Wednesday, November 25, 2015

Greater Hartford CAN Meeting 8/26/15

Greater Hartford Coordinated Access Network
Meeting Agenda
Wednesday, August 26th, 2015
Next Meeting: Wednesday, September 9th, 2015

In Attendance:
Brian Baker – South Park Inn
Janet Bermudez – Hands On Hartford
Suzan Bibisi – Tabor House
Cordelia Brady – The Open Hearth
Crane Cesario – DMHAS / Hartford COC
Roger Clark – ImmaCare
Stephanie Corbin – Community Health Network
Rosa DeJesus – Mercy Housing
Nate Fox – Center Church
Amanda Girardin – Journey Home
Ruby Givens-Hewitt – My Sisters’ Place
Tenesha Grant – Mercy Housing
Tomiko Grant – Salvation Army Marshall House
Mollie Greenwood – Journey Home


Mimi Haley – Connecticut Coalition to End Homelessness
Amber Higgins – CHR
Brittany King – The Open Hearth
Steve MacHattie – ImmaCare
Matt Morgan – Journey Home
Toni Orlando – The Door of Hope and Courage
Heather Pilarcik – South Park Inn
Patricia Pollicina – Chrysalis CABHI / FUSE
Amy Robinson – CRT SSVF
Chris Robinson – Chrysalis CABHI
Iris Ruiz – Interval House
Sarah Simonelli – Chrysalis Center
Sandra Terry – CRT
Jose Vega – CRT McKinney


1.      Introductions
a.      We usually start our meetings with announcements and the problems we’re trying to solve, and as a result our housing matching work gets pushed to the end of the meeting.  Today, we decided to start with housing matching, and then work through some systems issues.

2.      Review Unsheltered list, MIA/On Hold List, Chronic Maybes list, Prioritized list
a.      We reviewed the list of clients that we know are unsheltered.
                                                              i.      There may be other people in the community who are unsheltered.  If you have a CAN Release of Information, please share that name with Journey Home so we can add it to the list.  If you do not have a release, try to get one so we can put them on our radar.
                                                            ii.      There will be a meeting on Thursday, September 3rd at 10:30 AM at ImmaCare.  It’s an outreach meeting to make sure we have captured everyone who is unsheltered in the lists we are currently maintaining.  We are hoping to gather information from outreach staff about who they believe is chronic, and to figure out who still needs to complete a UHA, a VI-SPDAT, or gather documents.
                                                          iii.      A few staff reported that they had recently been to Bradley Airport and had not seen any clients staying there, a dramatic change from the reports we heard during the colder months. 
b.      The second item is to review the MIA/On Hold list.  This list is made up of clients who have been identified as chronically homeless, but who are MIA, or currently On Hold (for example, clients who are incarcerated, clients who refuse to pay a portion of their rent). 
                                                              i.      We asked that if any staff had any updates about clients on this list that they make a note by the client name, write their name at the top of the list, and return their papers to Amanda of Journey Home. 
1.      Trish Pollicina of Chrysalis announced that there were FUSE openings that were already available, or would be available soon. 
a.      Brian Roccapriore of CCEH has said that he can help communities crosswalk their priority lists against the FUSE eligible list to help determine candidates for those programs.  Journey Home will send him our priority list soon to start generating referrals for the FUSE program. 
2.      Stephanie Corbin of CHN expressed that she could help look up client medical records as needed, but in order to do that the client needs to have signed a Community Care Team release of information.
                                                            ii.      Next, we reviewed the Chronic Maybe list.  This list is comprised of all clients who self-reported as chronically homeless in their CAN appointments or when completing the UHA.  As a result of limited access to client records in CTHMIS, Journey Home is not always able to verify whether a client is chronically homeless based on what is visible in HMIS.  If we cannot verify their homelessness through CTHMIS, they are added to this list. 
1.      If any staff believed that a client on this list is chronically homeless, we need staff to help gather the necessary evidence of chronic status, and to then share that information with Journey Home. 


