1. 2:12 Envisioning an Effective Systemic Response to Rural Homelessness
Carrie Poser – CoC Director, WI Balance of State CoC
July 2018

2. CoC Basics
Balance of State is a 501c3 non-profit organization that covers all of Wisconsin except Dane, Milwaukee, & Racine counties. There are 21 “members” or local homeless coalitions, a volunteer Board of Directors, and 3 paid staff.
Share a state-wide HMIS system, HMIS lead, & governance
The geography includes:
A population of approximately 3.8 million people
Covers over 62,000 square miles
Takes approximately 6 hours to travel north to south, 4 hours to travel east to west
Bordered by the Mississippi River, Lake Superior, and Lake Michigan
69 different counties, 15 consolidated plan jurisdictions, 11 Native American tribes
With the largest county being Waukesha (396,488) and the largest city being Green Bay (105,207)

4. Funding The total CoC FY2017 = $9,014,902
40% PSH, 28% RRH, 19% TH
HMIS $371,429 (ICA)
The BOS receives two direct HUD awards: CoC planning ($275,671) & SSO-CE ($404,506).
The total EHH (ESG + 2 state pots of funding) FY2018 from State of WI = $3,657,448.
Support 20 lead agencies (including the BOS) & 58 sub-recipient organizations
Services include: emergency shelter, rapid re-housing, prevention, HMIS & outreach
For Veterans:
There are 5 different VAMCs with 10 housing authorities and one Tribal Housing Authority administering HUD-VASH Vouchers (343 vouchers).
There are 3 different non-profits administering Supportive Services for Veteran Families (SSVF) funds across the Balance of State ($3,192,107)*. *This numbers includes some funding for Milwaukee and Racine.

5. Data
During the Jan PIT count, there were 4,907 people experiencing homelessness on 1 night in Wisconsin.
Balance of State makes up 64% of State total
BOS Total = 3, *decrease from 2017 (3348) & 2016 (3445)
52% in households with children
48% in households without children
BOS Veterans = *decrease from 2017 (180) & 2016 (236)
BOS Chronic = *increase from 2017 (232) & 2016 (187)
BOS Unsheltered = *decrease from 2017 (137) & 2016 (132)
ICA created an interactive graphic to illustrate local system performance measure impact.

6. Coordinated Entry CoC-wide system based on no wrong door.
20 coalitions with a Local CE lead and Non-HMIS list holder
Each coalition has 4 lists: HMIS - HH with kids, HMIS - HH w/out kids, HMIS - prevention, & Non-HMIS.
Approved 2.0 Manual and order of priority across CoC
Realistic look at need at the Balance of State level and the local coalition level
Increase PSH units and/or enhance moving up strategies to free up units
HH w/out children ( = 545) HH w/children (85) Total = 630 units
Increase RRH units with intensive case management (similar to PSH level if needed)
HH w/out children (720) HH w/children (268) Total = 988 units
Focus other RRH units on lower barrier (less than 12 mo of homeless, no disability)
HH w/out children (332) HH w/children (197) Total = 529 units

7. BACK POCKET STUFF: Coordinated Entry

8. Coordinated Entry Committee
Where to begin?
Created to develop the coordinated entry policy & system for the Balance of State
Spent 1 year reviewing, talking, researching, and discussing
Split off a group to work specifically on written standards for PSH, TH, and RRH
Once the standards were passed by the membership, the system became easier to manage.
HMIS Lead heavily involved in entire process
Committee Members were a diverse group that included:
Housing providers – DV and non-DV
Emergency Shelters – DV and non-DV
Mixture of funding (COC, ESG, non-HUD)
Shelter staff, case managers, program managers
Currently operates to review policy issues and has multiple teams working on different tasks:
Implementation
Grievance DV
Youth
Evaluation
Other Systems of Care
Prevention
Outreach

9. Coordinated Entry – Written Standards
Developed in committee, approved by Board, voted on by the membership:
COC funded Permanent Supportive Housing in 2014 and revised in 2017
COC funded Transitional Housing in 2014 and revised in 2017
ESG funded Rapid Re-housing in 2014 and revised in 2016
COC funded Rapid Re-housing standards passed in 2016
Order of Priority
Oops . . Missed Order of Priority (TH & PSH)
In 2016, with the revision of the ESG funded RRH written standards, the order of priority was re-authorized.
In 2016, with the release of HUD’s new Chronic Homeless definition and then order of priority, the Board approved the HUD notice as the PSH order of priority.

