(Chronic) For individuals with disabilities, provide support for securing SSI or SSDI

Build a by-name data set and report monthly data for all single adults, inclusive of Chronic & Veterans

  • Resources:
  • Potential initial tests of change:
    • Report 3 months of data for all single adults to identify individuals at risk of aging into chronicity
    • Conduct 1:1 interviews with 5 single adults who recently inflowed from one cross-sector partner who is interested in improving local upstream partnerships (healthcare/hospitals, criminal justice, foster care) to gather ideas for more effective cross-sector discharge planning

Utilize available RRH resources paired with PHA resources to prevent people from entering chronic homelessness.

For individuals at risk of experiencing chronic homelessness, partner with PHA to create a homeless preference in which PHA takes prioritized referrals from the CoC for Section 8 vouchers.

Implement a pre-screening tool to support entry points in identifying level of client need and allocate resources for housing crises that can be resolved within 0-14 days. Identify one program to pilot utilization of the tool.

Establish and sustain a Coordinated Homelessness Prevention system that prioritizes responses for individuals at greater risk of experiencing literal homelessness, leveraging foundational priorities and engaging key stakeholders, including those with lived experience.

To develop and implement a localized, adaptable Coordinated Prevention Roadmap that serves as an actionable guide for the Core Prevention Team. This roadmap will outline the necessary steps, timelines, and responsibilities needed to create a sustainable Coordinated Prevention system, enabling communities to track progress and ensure continued development.

Establish housing placement plans with cross-sector partners before exit (the foster care system prior to youth exiting care, justice system prior to release, etc.)

Survey veterans assessed in the past 90 days and use data to discover the systems and services they touched previous to entering the homeless system.

Implement a simple tool to assess risk of homelessness for use in mental health clinics, VA hospitals and medical care, and prison or jail prior to exit; create a pathway to connect the individual with diversion resources within that non-homeless program or in the homeless system.

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