Coordinated Assessment

1. Coordinated Assessment

2. Federal Definition “…a centralized or coordinated process designed to coordinate program participant intake, assessment, and provision of referrals. A centralized or coordinated assessment system covers the geographic area, is easily accessed by individuals and families seeking housing or services, is well advertised, and includes a comprehensive and standardized assessment tool.” - CoCInterim Rule, Section 578.3

3. Components • Access • Assessment • Assignment • Evaluation

4. Components 1. Access: Coordinated and simplified entry point into the homeless response system.

5. Components 1. Access: Coordinated and simplified entry point into the homeless response system. • Well-advertised, collaborative process with no side doors and no wrong doors.

6. Components 1. Access: Coordinated and simplified entry point into the homeless response system. • Well-advertised, collaborative process with no side doors and no wrong doors. • Access to initial assessment no matter where first point of contact may be.

7. Components 2. Assessment: Uniform,progressive assessment and documentation of clients’ housing needs and barriers by well-trained and clearly identified assessors.

8. Components 2. Assessment: Uniform,progressive assessment and documentation of clients’ housing needs and barriers by well-trained and clearly identified assessors. • Initial Assessment : Screen to divertor prevent homelessness.

9. Components 2. Assessment: Uniform,progressive assessment and documentation of clients’ housing needs and barriers by well-trained and clearly identified assessors. • Initial Assessment : Screen to divertor prevent homelessness. • Full Assessment: Comprehensive assessment to identify: • history of homelessness, • barriers to housing, and • personal goals,skills and assets of household.

10. Components 2. Assessment: Uniform,progressive assessment and documentation of clients’ housing needs and barriers by well-trained and clearly identified assessors. • Initial Assessment : Screen to divertor prevent homelessness. • Full Assessment: Comprehensive assessment to identify: • history of homelessness, • barriers to housing, and • personal goals,skills and assets of household. • Priority scoring based on assessment and community prioritization.

11. Components 3. Assignment: Linkage to appropriate services based on assessment, system mapping and written programs standards.

12. Components 3. Assignment: Linkage to appropriate services based on assessment, system mapping and written programs standards. • Utilization of uniform system tools and process based on system mapping.

13. Components 3. Assignment: Linkage to appropriate services based on assessment, system mapping and written programs standards. • Utilization of uniform system tools and process based on system mapping. • Waitlist and prioritization based on assessment score and community priorities.

14. Components 3. Assignment: Linkage to appropriate services based on assessment, system mapping and written programs standards. • Utilization of uniform system tools and process based on system mapping. • Waitlist and prioritization based on assessment score and community priorities. • Assistance with linkage to services for individuals with high barriers.

15. Components 4. Evaluation: Comprehensive evaluation of consumer outcome and performance (program, agency and system) to increase; effective use of resources (both staff and fiscal), quality of service to consumers, and the ability to proactively identify and plan services.

16. Components 4. Evaluation: Comprehensive evaluation of consumer outcome and performance (program, agency and system) to increase; effective use of resources (both staff and fiscal), quality of service to consumers, and the ability to proactively identify and plan services. • Establishment, promotion and review of system-wide performance standards.

17. Components 4. Evaluation: Comprehensive evaluation of consumer outcome and performance (program, agency and system) to increase; effective use of resources (both staff and fiscal), quality of service to consumers, and the ability to proactively identify and plan services. • Establishment, promotion and review of system-wide performance standards. • Annual review of system tools and process with multi-level feedback.

18. Opportunities for improved client outcomes. • Better utilize resources. • Opportunities for improved data: • Principals of effective crisis response • Experience with the Rapid Re-Housing Demonstration • CoC and ESG requirement Why Coordinated Assessment?

19. COORDINATED • Coordinated • Standardized assessment/forms. • Uniform process • Referral is comprehensive and done with understanding of entire system. • “What housing and service strategy is best for this household based on the services available?” System Change CURRENT • Uncoordinated • Forms & Assessment are unique to system (prevention, ES, PH) • Forms & Assessments are different for each provider. • Referrals inconsistent and sometimes incomplete. “Should we accept this client into this program?”

20. The Fargo-Moorhead Pilot • Start Date: July 2, 2012 • Goal: Soft Pilot of Coordinated Assessment • Involved 4 Pilot Agencies • Tested: - Triage tool, - timing, - access, - opening up HMIS - targeted referrals • Included evaluations of: - consumers, - agencies - community partners

21. What we learned! • Triage Tool • simplified process for consumers & Case Managers • Training is essential. • Multi-levels assessment process is necessary for those with higher barriers to and to prioritize waiting listsand to help assure accuracy of referrals. • Took about 20 minutes longer post CA, but they felt they had a better assessment overall.

22. What we learned! • HMIS • Open system can provide benefits to consumers & agencies. • Need access to HMIS for non-HMIS referral agencies.

