Coordinated Assessment: The Remedy for a Fractured Service Infrastructure

Coordinated Assessment: The Remedy for a Fractured Service Infrastructure

Coordinated Assessment is the current buzzword of those dedicated to homeless response services. Since the recent release of the 2014 HMIS Data Standards, much conversation, planning, and not to mention angst, has erupted surrounding this new requirement. However, while the implementation of coordinated assessment presents an unprecedented challenge, it will also bring unprecedented benefits.

The U.S. Department of Housing and Urban Development (HUD) set forth the requirement for coordinated assessment to in order to cure a fragmented service infrastructure status quo. The end result of this implementation will be collaborative service networks that efficiently, and precisely, meet the needs of those who are homeless or at risk for homelessness.

In this article, we’ll discuss:

  • What a coordinated assessment system is
  • The structure of a successful coordinated assessment system
  • Key elements of a successful coordinated assessment system

 

What is a Coordinated Assessment System?

Per the HEARTH and associated HUD regulations, a coordinated assessment system must meet the following criteria:

  • Cover the entire continuum of care.
  • Be easily accessible and well advertised.
  • Utilize an assessment tool that is standardized across the whole system.
  • Be attuned to local needs and conditions.
  • Include at least the Continuum of Care and Emergency Solutions Grant programs.

HUD intends for coordinated assessment systems to establish system-wide entry, assessment, and referral processes. More specifically it will improve the following:

  • Service Provision
    • Referral appropriateness
    • Assessment time
    • Assessment consistency
    • Placement time
    • Multi-provider coordination
    • Service access
  • Data Accuracy and Access
    • Individual tracking
    • System monitoring
    • Resource allocation–planning
    • Reporting

 

The Structure of a Successful Coordinated Assessment System

On March 2014, Eric Grumdahl—Policy Director for the U.S. Interagency Council on Homelessness (USICH)—gave a speech, titled “Coordinated Assessment: Putting the Key Pieces in Place,” at a gathering of community stakeholders focused on ending veteran and chronic homelessness.

Grumdahl listed several several critical questions many communities have regarding their plans for coordinated assessment:

  • Is our response reducing how many people experience homelessness?
  • Does our response ensure that scarce resources are used well?
  • Does it contain the right mix of interventions?

He then identified the following key tactics for effective homeless services, many of which the highest-performing communities have already adopted:

  1. Utilization of data to measure system and program performance and inform resource allocation decisions.
  2. Engage and leverage mainstream systems and resources to the fullest extent.
  3. Conduct systematic decisions for resource allocation and investment that extend beyond program-specific allocation. Connect the right individual to the right resources.
  4. Utilization of research-backed practices, such as Housing First practices.
  5. Capitalize on existing resources in order to present clear cases for funding.

 

Key Elements of a Successful Coordinated Assessment System

Communities nationwide are beginning the process of creating coordinated assessment systems. Amidst this bustle of preparation, the central question voiced is a logical one—How do we do it?

In the same presentation mentioned above, Grumdahl and USICH discussed the diagram below.

In this diagram, USICH has outlined the flow of a successful coordinated outreach system. Coordinated assessment is paired with utreach, and both are linked with discharge planning of mainstream systems. Outreach identifies the existence of need, then coordinated assessment further defines this need, and establishes the criteria for service prioritization. In turn, this leads to rapid and targeted connection to the services that are appropriate for the individual or family in need.

The presentation then discussed the five elements of a successful coordinated assessment system. Each are discussed below, and paired with each of these five elements is an explanation of associated benefits that will result from coordinated assessment.

 

Strategy 1: Design Network Structure with a ‘Multi-Door’ Approach

Create a system that accommodates the fact that each person or family will take a unique path to permanent housing.

Benefit: The chronically homeless arrive at many doors when seeking assistance. And they often become lost between the mainstream system (e.g. hospitals, in-house psychiatric centers, etc.) and the homeless response system. Through coordinated assessment, communities will establish the meaningful connections between these disparate systems that lead to swift, efficient, and effective service placement for chronically homeless persons.

 

Strategy 2: Enhance Outreach to Connect with Those In Need

In a coordinated assessment system, effective and assertive outreach will become paramount to successful intervention. Without connection with those in need, service providers cannot determine and carry out targeted intervention services.

Benefit: According to the 2013 Annual Homeless Assessment Report (AHAR) To Congress, 35 percent of the homeless is unsheltered. Coordinated assessment will amplify the beneficial results of outreach measures to the unsheltered homeless population. It will create the type of networked service infrastructure that is currently so desperately lacking.

 

Strategy 3: Create a System Unique to Your Community Context

Configure your HMIS system to generate data that can drive the creation of your coordinated assessment system.

Benefit: Sophisticated HMIS reporting capabilities are required to maintain a coordinated assessment system. With this sophistication will come new capabilities to determine demographic and socioeconomical characteristics, which can in turn inform decision-making and allocation of resources.

 

Strategy 4: Streamlined Service Access and Precise Assessments

Communities must centralize access within your community, coordinate street outreach, and integrate homeless response resources with those of mainstream services. They must also assess the needs of individual and family needs to find the intervention of appropriate size and type.

Benefit: Both the Vulnerability Index (VI) and the Service Prioritization Decision Assistance Tool (SPDAT) are outreach reporting tools that prioritize housing services by assessing the acuity of specified medical and risk factors, respectively. These outreach reporting tools will address problems arising from the common yet faulty ‘first come-first served’ strategy, which has costly consequences – it lumps together the most vulnerable and incapacitated individuals with those in less dire housing situations.

 

Strategy 5: Align Housing Interventions

Coordinate and align prevention, rapid re-housing, affordable housing, and permanent supportive housing.

Benefit: A coordinated assessment system will call for an HMIS system that can generate sophisticated housing reports and needs assessments, which will in turn further delineate housing needs for individuals and families.

 

In Sum…

A coordinated assessment system goes beyond the HMIS, HUD requirements, and data. It is about people. It provides an entire system that is dedicated to enabling the client to interact with service providers to choose interventions that meet their unique needs and achieve their goals. It paves that way for even those that are most in need to reach self-sufficiency and holistic well-being.

Hence communities should look beyond the overbearing challenges of meeting the October 2014 implementation date, to recognize the substantial opportunity brought upon us by this new requirement.

“Coordinated assessment puts people—not programs and not tools—at the center of offering the interventions that work best.”