeless found at least 65,000 people were experiencing homelessness in Chicago in 2020, including those who temporarily stayed with others in addition to people living in shelters and on the street. Additionally, similar to national data, although African American Chicagoans make up roughly 30 percent of the city's population, they represent 70 percent of the City’s homeless.  For housing advocates and activists, ending homelessness is connected to the moral imperative to end racial inequities within our society’s systems, policies, and social practices.    INTRODUCTION:  Today, we’ll be talking with Emily Krisciunas (Chris-shoe-nas), Director of Chicago Funders Together to End Homelessness.  Incubated at Michael Reese (a public foundation) since 2020, CFTEH seeks to foster a person-centered, ecosystem approach to ending homelessness that reaches across systems and sectors.  CFTEH is one of several local networks of Funders Together to End Homelessness - a national network of funders supporting strategic, innovative, and effective solutions to homelessness.  CFTEH has more than 30 members and is comprised of a shared table of family foundations, community foundations, corporate philanthropies, and the local United Way. The collaborative is guided by a steering committee of four funders and two full-time staff. Collectively, CFTEH members have directed more than $50 million over the last two years towards efforts to prevent and end homelessness in Chicago, supporting more than 200 organizations across the region since 2020. In 2022, CFTEH launched its first pooled fund effort—the Housing Justice Fund—which makes grants to support advocacy, community organizing, and narrative change efforts.  In our conversation, we’ll learn about how the local philanthropic sector came together to co-create a strategy to end homelessness in Chicago with providers, advocates, government, community partners, and residents with lived experience.  Welcome Emily!    QUESTIONS:     I’d like to start by having you share with us the origin story of CFTEH.      Thanks for having me.  Nice to be with you.  I think that CFTEH began as a more informal network of, maybe, 10 or 12 local foundations.  So much of this groundwork was laid long before I came onboard in 2020. And I think that this group grew out of this observation that philanthropy has a ton of resources, and a ton of power to help end homelessness, but that those resources aren’t always well coordinated or optimized.  Both within philanthropy and with partners in the public sector.  And around the same time, we had colleagues who were connected to the organization that you mentioned in the introduction, Funders Together to End Homelessness at the national level, and were starting to see these local collaboratives pop up in other communities.  There was one really notable one in Los Angeles called Home for Good that I think was particularly influential.  And so this group of funders started to be interested in replicating that collaborative model here in Chicago.  And in order to do that, this group realized that they would need a home, sort of a backbone – administratively and operationally for that work, and we were so lucky that Michael Reese Health Trust was beginning the process to becoming a public charity, which gave them some new resources at their disposal.  They could incubate new initiatives; they could advocate in a different way. So, in 2019, before I came onboard, they raised their hand within the group and volunteered to be the home for CFTEH, which enabled the group to hire their first dedicated staff person, which became me.    In 2022, CFTEH created its first strategic plan.  I understand you conducted a series of listening sessions with community and stakeholders to begin the process.  What were the key takeaways from those sessions?  It’s a great question and felt like an important phase in CFTEH’s work.  There were two big pushes around listening.  The first one came when I started in the role.  As a precursor to strategic planning, I met one-on-one with all of the funders who were participating in the collaborative, and I wanted to get a sense of how they thoughts about addressing homelessness, and what their own grantmaking priorities were, and what their motivations were to be in the group.  I remember this thing that Marianne Philbin, who is a colleague at Pierce Family Foundation kept saying, which was, “CFTEH should be doing things that it can uniquely do as a group that individual foundations can’t do on their own”.      And that felt like a recurring theme in all of the conversations that I had with funders.  But what I think wasn’t clear from the beginning was what exactly that “what” be?  What was the unique contribution that CFTEH would have that individual foundations could not do on their own, but that became a guiding set of questions that informed the second round of listening that we did in 2022, which as you said, was focused not within our philanthropic community, but instead on all of our external partners.     So, you’re exactly right.  We did, with your help, interviews and focus groups with at least 50 community stakeholders, and these are people with lived expertise of homelessness, advocates, colleagues in government, policy makers, service providers, and I think there were a bunch of important takeaways from that experience.  They really centered around the role that philanthropy has to play in naming and addressing the role that racism has in homelessness, and drawing that connection a little more clearly.  They wanted philanthropy’s help in promoting this more expansive definition of homelessness, not the often narrow federal government definition of homelessness that is just a person maybe, staying on the street, or in a shelter or on the train, but instead this much more expansive experience of people who are maybe couch surfing, or living doubled-up or under the threat of violence in their home.    They were really interested in seeing CFTEH think about its power and how it wields it and how it shifts it to communities who are impacted by homelessness.  Partners also had some really helpful critiques, frankly, about the way philanthropy often does grantmaking.  About how arduous and burdensome that process can be.  How inflexible it can be.  That was really something that we saw reinforced in our own grantmaking data that CFTEH reflected on in its strategic planning process where we saw a lot of grants being made just a single year at a time, often restricted.  So, we got a lot of feedback from community stakeholders about the role that CFTEH could play in maybe helping model grantmaking in a different way, and nudging and supporting our foundation members in making their grantmaking processes around ending homelessness as flexible and accessible as possible.    I understand that from those listening sessions Emerged a set of “guiding principles”.  Can you share those principles with us that will guide the work of CFTEH for the next three years?  We landed on four of them, and looking back I can see the way that each of them feels really anchored to the community feedback that I just highlighted for you.  So, the guiding principles in the CFTEH plan are:  To lead with and center racial equity in housing justice in all of the work that we do.  The second one is on Targeted Universalism.  An acknowledgement that homelessness is so disproportionately experienced by communities of color, and particularly Black and African American communities, and so approaches to ending homelessness ideally will benefit all people experiencing homelessness but should really be targeted to the groups and communities who are experiencing it the most, disproportionately.   The third one is around centering people with lived expertise in homelessness and housing instability in all of the decision-making that we do. And we’re exploring all day, every day, different ways to do that in the work of CFTEH.   And then the fourth one is around this idea that, fostering a person-centered, ecosystem approach to ending homelessness, as you mentioned in the intro. This idea that homelessness is this idea that is really simple, in that the solution is housing, but that it is [also] really complex, in that all of these different systems, frankly, are failing people who come to experience homelessness and are often interacting with the justice system, or the employment system or education system, but at the end of the day it is still a person a neighbor who is experiencing homelessness and that we have to keep the person at the center, even though we’re talking about lots of complex systems that are contributing to that persons, perhaps, lack of access to housing.      What can you share about CFTEH’s strategic plan, including goals and objectives?      Our north star in the strategic plan is for CFTEH, this community of funders, to contribute to a significant reduction in the number of people experiencing homelessness in the Chicago region.  With that focus, in particular on

