San Francisco Rations Housing by Scoring Homeless People’s Trauma. By Design, Most Fail to Qualify.

Tabitha Davis had simply misplaced twins in childbirth and was dealing with homelessness. The 23-year-old had slept on associates’ flooring for the primary seven months of her being pregnant, earlier than being accepted to a brief housing program for pregnant girls. However with the lack of the twins, the housing program she’d utilized to stay in after giving start — meant for households — was now not an choice.

After a number of weeks in a resort, which a prenatal program for homeless folks had paid for whereas she recovered, Davis went to a brick constructing in San Francisco’s South of Market neighborhood to use for a everlasting, backed housing unit. There, a case employee she’d by no means met requested her greater than a dozen questions to find out if she was eligible.

Among the issues he requested: Have you ever ever been sexually assaulted whereas experiencing homelessness? Have you ever ever had to make use of violence to maintain your self protected whereas experiencing homelessness? Have you ever ever exchanged intercourse for a spot to remain? “These are the questions that actually bothered me,” she stated. “No matter my expertise is of being sexually assaulted, or what I needed to do to be able to keep protected on the streets, shouldn’t pertain as to whether or not I deserve housing.”

That day, Davis was knowledgeable that the rating she’d been given primarily based on her solutions to the questionnaire wasn’t excessive sufficient to qualify for everlasting supportive housing. It was a devastating blow after an already traumatizing few months. “I believed, ‘You set me on the streets proper now, mentally, I’ll kill myself,’” she stated.

What Davis encountered with these questions known as coordinated entry, a system designed to match folks experiencing homelessness with housing. In San Francisco’s system, candidates are requested 16 core questions, and their solutions are given a degree worth which is then tallied. The overall quantity is meant to replicate candidates’ vulnerability; at present, a rating of 118 factors means they qualify for one of many metropolis’s everlasting supportive housing models, which is backed by the federal government and comes with wraparound supportive companies. Candidates with decrease scores might qualify for lease help or a bus ticket out of city, but when they need housing in San Francisco, they’ve to attend six months earlier than taking the take a look at once more.

Although town’s Division of Homelessness and Supportive Housing has an annual funds of $598 million and nearly all of that’s spent on housing, there merely aren’t sufficient everlasting supportive housing models out there to accommodate the 1000’s of homeless folks in San Francisco. (A 2019 survey estimated the variety of homeless folks at greater than 8,000.) The brink for approval is instantly tied to housing availability, and proper now, roughly one-third of people that take the evaluation rating excessive sufficient to qualify.

“It’s actually prioritizing scarce sources,” stated Cynthia Nagendra, the division’s deputy director of planning and technique. “There must be some prioritization, sadly, till now we have some housing useful resource for each single individual.”

Coordinated entry was meant to be a extra goal instrument than the earlier system, which supplied sources on a first-come, first-served foundation. In distinction, coordinated entry goals to find out who’s most weak and who ought to subsequently get entry to the restricted provide of accessible housing.

By way of information requests, the San Francisco Public Press and ProPublica obtained the questions and scoring algorithm utilized in San Francisco’s coordinated entry questionnaire, which has by no means earlier than been made public. The information organizations solicited suggestions on that instrument from front-line employees, lecturers and folks experiencing homeless. Some raised objections to how the questions had been phrased. Others identified inequities within the scoring. And lots of extra criticized the best way it was administered, suggesting that the method itself — during which candidates are requested very private questions by a stranger — would possibly make it unlikely that already-distressed folks would reply precisely.

In our interviews, it turned clear that the survey fails to establish lots of the vulnerabilities it was meant to catch. And what was purported to be an goal instrument winds up, because of the way it’s written and administered, making it more durable for sure populations — immigrants, younger folks and transgender folks, amongst others — to get indoors, consultants and advocates advised us.

For Davis, that meant a number of the hardships she was experiencing had been neglected. As an example, there was no query within the survey that may give her factors for the losses she had simply suffered. Failing to qualify for housing resulted in weeks of stress and instability whereas she recovered from the trauma of dropping her youngsters. Finally, with the help of case employees at a number of organizations, she discovered a spot in a transitional housing program for youth. However being advised, in the course of the lowest second of her life, that she didn’t qualify for everlasting housing left its mark. “It made me really feel invalid in my very own expertise,” she stated.

In response to those critiques, homelessness division spokesperson Denny Machuca-Grebe stated in an e-mail, “I wish to make it clear that anybody who involves our division for assist ought to NOT ‘be not noted.’” For these deemed ineligible for housing, he stated town provides different companies; these might embrace shelter placements, relocation assist and rental help. Normally, the division had not responded to requests for feedback about particular person circumstances up to now, and it didn’t touch upon Davis’ expertise.

