Homeless Crisis Response Program

Balance of State Continuum of Care
Homeless Planning Region 16

The Community Action Commission of Fayette County, in partnership with homeless planning region 16, presents the Coordinated Entry process on this page.  The purpose of this page is to serve as a starting point for any individual and service providers seeking information on how to access the homeless crisis response system in Clinton, Fayette, Highland, Pickaway, and Ross Counties.  As the 2017 coordinated entry planning process is underway, please continue to visit this website for details and updates.

Community Resources for the Homeless & At-Risk

Region 16 Housing Inventory Chart 2017
Available Housing List
Clinton County Specific Resources
Fayette County Community Resource Guide
Fayette County Available Housing List
Highland County Specific Resources
Pickaway County Specific Resources
Ross County Specific Resources

Region 16 Management & Structure

Bylaws & Operating Procedures
Regional Committees & Membership Rosters


Region 16 Coordinated Entry Plan November 2017
Grievance & Appeal

Coordinated Intake File Documents

The Coordinated Intake File is the common file shared among all homeless service providers in the region.

  1. .Tab 1 CE Checklist This form is to track required documents needed for the CE tab
  2. Diversion Form Update 9.21.18 – This form is completed once on the HoH. This form must be included in referrals.
  3. 2018 HMIS Unsheltered form – This form is completed if the household cannot be diverted from homelessness, but there are no shelter beds and/or the individual refuses services.  (HMIS or paper)
  4. HMIS-Intake-Form-All-Programs – This form is completed in HMIS & can be printed out or use the paper copy provided here.
  5. Regional Universal Release Form – This form must be completed by each homeless service provider.
  6. HMIS Release Consent forms– These forms must be completed by each homeless service provider.
  7. Homeless Status Documentation This form must be completed by referring agencies.
  8. Income & Supports Verification – These forms must be completed by referring agencies.
  9. PSH Documentation for non-PSH Programs – These forms must be completed by agencies referring participants to PSH.
  10. Single, Family & TAY VI-SPDAT – This is completed in HMIS & the score will be present on the HMIS referral.

Rapid Re-Housing Forms

Protect Yourself from Lead Brochure

Permanent Supportive Housing Forms

PSH Documentation for PSH Programs

Brochures & Flyers

HCRP RRH Info sheet
SSVF Brochure 2017
Clinton County SSVF Brochure
Destination Home Brochure
Fayette County Homeless Shelter

Regional Profile

Region 16 is comprised of Clinton, Fayette, Highland, Pickaway, and Ross Counties.  In the document below, you will find basic information regarding the economic and demographic conditions in the area.  Regional and community partners may utilize this information in the development of proposals for funding.

Region 16 Economic & Demographic Profile