How the integrated workflow runs
- Intake and triage: identify urgency, safety needs, and immediate barriers.
- Assessment: determine housing barriers, mobility needs, and financial stability risks.
- Service plan: align housing steps with transportation scheduling and financial milestones.
- Stabilization: reduce missed appointments and failed handoffs through coordinated follow-up.
- Retention: maintain stability through ongoing case management and escalation pathways.
See program specifics in Programs.
Memphis implementation phases
- 0–30 days: stabilization (intake, immediate housing steps, mobility set-up)
- 30–60 days: mobility integration (reliable access to care, work, and training)
- 60–90+ days: long-term stability (retention, income routines, sustained supports)
Built for a Memphis context where transportation gaps and fragmented service ecosystems can interrupt care, work, and housing retention.
Staffing model (touchpoints)
- Case managers: integrated service planning, follow-up, retention supports
- Housing navigators: placement coordination and provider/landlord communication
- Transportation coordinators: scheduling, tiering, vendor coordination, trip resolution
- Financial coaches: budgeting, milestones, coaching cadence aligned to stability steps
- Data & outcomes staff: measurement, reporting, continuous improvement
- Compliance & QA: accessibility, safety, privacy processes, incident review
- Program director: operational oversight, partner coordination, performance management
- Executive director: strategy, funding, governance alignment, community accountability
Outcomes & evaluation (what we track)
- Housing retention (30/60/90-day and annual)
- Transportation reliability (trip completion, on-time performance, issue resolution)
- Reduced missed medical appointments through coordinated mobility planning
- Employment placement and training follow-through (where applicable)
- Income stabilization and financial milestones (budgeting, savings steps, bill protection)
Partner ecosystems that reinforce trust live on Partners.
Risk, compliance, and safety
- Trauma-informed care: predictable communication and nonjudgmental support
- Veteran privacy: minimum necessary information sharing for coordination
- Transportation safety: incident reporting and escalation paths
- ADA / accessibility: accessible options and accommodations where required
- Financial data protection: sensitive data minimization and safe handling
- Continuous quality improvement: learn-and-improve loops based on outcomes data
Care-model inspiration (principles)
- Warm, human-centered experience: welcoming, safe, dignified pathways
- Clean structure and clarity: simple navigation, modular programs, clear next steps
- Professional and scalable: funder-ready reporting and operational consistency