Finding the Gap
For the past week I’ve been running circles in my head about the Coordinated Assessment (CA), wondering if it’s benefiting individuals experiencing homelessness or if it’s perpetuating people’s homelessness for longer than necessary. The Coordinated Assessment is a 50 question test that evaluates an individual experiencing homelessness’ vulnerability while living on the street; their “likelihood of dying”. The idea is that with this standardized assessment the right resources can be effectively and efficiently directed to the right individuals. The test presents itself as serving the popular of homeless in the same manner as an emergency room serves their population. An emergency rooms will prioritize who to treat as they come in the doors, the most vulnerable at the top of the list and those with less severe issues are deprioritized. The CA does the same thing, it prioritized those who are most likely to die on the streets, and the others who could survive on the street for a little while longer are deprioritized.
Coordinated Assessment also claims that it saves the government money by housing the ‘most costly individuals to the state’. An individual that is costly to the state will accrue the most costs in two budgets: emergency room visits and incarceration. An individual may visit an emergency room because of accidents or general sickness, these costs since the individuals cannot pay them back fall to the state. An individuals is also likely to be take into jail while experiencing homelessness as well due to any number of reasons. By housing an individual, they have fewer emergency room visits and are less likely to become incarcerated. By reducing the number of individuals experiencing homelessness, the state then will see a reduction in these two budgets. This cost efficiency was part of the City of Austin’s motivation to implement the CA in the first place.
When we spoke with actual individual’s experiencing homelessness, we found the CA is doing what it was designed to do. It saves the state money and it houses those most likely to die on the street. One of these individuals we spoke with took the CA and scored high enough to be placed in a program offered by ARCH called “Rapid Rehousing”. This is a program designed to take those that are most likely to die on the street and put them in whatever housing facility the caseworker can find as soon as possible. So he was able to be housed within in a few weeks after taking the assessment. In his case, the CA was able to get him in contact with the individuals he needed to receive his housing. For individuals like him, the CA is working.
We also spoke with a woman who is staying at the Salvation Army with her child. She’s been there for 60 days, she’s only allowed to stay there for 90 days. As her time there is coming to an end, she’s been furiously thinking about what she will do next. This women has taken the CA, but she did not scored high enough to qualify for any program that would put her into immediate housing. Based on the CA’s judgement, she should be able to survive out on the street a little while longer. She’s healthy, young, working, has no drug issues, mental health issues, or criminal record, all of these things for the CA support the claim that she can self resolve. In reality, she feels she cannot self resolve and that she doesn’t have any other options after she is let go from Salvation Army.
Previously I keep comparing the two stories, the women who is facing the loss of so much in her life because she’s too healthy/clean/high-functioning to qualify for rapid rehousing, and the man who almost haphazardly received housing after being convinced to take the CA. How can there be a system in place that gets both individuals housed? You can’t dismissed either individual’s needs to be housed, but through a series of questions the CA prioritizes their needs.
I came to something of the conclusion that there is a gap of individuals who aren’t being served by the CA. The individuals who are too high functioning are within this gap. ARCH and the CA are meant to serve those who most ‘need’ housing based on who will die on the streets, but there are others who aren’t seen as ‘needing’ housing because their not in a high enough state of vulnerability.These are the individuals who aren’t being served in the current system. I believe Garrett and I can design for these individuals.