GH CAN Operations 8/9/17

Greater Hartford Coordinated Access Network

Operations Agenda

Wednesday, August 9^th, 2017

1.      In Attendance

Alicia Akers, CRT

Anita Cordero-Doers, ImmaCare

Crane Cesario, DMHAS

Stephanie Corbin, Mercy

Rochelle Currie, The Connection

Catherine Damato, CRT

Sarah DiMaio, SAMH

Luciana Degray, YWCA

Dave DuVerger – South Park Inn

Angel Fernandez, The Open Hearth

Klaudia Lobeska, EHS

Gerilyn Harrison – SAMH

Malika Nelson, CHR

Heather Pilarcik, South Park Inn

Natalie Ramos, ImmaCare

Luz Serrano, ImmaCare

Lisa Quach, Journey Home

Jennifer Greer, CHR

Rikka Racelis, Chrysalis

Tanesha Shucer, My Sister’s Place

Audrey Kennedy, South Park Inn

Lourdes Ward, CRT

a.      Leadership Updates – Mollie Greenwood

·        RRH Bridging – One big thing we discussed at Leadership is that we need to set some consistent standards in place in our community around bridging from RRH to PSH.

o   We will share RRH policies once it’s finalized. Other communities have discussed where everyone gets rapid rehousing and only get PSH if you fail. Prevents people from sitting in shelter to “become” chronic and also folks comparing what housing intervention their friends got.

·        CCT Release – We talked about some of the benefits to having releases completed. 

2.      Case Conferences – Fred Faulkner

3.      Coordinated Entry:

a.      Shelter Waitlist Marking – Heather Pilarcik

                                                    i.     Heather wanted to get input from other SmartSheet users on how it’s been working in their shelters. She is typically not always the one that is on the smart sheet making calls. Heather started calling a couple of weeks ago and ran into issues. There were clients on the waitlist who were added in June. There are clients on there with absolutely no contact information listed in columns. Heather made some calls and notes but didn’t really hear back from people. Next day, she received an email from Steve that she didn’t properly fill out a couple of columns. She also received another email from Steve asking to update status for clients who were already called. She feels frustrated with the whole process. They are still getting people who walk in for beds every day. They also get 10-15 calls per day from people calling for shelter beds. There are people out there who need beds and need to get in. Facilitating that process without becoming withholding to the process is something we need to think about. There is a big gap with people who are at our door and call our phones in distress looking for shelter. It comes down to clients need shelter beds. Making them call 211 to get into shelter beds while they’re at the door does not minimize the hurdles. What is the value of the data collection? Already have to do case management and having to enter columns is one more thing to worry about.  

                                                   ii.     Stephanie Corbin – diversion center staff being told that all beds are full. Question of why are there open beds? Are you not reaching people? Heather responded that they made 40-50 calls over the weekend and no return calls or no shows. There’s also clients on the list with no contact info. They also have had people report they no longer need shelter, which is good. Assumption that all beds are full might be because there is still a waitlist. Roger Clark states that anytime he calls from the waitlist, people don’t show up. Last 6 people who came into shelter were all from Tony Mack. Shelters feel that calling smart sheet is not working. People aren’t coming in. East Hartford shelter has issues with families who don’t like the rules but she is telling folks the rules when she is calling. Open Hearth had 6 beds open and proceeded to call clients but only 1 showed up. People show up at the door and then Angel takes them if they’re in the list. If clients show up and are in unsheltered section, you can take them.

                                                  iii.     What are the issues that seem fixable? Clean it up. Standard will be anyone who has not been active for 90 days will be removed. Suggestion to have smartsheet flag someone who has been on for more than 90 days. Also could cross reference BNL/Inactive with Smartsheet to see who has been inactivated. Angel goes through the list and noticed that people are not marking the clients are yellow or inserting notes in the chat box. Journey Home looked at Fairfield’s list and they aren’t using the chat bubbles like we are. They are using drop-down options and only use notes for outreach workers who tried to locate client. This would be easier since it’s just a click. Anybody that has a call out right now will be yellow. We will prioritize big cleanup and work on policies around cleaning and managing the list.

4.      VI-SPDAT and Full SPDAT Policies – Mollie Greenwood – Did not get to discuss.

5.      Coordinated Exit:

a.      Recently Housed - Did not get to discuss.

b.      DMHAS/DOH Policies on Refusers – Lisa Quach - Did not get to discuss.

