(Note: Items and issues that are to be monitored are indicated in bold font. Other informational items, and general Community Standards related to the philosophy of homeless service delivery, is either indicated as noted or follows bolded items for further clarification.)
All County funded not-for-profit organizations (NPOs) contracted to provide homeless services are required to become certified according to Standards and timeline established by the Human Services Department Program Development, Research and Development Division (PDRED). PDRED may be contacted at: (954) 357-6978 by organizations not yet certified and desiring to begin this process. Technical assistance will be provided by the County Human Services Department to assist organizations to both attain and maintain certification standards.
All non-County funded providers are encouraged to become certified to improve the overall quality and uniformity of service delivery countywide.
- All shelter providers are required to develop and implement an aftercare plan. This may be done by the agency's own staff or in collaboration with other agencies/community partners. Each facility should attempt to track and provide follow-up supportive services to its program graduates for up to 90 days after discharge. In some cases, this may be impossible when a Client leaves a facility without a proper discharge interview/plan in spite of facility policies to provide discharge planning.
- In cases where a Client moves from an emergency shelter to a full service transitional shelter or permanent supported housing program, the obligation for aftercare will fall to the staff of the new Continuum facility. The emergency shelter should then merely track the Client's living situation, with the help of staff at the Client's new facility, for any required outcomes reporting.
- When a Client moves from any facility to market-rate housing or is reunited with family or friends providing domicile in the community, agency case workers should make a concerted effort to maintain contact for at least six (6) months after discharge. Face-to-face visits should be done at three (3) months and at six (6) months and monthly if possible. Supportive services should continue during this time to help prevent a recurring episode of homelessness. Clients in need of ongoing services should be linked with Broward County Family Success Centers as appropriate.
Best Practices / Outcomes
Community Standards: All providers are encouraged to develop and implement an ongoing research, review and training program designed to identify and incorporate programmatic elements of local and national agencies which are considered Best Practices by HUD and other authorities. The goal is to improve the effectiveness of service delivery to homeless Clients and to achieve the highest possible outcomes. Such programs may include, but are not limited to: staff attendance at local, state and national training conferences and workshops including HUD Best Practices Symposiums, Internet searches for Best Practice models and contemporary program literature. References to Best Practice model is required as part of all County funding applications.
Outcome measures, designed to demonstrate a program's success at aiding Clients to attain financial self-sufficiency and permanent housing independence, are required of all County funded providers. Programs, which target various disabled homeless sub-populations, aim at assisting Clients to maintain their highest possible level of independence and functioning.
Community Standards: All Clients who are employed or receiving financial benefits are encouraged to establish a savings plan with their caseworker. All Continuum facilities are encouraged to provide a method for Client savings, proper receipting and financial accountability and budgeting training to Clients.
- A transitional shelter or permanent supported housing shall require Clients who are employed or receiving benefits to contribute towards the cost of their housing and services and/or to a client savings account, only where these arrangements are clearly defined to the Client and written policies are adhered to. And only consistent with Federal limits on the percentage of income (not exceeding 30%) that can be paid for housing that is affordable and consistent with any other applicable federal, state or local regulations. Emergency phase shelters may not charge for shelter and basic necessities.
Cultural Sensitivity / Diversity
All care facilities should demonstrate sensitivity to Clients's primary languages and cultural backgrounds. Any County-funded provider shall arrange for ongoing translation services as required by client(s), within 24 hours of request and should consider bilingual qualifications in its hiring practices.
There shall be no discrimination on the basis of race, color, gender, sexual orientation, disability, religion, or national origin in the provision of housing and services to Clients by providers. No religious practice or affiliation requirement shall be imposed upon Clients or prospective Clients at County funded facilities.
Common Service Plan
Community Standards: Comprehensive assessment of current social, health (including mental health and substance abuse/use) and employment/education conditions are essential in order to establish a program for the individual as he or she proceeds along the Continuum of Care/Services.
During one's stay at emergency and transitional facilities an individualized Common Service Plan should be developed, describing the Client's needs for supportive services, establishing a service/referral plan and outlining the Clients personal goals toward attaining residential, financial and personal stability and self-sufficiency. The Client must participate in both the development and implementation of his/her care or recovery plan.
