Vermont Legislature SmartTranscripts:

[Speaker 0]: Okay. Good afternoon, everyone. Welcome back to another version of House Human Services. We're joined by the long care, term long term care ombudsman, Kylie. I always always wonder. Feel like I'm not pronouncing it right. So welcome. The floor is yours. And just reminding witnesses that they have fifteen minutes, and we'll take another, couple of minutes afterwards for any questions from the committee. So thank you very much for being here. Absolutely. I'm just trying to access the meeting here and so I can share my presentation. You're coming in now about Okay.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: Mute. I assume I need to mute on my end.

[Speaker 0]: Yes. You do need to mute. If you don't, we're in trouble. And, members, we have the presentation on our web on our website.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: Okay, hopefully I can be heard online.

[Speaker 0]: You have to share it on your

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: And let me see, I should know how to do that.

[Speaker 0]: Okay,

[Rep. Zon Eastes (Member)]: I do. Yeah. Shouldn't It's Canada Pips or United States. I think I got it. Yes. Okay, there we go. They just sit.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: Okay, I'm the State Long Term Care Ombudsman at Vermont Legal Aid. Thank you for having me. I'm just going to start with a tiny bit of background. Long Term Care Ombudsman programs were started by the federal government in the 70s in response to widespread concerns about the quality of care in nursing homes. And in Vermont, it was embedded in state statute and the program was expanded to include all licensed long term care facilities. So that's nursing homes, res care and assisted living, which is over 130 long term care facilities in Vermont. And we also cover individuals who receive long term care in the community through the Choices for Care program. The main thing we do is we have ombudsman are set throughout the state that visit facilities, talk to residents, learn about their concerns, learn about what they need and work to resolve their issues. In addition to that, we visit every facility to just monitor the conditions there. We also work to educate residents and facility staff about residents' rights and quality care. And we also work on systemic issues throughout the state. Our main goal is to provide person centered advocacy. So the client sets the goals, they decide what the issues are and whether it's been resolved to their satisfaction. Our team currently is seven long term care ombudsman, one covers the statewide hotline and the rest work directly in facilities throughout the state. Then there's me, the state long term care ombudsman. We added a position in Bennington in 2024 in response to significant concerns about the facilities there. We were finding that the the team we had, it it took too long to travel there, and we couldn't be there often enough, and we would just see the same issues come up over and over again. They weren't being resolved. And then we knew the Mission Care facility was opening up. Mission Care was created to house hard to place individuals, people with significant mental health issues and former incarcerated people, things like that. And we knew that we needed feet on the ground in that facility to ensure that people were getting quality care and that their rights were being respected.

[Speaker 0]: Does that include the veterans home? Are you able to go into the veterans home?

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: Yes, it does include the veterans home in Bennington. Yep. So I think the best way to understand what we do is through some case examples. So one example, we worked with a woman who had vision impairments, but did not have dementia, but was put in a dementia ward. She reported that she was not being treated with dignity and respect. People, staff would come into her room and they wouldn't speak to her directly before touching her for They also wouldn't respond to her requests for help. She would wait for hours on a commode for help. She would wait for hours in bedding for help. And her son reported that he would come and visit and repeatedly find her oxygen tank wasn't hooked up even though she couldn't unhook it. Also have access to stimulating activities. So our ombudsman came in and worked with the facility to reeducate staff on treating residents with dignity and proper care techniques. We also got her reassessed and she was able to move out of the dementia ward and into a unit, a regular unit with more activities and access to the outside. In the end, she reported that she both was receiving better care And most importantly, she felt like she was able to ask for help when she needed it and speak up when she had an issue. One other example is we had a hospice nurse reach out to us and say that she was working with residents in a facility, and the facility wasn't honoring the hospice orders for pain relief. So she was seeing residents who were actively dying and in pain. Our ombudsman went to the facility and spoke to the facility, and they said that they were working under corporate orders that dictated how often they could administer medications and that they could be administered as often as hospice prescribed. So the ombudsman worked at the facility to understand that they couldn't have a corporate policy that did not allow residents to get the proper care. The facility understood and agreed to follow hospice orders for pain management in the future. Dan asked me to talk about how our program addresses the Aged Strong Vermont's plan, and we are so well aligned that I think I could talk all day. It's hard to fit into a fifteen minute talk, but I'm gonna try to go through it really quickly. So I'm gonna talk about our program in line with the eight strong Vermont principles for aging well. So one of them is financial security. We do a lot of work with with clients working with billing about try to work out billing disputes between facilities and residents, and these can be really large bills that significantly impact financial security. Tens of thousands of dollars or more than $100,000 in these bills sometimes. We also help clients regain access to their money when sometimes they've been cut off and also help them direct how their money is being spent. Sometimes those wishes are not being respected. And we also intervene when they believe that their representatives are mishandling their funds. So just in fiscal year twenty five, we worked on 40 complaints related to financial and property concerns and an additional eight alleging financial exploitation. Sorry, I'm trying to move this window around. Optimal health and wellness is another principle. That's our bread and butter. We intervene when staff are not responding to requests for help or not addressing residents' symptoms. We also facilitate care planning and intervene when the care plan is not being followed. In fiscal year 'twenty five, we worked on 146 complaints related to quality care. The State Plan on Aging also talks about the importance of access to good quality food for optimal health and wellness. We worked on an additional 40 complaints about food in fiscal year twenty five. Social connection and engagement. We work with residents to ensure that they can access their loved ones and the activities that are meaningful to them. In fiscal year twenty five, we worked on 25 complaints related to activities, community integration, and social services. Housing, transportation, and community design. One of our biggest issues that we work on is involuntary discharge helping residents appeal when a facility wants them to leave against their will. We also help resolve disputes between facilities and residents to try to keep it from getting to the point where they're being involuntarily discharged. And we help out when there's issues with the conditions or habitability in the facility. In fiscal year twenty five, we worked on 48 complaints related to involuntary discharge and 18 regarding living spaces and facilities. Family caregiver support is another principle. We work with family members and friends to help resolve and understand issues. We received complaints from family members and friends in fiscal year twenty five. We worked on 198 complaints that we had received from representatives, friends and family members of residents. Self determination is core to our work. As I explained that we take direction from the resident, we work on what is important to them. We intervene when facilities fail to uphold residents' rights. They try to ensure that they are allowed to make decisions and how their care is received. We provide information and advice to clients about their rights, and we conduct trainings to both staff and residents on resident rights. In fiscal year '25, we worked on 82 complaints related to autonomy, choice, and rights. Safety and protection, we get involved in cases where the resident wants help with concerns about abuse, neglect, or exploitation. We

[Speaker 0]: try to resolve the issue, and

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: we also make referrals to adult protective services, Medicaid fraud and abuse, and other relevant agencies like that, and we try to connect them to legal services if they need help with things like dissolving a guardianship or power of attorney. In fiscal year twenty five, we worked on 19 complaints related to abuse, gross neglect, and ex patient. And finally, coordinated and efficient systems of service. As I said, we spend time in every licensed long term care facility in Vermont, listening to residents concerned, learning about their situation. And we either try to address the problem ourselves or refer them to somebody who can better help. We we met with a program just yesterday who said they consider us their eyes and ears for a facility for making sure they get the referrals from people that need their help. We also participate in a long list of work groups, committees, and councils to make sure that the voice of long term care recipients is heard. And our work has systemic ramifications of helping to avoid hospitalizations and also homelessness through our monitoring and advocacy. And we also help ensure that the large amounts of money that both private citizens and the state are spending on long term care is going to quality care and not just going to profits for the private long term care facilities. In fiscal year 'twenty five, we documented over 300 instances of information and advice to individuals and 200 consultations with facility staff and choices for care providers. So for fiscal year twenty seven, we are asking for an additional $275,000 to be added to our base budget. We haven't had an increase or since '27, it'll be three years since we had our last increase. We will have to lay off staff in '27 if we don't receive an increase. And I can't emphasize enough how important it is for us to have sufficient staff to be able to cover over 130 long term care facilities in Vermont in person. We can't do the work remotely, and we can't have just a few staff having to travel to these locations because they can't be in the facility if they're on the road all day. And I just wanted to end with a recent lovely note that we got from the daughter of a client. So she said our ombudsman prioritized my mother's voice despite her vascular dementia and aphasia at a critical time when she felt she had no voice. Please keep up the good work on behalf of Vermont's elders.

[Speaker 0]: Thank you. Appreciate that. So open it up for questions from committee members. Go ahead, representatives. I

[Rep. Daniel Noyes (Clerk)]: know a lot of your work is center based where you're looking at nursing homes, but you also go into people's homes who are receiving in home care through Choices And for I was just wondering if you could talk about what the numbers of individuals that are in each setting and just-

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: Let's see.

[Rep. Daniel Noyes (Clerk)]: I'm sure there's a little different than if you're being cared for by basically a nursing home with You mean a breakdown of the statistics that you Yeah, I was just wondering that are being cared for by their children or something.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: So I don't have people who are in the community and not on Choices for Care, but I have there are 2,800 nursing home beds in Vermont, about 3,300 residential care and assisted living beds in Vermont, And there's about 4,600 people on choices for care in Vermont. Does that answer your question? Thank

[Rep. Zon Eastes (Member)]: you. So it's a lot of people.

[Rep. Esme Cole (Member)]: It's a lot of Yeah, it's a lot

[Speaker 0]: of people. But I guess I wanted to maybe follow-up a little bit on that question from Ref Noyes. Thank you for identifying by category the number of instances that you've been involved. Do you have the number of unduplicated cases, if you will, unduplicated individuals? I do. And I did include our Oh, I'm sorry. No, it's Okay. Our annual report. It's in the annual report.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: Yeah. And I should note that off the top of my head.

[Speaker 0]: That's okay. I'll look in the annual report. I'm sure it's Yeah. Wasn't a lot of overlap in

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: those numbers other than I did do separate categories, even though you could argue there's a lot of overlap in those categories, it was mostly separate except for the number of referrals received from family and friends. Those overlap with the other categories of care concerns and things like that.

