HOME- LESSNESS RESPONSE 101 F O R H E A LT H C A R E P R O V I D E R S A N D STA K E H O L D E RS WHAT TO EXPECT FROM THESE MATERIALS The following pages contain foundational information for health care providers about how homeless assistance works at the local level, with particular focus on two critical components: Continuums of Care (CoCs) and Coordinated Entry (CE). Additionally, you will find practical, action-oriented suggestions on how to participate in your community's response to homelessness. What's included Just enough information and suggested actions to empower and encourage health care providers and other stakeholders to take the first steps to engage and collaborate with their communities' homeless response systems. Specifically: • The case for collaboration • Homeless assistance in a nutshell: CoCs and CE • Opportunities for participation in CE • Examples of successful homeless assistance and health care partnerships (including those with hospitals, health plans, and other health care providers) • Basic information about how to connect with your local CoC(s) What's not included A lot of technical details about homeless assistance programs, systems, operations, and funding that often vary from one community to another. Materials developed in February 2021 by Homebase, in partnership with and with the support of the California Health Care Foundation. Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs WHY CROSS-SYSTEM COLLABORATION IS NEEDED Cross-system collaboration better serves people who are experiencing or at risk of homelessness. It Just as the health care system also makes things easier, less costly, and more efficient for both health care and homeless assistance is not designed or equipped to systems overall. address patients' housing needs, Addressing the health-related needs of people experiencing homelessness is central to ending homeless assistance programs homelessness. Similarly, stable housing is fundamental to maintaining good health and minimizing and systems are not designed the costs of unnecessary emergency department (ED) use and hospital admissions. or equipped to take care of the often complex medical or behavioral health needs of people Housing is a key determinant of health. experiencing homelessness. Poor living conditions affect people's vulnerability to illness and disease and their Coordination is critical to leverage ability to benefit from treatment and manage their conditions. People experiencing both systems' resources to better homelessness contend with communicable diseases and infections, exposure to serve people and to improve extreme weather conditions, malnutrition, stress, lack of running water to maintain outcomes for individuals and cleanliness, and lack of refrigeration for medication and food. families as well as the systems designed to support them. People who are homeless are at greater risk for poor health. The mortality rate among people experiencing homelessness is 3-4 times higher than for the general population. People experiencing homelessness have higher rates of infectious and acute illnesses (skin diseases, tuberculosis, pneumonia, asthma) and chronic diseases (diabetes, hypertension, HIV/AIDS, cardiovascular disease); have higher incidences of mental health issues and/or substance use; and are more likely to be victims of violence. Homelessness is correlated with frequent use of ED and other high-cost health care interventions. The high proportion of complex health needs and co-occurring primary and behavioral health conditions increases the number, intensity, and scope of services people experiencing homelessness need. Homelessness inhibits the long-term, consistent care necessary to treat these conditions, aggravating health problems and making them both more dangerous to the individual and more costly to health care systems, especially managed care plans and hospitals. Homelessness also increases the likelihood of excessive ED use, inpatient treatment, and crisis services. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs FUNDAMENTALS OF HOMELESS ASSISTANCE F O U N D AT I O N A L K N O W L E D G E TO E M P O W E R H E A LT H C A R E P R O V I D E R S T O E N G A G E H O M E L E S S R E S P O N S E S Y S T E M PA R T N E R S Although various types of funding for homeless assistance come from the federal and state governments, homelessness response happens at the local, community level. In California, "community level" most often means the geographic area covered by a single county. County or city governments provide some homeless assistance, but no single agency or organization administers all resources and services. In almost every community across the country, a myriad of organizations and agencies provide a variety of types of assistance to individuals and families at risk of or experiencing homelessness. This assistance may include: Financial support Emergency (one-time assistance or shelter ongoing rental assistance) Temporary or permanent housing Supportive services (e.g., case management, assistance applying for benefits, connections Transportation to medical or behavioral health assistance care, help finding or securing housing) Necessities like food Due to limited resources, the vast majority of housing assistance is prioritized for people living on the street, sleeping in vehicles or tents, or staying in emergency shelters. Communities often further prioritize housing and intensive supportive services for people experiencing "chronic homelessness," which means those who have a disability and have been homeless for more than a year. The next few pages will provide an overview of two critical components of local homeless assistance: the Continuum of Care and Coordinated Entry. