Coordinated Entry

H4HP Coordinated Entry – A New Connection Approach

Connection Services Request Form

H4HP Coordinated Entry Policies April 2023

Coordinated Entry Process Overview Diagram

Update for March 30, 2023

Coordinated Entry is a systemic approach to connecting people experiencing homelessness with available assistance in the community. It is an important way to ensure fair and equitable access to limited housing resources and is a Federal and State requirement.

After a three-month pilot period, in April 2023, Santa Cruz County Housing for Health Partnership (H4HP) has launched a redesigned Coordinated Entry System. The new system uses designated Connectors applying housing problem solving techniques and a new assessment and planning tools to assist as many people experiencing homelessness as possible. The approach recognizes that there isn’t an immediate housing resource available for each person, so focuses on providing individual assistance to help people gain access to an array of potential supports rather than putting everyone on a list that, for most, does not result in regaining housing.

The goals of the new Coordinated Entry System are to (1) Facilitate connections to mainstream and community services for as many persons experiencing homelessness as local resources allow; (2) Streamline the process for matching to limited housing resources within the Housing for Health Partnership network (CoC); and (3) Prioritize resources for households with the most significant barriers to getting and keeping housing and for those with the greatest personal health and safety risks.

H4HP Connectors may work as part of an outreach team, drop-in center, multi-service center, or other program serving people experiencing or at risk of homelessness. They engage with persons experiencing homelessness, build rapport, enroll participants in HMIS programs and collect participant data. Connectors offer problem solving assistance with all participants and may conduct a Housing Needs Assessment (HNA). The HNA provides Connectors and participants with information needed to create and act together on an individualized Housing Action Plan and provides information to determine which participants are eligible and prioritized for H4H-supported housing and services. Only the highest priority households are added to the queue for the system’s limited housing resources.

Status of Coordinated Entry Transition

The rollout of the new Coordinated Entry system took place in a phased process. The prior assessment tool (the VI-SPDAT) was retired on December 31, 2022. Since January 2023, H4H has been making referrals from those that were prioritized under the former Smart Path CES model and that had recent service history records in HMIS. The Housing Needs Assessment also rolled out in January 2023 and Connectors have been reaching out to engage with anyone still on the previous list. When this process is completed and the list exhausted (anticipated to be in April), matching from the new Housing Queue will begin.

The current capacity for conducting Housing Needs Assessments is limited by the number of available Connectors and the training and technology needs associated with the role. Connectors may be dedicated full-time to CES or may have other roles within an agency so long as they are able to do Connector functions. They work intensively with participants and have limited caseloads; some Connectors take new participants only from within their agencies or from specific subpopulations, such as families or youth, while others may work with anyone experiencing homelessness. H4H will be expanding the number of Connectors as quickly as possible. Agencies interested in learning more about the Connector role and potentially becoming a Connection Point should contact HousingforHealth@santacruzcounty.us.

To help the community understand the new approach, H4H will provide a series of presentations, including a recorded webinar in the Spring as well as presentations to specific groups and community organizations. More information and presentation dates will be available shortly.

The Coordinated Entry Redesign is part of a larger system-wide effort the Housing for Health Partnership is launching in 2023. H4H Division staff will be working with partner organizations and providers to more fully develop a data-driven system by implementing updated Homeless Management Information System (HMIS) policies and procedures and coordination around data use and interpretation for addressing system issues.

Additional updates on the CES transition and redesign will be available on this webpage as they roll out. Questions can be directed to HousingforHealth@santacruzcounty.us.

Coordinated Entry Update: New Temporary Referral Process, March 7, 2023

The first cohort of Housing for Health Partnership (H4HP)  "Connectors" has been trained on the redesigned Coordinated Entry model, including using the new Housing Needs Assessment, Housing Action Plan and the HMIS functionality to capture data. The first cohort of "Connectors" is piloting the redesigned model, implementing the new tools with Smart-Path participants.

Coordinated Entry Redesign is part of a larger system-wide effort to work with partner organizations and providers to more fully develop a data driven system. Coordinated Entry is focused on assessing and referring those who are un-housed to permanent housing resources.

Until the new model officially launches (currently slated for April 1) and to ensure family and Transitional-Age-Youth (TAY) housing programs with available openings can be filled, a temporary process for referring families and TAY participants to the Coordinated Entry system has been developed. The following process should be followed by providers when they identify unhoused families or TAY: 

  • Ensure the family/individual has an HMIS profile and current Release of Information.
  • Send the family’s Head of Household or TAY Individual Unique Identifier to HousingforHealth@santacruzcounty.us. For families, please include the household size and ages of the children.
  • Housing for Health staff will add TAY or families to the new interim housing queue for potential referrals when there are openings.

Note: This is a temporary process and is expected to discontinue when the redesigned CES model launches Spring 2023 or shortly after.

Coordinated Entry Redesign

The Smart Path Coordinated Entry System will no longer be available for assessment and referral to housing resources after December 30, 2022. Housing for Health (H4H) Division staff, working with Bitfocus and Focus Strategies, has developed a redesign of the coordinated entry process for the Continuum of Care (CoC). The changes are critical because the CoC does not have sufficient permanent housing available within the community to house all people experiencing homelessness who interact with the system; only 133 referrals to housing were made over the last year and 1,774 were living without shelter in the 2022 Point in Time Count. The redesign will allow ongoing and more regular support for those experiencing homelessness. H4H Division staff has involved community members and people with lived experience of homelessness in the development of the redesign.

On December 14, 2022, the Housing for Health Partnership Policy Board approved three action steps to allow H4H Division staff move forward with a redesign expected to be implemented April 1, 2023.

  1. The Vulnerability Index- Service Priority Decision Assistance Tool (VI-SPDAT) will no longer be used as an assessment after December 31, 2022.
  2. Specific staff may voluntarily engage in housing problem solving using paper versions of a new assessment (Housing Needs Assessment) and a Housing Action Plan from January 2023 through March 2023.
  3. Active participants on the Housing Queue on December 31, 2022 will continue to be prioritized, matched, and referred to housing based on VI-SPDAT scores through March 2023.

Therefore, effective December 30, 2022, the Smart Path assessment workflow will be disabled in Clarity. In January, February, and March, H4H Division staff will be working with designated providers to pilot the new process. The process uses a problem solving approach to assess and work with people experiencing homelessness in moving towards stable housing; select staff designated to provide this service are referred to as Connectors. The approach is intended to facilitate frequent and useful engagement with people experiencing homelessness, as well as more transparency for participants and service providers about who will be referred to housing programs and what the timeline is. The Housing Needs Assessment, which is integrated into this process is designed to both assess and prioritize the most vulnerable households for system housing resources as well as to support the development of concrete Housing Action Plans. As a part of the pilot, designated Connectors will be working to transition many of those currently active on the community queue to the new Housing Queue.

The Coordinated Entry Redesign is part of a larger system-wide effort the Housing for Health Partnership is launching in 2023. H4H Division staff will be working with partner organizations and providers to more fully develop a data driven system by implementing updated Homeless Management Information System (HMIS) policies and procedures and coordination around data use and interpretation for addressing system issues.

Updates on the transition and redesign will be available on this webpage as they roll out. More information on the requirements and expectations associated with becoming a Connector will be forthcoming. Specific questions can be directed to HousingforHealth@santacruzcounty.us.

Address: 1000 Emeline Ave., Santa Cruz, CA 95060 |
| Phone: 831-454-7312
| Fax: 831-454-4642