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 individuals and service providers seeking information on how to access the homeless crisis response system in Clinton, Fayette, Highland, Pickaway, and Ross Counties. Please continue to visit this website for details and updates.
These programs serve all households regardless of race, color, national origin, religion, sexual orientation, gender identification, age, familial status, or disability.
Community Resources for the Homeless & At-Risk
Clinton-County-Specific-Resources
Fayette County Community Resource List 2-2025
Fayette-county-housing-resource-list-2024
2024-Highland-County-Community-Resource-Directory
Region 16 Schools Homeless Liaison Info
Pickaway County Specific Resources
Ross County Specific Resources
Ohio School Homeless Liaison Contact Info
Fayette County: Customer Satisfaction Survey
Region 16 Management & Structure
Bylaws & Operating Procedures
Regional Committees & Membership Rosters
Program Policies & Notices
HMIS-Client-ROI-and-Posted-Data-Privacy-Notice
Region 16 Coordinated Entry Plan revised 2024
Region 16 RRH Policies & Procedures Revised 2026
Region 16 PSH Policies & Procedures Revised 2026
Case Closeout and Termination of Assistance
Domestic Violence Policy
Region16 Grievance Packet CURRENT-To be posted in office and can be provided to clients enrolled in housing programs.
Access Points in Region 16
Clinton County:
Clinton County Services for the Homeless- 36 Gallup Street, Wilmington, Ohio 45177; 937.382.7058
Highland County:
Highland County Homeless Shelter- 145 Homestead Avenue, Hillsboro, Ohio 45133; 937.393.0634
Fayette County:
Brick House Emergency Shelter- 320 North Hinde St, Washington C.H., Ohio 43160; 740.333.7580
Community Action- 1400 U.S. Route 22 NW, Washington C.H., Ohio 43160; 740.335.7282
Pickaway County:
Integrated Services for Behavioral Health: 1154 North Court Street, Circleville, Ohio 43113; 740.270.6701
Pickaway-CAC of Fayette County-AP: 740.505.8919
Ross County:
Community Action: 250 North Woodbridge Avenue, Chillicothe, Ohio 45601; 740.702.7222
McArthur Gardens:740-270-6701
Veteran Providers:
LSS Faith Mission of Fairfield County-SSVF: 1681 East Main St. Lancaster, OH 43130; 740.653.2012 ( Fayette, Highland, Pickaway, Ross Counties)
St. Vincent de Paul of Dayton- SSVF: 1133 S Edwin C Moses Blvd, Suite 285, Dayton, Ohio 45417; 937.222.7349 ( Clinton County)
Diversion Assessment- (completed by Access Point)
HMIS DATA- RELEASE-ROI– This is completed for the HOH ONLY by the Access Point. In-Person Consent Form or Verbal Consent Form are both provided, use accordingly.
Diversion-Assessment-2025 – This form is completed by the Access Point for the Head of Household (HOH) ONLY. If Diversion is NOT successful, this form must be included in the CE File.
*If the household is NOT diverted, the Diversion Assessment MUST BE PRESENT in the Coordinated Entry File.
Coordinated Entry (CE) File- (completed by Access Point)
The Coordinated Entry (CE) File is the common file shared among ALL Homeless Service Providers in the region & is required to be completed for ALL referrals.
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- CE Checklist-This form is to track required documents needed for the CE File.
- Diversion Form – This was completed by Access Point during the Diversion Assessment & must be included in the CE File.
- Referral for ES/RRH/PSH (as applicable)- Will be completed & printed from HMIS when the HARP tool is completed & HOH provides verification of homelessness to Access Point
- Regional Universal Release Form-This form must be completed by Access Point.
- Diversion Data Release Forms – This form was completed for the HOH during the Diversion. If children are present in the HH, they MUST BE ADDED NOW.
- Homeless-Status-Documentation– This form must be completed by Access Point & be accompanied with verification of homelessness.
- HMIS AP Enrollment – Completed in HMIS by the AP. MUST be printed from HMIS & placed in file. Blank pdf copies are available on COHHIO’s website.
- Income Verification Forms– These forms must be completed by Access Point & be accompanied with required income documents if applicable.
- Copies of the entire HH’s PII.
- PSH HOMELESS VERIFICATION FORM NEW 2026 ONLY completed by Access Point when referring HH to PSH
- PSH- DISABLING CONDITION FORM
- STAFF CERTIFICATION OF ELIGIBILITY
- Certification of domestic violence, dating violence, sexual assault, or stalking
- Notice of occupancy under VAWA (13 & 14 must be included in client file and client must be given a copy)
- Please Note: Homeless program referrals require a HARP score, which is provided through HMIS. Emergency Shelter’s MUST complete the HARP within 5-8 days of HH enrollment into their homeless emergency shelter program & maintain a signed copy of the completed HARP in the HH’s file. All HARP’s must be completed within 5-8 days of AP enrollment, with the exception of TAY, Unsheltered & those with prior homelessness which can be done the same day they present. If a blank print out of a HARP is needed, please use the following link for a printable version the appropriate HARP Tool: https://cohhio.org/boscoc/coordinated-entry/
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Rapid Re-Housing (RRH)
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- ENROLLMENT-TAB-RRH
- Case Management Tab
- HOUSING TAB RRH
- HQS Inspection– complete in Housing tab
- Lead-Based-Paint-Requirement
- Lead-Paint-Disclosure-Form-Rentals
- Protect Your Family From Lead Pamphlet 2026
- FINANCIAL ASSISTANCE TAB RRH
- RRH Rent Calculation 30P– completed at MOVE IN and updated monthly if HH income below 30%. (complete in Financial Assistance tab as applicable)
- RRH Rent Calculation 50P- completed at MOVE IN and updated monthly is HH income above 30%.(complete in Financial Assistance tab as applicable)
- Blank W9 complete in Financial Assistance tab
- RECERTIFICATION TAB RRH
- OUT OF OFFICE LOG
- Region16 Grievance Packet CURRENT
Permanent Supportive Housing (PSH) Forms
(currently available in Fayette Co. only)
- ENROLLMENT-TAB-PSH
- Case Management Tab
- HOUSING-TAB-PSH-1
- HQS Inspection– in Housing Inspection tab
- Protect-Your-Family-From-Lead-Pamphlet-2026
- Lead-Based-Paint-Requirement
- Lead Paint Disclosure Form – Rentals
- Rent-Calculation-Excel-PSH– in Housing tab
- Fayette Utility Allowance– in Housing tab
- CAC Utility Reimbursement Form Authorization (Complete first section yearly at Recertification, second section, complete monthly
- PSH-CAC Third-Party Lease– in Housing Inspection tab when applicable
- FINANCIAL ASSISTANCE TAB PSH
- Regional-Universal-Release-Form (6)
- Blank W9– in Financial Assistance tab
- RECERTIFICATION-TAB-PSH (4)– completed ONE YEAR from enrollment into project
- OUT OF OFFICE LOG
- Region16 Grievance Packet CURRENT
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Brochures & Flyers
- Region-16-HCRP-brochure
- HCRP-Eligibility-Flyer (revised 2025)
- SSVF Brochure 2025
- Clinton County SSVF Brochure
- LANDLORD BENEFITS
- PSH DH.S+C Brochure
- Stable Futures 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.
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