6.      Announcements

a.      Hands On Hartford and a number of community partners are working on planning the Day of Sharing and Caring, and needs lots of help planning and pulling off the event.  If you’re interested in assisting, please contact swalker@handsonhartford.org

b.      Salvation Army is offering an Anti Human Trafficking Training at Capitol Region Mental Health Center Tuesday, 9/26 from 1-4 PM.  Register for training with Cat Damato at damatoc@crtct.org

GH CAN Housing Data

Data Element	Number	Notes
Chronically homeless households housed in 2015	102	This includes clients housed through GH CAN programs as well as through other subsidies or independent housing
Chronically homeless households housed in 2016	211	This includes clients housed through GH CAN programs as well as through other subsidies or independent housing
Chronically homeless households housed in 2017	130	This includes clients housed through GH CAN programs as well as through other subsidies or independent housing
Total Chronically homeless households housed in GH CAN	444
Verified Chronic Matched	25
Verified Chronic Not Yet Matched	18	We currently have 18 chronic verified clients who have not yet been matched to housing.
Potentially Chronic Refusers	2
Verified Chronic Refusers	3
Potentially Chronic Matched	1	These households did not disclose a disabling condition, and are matched to various programs.
Potentially Chronic Not Yet Matched	39	Right now we believe 39 households have the chronic length of homeless history, but none of these individuals have their homeless and disability verifications completed.

DMHAS/DOH Guidance on Due Diligence- Refusal of Services Policy

To ensure that we serve all individuals experiencing homelessness identified in the Coordinated Access Networks (CANs), communities must ensure that engagement is an ongoing process.  We know that engagement can be particularly challenging for individuals who refuse offers of housing assistance from the CAN.  This guidance from the Department of Mental Health and Addiction Services (DMHAS) and the Department of Housing (DOH) is meant to provide CANs with a process that enables them to identify refusers within your CAN and ensure that they continue to be discussed at housing matching meetings and offered housing resources when available.

REFUSERS

A refuser is defined as an individual experiencing homelessness who is ACTIVE on the By-Name List (BNL) and has declined three different offers of housing assistance from CAN housing providers.  After the third offer is declined, the CAN will change the individual's sub-status on the BNL to "Refuses CAN Assistance." DOH CAN Managers will review the BNL on a regular basis to identify new refusers, and schedule case conference meetings that include a representative from DMHAS, a DOH CAN Manager, and CAN housing providers.  The purpose of these case conference meetings will be to plan for housing assistance options that can be offered to the refuser(s) in the future.

DUE DILIGENCE CONTACT ATTEMPTS FOR REFUSERS

CANs will designate a person/persons to attempt to contact refusers a minimum of once every two weeks for the purpose of offering the person shelter and/or housing assistance.  These contact attempts--and their outcomes, if applicable--will be recorded in the HMIS client record of the refuser by the designated person/persons.   

Due diligence contacts will be attempted and recorded in HMIS every two weeks for as long as the refuser remains ACTIVE on the BNL as a refuser. Due diligence contact attempts will be suspended when/if the refuser is INACTIVE on the BNL, and will resume when/if the client becomes ACTIVE on the BNL again.

REFUSERS AND HOUSING PLACEMENT MEETINGS

In order to be designated as a refuser, an individual will have risen to the top of the BNL prioritization and refused multiple offers of housing assistance.  Refusers—who are known to be vulnerable and in need of housing assistance—are listed on the HMIS BNL and should be discussed at regular CAN Housing Matching/Placement meetings in priority order per CAN matching procedures. The designated person(s) attempting to make due diligence contact with refusers should provide updates about the status and outcome of due diligence contact attempts for all refusers at these meetings. 

INACTIVE CLIENTS

Clients on the BNL can be marked as INACTIVE if they have no HMIS enrollment activity in the preceding 90 days, provided that at least three attempts have been made over the course of the 90 days to contact the client.   Refusers covered by this due diligence policy can be marked as INACTIVE on the BNL if they have no HMIS enrollment activity in the preceding 90 days AND if there have been at least three unsuccessful contact attempts in the preceding 90 days. Refusers covered by this due diligence policy can also be marked as INACTIVE on the BNL if the outcome of a due diligence contact attempt confirms that the refuser is no longer literally homeless, or is no longer living in the state.

TRACKING DUE DILIGENCE CONTACT ATTEMPTS IN HMIS

Instructions for tracking due diligence contact attempts made to refusers in HMIS are attached to this policy.  Additional questions about tracking due diligence requests in HMIS and/or requests for access to use the tracking functionality in HMIS should be directed to the Statewide CAN Manager for Data Analysis:  Beau Anderson (beau.anderson@ct.gov).

