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HomeMy WebLinkAboutFMCoC Draft Prevention and Diversion Policies (7-15-2020) (1) (2)The FMCoC CES Policies and Procedures is a living document and subject to change. It will be reviewed and updated as needed, following best practices and FMCoC approval. (Draft) Prevention and Diversion Policies Fresno-Madera Continuum of Care OVERVIEW These policies are intended for possible insertion into the existing FMCoC Coordinated Entry Policies and Procedures. If adopted, this document would replace the sections titled “Access” and “Diversion” in the October 2019 version of the policies. SERVICE DEFINITIONS PREVENTION Prevention refers to all services meant to assist people who are currently housed, but who are likely to lose their housing in the near future. The goal of prevention is to help people stay in their homes or locate alternate housing so that they never become homeless. Typical prevention services include payment of rental arrears, mediation, and tenant legal services. DIVERSION Diversion refers to all services meant to assist people who are currently seeking shelter, i.e., people who have lost access to their previous housing, but who have not yet spent a full night on the streets or in a formal emergency shelter. The goal of diversion is to help people resolve their ongoing housing crisis with little or no use of the emergency shelter system. Typical diversion services include collaborative problem-solving, vehicle repair, transportation assistance, and payment of a security deposit. RAPID EXIT Rapid exit refers to all services meant to assist people who have moved to an emergency shelter within the last 30 days. The goal of rapid exit is to help people quickly return to permanent housing with only a modest use of resources specific to the homeless system of care. Typical rapid exit services include housing-focused case management and limited short- term financial assistance. INTENSIVE SUPPORT Intensive support refers to all services meant to assist people who have been experiencing homelessness for more than 30 days. The goal of intensive support is to improve physical, behavioral, and financial health, to assist people experiencing homelessness in finding suitable housing, and then to help those people stabilize in their new housing so that they will not return to homelessness. Typical intensive support services include Transitional Housing, Rapid Re-Housing, and Permanent Supportive Housing. PROBLEM-SOLVING APPROACH A problem-solving approach refers to all services that are meant to help clients identify how they can use the resources they already have to secure housing, either by themselves, or in conjunction with limited one-time financial support. A problem-solving approach could be included as part of prevention, diversion, or rapid exit: the focus is on the style of case management, not on the time at which the services are delivered. EMERGENCY SHELTER Emergency shelter refers to indoor structures equipped with indoor utilities that can rapidly accommodate people experiencing homelessness without the need for a lease or the agreement of individual landlords. Emergency shelters are intended to provide a safe place for people experiencing homelessness to come in off of the street and access services that will help connect them to housing, including rapid exit services. BRIDGE HOUSING Bridge housing is a sub-type of emergency shelter that is reserved for people who have already been matched with a specific permanent housing placement. The goal of bridge housing is to support the well-being of people experiencing homelessness and give them a safe and easily accessible place to wait until the housing opportunity they have been matched with becomes available. If the housing opportunity comes in the form of a rental assistance voucher, then clients in bridge housing will normally receive housing case management assistance intended to help them utilize that voucher. STREET OUTREACH All other types of services for the benefit of people experiencing homelessness are considered street outreach, including services that are provided in tiny homes with outdoor utilities, utility sheds, legal encampments, daytime-only drop-in centers, and other accommodations that do not allow clients to spend the night in an indoor environment with running water, sewage, heat, and electricity. ACCESS SITES Access to the Fresno-Madera Coordinated Entry System (CES) needs to balance two goals: 1. Client access should be easy, fast, and immediately useful. 2. Clients with similar needs should receive similar care regardless of where or how they first access the system. Accomplishing both of these goals in the context of a CES that is still growing and evolving requires careful design. In particular, it is important to make sure that all access sites are fully prepared to screen and refer clients for the full range of services available in the community. Therefore, in order to be considered a formal access site, a program must be capable of performing all of the following tasks: • Sign the Coordinated Entry Participation Agreement • Screen clients to determine if they currently have symptoms of COVID-19 • Screen clients to determine if they are currently fleeing domestic violence • Enter case management notes and Coordinated Entry Data Elements into HMIS • Provide initial case management services using a problem-solving approach, or make a warm hand-off to an agency that can provide these services • Participate in trainings on how to ensure trauma-informed care, and carry out appropriate safety planning to protect clients who are fleeing domestic violence. • Administer the VI-SPDAT for clients who cannot be successfully diverted • Receive approval from the FMCoC Coordinated Entry System Committee If a program can perform all of these tasks, then it can be a formal access site, regardless of its format. For example, permanent housing programs, emergency shelters, street outreach teams, and telephone hotlines