Monday, August 13, 2018

GH CAN Operations Committee 8/1/2018


Greater Hartford Coordinated Access Network
Operations Agenda
Wednesday, July 18th, 2018

1.      Welcome and Introductions
Crane Cesario- CRMHC, DMHAS
Stephanie Corbin- Mercy Housing & Shelter
Mary Davenport- The Network
Sarah DiMaio- Salvation Army Marshall House
Fred Faulkner- The Open Hearth
Heather Flannery- South Park Inn
Maria Jackie Florez- Mercy Housing & Shelter
Ruby Givens-Hewitt- My Sister’s Place
Kelly Gonzalez-  Journey Home
Mollie Greenwood- Journey Home
Geri Maciel- Salvation Army Marshall House
Lorenza Mack- Journey Home
Malika Nelson- CHR
Lisa Quach- Journey Home
Jamie Randolph- Salvation Army Marshall House
Leana Ruiz- Journey Home
Tyeisha Saffold- CRT East Hartford Shelter
Zoe Schwartz- CRT
Monique Shand- YWCA
Niya Solomon- Journey Home

2.      Case Conferences – Fred Faulkner
195590
3.      Leadership Updates – Crane Cesario
a.      Operationalizing Section 8 Housing Choice Voucher Preference – Leana Ruiz, Lisa Quach
                                                    i.     Changes will be made to the language of this preference.  Changes will include positive language as well as the progressive engagement taskforce will further consider bridging criteria and HCVP (Youth & Families) will mirror what is decided upon.
b.      CAN Release of Information
                                                    i.     We are revamping the CAN ROI to have an additional page that will allow us to case conference clients within the CAN.  This portion of the ROI should be signed when the VI SPDAT is being administered. The goal is to have this updated addendum for September 1.

4.      Coordinated Entry
a.      SmartSheet Shelter Priority List Process – Stephanie Corbin
                                                    i.     Families who are reporting they will stay unsheltered tonight and single woman with children safely housed, but who report that the head of household will stay unsheltered will not be put on the waitlist instead they will be directed to the overflow by Diversion staff.

5.      Coordinated Exit
a.      Recently Housed – Lisa Quach
b.      Housing Data – see p.2

6.      Anthem Blue Cross Presentation on Medical Services
a.      A few presenters, including our region’s Sales and Services Representative, Rob DeHostos came to present the extra benefits that the dual population (Medicare and Medicaid recipients) might be eligible for.   


Tuesday, August 7, 2018

GH CAN Operations Committee 6/20/2018


                                            Greater Hartford Coordinated Access Network
Operations Agenda
Wednesday, June 20th, 2018

1.      Welcome and Introductions
Janet Bermudez- Hands on Hartford
Manuel Cadena- Catholic Charities
Stephanie Corbin- Mercy Housing & Shelter
Roger Clark- ImmaCare
Mary Davenport-  The Network
Sarah DiMaio- Salvation Army Marshall House
Fred Faulkner- The Open Hearth
Maria Jackie Florez- Mercy Housing & Shelter
Ruby Givens-Hewitt- My Sister’s Place
Kelly Gonzalez-  Journey Home
Mollie Greenwood- Journey Home
Geri Maciel- Salvation Army Marshall House
Kyren McCrorey- The Open Hearth
Andre McGuire- CRT McKinney
Lisa Quach- Journey Home
Chris Robinson-  Salvation Army Marshall House
Amy Robinson- VA
Iris Ruiz- Interval House
Niya Solomon- Journey Home
Jose Vega-  CRT McKinney

2.      Case Conferences – Fred Faulkner
a.  CCADV 

3.      Coordinated Entry
a.      SmartSheet Shelter Priority List Process – Stephanie Corbin
                                                    i.     Unfortunately, right now the waitlist is not working and turnover is not occurring at the shelters. Cleaning up the waitlist after 90 days is helping a bit, but we need to find a better way to ensure the people on the waitlist are getting into shelter beds. We need to ensure that outreach can access these beds for unsheltered clients.
                                                   ii.     Outreach and Diversion in New Haven are only referring the top 20 on their shelter waitlist to the open shelter beds based on priority. They are also doing a morning call with diversion and shelters daily to case conference and get accurate number of beds available per shelter.  Having this call daily will minimize many issues such as clients shelter shopping, miscommunications surrounding clients being exited by shelters and bed availability.
                                                  iii.     Amy Robinson suggested we should have a cooling and warming center all year round.
                                                  iv.     Roger Clark suggested we start the list all over and delete the whole thing.
                                                   v.     Jose Vega suggested we clean up the Smartsheet every 30 days instead of 90 days.
                                                  vi.     Stephanie stated that New Haven is cleaning their list weekly but she doesn’t want to make any changes to diversion and the shelter waitlist until we speak with the National Alliance to End Homelessness and see what is working for them.
                                                vii.     It was also suggested that we create a voicemail at diversion where clients can check in for availability of shelter beds and to provide any updated contact information.
                                               viii.     We will bring the suggestions to the National Alliance to End Homelessness and see what we will do moving forward with hopes that it will be implemented in July.
                                                  ix.     The Network will donate Hopeline phones that diversion can hand to clients without any contact information to minimize the barrier of shelters not being able to contact clients for shelter beds.   These phones already have minutes on them and are active until December 2018.