[Speaker 0]: That makes sense. What I'm trying to also understand is from your request, what percent increase is that? What's the ombudsman budget? Oh, sure. It's currently a million it's about a million 81 or a million 82. It's fluctuated slightly in the past couple years, not including onetime funds. And so the use of these funds would be for salaries? What what's the funds for? Well, it's I mean, I saw you you said you would have to reduce staff if you Yeah.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: I mean, our our costs are mostly salaries, transportation, and it's both our program and the overall Vermont legal aid administrative

[Speaker 0]: costs that we contribute to.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: Vermont legal aid had to shrink some last year, which means that those of us that

[Speaker 0]: are left Had paid higher admin. Unless, of course, they reduce admin costs too, which they probably did. It's just trying to do calculation here off the top of my head, which is never a good idea.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: As I said, we added a a position in Bennington. It just it was getting too bad to ignore. Yeah. So I mean, it's roughly

[Speaker 0]: a 27% increase. In three years. Yeah. Oh, right. Yeah. Okay. Any other questions? Thank you very much. Thank you. Appreciate it. Okay. Next, we're going to hear from Connor Timm and chair. We're doing technical presentation.

[Connor Timm (Executive Director, HomeShare Vermont)]: You so much for having me. There was some debate as to whether I should refer to you as Madam Chair or Chair Wood, so I'll leave it

[Speaker 0]: on You can just do whatever you feel like.

[Connor Timm (Executive Director, HomeShare Vermont)]: Either way, thank you very much for having me. I am lucky enough to know a few of you just from running around in the halls here, so it's nice to connect with all of you in person. My name is Connor Chittenden. I'm the executive director at HomeShare Vermont. A lot of what I was gonna talk about, at least in terms of, themes came up in the last presentation, so it's good that this fits together. I'm here to discuss how continuing to fund HomeShare Vermont's most recent expansion both satisfies the health goals that we just discussed, those eight pillars, and also saves Vermonters individual money at the same time. So last year, the legislature appropriated $235,000 to extend our reach to include all three counties in the kingdom, Southern Half of Windsor County and all of Windham County. So this was a big swing for us. For those of you who've known our program over the last four to three years, we are sort of notorious for going very slow and very intentionally. But basically, last year, the demand was just it was too much. Probably the hardest thing that case managers would tell us is when we got a phone call from someone we couldn't help. Hearing someone's situation and then saying, I'm sorry, we don't serve that area because we don't have the capacity, that'll kill you. So we decided we needed to start moving a little faster and changing our strategy. So that's why you saw us last year. And last year, we asked for base funding, and we got one time funding, which was a common trend. I totally understand how that happens and why that happens, but that's what puts us back in this chair today. So what we're looking for today is just to continue on doing the work we're doing with the funds that we advocated for last year. I'll go through quickly what we do, although I'm sure almost everyone in this community knows us very, very well. But just for those watching at home, and I'm sure there's thousands

[Speaker 0]: More than you might I'm

[Connor Timm (Executive Director, HomeShare Vermont)]: one of those people sometimes, so I wonder what I sound like on point five 1.5 speed. So home share Vermont is a program that matches older Vermonters, Vermonters with disabilities, and anyone with extra room in their homes with folks looking for an affordable place to live. Post charge a below market rent in exchange for some assistance in the form of household chores that run the gamut from handling shoveling, to meal preparation, to transportation, to ellipses. There's so many different things we can talk about on that, and I'm happy to go through some cases with you. While our guests do not provide personal care, it's clear that the nearly forty forty thousand hours of assistance makes a real impact on the quality of life for hosts in that program. The exact number is about thirty eight thousand. I rounded up. I've attached our outcomes report for you to look over at your ledger, but I wanted to zoom out a little bit today and talk a little bit about those eight pillars we talked about.

[Speaker 0]: And did you send those to Laurie in a bit? It should

[Connor Timm (Executive Director, HomeShare Vermont)]: have been it should have arrived. If not if not, I have hand I have paper copies too.

[Rep. Esme Cole (Member)]: I don't see it on our Okay.

[Chad Simmons (Housing and Homelessness Alliance of Vermont)]: Let's do it.

[Speaker 0]: I would slip.

[Rep. Todd Nielsen (Member)]: I

[Connor Timm (Executive Director, HomeShare Vermont)]: also have annual reports for those who are excited about that.

[Rep. Zon Eastes (Member)]: So

[Connor Timm (Executive Director, HomeShare Vermont)]: as you all know, there's those eight pillars that we just went through again. I'm not gonna you guys are the authors of those, so I'm not gonna really go over them for you. But I want you to hold those in the front of your mind. I'm gonna tell you a little story about one of our matches. This is one of right now, we have a 107 matches that are active. This is just one of those stories. And so it gives you a sense of how it fits within those eight pillars. Okay? So Shirley is a 94 year old grandmother, and mother living alone with six grown children nearby when she's lucky in that respect. The kids were rotating through living with mom for a few days at a time as it was clear to them that living alone was less feasible than it had been, which is easy to imagine. It was working okay by everyone's estimation, but surely was starting to get tired of them quite frankly. Those were her words. They were getting on my nerves, which fair. Right? So enter Beth who had applied through Home Shield Vermont. Beth is a part time health care health care worker who was having a hard time affording rent anywhere and was being and was interested in saving up money for a condo. The two get along getting get along really, really well. Beth does most of the cooking with a lot, and I'm gonna stress a lot of advice and oversight from Shirley, including instructions on her famous salmon wiggle, which I've never had, but some of you might have had in the past. So there's a lot of interaction going on there. On Mondays, religiously, they go out for bingo, which is a lot less worrisome with Beth in the picture and in the car. On other nights, the pair make sure to be done with dinner but in time for Jeopardy and Wheel of Fortune. They have regular they have a regular reality TV show schedule, and they are not above throwing things at the TV if emotions run hot. Shirley's kids are able to focus on their relationship with their mother, and they have a lot more capacity to deal with issues, advocacy, appointments, all the things that go along with having a mother who's, at this point, 96, 98. Shirley has her home back as she sees it, and she has made a really good new friend with Beth, she refers her as her seventh daughter, which is or seventh child, which is sweet. Rather than paying the high cost of assisted or supportive living, Shirley has remained in her home as she wanted to, and she's kept up and improved her social life, and everyone's peace of mind is greatly improved. If you're interested in learning more about this, there is a link in the testimony. I don't know if it'll come through from the PDF, but it was a Vermont public story that came out in print. And I think it's on yeah. It's it's on the radio as well. So if that's interesting to you also, in our newsletter, if you get our newsletters, you'll see these stories every quarter. I wanted to bring this story to your attention because it's a great example of how the home share model really gets to all eight pillars, all of which are difficult to tackle in their own right. Right? Number four alone, housing, transportation, and community design is a massive undertaking. Chad can tell you all about how difficult that is. But we do this in all in one easy and very affordable and efficient step. There's no construction, no zoning. We just make a good match. As you can see from our impact report, Vermonters saved over $1,400,000 last year as a result of their participation in Home Share Vermont, and I believe that's just the tip of the iceberg. We have not included, the savings to meal programs, health care centers, Medicaid, and Medicare spending, that each one of our clients has generated, partially because it's hard to track, which I'm sure you all can appreciate, but mostly because there's just so many knock on effects that we wouldn't we wouldn't know when to stop. There's a lot of downstream impacts to the work that we do. We are, painfully aware of the fiscal challenges this body is grappling with, and we appreciate all the work that you're doing to keep Vermonters healthy. I really do. What's clear to us, however, is that our work will only become more important as those federal cuts come to trickle down and shake the fabric of the social safety net that we have here in Vermont. More and more older Vermonters and Vermonters with disability will need more options for making ends meet in the coming years. If interest in this new service areas that we've opened up is any indication, they see HomeShare as one of those options. I don't know how many programs that reach Vermonters in such a holistic manner or tackle multiple community issues as efficiently as HomeShare does. One of the keys of that success is our partnerships that we forged with the Thompson Senior Center, the Northeast East Kingdom Council on Aging, and Windham and Windsor Housing Trust. Basically, what we do with them is share case managers. So when we came to we didn't talk to you either about this last year, but you probably heard through the grapevine how it works. Rather than us going out and hiring full time employees and dropping them into a new area, we borrow, share, lease, whatever the term is. We pay for ten hours or fifteen hours of case management for a case manager who's already embedded in the community, already working with people who are in our our wheelhouse and know the landscape, the region, the towns, all the different things. Bless you. And so what that allows us to do is hit the ground running. It allows us to save a lot of taxpayer money because we're not paying benefits or anything like that. We're just paying those hours. It also allows us to move some money into organizations that are doing really good work on the ground and give them a little cushion for maybe a growth plan. Maybe it helps them move that next to that next employee. Maybe it helps them shore up another program or what have you. So that's kinda why we do it the way we do it. It we can't really get away from that mutual benefit thing. It's just in the DNA for us. So, we like to think that that's a big part of what makes the program work, and, certainly, this new model has made it made statewide coverage a lot more possible, in the future. So, you know, my ask is for less than $250,000, we can continue to serve 12 of Vermont's 14 counties and be in a position to scale that service up as need demands. Again, as you see from our impact report, our participants feel safer. They feel happier. They feel less lonely. They enjoy their homes more when they're home sharing, and we hope you're con you'll consider them when you consider our requests. Thank you. I'm happy to talk about data, as you know, or anything else, but Thank I want to keep it short and sweet for you all.

[Speaker 0]: Thank you. So I'm going to presume that the governor did not include some the money in your base for

[Connor Timm (Executive Director, HomeShare Vermont)]: base We got our regular allocate our pre fiscal twenty six allocation, which is generous, and we appreciate that. But that is our 480,000 that goes into our base funding, that is in Dale's

[Speaker 0]: It wasn't anything for the expansion.

[Connor Timm (Executive Director, HomeShare Vermont)]: It wasn't anything for the expansion, which to be fair, he he was given one time you know, was one time funding. I did make the request of Dale in October, and that didn't really come through.

[Speaker 0]: And and and tell me again, what's the dollar amount? You said less than

[Rep. Zon Eastes (Member)]: $202,135,000.

[Connor Timm (Executive Director, HomeShare Vermont)]: 35. Yep. That's what we asked for last year. That's what would be helpful this year to continue doing that work.

[Speaker 0]: And is any of that matchable with global commitment?

[Connor Timm (Executive Director, HomeShare Vermont)]: We are well, so this is what's interesting. We are already getting some global commitment.