can all serve as access sites. Physical access sites should be located near public transportation and near known homeless populations. All access sites should be handicap-accessible. In general, all access sites should serve all homeless populations. The CoC may designate specific access sites for adults with children, adults without children, unaccompanied youth, households fleeing domestic violence, persons at imminent risk of literal homelessness, and/or veterans. Programs that are only able to perform some of the tasks listed in the bullets above may still be welcomed as supporting partners of the Coordinated Entry System, but will not be considered formal access sites. INTAKE PROCEDURE Clients should only enter the Coordinated Entry System through formal access sites that meet the criteria described in the section above. If a client presents seeking services at another site, then that site should provide a warm handoff to the nearest available formal access site. Once a client arrives at a formal access site, the client should be: informed of the CES Rights & Responsibilities, asked to sign a Release of Information form, and asked to complete all of the “pre-screening” tools, including the COVID-19 screening tool, the Diversion & Homelessness Prevention Screening Tool, and the Domestic Violence Survivor screening tool. Based on the results of these pre-screening tools, the access site will take one or more of the following courses of action: 1. Refer the client for emergency services, potentially including 911, based on active severe symptoms of COVID-19 or another health emergency. The Public Health Department should be promptly informed of all contact with contagious diseases. 2. Refer the client for services tailored for survivors of domestic violence and assist the client in making and following an appropriate safety plan until a DV provider is able to provide assistance. 3. Work with the client through a problem-solving approach to see if the client can benefit from prevention, diversion, or rapid exit. 4. If the client appears to be literally homeless, and cannot be successfully diverted, administer the VI-SPDAT. 5. If the client appears to be literally homeless and no viable safe housing solution can be promptly identified, attempt to connect the client to emergency shelter. 6. Record all results in HMIS. 7. If the client is being considered for permanent housing, then submit completed screening tools to the Housing Matcher within 72 hours of encountering the client. The Housing Matcher is the person responsible for processing match forms that have been submitted to HMIS and initiating appropriate referrals for PSH and RRH. 8. If the client is being discharged from a hospital or other healthcare setting, attempt to communicate with the client’s primary health care provider (with the client’s consent) to update the health care provider on the client’s new location and any expected urgent medical needs (e.g. delivery of medication, follow-up wound care, etc.). PRIORITIZATION OF EMERGENCY SERVICES Emergency shelter beds are most appropriate for clients who have been contacted by a street outreach team, who need additional resources in order to continue to engage with supportive services, or who face high barriers to housing that could interfere with their ability to find alternate housing or shelter. Emergency shelter beds are least appropriate for clients who have independently arrived at an intake site and who may have some capacity to secure housing or shelter outside of the homeless system of care. To balance the need for emergency access to beds with the priorities described above, emergency shelters are encouraged (but not required) to seek out referrals from the Coordinated Entry System when they have an opening, and to hold those beds open for up to 48 hours while case managers attempt to locate a high-priority client and invite them to accept the shelter bed. The Coordinated Entry System should use multiple means to contact the household being offered the bed, including e-mail, multiple calls, voice mail, and in-person searches of areas (if any) where the client is known to frequently spend time. If the client cannot be located within 48 hours or does not promptly accept the bed after making actual contact with the Coordinated Entry System, then the bed can be released for a different client. Likewise, if more than 20% of the shelter’s beds are currently open, then the shelter may place new clients without waiting for high-priority clients until the fraction of available beds at that shelter drops below 20%. Some shelter beds are reserved as bridge housing, meaning that they are designated as places where people can safely wait for a particular housing opportunity to become available. For example, a homeless client who has secured a lease on an apartment that does not begin for another week would be eligible for bridge housing. Operators of bridge housing may not allow their beds to be used by the general homeless population in ways that could endanger their ability to accommodate a client in need of bridge housing. Bridge housing serves a vital role in maintaining the stability and reliability of permanent housing placements. In addition, some shelter beds are reserved as quarantine or isolation housing, meaning that they are intended for people who are symptomatic, testing positive, high-risk, or otherwise exposed to COVID-19. These beds cannot be used without appropriate screening procedures to ensure that the client actually meets the relevant medical and/or public health criteria. It is an urgent public health priority and a top priority for the Coordinated Entry System to direct all high-risk persons to non-congregate shelter, or, if no non-congregate shelter is available, to the most secure facility that can be provided to minimize the spread of COVID-19. Except as described above, all other emergency services will be provided on a first-come, first- served basis for all those who qualify and are in need. Fresno