Solutions: Coordinated Assessment

Université York
Mars 17, 2014

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.

National Alliance to End Homelessness logo.

Coordinated Assessment toolkit

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:

Planning and Assessment
Data and Implementation
Community Examples and Materials

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”.

Centralized Intake

A door.

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.

FROMGaetz, S. (2014). Coming of Age - Reimagining the Response to Youth Homelessness in Canada. Homeless Hub Research Report Series.

*To enable this, communities must ensure client consent, and address privacy concerns at the legislative and agency levels.

Stephen Gaetz est un professeur à la Faculté d'éducation de l'Université York et est le directeur de l'Observatoire canadien sur l'itinérance et du Rond-point de l'itinérance. Il est dorénavant également le président de Chez Toit, une oeuvre de bienfaisance canadienne en tête de file qui se concentre sur les solutions à long terme à l'itinérance.

Le docteur Gaetz se consacre à un programme de recherche qui met en lumière la justice sociale et tente de rendre la recherche sur l'itinérance utile pour les prises de décisions politiques et l'élaboration des programmes. Ses recherches sur l'itinérance chez les jeunes sont axées sur les stratégies économiques, la santé, l'éducation et les questions légales et juridiques, et plus récemment, il a porté son attention sur les politiques et en particulier sur la réponse canadienne à l'itinérance. Il a dernièrement publié deux oeuvres sur l'itinérance au Canada, dont : L'approche Logement d'abord au Canada – Appuyer les collectivités pour mettre fin à l'itinérance (2013) et Youth Homelessness in Canada: Implications for policy and practice (2013). De plus, il a publié un livre sur les réponses communautaires aux problèmes touchant les jeunes en Irlande et écrit une multitude de rapports et d'articles publiés dans une grande variété de revues approuvées par des pairs. Le docteur Gaetz a également été doyen associé de la Recherche et développement professionnel de la Faculté d'éducation. Avant de se joindre à l'Université York, le docteur Gaetz a travaillé dans le secteur de la santé communautaire à Shout clinic (une clinique de santé pour les jeunes de la rue de Toronto) et Queen West Community Health Centre à Toronto.

Le docteur Gaetz a joué un rôle de leader international dans la diffusion des connaissances dans le domaine de l'itinérance. York a accueilli la Conférence canadienne sur l'itinérance en 2005 – la première conférence de recherche en son genre au Canada. En outre, l'Université York accueille dorénavant l'Observatoire canadien sur l'itinérance et le Rond-point de l'itinérance, le premier centre de recherche complet et interdisciplinaire basé sur le web au monde. L'objet principal de ce réseau est de travailler de pair avec les chercheurs partout au Canada afin de mobiliser les recherches de telle sorte qu'elles aient un plus grand impact sur les politiques et la planification relatives à l'itinérance. Par l'entremise du RCRI, le docteur Gaetz publie des recherches pertinentes pour les prises de décisions politiques, y compris deux rapports récents sur l'itinérance chez les jeunes : Un endroit sûr et décent où vivre – Vers un cadre Logement d'abord pour les jeunes (2012), et Une ère nouvelle – Repenser les interventions auprès des jeunes sans-abri du Canada (2014); la Définition canadienne de l'itinérance (2012); Le coût réel de l'itinérance – Peut-on économiser de l'argent en faisant les bons choix? (2012); Vos papiers s'il-vous-plaît – Le contrôle policier des jeunes de la rue à Toronto (2011); et L'importance de la famille – Les jeunes sans-abri et le programme Family Reconnect de Eva's Initiatives (2011).

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