Monday, November 9, 2015

Greater Hartford CAN Pre-Implementation 5/21/14

Greater Hartford Coordinated Access Network

Meeting Notes

May 21, 2014

In Attendance:
Sandy Barry- Salvation Army (Marshall House)
Steve Bigler- CRT
Wendy Caruso- 211, United Way
Crane Cesario- Capitol Region Mental Health Center/ DMHAS
Roger Clark- Immaculate Conception Shelter and Housing Corp. 
Mary Davenport- The Network Against Domestic Violence
Kitty Dudley- Dept of Correction
Brenda Earle- Dept of Housing
Fred Faulkner- Open Hearth Assoc.
Bryan Flint- Cornerstone Shelter
Rosemary Flowers- My Sister’s Place
Louis Gilbert - Immaculate Conception Shelter and Housing Corp. 
Mary Gillette- Mercy Shelter and Housing Corp
Amanda Girardin- Journey Home
Kristen Granatek- CT Coalition to End Homelessness
Andrea Hakian- CHR
Amber Higgins- CHR
Dave Martineau- Mercy Shelter and Housing Corp.
Amina Musa- Journey Home
Pieter Nijssen- TriTown Shelter
Diane Paige-Blondette- My Sisters’ Place
Sarah Pavone- CRT
Heather Pilarcik- South Park Inn
Lionel Rigler – City of Hartford
Marilyn Rossetti- Open Heath Assoc.
Iris Ruiz – Interval House
Dave Shumway- Immaculate Conceptions Shelter and Housing Corp. 
Jose Vega – CRT
Dan Walsh – Veterans Inc,

Crane called the meeting to order at 1:40.

Those in attendance were instructed to break out by Sub-committee:
1.       Individual Men and Women
2.       Families
3.       Data Quality Management
4.       Resource Sharing

It was ultimately determined that since the priority is figuring out the GH-CAN protocol for referrals from 211 that only the first two subcommittees would meet.

At the GH-CAN meeting on May 14th we answered the following three questions:
1.       What is your Coordinated Access Network Region (name of the CAN)? Greater Hartford CAN

2.       Do individuals and families have different intake process (workflow) once they are referred to the CAN? [ YES / no ]
If yes above, is the initial interview conducted by different people (or locations) within your network? [ YES/ no ]
Priorities for this meeting were to continue working to obtain the answers for the following questions:
3.       How many intake locations will be available at the CAN?
If you utilize more than 1, are these locations ‘open’ at the same time, or do they alternate days?
4.       Approximately how many staff people will be accessing the referral “buckets” in your network (sometimes referred to as Duty Service Coordinators)?

5.       After the initial intake, briefly describe your referral and case management process for that client for the following scenarios (if it is different for individuals and families please specify):

-          Client doesn’t show up (if you need to do something more than just check the ‘did not show up box’?)
-          Space is available at a local network (shelter, TLP, SHP, voucher)
-          Space is NOT available at a local network at the time of interview / intake?

Family Subcommittee Breakout:

Membership:  Iris Ruiz- Interval House, Mary Davenport- The Network, Brenda Earle- Dept of Housing, Sarah Pavone- CRT/East Hartford, Heather Pilarcik- South Park Inn, Amina Musa- Journey Home, Marilyn Rossetti- The Open Hearth, Sandy Barry- Salvation Army Marshall House, Amber Higgins- CHR, Rosemary Flowers- My Sisters’ Place, Pieter Nijssen- TriTown Shelter