A Common Service Plan is encouraged but not required for Safe Haven, Tiered Incentive and Outreach Phase Clients.
- The Common Service Plan is required to be shared (with proper release of information) with other Continuum agencies and shelters the Client might access. This is to insure the continuity of care, reduce duplication of services and to increase the Client's accountability for completing agreed upon goals.
Continuum facilities should assist by linking with/referring to internal and/or external services such as, though not limited to benefit programs, in-patient/out-patient mental health or substance abuse treatment or support groups, educational/vocational opportunities, job counseling, training and placement, child care, legal services and transportation (see Supportive Services).
- The case managers shall be responsible for producing a comprehensive or revised assessment, as the case may be, of the Client's current social, health (including mental health and substance abuse or use) and education/employment and other needs. The case managers shall play a major role in assisting the resident in the development, or revision, and implementation of a Common Service Plan that will enable the Clients to successfully achieve his/her personal goals and objectives by addressing unmet needs.
- Clients shall be assisted in initiating an individualized Common Service Plan within twenty-four (24) hours of the completion of their comprehensive assessment of their current social, health and education/employment conditions and needs.
- The individualized Common Service Plan shall be based on the comprehensive assessment of Client's conditions and needs, as well as case manager's recommendations, and the Client's personal goals and objectives. Goals and/or services sought by the Client should be consistent with those articulated by the Client during initial engagement and assessment by outreach, assessment and placement programs or while in the care of another provider.
- Meetings with the Client's case manager to evaluate progress toward goals set fourth in the Common service plan should be conducted on a weekly basis, at least until placement in permanent affordable housing.
- In the event that a Client developed a Common service plan while in the care of another provider, the new provider shall incorporate the Client's Common service plan into the Client's service plan, subject to revision by the Client and his/her case manager.
- The Common service plan is an individualized contract based upon the participant's current state, capabilities and personal goals. The Common service plan shall describe the participant's needs for supportive services and outline the steps that the participant must take in order to begin the personal process towards residential and financial stability and self-sufficiency. The Client's signature on the Common service plan signifies his/her commitment to obtaining residential, financial and personal stability and self-sufficiency.
- The individualized Continuum of Care Plan should address the following goals and objectives that respond to the following potential needs: health (including mental health, including substance abuse), education, vocational skills and employability, benefits, housing, child care, and legal services, as well as family/interpersonal issues and spirituality.
- Unrealistic goals should be avoided to prevent discouragement with the rehabilitation process. Conversely, too simplistic goals should be discouraged to prevent loss of interest by the Client due to the existence of too few challenges. The choices made by the Client with the assistance of his/her case manager should be meaningful, realistic and within the Clients range of skills, abilities and present circumstances.
- Common service plans are intended to be individualized, flexible service plans facilitating steady movement toward independent living at a pace suited for each participant's circumstances and needs. The Common service plan must be adjusted to reflect the progress or identified areas where additional attention is needed either by the Client's own efforts or through the provision of additional services or resources.
Core Case Managers Functions:
- Assessment- a thorough evaluation detailing the Client's current potential strengths, weaknesses, service needs and appropriate resources to meet the service needs.
- Planning- the development of a holistic service plan with each Client, containing service goals and appropriate time lines.
- Linkage/Brokerage- the process of referring or transferring Clients to all required internal and external services.
- Monitoring- the continuous evaluation of the Client's progress, leading to reassessment and development of new service linkages, or other dispositions as indicated.
- Advocacy - interceding on behalf of a Client or group of Clients to assure access to needed services and/or resources.
- Collaboration B with any other case managers assigned to a Client including, but not limited to, community case managers for mental health and substance abuse Clients.
Community Standards: Areas of case managers' intervention should include but are not limited to:
- Service planning.
- Assistance in obtaining food and clothing and transportation.
- Referrals for in- or out-patient mental health services, substance abuse treatment, and medical services.
- Assistance in obtaining benefits.
- Provision and/or referrals to self-sufficiency related programs and services such as adult education, vocational training, job counseling, training and permanent placement services, childcare and legal services and transportation.
- Assistance and referral in obtaining appropriate housing placement in the Permanent, Affordable & Supported Housing level of the Continuum of Care.
