Solutions: Coordinated Assessment
Coordinated Assessment (also known as Coordinated Intake, and in the UK as Common Assessment) is key to delivering integrated and focused early interventions for individuals and families at risk of homelessness. It is a standardized approach to assessing a person’s current situation, the acuity of their needs and the services they currently receive and may require in the future. It takes into account the background factors that contribute to risk and resilience, changes in acuity and the role friends, family, caregivers, community and environmental factors play on a person’s development and ability to move forward with their life. The National Alliance to End Homelessness in the US argues that coordinated assessment undergirds a more efficient and effective homelessness response through:
- Helping people move through the system faster (by reducing the amount of time people spend moving from program to program before finding the right match);
- Reducing new entries into homelessness (by consistently offering prevention and diversion resources upfront, reducing the number of people entering the system unnecessarily); and
- Improving data collection and quality and providing accurate information on what kind of assistance consumers need. (Coordinated Assessment Toolkit by NAEH).
The key to coordinated assessment is to employ it as a system-wide process by having all agencies use the same assessment framework and instrument in order to standardize current practices and provide comprehensive and consistent client information. In the United States, researchers have advocated for coordinated assessment as key to effective prevention and rapid rehousing programs. If a community has adopted a ‘system of care’ approach, measures should be taken to share the information between agencies and providers* and thus reduce duplication of assessments and enable effective case management, such that clients get timely access to the most appropriate services based on need. So while common assessment means that all agencies use the same tool, centralized intake refers to a pooling of information that different providers can have access to. This facilitates systems coordination and means that people accessing services won’t have to tell their story multiple times (and it is important to remember that these stories can be emotionally difficult to share (traumatic) or stigmatizing (LGBTQ status, criminal involvement, mental health problems etc.). This is important, because in larger cities, people who are homeless often complain about having to retell their story upon intake at every new agency.
The NAEH has developed this toolkit to help communities plan for, implement, and evaluate a coordinated assessment system. The toolkit is designed to allow individual communities to modify and tailor the tools to fit their individual needs. The toolkit includes the following components:
Common Assessment Framework for Youth (United Kingdom)
The Common Assessment Framework (CAF) was designed as a generic assessment tool to be used by practitioners from different sectors in England. The CAF is intended to: “help practitioners working with children, young people and families to assess children and young people’s additional needs for earlier, and more effective services, and develop a common understanding of those needs and how to work together to meet them”. It is considered a key tool for the coordination of services. The idea is that everyone who works with young people should know about the CAF and how to deliver it. The CAF builds upon “Every Child Matters – Change for Children”, a national framework to help local communities develop effective and integrated supports for children and young adults. The CAF consists of:
- a pre-assessment checklist to help decide who would benefit from a common assessment
- a process to enable practitioners in the children and young people’s workforce to undertake a common assessment and then act on the results
- a standard form to record the assessment
- a delivery plan and review form
Linked with a case management strategy (see below), the assessment helps identify needs and coordinate interventions. Implementation of the CAF has been a challenge in some jurisdictions, due to capacity and resource issues. However, evaluations of the CAF have demonstrated positive service outcomes, including an improvement in “multi agency working, information sharing and (a reduction in) referral rates to local authorities”.
Coordinated assessment is often supported by some form of centralized intake or single point of entry, which could be the first emergency shelter someone presents at, a dedicated assessment facility, or through a dispersed model where people come into contact with key workers in the system, in schools, community or social service settings. Getting timely information and supports to individuals and families is crucial, given that educators and other service providers may not readily identify individuals and families at the time of crisis. Centralized intake means that not only is a common assessment used, but that the information gathered is centralized so multiple service providers have access to it. The argument is that homeless services become less fragmented, access is more seamless, and scarce resources are used more effectively. In the American context, centralized intake and assessment is often conducted with, and supports the use of, the HMIS system. Central intake was a key program requirement of HUD’s 2008 Rapid Re-Housing for Families demonstration project.
Several communities in the United Kingdom have pioneered “Single Point Access” information and assessment,an easy to access hub (via phone or internet) where people can get needed information, supports and access to services. As a system, it relies on a strong communication strategy so that individuals and families know about it (through schools and community centers, for instance), a good assessment system (such as CAF), and strong organizational links to services both within and external to the homelessness sector. As both a ‘triage’ service and a clearinghouse, a single point access service ensures consistency of assessment, a reduction in duplication, and an enhanced and effective evaluation of the appropriateness of services.
Given advances in technology, the basic principles of “Single Point Access” could be provided in a more decentralized fashion through web-based supports and/or a more diverse range of agencies and services. Such an approach would require a common assessment framework, a shared data management system and a communication and promotion strategy. Ideally would be made available through schools, community centers and other places frequented by young people.
FROM: Gaetz, S. (2014). Coming of Age - Reimagining the Response to Youth Homelessness in Canada. Homeless Hub Research Report Series.
Stephen Gaetz is a Professor in the Faculty of Education and is the Director of the Canadian Observatory on Homelessness and the Homeless Hub. He is also President of Raising the Roof, a leading Canadian charity that focuses on long term solutions to homelessness.
Dr. Gaetz is committed to a research agenda that foregrounds social justice and attempts to make research on homelessness relevant to policy and program development. His research on homeless youth has focused on their economic strategies, health, education and legal and justice issues, and more recently, he has focused his attention on policy and in particular the Canadian Response to homelessness. He has recently edited two volumes on homelessness in Canada, including: Housing First in Canada – Supporting Communities to End Homelessness. (2013) and Youth homelessness in Canada: Implications for policy and practice (2013). In addition, he has published a book on community-based responses to youth problems in Ireland and written numerous reports and articles published in a wide range of peer reviewed journals. Dr. Gaetz was Associate Dean of Research and Professional Development in the Faculty of Education Prior to his time at York University, Dr. Gaetz worked in the Community Health Sector, both at Shout Clinic (a health clinic for street youth in Toronto) and Queen West Community Health Centre in Toronto.
Dr. Gaetz has played a leading international role in knowledge dissemination in the area of homelessness. York played host to 2005’s Canadian Conference on Homelessness – the first research conference of its kind in Canada. In addition, York University now hosts the Canadian Observatory on Homelessness and the Homeless Hub the first comprehensive and cross-disciplinary web-based clearinghouse of homelessness research in the world. The focus of this network is to work with researchers across Canada to mobilize research so that it has a greater impact on homelessness policy and planning. Through the CHRN Dr. Gaetz is publishing policy relevant research, including two recent reports on youth homelessness: A Safe and Decent Place to Live: Towards a Housing First Framework for Youth. (2014) and Coming of Age: Reimagining our Response to Youth Homelessness in Canada. (2014), as well as The Canadian Definition of Homelessness (2012), The Real Cost of Homelessness. Can we save money by doing the right thing? (2012), Can I See Your ID? The Policing of Homeless Youth in Toronto (2011), and Family Matters: Homeless youth and Eva’s Initiatives “Family Reconnect” Program. (2011).
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The analysis and interpretations contained in the blog posts are those of the individual contributors and do not necessarily represent the views of the Canadian Observatory on Homelessness.