By Erica C. Barnett
The King County Regional Homelessness Authority will announce a large, one-time philanthropic contribution next week that will fund startup costs for a “peer navigator” program at the authority, PubliCola has learned. The money to stand up the program will come from a combination of major corporate donors and foundation grants. It’s unclear whether next week’s announcement will also include funding for new shelter, such as the high-acuity medical shelter that the city council partially funded last year.
Peer navigators are case managers with lived experience who help “navigate” people experiencing homelessness into services, shelter, and housing. Last year, the KCRHA asked the Seattle City Council for $7.6 million to hire 69 navigators who would each work with about 15 clients in downtown Seattle. The council declined to immediately fund the program, and asked the authority to come back with a “system-wide needs assessment” that would look at other organizations doing similar or redundant work and include a plan for sustainable long-term funding.
The KCRHA declined to respond to questions about next week’s announcement, which will reportedly involve funding from Challenge Seattle (former governor Chris Gregoire’s CEO roundtable, which weighed in recently on chronic homelessness) and We Are In, a homelessness “education and awareness project” backed by the Gates Foundation, Vulcan, the Ballmer Group, the Seattle Chamber, and the United Way, among others. (Neither Challenge Seattle nor We Are In responded to PubliCola’s requests for comment.)
The question of “navigation to where?” is as relevant now as it was last year, when the city council first debated whether to fund the program
A spokesman for Mayor Bruce Harrell, who will be participating in the announcement, also declined to comment until next week.
The KCRHA has already advertised two peer navigator program co-director positions whose $100,000 to $130,000 salaries will be funded by We Are In. According to the job description, “The role of a peer navigator is to accompany and advocate for people across systems. The peer navigator will be a consistent presence, from initial engagement through permanent housing.”
When KCRHA director Marc Dones sought one-time city funding to set up the peer navigator program last year, they said the agency planned to use one-time funds to get the program up and running and seek reimbursement from Medicaid to pay for the program’s ongoing operation costs after the first year. If the plan is still to fund the program through Medicaid after its first year, the concerns council members raised last year about the program’s sustainability remain relevant.
Council members who supported the peer navigation idea in concept noted last year that Medicaid is notoriously picky about what sort of services it will pay for. “I understand that Medicaid reimburses, for example, for 15-minute allotments only, and what I understand from some of our community partners who provide similar peer support systems, outreach and engagement systems, [is that meeting with clients] often takes two to three hours,” Councilmember Teresa Mosqueda said at the time.
A two-tiered system in which the KCRHA pays much higher wages than nonprofits can offer for similar positions could worsen the staffing crisis at existing agencies, nonprofit service providers noted.
Responding to questions at the same meeting from Councilmember Tammy Morales, council central staffer Jeff Simms said, “there’s a lot of questions regarding that potential.” If Medicaid doesn’t agree to fund the program, Simms continued, “in the long term, we’d be looking at needing to find a different way to pay for this type of approach.” The KCRHA receives most of its funding from the city of Seattle, with the balance coming from King County.
Asked about Medicaid reimbursement for peer navigators, in general, KCRHA spokeswoman Anne Martens pointed us to a Medicaid waiver program that could potentially “reimburse accreditation of peers as well as reimburse for their time.” Some local homeless service providers, including Catholic Community Services, receive funding to help high-risk clients, including those experiencing chronic homelessness, through a program called Foundational Community Supports. Nonetheless, this remains an area of uncertainty for the future of a program funded with one-time philanthropic donations.
Another significant outstanding question is whether peer navigators are the best use of limited philanthropic and government resources for homelessness. The question of “navigation to where?” is as relevant now as it was last year, when the city council first debated whether to fund the program. During the four years of the Durkan administration, Seattle added just 350 new permanent shelter beds as the total number of people experiencing homelessness surged. If peer navigators are just another kind of case manager for people living outdoors, their effectiveness will be constrained by the lack of off-ramps leading people out of homelessness in Seattle—off-ramps such as non-congregate shelter, long-term rent assistance, and permanent supportive housing.
A team of outreach workers employed directly by a government agency will almost certainly be better paid than existing service providers who do similar work, who have found it nearly impossible to retain long-term staff due to low wages and burnout. The council secured a one-time 5.8 percent wage adjustment for homeless service providers, on top of a one-time 3 percent inflation adjustment, last year, but they remain woefully underpaid.
A job listing for case managers in the Downtown Emergency Service Center’s HOST program, which provides intensive case management and outreach similar to what peer navigators would provide for their clients, shows a starting salary of $51,000 a year. A two-tiered system in which the KCRHA pays much higher wages than nonprofits can offer for similar positions could worsen the staffing crisis at existing agencies, service providers who spoke to us on background about the proposal noted.
Finally, it’s unclear how people would be prioritized for the peer navigator program, which Dones proposed last year as part of the KCRHA’s downtown Seattle emphasis plan. The county’s Lived Experience Coalition will play a large role in designing the program, according to the program description on KCRHA’s website.