4.      Leadership Updates
a.       Homeless length of time will be the next priority.  At this time, HMIS doesn’t have ability to track this, but we are confident that it will be accessible through HMIS in the near future.  
b.      Duplicate Records-  currently only have 200 duplicates. The functionality to merge duplicates is broken, but Nutmeg will work on it.  Please do not create duplicate records.
c.      BOS application for PSH or expanding RRH/PSH services are due next Friday, June 29th.

5.      Coordinated Exit:
a.      Recently Housed – Lisa Quach
b.      Housing Data – see p.2


6.      Announcements
a.      Dinner in the Park will be held this Saturday, June 23rd at 5:00 PM.  Journey Home will be providing a free meal at Bushnell Park, near the pump house. 
b.      Due the successes in housing the most vulnerable homeless households the state only has a very limited number of chronically homeless households remaining to be housed. As a result, DOH has changed the eligibility criteria for Security Deposit Guarantee Program from those who are verified chronically homeless to anyone entering Permanent Supportive Housing with a Section 8 voucher, RAP certificate or 811 subsidy. This also includes those utilizing State of CT Section 8 Vouchers to “move on” from PSH. The process for the applications will remain the same, either coming from the local CAN approved contact or the DOH CAN manager.
c.      IH is back up and running
d.      HOH July 4th Dinner
e.      HOH Job openings




f.        
                                                                                                                

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
179
This includes clients housed through GH CAN programs as well as through other subsidies or independent housing
Chronically homeless households housed in 2018
54
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
546

Verified Chronic Matched
37

Verified Chronic Not Yet Matched
4
We currently have 4 chronic verified clients who have not yet been matched to housing.
Potentially Chronic Refusers
2

Verified Chronic Refusers
2

Potentially Chronic Matched
3
These households did not disclose a disabling condition, and are matched to various programs.
Not Chronic Matched
7

Potentially Chronic Not Yet Matched
36
Right now we believe 36 households have the chronic length of homeless history, but none of these individuals have their homeless and disability verifications completed.
Individuals - Active – Not Matched
555
This is Enrolled in CAN, Enrolled in TH, and In an Institution
Families – Active – Not Matched
22
This is Enrolled in CAN

SmartSheet Shelter Priority List Data
Individual Men
Individual Women
Families
177 Unsheltered
73 Unsheltered
26 Unsheltered
254 Total
135 Total
60 Total


GH CAN Leadership / GH Sub-COC Meeting 7/18/2018


Greater Hartford Coordinated Access Network
Leadership Committee Agenda
Wednesday, July 18th, 2018

In Attendance:
Liany Arroyo – City of Hartford
Sonia Brown – CRT
Crane Cesario – CRMHC, DMHAS
Kate Chamberlin - CCEH
Stephanie Corbin – Mercy Housing and Shelter
Fred Faulkner – The Open Hearth
Heather Flannery – South Park Inn
Mollie Greenwood – Journey Home
Jen Greer - CHR
Daniel Langless – Beacon Health Options
Rebekah Lyas – ImmaCare
Steve MacHattie – Mercy Housing and Shelter
Matt Morgan – Journey Home
Lisa Quach – Journey Home
Lionel Rigler – City of Hartford
Amy Robinson – US Dept of Veteran Affairs
Iris Ruiz – Interval House
Zoe Schwartz – CRT
Barbara Shaw – Hands On Hartford
Kathy Shaw – My Sisters’ Place
Niya Solomon – Journey Home
Cathy Zeiner - YWCA

CT BOS COC Items
1.      HUD Application – Application is out.  It seems like it may be easier than previously for renewal applications.  Crane strongly recommends paying attention and read between the lines on what isn’t coming out in written form. 
a.      Some of HUD’s language doesn’t make sense.  If you have questions or concerns about your renewal evaluation, please let Crane know.  We still don’t have guidance on merging. 