3.      Housing Referral Group
a.      Since the GH CAN switched to meeting twice a month, there were some times when housing providers needed referrals for their housing program before the next meeting time.  The way that Journey Home provided these referrals was by sending out an email to everyone in the Housing Referral Group with the suggested referrals, asking that staff reply to the email if they had concerns about any of the referrals that were being made. 
                                                              i.      We determined that we would continue making any interim referrals through this same process, and can revisit this issue as needed in the future.  If you have feedback or suggestions for improving the interim referral process, please contact Mollie Greenwood at mollie.greenwood@journeyhomect.org
b.      New Referrals - Moving On, CHR Manchester Rental Assistance, Catholic Charities Cathedral Green, Project Teach TLP, Project HEARRT
                                                              i.      As a reminder, any openings in housing programs should be reported in the Housing Availability Form, so that we can track the openings centrally.  That form is available here: https://docs.google.com/a/journeyhomect.org/forms/d/1G4L9g2IMkah_-ROMAi1BHD9_rr8CfoDWG8Yfzu4iBYI/viewform
                                                            ii.      In addition, in order to maintain up-to-date, centralized information about all referrals in the GH CAN, there is a form that all housing providers should complete to track the status of all pending referrals.  That form is the Housing Outcomes Form, and it is available here: https://docs.google.com/a/journeyhomect.org/forms/d/1Ob9qxQSnU49TNhElr-K3t-4gZj8NwTxu9VINb8hhu1s/viewform?c=0&w=1
                                                          iii.      We reviewed a handful of specific cases that we wanted to review as a group.  Some of these clients had completed the VI-SPDAT multiple times and received different scores which would make them different priority levels. 
a.      We wanted to take some time with the group to review the suggested protocols on when to complete a full SPDAT.  We still need to figure out what is going to happen in these cases for clients who are unsheltered. 
b.      One thing we didn’t talk about before the SPDAT training is that we had a limited number of spots at those trainings.  It’s a general question and problem for us as a CAN to deal with.  We are getting more and more pressure to work together, but all organizations have existing commitments and capacity limits.  We need to keep this conversation going.  If folks could commit to doing a couple of SPDATs outside their agency each month that would be doubly helpful, but we also recognize that agencies can’t necessarily commit to that here, at this meeting.
2.      Mimi Haley of CCEH reminded us that the SPDAT tool can be used in sections.  If staff thinks that the client was really underrepresenting their needs on a portion of the VI-SPDAT, then someone need only complete the related portions of the full SPDAT tool, not necessarily each piece.  At this point, the full SPDAT tool is not available in CTHMIS, although that functionality is expected with the next upgrade. 
                                                           iv.      Available units:
                                                             v.      CRT’s Project Teach TLP has 6 openings – Six referrals were made, but GH CAN staff indicated that they did not believe one client would be employable, and so that referral may not work.
                                                           vi.      CHR Manchester Rental Assistance has 1 opening– Two referrals were made to CHR.
                                                         vii.      Project HEARRT has 1 opening– Two referrals were made to Project HEARRT
                                                       viii.      Family Matters has 1 opening– One referral was made to Family Matters
                                                           ix.      Cathedral Green has 1 opening- No families were referred to Cathedral Green at this meeting, Journey Home will revisit the list of families on the Master List to try and find families who fit the eligibility criteria for the program.
                                                             x.      Moving On has 3 openings- Three referrals for Moving On were made at the meeting.


4.      Announcements
a.      GH CAN Meeting Schedule – switching to bi-weekly meetings (see p.5-6)
b.      Diversion funding at CHR Enfield is available.  If you have a client at a CAN appointment that you believe is eligible for this assistance, please contact Philomena McGee (860) 253-5020 x136
c.       Zero: 2016 Chronically Homeless Veteran Check-In
d.      Develop a sub-group to discuss a regional shelter wait-list option
e.      Homeless Outreach Meeting September 3rd at  10:30 AM at Journey Home, 241 Main St., 5th Floor
f.        CAN Policy Sub-Group “CAN Goals and Objectives” Document – Posted on Journey Home’s CAN website.
g.      HMIS Evaluation Survey has been emailed to all HMIS users.  Please complete this survey by the end of the month.

