October 29, 2019 Councilmember Bagshaw: I want to take this opportunity to follow-up with you about some of the questions regarding the LEAD program. Since its inception, LEAD has grown exponentially and it has become a national model for diversion. As discussed below, the City’s investments have also grown exponentially, while the program’s referral base has changed significantly and demand has become overwhelming because we lack other alternatives. This makes it a critical time to ensure that programs like LEAD are appropriately funded and we have the right individuals connected with the right programs. As you know, Mayor Durkan has long been a champion of programs that are alternatives to incarceration, and she strongly believes in diversion and restorative justice programs. Decades ago, the Mayor worked to establish some of the nation’s first Drug Courts and Mental Health Courts in King County to provide alternatives to incarceration and as U.S. Attorney created one of the first Federal Drug Courts in the nation. Programs like LEAD that provide alternatives to incarceration are an important component of a comprehensive strategy to help reduce the likelihood of recidivism among participants. At the same time, there is never one right tool for everyone. That’s why she believes strongly in a range of approaches to address individual needs and prevent and address criminal conduct. It is our commitment to this strategy to help those in need that drives us to understand the impact of the City’s investments. For more than a year, we have worked with LEAD to both build data and to try to understand the engagement of individuals in the program and the outcomes they are achieving. We do this to understand who is best served by the LEAD model and the quality of impact the City’s investment is having. This standard of performance-based contracting, which I know you are also committed to, has been adopted by HSD’s Homeless Strategies and Investments Division and is showing increasing evidence of its positive impact on program success. Since the City began piloting its investment in LEAD, funding has grown more quickly than most City programs from approximately a $1,000,000 investment from the City and County to $6,275,000, which represents a 605% increase since 2015. A 2015 academic study showed some recidivism improvement for the LEAD group compared to the control group. Because LEAD has grown exponentially since this study, serving new client groups and new areas in our city, it is more important than ever to have a full view into the breadth of its outcomes and individual data to ensure not just accountability and performance but to ensure we get the right people in the program. We have been working with LEAD to understand its program model and outcomes, similar to the expectations that we expect among other contracts in the City, such as: • How long it takes for each participant to go from referral to enrollment in the program and what happens to the person in the intervening period; Office of the Mayor 600 Fourth Avenue, P.O. Box 94749, Seattle, WA 98124 206-684-4000 seattle.gov/mayor Councilmember Bagshaw LEAD Performance Metrics October 29, 2019 • • • For each participant, what are the frequency and quality of meetings with LEAD and the outcomes for the client; The number of individuals who are exiting the program; and Of particular importance will be for each participant: o If experiencing homelessness, has shelter and/or housing been obtained; o If there are behavioral health issues, have they received services or are in recovery, and the outcome of those services; and o Has there been any recidivism and if so how often and what sort of police, jail or court contact(s) have occurred. On the basis of information provided to date, there remain questions about outcomes and the level of client engagement occurring. “Active” participants are described by LEAD as those who have had one or more “substantive meeting with their assigned case manager” within the last three months. LEAD reports 718 Seattle current participants who have completed intake, of which 561 of those are “active.” We do not have data which shows the average frequency of meetings with clients, or the overall or individual impact such engagement has. LEAD does not currently work on a model that evaluates the number of case management contacts in 2018. This is in part because of the necessity to meet clients where they are and to support them and their individuals challenges and situations. But as a result, it is difficult to judge the actual case management ratio based on workload. For key objectives, LEAD was able to quantify: • • • During the last 15 months, LEAD received 565 approved referrals, both social contact and diversion. Of those, 44% have not completed their intake. In 2018, 41% of active participants began substance use disorder treatment services and 12% began mental health services. LEAD did not report on percent of participants actively engaged in treatment nor outcomes from those services, although LEAD indicated that the County’s Behavioral Health and Recovery Division and REACH may be able to report on treatment outcomes if contractually required. They estimate that 70% of LEAD participants were experiencing homelessness at intake. In 201718, about 27% of participants obtained permanent housing. As reiterated in recent testimony before the City Council, LEAD is at its core a criminal justice diversion program. Unfortunately, LEAD has thus far been unable to provide the City with recidivism data or overall impacts and criminal justice outcomes. This is because LEAD does not track information related to arrests by police officers, filings and court appearances, nor any subsequent interactions with jail by their program participants. Some court data is available, such as failures to appear, but that data is still being gathered. This lack of data does not mean LEAD is not positive for many clients – it is, but we must be able to evaluate the degree to which LEAD is meeting its prime objective of reducing criminal recidivism. Given the scale of issues and resources available, it is prudent to understand who most benefits from the program and what accountability is possible. We must have a range of programs, as no one program will have the impacts we need to reduce criminal activity and involvement in the criminal justice system. Page 2 Councilmember Bagshaw LEAD Performance Metrics October 29, 2019 We are committed to serving those in our community who would benefit from diversion, and our office is collaborating with LEAD to create a system to better track performance and individual results and to determine how the City should define and measure success through the 2020 contract. We have assigned resources from the Seattle IT department to work with LEAD to finish a database that will allow better data-capture going forward. Additionally, we will be engaging an external consultant to prepare an assessment of LEAD’s program model and its alignment with the program’s mission and theory of change. Among our topics of interest are referral protocols, best practices in behavioral health services for a similar population and case management practices, and, perhaps most importantly, how is success defined and measured for participants, the community and the criminal justice system and LEAD’s feedback loop for ensuring continual process improvement. We all want positive outcomes for participants and increased community confidence in our strategies. As we move forward, these metrics will provide insight to short-term as well as long-term impacts and thus inform current and future investment levels in LEAD. Regards, Michael Fong Senior Deputy Mayor Page 3