Field Notes: Moving to Common Assessment & Coordinated Access

written by naehblog
August 29, 2012

In today’s guest blog Iain De Jong discusses ways communities might begin to plan coordinated assessment processes. De Jong is President & CEO of OrgCode Consulting, an international consulting firm focused on ending homelessness, driving change to promote community prosperity and challenging the status quo.

As regulations change for Continuums of Care (CoC) and Emergency Solution Grant (ESG) recipients through the HEARTH Act, communities need to focus their attention on acting like a system – not a collection of independently operating projects. In a lot of instances, this means that the way which most CoCs and service providers operate must change.

The ESG Regulations, released in December of 2011, include a requirement for communities to develop and implement a centralized assessment system. All ESG recipients are required to participate in the community’s coordinated assessment system to initially assess the needs of each household seeking prevention or homelessness assistance.

The CoC Regulations, released in July of this year, also indicate that a centralized or coordinated process must be implemented to handle program intake, assessment, and referrals. The coordinated assessment process has to cover the CoC’s geographic area; it has to be easily accessible by households seeking housing or services; it has to be well advertised; it has to use a comprehensive and standardized assessment tool; it must respond to local needs and conditions; and, it needs to cover all ESG and CoC programs.

Simply put, coordinated assessment allows for the most efficient use of resources while improving consumer access to housing and supports. Coordinated assessment leverages the strengths of individual service providers. It makes the system much easier to navigate for households experiencing homelessness. And it reinforces the core concept that homelessness programs fundamentally exist to end homelessness.

Depending on your community’s terrain of local providers, geography, and available resources, different models should be considered. For example, if you are a small to mid-sized community that has good public transit, maybe a central location would be a good fit. If your CoC covers a large area or a large city you may consider a computer-based system, or using an existing 2-1-1, or establishing regional hubs throughout the area. Some communities are also using mobile assessment teams, which are in essence a group of specialized intake workers that go to where homeless individuals and families are rather than expecting the individual or family to go to them.

Coordinated assessment is NOT business as usual for most communities. The level of coordination in the referral process and the formal steps to ensure its success removes ad hoc approaches to getting consumers to the right program. Standardized forms and assessment tools used in a community can unsettle some service providers, but at the same time ensure greater consistency in service for people experiencing homelessness. The decision to focus services on the housing needs of specific individuals (rather than the more common program-centric approach) is a sea change in some communities.

For coordinated assessment to work, service providers across the CoC need to be fully aware of the extent of the changes, the regulatory requirements, and what it will mean for them and the people they serve. If there are funding implications related to involvement, these also need to be made transparent.

There are various steps involved in the creation of a coordinated assessment process.

One of the first, fundamental steps is to shift the service mentality amongst service providers in the community. This new arrangement of services can be seen as threatening by service providers – as if their autonomy is being taken away. While a natural reaction, the conversation must be about leveraging the strength(s) of each provider in the CoC. “Embracing the Freak Out” is helpful, and service providers should be encouraged to constructively put their concerns out on the table so each one can be addressed. Some providers will be more vocal than others; others may be passive aggressive. Others still will be encouraged by what the opportunity of common assessment and coordinated access represents, but will remain concerned about how they will keep beds filled or ensure there are a set number of people in programs to make operations viable.

As a part of this first step, education about the possible models, guiding principles, and assessment tools becomes important. Service providers need to understand that no longer will there be “side doors.” Coordinated assessment means people experiencing homelessness are assigned to programs through a collaborative approach, and are not made through individual provider’s decisions. Relinquishing the manner with which people experiencing homelessness access services that end their homelessness is deliberate and demanding.

The next step is to create a complete inventory of services and eligibility criteria. While most communities have this or something in the early stages of it, what is often the case is that what service providers write down on paper and whom they actually serve can be slightly different. Or in other instances, a service provider may consider an exception to their service population in certain circumstances – but the criteria for the exception is not made public. All that services are able to provide and whom they are able to serve must be made completely transparent.

Then, analysis and in-depth consultation can begin on which model would be a good fit for your community. Once a model shows promise it is usually tested in a smaller scale, or by using a beta version of the assessment tool chosen. Given the recent emphasis on ending chronic homelessness as a national priority, the assessment tool chosen is one that should allow for continuity and provide direction to case management services after the initial assessment. The assessment tool must be grounded in evidence and proven to work rather than being an assortment of ideas put together by a group of well-intentioned social workers on the back of a napkin.

Next, the coordinated assessment process the business process is documented, the assessment tool manual is finalized, and the training for providers is conducted. The training is a documented process outlining the rationale and approach from a client, service provider, and system perspective. Film this training, as it can be helpful for ensuring consistency when there is staff turnover.

The journey towards common assessment and coordinated access is not an easy one. But if we truly want to see every community function as a homeless and housing service system rather than a collection of projects, it is absolutely critical.