  According to the National Alliance to End Homelessness, in 2020, there were over half a million people experiencing homelessness on our streets and in shelters in America.  Seventy percent were individuals, and the remaining 30 percent were families with children.  They lived in every state and territory, and they include people from every gender, racial and ethnic group.    However, some groups are far more likely than others to become homeless.  In the same year, The U.S. Department of Housing and Urban Development Annual Homeless Assessment Report to Congress revealed that African Americans are overrepresented in the population of people experiencing homelessness compared to their share of the overall US population.  A recent report by the Chicago Coalition for the homeless found at least 65,000 people were experiencing homelessness in Chicago in 2020, including those who temporarily stayed with others in addition to people living in shelters and on the street.  Additionally, similar to national data, although African American Chicagoans make up roughly 30 percent of the city's population, they represent 70 percent of the City’s homeless.  For housing advocates and activists, ending homelessness is connected to the moral imperative to end racial inequities within our society’s systems, policies, and social practices.    INTRODUCTION  The Center for Housing and Health’s unique program, the Flexible Housing Pool, works to address the region’s homelessness through system coordination. Through the Flexible Housing Pool (or FHP), Cook County is able to rapidly house and provide supportive services to some of the region’s most vulnerable populations, including individuals experiencing homelessness who cycle through the criminal justice system and utilize hospital emergency rooms for care.  In this episode, I’m talking with Pete Toepfer, Executive Director of the Center for Housing and Health. The Center’s mission is to honor every person’s right to a home and health care by bridging the housing and health care systems to improve the lives of Chicagoans experiencing homelessness.  We’ll hear more from Pete about how FHP has expanded in the past three years to meet the growing demand for permanent supportive housing and how the organization is centering racial equity in its strategic priorities.    Welcome Pete!     QUESTIONS    Just last week, the Flexible Housing Pool, or FHP, housed its 1,000th resident. Congratulations on this milestone! Can you share more about its significance in the context of serving people in the Chicago region experiencing homelessness?    Kuliva.  Thanks so much.  As you pointed out, an awful lot has changed since 2019.  The least of which was the covid 19 pandemic.  For a little context, in the first year of the Flexible Housing Pool, like lots of projects that are starting up, it began fairly slowly.  In the first year we housed just under 60 people, and now we’re at 1,000.  So as you can tell, the growth has been very, very rapid, but very, very necessary when we’re talking about the tens of thousands of our neighbors who are homeless each year in Chicago.  So, for me, the biggest takeaway is that we have dramatically improved the lives of a thousand of our neighbors, and many of those are children.  About 350 of those thousand people are minors/children.  So those are children who will not have to experience the trauma of living in cars and bouncing between an aunt’s house or grandma’s house,  a shelter and that can focus on school, friends and playing.  Just like every child should do.      One of the stories that I feel is really fitting around the Flexible Housing Pool is one of the first residents who received housing as a result of the Flexible Housing Pool.  Her name is Kayla Wallace, and she was actually one of the residents who was at an early press conference talking about the promise that the Flexible Housing Pool could bring.  She was also someone who had been bouncing between hospitals, got seriously injured on the job while working as a tour guide on one of the double-decker buses downtown, and was no longer able to pursue her musical career. Fast forward to today.  Kayla is now chair of the Flexible Housing Pool governance council.  This is essentially the Board of Directors for the Flexible Housing Pool that makes decisions about where we are going as an overall project that brings together all the community stakeholders.  She is representing tenants of FHP, and is facilitating the meetings.  It really is a full circle moment for her and for the Flexible Housing Pool.  I think that speaks to one of the points that you brought up about how we’re trying to live out the value of racial equity within the Flexible Housing Pool.  That, within that governance council, residents of FHP have, per the bylaws, 40 percent of the seats.  These are folks who have experienced homelessness and they have the same voting power as someone who put in six million dollars.  