Developing a new Coordinated Entry Tool

La version française de ce billet se trouve ici.

I was recently asked to assist the Calgary Homeless Foundation (CHF) in developing a new common assessment tool. Here are 10 things to know:

1. Common assessment tools serve important functions in many communities. Homelessness officials seek to provide persons experiencing homelessness with available housing and supports. In order to facilitate such matches, officials interview persons experiencing homelessness, often using the same standardized survey for each person. Officials assess the person’s needs and goals; survey results then allow local officials to match the person to appropriate housing and other supports. The surveys themselves are referred to generically as common assessment tools.

2. Though an early adopter of a common assessment tool, Calgary was encountering challenges with its tool. Calgary’s homelessness sector wanted to develop a new Coordinated Entry Tool (CET) for intaking new clients into its homeless-serving sector, following several years of constructive feedback from local stakeholders.

3. My first order of business was putting together a strong consulting team. Our group consisted of John Ecker, Tim Patterson and Christina Sim. John, a well-known researcher with expertise on LGBTQ+ housing and homelessness, had previously worked on a comparison of existing common assessment tools. Tim has more than three decades of experience working with Alberta’s Indigenous communities and has strong knowledge of Calgary’s homelessness sector. Christina has more than two decades of experience in the homelessness sector and worked for the Kwanlin Dün First Nation for more than 17 years.

4. In order to help Calgary develop a new tool, we undertook a multi-phase process. This included: a literature review; observations of how the old survey was being administered; observing two Placement Committee meetings (where matches are made between clients and resources); and consultations with a variety of stakeholders. Those stakeholders included persons with strong knowledge of ‘second generation’ (i.e., newer) approaches to common assessment tools, health officials, justice officials, Indigenous stakeholders, people currently experiencing homelessness, staff who work with racialized persons, and staff who work with persons with disabilities.

5. Initial work on this project uncovered several themes. Specifically, we heard that a new tool should seek to have the following features: fewer questions; more open-ended, strengths-based questions; and, if possible, an understanding that clients should not receive a numerical score prioritizing some clients (peer-reviewed research and evaluations reveal that numerical scores can show biases across race, culture, age, and gender).

6. While process was technically ‘out of scope’ for this exercise, the consulting team did hear several process-related themes from the local community. Specifically:

• Any new tool should be administered by a staff person with a pre-existing positive rapport with the client.
• The physical setting where the new tool is administered requires privacy.
• The new tool should be administered in the client’s preferred language (which may require translation services).
• The check-in process (when a client’s file is updated) should be ‘user friendly.’
• Clients should have the option of bringing an advocate with them when the tool is administered.
• Staff administering the tool should have knowledge of various forms of support/referrals, including those pertaining to Indigenous peoples and newcomer services.

7. A piloting process helped us refine a draft of the newly developed tool. A draft CET was piloted with a cross section of participants, staff, and locations. Members of both the consulting team and CHF staff did some observation of the administration of the draft CET. A focus group was then held with the staff who had done the piloting. A mock Placement Committee meeting was held subsequently, during which time participants reviewed the ‘cases’ of clients who had been the subject of the newly drafted CET.

8. Additional consultations took place with Calgary’s Indigenous community. Post-piloting consultations through ceremony with Elders were held at both Miskanawah Community Services Association and the Aboriginal Friendship Centre of Calgary. It was made clear by all parties that the new CET is a ‘living document’ (i.e., there will be ongoing quality improvement).

9. Calgary’s newly developed Coordinated Entry Tool has several new features. Specifically, the new tool:

• has more open-ended, strengths-based questions (and fewer ‘yes-no’ questions)
• contains more personal language, rather than clinical language
• is more conversational
• offers two options/suggestions for appropriate housing models for each client (rather than just one, which was previously the case)
• does not use a score to prioritize clients for housing and services

10. A Research Advisory Group supported the process, helping us remain connected to the local community. There were biweekly meetings between the consulting team and CHF, as well as bimonthly meetings between the consulting team and members of a Research Advisory Group (RAG). RAG members voted in favour of adopting the newly drafted CET, referring to the new version as Coordinated Entry Tool 1.0.

In sum. Calgary’s homeless-serving sector has developed a new common assessment tool that is intended to better address the needs of persons experiencing homelessness. It did this through a consultative, community-driven process that will continue as the new tool is rolled out. The new tool is available here.

I wish to thank Jenny Morrow and Annick Torfs for assistance with this blog post.