2.10 Joyce Probst Alpine
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- 1. Dayton-Montgomery CountyFront Door Assessment
National Alliance to End Homelessness
First Contact: Creating a Front Door to Your Homelessness System
July 13, 2011
2. Moving from a program centered system to a client centered
3. Front Door Assessment Overview
A consistent assessment tool and scoring process to determine appropriate exit from homelessness, administered at all the front doors to the homeless system.
Policies related to program and client acceptance expectations.
4. Homeless System in Dayton-Montgomery County
5. Dayton-Montgomery County CoC
Homeless Solutions Community 10 Year Plan: A Blueprint for Ending Chronic Homelessness and Reducing Overall Homelessness in Dayton and Montgomery County, OH adopted in June 2006
Received $7.2 million in 2010 CoC funding from HUD
965 homeless people in 2011 Point in Time Count
6. 7. Development of the Front Door Assessment
System defined by program eligibility and intake decisions made by individual programs.
Shelter case managers to submit applications for every possible program person could be eligible for.
Lack of data on client need to make system planning decisions.
Rapidly exit people from homelessness to stable housing.
Efficient and effective use of system resources clients receive appropriate services.
Ensure that all clients, including the hardest to serve, are served.
Transparency and accountability throughout the assessment and referral process.
10. FDA Development Background
10 Year Plan finding that some homeless people were never successfully engaged by the existing system and that the system was hard to navigate.
2007-2009 Initial Front Door Committees meetings
Review assessment tools from other communities
Develop assessment structure (independent organization vs. existing providers)
Identify provider concerns (oversight of assessors to ensure objectivity and fairness)
Interim implementation of assessment in family system because of temporary closure of a shelter program
Secured funding and developed RFP for Front Door consultants
Requirement to participate in Front Door Assessment once it started in RFPs for local and CoC funding for last 2-3 years.
11. FDA Development
Jan 1st Aug 1st 2010 The Front Door Committee and Consultants:
Conducted client focus groups on current system and provider interviews and meetings by program type
Defined each program type in system clients served, length of stay, program & system outcomes (using HEARTH), positive exit destinations
Developed assessment tool, scoring matrix, referral process and timelines
Developed policies related to FDA implementation PSH priorities
Programmed FDA into HMIS
12. FDA Development (cont.)
Trained assessors on FDA
Trained providers on receiving FDA referrals
Developed FDA reports
Provider input through meetings and calls at every step of the process. Substantial changes made to every FDA component as a result of this input.
Initially expected July 1st implementation but significant provider concerns in June delayed implementation for a month.
13. Provider FDA Concerns
No provider refused to participate in FDA. The concerns expressed before implementation included:
Developed program over long period including entry screening criteria of time to ensure serving right clients
Currently receiving referrals from other sources
Lack of PSH and affordable housing made outcomes hard to achieve
Need more than 7 days to decide if they will take a referral
Requirement to take 1 in 2 referrals too limited, may need to reject several consecutive referrals
Takes operational control over who they serve from the agency, agency needs ultimate control over who is housed and evicted
Proposed process is too bureaucratic
Assessment tool does not adequately assess mental health or predict client behavior
Requiring reviews of self-referrals will delay clients receiving services
14. Response to Provider Concerns
Delayed implementation by 1 month to discuss concerns and conduct additional training.
Changed rejection policy to 1 in 4 referrals instead of 1 in 2.
Agreed to Six Month Review to assess FDA implementation impact.
15. Intake Assessment
Initial questions What led you to come here? What do you need right now? What is your plan for leaving shelter?
HUD required data elements with additional housing questions focused on whether household can be diverted from shelter
Clients support network/Independent living
Questions related to leaving shelter legal issues, pregnancy, IDs, school location for children, homeless history
Rick Assessment sex offender status, mental health, medications
Diversion Plan developed if appropriate
16. Comprehensive Assessment
Five year housing history
Five year employment history
Income - Benefits & Entitlements
Legal (5 year felony history & 10 year incarceration history)
Physical & Behavioral Health with disability documentation and substance use frequency; includes questions from Vulnerability Index
Independent Living Skills assessment
17. Housing Barrier Screen
Elements from all eight Comprehensive Assessment domains total of 59 questions
Scored differently for different populations (youth, families, singles)
Barriers scored as Low, Medium, High
18. Referral Decision Worksheet
Assessment filters applied:
Income, independent living skills checklist score, Housing Barriers score, disability status, recovery status, life transition issue, placement considerations (ie. sex offender, veteran, accessible unit, school district)
Referred to Rapid Rehousing if client has regular income or recent work history
If not Rapid Rehousing then scored for:
Permanent Supportive Housing
19. Assessment & Referral Process
Assessment- conducted at all Front Doors
Intake goal is diversion, done within first 3 days (one-third of shelter clients stay 7 nights or less)
Comprehensive assessment done within first 7-14 days
Referral decision worksheet to identify most appropriate program type to help client move to permanent housing.
All eligibility criteria set by funding sources must be complied with
Programs must remove additional barriers to entry
Priority for PSH openings for long-stayers, elderly and medically fragile
Process to refer appropriate client to specific program when opening occurs.
Done by system staff for transitional housing, PSH and Safe Haven
Planned to be in HMIS but providers can not see referrals because HMIS is closed
Require that programs accept 1 in 4 referrals.
Eliminate all program entrance requirements except those required by funding (i.e. no drug testing).
All program vacancies must be filled through the Front Door process close the side doors.
Development of program and system performance outcomes based on HEARTH.
21. FRONT DOOR ACCOMPLISHMENTS AND SIX MONTH REVIEW FINDINGS
Closed side doors into CoC programs so all homeless system resources used for people in shelter or on the street.
31 of 57 long-stayers (more than 200 nights of homelessness in 2010) housed.
Established policies about expectations for people in shelter:
use income for housing
expected to accept first appropriate referral
Have client-centered data for HEARTH planning.
23. Six Month Review Findings
HMIS functionality and reporting issues limited data collection and management capacity.
Assessment process implementation not always followed consistently. Additional definitions for client history needed.
Front Door Assessment policies not uniformly adopted by all providers.
24. Six Month Review Findings (cont.)
Improvement in tracking, management and reporting of Front Door Assessment processes needed.
Front Door Assessment implementation identified gaps and deficiencies in program approaches and operations across the homeless system.
Open HMIS so all providers can see all data for all clients increase coordination.
In first 6 months 1,051 assessments conducted
32% scored for Permanent Supportive Housing
4% scored for Safe Haven
24% scored for Rapid Rehousing or Permanent Housing
39% scored for Transitional Housing or Programmatic Shelter
63% of the households scored on the Front Door Assessment are not disabled enough to need PSH or Safe Haven. Need efficient and effective way to get them employed and into affordable housing with appropriate supports.
26. FRONT DOOR IMPLEMENTATION CONSIDERATIONS
27. Resource Commitments
Consultants $200,000 over 2 years
HMIS programming staff
Meetings, staff training
Front Door assessment agencies spend more time on assessment, HMIS and referrals
28. Process and Products
Front Door Committee
Development of forms, manuals, reports
Very intensive HMIS work
Assessment in HMIS
Process and referral reviews, esp. PSH referrals
29. Next Steps for Your Community
Look at data
How long are people in shelter? Who are your long-stayers?
Where do they go?
Do your housing programs take all their clients from shelter or streets?
Look at program entry process and criteria
Who is not being served?
Start talking about who each program type in your system should be serving and how your system ensures that everyone is served
30. Joyce ProbstMacAlpine
Manager of Housing & Homeless Solutions
Montgomery County, Ohio