36C26118Q0096-010.pdf

ATTACHMENT 1

HUD-VASH ACUITY ASSESSMENT

Instructions:

- Please choose the appropriate level of functioning in each area (1-3),

- Total the Acuity Score

- Include Preference Score and include in Grand Total

ACUITY RANKING -

Level 1: Score 5-8 Level 2: Score 9-11 Level 3: Score 12-18

Level 1 = Quarterly home visits (Monitor Status, should be preparing for graduation)

Level 2= At least one monthly visit in home

Level 3 = More than once a month (minimal of weekly face-to-face visits, with a minimal of 2 of those visits being in the home per month)

The expectations for case management visits are as follows:

High Acuity: A minimum of weekly face to face visits, with a minimum of two per month being with the case manager and in the Veteran’s home (if housed)

Medium Acuity: A minimum of one face to face visit per month, if Veteran is housed, one home visit per month.

Low Acuity: A minimum of one home visit quarterly with monthly phone calls, documenting Veteran’s status for graduation and expected graduation date.

Categories

SVA CORE

Mild- Stable

Moderate

Severe-Crisis

SVA

CORE

HOUSING Housed from 6 months to 1 year without lease violations.

Able to do complete annual recertification with minimal assistance.

Housed less than 6 months.

Needs assistance with lease adherence and with annual recertification process.

Homeless with or without voucher or housed, but in eviction process.

MENTAL

HEALTH

Has MH diagnosis, symptoms that minimally interfere with functioning , compliant with treatment or no MH dx

Has MH diagnosis, is connected to services, needs monitoring for compliant with treatment

Chronic mental illness without treatment, refusing or non-complaint with tx. Severe MH symptoms leading to frequent hospitalizations, frequent interpersonal conflicts, hoarding, cluttering, lease violations, suicide attempts, etc.

SUBSTANCE

USE

No use, maintaining sobriety or use without harm

Hx of SUD, sobriety or use but in treatment;

At risk for relapse

Risky and unsafe behaviors due to active use and no desire for recovery.

PHYSICAL

HEALTH

No urgent medical issues or has medical issues and connected to Primary Care

Chronic health problems but in treatment and needs monitoring and assistance

Terminal illness, chronic illness @ imminent and acute risk, resulting in frequent ER trips – minimal or non-compliant with treatment

FINANCES Stable source of income over $1500 Income is between $851 - $1,500

Income is 0 - $850, or at risk of loss of income/benefit

ACUITY SVA

CORE:

PREFERENCE

SVA CORE

Homeless Senior (65+) (+1) Female (+1) Veteran with Dependent (+1)

GRAND

TOTAL: