Coordinated Entry March 2018

Access Consideration: Different Access Points Required: Same assessment approach at all access points. May include separate access points for: adults without children adults accompanied by children fleeing DV, dating violence, sexual assault, stalking, other dangerous or life-threatening conditions unaccomp-anied youth persons at risk of homelessness

Additional Access Requirements Ensuring Access: Emergency Services Homeless Prevention Marketing and Accessibility Safety Planning Street Outreach Few barriers EMERGENCY SERVICES – The coordinated entry process must allow emergency services, including all domestic violence and emergency services hotlines, drop-in service programs, and emergency shelters, to operate with as few barriers (CLICK) to entry as possible. Also, households must be able to access emergency services independent of the operating hours of the coordinated entry’s intake and assessment processes (CLICK). That doesn’t mean a CoC can’t use the coordinated entry to prioritize emergency shelter beds, but if that process is creating a bottleneck or resulting in empty crisis beds then it isn’t operating in the true intent of coordinated entry. HOMELESS PREVENTION: CoC’s access point(s) must be easily accessed by individual and families seeking both homeless or homelessness prevention services. Prevention must be a part of coordinated entry and coordinated entry must be designed to support persons at risk of homelessness! Marketing/Accessibility CoCs’ written policies and procedures for the coordinated entry process must: Include a strategy to ensure the coordinated entry process is (CLICK) available to all eligible persons regardless of race, color, national origin, religion, sex, age, familial status, disability, actual or perceived sexual orientation, gender identity, or marital status. Document steps taken to ensure access points, if physical locations, are accessible to individuals with disabilities and document steps taken to ensure effective communication with individuals with disabilities, (CLICK), and Take reasonable steps to offer CE process materials and participant instruction in multiple languages to meet the needs of minority, ethnic, and groups with Limited English Proficiency (LEP). Safety Planning CoC has a specific written CE policy and procedure to address the needs of individuals and families who are fleeing, or attempting to flee, domestic violence, dating violence, sexual assault, or stalking, but who are seeking shelter or services from non-victim service providers (CLICK). Street Outreach Written policies and procedures describe how street outreach efforts funded under ESG or the CoC program are linked to the coordinated entry process (CLICK) The Notice specifies several CE requirements must be documented in your Continuum’s coordinated entry policies and procedures. During today’s presentation we are going to call out a few of those instances. Non-discriminatory Fleeing and seeking services from non-victim service providers Linked to CE Access isn’t tied to CE open hours Disabilities and Language

Write it down: Access Requirements CoC’s written CE policies and procedures must: Document a process ensuring access to emergency services during off hours Document steps taken to ensure 1) access points are accessible to individuals with disabilities and 2) effective communication with individuals with disabilities Address the needs of individuals and families who are fleeing violence Describe how street outreach efforts funded under ESG or CoC are linked to the CE process The Notice specifies a number of requirements that must be documented in writing in a CoC’s coordinated entry policies and procedures. This isn’t just about having it written down—having it written down is a reflection of the work that you’ve done to make decisions as a planning body and codify it in something that everyone is held to. To review, you have to document a process ensuring access to emergency services when Coordinated Entry is not open or available Document how the CoC is ensuring accessibility to households with disabilities Document how you’re addressing the needs of households fleeing violence, and Document how ESG or CoC funded outreach efforts are linked.

Assessment: Requirements and Considerations Standardized process to document needs and preferences Could be completed in phases CoC provides assessor training at least once annually Participant presents at any access point Standardized Assessment process After a household accesses coordinated entry, they are assessed. No matter which access points at which a participant presents, they are going to encounter the same next step. The same next step means that everyone gets assessed, but it could mean that all youth are assessed with a youth-specific tool, or all families with a family-specific tool. “Standardized assessment” simply means the use of one or more standardized assessment tool(s) used to determine a household’s current housing situation, housing and service needs, risk of harm, risk of future or continued homelessness, and other adverse outcomes. Those five populations that can have different access points can also have a different assessment, as long as everyone within the population gets the same one. Another consideration is using phased assessments, so you’re not using a single assessment just once, but rather only getting the information needed to prioritize and refer someone for that particular phase. We have another poll question in a minute that gets at this, so if you have questions, hopefully we’re answer them there. The Notice also requires CoCs to train assessors at least once annually to make sure all staff administering assessments have access to materials that clearly describe the methods by which assessments are conducted. The training curricula should include the review of CE policies and procedures, prioritization process, and criteria for uniform decision-making. CoCs must distribute training protocols and offer at least one training to all participating staff within 12 months of the publication of the Notice.

Write it down: Assessment Requirements Establish criteria used for uniform decision-making Prohibit “screening out” from assistance Protect all data collected through the CE assessment process Establish that the assessment process cannot require disclosure of specific disabilities or diagnosis Provide training to staff administering CE processes There are a number of things that need documented. CoCs have to document criteria for uniform decision-making in the assessment process and make sure people aren’t screened out of assistance based on perceived barriers. These perceived barriers include some usual suspects, like too little or no income, active or a history of substance abuse, domestic violence history, resistance to receiving services, the type or extent of a disability-related services or supports that are needed, history of evictions or poor credit, lease violations or history of not being a leaseholder, or criminal record. There could be others, but these are the usual barriers that are unnecessarily placed on households. The policies and procedures also have to document how the coordinated entry information is protected using the same privacy and security protections extended to all HMIS data. Establish that programs may require participants to provide certain pieces of information to determine program eligibility only when the applicable program regulation requires the information to establish or document eligibility. CoC must establish written policies and procedures establishing the process, frequency and curricula for training of all assessors. We want to make sure anyone conducting an assessment has been trained to do so.

Prioritization: What does it mean? Requirement: Prioritize most severe service needs / highest vulnerability But how do we know? Defined by community-established principles Ask: What does it mean in your community to have the most severe needs or be most vulnerable? Ask: How do you account for differences in populations? Data collected via the assessment process is used to prioritize households for assistance. You’ll see in the notice that coordinated entry must, to the maximum extent feasible, ensure that people with more severe service needs and levels of vulnerability are prioritized for housing and homeless assistance, before those with less severe service needs and lower levels of vulnerability. The notice indicates a set of factors that could define prioritization, including: significant challenges or functional impairments that require a lot of support to maintain permanent housing; high use of crisis or emergency services; Unsheltered status, especially youth and children; vulnerability to illness or death; risk of continued homelessness; vulnerability to victimization, like physical assault, trafficking or sex work; or other factors determined by the community that are based on severity of needs.

Prioritization: Requirements and Considerations Participant presents at access point Assessment Process Prioritization Case conferencing The assessment is one source of information about a households’ needs, but it might not produce all the information necessary to determine prioritization, either because of the nature of self reporting, withheld information, or circumstances outside the scope of questions. For these reasons, it’s important that case workers and others working with households have the opportunity to provide additional information through case conferencing or another method of case worker input. It is important to remember, however, that only information relevant to factors listed in the coordinated entry written policies and procedures may be used to make prioritization decisions, and must be consistent with written standards governing CoC and ESG funded projects. You may find that in establishing prioritization principles that your written standards need to be updated to ensure consistency. A community-wide list generated during the prioritization process, referred to variously as a “By Name List,” “Active List,” or “Master List,” is not required, but it can help communities effectively manage an accountable and transparent referral process. If a community-wide list is used, CoCs must extend the same HMIS data privacy and security protections prescribed by HUD in the HMIS Data and Technical Standards to “By Name List,” “Active List,” and “Master List” data. Principles and written standards consistent Master/By-Name Lists

Write it down: Prioritization Requirements Document specific, definable prioritization criteria Include the factors and assessment information used for prioritization decisions Clearly distinguish between the interventions that will and will not be prioritized Document process for participants to file a discrimination complaint Specify the conditions for participants to maintain their place in CE prioritization lists when the participant rejects options

Referral Requirements and Considerations Participant presents at access point Assessment Process Prioritization Referral Uniform across projects No screening out After a household has accessed the coordinated entry, been assessed, and prioritized, they are referred to a project. Referral has to be uniform for all beds, units, and services available at participating projects, which must be all CoC and ESG funded projects, but hopefully extends well beyond that to pull in other mainstream housing and services. The coordinated entry is not screening out potential project participants based on perceived barriers, but if projects haven’t lowered their barriers, there’s a break in the chain. What happens when an agency rejects a referral? CoC- and ESG-program recipients and sub-recipients use the coordinated entry process as the only referral source from which to consider filling vacancies. We also refer to this as closing the side doors. Basically, if your project gets referrals from a bunch of different sources, you have no way of knowing whether the people being referred to you have the most severe needs. So closing the side doors means that you as a provider participate in establishing prioritization principles as part of the broader system of care, and then you rely on the coordinated entry process to reliably follow those principles, so that you know you’re getting referrals of people who most need what you have to offer. The Referral component provides another opportunity for the CoC to support participant autonomy and a client-centered approach. Make sure to consider the participant’s preferences and goals while identifying referral options. It might be that the participant has a particular neighborhood or service provider that they feel is well positioned to support their housing placement and ultimate success. For CoC and ESG projects, CE is only referral source

Write it down: Referral Requirements Document assessment, vulnerability and need-based factors used to make prioritization decisions, including homelessness prevention services Include a process by which individuals and families may appeal coordinated entry decisions Document protocol for participant rejection of a referral