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs 5 KEY THINGS TO KNOW ABOUT CONTINUUMS OF CARE What is a CoC? Short for "Continuum of Care," CoC is the umbrella term for the group of organizations and agencies (including community- based organizations and local government agencies) that collectively coordinates homeless assistance activities and resources in a community. There are currently 44 CoCs in California; most cover a single county, but a few cover a single city or two or more adjacent counties. 1 A CoC is not a legal entity. It is a coalition of organizations and entities that meet regularly to discuss and plan their community's homelessness response. Each CoC designates an entity to apply for federal funds on its behalf. The designated entity, often a local government agency or nonprofit organization, is referred to as the "Collaborative Applicant" or "CoC Lead Agency." It submits the CoC's application for homeless 2 assistance grant funds from the U.S. Department of Housing and Urban Development (HUD). CoCs also must have a board comprising representatives from local homeless assistance organizations and at least one person with lived experience of homelessness. A CoC's board oversees the requirements associated with HUD funding. HUD awards homeless assistance grant funds to CoCs through an annual competitive process. Each CoC runs a local process based on community priorities to determine which organizations should receive funding from HUD's award and for what purposes. The CoC's designated Lead Agency 3 uses those determinations to apply for HUD funds on behalf of the community. The primary thing CoCs and CoC-funded organizations use HUD funds for is rental assistance to help people exit homelessness. Some programs combine rental assistance with services for people who need more than financial support to get and maintain stable housing. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs 5 KEY THINGS TO KNOW ABOUT CONTINUUMS OF CARE The primary purpose of a CoC is to promote a community-wide commitment to end homelessness. CoC members attend meetings, participate in community-wide planning, and coordinate with each other. While many agencies that participate in a CoC receive HUD funding, entities that do not receive 4 HUD funding may still participate in the CoC for a variety of reasons: to increase the impact of their own work, to learn more about the different resources available in the community to better serve their clients, to learn strategies and best practices for responding to homelessness, to build relationships with other leaders and organizations with similar missions and values, to better position themselves for future HUD funding, etc. HUD requires CoCs to develop certain processes. Because each community has a variety of assistance programs and resources to support people 5 experiencing or at risk of homelessness, HUD requires every CoC to have a process in place to ensure that people who need housing and other supports are connected to local resources in an equitable and coordinated way. This process is called Coordinated Entry. Types of stakeholders who participate in a CoC include: • nonprofit homeless assistance providers; • EMT/crisis response teams; • community- and faith-based organizations; • hospitals; • victim service providers; • affordable housing developers; • local governments; • law enforcement agencies and jails; • public housing agencies; • community health centers and clinics; • school districts; • people with lived experience of homelessness; • social service providers; • organizations that serve specific populations • substance use service organizations and mental (e.g., veterans, youth, LGBTQ+ people, people with health agencies/service organizations; disabilities); and • local businesses; • advocates • street outreach teams; Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs COORDINATED ENTRY BASICS What is Coordinated Entry? Coordinated Entry (CE) is the process each CoC sets up to ensure that people experiencing or at risk of The idea behind Coordinated homelessness are prioritized for resources based on severity of need, and that people are matched to Entry is similar to emergency available resources most suitable to meet their needs. CE's primary purpose is to allocate housing room triage, which ensures that resources fairly and appropriately. someone having a heart attack is treated before someone with a broken arm, even if the person Benefits of Coordinated Entry with the broken arm arrived at Without Coordinated Entry, people experiencing homelessness have to seek out multiple individual the emergency room first and organizations that might be able to help them. Not only is this extremely burdensome for people already in has been waiting for hours. crisis, but even those who can successfully find, visit, and apply for help at different agencies often end up Under Coordinated Entry, this on numerous separate waiting lists for housing. means that higher-acuity Coordinated Entry removes reliance