10. Balance of State Prioritization Policy
Prioritization for Permanent Supportive Housing (PSH)
Chronic homeless and longest history of homelessness, and most severe service need
Chronic homeless and longest history of homelessness
Homeless with disability and longest history of homelessness
Homeless with disability and most severe service needs
Homeless with disability and came from place not meant for human habitation, safe haven, or emergency shelter
Homeless with disability and came from transitional housing
Prioritization for Transitional Housing (TH)
Category 1 or 4, Homeless with disability and most severe service need
Category 1 or 4, Homeless without disability and most severe service need
Category 2, Homeless with disability
Category 2, Homeless without disability
Prioritization for Rapid Re-housing (RRH)
Category 1, Most severe service need

11. Coordinated Entry Key Terms
The Local Coordinated Entry Lead – the person chosen by the local coalition to serve as the point of contact for coordinated entry in the community.
The Local Coordinated Entry System (LCES) – a geographic area represented by one or more local coalitions that implements the WI Balance of State CoC Coordinated Entry System
The Non-HMIS List Holder – the person designated by the local coalition to manage the Non-HMIS Prioritization List for the LCES.
The Non-HMIS List – a prioritization list powered by Google Docs that uses anonymous, unique identifiers in order to accommodate domestic violence survivors and other households that do not consent to sharing their information in HMIS

12. Expectations of the Local CE Lead
Serve as the CE expert in the LCES
Ensure a consistent and accurate flow of information between the CoC and the LCES and the local coalition
Must be able to run reports in HMIS
Ensure all participating agency staff within the LCES have completed the required trainings
Attends all CE and CE Lead trainings
Provides updates on CE system updates, changes, etc. to the local coalition
Works collaboratively with the Non-HMIS List Holder
Maintain copies of all Agency and Staff Agreements for the LCES
Update the CoC training spreadsheet
Ensure participating staff and agencies are complying with CoC CE policies and procedures
Ensure marketing and outreach activities are occurring within the LCES
Ensure the LCES has established an after hour plan and the plan has been communicated to relevant stakeholders
Complies with all HMIS policies and procedures

13. Expectations of the Non-HMIS List Holder
Maintain the Non-HMIS Prioritization List in Google Docs, including trouble-shooting problems, identifying and communicating issues and concerns with the Google Form and the Prioritization list
Upon request from a housing project, provide the highest prioritized person’s unique identifier, prioritization information (VI-SPDAT score, length of time homeless, chronic status) and the referring agency’s contact information
Respond to requests from participating agencies and staff in a timely manner
Attend all CE and List Holder trainings
Work collaboratively with the local CE lead

14. Coordination with ESG
The ESG Grant Administrator is the State of Wisconsin – Division of Energy, Housing & Community Resources (DEHCR).
Funding is allocated to each local continua through a process of formula and data. There is a requirement to have rapid re-housing, but options to fund prevention, emergency shelter, or outreach.
In the program specific rules, the ESG Grant Adm. requires compliance with the HUD- recognized CoC’s coordinated entry process and approved written standards for programs.
Ongoing collaboration between CoC Director and ESG Grant Admin.
Joint monitoring plan in 2017
CoC Certification signed by CoC Director (to be eligible to apply for ESG funds)
Agree to participate in PIT, coordinated entry, BOS committee
Agree to provide data reports upon request
Acknowledgement of BOS and ESG Grant Admin partnership in the development of performance standards, evaluation, and monitoring.