23. What we learned! Other • Education & training is essential! • Process in writing. • Tool not enough, • Case Management is needed to help individuals prepare for housing once on the list (obtain ID’s, gather rental history, etc.) • Few individuals follow-up on their own.

24. Moving Away From… • Having to call the same programs every day for weeks or months • Being sent from program to program • Finding out about more helpful programs too late • Being asked the same questions over and over again

25. CARES is a collaborative initiative between North Dakota & West Central Minnesota Continuums of Care (CoC) designed to create a more effective and efficient homeless response system.

26. CARES Partners • Churches United for the Homeless • City of Fargo • City of Moorhead • Clay County Housing & Redevelopment Authority • Creative Care For Reaching Independence • Dorothy Day House of Hospitality • Fargo Housing & Redevelopment Authority • Fargo Public Library • First Link • Gladys Ray Shelter and Veterans Drop-in Center • Lakes & Prairies Community Action Partnership • Legal Services of NW MN • Moorhead Public Housing Authority • New Life Center • SouthEastern North Dakota Community Action Agency • The Salvation Army of Fargo, North Dakota • Fargo VA • Welcome House • YWCA Cass-Clay

27. CARES Overview The jointCoC initiative is based upon; • A desire to ease access to services for clients who migrate across the ND/MN border. (26.8% • A long history of cross-boarder collaboration • FM Coalition for the Homeless • Tri-annual Wilder Study • Annual Homeless Point-in-time count • A desire to have improved data. • Better understand duplication of client data & services • Identify gaps & needs for improved system planning.

28. Guiding Principles • Reorient service provision • Identify which strategies are best for each household • Link households to the most appropriate intervention • Provide timely access and appropriate referrals • Shorten the number of days homeless • Provide immediate access to information • Create an advanced system Collaborate • Provide for ongoing participation

29. Anticipated Benefits • Client focused • Increased efficiency • Improved Communication • Planned service strategies • Better-quality data • Greater Consistency

30. Client focused: • Easier access. Don’t have to navigate what can sometimes be a complex system. • More effective outcomes for clients when linked to right intervention. Anticipated Benefits

31. Anticipated Benefits • Increased efficiency: • Case managers will have quick access to online service directory and key client data. • Clients do not have to repeatedly fill out intake forms and repeat their story. • Progressive assessment and online directory simplify eligibility and referral process.

32. Improved Communication: • Easier for agencies to identify discrepancies, missing data and issues. • Agencies utilizing system have reported better collaboration in helping client achieve goals. Anticipated Benefits

33. Planned service strategies: • Communities can prioritize service specific populations/subpopulations based on current trends and needs of clients. • Service delivery system is clear and intentional. • Written standards for administration of programs. Anticipated Benefits

34. Better-quality data: • Increased understanding of system gaps/duplication (unduplicated & system-wide). • Easier to review performance (agency, program and system). Anticipated Benefits

35. Greater Consistency: • Equal access to services for anyone entering the system eliminating inequality based on personality conflicts, discrimination or agency/client history. • Process (access, assessment, and referral) is the same for everyone and based on assessment score not where or when a client enters the system. Anticipated Benefits

36. Managing Expectations • Coordinated Assessment won’t create more housing. • An assessment tool and open system won’t deliver perfect information. • A system mapping survey and assessment tool alone won’t change your system.

37. Planning: Next Steps System Mapping Continue with HUD Technical Assistance Establish a Governance Structure Launch an open data management system.

38. 1. Understand existing system interventions: • Identify stakeholders and services in each CoC system. • Identify the system gapsand duplications • Identify the flow of persons through the system. • Help to establish link between CARES assessment and intervention: • Determine assessment score linkage to intervention type. • Help individuals be placed in right intervention as soon as possible to assure best outcome and utilization of services. • Help set written standards for CARES: • List eligibility criteria for intervention and programs. • Identify intervention components and definitions. • Help determine processes and protocols. • Determine system intervention improvements: • Evaluate inventory for potential development. • Determine if there are needed changes to the flow. • Analyze inventory for potential reassignment or program specialization to better meet needs of the system. Planning: System Mapping

39. Planning: TA • Coordinators participate in monthly progress calls. • Review TA timeline and make assignments to respective committees. • Review example documents provided by TA providers. • Host TA calls and webinars as needed to provide education, support and information to identified groups (committees, subpopulations, governance, etc.) • Send proposed forms, policies and protocols to TA providers for review.

40. Planning: Structure • Elect a Governance Board • CoC’s vote on representatives. • FMCHP votes on representative. • Participate in a Committee • Protocol • Implementation • Performance & Evaluation • Data • Hire Staff • Continue to fundraise for key positions • Evaluate reassignment of existing resources

41. Planning: Data Participate in State of MN HMIS Technical Assistance Obtain estimate from Bowman for Data Bridge Review and pilot potential assessment tools Develop a fundraising plan for Data needs.

42. THANK YOU! Questions? Comments?