[Speaker 0]: I see that.

[Connor Timm (Executive Director, HomeShare Vermont)]: I would love to have seen that money be less state money and then have the global commitment funny money match that. There was discussion of that at Dale, and then I'm not privy to what what the how the decision came through, but that is a lever that I would love to see pulled if that global commitment is in fact a commitment from the federal government, which I think we're all assuming is at this point.

[Speaker 0]: I think you're probably funded under investments with the USS. That's correct. Yeah. And I think there's some worry about investments.

[Connor Timm (Executive Director, HomeShare Vermont)]: That's my read on it as well. So I think they probably didn't wanna push harder on a on that situation. However, I think it's a great idea. You know? That would be a We because are certainly an investment. Spend money upfront. You save a lot of money down the line.

[Speaker 0]: Any other questions from committee members? Thank you very much. Thank you. Thank you so much. Okay. I think that concludes our list of witnesses. We don't have any more for the rest of the week, do we, on this topic? One? Okay. No. That's pretty much it. All right. So, okay. So we are going to change gears a little bit. And you might recall, I said yesterday that I felt like we needed to have a bit more background on the coordinated entry assessment process and how that really plays out, how that prioritization works, because we're contemplating at least utilizing it as a method for prioritizing the use of resources within the housing proposal that we're looking at. So we invited the Ballant of State and the Chittenden County folks to be with us today. And I want to extend my appreciation because the invitation was not quite last minute, but it's just been something that felt like we couldn't go further on this, answering this question about how would we prioritize individuals without having a clearer understanding about how this works. Welcome. And Jess, hi. I see you on the screen. Welcome. It's a document. I don't know. Maybe you can go and find us.

[Rep. Eric Maguire (Member)]: So, yeah.

[Speaker 0]: Looking. Am looking to see. We have lots of documents today.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: So Who's

[Speaker 0]: counting, right, Laurie? So I don't see one. Okay. So welcome. Thank you. And I have to apologize because I have to leave right about exactly at 02:30 because I have a medical appointment. 03:30? Two 02:30? Okay. But you'll be able to continue in whatever form, but our our other capable people at the head of the table here will help facilitate. I just didn't want you to think I was walking out on you. Okay.

[Chad Simmons (Housing and Homelessness Alliance of Vermont)]: For the record, my name is Chad Simmons with the Housing and Homelessness Alliance of Vermont. Thank you for the invitation. This testimony will kind of build upon what, we shared, in January, on January 27, and then again on February 11. And, really, our hope is to, as the chair had pointed out, to get a little more granular on the coordinated entry process and assessment and provide a little bit more detail on what that entails. Our hope and I'm just gonna speak for a couple of minutes and then hand it off to my colleagues who are more of the experts in this field and practitioners, and I think that's an important component of how we function as an alliance, is that I really lean on our members to provide that background and information to you all. So our hope is to talk a little bit about the implications and potential of using a coordinated entry assessment for a broader expansion of what was intended beyond its original use. Then we specifically looked at the opportunities, challenges, and what would be needed in order to use that coordinated entry assessment for a broader array of needs. And I think it goes back to what I shared with this committee earlier around people are complex and systems should be simple. Just thinking about, there are some times where it makes a lot of sense to build from an existing processor system, and there are other times it might be it might make more sense to look at keeping that that processor system as it is and not overcomplicate it, and then build a streamlined or a really thoughtful process that builds on top of that. So that's kind of what we're hopeful today, and we welcome questions and committee consideration for us to answer. So with that, I'll hand it off to Jess first, who I've learned a lot from in the the the weeks that I've been coming onto this job, and she'll be able to talk a little bit more about the data and background coordinated entry assessment. And then we'll have an Okta tailor to be able to provide some additional.

[Rep. Esme Cole (Member)]: Great, thank you. Yeah.

[Speaker 0]: Thank you, Jess. And do you folks have any documents? I have one that I can

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: send along after. Yes, for sure.

[Speaker 0]: Okay, all right, great. So welcome. I

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: didn't have a chance to create a document. I do have a couple of notes for myself, but they're not comprehensive enough.

[Speaker 0]: That's okay. If there was something we were supposed to be following along, I just wanted to be able to do that. It's all good.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: For the record, my name is Jess Graof. I'm the program director of Franklin Grand Isle Community Action, which is a program of CBOEO, the Chimpan Valley Office of Economic Opportunity. I also sit on the board of the Balance of State Continuum of Care as well as on the board of HHAV. And I found out yesterday you had some questions about coordinated entry and I came to provide some information about that. I'm a little starstruck because I watch you all the time on television.

[Speaker 0]: I don't know. We

[Rep. Esme Cole (Member)]: need

[Speaker 0]: to improve your YouTube But thank you for being here.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Yeah, thank you for having me. And so in some preparation, I didn't watch your conversation yesterday yet. I'm sorry, it's been a bit of a busy twenty four hours. That four day week makes things a little bit more hectic. But I did quickly rewatch some of the conversation from Friday where you were having a conversation with the Interim Commissioner Hoffman. And some of the conversation there was about consideration of expanding the use of HMIS in coordinated entry. Both with AHS ESD staff utilizing it. And then also potentially as an access point to shelter. So I'd like to talk about that a little bit. But please along the way, I'm really here to answer questions. Coordinated entry is a really complex, detailed process. And it's very reasonable to have questions about how it functions and how it works. And I'll do my best to explain as much as I can. I think across the board, the community of agencies really agree it would be great to have ESD staff using HMIS, having licenses and utilizing that. We have a lot of back and forth with them where they are sending referrals for us to complete assessments and sending lists all of the time for us to confirm coordinated entry enrollment. And I do think there could be a lot of efficiency around them having direct access into that system. And I also foresee some significant challenges with utilizing it as a way that people access or are prioritized for shelter. And some of that is just that the system hasn't been designed for that yet. And it really can take some considerable time for us to make changes within that system. It's quite complicated. The assessment itself is a 27 page document. And it is designed meeting certain HUD requirements and guidelines that we have to meet. But it is designed to ask questions that help us to put households and individuals on a prioritization list or a master list. Those two terms are used interchangeably. And it's also designed to ask questions that allow us to make referrals. And there's sort of two types of referrals. There's formal referrals that are built into the coordinated entry process and built into HMIS. Some examples of that would be family supportive housing or permanent supportive housing programs. And then it also has all of these sort of regional informal correlations to referrals. So even by asking the age of the child and knowing that the answer is the child is under six, We might be referring them to a certain type of parent child center programming or identifying that an individual has some history of engagement with the Department Corrections allows us in my region to make a referral to restorative justice which has a case manager that can provide housing case management for folks. So there's a lot of layers to that. And then the questions that help us put people on the prioritization or master list, sorts that, the way it sorts that list is very HUD guided. But the people that rank on the top of the list are people that meet HUD's definition of chronic legalness, which would be having a disabling condition and being homeless for twelve consecutive months Or having four separate episodes within a three year period that totals for twelve months. And so that's sort of the first ranking. And then within that, there are all these questions that identify the complexity of care of the case. And that helps to sort within that list. And then the second tier is people who are disabled but not chronic. So they haven't met that duration measure. And then third is sort of everyone else. And what it doesn't necessarily do, which could be problematic for helping in the way that you are sort of considering for accessing the shelter is we could have someone who came in, you know, yesterday, who was a household with very young children who is living in their car and is really quite vulnerable. And if they did not have a disabling condition and hadn't met that definition of the four separate episodes within three years that totaled twelve months, if this was their first time into homelessness, then that prioritization list would hold them really low on it. And there would be all sorts of things we'd be triaging, right? Those connections to those warm handoffs that we'd be making to case managers and services. We're really lucky in our area to have ample case management specifically for households with children. But as far as you would see them on that prioritization list and within that HMIS system, they wouldn't flag at the top. And then there are some times when we have had specialized programs, family supportive housing is an example, where within HMIS there's a separate list that can be pulled that pulls specifically for that program based on the criteria for that program. And so that household that I gave as an example might well pull onto that list depending on other factors. The other complication with this is the system can take quite a bit of time to change. The balance of state, COC somewhat recently did make some changes to our coordinated entry assessment. We had had one list for a long time and decided to create sort of two lists. One for people who met the literal homelessness definition and another for ACLIST. And so we updated the assessment and had to do a whole ICA, the Duke Community Alliance. Sorry, might have got that acronym wrong. They made a whole bunch of changes for us. That process took us two and a half years. And it was involving a lot of really thoughtful planning, checking to make sure we were within HUD requirements. A lot of training had to happen. One of the difficulties really is that the people that are responsible for making those types of changes and improvements in the system are often also the people who are doing the work. You know, they're also doing the assessments or working in the food shelf or at the motels doing the case management. We just have not that many people that we can sort of share the workload, which can make it very difficult. Coordinated entry, I think, is actually a system that works really well. One of the things that we do is annually assess how well it's working and we're in the process of doing that right now with the balance of state. So we are looking currently at data from 07/01/2024 through 06/30/2025. During that time, statewide, we had two twenty partners signed on to partnership agreements. We received 3,990 referrals. We completed 3,129 assessments. Eighty seven percent of those referrals were contacted within three days of receiving the referral. There was a six day average period between referral and when the assessment was completed. And during that time we exited fifteen seventy six households to permanent housing destinations. And another seventeen twenty nine to what's deemed within the system as non permanent, but does include nursing homes as an example of what is considered still within the system to be non permanent. We have discussions about

[Speaker 0]: that. Jessica, I'm just gonna ask, sometimes you're trailing off a little bit in terms of being able to hear you. Maybe, yeah, if you got a little bit closer to the computer, that would be great. Thank you.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Yeah, of course. Although I think the coordinated entry system really works quite well, it is significantly restricted by a lack of resources. And primarily those are having enough housing, housing vouchers and service providers. I think it would work so much better if we had the tools in our tool belt to really do the work. The process is there, the system is there, but the resources that make it effective are still lacking. But we're making progress on that. Even when we were assessing our data, we can look back over a five year time period and we can really start to see, for example, where there have been investments in building housing that we are able to house more folks. And we really thank you all for a big role in that. Any questions?

