What is CAA?

Introduction

Coordinated Access and Assessment improves coordination among agencies while reducing redundancies in services as information and data becomes centralized and standardized. CAA works to improve the client experience within the System of Care through improved access and support for system navigation. Furthermore, a more robust triage process allows for more effective and accurate program placements. It ensures the most vulnerable people in our community are referred to housing programs equipped to meet their needs. Coordinated Access and Assessment operates based on a triage model, targeting and prioritizing individuals based on chronicity, individual needs, and vulnerability factors.

Calgary Homeless Foundation and Coordinated Access and Assessment

There is only one common characteristic of people experiencing homelessness – they do not have a home. There are many reasons why people do not have a home; this is often called “root causes” of homelessness. Calgary Homeless Foundation recognizes that there are three main ‘society’ causes to homelessness, and is empathetic to the personal issues and situations that can contribute to an individual becoming homeless. We work with government, stakeholders and the Homeless Serving System of Care (HSSC) to address societal contributors such as macroeconomics, public policy and availability of local resources. On an individual basis, our primary focus is to quickly connect that person to supports to end their experience of homelessness permanently. This is the fundamental principle of Housing First.

In recognition of the diverse and unique needs of the people we serve through the HSSC, Calgary Homeless Foundation aims to fund a variety of Housing First programs to meet the needs of all people experiencing homelessness. Unfortunately, the demand for housing programs exceeds the spaces available in housing programs. As such, Calgary Homeless Foundation works to coordinate the programs to assess the needs of the clients and match programs and services to their needs to end their experience of homelessness permanently. This is done through a program called Coordinated Access and Assessment (CAA). CAA acts as the entry point into all housing programs funded by Calgary Homeless Foundation.

Due to the lack of available program spaces, CAA is designed to meet the needs of the most vulnerable first by triaging. It creates a more efficient homeless serving system by:

• helping people move through the system faster, thereby 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 up-front
• improving data collection and quality to provide accurate information on what kind of assistance consumers need

The CAA team of Housing Strategists provides standardized service delivery for homeless individuals or families seeking housing services. The CAA Team at SORCe is operated by the Distress Centre, and is primarily delivered from the fixed location of SORCe, with capacity for mobile outreach services.

The Issue

Coordinated Access and Assessment (CAA) was implemented in September 2013 to “build coordinated intake into the homeless-serving system”.[1] It represents a single, standardized process for people at risk of or experiencing homelessness to access housing and support services. With coordination and efficient intake processes, clients can access appropriate housing services with better accuracy, minimizing stress and respecting client dignity.

CAA improves coordination among agencies while reducing redundancies in services as information and data becomes centralized and standardized. CAA works to improve the client experience within the System of Care through improved access and support for system navigation. Furthermore, a standardized assessment process allows for more effective and accurate program placements. It ensures the most vulnerable people in our community are referred to housing programs equipped to meet their needs. CAA operates based on a triage model, targeting and prioritizing individuals with the highest needs and chronicity of homelessness.

[1] Calgary Homeless Foundation, Annual Report 2013, p.5

Why Coordinated Access and Assessment?

Homeless individuals are not a uniform population. Various interventions and programs within a Collaborative Service Delivery Group are necessary to successfully meet the needs of the individuals within this demographic. Coordinated Access and Assessment provides a single entry point into the HSSC that helps identify the needs and interventions most appropriate for individuals within each target group through the use of standardized assessment tools. For more information please see the Program Type Resource Guides for each sector listed under the Resources section, or click here for a list of our funded programs accessed through CAA.

CAA has four primary activities to guide the System of Care:

• Prevention services aimed at “closing the front door to homelessness”
• Diversion services to re-direct individuals and families to community-based services rather than to emergency response/homelessness services
• Assessments for individuals and families who face barriers to exiting homelessness on their own
• Adaptive Case Management, Supportive Housing and Place-Based Supportive Housing referrals

CAA creates a more efficient homeless serving system by:

• 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
• Ensuring people are referred to appropriate programs designed to meet their needs, effectively reducing recidivism into homelessness and improving client outcomes
• Improving data collection and quality and providing accurate information on what kind of assistance individuals and families using homeless sector services need

CAA is designed to direct specific target populations towards interventions that best meet their needs. In this way, not only will people experience more success when matched to the correct program, they will also be provided the level of service that meets their needs while promoting housing stability and independence as appropriate to their unique situation.

Ensuring resources are targeted to first address those with the highest level of need provides greater efficiencies in the System of Care while streamlining its operations and facilitating best use of finite resources. In addition, for those with lower needs, utilizing only those resources necessary to address their needs, promotes a sense of self-empowerment and achievement which are vital to limiting dependency on the HSSC and to individual well-being.

As CAA triages people with complex needs and lengthy chronicity, it is necessary to provide multiple access points to the homeless-serving system that are accessible and low-barrier – this may include outreach to encampments, corrections and hospital wards.

What is the Coordinated Access and Assessment?

Without a coordinated entry and assessment to determine client needs, individual agencies have historically independently determined which clients they accepted into their programs through agency-specific eligibility requirements and program entry. This led to multiple system access issues and obstructions. The CAA program allows agencies to work together with a common language, questionnaire tool, processes and policies. This provides greater ease of access for clients and more consistent, harmonized processes across the sector, regardless of where or how an individual enters the System of Care.

CAA also eliminates a common outcome of agency-centric systems of care where by clients could apply for entry into multiple programs at the same time to increase their likelihood of acceptance. This resulted in a system with multiple wait-lists and no way of knowing if the same client waits on numerous lists.

When defining structure in the system of care, it is important to have a thorough understanding of the needs of the population and the programs required to meet those needs. False data related to program wait-lists can skew funding decisions and lead to a HSSC not representative of client needs.

Successful CAA programs identify the needs of the target population, guiding interventions and funding towards the program types in most demand.

THE IMPLICATIONS

The program was designed to coordinate single-point entry into the system of care and refer clients to the best program to meet their needs. While CAA has improved our knowledge regarding system gaps and program waitlists, it has not impacted the environmental factors that contribute to homelessness in Calgary, such as high rates of migration to the city, limited affordable housing options and lack of employment opportunities. Additionally, while we aim to coordinate the system of care through CAA, the need continues to outweigh the resources and therefore bottlenecks occur and individuals remain not receiving services until more program spaces are funded.

Consistent and repetitive communication is critical to the success of the program. Moreover, the collection and use of client and user feedback must be respected and valued. Through recent CAA Enhancements based on community feedback and data, a standardized tool (The Housing Plan) is now available to Housing Strategists to enhance the work being done with individuals on achieving housing independently. The program will continue to be modified and improved to achieve the desired outcomes and to support continued advocacy for increased resources and partnerships.

For a system long marked by navigational challenges, CAA demonstrates a concrete move toward centralization and coordination of services. A Collaborative Service Delivery Group can ensure resources are optimally deployed so that the right intervention for the right client at the right time is available for everyone seeking help.