Interim Prioritization FAQ For Providers
Coordinated Entry for All (CEA)
Interim Prioritization Overview
- Prior to 2019, households were prioritized for housing resources based on a formula that weighted a household’s VI-SPDAT score, how long they reported experiencing homelessness, and the length of time since the VI-SPDAT has been entered and saved in HMIS.
- The results produced by using the VI-SPDAT score as the primary factor in prioritization showed significant racial disparities: As of late 2017, for families and single adults, each point increase in assessment score was associated with an increase in the percent of White family heads of households.
- We know the VI-SPDAT is a screening tool that alone does not adequately capture the realities of a household’s vulnerability. Our community is moving towards creating a new, locally developed tool that addresses racial equity as a factor in household prioritization- but in the meantime, we are committed to disrupting racial inequity with the tools and data we currently have access to.To learn more about King County's commitment to leading with race, please visit https://kingcounty.gov/elected/executive/equity-social-justice/tools-resources/Racial-Justice.aspx
To that end, an Interim Prioritization workgroup was formed to create new formulas that utilize data already contained in the Housing Triage Tool, as well as length of time homeless and answers to supplemental questions. Supplemental questions are listed in the Housing Triage Tool form in HMIS, and include living history, disabling conditions and criminal background information.
Frequently Asked Questions
The IP workgroup is tasked with quickly revising the formula used to identify the most vulnerable single adults, young adults, and families for the Coordinated Entry for All (CEA) priority pool. To implement quickly, the interim formula identified by the IP workgroup must be based on currently available data (i.e., without reassessing individuals or collecting new data).
Goals of the new formulas for interim prioritization:
- For the proportion of people of color being prioritized for housing to be more similar to the proportion of people of color experiencing homelessness in King County.
- To disrupt racial inequity in our housing resource matching and prioritization process.
The community has voiced concerns about the racial equity of the prioritization process and the way our system measures vulnerability. Our primary concern is that the proportion of people of color prioritized for housing (i.e., appearing on the priority pool) does not resemble the proportion of people of color being assessed via CEA or the population served by King County’s homeless housing system.
The IP workgroup includes one primary and one alternate representative from the stakeholders below. King County Coordinated Entry for All and Performance Measurement and Evaluation staff provide data and facilitation for the group as well, but do not participate in voting on the direction of Interim Prioritization scoring formulas for each population.
- Single Adults CEA workgroup (1)
- Families CEA workgroup (1)
- Youth and young adults CEA workgroup (1)
- Case conferencing (4)
- Single Adults
- Youth and young adults
- Persons with lived experience of homelessness (2)
- Physical health challenges and needs of people experiencing homelessness (1)
- Behavioral health challenges and needs of people experiencing homelessness (1)
- Data analysis and evaluation related to homelessness and housing (1)
Quickly revise the scoring formulas used to prioritize single adults, young adults, and families for housing to achieve greater racial equity.
Continue to review the new formulas’ impacts on a monthly basis. Consider additional revisions to the formulas that improve racial equity (again, using only currently available data).
Develop a new assessment tool using rigorous methods though the assistance of expert consultants. The IP workgroup recognizes this will require significant resources and a lengthy testing and validation process.
The IP Workgroup used the following definition of vulnerability: “Increased likelihood that someone would be harmed or victimized or die while homeless. Increased likelihood that a person would not be able to secure and/or maintain housing without additional support.
Step 1: King County’s data analysts reviewed response patterns to currently available triage tool and VI-SPDAT questions for each population.
Step 2: King County’s data analysts identified questions where people of color responded differently than white respondents (>5% difference plus or minus) and the question was related to vulnerability (as defined by the community, below).
Step 3: IP workgroup members ranked the potential new questions based on their impact on a person’s vulnerability.
Step 4: King County’s data analysts used this feedback to test new prioritization formulas that gave less weight to the VI-SPDAT and more weight to the factors identified by the workgroup.
Step 5: IP workgroup members reviewed the impacts of the different formulas on racial equity and voted on the formula that improved racial equity the most.
This information also can be found in the Interim Prioritization presentation, linked above.