Excluded Populations

Coordinated entry was first carried out in 2018, after the Division of Housing and City Improvement started requiring areas that apply for federal homelessness funds to create a instrument “to make sure that individuals who want help probably the most can obtain it in a well timed method.” A lot of the remainder of the nation adopted a instrument known as the Vulnerability Index, Service Prioritization Choice Help Device. San Francisco developed its personal set of questions, meant to find out which unhoused individuals are in best want of a house.

Within the 4 years for the reason that requirement was carried out, some cities and counties have reviewed their coordinated entry methods and uncovered traits comparable to vital racial or gender biases. A 2019 evaluation of knowledge from Oregon, Virginia, and Washington discovered that despite the fact that folks of colour had been overrepresented within the homeless inhabitants, they tended to attain considerably decrease than their white counterparts, making it more durable for them to entry everlasting supportive housing. The examine beneficial that HUD think about revising its coordinated entry tips to make sure that communities “equitably allocate sources and companies.” This 12 months, San Francisco began its personal evaluation of its coordinated entry course of, and it expects to current the findings earlier than the tip of the 12 months.

Practically each professional we interviewed advised that the experiences of individuals of colour is probably not absolutely mirrored of their solutions to the coordinated entry questions. San Francisco’s personal knowledge reveals Black, white, Asian and Indigenous folks being accepted for housing at roughly equal charges. However Nagendra, from the Division of Homelessness and Supportive Housing, is wanting into considerations that situations that usually make folks of colour extra weak usually are not being absolutely captured and that the numbers might not inform the entire story. “Whenever you have a look at quantitative knowledge, ours will present we are literally prioritizing people who find themselves Black at an equitable charge. However once we discuss to folks, they could inform a unique story,” she stated.

Courtney Cronley, an affiliate professor of social work on the College of Tennessee who has written about racial bias in coordinated entry methods, pointed to one in all San Francisco’s questions for instance of doable bias in motion: “What number of instances have you ever used disaster companies up to now 12 months (for instance, psychological well being disaster companies, hospital, detox, suicide prevention hotline)?”

“Black individuals are much less doubtless to make use of formal well being care methods,” Cronley stated. “They’ll attain out to household and associates and social help methods relatively than going to the physician. The physician is just not somebody that they essentially belief. These questions are biased in direction of individuals who’re white in our communities and biased towards African Individuals.”

The Division of Homeslessness and Supportive Housing has additionally stated that only a few transgender and gender-nonconforming folks have been taking coordinated entry assessments. In a December 2021 assembly, Megan Owens, the division’s coordinated entry supervisor, offered demographic knowledge on who was being assessed. She stated that the variety of folks reporting these gender identities throughout assessments is “decrease than in one of the best estimates of the homeless inhabitants.” In March, metropolis knowledge confirmed that transgender and gender-nonconforming folks constituted solely 2% of these taking assessments to attempt to get housing.

Critics of San Francisco’s coordinated entry system additionally say that one of the crucial fundamental questions, “How lengthy have you ever been homeless this time?” results in the exclusion of immigrants and youthful folks.

That query would possibly sound easy, nevertheless it’s troublesome for many individuals to say how lengthy they’ve been homeless — and answering precisely might be important to getting housing. That’s as a result of San Francisco’s algorithm grants folks extra factors the longer they’ve been unhoused: An individual who has been homeless for greater than 15 years receives 12 extra factors than somebody who’s been homeless for one to 2 years. Anybody who says they’ve been homeless for lower than a 12 months will get zero factors on this query. (On common, adults who qualify for housing in San Francisco report being homeless for six years.)

Gayle Roberts, the chief improvement officer at Larkin Avenue Youth Providers, a nonprofit serving younger homeless folks in San Francisco, stated it’s “widespread data amongst social service suppliers that it [the coordinated entry system] is weighted closely towards serving the wants of those that have skilled homelessness the longest.”

Laura Valdéz, government director of Dolores Avenue Neighborhood Providers, is one in all a number of nonprofit leaders who questioned the efficacy of the system. “For a lot of newly arrived immigrants, the best way they actually interpret that query is since they’ve been right here in San Francisco,” she defined. “So their scores are actually low compared to other people. However a big share of our immigrant neighborhood had been unhoused of their dwelling nation.”

Valdéz additionally stated the coordinated entry system can lead folks residing open air to accrue vital trauma earlier than they qualify for everlasting supportive housing. This system, she stated, “requires folks to remain in that system that’s creating larger and larger hurt to them for them to have the ability to rating larger.”

The duration-of-homelessness query may also be difficult for homeless youth, outlined as these between 18 and 24. In a 2019 rely, they accounted for 14% of town’s homeless inhabitants. Many younger individuals are intermittently homeless, making it troublesome to calculate the total size of that have, stated Dr. Colette Auerswald, a professor of neighborhood well being sciences on the College of California, Berkeley.