GH CAN Leadership Items
2.      Beacon Health Options – Dan Langless
a.      Beacon Health Option is also known as CT Behavioral Health Options.  Beacon is the administrative services provider.  All Medicaid authorizations go through Beacon Health Options.  There are a lot of different levels of care provided for adults and children. 
b.      Within the services that Beacon provides, they have intensive care managers (licensed clinicians) who go out and meet directly with Beacon’s members.  Beacon also employs peer specialists.  There are ICMs and peer specialists for both individuals and families.  Beacon’s staff engages with folks who are frequent users of medical services.  In Dan’s role, he deals a lot on a systems level.  On the way in, he was speaking with Barbara.  They bring data out to the hospitals around length of stay, readmission rates, discharge information completion rates. 
c.      Beacon is also beginning to look more at housing as healthcare.  He wants to start building stronger partnerships with providers around the homeless services sector.  Beacon Health Options wants to be on the forefront of building these partnerships. 
                                                    i.     Hartford Healthcare partnered with South Park Inn, and are funding 5 beds at South Park Inn, and folks can do care plan transitions out of South Park Inn.  It’s operating like a medical respite.  It helps Hartford Healthcare reduce lengths of stay. 
1.      This program serves both individual men and individual women. 
2.      It’s being paid for by Hartford Hospital directly, not by Medicaid dollars. 
3.      St. Francis hospital is interested in doing a similar model and partnering with a particular shelter or housing system. 
4.      Yale has had a similar partnership with Columbus House for several years.
5.      The Respite program has been operating for a while, about a year.  Heather encouraged Crane to reach out to Jeff Katz.  It’s named “respite”. 
                                                   ii.     Dan’s interested in getting out to each of the shelters in the next few months to learn more. 
                                                  iii.     We want to move this state to value-based payment, which would let Medicaid dollars available for activities outside of treatment.  It would be a change from our current fee for service structure. 
1.      Additional advocacy is needed, because this is a change that would need to happen through the CT legislature. 
a.      Liany said that the state has to ask for a waiver and there has some reluctance in the past. 
b.      Barbara Shaw sits on the Reaching Home Health and Housing working group and there seems to be some forward momentum. 

3.      SmartSheets Shelter Vacancy Updates – Rebekah Lyas
a.      Rebekah noticed that the sheet wasn’t updating the date that the change would be, to see that there are zero changes.  It might look like Rebekah isn’t updating the sheet for a week. 
b.      There’s a larger issue though, where the list has not been being updated daily.  Rebekah was not sure whether it was an ImmaCare-specific issue.
c.      Stephanie says that it appears to be a secondary issue.  It makes it very challenging on the Diversion Center and on the Outreach Teams because if information isn’t being reflected as a change.  Stephanie has been calling shelter to shelter to identify possible changes.  Stephanie isn’t sure if there’s an issue coming from the shelter side in making updates.  Every morning at ImmaCare folks know immediately whether beds are available.  In theory the process is very simple, but it seems like it’s not happening with good consistency. 
d.      Waitlist Changes – Stephanie Corbin, Mollie Greenwood
                                                    i.     Last week some folks from the Diversion Center and Kelly as a representative of outreach came together to discuss some issues around the timing of the shelter waitlist.  We have some suggestions for how to change and improve our process.  One suggestion is to only be calling shelters from Diversion if there are no folks who are verified and not yet in.  Another suggestion is to only call the top cohort of folks on the waitlist.  All of these ideas are challenging to implement because of reasons like having no phones, and like outreach not being able to verify folks. 
                                                   ii.     What we’re struggling with, if people are coming into Diversion and aren’t verified, it’s becoming a little more of a judgment call.  This is in contrast with some of the folks who are being verified by outreach workers and who aren’t climbing to the top of the list. 
                                                  iii.     There’s some concern around making this process too high barrier by not ever relying on self-report.  It’s making it more challenging to get folks into beds. 
                                                  iv.     Mollie ad this to the next agenda for discussion!!!!
                                                   v.     Family Shelter Overflow Planning-
1.      We expect this to be very few and far between, as a cohort who are being identified as literally homeless after hours.  It’s a way to operationalize the fact that if a family showed up, we would all be realistically taking them in that night and trying to make a game-plan the next morning. 
2.      We still have people on what’s being labeled as the family waitlist.  We have a cohort of “families” who are on the waitlist, but where a head of household is unsheltered and children are somewhere else.