GH CAN Leadership 8/9/17

Greater Hartford Coordinated Access Network

Leadership Agenda

Wednesday, August 9th, 2017

1.      In Attendance:

Brian Baker – South Park Inn

Sonia Brown – CRT

Crane Cesario – DMHAS

Cat Damato – CRT

Sarah DiMaio – Salvation Army Marshall House

Fred Faulkner – The Open Hearth

Rosemary Flowers – My Sisters’ Place

Lou Gilbert – ImmaCare

Dave Martineau – Mercy Housing and Shelter

Kyren McCrorey – The Open Hearth

Matt Morgan – Journey Home

Amy Robinson – VA

Iris Ruiz – Interval House

Cathy Zeiner – YWCA

Lauren Fair – Salvation Army

John Lawlor – The Connection

Justine Couvares- Chrysalis Center

Stephanie Corbin – Mercy Housing and Shelter

 

2.      Sub-COC and CAN Leadership Meeting Structure – Crane Cesario, Cat Damato

a.      Since we merged with BOS, there has been a lot of crossover between meetings.  The GH sub coc and Hartford sub COC could become one entity, and could join in with CAN Leadership’s regularly scheduled time.  We needed to determine the best way with figuring out how to implement these structures.  Last week, Dave Martineau, Sarah DiMaio, Crane Cesario, Matt Morgan, Cat Damato, and Mollie Greenwood met to discuss the meeting process. 

b.      We’re looking to have sub COC meetings take place the second meeting of the month.  We will lead the agenda with COC related issues at that second monthly meeting. 

                                                    i.     The reason we chose the second meeting of the month is to ensure we get the BOS COC meetings at each meeting of our subCOCs.  If you have issues related to CT BOS, you can always contact Crane and Cat. 

                                                   ii.     Crane and Cat offered to review your COC applications before sending them to BOS if that is of interest to any applicants. 

                                                  iii.     You can view the BOS webinar trainings on applications whenever you want to. 

3.      DOH Guidance

a.      on PSH and RRH Prioritization (see p. 4-6 )– Matt Morgan

                                                    i.     An issue that has come up statewide, we have been talking about the issue of how to manage households who don’t seem to be succeeding in RRH.  We know we need to follow HUD’s prioritization in terms of how to fit these households into our prioritized list.  Over the last 3 months, we have been seeking feedback from other parts of the state. 

1.      The determination is that if you don’t have any remaining chronically homeless individuals or families, you can move people who are not chronically homeless in RRH to permanent supportive housing. 

2.      So, under homeless individuals and families with severe service needs, we are looking to incorporate people with disabilities and severe service needs.  Within that group, people with a VI/NST score of 8 or higher, and who have been homeless for over 8 months, they would be the next prioritized. 

a.      Within that, folks who are unsheltered would be prioritized first.

b.      Folks failing out of RRH would be prioritized second.

c.      Folks literally homeless, but currently sheltered, would be prioritized third.

3.      It would help us to have a flow-chart, because this narrative writing is difficult.  A concern Crane has is, looking at folks earlier in the process than month 5.  It’s becoming extremely challenging for the RRH programs serving the folks who are chronically homeless.

4.      The programs we have in place aren’t always equipped to move within the policies that we have.   It may be necessary to bring up people for case conferencing much earlier. 

                                                   ii.     Bridging to PSH (p. 2) – Crane Cesario

1.      One way of trying to manage the issue of people “waiting” to hit their 12 months of homelessness would be putting everyone through RRH first.  In Norwich, there was a pilot program where 43 individuals with serious mental illness all received rapid rehousing assistance.  42 of 43 folks were successful.  One problem we have is that CHR has a program that is taking only the chronically homeless into their RRH program.  We need to figure out how we manage keeping track of who we KNOW needs to be bridged, and who we think might need to be bridged.  We don’t want to create a two-tiered system. 

a.      We do have more RRH resources, but we continue to have PSH programs with openings, and you don’t want to harm your PSH programs by waiting for openings.  What Crane suggests, as Leadership, is how many folks we think need to be bridged, and manage that over time.  We need to make sure that RRH programs are able to meet PSH program standards.  We need to sit down with folks who are interested.  People in RRH may have zero income, not all PSH programs can take full caseloads of zero income households. 

b.      Dave reminded us that when we initially adopted the VI-SPDAT, the goal of that tool was to help us organize where households would be able to succeed.

                                                                                                                i.     We’re learning that it is often an income issue.  That is a piece that may not have come into our thinking when we were looking at the VI-SPDAT originally.  We aren’t doing a whole lot of that assessment with any consistency. 

