1. Having read Breaking the Cycle of Homelessness: The Portland Model (12-year plan, 1988); Home Again: A 10-year Plan to End Homelessness in Multnomah County (2004); and A Home For Everyone (2014) - all promising unprecedented collaboration, coordination, community engagement, multisector involvement, behavioral health, first responders, public safety, equitable and representative governance structures including different government agencies, strategies and action items, etc - what is new about this plan? What suggests this plan will be successful when the previous efforts have failed? 
  1. How many individual shelter spaces currently physically exist in Multnomah County?
  1. How many shelter spaces are currently physically occupied?
  1. How are the number of shelter spaces physically available and the number of spaces occupied updated in real time? ANS: 2494 available beds. This number is pulled from HMIS. JOHS is trying to improve getting information updated more quickly.
  1. One reported measure of success for the Homelessness Response System is to reduce unsheltered homelessness by 50% of the number of people identified as unsheltered by the end of January, 2024. 
  1. How was the 50% number determined? 
  1. I have heard the city of Portland made this a condition of signing on to a joint City-County agreement, but there was no clear basis for why this percentage was chosen. What did the city suggest to you was their reasoning? What data, studies or county practices have led the county to confirm this as a viable goal? On its face this seems unfeasible. 
  1. The plan states that Multnomah County “secured data” leading to a “more accurate by name count” that identified 11,153 people experiencing homelessness. What does “secured data” mean? Where was the data secured from and how was it obtained/secured? How is homelessness defined in this context?
  1. After noting that the “more accurate” by name count included 11,153 people, a location was identified only for 8,595. Why is the 11,153 number listed as a “more accurate” number when so many individuals can’t be located? Why are individuals who can’t be located included on a by name list? This should be an accurate and complete list of people that follows them in real time, so it seems we should know where they are. 
  1. Of the 8,595 people who could be located, 5,398 were listed as “unsheltered.” How was that determination made and confirmed? If people are listed as being unsheltered, but considered to have a known location, how are those seemingly contradictory points reconciled? How do we know where the unsheltered people are? 
  1. Best practice for by name lists suggests that they “allow you to know everyone in your community experiencing homelessness in real time.” Does the County’s list contain this information? 
  1. I have seen different descriptions of what the 50% reduction of unsheltered homelessness goal is, and was told something different again when I spoke with your team last week. I would like to make sure I understand this correctly.

I believe the outcome to be achieved is that 50% of those on the county’s by name list who are living unsheltered will be placed in housing or shelter by 12/31/25. Is this accurate? If not, please clarify what the 50% reduction will be.

  1. The information on a by name list is necessary to understand the scope of homelessness in the community, understand how people move in and out of the homelessness system on an ongoing basis, allow for the setting of accurate goals to reduce homelessness, and allow us to understand if we are making progress. The idea is to be able to follow individuals through the process from start to finish and get them what they need to end their homelessness.
  1. Will the 5,398 people actually on the list who were living unsheltered as of 1/31/24 be tracked and targeted to move through the system so that at least 50% of these specific individuals will be placed in shelter or housing by the end of next year (the goal of a true by name list)? Or will it just mean that the number will be used as a baseline number not tied to actual people (which belies the purpose of a by name list)? Is it possible that people living unsheltered who were not on the list could be placed in housing or shelter, and this would count toward the 50% reduction? (again belying the purpose of a by name list)
  1. Who is actually following the 5,398 people on the by name list in a centralized way and tracking them as individuals?
  1. One Goal 1 Action Item is to establish and implement the Homelessness Response System. Will this need any Board authorization or approval?
  1. Another Goal 1 Action Item says to “Review and make changes to the referral and placement system to navigate individuals leaving institutional healthcare systems to the appropriate setting for their needs.” It notes that CCOs, the OHA and HRS will be responsible for this. 
  1. How have these entities been involved in the planning process so that they understand their roles and responsibilities?