- It is recommended that all care providers develop a multi-disciplinary approach toward providing care to the Clients to ensure a holistic response to the Clients's needs. Care providers are encouraged to develop multi-disciplinary care teams, comprised of the Clients's case managers, a health care worker caring for the Client, and/or government or community providers directly serving the Client, that would meet to review Client progress, make recommendations, and ensure successful referral to additional services and resources. Such approach ensures effective, comprehensive service provision within the Continuum or in the community.
- Clients have both privileges and responsibilities relating to their stays at the care facilities which should be set forth in a Resident/Client Agreement that each Client should sign upon admission to the facility.
Continuum of Care facilities/services should facilitate and promote a Client's sense of belonging within or to a community.
As part of the recovery goals of homeless Clients, all Continuum facilities and programs should include a specific community re-integration program component. This may include, but is not limited to: mentoring programs, outside recovery groups (such as AA, NA, CoDA) etc.), voluntary attendance at community-based worship services, volunteer activities in the community, field trips and guest lectures by business persons, elected officials and other prominent and active members of the local community.
- Shelters and residential facilities should develop Neighborhood Advisory Boards where issues of neighborhood impact have been raised.
Case management services shall be preceded by a comprehensive assessment of the Client's current social, health (including mental health and substance abuse/use) and education/employment conditions. Screening for emotional disorders and dysfunctions, including substance abuse, and for other serious mental health impediments to independence, shall be performed by, or under the supervision of, qualified mental health or substance abuse professionals. The comprehensive assessment of the Client's social, health and educational/employment needs shall commence within seventy-two (72) hours of admission of the Client to a care facilities.
In the event that a temporary referred a Client care provider or another transitional care facilities, the Client's comprehensive assessment documentation prepared by the referral provider shall be reviewed and revised by the transitional care provider. Such review and revision shall commence within seventy-two (72) hours of admission of the Client to a care facility.
- The comprehensive assessment shall include treatment and referral recommendations and will form the basis for the Client's individualized Common service plan and referral services provided to the Client. The comprehensive assessment shall be comprised of information gathered by caseworkers, at intake through Client interviews and through medical and referral information.
Cooperation / Continuum of Care
Community Standards: Each care provider shall work closely and cooperatively with Broward County Homeless Initiative Partnership; The Broward Coalition for the Homeless (BCH), Inc. as well as other community- based service providers to effectuate service provision to homeless Clients.
Confidentiality and Sharing of Information
- County funded providers are required to share Client data and demographics electronically using the County approved software.
- All care facilities shall comply with all federal and local state laws and regulations governing the confidentiality of information regarding AIDS/HIV status and medical, substance abuse or mental health history, referral or treatment. Clients' privacy must be guaranteed with regard to information not otherwise protected from disclosure by federal or state laws and regulations that is shared with the transitional care facilities's staff members.
- Care facilities shall respect the privacy of a Client's personal mail and telephone calls.
Community Standards: Client information may be subject to disclosure as provided by laws including investigation by law enforcement, probation officers, and DCF protective services related to minors or the elderly, subject to any limitations on disclosure set forth in state or federal law, including those laws protecting the confidentiality of information regarding HIV/AIDS, substance abuse or mental health history, referral or treatment.
Sharing of Clients' information with other providers to whom Clients may be referred is necessary to ensure effective provision of services, attaining the Client's Common service plan goals, and efficient use of Continuum resources. The necessity of sharing information with other service providers shall be explained to the Client. Client information shall only be shared upon the Client's written consent.
Empowerment of Homeless Persons
Community Standards: Continuum providers should train and establish formerly homeless para-professional staff at all levels: kitchen, custodial, administration, counseling, shelter operations etc.
- Every continuum shelter or agency should create an advisory council made up of current residents or Clients. Senior staff, preferably the shelter or agency director, should meet with the council on a monthly basis to solicit input and discuss rules and other aspects of agency operations.
- Every agency, which primarily serves homeless persons, should have homeless or formerly homeless person included in the composition of its local governing board.
- All residential facilities must adhere to local zoning and fire code regulations governing maximum occupancy for all dwelling units.