“Perhaps they stayed on their buddy’s sofa for 5 days and so they had been on a bus final night time,” she stated. “So they could be like, ‘Properly, at some point,’ however really they’ve been in an unstable state of affairs for a extremely very long time.”

San Francisco’s homelessness division acknowledges this bias towards younger folks looking for housing. In an try to deal with the age hole, the division included two questions which are solely scored for folks ages 18 to 24: “Within the place you might be staying, are you experiencing bodily or sexual violence?” and, “Within the final 12 months have you ever traded intercourse for a spot to remain?” In the event that they reply sure to both one, it supplies a big bump of their general rating: 12 factors for every query. But when anybody older than 24 who has been sexually assaulted or has traded intercourse for a spot to remain will get no factors in any respect. (Whereas the solutions to those questions are solely scored for 18-to-24-year-olds, they’re requested of each one who takes the evaluation. When requested why these questions had been requested of people that couldn’t obtain factors for answering, the division stated it was for “knowledge gathering.”)

Machuca-Grebe, the division spokesperson, defined that the query was added as a result of “now we have discovered that with out the rating positioned on the questions for youth, they’d be severely beneath prioritized — resulting in a disproportionate exclusion of youth.”

Davis was within the 18-to-24 age vary when she first took her coordinated entry evaluation, so these questions had been scored. However she doesn’t imagine they need to be requested in any respect.

“There’s not a single person who I can consider that’s female-presenting that hasn’t been sexually assaulted whereas experiencing any a part of their life, not simply homelessness,” she stated. “So that you’re telling me that as a result of somebody hasn’t been raped, that she doesn’t get housing, after which she stays on the streets after which does get raped? And now she will be able to? No, that doesn’t make sense.”

Questions From a Stranger

It isn’t simply the wording and scoring of the questions that give consultants pause. In addition they stated that the best way the evaluation is given can fail to precisely assess an individual’s vulnerability.

In San Francisco, all questions have to be learn by a skilled employees member from one of many nonprofits that contract with town to conduct the evaluation. The questions are pulled up on an iPad or a pc. A drop-down menu provides a prewritten set of solutions to pick from, and the rating is routinely added up by the software program.

Coordinated entry assessments are steadily performed in semi-public locations, like a bustling workplace or a avenue nook beneath a freeway. Candidates hardly ever have a preexisting relationship with the individual asking the questions, and, as a result of understaffing at many nonprofits conducting assessments and the excessive variety of folks in want, there is probably not time to construct one.

“You actually need to have interviewers set up rapport and relationship with the consumer previous to conducting or doing any evaluation, as a result of in the event that they don’t belief interviewers, they’re simply not going to speak to them,” stated Cronley, the College of Tennessee professor.

The stakes are excessive: When an interviewer chooses the “Consumer refused” choice from the pull-down menu of potential solutions, the applicant receives zero factors for that query.

Valdéz additionally sees lack of belief as an issue within the communities she serves. “Many people wouldn’t really feel snug talking about our private traumas, in 45 minutes, to an entire stranger,” she stated. “My household skilled homelessness, and I can let you know proper now, if I’m sitting in entrance of somebody that I’ve simply met, it is extremely unlikely that I might share that in an evaluation.”

This was a priority voiced by Auerswald, the Berkeley professor, concerning the youth questions on violence and buying and selling intercourse for a spot to remain. She stated the phrasing wouldn’t safe correct outcomes.

“My worries right here is that quite a lot of younger individuals are gonna say no,” she stated. “And clearly, right here, they actually need to say sure. It’s one in all their solely hopes at prioritizing for housing, despite the fact that it’s a brilliant traumatizing query.”

Individuals’s private interpretation of every query can have an effect on their solutions, Auerswald stated. “Loads of younger people who find themselves trafficked would say no to this query,” she stated. “They’d say, ‘Properly I wasn’t raped, it wasn’t violent. I’ve somebody taking good care of me and I’m paid or given one thing in change.’ Definitions of violence are totally different now. Violence is quite a lot of issues. You’ll be able to have intercourse beneath risk of violence, even when you don’t have a mark on you.”

Cronley stated racial bias in little one welfare and policing performs an identical position in figuring out how forthcoming individuals are prepared to be when answering these questions.

“Black girls are going to be extra prone to concern that their youngsters shall be taken away from them in the event that they report illicit behaviors, or in the event that they report any type of psychological well being challenges,” she stated. “If you happen to’ve received youngsters and also you’re homeless and also you’ve traded intercourse for cash, you’re not going to inform them that you simply did that. No method.”

