Aunt Bertha Partners with ECHO to Transform Homeless Intake

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We know that housing is a critical need nationwide, now more than ever. With unemployment rising dramatically, public health at a critical risk, and stays of eviction expiring in communities across the U.S., nonprofits that support the homeless now have a substantially larger influx of those in need. 

Research has shown that addressing housing needs directly correlates to better outcomes across health, education, work, incarceration, and substance use — so the benefits of providing housing services are exponential in a community. But despite the importance of housing, it continues to be a challenge to connect people with housing services throughout recent history.

We’ve seen that housing has been the most searched service across the country, but studies show that it is simultaneously the most expensive service to provide. This not only means that housing is a limited resource, but the most difficult resource to access. 

At Aunt Bertha, this raised the question: what has been done to solve homelessness to date, and what more can we do to help make it easier to connect to necessary services? 

Partnering for Greater Impact

In Austin, TX (where Aunt Bertha is headquartered), 2,255 people experience homelessness each night, either living outside or in shelters. To serve our mission to connect all people in need to services that can help them, we started by exploring ways to help the homeless in our hometown.

Enter Ending Community Homelessness Coalition (ECHO), the lead agency that provides backbone support for Continuum of Care and Coordinated Entry systems throughout Travis County, TX, which includes the city of Austin. ECHO has the no-less ambitious mission of ending homelessness in Travis County, working closely with nonprofits and government agencies to coordinate assistance and housing for people experiencing homelessness in the community.

We partnered with ECHO to find a solution together. From June to August 2019, we collaborated with ECHO to evaluate their current systems and identify opportunities for improving their intake processes. The results were co-designed tools that improved on their existing processes, and we’re pleased to say they serve as a framework for any Continuum of Care in the country. 

To fully understand the challenges ECHO was facing and the impact this work made, it’s important to first look at what Continuums of Care are responsible for accomplishing, and how they came to be.

The Origins of Continuums of Care

In the wake of the subprime mortgage crisis between 2007 and 2010, the government established a network of nonprofits devoted to addressing homelessness nationwide. The goal of this network was to coordinate housing placement across the thousands of programs that receive United States Department of Housing and Urban Development (HUD) funding. This includes the vast majority of all homelessness housing programs in the country.

These organizations, called Continuums of Care, provide oversight in every city, county, and region in the country. Continuums of Care can be as small as a city or as large as a state, depending on the density of homelessness. All homelessness agencies collaborate with their Continuum to establish shared guidelines for how to serve every person experiencing homelessness in their area, based on their community’s needs.

A key part of a Continuum’s job is establishing a uniform system entry assessment to: 

  • Intake new people and families experiencing homelessness; 
  • Assess how dangerous and chronic each person’s homelessness situation is; and 
  • Match people to the programs that will best fit their needs — serving the most vulnerable first.

This standardized intake assessment, called Coordinated Entry, is then shared by all homelessness agencies in an area so that each can quickly, effectively, and consistently match people experiencing homelessness with the services that can best fit their needs, even if that service is at a different agency. With Coordinated Entry, each agency can move beyond the first-come-first-serve model and instead  prioritize clients with the most urgent needs, who are the best fit for their specific service.

Co-Designing to Transform Coordinated Entry

To serve ECHO, and to connect people to housing services, we first needed to understand the gaps in their existing technology, difficulties in their daily work, and places where Aunt Bertha could help them serve people more effectively. We set up a series of walk-throughs with the ECHO team to understand their current processes and technology. Here’s what we learned:

