1. The city of Seattle has amended its $60,000 contract with former King County Homelessness Authority CEO Marc Dones, who was supposed to spend the latter half of this year coming up with ways to maximize the use of Medicaid funding for homelessness programs.

The latest iteration of the contract directs Dones to come up with “recommendations with respect to the local federal unsheltered initiative “All Inside” … [including] considerations for the local initiative’s statement of work, actionable workplan and performance plan,” in addition to the work Dones has already done on Medicaid. In an email on August 7 titled “Landscape to Date,” Dones concluded that there were several “significant” but “solvable” challenges to billing Medicaid for homeless services.

All Inside is a Biden Administration program that provides technical assistance to cities, including Seattle; it does not include additional funding for housing or services.

The pivot is particularly striking given Dones’ previous advocacy for using Medicaid Foundational Community Supports funds to pay for Partnership for Zero—a privately funded effort to end unsheltered homelessness downtown that folded, after housing 230 people, this month. Dones was so bullish on the program that they predicted it would pay for at least 85 percent of Partnership for Zero’s services by next year, brushing aside concerns from homeless service providers and elected officials that the program is complex, highly restrictive, and expensive to administer.

In their latest update, Dones identified “four significant issues” with using Medicaid to fund homeless services. First, Dones wrote, agencies often have to spend a lot of time and staff resources documenting and administering programs in order to get reimbursed. Second, Dones wrote, agencies have to spend a lot of time “chasing” clients to collect billable hours, creating a “significant gap in what is called the ‘billable units of service’ and requir[ing] agencies to fund activities that are related to enrolled clients with no path to reimbursement.”

The third issue Dones identified is that FCS is not a reliable source of funds for behavioral health services. And the fourth was that Medicaid reimburses agencies slowly and often rejects claims for minor or technical reasons, making it hard for providers without large cash reserves to use it as a reliable source of funding.

Providers raised every one of these issues when the KCRHA tied the future of Partnership for Zero to Medicaid funding earlier this year, but were largely ignored.

Dones has completed approximately half of their 240-hour contract, according to a schedule of “deliverables” included in the contract document. So far, Dones has produced a timeline and scope of work, a 600-word email describing the “landscape to date,” a 450-word email containing a “Draft Assessment” of All Inside, and a list of five stakeholders to talk to about various topics, including the “intersection of public transit and homelessness,” “intersection of organized crime and encampments,” and “pro social public space activation to prevent encampments.”

2. The final version of a report documenting what went wrong with a hotel program run by the Lived Experience Coalition reaches substantially the same conclusions as an early draft PubliCola covered back in August, but does include a number of notes contributed by the LEC, which has blamed budget missteps that led to the collapse of the program primarily on its then-fiscal sponsor, Building Changes, and the KCRHA.

As we reported last month, the report, by independent consultant Courtney Noble, concluded that the LEC was in over its head when it accepted $1 million in federal funding to run the hotel-based shelter program, which was the advocacy group’s first such contract. Noble also reported that other factors, including a lack of transparency from Building Changes and a hostile relationship with the KCRHA and Dones, contributed to the program’s failure.

The final report now emphasizes systemic issues and removes references to the LEC’s initial proposal, which included hot meals, mass shelter, and supplies in addition to the hotel rooms that were the core of the LEC’s final contract. It also softens suggestions that the Lived Experience Coalition should participate in the regional Homelessness Management Information, a central clearinghouse for information about people who interact with the homelessness system, in order to access federal Emergency Food and Shelter Program funds in the future.

The LEC has said that gathering the kind of data required to participate in HMIS would re-traumatize their clients; additionally, according to the final report, they “believed that KCRHA leadership was retributive, and wanted to punish them for stepping out of their advocacy lane to run the hoteling program. LEC maintained that they were still not a direct service provider, and believed that participating in HMIS would strengthen KCRHA’s argument that they were.”

In footnotes to the report, the LEC said the audit itself should go through a racial equity analysis “due to the fact that the audit was conducted by a single individual of a particular racial background and socioeconomic class” who may have unconscious bias. Additionally, the LEC objected to the consultant’s suggestion that conflict between “personalities”—at a minimum, Dones, LEC director LaMont Green, and Building Changes director Daniel Zavala—contributed to the collapse of the hotel program.

It has historically an issue when poor white, black, brown, and indigenous people come together to speak truth and organize to urgently improve failing systems resulting in the dehumanization, pain, suffering, and early death of our unhoused neighbors that the systems do not want to be accountable and then turn to tactics such as defunding, gaslighting, and mischaracterizing their work,” the LEC wrote.

Finally, the LEC said it’s inaccurate to call the hotel program a failure. “The program did not fail, it served over 400 people during a time period when we saw record deaths among those experiencing homelessness,” the group’s final footnote says.