                                                                                                               ii.     We’re housing the toughest to house, and we don’t know what their ability is to obtain income, either.  We’re also taking chances.  We don’t want to mess up the outcomes. 

                                                                                                              iii.     Sonia has a few people on the waiting list for the housing choice voucher program, so that person may be able to move easily into the Section 8 Housing Choice Voucher.  CRT won’t have enough in-house support or S8HCVs to manage that whole situation. 

                                                                                                              iv.     Additionally, the HPASS program have been working with folks who had higher scores than they had previously anticipated.

c.      When we originally talked about the VI scores, the question was, if they have a high score, are they able to go into Rapid ReHousing.  We wanted to give it a try.  But the programs are still going to be held accountable. 

                                                                                                                i.     We really need to establish a subgroup- two subgroups.  Sonia, Kara, Sarah, Andrea or Amber.  After that group has met, we need to determine which PSH providers want to join as bridgers. 

                                                                                                               ii.     We also need to determine what happens in the rare cases that a PSH program has an opening and there are no RRH folks.  How do we manage buildings, which are site based?  They come with services. 

                                                  iii.     RRH Exemption Policy – Sonia Brown

1.      For CT BOS, we’re able to take higher income people, but a person needs to lose income to stay in their program longer than 3 months.  Let’s write a rebuttal.  We either need to add a clause about this into the exemption form.    This will be another item to add on the meetings.  It was probably a good goal to try and reduce expenditures. 

2.      Let’s assume good intent.  Sonia and Sarah and Crane will

b.      DOH VI-SPDAT and Full SPDAT Policy – Mollie Greenwood

                                                    i.     Mollie reach out to DOH – new VI-SPDAT should be done by a different provider.  We don’t think that’s necessary internally. 

c.      DOH/DMHAS Due Diligence/Refusers – Mollie Greenwood

                                                    i.     90 days – people may be institutionalized, we’re not yet changing them to be less than 90 days.  We don’t want to harm the client. 

                                                   ii.     Sarah talked about the 3 phone calls- Journey Home has reached out to DOH for further clarity about whether 3 phone calls are required in each case, or if a thorough data review can substitute for multiple phone call attempts.

4.      CCT Release of Information Processes – Matt Morgan

a.      At the last CAN Ops meeting, we asked all agencies which organizations are having folks sign Community Care Team Releases.  St. Francis and Hartford Hospital both have a version of this release.  This release allows all healthcare providers in our region to be able to case conference and discuss challenging cases. 

b.      The sense is it could help us communicate with folks.  Some shelters wanted to be able to use this CCT ROI to communicate with healthcare providers. 

c.      We recently got HMIS to add CCT Releases as a tag for type of document.  One of the first steps we took in terms of better coordination was having data sharing agreements and having one shared release of information.  There are many things we’re trying to improve when it comes to healthcare. 

                                                    i.     This could help with getting SAGA, SSI, SSDI, compassionate allowance, getting people into Medicare part B[MG1] [MG2] [MG3] ,

5.      GH CAN Housing Data – see p.2

6.      Future Agenda Items

7.      Announcements

a.      Hands On Hartford is working on planning the Day of Sharing and Caring and needs lots of help planning and pulling off the event.  The event is currently scheduled for 11/2 from 11:00AM – 2:00PM If you’re interested, please contact swalker@handsonhartford.org

b.      Salvation Army is offering an Anti Human Trafficking Training at Capitol Region Mental Health Center Tuesday, 9/26 from 1-4 PM

GH CAN Operations 7/27/17

Greater Hartford Coordinator

Operations Agenda

Wednesday, July 26^th, 2017

Attended: Alicia Akers (CRT), Janet Bermudez (Hands on Hartford), Manuel Burnias (CRT), Roger Clark (ImmaCare), Catherine Damato (CRT), Angel Fernandez (Open Hearth), Luciana DeGray (YWCA), Klaudia Lobeska (East Hartford Shelter), Gerilyn Maciel (Salvation Army), Andre McGuire (McKinney), Maureen Perez (McKinney), Heather Pilarcik (South Park Inn), Kyren McCrorey (Open Hearth), Luz Serrano (ImmaCare), Wendy Walker (McKinney), Serlena Weatherington (Mercy), Anita Cordero (ImmaCare), Jackie Florez (Mercy), Shefia Ibrahim (Mercy), Rikka Racelis (Chrysalis Center), and Tanesha Shuler (My Sister’s Place)

1.      Welcome and Introductions

a.      Leadership Updates

a)      Mollie says there are 38 clients who meet the criteria of chronic who have not been verified but do not know where they are right now.

b)     Mollie says clients are being diverted at the CAN appointments more than last year.

c)      Mollie says that Leadership discussed about if respite programs and recovery programs should be listed on the HIC Chart. Recovery programs are not on the HIC Chart right now.

e)     Roger asks how to get programs on the HIC?

i.                 Mollie says Balance of State needs to approve and program needs to agree to put their data on HMIS.