- All Continuum of Care facilities shall comply with local and state ordinances, laws or regulations governing the prevention and/or control of communicable air-borne diseaseswithin residential facilities which may include the implementation of structural or environmental measures and quarantining, notification and health screening procedures.
- All care facilities shall maintain safe, clean, and sanitary conditions and the opportunity to keep papers, documents and valuables safe. Beds, pillows and bed coverings (e.g., sheets and blankets) shall be clean and sanitary (e.g., free of infestation).
- Donated clothing must be washed/sanitized prior to distribution to Clients.
- Personal hygiene facilities shall be made available to each Client. Such personal hygiene facilities shall be kept clean and sanitary and maintained in operable working condition at all times, subject to periodic emergency interruptions due to maintenance or repair.
Housing quarters offered to the Client shall be consistent with the Client's individualized Continuum of Care Plan. In the case of residential facilities that are not single gender facilities, separate sleeping quarters and personal hygiene facilities shall be provided and maintained for (1) single male adults (2) single female adults, and (3) families.
- Housing and shelter design (light, ventilation, commodiousness, color scheme, finishes, cleanliness etc.) and operations should facilitate the recovery, dignity, and overall stability and sense of well-being of its residents. Physical design should be based on Best Practice models.
- Building, yards, landscaping, outdoor patios, rooms, common areas, roofs, windows, screens, plumbing, appliances, counters, shelving, doors, locks, paint, tiles, base boards, carpeting etc. must be properly maintained, regularly cleaned, repaired, and kept in good working order. (Consult rules for Adult Living Facilities required by State of Florida Agency for Health Care Administration (AHCA)).
A regular cleaning schedule, with staff inspections, must be adopted for every facility (a sample shelter score card may be obtained from the office of the HIP Administrator Ph.: 954-357-6101).
- Exterior building designs should be unobtrusive in neighborhood settings, should enhance area aesthetics and should avoid calling attention to any institutional aspect of a facility's function. Housing and shelter must comply with all local zoning, design review, signage and landscaping requirements consistent with fair housing regulations.
Clients may be required to participate in the general housekeeping of care facility.
- Written intake eligibility criteria are clear, specific, nondiscriminatory and readily available to both Clients and referring entities.
Length of Stay and Options
- Each Client must be informed as to the facility's lengths of stay requirements and options. Lengths of stay should be consistent with Continuum definitions for the type of facility. However, length of stay should be made on a case by case basis, and predicated on the Client's demonstrated commitment to the goals established by the Client with assistance of case management in his or her individualized Common service plan.
- Linkage with the next phases of the Continuum must always be explained to the Client as part of the process for developing the Client's plan along with a clear explanation of how Clients attain other housing options by working on and achieving their goals.
- All program services must have as their goal preparing the Client for success at the next phase of the Continuum of Care, and ultimately self-sufficiency in Permanent, Affordable & Supported Housing.
- Facilities shall comply with all local and state ordinances, zoning regulations (in accordance with Fair Housing rules), laws or regulations governing residential facilities and/or housing conditions and secure necessary licensing as may be required under such local or state law. Treatment facilities shall also comply with local and state ordinances, laws or regulations governing providers of substance abuse or mental health treatment and related services.
Chemical Dependency/ Abuse Treatment providers shall meet standards and regulations contained in Amended Rule 65D -30 and as amended from time to time and shall obtain a license to operate the program according to definitions and classifications more specifically contained in Section 65D -16.009 F.A.C. and as amended from time to time.
Providers serving the mentally ill shall comply with Rule 65E - 4.016 and shall obtain a license to operate the specific program or Alevel of care@ as classified in section 65E - 4.016 (4) F.A.C. and as amended from time to time.
Community Standards: Where the care provider aims to serve the dually diagnosed population, the disability that is the primary to be addressed shall determine whether a substance abuse or mental health treatment license is the appropriate choice. However, regardless of license, both types of treatment providers are encouraged to provide integrated, holistic treatment to the dually diagnosed.
It is recognized that certain providers rely on 12 steps and faith based recovery modules to assist persons in recovery from substance abuse and are, therefore, not required to adhere to the more stringent licensing requirements of treatment programs. Similarly, counseling is distinguished from mental health treatment in that mental health treatment necessarily involves the prescription of medications for major psychiatric disorders, whereas counseling is didactic in nature and addresses less severe emotional and behavioral issues. Certain types of counseling and therapy are also governed by state licensing requirements.
