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Special Focus Project

Framework

The Special Focus component of CORE (Community Outreach Response and Engagement) is an experimental project focused on identifying and encouraging a meaningful change in trajectory for service-resistant homeless individuals who are also committing crimes and contributing to public safety issues. Special Focus participants are identified by law enforcement organizations through factors that include a history of low-level offenses that impact community wellness and the environment, including our parks and local waterways.

Special Focus participants are initially invited to engage in services by an outreach worker. If a Special Focus participant chooses to engage, their progress will be tracked in a two-month cycle using a Progress Matrix tool (pdf) that covers five distinct areas of well-being: 1) Physical Health and Wellness, 2) Mental Health, 3) Substance Use, 4) Engagement with the Criminal Justice System, and 5) Housing. Participants will be expected to make meaningful progress in all relevant areas in order to maintain a “Forward Progress” status.

Progress updates on participating Special Focus clients will be provided regularly to all participating agencies.

Please note that the names of Special Focus referrals and/or participants will NOT be shared publicly. Referrals to the Special Focus project can only be made by participating law enforcement agencies.

Please note that this project is an unfunded, experimental, pilot project. Project design can and will change as we learn more about the effectiveness of specific strategies within the project design.

Draft Workflow

Step 1: Law Enforcement Agency submits a name for consideration for Special Focus.

Step 2: DSS Team reviews list, and assigns status as follows:

  • Accept = DSS Team will serve as primary point person for this client.
  • Send to BHRS = DSS Team believes client’s needs are primarily BH-related.
  • Veto = DSS Team does not believe client is appropriate for Special Focus project and is unwilling to work with this individual due to past experience.

Step 3: BHRS Team reviews list, and assigns status to the “Send” clients as follows:

  • Accept = BHRS Team is willing to serve as primary point person for this client.
  • Veto = BHRS Team does not believe client is appropriate for the Special Focus project.

Step 4: DSS Team creates a provisional paper case file for all accepted clients.

Step 5: Relevant team (DSS or BHRS or joint) make contact with accepted clients and invite them to participate by signing a Release of Information (ROI). If client refuses to sign ROI, the client will not be enrolled and will be considered “failure to launch.” Regular mainstream services will continue to be provided.

Step 6: For participating clients who have signed an ROI, Team will determine a Baseline Score per Progress Matrix. Participating clients will also be referred to an appropriate Enhanced Care Management (ECM) provider engaged in providing CalAIM services to the Justice-Involved Population.

Case files and communication to partners will NOT include any protected health information unless the client has signed a Release of Information that allows such disclosure.

Ongoing:

Participating clients will be scored on the Progress Matrix on a 60-day cycle.

Current status will be logged in case file, as well as recorded on the Master Spreadsheet.

Current status of all referred Special Focus participants will be shared with all collaborative team participants on a monthly basis.

For more information about CORE, please Contact Us. Thank you!