Here are the excerpts:
In 2014, as a result of a successful Request for Proposals (RFP) process, the Allegheny County [PA]
We ask the reader to bear two considerations in mind while reviewing this report and the methodology/implementation of the AHA. The first consideration relates to our interest in ongoing review and transparency of the work. The information contained in this report is preliminary and based on a model that has been and continues to be revised as we learn more about the impact of the PRM and the business processes of the AHA. We are working with the County and with partners to fine tune the model over the next several months. The outside evaluation, for which the County plans to issue a solicitation in 2021, will also inform modifications of the model.
The second consideration relates to the onset and impact of the COVID-19 pandemic. While the Allegheny Link (which operates Allegheny County's coordinated entry system for homelessness services) and the County's
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DHS, through its network of service providers across the County, provides a
The number of available long-term housing beds or units fluctuates throughout the year as newly funded programs begin, others close and/or seasonal shelters open. As of
The Allegheny Housing Assessment (AHA) will be utilized to better describe the impacts of unmet housing needs and support the prioritization of people for bridge/transitional housing, RRH and PSH. Because clients can stay in these programs for a long time, only a fraction of these units become available through turnover in any given year. In 2019, about 800 of these housing units became available through turnover as households exited these programs (approximately 200 families and 600 singles), according to household exit records in the County's homeless management information system (HMIS). In 2019, more than 2,000 households (approximately 600 families and 1450 singles) experiencing homelessness and determined to be eligible for PSH, RRH or bridge/transitional housing received a risk assessment through the coordinated entry system. Thus, last year, a housing gap of approximately 1200 units existed and the County could serve less than half of the households (singles and families) that were assessed. This highlights the importance of appropriately prioritizing the most vulnerable households for these limited services.
Table 1 provides insight into the supply and demand of PSH, RRH and bridge/transitional housing units as well as a snapshot of the monthly waiting list of households that have been assessed and are eligible for a housing referral when a unit becomes available. For single households,76% of RRH units (205/270), and 21% of PSH units (152/729) became available in 2019 due to the turnover of households exiting programs. Single bridge/transitional housing units had higher turnover in 2019, with approximately 215 households exiting the roughly 140 units available throughout the year. For households with children (families) in 2019, 57% of RRH units (89/157), 31% of PSH units (121/386) and 17% (1/6) of bridge/transitional housing units became available through turnover throughout the year.
Content omitted: Table 1: Counts of availability and demand for funded units in PSH and RRH
Whereas all individuals and families experiencing homelessness are eligible for emergency shelter services, RRH, PSH and bridge/transitional housing programs require clients to meet 5 eligibility thresholds and be assigned priority status on the waiting list. Table 2 describes the eligibility rule for each type of housing program.
Content omitted: Table 2: Homeless Services Type and Eligibility Rules
The Allegheny Link manages Allegheny County's coordinated entry system. Link staff assess and prioritize homeless individuals and families for long term housing./2
Annually, the Link conducts more than 2,000 assessments for homeless services.
Link staff ask a set of questions to assess current vulnerability and risk to help determine programs for which potential clients are eligible./3
This assessment includes compiling their history of episodes of homelessness to determine if they are 1) chronically homeless (defined as having a disability and being homeless for 12 or more consecutive months, or having at least four separate homeless episodes totalling at least 12 months over the past three years); 2) fleeing domestic violence; and/or 3) a military veteran. To conduct this assessment and eligibility process, Link staff had been utilizing the Vulnerability IndexService Prioritization Assistance Tool (VI-SPDAT).
Vulnerability Index-Service Prioritization Assistance Tool
The Vulnerability Index-Service Prioritization Assistance Tool (VI-SPDAT), developed by Orgcode (2015),/4 asks clients to provide self-reported information about their current situation and past experiences. Examples of assessment questions include “Have you threatened to or tried to harm yourself or anyone else in the last year?”; “Do you ever do things that may be considered to be risky, like exchange sex for money, run drugs for someone, have unprotected sex with someone you don't know, share a needle or anything like that?”; and “Will drinking or drug use make it difficult for you to stay housed or afford your housing?” This information, along with information about the length/frequency of homeless episodes, is used to establish priority for services.
VI-SPDAT scores are calculated based on a predefined matrix that weights the answer to each question. These weights are determined by the VI-SPDAT vendor and there is little information available on how they were constructed. Clients who receive a sufficiently high score are placed on a waiting list for relevant programs. In 2019, more than 2,000 such assessments were conducted.
The VI-SPDAT relies upon self-reported information and is dependent upon a client's memory and willingness to share personal information. Asking people in the midst of a housing crisis to provide answers to sensitive personal questions is not the best way to conduct an accurate assessment. DHS identified this and a number of other concerns related to use of the VI-SPDAT for assessing and prioritizing clients for services:
* The VI-SPDAT assessment can take up to 45 minutes to administer.
* The VI-SPDAT has not been validated for Allegheny County, meaning that its effectiveness at stratifying higher-risk individuals and families is unclear.
* Some VI-SPDAT assessment questions are difficult to ask someone in a crisis because they are intrusive and potentially stigmatizing. This can lead to a situation in which the relationship between agency and client is undermined, especially if the client reveals extensive private information and is still not offered any services. Feedback from focus groups confirmed that it was often difficult for clients to answer these questions.
– Too often, individuals and families score high enough on the VI-SPDAT to be put on the waiting list but not high enough to ever receive services.
– Because recollection of past experiences (especially traumatic experiences) can be faulty, there are concerns that VI-SPDAT scores may not result in accurate waiting list status, particularly for already-stigmatized groups.
– Much of the information required by the VI-SPDAT is already held within
Considering these concerns, DHS questioned whether housing placement decisions were being made based on accurate information and whether the limited number of available slots were going to the individuals and families who could most benefit from them. Figure 1 illustrates the process by which homeless individuals/families were assessed and prioritized for housing prior to implementation of AHA. First, a person experiencing homelessness would make contact with the Link, either by telephone or in person via an office visit with a Link staffperson. Second, a number of questions were asked to confirm the person's housing status, determine if they might be eligible for programs that serve special populations (e.g., families with children, veterans, 18-through-24-year-old youth and people experiencing domestic violence) and complete the VI-SPDAT assessment. These inputs generated a score and the person/household was added to the housing waiting list. When a program had a vacancy, Link staff made contact with the client to confirm that they were still experiencing homelessness and to discuss the housing program to which the client was being referred. An electronic referral was then sent through the County's homeless data system to the service provider with the client's information to begin the client enrollment process.
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When the number of homeless people in need of longer-term housing programs (PSH,
The AHA tool replaces the VI-SPDAT, a prioritization system without local validation. In Allegheny County, the score generated by the VI-SPDAT was uncorrelated to any of the observed harms from which homelessness services are designed to protect. It is important to state here that the current version of the AHA tool is the first version and will be refined over time.
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REPORT, TABLES and FOOTNOTES: https://csda.aut.ac.nz/__data/assets/pdf_file/0009/425475/FinalAHAMethodology.pdf
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