15. Role of Emergency Shelters
Every ESG-funded Emergency Shelter and Homeless Motel Voucher program is required to participate in the Coordinated Entry process.
To participate means:
You are completing a Pre-Screen Form on all households (or unaccompanied youth) in the shelter or motel voucher program and retaining the form in a client file.
You are completing the VI-SPDAT or VI-F-SPDAT assessment tool with all willing clients and documenting any refusals.
You are referring all of those clients to the prioritization list in HMIS (or the Non-HMIS list if applicable).
You are the point of contact for those clients whether they remain in your shelter or not.
You are actively helping clients to secure housing.
You will conduct follow-ups on those clients remaining on the prioritization list for 90 days or more

16. Role of Housing Providers
Every ESG (EHH) and CoC-funded housing project is required to participate in the Coordinated Entry process.
To participate means:
You are completing a Pre-Screen Form on all households (or unaccompanied youth) that contact your agency (in person, over , by phone) and indicate they are experiencing a homeless situation
You are completing the VI-SPDAT or VI-F-SPDAT assessment tool with all willing clients and documenting any refusals.
You are referring all of those clients to the prioritization list in HMIS (or the Non-HMIS list if applicable).
You are the point of contact for those clients whether they are served by your agency or not.
You are actively helping clients to secure housing.
You will conduct follow-ups on those clients remaining on the prioritization list for 90 days or more

17. AND
When you have an opening in your housing project (RRH, TH, PSH) you must take the person highest on the prioritization list.
You must access the HMIS prioritization list and contact the Non-HMIS List Holder.
You must attempt to contact the person 3 times with a minimum of 24 hours between each attempt.
If you cannot reach the person, you must document that in the notes section in HMIS as well as let the Non-HMIS List Holder know (if the person came from that list).
Then, you can move on to the next highest person on the list and repeat the above- referenced process.
In the Balance of State CoC, it is prohibited for any HUD-funded homelessness assistance programs to serve individuals and/or families experiencing homelessness or who are at imminent risk of homelessness, without the household first going through the Coordinated Entry System and receiving a referral to the Prioritization List.

18. Three Phases PHASE #1: Placing persons on the Prioritization List
Participant Consent and Pre-Screen
Assessment
Referral
PHASE #2: Follow-up while persons are on the Prioritization List
PHASE #3: Removing persons from the Prioritization List
Eligibility determination
Program enrollment

19. Participant Consent and Pre-Screen Form
When an individual or family enters shelter or contacts a housing provider, the first coordinated entry step is to complete the Pre-Screen Form.
The Pre-Screen form:
Allows the agency to gather the minimum information needed to make a referral to the Prioritization List
Allows the agency to document the person’s consent to share information for the purposes of the referral
Can be completed over the phone or in person
Must be retained in the client file or scanned and uploaded into HMIS
Additionally, the following information must be documented on the Pre-Screen form:
If the client does not agree to complete provide the information for the Pre-Screen form, or
If the client declines to consent to sharing information, or
If the client declines the assessment – all this information must be documented on the Pre-Screen form.

20. Client Rights and Responsibility Form
In addition to the Pre-Screen form, the Client Rights and Responsibilities form must be completed.
The document includes:
Client rights related to coordinated entry
Client responsibilities related to coordinated entry
Grievance policy and process
Acknowledgement and Consent
The form can be done in person or over the phone.

21. Assessment
The WI Balance of State CoC uses 3 different assessment tools.
VI-SPDAT = used for single adults and households without children
VI-F-SPDAT = used for households with a least one adult and one child under age 18
TAY-VI-SPDAT = used for youth aged 24 and younger
All staff should be trained in using a trauma-informed care approach when conducting assessments. Privacy and confidentiality shall be maintained through this process.
Every staff person completing an assessment must complete the required training, sign a staff agreement, and use the approved introductory script.
The score is entered into HMIS or the Google Form (non-HMIS).

22. Referral The Prioritization List is divided into two lists:
Household without children (includes single adults, adult-only households, unaccompanied youth)
Households with children
A referral to the list can be done in one of two ways:
HMIS Prioritization List
Non-HMIS Prioritization List
Multiple referrals across Balance of State
Prioritization is a separate process from determining project eligibility. No one should be denied a referral to the list because they lack verification or documentation.
While on the list, participating agencies are encouraged to help clients become “document ready” – such as obtain disability verification or gather third party documentation of homeless episodes.

23. Follow-Up At minimum, follow-up contact must occur every 90 days.
At follow-up, the following information must be gathered:
Confirm or update contact information
Confirm or update homeless situation
Confirm the person(s) need for housing interventions
Confirm the person(s) desire to remain on the prioritization list
If the person(s) no longer need or desire to remain on the list, the agency must close the referral to remove the household from the prioritization list.
If the agency was unable to contact a person on the list, after 90 days of no contact, the referral is cancelled from the list.

