Monday, November 9, 2015

Greater Hartford CAN Pre-Implementation 7/23/14

GH- CAN Meeting
July 23, 2014 Meeting Notes
In Attendance:


Ashley Blanchard- DHMAS
Wendy Caruso- 211
Roger Clark- Immaculate
Joel Cox – Town of Enfield Social Services
Mary Davenport- The Network
Bryan Dixon – InterCommunity
Brenda Earle- Department of Housing
Fred Faulkner- The Open Hearth
Bryan Flint – Cornerstone
Tenesha Grant – Mercy Housing
Mark Jenkins – BHCA
Mollie Greenwood- Journey Home
Andrea Hakian – CHR
Patrice Moulton – CRT / East Hartford Shelter
Roxan Noble- Chrysalis Center
Tina Ortiz- CRT
Heather Pilarcik – South Park Inn
Sara Salomons – CRT
Barbara Shaw- Hands On Hartford
Dave Shumway – Immaculate
Jose Vega- McKinney
Tamara Womack – My Sister’s Place



Introductions:
·         Crane Cesario was not able to be present this week, and Matt Morgan will not be present next week.
·         Wendy Caruso from 211 was here, and had some updates to share about the state of affairs with 211 since New Britain/Bristol’s CAN went live a few weeks ago.
o   Average wait time for people on the phone is 2 minutes- this has alleviated people in a housing crisis having to wait for a callback from 211.
o   Individuals who walk into shelters still need to go with 211, so 211 has added an option for shelters.  If a client walks into a shelter and needs to go through 211, there is a prompt for shelters to press so that clients will not be waiting on the shelter’s phone. 
o   After New Britain’s CAN expressed how troublesome waiting on the phone with 211 could be for our clients, the issues were resolved the next day. 211 is willing to be very flexible as CANs go live.
o   So far, the CAN assessment appointments have been numerous- New Britain’s appointments are already being scheduled 2 weeks out due to the high volume of callers.
o   Most callers are being diverted rather than going into shelters, but there is a very high volume of callers, and the actual number of people dealing with housing crises is becoming much more evident.
§  211 does have access to a language line, so speakers of other languages are receiving assistance through 211, and 211 will make a comment of their language barriers in their file.
Updates:
·         Shelter Availability Protocol:
o   Bryan woud like everyone’s contact information so that the group can try to start emailing instead of using google docs.  Google docs has been challenging for some to log into, and may not be user friendly for all the shelters, so Bryan has volunteered to collect shelter information from everyone on a daily basis.
o   He hopes that over the next few days, people will start emailing him their shelter availability.
o   As he receives emails from other shelters, he will input that information into the google document
o   The group decided to start immediately with testing a process for reporting shelter bed availability through google documents and email on a daily basis, even if there is no availability.  Matt and Bryan will send out instructions this week for how to begin this process.
o   Crane sent out an email stating that waitlists can be created in ECM right now- it will be in the tools of the system.  The CAN can either create a centralized waiting list, different waitlists for different clients, different waitlists for different types of housing, etc.  This will be discussed further at a future meeting.
·         Updated GH-CAN Housing List/ Universal Housing Application
o   Journey Home has updated our GH-CAN Housing list (part of the meeting materials)
o   JH added a column for which programs are already entered into the UHA
o   There are some blanks in this list in reference to why some programs aren’t participating in the UHA, if anyone has information to fill in these blanks, please send it to Journey Home.
o   If anyone has programs that exist at their agency, but aren’t listed on this form, please send that information to Journey Home as well.
Workflow Question
·         For a person who goes to a GH-CAN assessment and cannot be diverted and needs shelter for the first time that night, what is protocol?
o   If the appointment assessor can’t contact anyone at a shelter, should we have the client call 211?
§  Maybe the assessor could have access to the google document to see where there is availability and contact that shelter directly?
o   When we go live it will be very important for all shelters to be uniform, and on the same page about what this protocol is.  Shelters won’t take walk ins if there is no availability, people will be triaged back through
o   If someone shows up without a phone at a shelter, shelters can call 211 directly through their landlines
§  It is important to teach the day shelters this protocol as we move closer to going live.
§  Wendy from 211 noted that even though New Britain/ Bristol started with one as needed.
o   At McKinney, if someone arrives at the shelter, the shelter staff usually enters them into ECM immediately.
§  Now, the new protocol is for walk-ins to call 211 immediately to make an appointment before they are discharged from the shelter
*The agenda had stated that we would now break into two groups to discuss teams for challenging persons and housing case conferences (housing referral committee) but because representatives from the DOH and 211 were present at the meeting, instead the group discussed this CAN’s consensus points to date with them*