on individual program waiting lists, which tend to be organized on a people are served before lower- first-come, first-served basis rather than taking acuity of need into account. Reducing the use of individual acuity people. waiting lists and focusing on acuity of need means individuals and families in the most dire circumstances can be housed before those in less severe need. It also means that getting help more quickly or finding out about different types of assistance beyond housing (e.g., benefits, insurance, or employment help) does not depend on the individual case manager someone is assigned (if any) or a person or family's own ability to navigate complicated systems. With Coordinated Entry, HUD mandates that each CoC do the following: • Use a standardized assessment approach with every individual or household that needs housing assistance to determine vulnerability, needs, and eligibility for resources. • Organize a community-wide waiting list for housing resources that prioritizes individuals and families based on vulnerability/severity of need rather than on a first-come, first-served basis. • Provide access to housing resources via one intake and referral process. Effective and equitable Coordinated Entry implementation depends on a wide variety of factors, including inclusive and thoughtful client- centered planning; buy-in and engagement at the client, staff, and leadership levels; sufficient and sustainable capacity and resources; and the ability to collect, store, and analyze accurate data to facilitate connection to resources and monitor performance. The more invested partners who contribute to CE planning and implementation, the better the outcomes are for everyone: CoCs, health care providers and systems, and most important, people experiencing homelessness. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs 5 KEY THINGS TO KNOW ABOUT COORDINATED ENTRY A well-functioning CE process ensures that (1) limited housing resources are prioritized to those most in need because of health issues, vulnerability to death or victimization, or the circumstances of their homelessness; and (2) people seeking housing are more likely to be matched with resources that meet their specific needs, regardless of where, when, or how they "show up" seeking assistance. Coordinated Entry is required. Every CoC must operate a CE system as a condition of receiving HUD funding, and every 1 organization that receives HUD's homeless assistance grant funding must participate in CE. All housing vacancies and rental assistance vouchers funded with HUD's homeless assistance grant funding must be filled through the CE process. Key components of Coordinated Entry: 1. Intake: entry by each person into the CE system; 2. Assessment of each person; 2 3. Prioritization of every assessed person based on vulnerability/severity of need; 4. A process to match resources to individuals or families as they become available, based on the established prioritization; 5. Referrals to housing programs that provide the matched resources; and 6. Placement of people into the housing programs to which they've been referred. CE is open to all organizations that serve people experiencing homelessness. 3 Only HUD-funded programs are required to participate, but the goal is for all local organizations with resources for people experiencing homelessness to participate, regardless of funding source. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs 5 KEY THINGS TO KNOW ABOUT COORDINATED ENTRY CoCs have flexibility in designing their CE processes. Every CoC's CE process must meet certain requirements, but CoCs have flexibility to customize their process. Based on local capacity, needs, and resources, each CoC must plan and design: 1. how and where to identify people in need of homeless assistance; 4 2. what tool(s) to use to assess each person or family; 3. what factors to include when determining relative vulnerability of those assessed (i.e., the information on which to base prioritization); 4. the process and people involved to match available resources to prioritized people and connect those people to the agencies that hold the resources; and 5. how to evaluate whether the process is working well. CoCs must evaluate and refine their CE processes to prioritize equity, address disparities, and improve outcomes. HUD has mandated CE for only a few years, so CoCs are at different points in implementation. 5 CoCs should regularly make adjustments to ensure that the process is working effectively and equitably. Even in communities with an established CE system, there is always room for discussions, planning, and changes to improve implementation. Stakeholders with diverse perspectives and expertise - including health care providers - are critical to identify issues and blind spots and inform changes. The next pages provide additional details about the components of CE and opportunities for health care providers to get involved to (1) ensure patients with housing needs are connected to the homeless assistance system, and (2) help inform and improve how CE works overall. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs KEY COMPONENTS OF COORDINATED ENTRY Coordinated Entry (CE) is a formal process through which people experiencing or at risk of homelessness access the homeless response system in a streamlined way, have their strengths and needs assessed, More on Assessment and connect to appropriate, tailored housing and mainstream services within the community. The key components of coordinated entry are described below. Relevant assessment factors include information about each person's needs, strengths, and preferences; System Entry Matching barriers they face to secure Clients seeking housing or services As housing resources become housing; length and duration make contact with the community's available, clients at the top of the of past and current episodes homeless response system, usually by community's priority list are given a of homelessness; and interacting with an outreach worker, choice to accept those resources for characteristics that make calling 211, or showing up at a service which they are eligible and which them more vulnerable while provider's site. appear to meet their needs. experiencing homelessness. Most assessment information is self-reported, and Assessment Referral people may underreport All individuals and families who Clients matched with a resource certain conditions for enter the system are assessed are referred to the program holding various reasons. in a consistent manner, using that resource, which requires a uniform decision making communication between those who More on Prioritization process and standardized made the match decision, the client, Prioritization schemes are assessment tools. and the program providing decided by each community the resource. and usually take into account Prioritization the severity of service needs, 1 2 Placement considering factors such as 3 Clients are prioritized for housing risk of illness, death, and/ and community resources based Clients are placed into the program or victimization; history of on factors agreed upon by the CoC, and ultimately into housing. This frequent use of crisis services; ensuring that limited resources are usually entails ensuring that the and significant physical or used in the most effective manner client is "document ready" and often mental health challenges, and that households most in need of requires the client, program, and substance use disorders, or assistance are prioritized for housing other partners to work together to functional impairments. and services. address various barriers to housing placement and stability. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs OPPORTUNITIES FOR HEALTH CARE PROVIDER PARTICIPATION IN COORDINATED ENTRY Coordinated Entry offers practical and meaningful opportunities for cross-system coordination. By plugging into a community's CE process, health care providers can: (1) ensure that patients with housing needs connect to the homeless assistance system in the way most likely to get them assessed, prioritized, and connected to available resources; and (2) contribute valuable expertise to improve the overall CE process over time, so housing resources get to those who need them most in an efficient and equitable way. Each improvement to the CE process and each patient connection to housing resources contribute to improved overall patient outcomes and decreased burdens and costs on the health care system. The following are examples of ways health care providers can participate in CE and contribute to its improved functioning. System Entry • Learn basic eligibility requirements to identify patients to connect to the CE system. • Know the entry points for your community's system and how to help your patients access them. • Develop protocols for notifying outreach teams of potentially eligible patients to get them quickly connected to CE. • Serve as a CE entry point to reduce the burden on patients and increase the likelihood that they will be assessed and prioritized for available resources. Assessment • Help review, select, and/or develop assessment tool(s) to more accurately capture health-related vulnerability. • Notify he CE system of patients who should be assessed. • Provide space for assessments to take place. • Administer assessments. 1 Prioritization 2 3 • Work with the CE system to ensure that critical health considerations are factored into prioritization schemes. • Participate in case conferences to explain when and how specific health conditions should result in individuals being prioritized more highly than the standard CE protocols suggest. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs OPPORTUNITIES FOR HEALTH CARE PROVIDER PARTICIPATION IN COORDINATED ENTRY Matching • Participate in matching case conferences to increase the likelihood of appropriate and successful matches for patients. • Help clients understand their options and how each might impact health care access and outcomes. Referral • Offer support to housing providers (e.g., provide health care or other services to clients) to increase the likelihood that referred patients are accepted and successful in housing placements. • Help clients procure necessary eligibility documentation (e.g., disability verification). Placement • Provide transportation help to get clients to appointments. • Follow up with housed clients to ensure continued connections to health care needed to support long-term housing stability. One more opportunity... The next page contains basic information about CoC data systems and how health care providers can help support CE operations through data review and analysis. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs BASICS OF HOMELESS MANAGEMENT INFORMATION SYSTEMS CoC and Coordinated Entry operations generate a lot of data that can be used to evaluate system performance and identify system needs. However, CoCs often don't have the capacity or expertise to identify and address data quality issues, perform meaningful data analysis, or determine the most efficient use of data. Health care stakeholders can provide invaluable support to CoCs by contributing expertise and time toward (1) regular and ongoing data quality review, (2) metrics development and progress monitoring, and (3) data analysis to identify areas for improvement. What is HMIS? HUD requires each CoC to collect and report certain information about the people they serve. Homeless Management Information Systems (HMIS) are the data systems that communities use to collect and analyze client, service, and housing data. HUD does not mandate that CoCs use a particular software program; each community may select any that can collect the required data elements, comply with HUD's data standards, and support reporting requirements. Information contained in HMIS other resources, monitoring client outcomes, and i tracking performance metrics at the organizational and HUD requires every community to track specific data system levels. However, the information contained in points and response options for each of various data HMIS can be insufficient for various reasons: elements. HUD also publishes data standards that CoCs must meet. Types of required data elements • Only programs that receive HUD funding are include the following: required to enter information into a community's HMIS (although additional programs - including • Basic client information, including whether the health care providers such as managed care plans client has a physical or developmental disability, and hospitals - often also participate with prior chronic health condition, HIV/AIDS, mental health agreement and training). issue, or substance use disorder • Inconsistent data entry and data quality and • Whether the client receives noncash benefits or has missing information often occur with so many health insurance, and if so, what kinds different individuals and providers entering data. • Information about client interactions with the • Client information contained in HMIS is largely homeless response system self-reported, and clients may refuse to answer Limitations questions or may provide incomplete or inaccurate information for a variety of reasons. Clients Having a single system to collect data about those underreporting their health conditions can served by a community's homeless assistance result in lower CE prioritization than their actual programs is extremely helpful for keeping track of vulnerability or acuity of need warrants. clients, coordinating the connection to housing and Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs PARTNERSHIP EXAMPLES: PARTICIPATION IN COORDINATED ENTRY System Entry • Yakima Neighborhood Health Services in Washington plan members experiencing or at risk of homelessness State and Heartland Health Outreach in Chicago serve as connect to the CE system to be assessed and prioritized Coordinated Entry access points for their respective CoCs. for housing resources. For example, United Healthcare They identify and complete the CE intake process for people Medicare plans in multiple communities have engaged who may be eligible for homeless services. with local CoC partners to match member lists with HMIS data to coordinate around shared clients in order • Family Health Centers of San Diego operates the city's to improve connections to health and housing resources. Housing Navigation Center, which provides on-site CE Similarly, L.A. Care worked with the Los Angeles CoC on intake, assessment, triage, and referrals for housing a data match to identify members staying in COVID-19 opportunities. non-congregate shelter motels and help connect them to • Washington State provided CoC and CE training to state needed psychiatric hospital discharge planning staff, so the staff could health services. better identify patients who were eligible for homeless • Hospital, clinic, and community health center staff assistance resources. The discharge planning staff could also - including social workers, nurses, physicians, and complete a prescreen assessment to facilitate a patient's psychiatrists - are often part of homeless outreach or entry into their local CE system. street medicine teams, which can serve as CE system • Managed care plans can work with CoCs to ensure that entry points for people experiencing unsheltered homelessness. Assessment • Health Care for the Homeless in Baltimore assisted in building • Albuquerque Health Care for the Homeless is an and testing the Baltimore Decision Assessment Tool, the assessment location for the CE system. Trained CoC's locally created CE assessment tool, and provided Engagement Specialists complete CE assessments for training for CoC staff to use it. clients, so they can be prioritized for and matched to housing resources. • The Clark County, Nevada, CoC developed a local CE assessment tool, and a variety of health care stakeholders • Valley Homeless HealthCare Program in Santa Clara County, participated in the development process. California, has an outreach team that administers CE assessments. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs PARTNERSHIP EXAMPLES: PARTICIPATION IN COORDINATED ENTRY Prioritization 1 2 3 • Alameda County Health Care for the Homeless and other prioritize people experiencing chronic homelessness county and community health care providers participate for programs that provide both housing and intensive in an initiative called Home Stretch. This initiative, part of supportive services. the CoC's CE system, was created to identify, assess, and The Effect of the Pandemic on People Experiencing Homelessness and CoCs People experiencing homelessness are among those most vulnerable to severe COVID-19 illness and death for numerous reasons. Because CE's primary purpose is to prioritize people based on vulnerability, CoCs across the country adjusted their prioritization schemes to incorporate COVID-19 risk factors, working with public health departments, local Health Care for the Homeless programs, and other health system stakeholders. Centers for Disease Control and Prevention (CDC) guidance and local health care provider expertise have been critical to inform the adjustments CoCs made to their systems, particularly their CE prioritization decisions. Matching, Referral, Placement • Daily Planet Health Services in Richmond, Virginia, health care providers identify and triage patients with and Hennepin County Health Care for the Homeless housing needs to enter the CE system, can request in Minneapolis, Minnesota, each participate in case special prioritization for patients with complex needs, conferencing to help match prioritized individuals and and help patients prioritized for housing to gather the families to available housing resources and monitor and documentation necessary to demonstrate eligibility advance their progress toward securing housing. for certain housing programs. • Houston's Coordinated Entry system partners with three • Valley Homeless HealthCare Program in Santa Clara Health Care for the Homeless programs to refer clients to County, California, helps clients who are prioritized health clinics, dental health services, mental health services, for Permanent Supportive Housing collect the HIV services, and housing. documentation needed to complete the referral and placement process. • Oahu's hospitals and Medicaid health plans participate in Coordinated Entry in a variety of ways. Participating Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs NEXT STEPS: LOCATE + LEARN ABOUT + REACH OUT TO LOCAL CONTINUUMS OF CARE There's no one way to collaborate with a CoC or participate in a Coordinated Entry system that applies across the board. Each CoC has different things to offer and needs different things from potential health care partners. Specific opportunities to participate in Coordinated Entry vary across CoCs as well, and there may be opportunities to partner other than participating in CE (e.g., by colocating health services at emergency shelters or housing sites, or by partnering on a medical respite/recuperative care program). The best way to engage with your local CoC(s) in a mutually beneficial way is to connect with and begin to build a relationship with representatives from key CoC stakeholders, such as the Lead Agency, CoC chair, or Coordinated Entry operator. Speaking with CoC and CE leaders is a great way to learn about the health needs of people who engage with your local homeless response system, share insights about your and your patients' needs, and discuss opportunities for cross-system collaboration and partnership to address those needs. The following pages contain a list of California CoCs by the geographic region they cover and includes the current website for each of them, to help you take the first step toward a cross-system partnership. Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs CALIFORNIA CONTINUUMS OF CARE Geographic Region Covered Name of CoC CoC Website https://everyonehome.org/about/committees/ Alameda County Oakland, Berkeley/Alameda County CoC hud-coc-committee/ Alpine County Alpine, Inyo, Mono Counties CoC https://www.imaca.net/ Amador, Calaveras, Mariposa, Tuolumne Counties Amador County https://www.centralsierracoc.org/ CoC (Central Sierra CoC) Butte County Chico, Paradise/Butte County CoC https://www.buttecaa.com/ Amador, Calaveras, Mariposa, Tuolumne Counties Calaveras County https://www.atcaa.org/ CoC (Central Sierra CoC) https://www.glendaleca.gov/government/depart- City of Glendale Glendale CoC ments/community-services-parks/homeless-services http://www.longbeach.gov/health/services/directory/ City of Long Beach Long Beach CoC homeless-services/ City of Pasadena Pasadena CoC https://pasadenapartnership.org/coc-program/ Colusa County Colusa, Glenn, Trinity Counties CoC (Dos Rios CoC) http://cgtcap.org/dosrios/default.aspx Contra Costa County Richmond/Contra Costa County CoC https://cchealth.org/h3/coc/council.php Redding/Shasta, Siskiyou, Lassen, Plumas, Del https://www.co.shasta.ca.us/index/housing-communi- Del Norte County Norte, Modoc, Sierra Counties CoC (NorCal CoC) ty/norcal-continuum-of-care https://www.edcgov.us/Government/HumanServices/ El Dorado County El Dorado County CoC Housing/pages/continuum_of_care.aspx Fresno County Fresno City and County/Madera County CoC http://fresnomaderahomeless.org/ Glenn County Colusa, Glenn, Trinity Counties CoC (Dos Rios CoC) http://cgtcap.org/dosrios/default.aspx https://humboldtgov.org/2512/Humboldt-Hous- Humboldt