24. Determining Eligibility
Because eligibility is different than prioritization, once there is an opening the responsibility of determining eligibility belongs to the housing provider.
If the household does not meet the project’s eligibility requirements, the household retains their spot or placement on the Prioritization list.
The only eligibility considerations allowed by the Balance of State are:
Disability verification
Chronic homelessness status
Homelessness status
Specific disability if the project is required to only serve persons with that disability

25. HMIS Prioritization List
Summary Page – Basic Information
Number of people referred to the prioritization list
Average length of time on the list
Longest a person has been on the list
Basic demographic information
Number of people removed from the list and reason
Housing Type Tab – RRH, TH, PSH priority 1, PSH priority 2
All people are included on all tabs.
People are prioritized on each tab by the Balance of State CoC approved prioritization
Accepted Tab
People accepted into housing and which project

26. HMIS Prioritization List
Declined or Cancelled Referral Tab
Acceptable reasons:
People removed because they have found alternative housing options
People removed because they request removal
Provider has been unable to contact for 90 days
Not Acceptable reasons:
Person was offered a housing option and declined
Person left emergency shelter
Common Data Entry Errors
Attaching the VI-SPDAT score
Shelter entry vs. Coordinated entry update – no adjustment to the Residence prior question (3.917)
Missing chronic homeless status questions
Referring to the correct list
Follow-up timeliness
Failure to complete a service transaction when accepting the referral

27. The Non-HMIS Prioritization List
The Non-HMIS Prioritization List collects information submitted through the Non- HMIS Referral Form powered by Google Forms.
The Non-HMIS Prioritization List was designed to mimic the HMIS Prioritization list. It was created by and is maintained by HMIS staff.
In order to refer a client using the Non-HMIS Process:
Staff must take the specific Non-HMIS training.
Upon completion, the staff receives the Google Form link.
The form includes all the same questions that are on the HMIS assessment, including a place for the VI-SPDAT score.
This process was created to offer an alternative to HMIS. This includes Domestic Violence agencies. However, it is not exclusively a “DV list.” Any person who does not want to share their data in HMIS can be referred to CE through the Non-HMIS list. This also opens the door for other systems of care to refer without requiring they have access/license to HMIS.

28. The Non-HMIS Prioritization List
The only person with access to the Non-HMIS Prioritization list is the Non-HMIS List Holder.
On the Non-HMIS Prioritization List, you are able to:
See the answers submitted through the Non-HMIS Referral Form powered by Google Forms
Make a decision to accept or decline a referral
See the prioritization of persons referred to the list for each of the project types based on the Balance of State prioritization policies for PSH, TH, and RRH (same as HMIS)
See the answers used to determine chronic homeless “yes or no”
See all persons accepted and declined

30. Prevention
As part of the Coordinated Entry Policies & Procedures 2.0 manual, a coordinated entry process for prevention was added.
All ESG (EHH) prevention projects must use this process as of January 1, Other non- ESG (EHH) funded prevention projects may use this process.
The Prevention process follows the same steps as the Homeless process.
There is a different Prioritization assessment tool and separate Prevention prioritization list.
Similar to the homeless process, prioritization is not the same thing as determining eligibility.

31. Prevention The assessment is completed for the head of household.
If there are two adults and no children, each person should complete the assessment.
There are 16 questions.
Each question is Yes or No.
There can be only 1 answer per question.
Each question has a corresponding score varying from 0 to 3 points.
The threshold for prevention services is a minimum score of 10.

32. Assessment Prioritizes those that would be the hardest to re-house
More points awarded to:
Less income
Less than HSD/GED
A child under the age of 6
Single parent
Household size 5 or more
Disability
4+ times homeless in past 3 years
3+ months of homelessness in the past 3 years
4+ times household had to move because of economic factors in last 2 years
4+ court ordered rental evictions within past 3 years
Currently fleeing domestic violence
Convicted of arson, drug dealing or manufacturing, or other felony against person/property
Sex offender
Lack of transportation

33. After Hour Plan HUD requirement for After Hour Plans:
Policies and procedures must document a process by which persons are ensured access to emergency services during hours when CE is not operating and how they will be connected to CE as soon as it is operating.
Situations to consider:
What happens if someone is homeless in your community at 3:00 am?
What happens if the police find someone homeless?
What happens if a person is at the ER and homeless?
What if our community does not have a 24- hour shelter or staff?
What happens if our community does not have a shelter?
We have a motel voucher program administered by an agency that closes at 4:30 pm and is not open on Fridays. How is this going to work?
We have on-call staff who can issue vouchers but it is funded with local dollars and not required to use coordinated entry. How will that work?