5.      CCEH visit
a.      Mimi Haley of CCEH met with Matt Morgan, Crane Cesario, Amanda Girardin, and Mollie Greenwood last week to discuss the requirement from Department of Housing that all regions develop a prioritized, by-name registry of all chronically homeless clients and all literally homeless clients by October 1, 2015. 
                                                              i.      We also discussed a list of areas that we’d like CCEH to provide technical assistance- a full list of those requests can be found on p. 10.
1.      Regarding HMIS, the top request for technical assistance was changes to the training process.  CCEH hopes to work with Nutmeg to provide more advance notice on upcoming trainings, as well as increase awareness about existing refresher webcast.
2.      Another HMIS-focused situation is reducing duplicate IDs in the system, and Nutmeg is working on this now.
3.      Mimi also discussed conversations that they are helping to facilitate with 211, regarding turnaways from shelter as well as how 211 can better assist to limit churning between shelters. 
                                                            ii.      Additionally, Mimi talked about areas that we suggested for best practice sharing, including how other regions prioritize available shelter beds, and how outreach is operating in other areas. 
                                                          iii.      As a component of Zero:2016 the Department of Housing has announced more resources will be available, and will be distributed to different CANs.  In order to be considered for these resources, all CANs need to compile a comprehensive by-name prioritized registry of clients by October 1, 2015.
1.      Greater Hartford is at a slight advantage, because a lot of work went into creating and maintaining a by-name registry during the 100 Day Campaign, and that work has continued in recent months.  The main thing for the region to focus on in anticipation of this October 1 start date is making sure we have captured as many people as possible in our lists. 
2.      Mimi of CCEH distributed a graphic showing CANs in different phases of development, and we think we’re doing well in terms of adopting a standard assessment tool and developing a by-name registry.  There are still areas we could improve, including coordination of outreach efforts and making sure we are truly capturing our whole population with our by-name lists. 
a.      In terms of compliance for this October 1st deadline, Mimi indicated that other staff from CCEH would be reaching out to CAN leadership to talk about what sorts of things the Department of Housing will be looking for as they review the progress of different CANs.
b.      At the most recent Balance of State Continuum of Care meeting, there was a discussion that if sub-CANs have separate prioritized lists, rather than one unified priority list for the region, their funding may be in jeopardy. 
c.       We discussed holding some sort of registry event to try and capture everyone in our region who is homeless that is not yet on the radar.  A number of staff raised concerns that planning a major event can be very time intensive, and there isn’t a long turnaround time between now and 10/1.  For our region, it may be helpful to think about how to accelerate and catch up to live appointment times.  Our registry activities may be more focused on inreaching to people already in shelter.
d.      Jose Vega of McKinney shelter asked CCEH how they could help to start conversations with the police, and Mimi said she would like to connect with him to start planning.
6.      Announcements:
a.      GH CAN Meeting Schedule – switching to bi-weekly meetings (see p.5)
b.      Diversion funding at CHR Enfield is available.  If you have a client at a CAN appointment that you believe is eligible for this assistance, please contact Philomena McGee (860) 253-5020 x136
c.       Zero: 2016 Chronically Homeless Veteran Check-In
d.      Develop a sub-group to discuss a regional shelter wait-list option
e.      Homeless Outreach Meeting September 3rd at  10:30 AM at ImmaCare, 168 Hungerford St.
f.        CAN Policy Sub-Group “CAN Goals and Objectives” Document – Posted on Journey Home’s CAN website.
g.      HMIS Evaluation
h.      A new staff person asked whether anyone knew of programs to assist a single female client in her 50s, a couple of providers offered to touch base with her after the meeting.
i.        Mimi Haley announced that CCEH will have trainings coming up on fair housing and safe shelters for transgender individuals in September, training information is available on CCEH.org
j.        On September 24th there will be a HUD grantee meeting at Elmwood Community Center.  Any agency with Shelter Plus Care grants, Supportive Housing Program Grants should attend.  The HUD email blast went out, and Crane Cesario forwarded it to the COC.  Any agencies with HOME, HOPWA, or COC funding should also attend.
k.       Another announcement is that CHR’s Rapid ReHousing program will be open soon, and staff would like to visit local shelters to talk about what Rapid ReHousing is, to make sure they get as many referrals as possible.  Please contact Amber Higgins at ahiggins@chrhealth.org to set up a time for her team to visit your agency. 
l.        There has been an update in No Freeze planning for this year.  The City of Hartford has been looking at available state properties in Hartford, but unfortunately a church that had previously hosted a No Freeze shelter does not have water, and so could not serve as the site for this upcoming year.  The City of Hartford is working with ImmaCare to see if they can come to an agreement that would allow ImmaCare to host No Freeze for one more year.