Consensus Points:
1.       Customized the Statewide Coordinated Access Workflow for the Greater Hartford Coordinated Access Network (GH-CAN)
a.      All those facing a housing crisis should call 211 (211 screens for emergency issues, domestic violence, and diversion) If not divertible, refers to GH-CAN for assessment
b.      Multiple Assessment Sites (Region and City Sites) (see assessment schedule for locations)
c.       GH-CAN Assessment Schedule has been set (see attached)
d.      At assessment appt:  ROI’s, assessments, referrals to GH-CAN resources
*still need to figure out what the assessments themselves look like- when will we use VISPIDAT?  What Releases of Information are needed?
e.       Special Cases:
                                                               i.      Immediate Shelter Need (before a GH-CAN Assessment is available)
1.       Call 2-1-1, Two referral points from 211 – Individual Men – Call Immaculate for shelter triage, Individual Women and Families – Call SAMH for shelter triage
2.       Presents directly at shelter/no phone – shelter will call 211 with client that night or following morning before discharge from shelter to schedule GH-CAN assessment.  If space is available at the shelter, the person can stay, but if no space is available, the shelter will contact ICSHC or SAMH for shelter triage
3.       People coming from shelter to GH-CAN appt. – default is people can return to that shelter unless otherwise notified
4.       If possible, move the GH-CAN appt. assessment to shelter where staying if staff has available time
*Brenda Earle from the Dept of Housing noted that this situation, one in which clients are eligible for an earlier appointment time if it is convenient for the shelter workers, doesn’t seem right- it might be considered cutting the line for someone to receive an earlier appointment than they were initially scheduled for.  This appointment has the potential to place them on waiting lists ahead of other people whose appointments should have come first.
CAN response was that this was a provisional circumstance that had been imagined in cases where
                1. Clients would need to transport themselves to a location that was difficult to reach
                2. Someone at the shelter happened to have extra time and the ability to complete an assessment.
                The goal of this provision was to alleviate stress on the clients by making appointments more accessible to them, when possible.
5.       If necessary, shelter will communicate to assessment appt that person cannot return to the shelter
                                                             ii.      Person presents at GH-CAN Assessment and does not need shelter tonight, but needs it tomorrow night/future night:
1.       Shelters will not make reservations for future nights or guarantee that a bed will be available on a future night.  However, if shelter is available that night, the person can stay that night.
                                                            iii.      All shelter in GH-CAN is full – CAN will notify Outreach team
                                                           iv.      Churning - People who have already been assessed, referred to housing options, referred to shelter, and now have to leave shelter (length of stay, not following case plan, banned) – Call Immaculate for shelter triage or SAMH for shelter triage and flag to Challenging Person Team. 
State of Connecticut simply says that you need to have some sort of length of stay policy, but they don’t dictate what the length should be.  It is worth noting that the Greater Hartford CAN has the most varied lengths of stay compared to any other CAN in the state.
                                                             v.      Two no shows to assessment appt – refer to Challenging Person Team
If someone doesn’t show up twice, do we schedule a new assessment? 
The Challenging Person team will meet to determine next steps for any homeless client who misses two appointments.  If they call back for a third appointment, 211 could potentially put them into a separate bucket of people who repeatedly miss appointments
                                                           vi.      Need to have backup location for if people cannot go to certain CAN appts due to assessment location restrictions
We discussed potentially having virtual interviews, possibly via webcam.  This might be addressed at the state meeting, and could be possible, but it would require a lot of technology working cohesively.
                                                          vii.      Develop plans for accommodating special populations:  Transgendered people based on identity, disabled, unaccompanied youth, teenage boys in families, infants under one, domestic violence victims
2.       Developed a GH-CAN Housing Inventory Chart that includes all permanent supportive, transitional living, and rapid rehousing programs
3.       Access Benefits – implement this system for shelters to help assess and apply for mainstream benefits
4.       Local Marketing Plan
a.      Need plan for communicating changes to consumers/clients of shelter system
b.      Developed list of stakeholders that need to be involved in planning and divided up list and reached out to them.
c.       Inviting healthcare institutions, police, other community stakeholders to planning
d.      Presented to Directors of Town Social Services statewide group
5.       Need to develop teams:  CAN Oversight Group (problem solving, implementation, evaluation of coordinated access), Housing Referral Team (Availability, Prioritization, Eligibility, Assessments) , Challenging Person Team (Problem-solving for difficult cases), Coordinated Care Team (hospitals/healthcare led case conferences)
6.       Developed a shelter bed availability protocol – update google document/email when there are available beds (on a nightly basis)
7.       Identified process to move from individual waiting lists to unified referral list for Rapid Rehousing, Transitional Living Program, and Permanent Supportive Housing based on priority and eligibility
a.      Need to set GH-CAN prioritization for PSH, TLP, RR (vulnerability, length of time homeless, chronic, etc.)
b.      Need to purge existing waitlists and scheduled date to stop accepting new paper applications separate from Universal Housing Application.  Need to assess shelter residents, TLP residents, and people on housing waiting lists for VI-SPDAT priority, length of time homeless, and UHA eligibility
We decided that the date when we would stop accepting new paper applications will be September 15th.

