Overview of Change

​A new case note template is now available for all Coordinated Access staff to use titled “CAN Case Note Template”. This template is available to all organizations. Additionally the template called “CAN Case Note”, which was an older template, has been retired and removed from the CAN organizations.

A preview of the case note content is below.

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Household Composition: Who will be living in the house?

Indicate if the household is an:
( ) Individual
( ) Young Adult (under 25)
( ) Family with Adults only
( ) Family with Children (include ages of all children)

Housing Status/History: Have a conversation to learn about the client’s current housing status and housing history. The questions below can assist with gathering the information.

Natural Supports: List family/friends/coworkers who are natural supports.

Sources of Income/Employment: How are they able to pay for their financial obligations and take care of their basic needs?

• Where did they sleep last night?

• Briefly describe housing history over past year: who did they previously stay with and why did they have to leave? Can they safely return?

• Did they ever have their own lease (past year or before)?

• When was the last time they had a stable place to live?

• What have they been able to do to avoid seeking shelter?

• What other housing options do they have for the next few days, weeks, or months (who can they potentially stay with)?

• Do they have anyone assisting them with meeting their basic needs? (name, relationship, contact information, type of support).

• If unsheltered, where are they taking care of their basic needs such as showering, eating meals, using telephone, etc.?

• Did you (CAN staff) speak with any of their natural supports/people they formerly lived with? If so, what was the outcome of that conversation?

• Can they possibly temporarily stay with natural supports?

Domestic Violence: Is there active domestic violence?
( ) Yes or ( ) No

Is there an active restraining order or protective order?

( ) Yes or ( ) No
If the client’s circumstances have changed, please refer back to Safe Connect at 888-774-2900

• If there is active domestic violence, was a connection made to Safe Connect and is there a safety plan in place?

  ( ) Yes or ( ) No

• Has Safe Connect assessed for safety?

  ( ) Yes or ( ) No

• Has Safe Connect referred the client back to CAN?

  ( ) Yes or ( ) No

Community Supports and Services: What community supports, or services are already in place?
Please provide contact information.

• Are there any community supports or services that they would like to be connected to?

Housing Barriers: Summarize what factors led to homelessness and what are the most significant barriers to accessing or stabilizing housing? (For example, utility arrearage, criminal history, poor credit, on the sex offender registry, lack of income, limited supports, etc.)

Plan/Next Steps: What plan/next steps were agreed upon during the appointment?

• What is the client going to do?

• What is the Diversion Specialist going to do?

• What additional referrals to resources were provided?

• What was the outcome of the appointment? Such as but not limited to diverted, referred to outreach, added to waitlist, etc.

*Create a person-centered diversion or housing plan – provide a copy to the client and attach to HMIS file.

Path to View

Case Management (Tab) > Left Menu: Case Management > Case Notes > Add New

CT HMIS Roles Affected

• ALL Roles