[Speaker 0]: So I am developing some clarity, but I'm not sure I'm totally clear yet. So it seems as though correct me if I didn't catch this correctly, at the highest level of priority is somebody who has a disability and meets the definition of chronic homelessness, which is for, I forgot, an extended period of twelve months or four separate episodes. Is that right?

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Yeah. So it has to be both. They have to have a disabling condition and they have to have been homeless for twelve consecutive months or four times in a three year period that equal twelve months.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Okay. Can I clarify something? I know that I'm not testifying. I just wanted to clarify that at a higher level that you're prioritized based on housing resources. So this priority that you're learning about from Jess is specific to housing resources, like permanent supportive housing, which I'll go a little bit into in my testimony. It's not specific to emergency shelter because there's different categories of emergency shelter. Criteria. There's different a lot of things. So they're two different, fundamentally different.

[Speaker 0]: Right, and that's what we're trying to understand. We're trying to understand whether or not it could be used for the latter. We we knew from the outset that this is a system that's been used to prioritize for permanent housing. We understood that. So can you elaborate a little bit more about how disability is particularly defined within that assessment process?

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: So for the purpose of the assessment, it is self attested to. And then when there is a resource that we can refer someone to from the master list, it can open a whole another process. Because for permanent supportive housing assistance and for permanent supportive housing programs, they require documentation of that and the documentation is quite extensive. So

[Speaker 0]: to

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Taylor's point, we had a permanent supportive housing program in the past year here in St. Albans, a Lake In Maple project. It was our first permanent supportive housing program. We had 11 units that we were able to refer to that held project based subsidies. Pathways would let us know they're running the program. They would let us know we need these referrals. And 11 units and it took almost 40 referrals for multiple reasons, including that people lacked documentation. They have to be able to actually demonstrate and prove at that point that they have a disabling condition and they have to prove and demonstrate the duration of homelessness. And then there's a whole another process where they have to be vetted by the landlord or property owner of the building and be accepted as a tenant. And so as referrals would get rejected, we would pull further down on our list.

[Speaker 0]: Okay. So essentially what I understood you say is that somebody says that they have a disability. When think different people might have different ideas about what disability means. And so during the assessment process is, are there questions that are asked, like, do you have trouble learning, or do you have a mental health condition, or do you have a physical disability that limits your activities of daily living? I'm trying to figure out if during that assessment process, are actually specific questions that are asked that the person answers themselves, so that's self attestation, but are a bit more detailed to try to get to that level of disability.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Yes. Yes, actually, to every single example that you gave. So it even will ask, did you have a five zero four in school? And then on the assessment it prompts that if they said yes to that, we should go back and make sure that they also attest to having a disabling condition. But it also asks them what their source of income is. So if somebody says social security disability, it would prompt us again to go back. So there's ways that we catch it. It's not just a yes or no. But it asks about chronic health conditions, physical disabilities, mental health disabilities, substance use, alcohol use, and developmental disabilities in sort of multiple ways.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Don't ask for documentation at the time of the assessment. So documentation to corroborate that someone is self attesting that they have a disability is not going to be sought or during that assessment specifically so it's not a immediate yes we know that this is what you're saying is fact with documentation So I wanna share that as well. I didn't know if that's something that you

[Speaker 0]: were thinking I I was picking up on I was picking up on that. Yeah.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Yeah.

[Speaker 0]: But it sounds like that for different housing different housing opportunities, it sounds like you do need to provide some evidence of that.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: And that's the work that's being done by those housing navigators or case management services when folks do attest that they have accessibility. It's getting that documentation ready to support their application when they do apply for housing or when they pop up on the list for permanent supportive housing or any resource that's available through coordinated entry.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: It also asks in several places if the condition is expected to be long term and a barrier to living independently. Which is an important part of that prioritization.

[Speaker 0]: Other questions from other committee members? Yeah, go ahead, Reverend Cole.

[Rep. Esme Cole (Member)]: Thank you. Is there an affidavit as well that goes along with the agent Myatt's system?

[Speaker 0]: You say that?

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: I can hear you. Yeah.

[Rep. Esme Cole (Member)]: Sorry. I don't know if you could hear me. But I'm wondering if there's an affidavit especially that aligns with any portion of your questions asked within HMIS.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: At the end, yes. They do sign something. The client signs something that is a client self certification, that the information that they provided is true, accurate, and complete.

[Rep. Esme Cole (Member)]: Thank you. That's helpful.

[Speaker 0]: Okay. So why don't we turn now to Taylor, right? Taylor, yes. Okay.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Good. Yeah, go ahead. Good afternoon, chair and members of the committee. For the record, my name is Taylor Thibault and I serve as the co chair of the Chittenden County Homeless Alliance. I'm also the associate director of homelessness prevention initiatives at Champlain Housing Trust, and I'm in charge of our emergency housing programs. I think, like Jess, I've had the opportunity to see you all on YouTube a lot recently. And I saw that there might be an interest in the Elmwood Community Shelter, or better known as the PODS. I am the manager of that program. And I also run Harbor Place, which is a hotel that actually works in tandem with the emergency housing program through ESD. And I also just want to name that while Jess was speaking, I was listening, but also looking at your guiding principles. And I just wanted to share and level set with you all that from my experience watching you all on YouTube recently and from today's testimony prior to mine, that you all are meeting those principles. And I've just really appreciated the work that you all are doing, specifically around homelessness and bringing that to the forefront this year and the many years prior to that. But I just thought it would be positive affirmation to know that what you're doing makes a difference. And I've been really appreciative of the process. I'm happy to be here. And I'm available if anyone has any questions outside of this, but also happy to answer questions at

[Rep. Anne B. Donahue (Ranking Member)]: the end.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Thank you, Taylor. Additionally, right before I start, I had sent a memo from the CCHA executive committee, I think hopefully to all of your emails. And Laurie, I hadn't seen it put up on the website, but that is available in your inboxes if you want to look at that while I'm sharing. While it's not specific to what I'm testifying about today, I think it might be helpful for background information, specifically if you reference the coordinated entry piece of that memo. And I'll just get started. And then you'll have the opportunity to look at this in print sometime today. So I want to begin again by acknowledging the thoughtful work that's gone into this bill and shared goal of strengthening Vermont's homelessness response system. I believe we're aligned in wanting a system that's coordinated, equitable, and responsive to need. I would like to speak obviously specifically to coordinated entry today. So as Jess stated, coordinated entry is a HUD defined system designed to prioritize households experiencing homelessness for housing resources based on acuity and vulnerability. In Chittenden County, our system is intentionally structured as a housing prioritization tool. It is built to match scarce housing interventions, such as permanent supportive housing to those with the highest level of need. In recent discussions, it appears there may be an interest, and you stated that today, in expanding coordinated entry to prioritize not only those housing resources, but other broader forms of shelter access, housing retention supports, and potentially other services that you proposed in your continuum. I want to be clear that the idea of strengthening coordination across systems is one we support. However, expanding coordinated entry in the way that would be represented a significant structural shift and would require careful implementation planning. First, it is important to note that our current assessment tools are designed specifically for those housing placements. Are structured to evaluate long term housing need, vulnerability, and sustainability. That framework is fundamentally different from assessing eligibility or prioritizing shelter. I'm going to go a little rogue here, but I just want to share maybe some of those philosophical differences that I was speaking of. For housing priorities specifically, it's vulnerability, chronicity, sustainability, long term need. But for shelter placements, decisions are often immediate. It's safety based, program specific, and shelters are not uniform across providers. Every shelter has eligibility criteria, staffing models, safety considerations, and integrating that shelter would require standardized work, eligibility alignment, workflow redesign, partner buy in, significant change in management. Okay, I'm going back. I just don't remember where I was. Where was I? Okay. Emergency shelter operates under different conditions. Individual shelters Okay, I'm echoing myself, but bear with me here. Individual shelters often have distinct eligibility criteria, program models, safety considerations, and staffing capacities. These are not uniformed across providers and integrating shelter placement into coordinated entry would therefore require significant alignment work to standardize criteria and clarify referral pathways in a way that preserves each program's operational realities. Additionally, in Chinon County, we're currently operating at full capacity with respect to completing housing assessments. Even with a housing focused scope, ensuring that all eligible households are assessed and case conference requires substantial coordination and staffing. Expanding assessments to include all individuals seeking shelter would require meaningful additional assessment infrastructure and workforce capacity to ensure that the process remains timely and does not unintentionally delay access to crisis services. More broadly, if coordinated entry is expected to serve as a centralized prioritized mechanism for prevention, shelter, retention, and housing services across the continuum, then would require significant systems change management across regions, restructuring and redesigning assessment tools, retraining frontline staff and partner agencies, development of new referral definitions and workflows, a longer implementation timeline to redesign system operations, expanding housing navigation and case management staffing, and broad buy in from community partners, health care systems, behavioral health providers, and other state departments. Coordinated entry can prioritize need, but it cannot resolve need if there is insufficient services and housing capacity behind it. If the system expands to hold all individuals experiencing or at risk of homelessness, we will more visibly see the gaps that already exist in larger systems. Inpatient mental health access, long term behavioral health supports, substance use treatment, and affordable housing supply. We and myself experience this daily at our shelters on a microcosm. We were where we accommodate individuals who require really high levels of care, because there are limited alternatives available. If the legislator intends to expand coordinated entry scope, then that policy must shift and be paired with dedicated infrastructure funding, workforce expansion, cross department coordination, clear operational guidelines, and a phased implementation strategy. And my intent is not raising these considerations to oppose an expansion, but to ensure that expectations are aligned with operational realities. Coordinated entry, it's a powerful tool. And if we are going to use it as asked to do more, we must build it accordingly. And that's the end, actually. Yeah. I also I thought there was more.

[Speaker 0]: But I wanted to leave you also with

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: some positive considerations because I was like, what would I wanna hear after someone's viewed that to me? When we're in this, like I don't know, this conundrum where we're not pushing forth more funding for this specific area, right? And I'm telling you, we might need a substantial amount of funding to be able to support an expansion within CE. And I was like, I would want to hear who else is doing that. And so I looked into that a little bit, and I just wanted to share what I had found. So nationwide, I was like, nationwide, who's you know, using CE in an expansive way?

[Speaker 0]: Oh, let's see if your research matches Rep. Rep.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Mcguire. Like, such great work. I just feel like you're, I don't know, you're just in a learning curve. And I've just really appreciated your work specifically on this. So thank you so much.

