Online Program

Enhancing HUD-VASH service delivery using lean management principals

Monday, November 2, 2015

Tanya Tabon, LCSW, Supervisory Social Worker VA Supportive Housing VA Palo Alto, HUD-VASH Menlo Park, VA Palo Alto Health Care System- HUD-VASH Program, Menlo Park, CA
Monika Muller-Eberhard, LCSW- VASH Case Manger, Domiciliary Service-HUD-VASH, VA Palo Alto Health Care System- HUD-VASH Program, Menlo Park, CA
Timothy Quinn, LCSW, Menlo Park HUD-VASH, VA Palo Alto Health Care System- HUD VASH Program, Menlo Park, CA
Topic:  The problems related to homelessness experienced by Veterans in the San Francisco Bay Area are compounded by a severe shortage of affordable and subsidized housing. California Housing Partnership Corporation issued a report in May 2014 citing that in Santa Clara County fewer than three out of ten extremely low income renter households will find affordable rents.  VA Palo Alto's Menlo Park HUD-VASH program felt the impact of a shrinking Santa Clara affordable rental market as Veterans found it increasing difficult to utilized their housing voucher as units were priced above the $1315, 1 bedroom HUD subsidy.  With an eye towards improved service delivery, VA Menlo Park HUD-VASH utilized lean principals to improve housing outcomes for Veterans.  Using lean principals VA Menlo Park re-designed our service delivery model to enhance the housing search process for Veterans, improve clinical case management services and improve employee job satisfaction.

Method:  VA Menlo Park HUD-VASH used lean methodology to examine and understand the inefficiencies within our service delivery and ways to improve services to Veterans.  By using a  lean approach to problem solving- VA Menlo Park HUD-VASH defined the multiple problems that impacted Veterans ability to secure housing, measured the problem, conducted a root cause analysis, implemented process improvements to reduce barriers, and finally evaluated  if the process improvements improved efficiency.

Results:  By implementing service delivery process improvements within VA Menlo Park's HUD-VASH program, 37% more Veterans moved into permanent housing between 8/1/2014-1/27/2015 n= 37 as compared to the same time period the year previous n=27.  VA Menlo Park HUD-VASH created two teams to enhance service delivery.  An Initial Care Team (ICT) to work with unhoused Veterans to secure permanent housing and a Continued Care Team (CCT) to address clinical issues with housed Veterans.  ICT Case Managers had a maximum case load of 15 unhoused Veterans and CCT Case Managers case loads varied from 35-46 housed Veterans.  The re-distribution of Case Managers case loads based on unhoused or housed status allowed for greater flexibility in each team to address housing placement issues and/or other clinical issues that arise once housing is secured. At present, VA Menlo Park HUD-VASH has continued with the two team approach as it yielded improved housing outcomes for Veterans. 


1 California Housing Partnership Corporation, Santa Clara County Report, May 2014

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe and Identify key steps in lean management principals and apply those techniques to their current model of service delivery, Evaluate current service delivery using lean management techniques, Describe how VA Palo Alto's HUD-VASH program used lean management principals to enhance service delivery

Keyword(s): Homelessness, Organizational Change

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have led our team in 2 performance improvment project using lean management techniques which have successfully impacted our HUD-VASH service delivery. By using principals of lean managment for process improvment, I've led my team of Social Workers and Peer Supports to improve permanent housing outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.