1. Coordinated Access & Assessment: Pre-Screen Training
September 24, 2014
Thank everyone for joining us today. We are really excited to have so much expertise in the room representing the entire sector.

2. Assumptions & Managing Expectations
Mistakes are Inventible
Need to adjust course along the way
Will need to tweak policy & process
Need Exceeds Resources
Lack of Housing
Lack of Program Spaces
Assumptions/Constraints:
Need Exceeds Resources – will not solve the bottleneck issue but it will help to manage waitlists, triage as best we can, identify gaps, information to advocated for more funding

3. What is Coordinated Access?
Single place or process for people to access housing services.
Information
Screening
Assessment
Referral
Information about programs and agencies that can provide needed housing or services;
• Screening and assessment process. Tools to gather and verify information about the person and his/her housing
and service needs and program eligibility and priority;
• A process and tools for referral of the person to appropriate programs or agencies; and
• In some cases, a process and tools for making program admissions decisions. An intake process could start with coordinated intake

4. Guiding Principles CAA is about building change in your community
Working to create an efficient system
Prioritize enrollment based on client need
Transparent and consistent
Client-focused approach to designing navigation processes
Housing First approach
Leverage HMIS – use of “real time” data
Supportive – work for broad-based consensus

5. Benefits Clients Service Providers Funders
Simplify & speed up the process to locate and access services
Appropriate referrals = less frustration & better service
Save time and resources
Appropriate referral stream
Begin documentation process – intake paperwork, consents, HMIS
Save time and resources allowing staff to focus on housing and case management
Interagency collaboration & coordination
Decrease the need for marketing at the agency level
Improved speed, accuracy and consistency in screening & referral process
Makes it easier to target resources efficiently and accurately
Supports Systems Planning Framework, HMIS and enhanced data
Clients: Everyone agrees housing is a basic right and we should be creating a system that fosters minimal barriers to that basic human right. In our current system, people have to shop around to find the right program. For those experiencing homelessness, this type of system compounds on the stress they are already facing.
A coordinated process will improve access to housing by simplifying the process. They will only be referred to programs they are eligible for and time and resources will be saved for everyone.
Service Providers:
Won’t have to deal with all those folks that are not eligible for your program. This is a huge benefit – we know it is very difficult for our front line staff to turn people away. For some it is nearly impossible. A coordinated intake takes the pressure off of front line staff to say no. Only appropriate referrals will be provided and only when there is space available.
Another common frustration from service providers is too much paperwork! Centralized intake could help reduce some of the initial paperwork. Information gathering could be started and passed on when the referral was made. This also helps the client – in our current system, they have to complete paperwork at each agency they are seeking services from.
A coordinated intake will continue to enhance the interagency collaboration and coordination that already in exists in Calgary and open doors for new partnerships.
Marketing – one of the benefits we saw from coordinated intake was the decreased need to educate the community on “what we do”. For example, do you ever get phones saying, “I heard you have damage deposits” or “I heard you have free housing”. There is a constant battle to educate the public and other agencies on what you r program is for. Any time the phone rings you can defelct the call to coordinated intake and they can answer those questions.
Funders:
Once again – the governing bodies are pleased to see resources being used efficiently.
Supports the 10 year plan and systems framework
Lastly – in our current system there is so much information we do not have about those folks that are not able to access services. It is difficult to identify service gaps without this data.

6. Housing First Programs
Homeless Population – Not Homogeneous – All Prevention options already exhausted
“Funnel” Of Homeless Services
Intake & Assessment – Acuity Determined
Permanent Supportive Housing Programs
Housing First Programs
Rapid Re-housing

7. Role & Responsibilities of the CAA Team
Assessment Tool
CAA Team Distress Centre/Wood’s
1 Coordinator
5 CAA Workers
1 Family
1 Youth
3 Singles
Located at SORCe
Can be mobile
Door Agencies – CHF Funded
Alpha
K2R
Mustard Seed
McMan
BGCC
IFTC
Dream Centre
Alex
CJHS
Aspen
AFCC
These two groups will come together and work in a coordinated way as one CAA Team serving the homeless serving sector as a whole and not individual agencies.
November 8, 2018

