Case Studies | , ,

How Coordinated Entry Serves Veterans Experiencing or At Risk of Homelessness

,   |  August 15, 2023

Story written by Allison Bond, Acting National Director of Health Care for Homeless Veterans, and Kally Canfield, System Improvement Advisor for Large Cities at Community Solutions. This was originally published on August 14, 2023, on the U.S. Department of Veterans Affair’s Homeless Program page.

VA has many homeless programs that serve hundreds of thousands of Veterans at risk of or experiencing homelessness each year. But for the most vulnerable Veterans to be helped effectively, they must be reached.

That’s where coordinated entry (CE) systems come in.

Local Continuums of Care (COC) assist individuals and families experiencing homelessness, providing the services needed to help them move into transitional or permanent housing. CE systems, which are required by the U.S. Department of Housing and Urban Development for all CoCs, are a vital part of ending homelessness for Veterans and non-Veterans alike, ensuring they are accounted for and given access to the homeless assistance programs that will best serve them.

Together, VA and community partners work to cultivate a system that encourages coordination and management to ensure vulnerable Veterans and those already experiencing homelessness are prioritized for housing and other support services.

How Coordinated Entry works

The CE process is a vital part of ending homelessness among Veterans. CE leverages cooperation between local homeless agencies and service providers to create a robust crisis response system. The teams of professionals work together as one unit instead of making individual decisions about who to serve and how best to serve them. This allows the system to effectively connect those experiencing homelessness with stable housing and service interventions.

Through this streamlined approach, Veterans at risk of or experiencing homelessness can have their needs assessed quickly and get connected with personalized housing opportunities and various social services. Standardized assessment tools and practices are used to evaluate the unique needs of each Veteran, which increases access to housing options and supportive services that will fit their needs.

Guiding principles of Coordinated Entry

CE creates a standard set of guiding principles so homeless service providers can make consistent decisions about combining their resources and using them effectively when serving the community. By employing uniform processes across the board, the CE system increases accessibility for Veterans and offers them a better-connected network of services.

It also emphasizes that instead of making a person fit into one program, we as service providers must understand and respond to each Veteran’s individualized needs.

The CE process includes four core elements:

  • Access is the initial engagement point — virtual or site-based — for individuals experiencing homelessness.
  • Assessment is the process of documenting a participant’s housing needs, preferences and vulnerability.
  • Prioritization is the process of assigning a level of need or vulnerability to persons seeking assistance so that housing and services can be allocated to those persons with the greatest need.
  • Referral is matching persons to available community resources, housing and services.

Before CE, communities had multiple partners focused on homelessness, doing their best with what was right in front of them regarding resources, staff, and Veterans walking through their doors. But nationally, we realized we could do better by working together.

Coordinated Entry at work

One example of a successful CE system is in the heart of our nation’s capital. CE for Veterans started in Washington, D.C., in 2014 with the help of The Community Partnership For the Prevention of Homelessness (TCP), the Washington VA Medical Center in Washington, D.C., and other valued partners.

“We can ensure that those Veterans who may not come directly to VA are still engaged and provided with those services, so we don’t leave them behind.”

illana marmon

“It’s a coordinated process that ensures that no Veteran slips through the cracks, so Veterans who may not necessarily use VA for services can be engaged and identified in other means,” explained Ilana Marmon, a coordinated entry specialist at the Washington VAMC.

Early in their CE development, TCP and VA came up with processes to share information about Veterans experiencing homelessness in Washington, D.C., with each other so they could clearly understand what the Veterans’ needs were. This involved understanding the relevant privacy laws and working with privacy experts to ensure that Veterans’ confidential health information was protected, and that the appropriate authorities were invoked when sharing.

When TCP or VA became aware of Veterans experiencing homelessness, the Veterans were added to the community’s Veteran By-Name List (VBNL). This comprehensive data source is updated in real time and includes every Veteran experiencing homelessness in each community. The VBNL also helps TCP and VA connect Veterans to outreach teams who help them gather important identifying documents, gauge their interest and eligibility for housing resources, and connect them with temporary and permanent housing. 

Throughout the process, multiple stakeholders, like TCP, VA, housing providers and other community service providers, discuss and carefully consider the next steps based on the Veterans’ wants and needs, with the end goal being permanent housing.

“We can ensure that those Veterans who may not come directly to VA are still engaged and provided with those services, so we don’t leave them behind,” said Marmon.

Finding success with Coordinated Entry

CE is doing well in D.C. due to participation from the entire community. Sha-Ron Haddock, former Health Care for Homeless Veterans coordinator with the VA Washington DC Healthcare System, shared that the organizations that are part of the local homeless response system fully embraced a focus on continued improvement.

“Everybody was willing to come together at that time — we wanted something different. What we were doing was working, but everybody was interested in seeing what else we could do,” said Haddock. “I think that’s a testament to the agencies in this area that are willing to partner with VA to do this. I think that made a big difference — we weren’t resistant to it.”

“I think that’s a testament to the agencies in this area that are willing to partner with VA to do this. I think that made a big difference — we weren’t resistant to it.”

Sha-Ron haddock

The community’s data-driven approach is another reason for its success. The data collected allows each partner to understand who is experiencing homelessness, what support they need and the resources available in the system to meet those needs. Data insights also help garner further buy-in and participation from other agencies and organizations. The ability to share data helps each party better locate, engage, and house each Veteran, which is the common goal.

“Qualitative and quantitative data becomes important here as buy-in from key stakeholders, such as case managers, shelter staff, and outreach workers, has helped facilitate Veterans’ overcoming of barriers in the housing process while staying true to the Veterans’ preferences as well,” said Noah Barr, coordinated assessment and housing placement coordinator for Veterans at TCP. “This is because we believe it’s more than just numbers; Veterans succeed when they are in the place they want to be.”

We must remember that there is no end to the ability to improve even the best CE system. Community demographics, resources, funding, and data-sharing opportunities change daily, which means CE practices and protocols must also keep up.

VA’s work is never done, and we are eager to create even more progress toward our mission to house every Veteran experiencing homelessness.

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