San Francisco Homeless Coordinating Board Administrative Review 2024 Report

Administrative Review Report Out 2024 San Francisco Local Homeless Coordinating Board October. 8, 2024

Agenda: Introduction Background Administrate Review Process Logistic of the Administrative Review Data points-Power BI Tracker Coordinated Entry Redesign Other channels of Review Thoughts, Feedback, Questions

Who is the Administrative Review Team? Department of Public Health Provider- An assigned Primary Care provider whose main function is to access EPIC records and provide recommendations around client's medical necessity for Permanent Supportive Housing. Department of Homelessness and Supportive Housing staff- Management Team, Social Workers, analysts and coordinator s whose main function is to review cases with the lens of HSH s prioritization criteria around chronicity, barriers to housing, and vulnerabilities and provide a determination. 3

Background on Administrative Review Process If people experiencing homelessness have participated in Problem Solving and Coordinated Entry at an Access Point and was not identified as Housing Referral Status despite their high barriers to housing, high vulnerability, and high chronicity of homelessness, their priority status can be reviewed through the Coordinated Entry Administrative Review process. Administrative Review can be initiated by a case manager, clinician, or provider working closely with the household, who can provide information about the individual s barriers to housing, vulnerability, and chronicity of homelessness. Administrative review cannot be requested by the household themselves. Since HSH has started tracking this review process in 2022, the team has completed 883 reviews. The department started this process in 2019 to provide a closer look outside of our general assessment process. Of those 883 reviews 689 (or 78%) have been prioritized and placed on a community queue because of the Administrative Review process. The Administrative Review was formally named the Clinical Review process and changed to the naming to Administrative Review in 2019. **These numbers are as of 10/4/2024 4

How does the Administrative Process Work? Currently in our system clients have a choice to visit our Access points under a program of their choice which are broken down into Adult, Family or TAY systems of care. Clients meet with staff and are asked between 17 and 19 questions( depending on which assessment) in the domains of vulnerability, chronicity, and barriers to housing. A score is assigned at the end of the assessment. If a providers feels as though the score is not reflective of the client's true situation providers can utilize Administrative Review. The Administrative Reviews is a 9-page document that providers fill out that asks more in-depth questions to illustrates a client's true situation. This form is located on our HSH webpage. Administrative Reviews for clients that have 1 year or more of chronicity in the ONE system take 15 business days to complete. For clients that have less than 1 year chronicity of homelessness in the ONE system, reviews can take up to 45 business days. Once the review is complete a response is sent out to the requesting provider. Clients will either remain at Problem Solving status or be placed on a queue and become Housing Referral status. Instructions are sent to that requesting provider to connect the client with an Access point for next steps. 5

This slide contains the following visuals: Contact Info ,Percent by Gender Identity ,Percent by Sexual Orientation ,Percent by Race Ethnicity ,HSH Logo ,Main Header ,Sub-Header ,Header Rectangle ,actionButton ,textbox ,INFO ,Text Box-Incomplete Race % ,Text Box-Incomplete Gender % ,Text Box-Incomplete Sexual Orientation % ,Refresh Date ,Gray Filter Box ,ONE System ID ,Count of Assessments ,Count of Unique Clients ,Prioritized via Administrative Review ,Administrative Review Date. Please refer to the notes on this slide for details

Coordinated Entry Redesign HSH has been working with community on a process called CE redesign since 2022.CE redesign is ad-hoc workgroup that is a three phase process redesigning San Francisco s federally mandated Coordinated Entry system. This partnership is with HSH, Local Homeless Board, service providers, and people with lived experience. We are looking at ways to improve the Coordinated Entry system based of recommendations submitted by this workgroup. HSH has received community feedback through the CE redesign process, that a better understanding of what factors help prioritize clients through the Administrative Review could directly help us understand how to improve the initial assessments. In response to that direct feedback from community HSH is improving our tracking of the Administrative Review. We are also looking at the tracking tools and workflows the Department of Public Health are using to determine eligibility. Administrative Review is an example of our cross departmental work that is vital to the homeless population. 8

What other channels are being used for Reviewing Clients? The Department of Disability and Aging Services & the Human Service Agency are partnering with the Department of Homelessness and Supportive Housing to conduct case reviews for Adults at High Risk of Self Neglect. This service is for clients with an open Adult Protective Services case. Outside of the Admin Review process there is a Clinical Review process. This is for clients that are already established as Housing Referral status. For Clinical Reviews, DPH works with the placement team to identify clients that need nursing units and reasonable accommodations. In these Clinical Reviews clients can also be identified as having higher needs then our portfolio can serve. These cases are clients that need services such as board and care or hospice. Currently if clients are Housing Referral Status and providers feel the client needs reasonable accommodations or nursing, they will need to submit a form for those needs to be evaluated. This includes accommodations for private bathroom and kitchen. Forms for both processes' links are attached in last slide. 9

Thank you for all your work and advocacy! Link for Reasonable accommodations: https://hsh.sfgov.org/RAForm For High Risk of Neglect cases that are connected to Adult Protect Services contact Kristina.leonoudakis@sfgov.org Link to Administrate review information and form: https: https://hsh.sfgov.org/services/the-homelessness-response-system/coordinated-entry/hsh-ce-admin-review/