The Priority Pool is replacing what was known as the “Top 40” or “By Name List” as the group of households in each population that are prioritized for matches to housing resources. Case conferencing groups will use this pool to match to housing resources. As households on the Priority Pool are matched to resources, CEA will bring more households into the pool. The priority pools for each subpopulation are created using the Interim Prioritization formulas. The priority pool will be sized to match the average number of available resources for each subpopulation within a 60-day period, and we will no longer use banding.
Starting January 1, VI-SPDAT assessments should no longer be referred to the community queue by any assessor.
The new process for sizing the Priority Pool to our available resources requires CEA referral specialists to be the only people managing queue referral moving forward, and will only refer prioritized households to the community queue. This will create a Priority Pool, which will be comparable to what is now known as the “top 40” or the “by name list.” Only those who have been identified as part of the Priority Pool and will be prioritized over the next 60 days for a match to permanent housing resources will be referred to the queue and only by a CEA referral specialist. For those households, you will see a new HMIS enrollment in “CEA CE Project” as part of our shift to Dynamic Prioritization.
Note: households will NOT be removed from the priority pool if they are not matched with a housing resource within 60 days. Our community is using this timeframe as a goal.
This is also in line with our larger system shift to Dynamic Prioritization- we know that households often hear service providers say “on the queue” as “on the waitlist for housing.” We want to be as clear and upfront with our messaging as possible and communicate that currently, with the housing stock our community has, CEA will not be a viable solution for everyone. By keeping a priority pool that is managed by CEA, we are holding ourselves accountable by working to match each household included on that pool to a housing resource.
Please note the new Coordinated Entry workflow:
- If a household is enrolled in HMIS and the Housing Triage Tool (assessment) is completed, that household is active
- Assessor does not refer household to community queue
- King County’s Performance Measurement and Evaluation team applies the interim prioritization formula to create a priority pool made up of active households (not all active households will be prioritized) which will be referred to the queue by referral specialists
- Households on the priority pool will go through Case Conferencing meetings that will function as they have been functioning and matches to housing resources will come from these meetings
- Households will be exited from the priority pool once they are placed into housing
- If a household is enrolled in a tenant-based resource (like RRH) and exits that program into homelessness, they will be re-referred to the community queue
Interim Prioritization will be in place until a new tool is developed locally for prioritization in Coordinated Entry. Due to the major shifts in governance of the homeless service system, a strict timeline is not available. However, we anticipate at minimum we will be using and continuously improving IP over the next year.
King County’s Performance Measurement and Evaluation team will pull assessment data every Friday to create the Priority Pool. CEA will refer these households to “CEA CE Project” in HMIS. Assessors will still be able to see household’s scores in HMIS, but those scores are no longer the primary factor for determining prioritization.
The first step in the shift to Dynamic Prioritization is to attempt Diversion with all households, even if the household has completed a Housing Triage Tool through Coordinated Entry. All viable Diversion opportunities should be attempted with the household. In the event the household is entered into the Priority Pool, CEA staff will alert the assessor/service provider working with the household the week the household is entered into the Priority Pool and invite the provider to join Case Conferencing teams. Households will be contacted by Housing Navigators assigned at Case Conferencing if the household is not receiving navigation.
Our community does not have sufficient housing resources to be able to meet the need. We recognize that providers often need to have extremely challenging conversations with the households they serve about the availability of housing resources. A main component of Dynamic Prioritization is the need for clear and realistic messaging to people experiencing homelessness. Providers are encouraged to move away from setting harmful and unrealistic expectations that “CEA will contact you when your name comes up for housing,” and instead focus on resources a household may be able to access outside of the Coordinated Entry System.
The IP workgroup will continue to meet monthly to review the impacts of the formulas on equity. They will continue to test ideas for new formulas that get us closer to our goal.
- CEA CE Project: If you see enrollment in this project in HMIS, this household is prioritized, but not necessarily on the Priority Pool. If a household is enrolled in CE Project but they no not currently have an active Community Queue referral, then they are either disengaged or have a pending housing referral.
- Community Queue + CE Project: If you see a CE Project enrollment and a Community Queue referral in HMIS, this household is currently on the Priority Pool.
If you have any concerns or questions, and please raise them during weekly case conferencing meetings. A CEA staff member will record and compile them, and they will be brought to the next Interim Prioritization workgroup meeting for consideration. If you do not regularly attend case conferencing, please send your feedback to firstname.lastname@example.org.