8. Prevention/Diversion
ACCESS
ASSESS
ASSIGN
ACCOUNT
Pre-Screen
SPDAT
SCORCe
SCS
SCS
Placement Committee
211
Prevention/Diversion
Client
Case Management
SCS
DOOR
Agency
Warm Transfer
SCS
SCS
Mobile Teams
Full SPDAT
ROI + HMIS Begins

9. SPDAT Assessment Tool
Service Prioritization Decision Assistance Tool (SPDAT)
Self Care & Daily Living
Meaningful Daily Activity
Social Relationships & Networks
Mental Health & Wellness
Physical Health & Wellness
Substance Use
Medication Personal
Administration/Money Management
Abuse & Trauma
Risk of Personal Harm/Harm to Others
Interaction with Emergency Services
Involvement in High Risk/Explosive Situations
Legal
History of Homelessness & Housing
Managing Tenancy
Self Care & Daily Living Skills Meaningful Daily Activity Social Relationships & Networks Mental Health & Wellness Physical Health & Wellness Substance Use Medication Personal Administration/Money Management Personal Responsibility & Motivation Risk of Personal Harm/Harm to Others Interaction with Emergency Services Involvement in High Risk/Explosive Situations Legal History of Homelessness & Housing Managing Tenancy
Service Prioritization Decision Assistance Tool (SPDAT) - used with over 10,000 unique individuals in over 100 communities across North America and in select locations around the world.
Originally designed as a tool to help prioritize housing services for homeless individuals based upon their acuity, the SPDAT has been successfully adapted to other fields of practice, including: discharge planning from hospitals, work with youth, survivors of domestic violence, health research, planning supports for consumer survivors of psychiatric care systems, and in work supporting people with fetal alcohol spectrum disorders. We are encouraged that so many service providers and communities are expanding the use of this tool, and OrgCode will continue to support the innovative use of the SPDAT to meet local needs.
November 8, 2018

10. Additional Functions Placement Committee Review SPDATs
Review Client Lists
Assign to Open Spaces based on Shelter Point Numbers
Placement Committee
Youth/Singles/Families
PARC is a model used by Children’s Services that utilizes expertise from a wide variety of service providers and professionals. They meet weekly to discuss housing placements for the most vulnerable and high needs clients in the system. This is a terrific practice that is greatly needed. Coordinated intake can work with this already existing system to further enhance and support it. There is opportunity for this group, along side coordinated intake to expand towards other populations such as youth or those being discharged from institutions. Moreover, Centralized intake can help facilitate transfers between programs to support our system of care.
November 8, 2018

11. Placement Committees YOUTH FAMILY SINGLES
Those in Attendance: Chair (CHF), Co-Chair (CAA Lead), Agency Representative that can accept referrals and if asked the individual completing the SPDAT to be presented)
YOUTH
Weekly Meetings – need to finalize day and time
Complete Terms of Reference
Review all SPDATS Completed that week through SORCe & Door Agencies
FAMILY
Suggested time is Tuesday mornings
Rotating locations
Aspen, IFTC, Children’s Cottage
SINGLES
Need to arrange day & time
High Acuity Programs including but not limited to Alpha PSH, Mustard Seed ARCH, Pathways, Homebase, CJHS Adult Reintegration, Drop-In HIS
SPDAT scores above 45
Mid-Acuity Programs including but not limited to Dream Centre, Aftercare, CUPS, Alpha HIS
SPDAT scores below 45 – no less than 40
November 8, 2018

12. SPDAT PRE SCREEN

13. SPDAT is built on 4 key domains
Risks
Wellness
Socialization & Daily Functioning
History of Homelessness
November 8, 2018

14. SPDAT is built on four key domains
The pre-screen determines if there is an issue; SPDAT determines the acuity and nature of the issue
The Pre-Screen covers the 4 domains in quick yes or no questions and takes about 15 to 20 minutes.
The FSPADT uses 20 components to cover the 5 domains and take about 1.5 to 2 hours. The extra domain is “Family Unit”.
The SPDAT uses 15 components to cover the 4 domains and take about 1.5 to 2 hours.
The pre screen determines if there is an issue – SPDAT determines the acuity and nature of the issue
SPDAT uses 15 categories to cover the four domains
- takes about 1 to 1.5 hours to complete
F – SPDAT (Family SPDAT) uses 20 categories to cover the four domains PLUS an the additional domain of
Family Unit - takes about 1.5 to 2 hours to complete
Pre screen covers the same key domains in only broad terms and takes about minutes to complete. (stick to yes and no answers – spdat collects the details)