34. After Hour Plan
In the Balance of State, each local homeless coalition was required to develop an “After Hour Plan” that addresses these issues. If the coalition included more than one county, the community was allowed to develop a plan for each county or combined.
The After Hour Plan had to:
Cover the entire geography of the local homeless coalition
Have a method of communication across the local coalition to all stakeholders involved
Have reasonable access to emergency services including shelter and/or motel vouchers
Include a direct connection to coordinated entry the next day
Be clear
Identify when it would be reviewed (at minimum annually)

35. Balance of State CoC - Coordinated Entry Data
HH without Children PL
Currently waiting on PL
1,777 people
Chronic Homeless
282 people
Veterans
89 people
Youth 18-24
204 people
Average LOT on list
443 days
Longest LOTH
2.4 years
HH without Children #
Accepted off List
1,093
Removed from List
3,719
Top Reasons Removed #
Found housing on own
1,791
Unable to contact
1,736
Asked to be removed
144
Total clients ever referred: 6,151
Why is # of reasons greater than # removed?
Because a client can be removed more than once for more than 1 reason.
HH with Children PL
Currently waiting on PL
898 families
Chronic Homeless
46 people
Veterans
10 people
Average LOT on list
374 days
Longest LOTH
2.3 years
HH with Children #
Accepted off List
890 families
Removed from List
1,934 families
Top Reasons Removed #
Found housing on own
1,667
Unable to contact
1,149
Asked to be removed
140
Total families ever referred: 3,721
HMIS Prioritization List as of 5/16/2018

36. Households without Children – Current Clients on Prioritization List
Households with Children –
Current Clients on Prioritization List

37. WI Balance of State CoC - Need
HH without Children #
Average time on list
Longest people on list
Chronic with disability
312
237 days (7.9 mo)
848 days
Non-Chronic with disability & more than 12 months homeless
233
262 days (8.7 mo)
790 days
Non-Chronic with disability & less than 12 months homeless and
Non-Chronic without a disability & more than 12 months homeless
720
175 days (5.8 mo)
706 days
Non-Chronic without a disability
332
141 days (4.7 mo)
694 days
Total
1,597
HH with Children #
Average time on list
Longest people on list
Chronic with disability 41
258 days
(8.6 mo)
735 days
Non-Chronic with disability & more than 12 months homeless 44
334 days
(11.1 mo)
749 days
Non-Chronic with disability & less than 12 months homeless and
Non-Chronic without a disability & more than 12 months homeless
268
233 days
(7.8 mo)
736 days
Non-Chronic without a disability
197
167 days
(5.6 mo)
827 days
Total
550
HH without children total on list (1777) and need (1597) – difference 180 data issues or not currently homeless (double up)
HH with children total families on list (889) and need (550) – difference 339 data issues or not currently homeless (double up)
HMIS Prioritization List as of 5/16/2018

38. Coordinated Entry Dashboard

39. Coordinated Entry Dashboard

40. Coordinated Entry Dashboard

41. Non-Mandated Partners
Balance of State CoC Coordinated Entry policies state:
Examples include: school district liaisons, public housing authorities, Department of Human Services, non-HUD funded shelters and housing programs
Recruitment is done:
Locally by coordinated entry lead and community partners
On State level (DCF, DHHS, DPI) and association level (WAHA) by the CoC Director

42. Lessons Learned
You cannot please everyone. Start with who must, then add who may.
Develop written standards & order of priority first
Keep domestic violence providers involved
Emphasize that coordinated entry is not a program, it is a process
Have both a plan for HMIS and Non-HMIS
Set up a grievance policy and procedure within the first 3 months of implementation
Don’t assume people will ask questions
But when they do, you need a group to turn to for questions: Implementation Team
Provide lots of opportunities for training