1.       Discussed that the Bristol/New Britain CAN trial went through the needs assessment and it takes about two hours per person to complete.
2.       The needs assessment that will be completed by the GH-CAN is for all housing related crises.  2-1-1 diverts the caller if possible, but if the person doesn’t disclose their needs explicitly they will have to be referred to the CAN. For example, If a person needs a security deposit and they don’t articulate to 2-1-1 that is what they are looking for, they will be referred to the CAN. After sitting down with the client for the comprehensive needs assessment it will be clear that all the client needed is a security deposit. Then, based on eligibility, the CAN staff will do what they can to ensure the person gets a security deposit.
3.       Based on what we determine our community schedule will be, 2-1-1 will schedule appointments for the clients.  They will be able to tell them what day, time and location to go to for their needs assessment.
4.       Discussed having families go to only shelters serving families for the needs assessment because shelters serving families are already familiar with the resources available in the community. Due to the fact that the needs assessment doesn’t only deal with shelter this familiarity will be an excellent resource.
a.       Shelters expressed a concern about the shortage of staff but decided if there is a set schedule (an assigned time slot for each week, for a set, designated amount of time) they will be able to contribute time for assessments each week.
5.       Discussed having the client showing up at a shelter and then having to be scheduled through 2-1-1 for a needs assessment.
a.       Why should the client do the needs assessment at another shelter?
b.      The response was: if the GH CAN decides to go with that protocol, when a client presents at a shelter and calls 2-1-1 they can instruct the 2-1-1 Housing Specialist to assign that client to the next available “CAN Assessment Slot” at that agency.  
6.       Purpose of CANs is to promote data sharing and active communication. We are moving away from the ‘my shelter, my client’ model and utilizing resources in the community at large to successfully house clients and improve their livelihood.
7.       Some communities have case conference calls every week to discuss clients and how they are improving. This is all a part of the HEARTH Act and a culture change that we are moving towards. We are going to have to actively communicate to make sure our client’s needs are being met.
8.       Discussion on Community-Wide performance
a.       Marilyn R: As a community we are now being looked at as a whole for performance  so when one shelter discharges a client without having a positive exit because their length of stay is up, it isn’t doing the community as a whole any favors
                                                               i.      Might have to look at length of stay policies and how they could be improved to reach the goals of Coordinated Access and the HEARTH Act.
                                                             ii.      Shelters can change their length of stay and eligibility criteria.  Dept of Housing doesn’t require a specific length of stay, only that the shelters have a length of stay.
                                                            iii.      For Coordinated Access, it would make things significantly easier if all the shelters got together to coordinate their eligibility and length of stay.
b.      Pieter: Can the CAN Assessment serve as the shelter intake:
                                                               i.      *Response: if that is what our community decides to do, by all means (understanding that the standardized forms are different and would all need to be completed)
                                                             ii.      However, the purpose of the CAN Assessment is not necessarily enroll people in shelter but to divert as many households as possible.
c.       Can the assessment be done on the phone?
                                                               i.      *Response: No, because clients have to bring with them a source of Identification (later found out this not required) and sign a release.
                                                             ii.      East Hartford gives clients 3 days to come up with a source of identification, this can be an option to include in our CAN.
9.       Won’t this CAN process frustrate clients more?
a.       It should eventually be better for the client because the CAN staff they are working with should be trained to know all of the possible resources available and they should only have to speak with this one contact instead of many. This Coordinated Access Network also places responsibility on the system to make sure the client’s needs are met as opposed to the other way around.
10.   Will this system be available on weekends?
a.       That is something the GH community will need to decide.  Staff is reduced on weekends, but there are still clients in need of assistance on weekends so there will be a need to figure out how this will work for our CAN.

11.   Any alterations to how we want to carry out our CAN (in regards to how long each appointment should be per person, location of assessments) can be done in ECM just tell Brenda and Wendy
12.   What should we do if a person shows up at our shelter and we are at capacity?
a.       This protocol is something we’re going to have decide as a community. In some parts of the state they let the person spend the night in a chair. We have to figure out viable and safe options for shelter.
b.      We could reach out to hospitals and police departments. They could let a person spend the night in an emergency room or  a police station until they can be redirected for shelter the next day or at their assessment appointment.
c.       Some communities have reached out to their local United Ways to access funding for people staying in motels.
13.   Possible Locations for Family CAN Point of Access:
a.       Soup kitchens- Mercy said their soup kitchen could be used as a site for assessments and they also have a family case manager. The family case manager already has their own clients to deal
b.      Brenda: House of Bread has a day shelter and staff on site everyday- she will reach out to them to encourage involvement in this process.
c.       Each Shelter provider needs to have a duty service manager for the CAN. It will be easier for them to do assessments since they know all the resources available in the community.
14.   Commitment to provide a 4 hour time slot (or roughly two assessments) once a week:
a.       -The Open Hearth
b.      -Salvation Army
c.       -South Park Inn
d.      -Friendship Center- Mercy
e.      -My Sister’s Place- (1/2 day)
f.        -The Network
g.       -East Hartford Community Shelter (1/2 day)

Other agencies we should reach out to:
·         House of Bread (Brenda) – (per Amanda already receives invites)
·         MACC (Brenda)- (Per Amanda- Sarah Melquist is involved and was on vacation for this meeting)
·         Manchester Social Services – (Per Amanda already receives invites)
·         Vernon Social Services
·         Intercommunity – (Amanda added them to the distribution list)
·         Loaves and Fishes in Enfield
·         Chrysalis – (per Amanda- Justine couldn’t make this meeting)
·         CRT’s scattered site community offices

15.   State agencies (such as DCF, DOC) will have to call 2-1-1 instead of the shelters to find housing for their clients.

CONCLUSION: We will hold 2 hr assessments and have at least 2 a day. Each agency is donating 4 hours of their time to do assessments.

****Remaining Questions:
1.       We need to figure out: How will we transport people around?
a.       Other communities have been striking deals with motels and cab companies.  
b.      Clients appointments in the “bucket” will usually be schedule a couple days in advance of the appointment so our CAN will have to figure out how to transport people to the apt.


