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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 system
  • 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
  • 8. Background
    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.
  • 9. Goals
    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
    Income
    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
    Debt/Expenses
    Legal (5 year felony history & 10 year incarceration history)
    Physical & Behavioral Health with disability documentation and substance use frequency; includes questions from Vulnerability Index
    Family/Dependent Children
    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 Housing
    Programmatic Shelter
    Transitional Housing
    Permanent Supportive Housing
    Safe Haven
  • 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
  • 20. Policies
    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
  • 22. Accomplishments
    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.
  • 25. Data
    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
    System staff
    HMIS programming staff
    Provider involvement
    Meetings, staff training
    Front Door assessment agencies spend more time on assessment, HMIS and referrals
  • 28. Process and Products
    Front Door Committee
    Monthly meetings
    Provider forums
    Development of forms, manuals, reports
    Very intensive HMIS work
    Assessment in HMIS
    Programming reports
    Case conferences
    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
    937-225-4218
    macalpinej@mcohio.org