Infrastructure Element: Planning Shelter Providers Housing Providers Service Programs Outreach Teams Mainstream Systems Crisis Response System that results in homelessness as rare, brief, non recurring There are many questions to think through when starting to plan, and we’ll highlight just a handful of considerations here. Planning a coordinated entry process can be challenging as you begin collaborating with partners to organize the crisis response system. You can start by convening all the important stakeholders in your CoC and agree on a guiding vision for your community. You’ll need active participation from the full range of CoC partners to achieve that goal, and while those listed here are by no means the only key partners, but they are all essential. That means doing things like: coordinating your outreach teams with existing access points; making sure service providers and shelter operators are making services equally accessible to all participants; engaging housing providers to prioritize homelessness, reduce barriers and prioritize serving the most vulnerable participants; and, connecting people to mainstream benefits to ensure they have access to all the resources, services and income supports to promote long-term housing stability. After you have all the necessary partners engaged you’ll want to agree on a set of guiding principles for your coordinated entry. Systems change work is difficult. Your CoC is very likely to experience conflict and disagreement about exactly how to implement and manage your system. Guiding principles can play an important role in help communities navigate these complexities and resolve differences. You’ll also want to define system gaps – you do that by assessing projected inflow into the crisis response system compared against the array of housing and services available to serve that projected demand. When you identify gaps, define a set of goals to address them. These goals can be about serving a priority population, achieving greater system efficiency, or improving system performance. Finally, define a set of operational standards that will guide the processes of your coordinated entry approach, and make sure those standards are shared and transparent. Principles Standards Gaps Goals

Write it down: Planning Requirements Establish policies guiding CE operations Define CE geography, participation expectations and roles, training, oversight and management Align written standards for providing CoC assistance with written policies and procedures for CE Ensure equal access to CE for all persons

Infrastructure Element: Management & Oversight Questions: Who develops/adopts/revises policies? Who sets performance expectations? Who monitors performance? Who resolves conflicts? Another infrastructure element is management and oversight. Designing a system approach and keeping it running smoothly and efficiently will require the CoC to define a process for decision making, management and oversight. Even if you had all the required elements and best practice approaches identified you would still need a way to keep all those elements working smoothly. Each CoC will need to define a CE governance and operational management approach that addresses the local needs and preferences of the CoC. HUD doesn’t dictate who should do this or how a CoC’s management and oversight of CE should be structured. It’s critically important that the CoC clearly establish how CE management decisions will be made, and how or who will provide oversight of the CE process. There are some questions you should be asking: For example, you’ll need a process, including a designated entity, for developing, adopting, and revising major CE design elements and CE policies. Who sets performance expectations for CE operators and partners? Who monitors performance and ensures compliance? Who resolves conflicts and how? Most CoCs will find it useful to explicitly identify an entity, person or committee to address these management considerations.

Infrastructure Element: Data Management Data considerations: Documenting participant needs and preferences and coordinating service delivery Maintaining Master/By Name List Protecting participant privacy Maintaining data security Evaluating Coordinated Entry Evaluating System Resources A lot of information gets collected and managed throughout the CE process. HUD doesn’t require that CoCs use their HMIS to manage CE data but many, if not most, CoCs will find great utility and benefit by using their existing HMIS infrastructure to support CE processes. Let’s look at some of those CE functions that involve data. At nearly every step of coordinated entry, data is collected, managed, shared, or used to evaluate results. From the initial contact with a participant, CE access and assessment staff will begin to document client characteristics, attributes, needs and preferences. This information will likely be captured in HMIS for most CoCs, although, again, its not required that CoCs do that. Some CoCs will create and manage a By Name List or Master List of people in the CoC experiencing homelessness. Often times these Master Lists are managed outside the HMIS environment. Some communities use a spread sheet, others might use a virtually stored document. Still others might incorporate their Master List into HMIS. Regardless of which approach the CoC adopts – whether in HMIS or with some other comparable or alternative system – all client-level information collected throughout the CE process must be treated like HMIS data. That means the HMIS Data and Technical Standards that govern client privacy, system security and data management protocols must be extended to other non-HMIS systems created for CE. CoCs will be required to assess their CE approaches. Data collected, managed and used for evaluation purposes such as client focus group results, client surveys, questionnaires… all of those data containing client-level information must also be protected and secured.

Write it down: Data Management Requirements Ensure adequate privacy protections of all participant information Define protocol for participant consent to share data If using HMIS, ensure all users are trained and understand CoC privacy and security expectations Prohibit the denial of services if participants don’t share

Infrastructure Element: Evaluation Annual CE evaluation answers the following questions: Does CE work for persons experiencing a housing crisis? Does CE work for providers of homeless assistance? Is CE functioning according to CoC’s design principles? Is CoC system more efficient and effective as a result of CE? Evaluation. CoCs are required to complete an evaluation of CE processes at least annually. This required element could address a number of different evaluation questions: Is CE working for clients? Are people with the greatest needs and vulnerability able to resolve their housing crisis more efficiently or effectively? Is CE working for homeless assistance providers? Do agency staff experience a more streamlined referral process and are they getting the types of referrals best aligned with the services and housing available through their projects? Is the CoC achieving the original design principles they identified during planning? And, what system level changes have occurred as a result of CE? How are the CoC’s system performance measures being impacted? Are fewer people becoming homeless? IS the length of stay being reduced? Are permanent housing placement rates improving? Are participants maintaining permanent housing placements and not returning to homelessness? These are some of the questions an annual CE evaluation process might consider.

Write it down: Evaluation Requirements Define frequency and methods by which CE evaluation will be conducted