Individual Men and Women (adult only households) Sub-Committee Breakout:
Membership: David Shumway- Immacualte , Louis Gilbert- Immaculate, Roger Clark- Immaculate, Dave Martineau- Mercy , Diane Paige-Blondett- My Sisters’ Place, Wendy Caruso- 2-1-1, Andrea Hakian- CHR, Kristen Granatek- CCEH, Steve Bigler- CRT, Bryan Flint-Cornerstone, Kitty Dudley- DOC, Fred Faulkner- The Open Hearth, Amanda Girardin- Journey Home, Crane Cesario- Capitol Region Mental Health Center/ DMHAS
1.       2-1-1 will do high level diversion and will refer housing related crises to the regional CAN-
a.       They WILL assess these clients for ALL programs they know of first.  If they CANNOT refer to ANY program, eligibility, etc, they will come to our CAN.
2.       Referrals from 2-1-1 will get  sent to a “bucket” in HMIS,
a.       Who gets access to the bucket is up to us, we need to figure out who will have access to the bucket when.  2-1-1 WON’T be sending referrals to each agency who is doing the referrals for that day, they will all go in one common “bucket” (by Families vs Individuals)
3.       How will we decide where women fall? 
a.       Possibly passed on do they have children with them at the time they call 2-1-1?
4.       When we are talking about locations, we have to remember that we are working on this in a regional manner.
a.       Bryan feels that most of Cornerstone’s clients come from Hartford so having the CAN location just in Hartford might work.
b.      Concerns about transportation.  It was determined that the CAN Assessments need to be IN PERSON, therefore getting clients to an appointment might be difficult.
5.       Wendy: If we decide to rotate the assessments each day to a different shelter, then the only question is how many slots/households/appointments do we want referred/ scheduled to our bucket for each time agency during the allotted time-frame
a.       When they are put in the bucket with “emergencies” be differentiated from “non-emergencies”?  Can we flag them differently?
b.      CAN agencies will NOT be calling clients in the bucket to schedule appointments, 211 will schedule them according to the protocol we give them.
c.       Example: We can specify something like “We want 4 people to be schedule for 9 am on Tuesday and Thursdays that will go to Immaculate”  Or we be more specify and say “Schedule 1 for 9AM and 1 for 11AM  at Immaculate on Tuesday and Thursdays”.
d.      Once someone is in the “individuals” bucket , we will know who is doing which intake because of what the client looks like or the apt they are scheduled for.
6.       Can people go to shelters and then go to the CAN for assessment the next day if it is an emergent shelter need? If 211 has already determined that they are absolutely requiring shelter and are not divertible then they shouldn’t have to do the CAN assessment.
7.       What happens if all shelters are full? 
a.       Can we come up with an emergency hotel fund? 
b.      Overflow beds?
8.       Dave M: Suggested that we have at least four locations, two in the surrounding towns and two in Hartford.
a.       Andrea seconded that idea, especially if the assessments have to occur face to face.
9.       We can consider resources/ agencies/ people that are not at this meeting today.
10.   Diane: how many housing related calls come through 211?  1000s maybe, it’s a top referral, but these numbers are statewide. But they divert a high level of calls to non- housing resources (Maybe 2500 calls shelter only, about 50% are diverted over a two year period)
a.       The number of need is irrelevant because we are determining our capacity to provide appointment slots
b.      However, we as a community have to determine what 211 does with the need #s above and beyond that which we have the capacity to do CAN Intake/assessments with.
11.   Who is doing the HMIS consent?
a.       211 it will start with a verbal release at 211
b.      CAN will have to do the signed ROI when we do intake assessment
12.   Do we have to enter data into HMIS as the CAN Intake?  Yes, so we will need to train other people in HMIS or figure out how to make our HMIS trained individuals available to do this work.
a.       Can anyone, outside of the traditional providers, who wants to get trained in ECM, get trained in ECM for this purpose? Kristen says yes.
13.   Need to remember it’s not just an intake/assessment we have to do something with that client as well by referring them to the appropriate services/program.
14.   Kristen: CAN will most likely do the “diversion assessment” and the VI-SPDAT at the intake appointments.  Other communities have done it, and it’s a two hour assessment process per client to meet the client, assess them and get whatever the appropriate referral is.
15.   If this is what the state and the feds want, we should be pressuring them to fund the gaps in the system instead of our philanthropic partners.
Questions to Answer:
1.       What agency will do intakes, on what day and how many intakes on that day?
2.       If the bucket is full, do we schedule for the next day, and the day after that, and the day after that?
3.       What do we do with someone who doesn’t need a “shelter tonight” but might need a bed tomorrow?
4.       Can we include a bunch of more non-residential agencies? Town social service agencies?  Need to ask non – homeless resource providers for assistance.  This would assist people from getting out of the shelter mindset. Hospitals, faith-based communities.  There are a lot of people that already work with these clients.
5.       Brenda will look into DOH doing statewide communication materials for culture change
Commitments:
Hartford:
ICSHC: Tuesdays and Thursdays, 8 hour days, can be flexible with the start and finish time depending on what the community deems necessary.
Surrounding Region:
Cornerstone will commit a 4 hour half day.
CHR will commit a 4 hour half day
Whole Group Conclusions:
Amanda to add Intercommunity to distribution list.
For next meeting can we cover: state agency system’s change. DOC, DCF, Hospital involvement, discharge plans.  How will we handle it? Local police departments?
Who is in charge of the design and implementation of the GH-CAN?
How often do we want to meet? Wednesday at 1:30, weekly (for now)
Can we tap into social work interns or students as a possible resource?
The hope is that the work will be reduced with the coordination, even though we might not be able to see it right now.

NEXT MEETINGS: May 28th and June 4th at 1:30 PM at 76 Pliny St. Hartford

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