7.      Journey Home distributed some draft language for 211 to try and reduce churning through different shelters.  The suggestion is for 211 to ask anyone who shows a recent shelter enrollment if they were discharged by the shelter.  That text is attached on p. 9. 
8.      Staff from CHR reported that at last week’s CAN Assessment Appointments, a DSC called over to Tri-Town shelter in Vernon seeking shelter for a client, and reported that after speaking with staff, they were informed the client needed to make the call themselves.  Tri-Town also indicated that they were no longer doing VI-SPDATs with clients who came to their assessment appointments.  GH CAN leadership will follow up on this update.
GH CAN Chairs:
Crane Cesario – crane.cesario@ct.gov



CCEH Technical Assistance Suggestions:
1.       HMIS Reporting/ Duplicate IDs
2.       Registry Information
3.       Zero: 2016- Coordinated Exit Specifically
4.       Appointment Backlog
5.       Leadership – How are other regions coordinating CAN leadership?
6.       Rapid ReHousing for high priority when PSH not available
7.       Shelter Waitlist/ Prioritization
8.       Outreach – How are other regions coordinating homeless outreach?
9.       211 Tracking of Turnaways from Shelter
10.   Churning as an unintended consequence of 211 as front-door to shelter
11.   HMIS training- annual schedule and refreshers available by webinar

GH CAN Parking Lot: Items for Continued Discussion
#
Category
Challenge
A
UNINTENDED CONSEQUENCES OF CAN PROCESS

1
Shelter search through 211
Clients churning, high shelter turnover
2
Shelter search through 211
People staying out of doors to avoid the 211 process
3
Shelter search through 211
Clients calling to get a hotel instead of shelter
4
Shelter search through 211
Empty beds in shelters
5
Client choice
Clients declining housing options – refusing to pay a portion



B
ACCESS AND DELAYS

1
Documentation
Challenges gathering documentation of homeless history
2
Client choice
Clients referred for a shelter bed who no show (Time frame established)
3
Case Conferencing
Clients who no-show for multiple appointments
4
Identifying appropriate clients for CAN
Backlog of CAN appointments
5
Navigation
Identifying clients who are not attached to navigation / need help gathering documentation



C
DATA AND PERFORMANCE MEASUREMENT




1
Data Quality
Multiple client records in HMIS
2
Data Quality
Misrepresentation of homeless status due to HMIS assessments not checking current status. 
3
Data Collection
Identifying/validating progress matching clients housed through CAN to Zero 2016
4
Assessment
Apparently inaccurate VI-SPDAT Scores: Concern Form / Full SPDAT