[Connor Timm (Executive Director, HomeShare Vermont)]: Okay, Doug, thanks.

[Rep. Esme Cole (Member)]: Yeah. Okay, where was I? It was Rhode Island specifically.

[Connor Timm (Executive Director, HomeShare Vermont)]: Fire away.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Yeah. It's specifically a model where I think that you, that looks very similar to what it is that you want to put forth. And then Delaware, Connecticut.

[Rep. Eric Maguire (Member)]: Keep going.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: That's all I got.

[Rep. Eric Maguire (Member)]: But what did all three of those states have in common that they did before they implemented that? They repealed

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Got me.

[Rep. Eric Maguire (Member)]: They repealed their general assistance emergency housing.

[Speaker 0]: Ah. Shoot. I didn't think I would

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: be put in this pigeonhole. Oh,

[Rep. Eric Maguire (Member)]: it's actually not a pigeonhole, but what

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: they

[Rep. Eric Maguire (Member)]: to implement the strategy that's been laid out here, they had to repeal or remove their general assistance emergency housing. Because even at the time, even though we have language in there saying that we're moving away from that, unless we repeal, fully repeal it or sunset, whatever it may look like. And it was done in a very stage way with Rhode Island. Then it allow the two systems to stop competing in the rotation into that coordinated entry system was designed to be able to take that overflow. Because at the time, if we continue to keep that GA benefit into place, is literally happening right now with this bill, we are imposing state benefit requirements onto nonprofit shelters. So, you are fully on target with that, but that was the one dynamic that was able to put it all

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: on the press. So I

[Speaker 0]: think the question I'd like to ask both of you is, so I think that we recognize that it would take investment, time, a planned process that would result in something that would be usable for what is envisioned to be more users than currently exist in the system. And so I guess the sort of bottom line question is, is that an investment that you think has worth, has value to do? In the alternative, what we would be having to look at is some other prioritization process. So we're trying to figure out, do we build on something that exists, recognizing that it doesn't necessarily totally fit what we're looking for right now, but based upon research, think that it could in the future with some investment and some changes to it and things like that. Or should we go down the line of creating some other prioritization for the emergency level of service? And we would still then be requiring people to participate in coordinated entry and to go through that assessment process. Just trying to figure out whether or not the I don't know what's that saying if the something about the squeeze and the juice, if the squeeze is worth the juice or something like that. Would out we of it what we think that we might based upon what you've been listening to, would we be getting out of it what we think would be worth the investment that it would take in order to have it meet those needs? And you you two are people who know better than us sitting here, certainly.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: I guess I'm not totally clear on exactly how you are envisioning using this. Is it that it would be for, there would be, the idea is that primarily, as it is true now also that shelter is the first level. And then motels, emergency housing is used when shelters are full or unavailable. And so are you talking about how we would be using coordinated entry to support access into motels?

[Speaker 0]: I'm not sure. I don't think it would be access into, because it's not fast enough. You've all and we've heard testimony about how the length of time it takes to complete, and it take some time. So it wouldn't be like sort of that immediate access, but within, you know, a certain period of time, you'd be required to participate in it. And if you didn't participate, then I guess the theory is then you would lose your access to that emergency housing. But I think, Taylor, one of the things I think that you brought up that I think is important for us to think about is there is kind of a different purpose when we're looking at identifying safety first and then the longer term strategy of planning for what hopefully would be permanent housing. But sort of the first objective is safety first. So, Rep. Anne Nielsen.

[Rep. Todd Nielsen (Member)]: Can I say a thank you thing?

[Speaker 0]: Of course.

[Rep. Todd Nielsen (Member)]: Thank you. I've done security there over the years at Harbor Place. I haven't been there in the last year or so. When I first did it many years ago it was kind of sketchy. Now the place is nice, it's clean, it's rules really happen, I'm really It's me.

[Speaker 0]: I'm Getting back for a while, and they caught me. It was

[Rep. Todd Nielsen (Member)]: a pleasure. And you've done a really good job.

[Rep. Esme Cole (Member)]: Aw, thank you. Thanks

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: so much.

[Speaker 0]: Thank you, Todd. Yeah, so Jess, you're trying to get at, is it nimble enough to use within a short period of time of entering emergency housing? Or could it be made nimble enough to be used within that short period of time that would then sort of help that person set a pathway with their case manager towards what would be permanent housing? And like, so is there like a mini coordinated assessment? Do you know what I mean? There That mini assessment

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: is what's happening. So if somebody's placed in a motel, they are always referred to coordinated entry. We're often calling same day. Sometimes they're like, wait, I haven't even checked into my room yet. I'll call you back in a bit. And we say don't worry about it, settle in, we'll call you back tomorrow or later in the day. And then we're scheduling the coordinated entry assessment with them for a bit of a later date, giving them words of encouragement, you know, when we're here and then we set it up. It's usually within a couple of days. In our office it's three to five. And then we're doing an assessment. And then economic services division sends us a list monthly of everyone in the motels. And well actually we get a list weekly of everyone in the motel. But once a month we get a list that we then fill out coordinated entry assessment yes or no. No referral received, please do follow-up which we've usually done in the interim because we use that weekly list as a backup check to make sure we've got everybody. And if we didn't get a referral, we call the motel or we go knock on the door just to check-in with them and get them scheduled. And then what also happens is if a guest hasn't enrolled with us, economic service hasn't enrolled in coordinated entry, we've called them multiple times and we're putting no on that, they leave the room. They are asked to leave the Motel Economic Services Division. Try to support they do a great job of trying to support them and connecting to us and give them space and opportunity to connect with us. But if we really have a time where they're not enrolling, then they can risk losing their room. Which is really hard for lead agencies and really hard for the coordinated entry process because it's a very important part of coordinated entry that their participation in that does not exempt them from services. So the opposite is if they lose their motel room, they're still able to engage with us and stay in coordinated entry. And there's the coordinated entry assessment for people not coming in through motels. On the first page, one of the very first questions is are you fleeing domestic or sexual violence? And that assesses safety really quickly. We stop the assessment and work on that safety goal, connect them to programs that can support them. The second page is a question that asks if you're looking for emergency shelter. We pause the assessment at that point and just focus on what are the plans for where the person's going to be that night, meet those immediate needs, and come back to the assessment when those needs have been met.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: I just want to share in Chittenden County that unfortunately is not the case. I want to be completely transparent that if folks are entering a hotel program and they're automatically referred to CE, that's absolutely accurate. And it can take six months to assess someone. So yes, those are questions that are atop of the assessment in Chittenden County, and they've been already accessing shelter. So I just want you to recognize that the capacity specific to Chittenden is a struggle, right? Like, we struggle to assess everyone that needs to be assessed in Chittenden County when they're already in shelter. So if we're trying if the goal may be to assess people prior to shelter, it's gonna need a there's a fundamental shift that would need to happen. I'm not saying like, don't reach for the stars and that it couldn't happen. It's just going to take time and investment and advocacy to ensure that that is something that happens.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: Thank you. Rep Garofano, Rep Eastes, Rep Maguire. So just to make sure I'm understanding correctly, so it's not consistent across the state, what Jess was talking about. And just correct my understanding, it's because of resources that it can take a long time to assess someone even in the shelters in Chittenden County, it's the lack of resources that are causing that.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Yeah, we don't have enough, and I'm sure other areas of the state have similar issues and I mean, I applaud, I would love to be doing what Franklin County does. I think that they do amazing work and that's exactly how you want the system to work. And unfortunately there's caps in how many people housing navigators and assessment people. We have people designated to assessments in Chittenden County but three. There's thousands of people in Chittenden County experiencing homelessness right now.

[Speaker 0]: Can I

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: clarify that my information especially from earlier is not just Franklin County?

[Rep. Esme Cole (Member)]: So you have two states.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Oh, Doug.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: And two states.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Data represents the bounds of state. So that's everything excluding Chittenden County. And that was 87% of all of the 3,990 referrals that we received over a twelve month period. Eighty seven percent were contacted within three days of referral. And there was an average of six days between referral and assessment. And Chittenden County has, homelessness looks different all over the state. And rural homelessness has significant complications, but so does urban homelessness. And there's lots of reasons for that, those differences. It doesn't really represent, I don't think, a difference in the system necessarily as some of the complications of the context.

[Speaker 0]: I think that one of the things that you actually both have pointed out is, one, that it is possible. And two, it does make me wonder about how we prioritize the use of resources with two COCs versus one COC. I'm going to go, we have Representative Eastes and then Representative Maguire, Representative Bishop, and Representative Cole.

[Rep. Zon Eastes (Member)]: I think I can wait. I mean, I think I'll wait.

[Speaker 0]: Todd, if

[Rep. Zon Eastes (Member)]: there are more questions

[Speaker 0]: Okay. Because I Representative Maguire.

[Rep. Zon Eastes (Member)]: Might be some idea. No.

[Rep. Eric Maguire (Member)]: Yeah. And I I didn't mean to interrupt you because I wanted to continue to hear your your outcomes in regards to what you looked at Rhode Island, so I'm going to be sagging you afterwards.

[Speaker 0]: Okay, great. Want to hear that too.

