Program managers retained their programs’ autonomy by picking screeners and the number of employees in that position for their program, screening location and time, and screening type (appointment, walk-in, telephone, and/or combination). Managers and staff also assisted in the creation of the UHHS tool by providing their program’s eligibility criteria and customary psychosocial assessment questions. The UHHS tool not only brought consistency to the screening process, but also removed any perceived biases by asking all veterans the same questions across all UHHS screening locations. Implemented on August 26, 2013, UHHS continues to be used.
UHHS Screening Tool
The UHHS tool is an assessment composed of 4 sections: (1) History; (2) Decision Tree; (3) Specific Program Eligibility Criteria; and (4) Plan. The sections exist as templates in the CPRS.
The History section asks about demographic information, diagnoses, alcohol and illicit drug use history, dependent status, outstanding legal issues, housing status, functional limitations, income and employment status, and potential benefit from and interest in psychosocial rehabilitation and care management. If the veteran would not benefit from and/or is not interested in participating in psychosocial rehabilitation and care management, the screener concludes the assessment, as these factors are eligibility requirements for all CHCP programs. Veterans can appeal their case to the screener’s program manager.
The Decision Tree template consists of 6 core eligibility criteria across programs that can serve to narrow the list of eligible programs: (1) Is the veteran currently homeless; (2) Has the veteran been homeless continuously for ≥ 1 year, or has the veteran had ≥ 4 separate occasions of homelessness in the past 3 years; (3) Does the veteran have a mental health or substance use diagnosis; (4) Can the veteran pay a program fee (9 of 16 UHHS-associated programs have no fees); (5) Is the veteran capable of self-administering medications; and (6) Can the veteran perform activities of daily living and does not need acute hospitalization?
Related: Using H-PACT to Overcome Treatment Obstacles for Homeless Veterans (audio)
Veterans are then asked in which town(s) they want to reside. The questions for the Specific Program Eligibility Criteria section are asked only for those programs for which the veteran is found to be tentatively eligible by the Decision Tree and has interest in participating.
The Plan section gives veterans the opportunity to appeal a UHHS finding to the specific program’s manager whose program they are not eligible to participate. Veterans also rank their preference for the programs for which they are interested and eligible. A shared folder contains all program census information. Through the screening tool, veterans devise a plan to contact the potential admitting program. Veterans are informed about the importance of keeping in contact with these programs, because programs will not hold openings for an indefinite time.
Completion of this screening assessment, which includes HOMES and the UHHS tool, generally takes 1.5 hours. After a veteran undergoes this assessment, a preadmission appointment is made with the first open program for which they are eligible and interested in participating. The main goal of this appointment varies by program, such as finalizing referral processes with associated community partners, performing a preliminary medical clearance, determining whether veterans have already used their program’s maximum allotted time, coordinating a Therapeutic Supported Employment Services assessment, or obtaining the required documents from veterans. If at the preadmission appointment, either the veteran declines participation or the program declines admittance, the veteran can follow up with other programs for which they met eligibility criteria and were interested in participating during the initial UHHS assessment instead of undergoing another housing screening.
Notification of Screening Results
The CHCP staff member who performs the screening is responsible for documenting the veteran’s name, phone number or means of contact, current residence, and housing outcome in a secure shared Microsoft Excel document called Housing Outcome. The Excel IF and VLOOKUP function link the original document to each program’s acceptance and petition documents. This linkage auto populates information entered in the Housing Outcome document to each program’s acceptance and petition documents if the veteran has a housing outcome associated with the program. CHCP staff members then look at their individual program’s acceptance and/or petition documents to see the list of veterans who have a housing outcome involving their program instead of having to sort through the Housing Outcome document. As a backup to the Housing Outcome document, screeners add the point of contact for the programs that the veteran had an associated housing outcome as additional signers to their CPRS screening note.
When UHHS was first implemented, the screeners had a daily call to discuss the screened veterans’ housing outcomes and screener experiences with the new system. Dr. Hooshyar also participated in this call as a means to answer screener questions and to get feedback. Within a month of UHHS implementation, these calls were cancelled, because the screeners felt comfortable with the UHHS process and the majority of housing programs were operating at full capacity.