They are truly the experts in the direction that we need [to go in].    So I think that one of the other things that’s exciting about where we’ve come is that we have two of the largest managed care organizations in the state who are now investors in the Flexible Housing Pool, because they see it as part of their best interest to help their members maintain health, achieve better health outcomes, and as a managed care organization is charged with doing, control costs. It is not a good investment to continue to have someone get hospitalized for conditions that could be better controlled in primary care settings, but that’s very difficult for people to do if they don’t have a stable place to live, and that’s exactly what the Flexible Housing Pool does. So, with CountyCare and Meridian Health Plan, we talk to them regularly about how we are serving their more complex members who really, but for having a safe and stable home, struggle, and cycle through different, high-cost crisis settings.      In the past, you’re reported chronic disease conditions, serious mental illness, justice system involvement and undocumented status as housing barriers experienced by FHP participants.  Considering the impact of the pandemic, what other barriers are you and your team working to address?    One of the big ones is that we want to ensure that people joining the Flexible Housing Pool have a meaningful choice in where they want to live.  We promote the value of “housing first” along with racial equity and both of those really hinge on self-determination.  We want folks to be able to choose the types of neighborhoods they want to live in.  That are close to their loved ones, close to transportation, the grocery store, to their health care resources.  But what we were finding as we really dug into our data, was that people were being clustered in the same neighborhoods that have historically been red-lined and disinvested for decades and decades in Chicago.  We alone as one program aren’t going to solve for that problem but we brought that concern to the larger governance council and the Chicago Department of Housing and said we want people to live everywhere in the city, but we want them to have meaningful choices, and we know that we’re not able to offer the same number of units in certain northside neighborhoods as we are in, say, Austin or South Shore.  Continuing to have folks clustered in the same neighborhoods is not ideal.  If that’s what people are choosing – wonderful.  But we know that without that actual choice, that it isn’t necessarily realistic.  So, what we are trying to do is set meaningful and achievable goals for increasing the number of units we have in what     we’re calling “opportunity neighborhoods”.  Ones that have lower percentages of poverty and lower percentages of violent crime, which generally are also correlating to places that have other types of resources.  That’s an effort we have going this coming year, especially as we launch a variety of new programs.    You also mentioned the really disturbing disparity that exists within the homelessness system in Chicago where upwards of 70+ percent of people experiencing homelessness identify as Black, despite only representing about a third of the City’s population.  We’ve been tracking that since day one to ensure that the folks coming to the Flexible Housing Pool are representative of the larger homeless community so that we are starting there but then also throughout their experience in the program that they are not falling off and disparities aren’t developing in different steps in the project.  Like, once we find them, do they actually reach housing?  Do they stay in housing once they enter the program?  And I can say with pride and confidence that we don’t see those disparities developing.  So about 80 percent of participants that we serve that identify as Black or African American, which should be the case based on what we know about the larger demographics of homelessness in the city.          My understanding is that the program cost is about $125,000 per household per year, which includes:  Outreach and engagement  Pre-tenancy supports (e.g., assistance with initial housing assessments and housing applications)  Tenancy supports (referrals to community-based services, transportation and connect to health and social services)   A housing subsidy  FHP Administrative costs    Can you share more on how this represents a return on investment for FHP partners and investors?      A quick point of clarification:  so, you’re about $100,000 too high.  It’s only about $25,000 per household, per year.  Which is still a lot, frankly, given what investors often are typically used to paying especially in the health care space.  But that $25,000 per year, as you mention, does cover a really wide spectrum of needed services from the time that