D
FUNDING

1
Funding
Need staff allocated for CAN Functions (navigation, management, etc.)



DRAFT
GH CAN Protocols on the Full SPDAT Assessment:
The full SPDAT assessment should be administered in the following cases:
·         When a staff who has previous experience working with a client does not believe the VI-SPDAT score accurately reflects client barriers or needs.  Used in this way, with proper consent, the staff person can collect additional information including medical documentation and statements from other service providers as they relate to the needs of the client
·         In cases where a client has completed multiple VI-SPDATs and have disparate scores that  suggests further assessment for different housing interventions
The full SPDAT assessments can also be used in the following way:
·         As a case management tool for clients who have gone from homelessness into housing, as a way to measure progress made in different domains
Who completes the full SPDAT with a Client?
·         The full SPDAT assessment should be completed only by staff who have been trained on how to conduct the SPDAT
·         The full SPDAT assessment should be completed by the/a staff person who is trained to administer the SPDAT at the agency of the staff person who has raised concerns about the client’s score and who is working with the client.
·         In the event that a CAN provider has concerns about a client’s VI-SPDAT score but is not currently working with that client, the provider should raise this concern at a CAN meeting so that this client can be referred to a SPDAT trained staff to administer the SPDAT
QUESTION: (HOW DO WE WANT TO MAKE THESE REFERRALS IN A WAY THAT IS FAIR ACROSS CAN PROVIDERS AND MAKE SENSE IN TERMS OF CLIENT CONNECTIONS?)
How should the full SPDAT be administered:
·         The full SPDAT should be completed in CT- HMIS, once this functionality become accessible.  Only in extreme cases when internet is not accessible should a full SPDAT be completed on paper.  In this instance the agency completing the full SPDAT is responsible for the entry of this data into HMIS within a week from the time it is completed.
·         The gathering of external documentation from other providers who have worked with this client is highly suggested, but not required, to assist with a comprehensive and accurate SPDAT assessment.  With client permission to release and share this information, any external, supporting documentation may be uploaded into the CT-HMIS system.
·         The full SPDAT can, and in some cases should, be completed over a longer period of time and multiple conversations with the client or other providers for whom releases have been obtained.
·         In the instance the SPDAT is being used as a case management tool to track the client’s progress across domains, the total and component scores may be shared with the client to assist with demonstrating improvements or areas on which they may want to focus.  For the purposes of determining a client’s status on the priority list, the client’s score SHOULD NOT be shared with the client.




DRAFT
GH CAN Protocols for 211 in cases where a client has an open shelter enrollment
·         If 211 is able to see an open shelter enrollment* in HMIS, they should ask the client if they are still staying in the shelter listed on HMIS.

·         If the client says no, 211 staff should ask whether the client has been discharged from that shelter

o   If client reports being discharged, 211 should contact the appropriate triage center to see if any other shelters have availability

o   If client reports that they have not been discharged from shelter, they should be informed that shelter beds are a limited resource, and there is no guarantee that there will be another bed available in the region.  211 and triage staff should not attempt to locate an additional shelter bed if clients are currently enrolled in, and have not been discharged from, a Greater Hartford regional shelter.

















*An open shelter enrollment will have the shelter name listed as the enrollment name, and will have “Present” listed as an end date, and the enrollment status will be “enrolled”.
Current GH CAN Meeting Schedule – Twice Monthly
A bi-weekly schedule proposal is attached, on back, to increase clarity.

The proposed schedule for the Greater Hartford Coordinated Access Network (GH CAN) plans meetings on the second and fourth Wednesday of each month.  Meetings are held on Wednesday afternoons from 1:30 to 3:15 p.m. at Sue Ann Shay Place Apartments Community Room, 76 Pliny Street in Hartford.   

The GH CAN is working on methods to fill vacancies with an immediate need.  We expect to have a plan in place for July 2015, including a conference call protocol. Please contact Mollie Greenwood at mollie.greenwood@journeyhomect.org to schedule an interim meeting or to confirm meeting time and location if you need an update.



2015
July 8th
July 22nd

August 12th
August 26th

September 9th
September 23rd
September 30th

October 14th
October 28th

November 18th  

December 9th
December 23rd




2016
January 13th
January 27th

February 10th
February 24th

March 9th
March 23rd
March 30th

April 13th
April 27th

May 11th
May 25th

June 8th
June 22nd

July 13th
July 27th


GH CAN Meeting Dates: Proposed Revision to Bi-Weekly Meetings
In order to ensure a more regular schedule moving forward, the Greater Hartford Coordinated Access Network will meet bi-weekly for the next year.  These meetings will take place on Wednesday afternoons from 1:30-3:30 PM at My Sisters’ Place, Sue Ann Shay Apartments, 76 Pliny St., Hartford. 
Please contact Mollie Greenwood at mollie.greenwood@journeyhomect.org to schedule an interim meeting time, or to confirm meeting times.


2015:                                                    
September
9/9
9/23

October
10/7
10/21

November
11/4
11/18

December
12/2
12/16
12/30
2016:

January
1/13
1/27

February
2/10
2/24

March
3/9
3/23

April
4/6
4/20

May
5/4
5/18

June
6/1
6/15





July
7/13
7/27

August
8/10
8/24

September
9/7
9/21

October
10/5
10/19

November
11/2
11/16
11/30

December
12/14
12/28




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