Most Vulnerable Review Team Protocol
The Most Vulnerable Review Team (MVRT) was created by the Nebraska Balance of State (BOS) Continuum of Care (CoC) to effectively provide for and meet the requirements of the coordinated entry system for the most vulnerable homeless population in the BOS CoC that would be best served in Permanent Supportive Housing (PSH).
The objective of the MVRT is to review the situation and circumstances of the most vulnerable homeless persons in the BOS, identify appropriate and available housing options, and offer to persons housing as quickly as possible regardless of the location of the housing or homeless person in the BOS CoC, and maintain an ongoing prioritization list for PSH placements.
The MVRT membership will include required and recommended members and is open to any housing or housing service provider in the BOS CoC.
- Required Members
- BOS CoC Permanent Supportive Housing Providers, ESG Street Outreach, Coordinated Entry Lead, Agency submitting person to MVRT for housing placement.
- Recommended Members
- Projects for Assistance in Transition from Homeless (PATH) providers, NDHHS Behavioral Health Rental Assistance Project providers (RAP), regional CoC representative, HUD VASH & SSVF VA Grants, other permanent housing providers.
Any literally homeless person (HUD Category 1 or Category 4) with a signed All Doors Lead Home release of information will be reviewed by the MVRT regardless of current housing placement as long as they meet one of the two requirements below:
- Have a Vulnerability Index Service Prioritization Decision Assistance Tool (VI-SPDAT) pre-screen total of 10 or greater.
- Is a Chronically homeless person per HUD's 2016 Chronic Homeless Definition, regardless of VI-SPDAT score.
All Doors Lead Home Coordinated Entry Release of Information Form
An affirmative response to the All Doors Lead Home Coordinated Entry Release of Information Form will be completed and documented in the HMIS all by all persons referred to the MVRT.
Pre-MVRT Call Requirements / Duties
Agency conducting pre-screen VI-SPDAT on homeless person that scores 10 or greater should enter VI-SPDAT assessment into HMIS and immediately make referral in HMIS to appropriate MVRT Team (BOS MVRT Single, BOS MVRT Family, BOS MVRT Vet). Agency / case manager making referral to BOS MVRT should plan on attending the regularly scheduled next MVRT meeting to lead discussion of the MVRT review of individual.
The coordinated entry lead will maintain the MVRT referral inventory in the HMIS and it will be available for review by all CoC Permanent Supportive Housing providers in the HMIS and available for review by non-HMIS MVRT team members from the coordinated entry lead.
Permanent Supportive Housing providers will attend each MVRT call with a listing of their current PSH availability and expected vacancies within the next week.
All participants should review the MVRT listing in the HMIS and accompanying client profile information in HMIS prior to MVRT call. Non-HMIS providers will have access to the MVRT referral listing via web connection through the coordinating entity.
Housing Plan & Placement Priority Order
All individuals scoring 10 or greater on the VI-SPDAT shall be staffed by the MVRT. MVRT Prioritization will be done prior to MVRT staffing meetings utilizing the MVRT Priority Ranking Formula Score. Components of the MVRT Priority Ranking Formula Score are derived from the HUD Order of Priority of Chronic homeless persons in CoC PSH : 1) Chronic Homeless Status; 2) history of homelessness; 3) months continuously homeless; 4) VI-SPDAT Assessment Score.
When more than one individual or family have identical Priority Scores, prioritization will follow the HUD Order of Priority of Chronic homeless persons in CoC PSH1: 1) chronically homeless individuals/families with the longest history of homelessness and with most severe service needs; 2) chronically homeless individuals/families with longest history of homelessness; 3) chronically homeless individuals/families with most severe service needs; 4) all other chronically homeless individuals/families. If none are chronic the priority order will follow HUD Order of Priority in Permanent Supportive Housing Beds not dedicated or prioritized for chronic homeless from the same July 28th 2014 notice. The highest priority individual/family will be staffed first and staffing will proceed down the list. In instances when all priority ranking criteria are identical the priority order within will be determined by random assignment.
The special populations of U.S. Military Veterans will be reviewed each as separate populations outside of the standard review process and ordering of their priority will follow the same priority order process outlined above.
MVRT Staffing Calls
The MVRT will meet via conference call every Thursday at 9:00 Central / 8:00 Mountain time on a conference line provided by the Coordinating Entity. The MVRT calls will be scheduled to last no more than 1 hour. An Adobe Connect web connection will also be provided by the coordinating entity to facilitate review of HMIS information.
MVRT Staffing will be structured to provide both the highest degree of standardization and efficiency.
- Permanent Supportive Housing Providers will each announce the availability, number and location of current PSH openings to include the number of single individual, family, and special population units.
- The Coordinating Entity will identify in HMIS from the MVRT Priority Listing (if any) individuals/families from prior MVRT Staffings with VI-SPDAT assessments that are higher than any new clients on the MVRT Referral List and the reason for remaining (no placement available, refused to relocate, etc.).
- If such remain than each case will be reviewed by team as to any new possible PSH placements or recommendation for other/lower level referral options (i.e. transitional housing, RRH).
- The MVRT will then begin review of MVRT Referral Listings for singles, families, and special populations.
- The agency that conducted the VI-SPDAT pre-screen assessment on the individual/family will briefly review the VI-SPDAT score, the client profile and any special circumstances related to the homeless individual/family (including pre-knowledge of individual/families willingness to relocate).
- If multiple PSH placements exist for individual/family the team will identify the most appropriate and the presenting agency will make a referral in HMIS to PSH provider and request that a referral be made in HMIS if not a HMIS participating organization.
- MVRT Referrals will be placed on the MVRT Priority Listing even if a current PSH placement is available and a referral is being made. The listing will be removed when the PSH agency receiving the referral enters the referral in PSH housing unit.
- If no PSH placements are available the MVRT team will add the referral to the appropriate MVRT Priority Listing assignment (1,2,3, etc…).
- The next case will then be identified by the Coordinating Entity and the process will continue until all clients on the MVRT Referral list have been reviewed and added to the MVRT Priority Listing in HMIS.
Permanent Supportive Housing Disability Verification/Documentation
The documentation/verification of a person’s disability is the responsibility of the PSH provider. Persons referred to the MVRT are not required to have disability verification/documentation on file in the HMIS to be reviewed and prioritized.
MVRT Priority Listing Maintenance and Use
The MVRT Priority Listing will be maintained in the HMIS and be available for all PSH providers to access through Shelter Point which includes the prioritization ranking for PSH, prior referrals made from MVRT staffing and reason not accepted, contact information of current housing/shelter provider and contact information for homeless person/family.
Only individuals/families that have been reviewed by the MVRT team will be included the in MVRT Priority Listing.
For PSH providers not participating in HMIS the MVRT Priority Listing Report will be available upon request from the Coordinating Entity.
Prioritized Persons not housed prior to Next MVRT Meeting
Persons, for which the MVRT has reviewed, prioritized, and a housing plan has been identified by the MVRT with a specified PSH provider are to be served with the specified MVRT placement plan even if the placement takes more than 1 week and their priority is reduced with a new referral/s being prioritized at the next MVRT meeting.
Prioritized Persons without Provider Contact
Prioritized Persons that remain on the MVRT priority listing for two weeks without continuing or new contact (contacts include continuing entry in shelter or motel/voucher program) since the initial referral will be removed from the Priority Listing. If they are subsequently contacted a new MVRT Referral will need to be conducted.
Revised CE MVRT protocol 08/04/15