[Rep. Eric Maguire (Member)]: So, what also hearing, and so forth, HMI's best system is the data backbone crisis response, it's not the full system itself. And obviously, full crisis response system is service oriented, proactive, whereas the HMIS system is data oriented and reactive. Now, believe we need to bridge that gap. And I know there is the ability to add in those mechanisms, I. E. Expand the data elements for prevention and retention. And I know if we can, so I guess my question is this, what does that look like to be able to expand the system to where we can put in the preventative and retentive tracking mechanisms? What does the cost possibly look like in regards to that? Because again, I'm going back to looking at we want to move forward in regards to building this continuum of care if we want to call it that but we also need the mechanisms in place through the HMIS system to track the prevention and the retention. And it's also from my understanding if those mechanisms are in place, there is funding available to those coordinated entry case managers that are funded for the retention piece to where we can continuing following the person up until like one year before they're actually exited out of the out of the system and where I'm bringing that from is from looking at a few other states. I'll bring up Utah, Utah, has those retention mechanisms in place through HMIS and they will not discharge somebody from the system up to one year of of stable housing. That way, they're able to stay engaged if you hit a three month mark point and you're seeing like, oh my goodness, you know, you're having a couple of struggles with this. You're able to access different levels of of, funding or services that keep the individual housed. And I know we are all aware of one of the things that is very recognizable is the, number of people that were in HMIS exited HMIS, and then returned to coordinated entry, which is upwards around we're pushing about a 45%, whereas other states that had those retention and prevention mechanisms within their system are showing anywhere between 12 to as high about a twenty percent. I don't want to use the word recidivism but you get it. You got where I'm going with that. Was that too much in one? I don't even know what my question was anymore.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: So we do have retention programs that are built into HMS right now. We have permanent supportive housing funding across permanent supportive housing assistance that has programs in most of the state. And the people who are qualified for those programs come off of the top priority list, the chronic list. And they are served without any time limit actually. And can remain in HMIS. They just wouldn't pull onto the master list anymore. So there's multiple programs within HMIS, which is a big database. And the prioritization or master list is one. But there's many programs running retention services. Not enough, but it certainly exists within HMIS. And in many places it's new. We have a new staff this year in my region who's doing that and has a caseload of 15 to 17. And CBOEO has another new position in Burlington that's doing the same for Chittenden County. So we are seeing some of that. And then prevention is captured in part in coordinated entry, although we're getting better at this with our at risk list, which would also include many individuals who came to us in a preventative manner to access HOT funding, which we also hold here. So when they access HOT funding, they are often entered into HMIS but not on the master prioritization list in a different program and a different list that says at risk for homelessness. And when we're able to prevent the homelessness, which we do for thousands of people a year across the state with HOT funding and rental arrearages or security deposits, then that is in that other list in HMIS.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: So yeah, to me, I think your answer is yes. That's a functional capacity in the HMIS. And I'm gonna be, I feel like I'm robotic when I answer this, but I think it's really expanding capacity for the amount of people that are doing that work and making sure that we have the funds to be able to support an increase in expansion of coordinated entry. We currently don't have the capacity to even assess the folks in Chittenden County. And we haven't expanded our assessment to include retention based resources for support services like financial assistance.

[Rep. Eric Maguire (Member)]: Yeah, the investments, I believe, are going to be made within whatever bill may be passed or whatever. Even the governor has expressed significant investments into case management, coordinated entry, whatever we want to use that term to get that resource out to our wonderful providers that are down there doing the work. So those investments are being made. I guess my point's coming to where we should be maximizing every single possible component that is available to be implemented within HMIS. That way, we are tracking everything across the board. I know data does not solve problems, but data helps you guide and get the necessary resources to where the true need is met. So I would just like to see whatever it's gonna take to maximize any possible mechanism within HMIS and use it at its ultimate capacity. That's what I'm going. That's what I'm expressing.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: But the ship and then.

[Rep. Todd Nielsen (Member)]: So I understand clearly the capacity issues, but there are fairly stark contrast between the balance of state and the Chittenden County Homeless Alliance and coordinated entry. Is there any philosophical differences between the two organizations with respect to the overall value of coordinated entry? Does that drive it to any degree?

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: No, I don't think there's philosophical differences in the

[Rep. Zon Eastes (Member)]: way that we

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: provide that service. We're aligned. We just don't have the same functionality in Chittenden.

[Rep. Zon Eastes (Member)]: Sure. Yeah.

[Rep. Todd Nielsen (Member)]: Yeah. All right. Thank you.

[Rep. Esme Cole (Member)]: Yeah. Thank you. Your perspectives are very helpful. And let's see. Where to begin here? So one point of tension, as I know you've probably listened to in the past several weeks, is these criteria to decide where someone goes. And that's of course why we're here today trying to figure out what is the best means for deciding who goes where and how quickly given our constraints of how much shelter there is, which is there, it's pretty, it's awful. But how have you fared, both of you, with the criteria that exists on the DCF side, especially that are being proposed to be continued in terms of criteria for emergency shelter. So those criteria have been decided upon by folks at the agency versus HMIS as another means of triaging people. Based in experience, tell us what route would you go? Would you continue with the status quo of how we sort people with those criteria or would you move into something a little bit more deeply

[Speaker 0]: informed by people's experiences? You

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: know, I think that it's an impossible question, right? I think at the core for both Taylor and I is that everyone deserves shelter. It shouldn't be a question. But having said that, we've lived with these categories for a while. We appreciate the medical exemption form. We've had good luck with that of being able to and we have collaborations with community partners so that when I'm sitting with someone here and I'm giving them a list of the categories of eligibility and we can't find one that they identify under, then I can talk to them about the medical exemption form and then I can connect them with a community provider who can usually help that. Additionally, the way that the emergency shelters are set up, in our region CBOEO, which is Community Action, also operates two shelters, Samaritan House, Wilton's House and Lori's House, our BD shelter. And they have their own wait lists that prioritize people in different ways. And I don't run a shelter so I'm not 100% sure in all of those categories. But the top one is often that somebody is unsheltered. And so the people who don't qualify for the motel program or no longer are eligible because they've maximized their days, when they stay in touch with the shelter, they become the highest priority for us to move them into shelter. We don't have enough shelter, there's still wait lists, But there's that bit of a balance where if someone then gets to the higher list for accessing a shelter bed.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: So my answer to that question is similar, like in the sentiment that Jeff said, fundamentally and philosophically, I think everyone should have shelter. And I think my answer is going to maybe throw a curveball out there. It's and this is not endorsed by CCHA or CHD, I just want to name that. This is like just my thought as Taylor Tiebaud, Is I think whatever you decide, it needs to be consistent. As someone that runs a hotel that is in operation with folks that are utilizing the emergency housing system, it's been the issue that has arisen so many times is stability. So like, whatever you're going to do, it just needs to be continuous and a space where people have the ability to put down a little roots, feel a little comfortable, meet with case management services. Like, yeah, you can do X, Y, and Z eligibility, but if you put an arbitrary time limit on that, it is challenging. And so I've seen families with children, like Sorry, I didn't know if I was going to say anything like this, but families with children that I'm sending to a tent and people with really significant medical comorbidities, same thing. And so, and that's just challenging. And it's not because I'm discharging due to behavior or lack of engagement or something, you know, where folks, you feel like folks maybe, you deserve, you know, never have I been there, but it's like, to see someone just have to leave and uproot their lives where they finally felt a sense of comfortability just due to the fact that it's been eighty days is horrific to experience as a service provider. I build money in my budget because of these rules to purchase tents and sleeping bags for kids. It's hard to swallow and live with and not take it home when I have a five and two year olds or I have a grandmother and I couldn't never imagine that situation. I would say that whatever you do, and I am glad I'm not in your shoes, that it just comes from a sense of and I heard in testimony yesterday, you're not gonna have the ability in the confines of the budget to be able to serve everyone. That's okay as long as we make this a program that is capable of allowing people to move on from it. What we're doing now is

[Rep. Zon Eastes (Member)]: just

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: putting someone in a pro it's not

[Rep. Zon Eastes (Member)]: a program, first of all.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: We're putting someone in a hotel room right and then they're staying there and they don't have access maybe I mean at Harvard place you do and so I love the fact that you're trying to build in autonomy and case management services and wraparound services to folks while they're utilizing the program. Think that's a great aspect.

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: Sorry.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: No, that's okay. That's just how I feel. I think it's really challenging.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: I agree with what Taylor just said. Actually, I do. And can I just point out that one of your questions is why do we have so many people that were exited out of coordinated entry that we enter? And part of that is that coordinated entry has a baseline requirement that we can touch base with you every ninety days. To get ahold of you, we have to move you to an inactive list. We do a status update. We update the timeline, how many months, etc. All this information every ninety days.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: I think that's a good segue though to say like

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: When people leave the motel, we lose touch with them. They lose their phone. They're camping. They've moved to six different parts of the state. They're in an RV and they've been asked to move it all around. And so it's not really always, and in fact most of the time, that they're getting housed and then not receiving the ongoing services and then coming back. Although that does happen. To be honest, we've been talking a lot about how we need to collect more data for you all and for us about that. But anecdotally that's what's happening. It's that they lost contact with the service provider and the reentry is that they're coming back into the system because they've been reconnected. And we also love data and we use the data all of the time. HMIS in each of the balance of state regions is part of a partnership agreement. We have a coordinated entry partnership agreement. And we have 25, 30, however many organizations at the table. And we look at our HMIS data all of the time and we use it to say gosh, look at how many people are coming back in. What information do we need? How do we increase retention services? And that's part of why we have all of these new retention services in the last year statewide. Or we look at it and say, gosh, we have this many children and we don't have a family shelter and what can we as a region and community do to address that? Or we were building a youth shelter in St. Albans recently and we planned the number of beds we needed by using our HMIS data to really look at how many youth we were serving that would qualify for that. So we fully agree that this is invaluable data in multiple ways that we actually actively use all of the time to shape the creation of programs and services in our community.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: I have two questions, and then I know there's

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: a couple other questions in

[Rep. Golrang "Rey" Garofano (Vice Chair)]: the room. So Jess, currently, are you able to differentiate the way you collect data between the people who you lose touch with and the people who have lost or returned because they've lost permanent housing?

[Rep. Zon Eastes (Member)]: Is that

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: We have in the system what's called the levers and the stayers. And we also look at their exit destination. What we aren't doing really well is of those returning or re enrolling, we haven't been asking questions about where you were, we're probably asking those questions in case management, you know, where we hear the story. But the data doesn't tell us the story across the board for how many of those reenrollments represent whether or not they were housed and what kind of housing, right? Were they housed in a project based subsidy or some kind of voucher? Or were they housed for a year, rent burdened and couldn't make it? We have a lot of questions about that. And so when we do this report that we're doing right now annually, we always make a wish list of things that we want to change. We know that that's been something that's been spotlighted for the past year. And we are hoping to really dig into that and make some active changes.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: And my second question, you mentioned reviewing data as a stakeholder group to kind of identify gaps. To what extent is AHS involved in those conversations to help resource some of those gaps that you're identifying in the various regions?