4.      Chronically Homeless Households with Physical Disabilities – Matt Morgan
a.      Over the last few weeks we’ve identified some households who meet the chronic homeless criteria who have physical disabilities.  Many of our programs have DMHAS funded services who are not being prioritized for the DMHAS-services opening.  We want to start thinking about whether there’s a way to do any swapping and get people into the openings. 
                                                    i.     Is it possible and feasible for us to swap someone out of the services?  There were organizations who seemed interested.
1.      Legacy shelter plus care programs from DMHAS doesn’t have DMHAS funded services because they don’t have services attached to certificates
2.      Efficiency units in Soromundi (which were formally TLP units) aren’t DMHAS funded for services.
3.      HOPWA programs as well, in some instances don’t have services that are DMHAS funded. 
                                                   ii.     We want to think about whether it would be possible to do some kind of a switch. 
1.      Mollie will send around a doodle poll to hold a meeting related to this.

b.      BNL Outliers – Mollie Greenwood            
                                                    i.     Everyone was reminded to make sure that the confidential information remains here. 
                                                   ii.     Went through the four columns of folks who are looking at a very detailed level.  We’re doing a lot of work simultaneously on working to show all the different categories of folks who have historically been on our lists. 
                                                  iii.     We are struggling as a community with folks who have been potentially chronically homeless for a long time.  We know they have a long homeless history, but verification of disabling conditions is taking a very long time.

5.      CAN Collaboration with Property Owner in CT– Matt Morgan
a.      There’s a housing program on Vine Street, named Horace Bushnell.  In the past few months, this property has been working with the National Alliance to End Homelessness and CT Department of Housing and are interested in participating with the GH CAN again. 
b.      This committee approved Matt Morgan to sign an MOU on behalf of the CAN to make these housing resources available for referral by the housing matching teams.

6.      Progressive Engagement Framework – Mollie Greenwood, Crane Cesario, Matt Morgan
a.      There have been a few statewide working groups that have been looking at Progressive Engagement as a framework for our CANs to operate.  The goal of progressive engagement is to provide light-touch services to as many people as possible, and only increase the level of services if folks seem to need additional assistance.
                                                    i.     Jen’s concern around Progressive Engagement is that when they’re housing chronically homeless people, they’re looking at affordability, which is usually a room-for-rent.  But Permanent Supportive Housing programs generally can’t backfill rooms for rent, they can only pay for individual units.  This costs additional resources in terms of security deposits to move people from a room-for-rent into an individual unit.  Rapid ReHousing programs are also able to serve fewer people when they’re taking very highly vulnerable people.
                                                   ii.     Jen’s concerned that in some instances the resources are coming around at different times, it’s really feeling like we are doing inconsistent referrals directly to Permanent Supportive Housing depending upon vacancies. 
1.      Some of this is an evolution because we do need to continue matching people to permanent supportive housing because we can’t leave vacancies open indefinitely. 
2.      On the PSH side, we’re seeing folks refuse PSH when it’s project based.
b.      One other big piece of discussion is around identifying what tool to use to objectively assess the level of service need for households once they are already housed by Rapid ReHousing.  Two suggestions are the Acuity Index and the full SPDAT assessment.
c.      Please send any feedback on this document that you have to Matt and Mollie for submission to the Progressive Engagement committee by Friday. 

7.      GH CAN Shelter and Housing Data – Mollie Greenwood
a.      Housing Program Vacancies 2017-2018 – Matt Morgan (see p. 3)
                                                    i.     This data is based on the openings that are reported to the housing matching meeting over the course of the year  The point here is to show how totally volatile our process has been. 
1.      Mollie – follow up with matt on how frequently this document should be coming back. 
2.      It would be helpful to have the numbers of housing vacancies.  Could we insert the table with the raw data into here.  Then we could see the RRH and PSH numbers embedded within this chart. 
b.      Trends (see attachment)
                                                    i.     The past three months we did not see a reduction in chronic homelessness.  A lack of vacancies in housing programs has been a factor. 
c.      Statewide BNL Report (see attachment)
d.      GH CAN Housed Data, GH CAN Waitlist Data (see p.2)
                                        
8.      Future Agenda Items?
1.      Homeless Outreach is a gap
2.      Double security Deposits as a potential gap
9.      Announcements
a.      South Park Inn is actively searching for a program director.  The job description is posted on South Park Inn’s website.  That person will eventually join this group. 



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
179
This includes clients housed through GH CAN programs as well as through other subsidies or independent housing
Chronically homeless households housed in 2018
68
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
560

Verified Chronic Matched
31

Verified Chronic Not Yet Matched
5
We currently have 5 chronic verified clients who have not yet been matched to housing.
Potentially Chronic Refusers
2

Verified Chronic Refusers
2

Potentially Chronic Matched
6
These households did not disclose a disabling condition, and are matched to various programs.
Not Chronic Matched
7

Potentially Chronic Not Yet Matched
32
Right now we believe 32 households have the chronic length of homeless history, but none of these individuals have their homeless and disability verifications completed.
Individuals - Active – Not Matched
611
This is Enrolled in CAN, Enrolled in TH, and In an Institution
Families – Active – Not Matched
25
This is Enrolled in CAN

SmartSheet Shelter Priority List Data
Individual Men
Individual Women
Families
83 Unsheltered/ In a Car
85 Unsheltered/In a Car
31 Unsheltered/In a Car
117 Total
125 Total
58 Total