KC Life 360

The Kansas City, Missouri Health Department (KCHD) participated in the Ryan White HIV/AIDS Program (RWHAP) Special Programs of National Significance (SPNS) Improving HIV Health Outcomes through the Coordination of Supportive Employment and Housing Services from 2017–2020. Through partnerships with Catholic Charities and reStart, KCHD developed KC Life 360 to expand housing and employment opportunities for people with HIV. KC Life 360 contributed to positive housing, earned income, and viral suppression outcomes for clients.

Kansas City, MO

Emerging Intervention
Support service delivery model
Retention in HIV medical care
Treat
People who are unstably housed
RWHAP Part A; RWHAP SPNS
City/county health department
Need Addressed

Recognizing the positive relationship between stable housing and outcomes on the HIV care continuum, the KCHD Planning Council advocated for more funding for safe, affordable, and permanent housing options for people with HIV. The RWHAP SPNS initiative helped KCHD leverage employment support and additional housing resources to meet this need.

Core Elements
Client enrollment

Case managers and peers at RWHAP Part A subrecipients identified individuals potentially eligible for the program and referred them to a KCHD housing specialist for a formal assessment. Clients were required to be newly diagnosed, not engaged in care, or not virally suppressed; be unstably housed; and want a job or to sharpen their skills. Many individuals learned of the program through word-of-mouth and were self-referred. The housing specialist then referred clients to Catholic Charities for employment support and reStart for housing support.  

Employment support

Catholic Charities provided individuals with skills to improve employment opportunities through resume writing, mock interviews, and communication tips. In addition, the organization connected individuals to potential employers and provided ongoing coaching services once employment was secured.

Housing

reStart focused on transitional housing for people who were homeless. The organization connected them to available U.S. Department of Housing and Urban Development (HUD) subsidies and housing units that would accept those subsidies, and provided support to promote successful transitions and independence. KC Life 360 also offered hotel gap lodging using RWHAP SPNS funds to provide housing for 30–60 days while more permanent options were found.

Other services and supports

All organizations and staff that participated in KC Life 360 worked closely with case managers to meet individuals’ needs outside of housing and employment, such as medical care, oral health care, and transportation. In addition, KC Life 360 implemented an innovative approach to reduce transportation barriers; the program distributed dozens of bikes donated by a local business to program participants to help them get to appointments and employment.  

Outcomes
Category Information
Evaluation data

KC Life 360 served a total of 115 clients between May 30, 2018 and September 29, 2020. As part of the SPNS evaluation, KCHD collected clients’ demographic, service, and medical data.

Measures

Percent of participants who accessed earned income, including through employment or Social Security Income (SSI) or Social Security Disability Income (SSDI), or housing—either permanent or temporary—at some point in the program. KCHD also measured the percent of participants that achieved or maintained viral suppression.

Results
  • 82% of clients gained access to or maintained earned income, mostly through full-time employment.*
  • 78% of clients gained access to permanent housing, 12% to transitional housing.*
  • 94% of clients achieved or sustained viral suppression.

*Program administrators note that some of these individuals eventually lost employment or housing.

“We started to have that conversation about how do we transform our housing programs so that we're not warehousing people, but we're really actually looking at how we move them along that continuum of care? Then [we started] to put the pieces in place that were needed to build that. KC Life 360 represented the culmination of that [work].”

Planning & Implementation
  • KCHD contracted with a housing agency, which was a pre-existing subrecipient through Housing Opportunities for People with AIDS (HOPWA) and RWHAP Part A, and a new partner, Catholic Charities, for employment services. Despite lack of RWHAP experience, Catholic Charities quickly integrated with KC Life 360 given the alignment of its mission with the program and positive reputation in the community.  
  • The participating agencies met on a bi-weekly basis to discuss process, improve coordination, and share client experiences for input.
  • KCHD added participating agencies to the KCHD data management system, SCOUT, which is also used by the Missouri and Kansas Part B programs, to give them access to clients’ medical and support service information. KCHD recognized that giving housing and employment specialists access to the “comprehensive chart of a client” helped them better meet client needs and coordinate with other providers.  
  • reStart leased a 22-unit building for transitional housing placements as allowable by Policy Clarification Notice #16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Use of Funds (PCN 16-02). This leasing process took almost two years to finalize. The leasing costs of the building were covered by HOPWA and RWHAP Part A, and KC Life 360 funds supported clients through case management related to housing and employment.
  • Catholic Charities modified a pre-existing employment training curriculum to better serve people with HIV by adding components related to disclosure and health.

Debbie and Jessica coordinate to provide clients many resources in addition to bikes, such as holiday meals.

Sustainability
  • KCHD put sustainability mechanisms in place to fund the strategy once the RWHAP SPNS initiative ended.
  • The agency relies on steady HUD funding for housing placements. In addition, KCHD hired the SPNS housing specialist as a full-time employee by reworking the use of HOPWA formula funds.
  • In addition, the participating housing and employment agencies have other funding streams to continue providing services. For example, individuals can still be referred to Catholic Charities for employment support after the SPNS program ended.

“Outside of formal sub-recipient contractual relationships, the key was to keep that kind of referral network and those wraparound services in the network.”

Lessons Learned
  • Given three different agencies provided services, referrals and coordination needed to be seamless to keep clients engaged. Therefore, staff often moved from location to location to serve clients instead of asking clients to travel. For example, if clients had an employment training at Catholic Charities, the housing specialists might meet them there to discuss housing issues. This co-location of services ensured that specialized staff and agencies provided housing and employment supports without requiring clients to move locations.
  • Similarly, staff met clients in community locations, such as the library or food establishments, to reduce transportation barriers and better serve them.
  • Catholic Charities identified job opportunities near bus stops, provided reimbursement for transportation costs, and distributed bikes to remove transportation-related employment barriers.  
  • KC Life 360 was able to secure HUD subsidies, but finding apartments to take those subsidies posed another challenge. The availability of one-bedroom apartments near public transportation is low in the Kansas City area. To address this issue, KCHD and reStart undertook a two-year initiative to sign a master lease with a 22-unit building. HOPWA covered leasing costs, and RWHAP Part A and KC Life 360 covered the costs of housing supportive services.
Contact the Innovator
City of Kansas City, Missouri Health Department
Travis Barnhart
Manager, Quality & Housing Services

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