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: In lots of ways. First of all, the whole coordinated entry assessment that we're in the

[Rep. Golrang "Rey" Garofano (Vice Chair)]: process It's all.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: It's led by OEO in a way that is collaborative and democratic and active listening but also very supportive. The coordinated entry lead agencies are so supported and coached and heard by OER staff. We just across the board have a great relationship with them. Couldn't do it without them. Wouldn't want to. And then we have ESD staff at the tables in most places, right? They're attending the meetings. They're sending us the lists. And we have reach out case managers that are coming because we're doing case conferencing. And

[Speaker 0]: I

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: think really good relationships with ESD. Also, where we talk about ideas and problem solve and really appreciate the heavy lift that this program is for them and collaborate the best way we can.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: And then I have representative Eastes and Paul again.

[Rep. Zon Eastes (Member)]: I just need to ask a question about, just because I don't understand it, a question about the current system that we have now. So when people are enrolled in this eighty day program, whatever not program, this eighty day thing we've got, that's their entry supposedly into coordinated entry, correctly. Am I correct about that? Or that's the moment at which they would get entered into coordinated entry?

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Ideally. Yeah. They may have already been involved, but it could have done what Jess is saying.

[Rep. Zon Eastes (Member)]: So what I'm starting to get a grip on is the notion of, as I'm thinking about some sort of system that could take care of this, the HYS system with all its various modules or something, it seems to me it's important to think about what emergency looks like in emergency housing as if it were a flood or something like that. If we're dealing with a flood, we don't bring probably our full blown systems to what we're gonna deal with. First, deal with the emergency that's And right in front of it strikes me that right now I hear a lot of thinking, like we're trying to meld all these systems together and sort of make everything work. And I think it's, I really like the idea of just, if we can get rid of our brains on the GA program almost entirely, that when does a person, when would a person actually enter HMIS? And it might not be, or the coordinated entry, it might not be, we might not put them on a list the first time they enter because of cold weather. It might take a few days before we put them in. Am I making any sense?

[Speaker 0]: I just see that. Yeah.

[Rep. Zon Eastes (Member)]: It seems to me that it's it's not just that we need systems and stuff like that. Need a whole brain set being rematch here. Yeah. And that that in order for us to get HMIS to actually work for us well, we need to see which modules are gonna support our longer term notions, which are making sure that people are housed in the long term. Every single person in Vermont is housed in the long term. That's that seems to me to be our goal. But I still hear a lot of people talking about how we're gonna deal with it in these emergency systems, and I don't think it's compatible. It seems to me like there's a line to be drawn there. Yeah.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: I'll let the witnesses respond and

[Rep. Zon Eastes (Member)]: I'll I'd go to like to hear reactions. I mean, I'm not I'm not I'm just guessing. I'm trying to figuring out a way to go forward here.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: What's your go ahead, Chad.

[Chad Simmons (Housing and Homelessness Alliance of Vermont)]: I'd like to hear just for Taylor's response first, but I do have a response to

[Rep. Zon Eastes (Member)]: that, yes.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: I can't imagine doing this work without motels. It's just often the easiest thing

[Speaker 0]: for motels.

[Rep. Zon Eastes (Member)]: Oh, no, I don't I'm thinking motels, yes. Just not in the GA Not in the way we think of them. Right, I know. They're a housing option.

[Rep. Eric Maguire (Member)]: A short term housing option.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Yeah, and they honestly work really well. And I honestly think if you look at If you really dig into it, they're very cost effective. The key is having services there. And we want to have services there. And in our region, the motels themselves, I mean, the people running those motels are so dedicated to this cause and our partners. And our clients often really also like a need, it feels trauma informed that they have their own room and own space. Although our shelter also has people in private rooms. But it's a really important tool and it is the fastest option that we have. I think it's, honestly, I also think Economic Services Division knows how to do it and has done it well. I think that the missing piece and the rhetoric that we hear all of the time is just the people who are staying there don't have the services that they need. And we agree that at other times we've had multiple staff who were on-site at motels every day. And when the federal ERAP funding ended, we lost a lot of that and it wasn't able to be supplanted. We did make some federal requests that we weren't able to secure. But motel rooms function quite well as emergency shelters if you have all of the services on-site that are the same that people would receive in Can

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: I just clarify your question? Sorry.

[Rep. Zon Eastes (Member)]: I have a question. Yeah.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: It was utilizing the HMIS as an emergency

[Rep. Zon Eastes (Member)]: Correct.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Is that what

[Rep. Zon Eastes (Member)]: you're saying? Well, and the notion that this eighty day notion that we currently have the program, that if that were not in this game, which I think it won't be, if we are I don't know exactly, but the notion of emergency seems to be around the idea that you can this service or this benefit for eighty days, and then it goes away. And that seems to be a real problem in the way this whole system works, it strikes me. So I don't know if that's clarifying at all, but

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: No, I think on the same wavelength here. But I feel like Chad has a better I

[Chad Simmons (Housing and Homelessness Alliance of Vermont)]: don't know about better, that's why I had Taylor and Jess go first. I think to just brought this up at the very beginning is at the onset, one of the major things that we are missing is decent affordable housing. And without that, folks are stuck. And until we are able to get things unstuck, we need tools in the toolbox like the hotels and motels. And as Jess and Taylor both pointed out, if you don't have those tools, we're just kicking people out and making things worse. We're passing the costs into different parts of our economy and our taxpayers and ratepayers, as we've heard in testimony over the last month. And so these tools are imperfect and they are absolutely necessary to A, decrease the suffering and B, kind of stop the flow of people in a way that they're not able to get the supports and services that they need. And so to Jess's last point around what is really needed is those services and the resourcing for the agencies, current agencies, as well as newer agencies who can kind of fill the gaps in those concrete support kind of ways.

[Rep. Anne B. Donahue (Ranking Member)]: Beth Cole.

[Rep. Esme Cole (Member)]: Thank you. I'm in Windsor County and I will say it's great to hear stories where the integration is happening, like in Franklin County, like you said, Jess. When you told me that that was a requirement for DCF to be entering people into coordinated entry, my job almost started working. It's not DCF or AHS.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: It's putting in folks into coordinated entry. They're sending referrals to our designated agencies who will do that work.

[Rep. Esme Cole (Member)]: So that is something like my lack of awareness about that was because the people who I'm talking to who have experienced it, they feel totally alone. Like there's no And I mean, is to your point, don't think I'm very Honestly, I'm quite confused about where the tension is about I don't want to get into party politics, why? People think that the Liberals want to keep the GA program, which is not true. It's exactly to Chad's point, which is we are using shelter, these motels, because we don't have affordable housing and we need to integrate case management in the picture. But I just didn't want, because we talked about Chittenden County, which is a whole, I guess, different place and then Franklin County, but I wanted to make sure like a lot of other counties, they are not seeing de effective. And I know Jess, maybe you think you've had different experience across the state, but I just like all the testimony we received from people with lived experiences, especially those coming to the front lines, like going to actual hotel rooms to interact with folks, they were like, where is the state? Where is the state? We're filling in these gaps. So I just don't want it to be looking like it's a pretty picture. And I know that's not exactly what we're trying to do, but it really is broken. And yeah.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: That's why I'm excited about this proposal for something different. So as a balance of state and as coordinated entry leads, we meet all the I was in an hour and a half meeting with the coordinated entry leads from all across the state today. And we do that once a month. And we meet as a coordinated entry committee once a month as well. So we have multiple times that we're getting together in statewide conference calls to the tune of probably like once a week. So I know that the process where ESD is referring and sending these lists is happening statewide. But I want to be really clear, people are still alone. I think I just want to say the point that I said earlier which is that when we sit down and assess somebody, we're looking at a 100 different ways to connect them to services. But there isn't a way to connect every person to services. The services are across they could have the coordinated entry assessment, be enrolled in coordinated entry and we could be touching base with them every 90 days for a check-in. It doesn't mean we have a coordinated entry is not necessarily case management. It gives us the opportunity to make that referral. But we don't have the housing case managers or navigators to connect people to. So it sometimes is a real light touch. It sometimes is just the assessor who they can call and check-in with, do some housing applications with. It hasn't always been that way. And we have had more services. But even then, we weren't able to reach everybody. We're not even able to keep those positions full, right? I had an open position for an outreach coordinator for nine months trying to get somebody to apply and take that. So sometimes it's not just the funding that's needed. We have shelters that have had to delay opening with all of the funding and the buildings secure and ready to go because they couldn't find, even with the funding, the staff to do the work. It is complex and hiccuppy. And even if coordinated entry is working really well, it doesn't mean that everybody who's enrolled in it was able to be connected to a resource that met their needs. Because for multiple reasons, we don't have the services available to do so.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: It also doesn't mean that everyone who needs to be in coordinated entry is in coordinated entry, which I think is what we've heard a lot in our committee, is that there's a lot of people left because, for whatever reason, either they didn't make it from the referral didn't make it from the hotels or motels, or they're just sleeping in their car, or they're getting services from a community provider that's not connected into. So that's the piece, I think, that you're bringing up. Anne and then Eric.

[Rep. Anne B. Donahue (Ranking Member)]: So, stepping back to earlier conversation maybe, but assuming that we were able to develop an enhanced system where we were really able to produce those outcomes where people are able to move when they're ready into what we've found stable, which may take more time, certainly will take a lot more services. I think we all understand that. But assuming we're putting that together and developing it and that that's working, whether it's a shelter or whether you call it shelter like, because it's actually hotels, but it's hotels with the rooms nearby, so the support staff are working and so forth. You have that system in place, and one of the things that's been referenced, and I think we recognize, if we're working under budget realities caps, that by definition means fewer people than now are in that level of help because they're getting a lot more help, and it's gonna result in people actually being able to move, hopefully, into success. Are we

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Thinking there's permanent housing out there too to move for these

[State Long-Term Care Ombudsman (Vermont Legal Aid)]: folks, yeah. Well,

[Rep. Anne B. Donahue (Ranking Member)]: if we're assuming a system that is going to connect people, then when they can't connect, then they're still in that system, which then further limits who's coming into it if there is no successful exit at this point, or if it's a much slower process to that. And we've talked a lot about when people are able to get somewhere that they need continued support, otherwise it just falls apart again and we've lost the human investment as well as financial. But I'm just saying, all that is in place, then we've got for at least a long time until this all pays off and succeeds and no one's homeless, right? For a long time, we've got more people who are not able to enter that level of support. That's the question of how do we identify the best system to prioritize. Right now, it's sort of based on these categorical things, and then even then there isn't enough room necessary for everybody who meets the category. But whatever system, the vision of what happens to all the people who are on the waiting list to get into emergency shelter?