Madera Continuum of Care Access Sites: MAP Point 559-512-6777 ext. 1 M – F, 8 am – 5 pm; Sa/Su 8 am – 12 pm Naomi’s House 559-443-1531 24/7; focus on DV survivors Golden State Triage 559-442-8075 M – F, 8 am – 3 pm The Welcome Center 559-334-6402 M – F, 9 am – 2 pm Madera Rescue Mission 559-675-8321 Varies PROBLEM-SOLVING APPROACH A problem-solving approach reduces homelessness by helping people identify immediate alternate housing arrangements and, if necessary, connecting them with services to help them secure, maintain, or return to permanent housing. A problem-solving approach is focused on helping households move past the immediate barriers they face in obtaining safe housing. Problem-solving approaches are most commonly associated with diversion, but they are also important for homeless prevention and for rapid exit services. The Fresno Madera Continuum of Care will practice this problem-solving approach at system entry and throughout the entire CES process. The problem-solving approach is pursued as a potential solution for households to become housed safely and quickly, without requiring more intensive services. If no realistic options for housing emerge through the problem-solving conversation, households continue with the Coordinated Entry System and are assessed and prioritized for deeper housing interventions. The goal is to create an environment where self-resolution is normalized and expected rather than the exception. The problem-solving approach includes, but is not limited to: 1. Empowering individuals/households to identify possible housing solutions based on their own resources, such as: a. Permanent housing on their own b. Viable, safe, permanent shared housing with family and/or friends c. Viable, safe shared housing with family and/or friends, with a plan for permanency 2. Referring clients to mainstream resources; 3. Providing the minimum assistance necessary for the shortest time possible; 4. Connecting clients to emergency shelter services; or 5. In rare cases, immediately conducting a Vulnerability Assessment (VI-SPDAT). UTILIZING PROBLEM-SOLVING STRATEGIES Who: At minimum, all FMCoC Access site staff, including but not limited to street outreach, MAP navigators, and shelter staff. Staff trained in the skills of diversion will support households through focused problem-solving. They will deliver expertise, encouragement, and a flexible combination of short-term services. What: A variety of short-term services, which can include: • Generating housing leads for households, often by leveraging existing relationships they have with landlords. • Mediating conflicts between households and landlords, relatives or friends who may be able to offer housing. • Connecting households to other community resources. When: Begins as a first step to anyone trying to connect to Coordinated Entry System and continues throughout the entire process. Where: All FMCoC-approved Access and Assessment sites including street outreach, MAP Points, shelters, etc. STEP ONE: EXPLAIN THE DIVERSION CONVERSATION. Sample Script: “Our goal is to learn more about your specific housing situation right now. Together we can identify the best possible way to get you a place to stay tonight and find safe, permanent housing as quickly as possible. That might mean staying in shelter tonight, but we want to avoid that that if at all possible. We will work with you to find a more stable alternative if we can.” STEP TWO: SCREEN FOR SAFETY. If the client indicated that the place where they stayed is unsafe, ask why it is unsafe. (If fleeing domestic violence, refer them to law enforcement and/or the appropriate local domestic violence provider. For Fresno County, call Marjaree Mason Center at (559) 233-4357. For Madera County, call 1 (800) 355-8989. STEP THREE: ENTER A DIVERSION & PREVENTION CASE NOTE A. Submit a case note in HMIS within 72 hours of the initial intake. B. If the client is eligible for specific Homelessness Prevention resources, then the client should be connected with those resources within 1 week of the initial intake. Access sites may seek assistance from the Housing Matcher if they need help identifying specific prevention resources for a particular client. STEP FOUR: HOUSING PLANNING Households that are unable to identify realistic options for housing through Diversion are assessed and prioritized for deeper housing interventions such as Rapid Re-Housing and Permanent Supportive Housing. This will require completing a Homeless Verification Form (if the intake site has access to the client’s history) or a Request for Homeless Verification (if the client’s case notes are being kept with another provider). Either way, the form must be completed and submitted to the Community Coordinator. TRAINING The Coordinated Entry System Committee will develop and conduct training on diversion as a part of the CES training protocol. Training materials from OrgCode Consulting, Inc., as well as other best practice models will be utilized. The training curriculum will focus on techniques of effective communications and conflict mediation. Training will also incorporate time to practice the problem-solving curriculum that was taught by OrgCode, using scenarios so that attendees can give examples of how they would solve common problems. Staff will be trained to guide the diversion process forward while always letting the households take charge in finding a housing solution. All Access staff will also receive training on Coordinated Entry. Training ensures that policies and procedures are fairly and consistently applied and high-quality services are delivered to households seeking homelessness assistance from access sites. Training opportunities are provided at least once annually to organizations and staff that serve as FMCoC-approved access sites. Training provides access site staff with clear direction on how screenings are to be conducted in-line the Coordinated Entry written policies and procedures, to ensure uniform decision-making and referrals.