15. Why complete the SPDAT Pre-Screen ?
#1. To determine if a client is a good candidate to complete a full SPDAT (triage)
#2. To assist the SPDAT process
Minimum score of 38 to be placed on singles triage = minimum of 9 on Pre Screen
Minimum score of 50 to be placed on family triage = minimum of 13 on F Pre Screen
SPDAT is detailed and personal (can have triggers) – it is not fair to complete a SPDAT with a person unless they have a chance of being matched to a program.
Responsible use of Mobile SPDAT staff time – complete one SPDAT plus travel and administration time takes approximately four hours.

16. How do I complete & score the Pre-Screen ?
Yes or No Answers
Anyone can do – just follow the instructions!
Read through the entire tool & instructions BEFORE completing with client
Pre-Screen
Detailed & Intrusive
Must have a certified SPDAT assessor complete
Approximately 15 in Calgary
SPDAT
Pre screen is an over view and only requires yes and no answers.
- SPDAT is much more detailed and will expand on the pre screen
Follow the pre screen tool and score according to the instructions in each section and then tally them up.
- even if enough is answered to get the maximum score in an
area continue to ask the intake questions as it provides valuable
information if it does proceed to a full SPDAT

17. Page #1 - General Information
November 8, 2018

18. Page #1 History of Housing & Homelessness
ADULTS: If no history of shelter use or rough sleeping they will be diverted.
Page #1 History of Housing & Homelessness
08/11/2018

19. Page #2 - Risks
SCRIPT: I am going to ask you some questions about your interactions with health and emergency services. If you need any help figuring out when six months ago was, just let me know.
08/11/2018

20. Page #2 - Risks
08/11/2018

21. Page #2 - Risks
08/11/2018

22. Page #3 Socialization & Daily Functioning
08/11/2018

23. Page #4 - Wellness
08/11/2018

24. Page #4 - Wellness
08/11/2018

25. Page #4 & #5 - Wellness
Continue on Page #5
08/11/2018

26. Page #5 - Wellness
08/11/2018

27. Page #5 - Wellness
08/11/2018

28. Page #5 Scoring

29. FSPDAT Pre-Screen
We did not include the FSPDAT Pre-Screen in today’s training however we will cover some of the larger themes.
If you will be using the FSPDAT please contact Natalie or Cathy and they will assist you further.

30. FSPDAT Pre-Screen The first 4 domains are the same as the singles
All questions are asked from the perspective of the family unit (any member in the family could be presenting with the issue
The FSPDAT Pre-Screen has a fifth domain of “Family Unit”
The family must score a 13 or higher to be eligible for a housing program
Family SPDAT Pre Screen The first four domains cover the same questions but are asked from the perspective of the family unit. F SPDAT Pre screen also includes the Family Unit domain. Total all 5 domains together – if 13 or higher refer for an F SPDAT

31. FSPDAT Pre-Screen – Examples Questions
Do any children 10 years of age or younger spend two or more hours on a typical day when they are home, but don’t see their parents?
Are there any children over the age of 10 that help out with things like picking up younger children from school or daycare, helping younger children with homework, preparing meals for younger children, helping younger children bathe, and/or putting younger children to bed on most days?
What is the total number of times the adults with the family have changed over the past year – including grandparents, aunts, uncles, friends, romantic partners, spouse, etc.?
What is the total number of times all children have left or returned to the family in the past year?
08/11/2018

32. Process for Pre-Screen
Step #1
Complete ROI & ensure you are on it!
Step #2
Complete Pre-Screen
Step #3
Score 9+ go to SORCe or to book an appointment
If the demand for SPDATs reaches a critical mass you will receive an automatic reply indicating wait times. The need far exceeds available program placements.

33. CAA & Agency Partnerships
If your organization regularly works with chronically homeless individuals it may worth setting up a standardized process for referrals
Allocated SPDAT times weekly or bi-weekly
One point of contact
Regular review & data collection
Natalie

34. Protect Client Privacy
Follow own agency protocol
Password protect
Double check address
Make sure the client is consenting to share information
Send password in separate
Go over the ROI form with the client
November 8, 2018

35. Walk through the Website
(to access forms & info)