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: I think that's a great question. I think I'll go back to just briefly, and I think, do you have something that you wanted to add? I just saw you out of my peripheral. No? Okay. Is that shelters, the one that I'm currently running at Elmwood, we prioritize people experiencing unsheltered homelessness, right? So the folks that may not be receiving that level of service in a shelter like facility would be prioritized through shelter, traditional shelter services, although we're all different in reality. So like specific to Elmwood, I would only be able to serve and prioritize adults who are unsheltered. But there's other systematic approaches for other shelter providers. It's just not universal, which it can be challenging for the folks that are not on that higher level need that you were talking about in your little bottleneck. Well, right, assuming, but the folks that you are able to, you do prioritize, they're

[Rep. Anne B. Donahue (Ranking Member)]: the folks who are, to some extent, getting, maybe we would like to enhance it more, but are getting what they need. Yeah. And I think you raise a good point. I think there needs to be more commonality in how that system can prioritize some consistency. But that's not answering them. What happens with the greater number of people who there is no entry door to? We create a waiting list where to the extent we can find them, it's like, well, you were next in the priority or are just gonna wait and attend until then? Are we gonna have

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: Lots of folks are doing currently, but I'm happy to hear, Jess.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: And I think some of the other conversations that you've been having about by mindfully having, which is mindfully creating specialized shelters for vulnerable populations would help with some of that. Right? If we had more family shelters, for example.

[Rep. Anne B. Donahue (Ranking Member)]: But that would be the same upper level system that I'm talking about. Are with services. Those are whatever that middle level between permanent housing and whatever emergency shelter, whether it's specialized, whether it's family, whether it's Those are all people who've made it in the front door. I think it's But we're having a no matter how many we have, it's still a smaller front door. That's what's happening

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: now. I mean,

[Speaker 0]: I think you can I've

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: heard a lot of conversation about this idea that we will get to this point where we will reduce the use of motel rooms as we build emergency shelter capacity. But one of the things that we as providers have not been able to really figure out is what's the bottleneck. For the past five years, like six years

[Speaker 0]: that we've been doing

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: this since COVID, it still is a one out, one in. One out, one in. It works really well. We housed more than 1,500 households last year through coordinated entry just in the balance of state. That doesn't include Chittenden so the number is even higher.

[Rep. Anne B. Donahue (Ranking Member)]: You're talking about permanent housing.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: You're you have to

[Rep. Esme Cole (Member)]: it. But

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: our coordinated entry list isn't going down. We don't have a measure yet of what that looks like. It's people couch surfing, staying with friends and family, sleeping in cars periodically, ending up in tents, back to sort of couch surfing. I don't know how far back that goes. This idea that without, to Chad's point, this process that Vermont's doing a good job of, you know, in the past year here, we added a building with 73 units and another one with 33. And we have more planned. And we are investing in housing on all levels, publicly, privately. Communities are embracing it. That has been a big change in the past six years and the legislature has been investing in it and private investors have been investing and we're making a lot of progress that way. And I think it will continue. But this idea that in the immediate future we would see a reduction in need for motel rooms based on shelter expansion, I don't think we have any data to show you that. And what you're talking about wouldn't be a new problem. It's the current. It is the current one. Motels have limited capacity already.

[Rep. Esme Cole (Member)]: Brenda, did you have something?

[Rep. Eric Maguire (Member)]: Just a quick question and actually in response to a few things. Over the last four years, well, even this COVID hit, we do a bit, you know, the hotel funding was mainly ARPA funds that we're able to utilize. We've maintained a GA emergency housing benefit that has been historically throughout all states as a stopgap temporary mechanism. And we we chose to continue the fact when our homelessness crisis to a general assistance emergency housing benefit. At this time, we literally have two competing systems going on to address homelessness to the point of if somebody is on a GA housing benefit, which is still governed under title 33 within the statute as a state benefit, there is no requirement, no nothing. It's a benefit. They are not required or obligated in any way, shape, or form to utilize anything within coordinated entry. Coordinated entry, as it's known, is ace completely anybody that is on a GA housing benefit, they have the choice whether or not to engage or not engage. They have that choice. Yeah, do. But

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: not in practice. Mean, have to send this list back by the twentieth and it says in bold, and I was on the statewide call this morning. And Washington County was expressing that they had sent their list back and people were being exited from the motels in droves. Right now, the understanding is according to

[Rep. Eric Maguire (Member)]: Because their benefit had expired.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Because what?

[Rep. Eric Maguire (Member)]: The benefit as it's laid on out, the GA housing benefit has their eligibilities and things

[Rep. Zon Eastes (Member)]: like that, the eighty day.

[Rep. Eric Maguire (Member)]: What I'm saying is we have two competing systems going on right now. We are still de factoing. Can still access the benefit. I used this example the other day. Would it be easier for me to access a shelter in Brattleboro or access the GA housing benefit? What's the eligibility verification, anything?

[Speaker 0]: You're clicking?

[Rep. Eric Maguire (Member)]: Oh, yeah. Sorry.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: I was picking that up and Oh, no. No. Sorry.

[Speaker 0]: Let

[Rep. Eric Maguire (Member)]: me just get to my point. We're we're attempting to serve two masters between the general assistance, emergency housing benefit and providing some level of a continuum of care in which people are engaging with coordinated entry. That's why I believe we one, removing the general assistance emergency housing benefit, I believe will be the it will provide more opportunity to get people the services that we need. In regards to the things saying, oh, we gotta get services into the hotel. Yes, I completely agree with that. But I look at just Rutland City. At this time, Rutland City has numerous hotels that are that are GA benefit placements. If the city or anybody goes or I go down the hotel and say, hey, listen, we're gonna utilize this entire hotel for this. We will run into significant, issues in regards to charters, to zoning, to they are they are permitting in regards to hotels. It's it's a lot more logistically difficult in Rutland than it may be in in other communities. And I'm factoring all that in. So that's why I'm saying we gotta tread lightly in regards to saying, hey, we might be able to work with these hotels on on this level. But again, I believe at this time, we are we are serving we are serving two masters. This grew because everything was de facto to a GA housing benefit.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Think just The GA housing benefit, 100%, I am certain, comes with the requirement for case management and coordinated entry referral. And if you do not comply with that, you will lose your room. And I would invite you to contact the homelessness prevention center in Rutland. Sarah Orvis is the person who is the coordinated entry specialist down there. She was on the call this morning and talking through some of that. But there is a services requirement and a case management requirement in order to receive a motel room. And you are exited from the program if you do not enroll and engage, which we have concerns about that. As lead agencies, it's really hard to say no on that list for somebody and know that they're going to lose their housing and there might be complex reasons

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: for I think to your point, though, that service varies based on the capacity of case management. So there may be times where folks like, I actually, I do attest that we get phone calls making sure folks are accessing or in coordinated entry in order to continue a stay, not after their eighty days, because that's not a thing, but even prior to that. So that does happen. And access and engagement and services looks different in other in counties, in different counties, right?

[Rep. Eric Maguire (Member)]: Yep. So just one last quick thing. Thank you very much, because I kind of was going around in a thing because I wanted to go back to where you brought up the point of consistency. That's why I was sharing where I was going. Because the other piece is the two mechanisms right now are so inconsistent to your point that you just made that shared that, the inconsistency right there.

[Taylor Thibault (Assoc. Director, Homelessness Prevention Initiatives, Champlain Housing Trust; Co-Chair, Chittenden County Homeless Alliance)]: The sentiment is similar, though. We would they would love people to engage and have access to that, and 's a certain capacity threshold, right?

[Rep. Eric Maguire (Member)]: And there is a limit that you can force, for the sake of a lesser word, an individual that has received a general assistance emergency housing benefit engage if they choose not to. Nope, I'm good, I got my eighty days, thank you very much. That still That can still occur.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: The verification comes every twenty or thirty days. So they'd be exited prior to their eighty. Because in order to they still have to, you don't just get eighty days, you only get like a thirty day period at a time. And the engagement is measured at the thirty. So you wouldn't get renewed for the next month if you hadn't engaged.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: So thank you. I'm watching the clock, and we've kept you here longer than we had you on the calendar. So I appreciate the conversation and the continued kind of back and forth and trying to understand. I think some of the takeaways from me are recommendation that whatever system we have has consistent requirements across the state. And if we choose to go with HMIS as the system that everyone is mandated to go through and require services to ensure the investments that come to fund those services. And then also acknowledging that the funding is limited, so kind of figuring out. But I hear there are opportunities to use HMIS more broadly than is currently being used as long as the resources are put forth to ensure that the services are available. So we are due on floor in fifteen minutes. So I appreciate your time. And we'll reach back out if we have more questions.

[Rep. Eric Maguire (Member)]: Thank you so much. Sorry about the pen thing.

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: Appreciate you. Thank you so much. It

[Speaker 0]: was really

[Jess Graff (Program Director, Franklin Grand Isle Community Action, CVOEO; Board member, Balance of State CoC)]: fun to be with you in real time and not just watching later. Thank you for the work that

[Rep. Golrang "Rey" Garofano (Vice Chair)]: Thank you're you so much for your testimony and your time.

[Rep. Eric Maguire (Member)]: Jess, thank you very much. Thank you.

[Rep. Golrang "Rey" Garofano (Vice Chair)]: Committee, just want to remind you before we go off live that tomorrow morning, asked, the speakers asked, we are due on the floor at 9AM. We have a very different schedule. Tomorrow, we're on the floor at nine for the state of the guard clock dance. And then we have a special resolution after that. Then we have at 10:30, we have our joint assembly to elect the Vermont State Colleges, and then they'll gather back in at 03:30 for the action calendar for the day. So you can refer back to the speaker's email from Saturday for that schedule, but please remember to be in your seats at 9AM tomorrow, not here. And we have a couple of minutes if folks want to continue reflecting on what we heard and how to move forward or maybe we leave it and we can kind of let it marinate a bit. Marinating on this. Get back to the conversation tomorrow.

[Rep. Eric Maguire (Member)]: I want to say a lot, Victor.