Exemptions to state licensing requirements, including those for religious organizations, are found in Florida Statutes (Attachment A and as amended from time to time) or can be obtained from the FL DCF ADAMH Program Office or HIP Administration.
Any County contracted homeless service provider is required to screen, or arrange for screening, of all homeless clients (or to document that the client was previously screened) for eligibility for mainstream programs, including but not limited to: Medicaid, State Children's Health Insurance Program, Temporary Assistance to Needy Families, Food Stamps, Supplemental Security Income (SSI), Workforce Investment Act, and Veteran's Health Care. If a client is deemed to be eligible for any of these programs, the contracted agency will be responsible; to the extent it is possible for the agency to do so, for obtaining the service or benefit for the client. Screening must be documented on a checklist and within a specific time range to be determined and approved by the Broward Coalition for the Homeless Continuum of Care Committee in conjunction with HIP Administration.
- All facilities must have provisions for properly storing, refrigerating, and retrieving residents' medications.
- Clients shall be provided a minimum of three meals a day, at least one of which must be a hot meal, at any shelter where the Client is earning no income and is dependent upon the facility for meals. Working Clients should be offered an opportunity for a cooked or bag lunch until first payroll.
- All meals served by emergency, transitional and permanent supportive housing phase facilities shall be nutritionally sound and balanced in compliance with USDA and other standards and/or regulations adopted and/or issued by the local public authority responsible for the regulation of meals at residential facilities as they pertain to both adults and children as applicable. Special health dietary considerations or requests for vegetarian meals shall be accommodated.
- Meal preparation facilities and staff must comply with local Health Department food safety licensing requirements for public safety.
Community Standards: It is recognized that nonresidential soup kitchens and other outreach programs may rely on donated food and, therefore, are encouraged to adopt the standards outlined in this section but are not required to do so unless so stated in a funding contract.
- All residential facilities must make a reasonable effort to meet medically appropriate dietary needs of all Clients.
- All care facilities shall establish and enforce house rules governing the use of alcohol, illegal use of controlled substance, fighting, violence, and/or inappropriate behavior for the purpose of protecting the health and safety of the Clients and staff.
- Violations of facility's house rules may be grounds for terminating a Client's length of stay and/or privilege of readmission, consistent with all local and state ordinances, laws or regulations governing tenancy, if and when applicable.
- Rules must be both posted in a conspicuous place in the facility and presented, reviewed and signed by Clients at intake. Homeless individuals and families served in continuum facilities shall be accorded dignity and respect.
- A grievance procedure providing for fair notice and hearing shall be made known and available to Clients by which to seek redress in the event that a Client has a grievance regarding the operation of the facility, or should the Client believe that he or she has been unfairly accused of a rule infraction, or in the event of a decision by the care provider to refuse or terminate services to the Client. Facility staff must sign acknowledgment of the same grievance policies and procedures.
- County funded providers must implement a system of Progressive Counseling to provide a variety of consequences for rule violations and failure-to-follow-plan short of and leading up to termination of stay. Actions that endanger the health and safety of other Clients and staff remain grounds for immediate termination but which still may be appealed through the normal grievance procedure.
Community Standards: Spirituality is recognized as an integral part of recovery for many homeless persons. Mandatory participation in religious activities is prohibited for County funded providers.
- Facilitation of voluntary involvement in faith-based community activities, of the Client's choosing, and inclusive of all religious creeds, is encouraged to be a part of all Continuum programs.
- Continuum facilities's administrators shall ensure that facility staffs have the qualifications, licensing, proper training, and supervision necessary and appropriate to the job function (s) with which such staff members are entrusted.
Staff-to-Client ratios should be appropriate for the facilitation of Client and agency outcomes outlined in other sections.
- Staff providing care to homeless individuals and families should receive special training in order to be sensitive to the special needs of this population and to be able to demonstrate a balance of both compassion and structure often lacking in the daily lives of the homeless. Development of a rapport between the Client and his/her case managers, establishing trust and familiarity, is deemed integral to establishing an effective service plan and a realistic, Client developed Common service plan.
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