We return this spring with a podcast reboot and begin with our Healthcare Justice Series with episodes that:   Focus on the social determinants of health  And highlight the needs of communities and populations experiencing barriers to health care   

Often in community development work, too many organizations are working in isolation from one another. According to the Collective Impact Forum, collective impact brings people together in a structured way to achieve social change.   In this two-part episode, I’ll be exploring the efficacy of the collective impact model from two perspectives: Philanthropy and Community Development. Today, I am talking with Nan Silva, Program Director with Community Memorial Foundation. Community Memorial Foundation aims to measurably improve the health of those who live and work in the western suburbs of Chicago.

Often in community development work, too many organizations are working in isolation from one another. According to the Collective Impact Forum, collective impact brings people together in a structured way to achieve social change.   In this two-part episode, I’ll be exploring the efficacy of the collective impact model from two perspectives: Philanthropy and Community Development. Today I’m talking with Tevonne Ellis (of Claretian Associates), who is the Network Coordinator for the South Chicago Neighborhood Network.

 In 1991 the United Nations declared housing to be a fundamental human right, and the United States has worked to reduce overall homelessness by over 20 percent between 2005 and 2013.  However, homelessness continues to persist across the country, with the highest concentration in mid-to-large metropolitan areas and disproportionately impacts those living in poverty, people of color and immigrants.  Those experiencing homelessness also have the highest rates of chronic mental, behavioral and physical disease have significant barriers to health care and affordable housing and a lower life expectancy.  Their use of emergency services for episodic care also leads to higher treatment costs.  

In this episode, I’m talking with Clarita Santos, Executive Director of Community Health Initiatives at Blue Cross and Blue Shield of Illinois. As Executive Director, Clarita advances Blue Cross and Blue Shield of Illinois’ investment strategy in alignment with the Plan’s vision and enterprise imperatives to address critical community health issues, focusing on access to care, health equity and population health. We’ll be talking today about how the FHP brings value and impact to those served by Blue Cross and Blue Shield of Illinois, and the vision for the health plan on investing in housing to improve population health outcomes.

As hospitals across the state are consolidating through mergers and acquisitions to gain market share, many Catholic hospital systems have made strong gains based on their financial strength.  As a greater share of Illinois hospitals is operating under the Ethical & Religious Directives for Catholic Health Care Services, a recent University of Chicago report indicates there are unintended consequences for women’s health and a disproportionate number of low-income women.  In this episode, we talk with maternal child health researcher and public health lecturer, Janine Hill about the report and the implications for health equity.  Janine's expertise in public health policy, health systems and maternal and child health research brings a unique perspective to this new challenge in Illinois, as the health outcomes for women and their children is largely dependent on broad access to comprehensive reproductive health care services.    Soar Strategies is a consulting and coaching firm committed to helping leaders and groups in the social good and corporate sectors to share their strengths, create goals, and achieve their professional as well as personal goals through a collaborative process.

The rapid consolidation of hospital systems across Illinois has been dominated by Catholic hospitals, making strong gains based on their financial strength.  With a growing share of hospitals now operating under the Ethical & Religious Directives for Catholic Health Care Services, providers in these systems of care face limitations on the provision of family planning services for their patients and limited options for OB-GYN training as well. A recent University of Chicago report indicates there are a disproportionate number of low-income women in health plans served by these hospital systems and that health disparities are likely to increase.  In this episode, we talk with a women’s health provider and women’s health advocate about the rapid consolidations, the report and the implications for patients and providers across Illinois.    In this episode, I’m talking with Kai Tao, ND, APN, MPH. For more nearly two decades, Kai has been in practice as a certified nurse-midwife, Deputy Commissioner with the Chicago Department of Public Health, Senior Policy Advisor for the Director of the Illinois Department of Health and Family Services, and Vice President of Clinical Operations with Planned Parenthood of Illinois.  In 2018, Kai launched Juno4Me, a non-profit that provides free IUDs and implants to people in Chicago. Kai’s extensive experience in women’s health, program development, public health policy advocacy, and clinical operations brings a multi-sectoral approach to the challenges of access and equity these recent hospital merges pose to women across Illinois. 

While the implications aren’t all immediately clear, our conversation with a public health sector leader will breakdown some of the key elements and outline ongoing advocacy and education campaigns that seek to support affected immigrant families and the organizations and institutions that provide direct services to those communities. In this episode, I’m talking with Luvia Quinones, Health Policy Director with the Illinois Coalition for Immigrant and Refugee Rights, or ICIRR. ICIRR, located in Chicago, Illinois, is dedicated to promoting the rights of immigrants and refugees to full and equal participation in the civic, cultural, social and political life of our diverse society, and works with many member organizations on various programs and campaigns to empower the immigrant community in Illinois.