2.      Case Conferences

-        No conferences were brought up at the meeting.

3.      Utility Assistance through Hands on Hartford

a)      Janet says Hands On Hartford received a one-time grant to help clients with utilities.

Janet  says the goal is to help clients with paying utilities and cannot exceed over $500 for per client.

b)     Janet says the completed application and copy of utility bill must be sent to her. Also, it will take about 10 business days for approval and for the check to be sent out.  Janet committed to trying to expedite her review of the applications, but that 10 days was the period of time that Hands On Hartford had to both review the application and documentation as well as to cut the check.

c)      Janet requested that all staffinclude case managers name and number on application in order to follow up if she has any questions while reviewing the application.

o   Shefia asks whether this program could it pay for back utility bills

i.                 Janet says yes.  She added that clients who have been helped out before for utilities are eligible as well.

f).  Klaudia asks whether, if a client has income and is able to pay a portion for bills that exceed $500, if the client has to pay up front.

i.                 Janet says yes they prefer that.

g). Janet says the preference is for clients who are in the process of trying to get housing to apply for this program since that has been a gap of services that has been addressed in this committee.

h). Mollie asks what kind of identification is required for submission of this form.Janet says as long as it has the person’s picture and name on the picture, any photo ID is acceptable.  The households do not need to have a DMV photo ID, things like a DOC ID, employment ID card, school ID card, or municipal ID will be sufficient for this application.

4.      PLAN of Connecticut

a)      Colleen says her agency is the trustee for the Special Needs Trust.  They are a charitable organization that receives a lot of donations from estates.  They then use these donations to provide grants to help folks with a disability.  In order to apply for one of these grants, individuals need to be able to prove that they have a disability and should submit an application.  The trust has paid for things like wheelchair ramps, hospital beds, and other items to assist households with disabilities.  They have paid for summer camps, too.  The trust doesn’t pay ongoing bills, just one-time expenses.   Applications can be sent directly to Colleen.

a.      The definition of disability for this trust is not the same as the one we use for HUD.  Chronic substance use is not considered a disability for this program.  The disability standards for the trust are the same as for social security, but a household does not need to be receiving social security benefits to qualify for the trust, they only need a letter from a doctor indicating that they are unable to work for 12 months or more.

b.      The trust doesn’t send checks directly to participants, but they can send checks or pay with credit cards directly to vendors.

b)     Shefia asks if the trust would pay for security deposits.

i.                 Colleen says they do help with security deposits and help with moving costs.

c)      Alicia asks if the client has to be a United States citizen.

i.                 Colleen says there are no restrictions if they are not U.S citizens.

5.      Coordinated Entry

a.      CCT Release of Information

a.      Mollie asks if anyone is using CCT as part of their intake process?

                                                              i.     Wendy says she was in the past, but did not find it a good resource for getting information about institutional stays.

                                                             ii.     Alicia says she was not able to get any official information for intakes and discharges for clients.

                                                            iii.     Gerilyn says SAMH is using this form as part of their intake.

                                                            iv.     Luz says ImmaCare uses the form as part of their intake.

                                                             v.     Angel says Open Hearth is not using the form during the intake process.

                                                            vi.     Klaudia says East Hartford does not use the form.

                                                          vii.     Heather says South Park Inn uses the form by a case by case with clients only if they are already aware that the households are high utilizers of ERs and/or treatment programs.

                                                         viii.     Je’Naya says CHR PATH does not use the form.

                                                            ix.     Luciana says the YWCA uses the form

                                                             x.     Serlena says Mercy uses it for all of their programs.

6.      Coordinated Exit

a.      Recently Housed

7.      Announcements

a.      Hands On Hartford and a number of community partners are working on planning the Day of Sharing and Caring, and needs lots of help planning and pulling off the event. If you’re interested in assisting, please contact swalker@handsonhartfored.org.

b.      Salvation Army is offering an Anti Human Trafficking Training at Capital Region Mental Health Center Tuesday, 9/26 from 1-4PM

c.      The time for the Rapid ReHousing Matching Meetings has changed- Rapid ReHousing matching will now begin at 1:15 PM and go until 2:45 PM

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