By August 8, we are working to:

1. Understanding who we serve.

Why: Having a clear understanding of the population will support individualized crosssector plans to meet needs and improve outcomes. Communicating the “what, why and how,” and where we need to support changes will enhance confidence for those not directly in the work.

2. Securing a site for additional housing with complex care.

Why: An estimated 100+ individuals are very high utilizers of shelter, public services, and emergency healthcare who are unlikely to sustain permanent housing without significant behavioral health and supportive services. Permanent Supportive Housing with complex care relieves multiple system bottlenecks at once — shelter beds, ER volume, jail throughput, and provider capacity.

3. Building a coordinated partner network.

Why: Outreach partners currently work toward shared goals through separate command structures, without explicit norms for communicating up, down, or across organizational lines. The Team of Teams approach — proven in complex multi-stakeholder operations — shows that shared consciousness, common purpose, and empowered execution allow networks of organizations to outperform any single agency working alone. A written work plan and consistent meeting cadence replace implicit assumptions with explicit operating norms, producing the foundation for trust and the integration that case-level work depends on.

4. Making our progress visible.

Why: Sustainable, accurate and timely data is available to the public that communicates progress and key trends.

5. Telling the story clearly.

Why: Homelessness response is structurally complex — multiple agencies, overlapping funding streams, evolving best practices — and the audiences who need to understand it are equally varied: funders making allocation decisions, elected officials and business stakeholders forming policy positions, and the broader public forming perceptions that shape political and philanthropic conditions. Direct service teams cannot simultaneously deliver coordinated care and produce the clear, consistent external narrative that sustained funding and public support require. A specialized communications partner builds and operates that external-facing layer, ensuring stakeholders understand what the work is, what outcomes it produces, and how they can engage meaningfully — without diverting frontline capacity from the work itself.

6. Connecting care across providers and systems.

Why: Kent County is home to many high-performing health, behavioral health, and housing organizations, but limited coordination across systems and at the patient level reduces the community’s ability to improve health and housing outcomes. With growing housing pressures, stronger data-driven, cross-sector coordination is increasingly urgent. Cross-sector ecosystems leverage cross-sector case conferencing to co-create care plans for complex individuals who also function as boundary crossers between systems. Connecting hospitals, FQHCs, CMHs, housing, and shelters will eliminate inefficiency while producing better outcomes for both the individual and the system.