  1. Why are healthcare systems and hospitals not included in this item?
  1. What collective body of individuals with healthcare experience came up with this item, as it does not seem to reflect the intersection of healthcare and homelessness?
  1. Strategy 1 contains an action item “engage in a community planning process to create a two-year sheltering strategic plan.” Why was it determined that a two year process would be needed, when community members have been providing this information for years and are frustrated at the lack of action, there is more than enough information already available to identify costs per bed per night, what the outcomes are, identify what’s working and what’s not, and create a plan within 6 months that could be shared with community members for feedback? 
  1. Another Goal 1 Action Item is to “develop an outreach and engagement strategy workgroup and steering committee similar to the Community Sheltering Strategy.” As with the Community Sheltering Strategy development of a two-year strategic plan, this seems like an unnecessary expenditure and use of time. How was this determination made, and why would the County not appoint a point person to take on this work and get it done in 6 months, rather than prolonging the process, costing a lot of money, and further frustrating and taking the time of providers who have participated in workgroups and given their opinions to the JOHS and the city and county for years?
  1. Another Goal 1 Action Item is to “create lower barrier, more accessible, and self-reporting documentation requirements for program eligibility for individuals with disabilities.”  What organizations and individuals with what expertise were involved in putting forward this goal? 
  1. Suggestions around planning for Medicaid do not seem connected to the reality of the Medicaid system, ongoing work at the state and federal levels, and what is actually needed to address the intersection of homelessness, behavioral health, healthcare, public safety, and other areas. Who made recommendations around Medicaid and how were the recommendations determined?
  1. Housing retention is one of the most important aspects of solving homelessness, yet there does not seem to be reliable data nor adequate reflection of this in the homelessness response plan. 
  1. What percentage of people currently “placed” in housing are followed up with and asked about retention?
  1. How are the people being followed up with contacted and by whom?
  1. How is retention measured for the people who are reached?
  1. What are existing “retention services” that will be expanded on and what has their effectiveness been shown to be?
  1. How was the retention rate of 99% of people housed by SHS specifically obtained? The number is on its face virtually impossible and suggests that our data and evaluation processes have significant errors that can profoundly impact how we assess and understand what’s working and what isn’t. The questions about data reliability, analysis and sharing are pervasive throughout the system, and I would raise a red flag here. 
  1. 26% of adults in the shelter system are identified as being “placed” in housing. I find this extremely concerning both because it suggests that our systems are failing at baseline, and it fails to account for other crucial information.
  1. What does being “placed” mean?
  1. What are these individuals’ retention rates in housing (i.e., of the 26% placed in housing, how many are still in that housing one year after being placed? And how are they contacted for follow up)?
  1. What happens to the 74% of people who aren’t placed? This seems like a major issue that should be addressed up front. If 74% of people are leaving shelter but not to housing, it’s essential that we know where they’re going and why.
  1. How many individuals died while in shelter in 2023? Out of how many total?
  1. How many people left shelters for the hospital in 2023?
  1. How many people died unsheltered in 2023?
  1. What is the process for identifying people who have died while unsheltered and when are these deaths identified? What is the time lag between when people die and when report of their death is made known?
  1. For the Strategy 2 (increasing short term shelter inventory by 1000 beds by 12/31/25) action item “Complete, build and open 555 beds budgeted and planned for”: Why is this included as building shelter capacity, when money has already been allocated through former budget processes? The arguments used to get funding for these beds was not part of this shelter strategic plan, and it seems disingenuous to include them now when they are already in the works. It seems like the 555 needed beds previously argued for should go toward their originally intended purpose, and that 1000 more than this should be the stated goal. 
  1. How was the 1000 bed number decided on? Even in addition to the 555 beds already budgeted, this seems like a very low number if there are at least 5398 people living unsheltered outside. 
  1. How were the CCOs, hospitals, health systems, and state government agencies repeatedly cited as having major roles and responsibilities in this process actively engaged in creating this plan and over what time period? Who from these organizations were involved and how were these individuals selected?