  • ECHO maintains client information in an inter-agency client database called ServicePoint HMIS (Homeless Management Information System). To receive HUD funding, everyone in their Continuum is mandated to use this HMIS system to report on their clients, services, and outcomes. 
  • The Travis County Continuum of Care also uses an assessment called the VI-SPDAT (Vulnerability Index – Service Prioritization Decision Assistance Tool) to gather information on client needs. ECHO had set up this Coordinated Entry needs assessment to be available within the HMIS system that all agencies shared. This allows assessments to be collected from many different agencies, centrally prioritized, and matched with the correct agency.
  • Their HMIS system already served a lot of their needs: interagency cooperation, central prioritization, creating shared visibility of relevant client information, among others. We didn’t want to replace or add complications within systems that were working well for them. But, we learned that most of their technology and process headaches actually came before the assessment even started. 
  • To receive a coordinated assessment, clients needed to visit a walk-in center, call on the phone, or sign up for a phone call through a Google form. Intake staff were dealing with an overwhelming volume of inquiries, and facilitated much of the initial pre-assessment intake through a shared spreadsheet. ECHO’s assessors were spending a lot of their valuable time manually figuring out if clients fit the definition of “literally homeless.”
  • Because housing is such a limited resource and there are so many people in need of it, literal homelessness is the federally mandated criteria that Continuums of Care use to determine which clients fall under their jurisdiction. By definition, “being homeless” means that a person is sleeping on the street, staying in an emergency shelter, and/or fleeing domestic violence. Each time a client called, assessors had to pre-screen them and determine if the client was even eligible for a Coordinated Entry assessment. For clients who didn’t fit the literal definition of “being homeless,” ECHO couldn’t directly help them, and could only suggest they contact a program outside of the Continuum of Care.

Key Opportunities to Enhance Pre-Screening

By walking through these processes with ECHO, we were able to identify three key opportunities to enhance their pre-screening process:  

  1. Enable ECHO assessors to spend more time working with the people they could help, and less time referring those not eligible for coordinated intake to other housing resources. 
  2. Give clients a better experience by providing instant feedback on whether they were eligible for coordinated assessment, or immediately connecting them to other resources in the community if they weren’t eligible.
  3. Provide better tools and reporting to help staff collaborate,  streamline workflows, share caseloads, and manage their overall program resources.

Based on these takeaways, we then built a prescreening tool that could complement their existing systems.

Introducing Our New Coordinated Entry Pre-Screening Tool

Our goal was to ensure that clients can still walk in, but for those who are online, our new prescreening tool had to automatically determine if that person is literally homeless before they interact with an assessor.  

The result is our new pre-screening form, in which clients provide basic information such as contact info, identify what kind of services they need, answer a series of questions on their unique situation to determine if they are literally homeless, and provide blocks of time that they’re available for an appointment.

Behind the scenes, ECHO’s assessors get instant insight into which clients are facing literal homelessness. The entire team has a shared view into how far each client is in the process of getting assessed. They have a suite of reporting that provides a top-down view of all their program’s work, as well as a workflow dashboard that sorts clients according to the next steps for their assessor.  

The analytics we’ve built for this prescreening tool provide ECHO with better ways to split the workload between several assessors, as well as crucial information that can help them manage their resources or apply for additional grant funding. 

For ECHO, this prescreening tool provides a much better experience for both clients and staff alike. For people who aren’t eligible, our form provides that feedback instantly, along with links to alternate resources in the community. For clients who simply need to update their contact information, the experience is fast and painless. Case managers can easily refer their clients through this form, allowing for better collaboration between the many organizations who are working with homeless individuals throughout Austin. 

Looking Forward: Supporting More Continuums of Care

We’ve continued to work with ECHO to fine-tune this suite of Coordinated Entry tools. For example, we’ve recently added workload reports so that program administrators can see how many in progress pre-screens each assessor has in their queue. 

We’re excited to continue rolling out this new prescreening tool to other Continuums of Care across the country. Our goal is to continue to learn more places where Aunt Bertha can serve our nation’s helpers. We’re now working with Continuums across several different coordinated models, who use other assessments such as the Vulnerability Assessment Tool (VAT), and with other agencies that offer services under Continuums of Care.

Next Steps for Continuums of Care

If you’re working within a Continuum of Care, here are a few resources we think would be helpful to you:

  • You can set up time with our team to learn more about how to get started with our prescreening tool quickly, easily, and most importantly — for free.
  • If you haven’t already claimed your program on Aunt Bertha’s social care network, you can do so here. Claiming only takes a minute, and gives you free access to edit your program information, manage referrals, screen applicants, see personalized analytics, and more! 
  • We’ll be co-hosting a webinar titled “Transforming Coordinated Entry: How to Take Homelessness Efforts Virtual Without Missing a Beat.” with ECHO on July 15 and would love for you to attend! If you’re interested you can RSVP here to reserve your seat.
  • You can learn more about how Aunt Bertha partnered with ECHO to help count the homeless population in our area during ECHO’s Point in Time survey.