Davis had sufficient expertise with methods for homeless people who she knew not answering the questions was not an choice. “I had no selection however to reply them or I couldn’t get into housing,” she stated.

For some, although, the expertise is so uncomfortable that they drop out of the method completely. A local of El Salvador, Luis Reyes has lived in San Francisco for 30 years and been homeless for 10 of these. Reyes stated he has taken the coordinated entry questionnaire twice — as soon as in 2019 and once more in 2020, proper earlier than the pandemic hit. Like Davis, he went to the brick constructing at 123 tenth St., town’s largest drop-in middle for these assessments.

“There was a man who did the evaluation in Spanish,” Reyes stated, by an interpreter, of his 2020 interview. “‘Are you incapacitated? Are you a senior citizen? Do you’ve AIDS?’” Reyes remembers him asking. “He even requested me if I used to be homosexual,” he recollects — a query that isn’t included within the coordinated entry evaluation. Reyes answered no to the entire above and says he was then advised he didn’t qualify for housing.

The expertise discouraged Reyes, who was residing in a shelter on the time of his second evaluation. He determined to not take the questionnaire once more. He has spent some months sleeping in his automobile, and extra just lately he stayed together with his girlfriend at a senior residing facility. However she’s not allowed to have friends, and shortly he must return to the streets.

System Beneath Overview

Throughout the nation, cities and counties are beginning to critically study their coordinated entry methods. Final 12 months, eight communities, together with Chicago and Austin, Texas, studied the information on their coordinated entry outcomes and found vital racial disparities. Each cities revised their methods utilizing neighborhood suggestions, redesigned their processes and wound up approving extra folks of colour for companies.

In San Francisco, 17,000 coordinated entry assessments had been performed between the launch of the system in 2018 and the center of 2021. This 12 months, town introduced it will be enterprise its personal evaluate to find out if the federal government is serving folks equitably and if the housing choices supplied are a great match for these in want. Nagendra, on the Division of Homelessness and Supportive Housing, is overseeing town’s evaluate.

“If issues have gotten away from our general intention and design, we are able to have a look at these issues and work out the place we have to redesign, refresh, no matter it could be,” she stated in an interview.

Town’s strategy to its evaluate is pushed by knowledge and leans closely on interviews, that are being performed in focus teams and thru outreach at encampments. The company plans to make the analysis findings public in late Might.

Critics wish to see a extra radical overhaul of the coordinated entry system and the best way it’s pegged solely to the provision of housing.

Joe Wilson, government director of Hospitality Home, a neighborhood middle for homeless folks within the Tenderloin neighborhood, the place nearly all of town’s unhoused inhabitants resides, explains the issue with that strategy.

“This algorithmic-based decision-making course of is designed to maintain the issue sufficiently small so we don’t have to actually tackle it,” he stated in an interview. “They’re not filling housing primarily based on want, they’re assigning it primarily based on capability. It isn’t logical, it’s not constant, and it’s not efficient.”

For instance, households was required to hit 40 factors to qualify for housing. In February, the Division of Homelessness and Supportive Housing doubled that quantity to 80 factors as a result of a scarcity of family-specific housing. Owens, the coordinated entry supervisor on the division, estimated that the change would scale back the variety of households who certified for housing to between 50% and 60% of these taking the evaluation, down from 75%.

Critics of the coordinated entry program have been proposing options as town begins its evaluate. In a February report, the Coalition on Homelessness, San Francisco’s largest nonprofit advocating for homeless folks, beneficial that town “develop an evaluation instrument that categorizes folks based on what kind of housing can be probably the most appropriate for his or her state of affairs, as an alternative of assigning them an eligibility rating. This can inform us what kind of housing and help is required, versus how a lot housing now we have.”

The group additionally proposes letting case employees and housing suppliers work collectively to establish one of the best place to deal with an applicant. This strategy, the Coalition argues, would create “a real-time housing placement system” that may extra shortly convey weak folks indoors. This might assist tackle town’s persistent problem in filling the vacant models it has out there: Because the San Francisco Public Press and ProPublica reported in February, 1,633 individuals who had been accepted for housing had been nonetheless ready to maneuver in — some for months — whilst greater than 800 flats sat vacant. No less than 400 folks had been on the waitlist for greater than a 12 months.

For these engaged on the entrance strains of the homelessness disaster, change to the coordinated entry system can’t come quick sufficient. Final July, in a gathering with the Division of Homelessness and Supportive Housing, Wilson advised a narrative a couple of consumer his group had helped.

“We have now an 86-year-old girl who has been homeless for 14 years who has not been prioritized for housing,” he stated, noting that she took a coordinated entry evaluation however didn’t hit the 118-point threshold for housing.

A key perception from that have, he stated: Algorithmic decision-making “strikes us away from absolutely the necessity of human judgment and human interplay in human companies.”