Coordinated Access List of Needs for Statewide Input
a.      CAN Release of Information – HMIS Release of Information
This Is a question for the HMIS steering committee- can we use the HMIS ROI as our own?
b.      CAN Grievance Policies, General Policies and Procedures
Will be discussed at the statewide CAN meeting on 7/24
c.       Training on VI-SPDAT and assessment process
Will be discussed at the statewide CAN meeting on 7/24
d.      Statewide Marketing tools
e.       Statewide guidance for shelters to modify their length of stay and return to shelter policies
The Greater Hartford CAN has the most varied length of stay between our shelters
f.        Some state funded programs require homeless verification, which negatively incentivizes people to go to shelter, sometimes unnecessarily.  Can this be modified?
There is no way to access federal money (or city money that comes from the federal government) unless a client is literally homeless.
It’s worth noting that people who are living in cars or other places unfit for human habitation do not need to live in a shelter to get verification of homeless status- they need only provide a personal statement to an outreach worker to gain literally homeless status.
g.      We need assistance on including PSH with waitlists managed by property managers other than housing provider
h.      Guidance on fair housing issues related to adding priorities (VI-SPDAT, etc.) to existing waitlists for PSH or TLP that have been managed by first come-first serve in the past. 
i.         How can a shelter communicate to bucket as needed (move a CAN appt.)
j.        Guidance for how to include transitional housing in unified referral list
Where is transitional housing in the Universal Housing Application?  Transitional housing is very tricky, because it is sometimes considered long-term shelter, and other times considered that it could be converted to rapid rehousing or supportive housing.
k.       Insights to how cold weather protocol will impact CAN process
*This should become an eventual agenda item
l.         Where will CAN assessment data be stored (VI-SPDAT, diversion tool)?
m.    Are any other regions planning to use teleconferencing for CAN assessment to health care institutions or other institutions?
n.      Can DMHAS release PSH case management requirements to allow for CAN Assessment time, and not negatively impact performance
o.      What is recommended CAN Assessment process? (ROI’s, Assessments, Referrals)
p.      In order to project the number of GH-CAN assessment appointments we will need per month, it would be helpful to have a report from CT-HMIS GH-CAN with data for the number of de-duplicated new entries to shelter per month
Matt Morgan said he would put in a request through CCEH to get that data report, but then later learned that Crane Cesario has already done so.
Annoucements:
·         The Department of Housing is going to have a lottery system for the state on August 4th.  They are adding 8,000 slots to a waiting list, and it is the first time in 7 years they have opened the list this way.  This is not a lottery for vouchers, the Department of Housing will not be giving away 8,000 more vouchers, just opening up the waiting list to receive candidates for the waitlist.

Future Agenda Items:
·         What happens when a client refuses to sign consent forms?
·         What is our CAN’s cold weather protocol?
·         What is the report from the statewide meeting July 24th?
·         What will happen at the assessment meetings?




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