County Humboldt County CoC ing-Homeless-Coalition Imperial County Imperial County CoC https://www.imperialvalleycontinuumofcare.org/ Inyo County Alpine, Inyo, Mono Counties CoC https://www.imaca.net/ Kern County Bakersfield/Kern County CoC https://bkrhc.org/ Kings County Visalia/Kings, Tulare Counties CoC https://www.kthomelessalliance.org Lake County Lake County CoC https://www.lakecoc.org Redding/Shasta, Siskiyou, Lassen, Plumas, Del https://www.co.shasta.ca.us/index/housing-communi- Lassen County Norte, Modoc, Sierra Counties CoC (NorCal CoC) ty/norcal-continuum-of-care Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs CALIFORNIA CONTINUUMS OF CARE, CONTINUED Geographic Region Covered Name of CoC CoC Website Los Angeles County (except the cities of Glendale, Los Angeles City and County CoC https://www.lahsa.org/ Long Beach, and Pasadena) Madera County Fresno City and County/Madera County CoC http://fresnomaderahomeless.org/ Marin County Marin County CoC https://www.marinhhs.org/homelessness-marin Amador, Calaveras, Mariposa, Tuolumne Counties Mariposa County https://www.atcaa.org/ CoC (Central Sierra CoC) https://www.mendocinocounty.org/government/ health-human-services-agency/adult-aging-services/ Mendocino County Mendocino County CoC mendocino-county-homeless-services-continu- um-of-care Merced County Merced City and County CoC https://www.co.merced.ca.us/848/Homeless-Assistance Redding/Shasta, Siskiyou, Lassen, Plumas, Del https://www.co.shasta.ca.us/index/housing-communi- Modoc County Norte, Modoc, Sierra Counties CoC (NorCal CoC) ty/norcal-continuum-of-care Mono County Alpine, Inyo, Mono Counties CoC https://www.imaca.net/ Monterey County Salinas/Monterey, San Benito Counties CoC https://chsp.org/ https://www.countyofnapa.org/1036/Napa-Continu- Napa County Napa City and County CoC um-of-Care Nevada County Nevada County CoC https://www.hrcscoc.org/ https://www.ochealthinfo.com/homeless_serv/ Orange County Santa Ana, Anaheim/Orange County CoC coc/2021 Placer County Roseville, Rocklin/Placer County CoC https://www.hrcscoc.org/ Redding/Shasta, Siskiyou, Lassen, Plumas, Del https://www.co.shasta.ca.us/index/housing-communi- Plumas Count Norte, Modoc, Sierra Counties CoC (NorCal CoC) ty/norcal-continuum-of-care http://dpss.co.riverside.ca.us/homeless-programs/ Riverside Count Riverside City and County CoC housing-and-homeless-coalition Sacramento County Sacramento City and County CoC https://sacramentostepsforward.org/ San Benito County Salinas/Monterey, San Benito Counties CoC https://chsp.org/ San Bernardino County San Bernardino City and County CoC https://wp.sbcounty.gov/dbh/sbchp/ San Diego County San Diego City and County CoC https://www.rtfhsd.org/ Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg Homelessness Re s p o n s e 1 0 1 Fo r Hea l t h C a re Prov ide rs A nd Stake h o lde rs CALIFORNIA CONTINUUMS OF CARE, CONTINUED Geographic Region Covered Name of CoC CoC Website San Francisco County San Francisco CoC https://hsh.sfgov.org/committees/lhcb/ San Joaquin County Stockton/San Joaquin County CoC http://www.sanjoaquincoc.org/ https://www.slocounty.ca.gov/Departments/Social-Ser- San Luis Obispo County San Luis Obispo County CoC vices/Homeless-Services.aspx https://hsa.smcgov.org/san-mateo-county-continu- San Mateo County Daly City/San Mateo County CoC um-care https://www.countyofsb.org/housing/continuumpro- Santa Barbara County Santa Maria/Santa Barbara County CoC gram.sbc Santa Clara County San Jose, Santa Clara City and County CoC https://www.sccgov.org/sites/osh/ContinuumofCare Santa Cruz County Watsonville/Santa Cruz City and County CoC http://homelessactionpartnership.org/ Redding/Shasta, Siskiyou, Lassen, Plumas, Del https://www.co.shasta.ca.us/index/housing-communi- Shasta County Norte, Modoc, Sierra Counties CoC (NorCal CoC) ty/norcal-continuum-of-care Redding/Shasta, Siskiyou, Lassen, Plumas, Del https://www.co.shasta.ca.us/index/housing-communi- Sierra County Norte, Modoc, Sierra Counties CoC (NorCal CoC) ty/norcal-continuum-of-care Redding/Shasta, Siskiyou, Lassen, Plumas, Del https://www.co.shasta.ca.us/index/housing-communi- Siskiyou County Norte, Modoc, Sierra Counties CoC (NorCal CoC) ty/norcal-continuum-of-care Solano County Vallejo/Solano County CoC http://www.housingfirstsolano.org/ https://sonomacounty.ca.gov/CDC/Homeless-Services/ Sonoma County Santa Rosa, Petaluma/Sonoma County CoC Continuum-of-Care/ Stanislaus County Turlock, Modesto/Stanislaus County CoC http://www.stancoha.org/coc/ Sutter County Yuba City and County/Sutter County CoC https://www.syhomelessconsortium.org/ Tehama County Tehama County CoC http://www.tehamacoc.org/ Trinity County Colusa, Glenn, Trinity Counties CoC (Dos Rios CoC) http://cgtcap.org/dosrios/default.aspx Tulare County Visalia/Kings, Tulare Counties CoC https://www.kthomelessalliance.org Amador, Calaveras, Mariposa, Tuolumne Counties Tuolumne County https://www.atcaa.org/ CoC (Central Sierra CoC) Ventura County Oxnard, San Buenaventura/Ventura County CoC https://www.venturacoc.org/ Yolo County Davis, Woodland/Yolo County CoC http://www.y3c.org/home1.aspx Yuba County Yuba City and County/Sutter County CoC https://www.syhomelessconsortium.org/ Materials developed in February 2021 by Homebase, in partnership with California Health Care Fo u nd atio n and with the support of the California Health Care Foundation. www.c h c f.o rg