Cover illustration for a new coordinated entry [into housing]: silhouettes of people of all ages, some of them holding hands, walk down a path that forks into six different directions, each leading to an apartment building or house. Lush trees grow behind the buildings.

Executive Summary

For unhoused people in San Francisco, accessing housing and shelter can be an arduous process undertaken during the worst period of their lives. Being homeless means living in constant crisis and uncertainty, a time of severe hardship and instability. In order to try and access housing (and for families, shelter as well) individuals are required to go through a system called “Coordinated Entry”. The way it works is that people choose from a small number of coordinated entry sites and get assessed. Based on the assessment rating, the system prioritizes who is worst off, and therefore most in need, and then the system is supposed to connect them with housing. The number of people who are considered the worst off is dictated by the number of housing units or subsidies available. Coordinated Entry is required by the federal government, but the city decides how to do it, and changes can be made at the local level. The city crafted the Coordinated Entry system by running focus groups with unhoused people and interviewing service providers. However, the service providers we spoke to felt that their input was not taken into consideration.

In this report, we asked 82 homeless people about their experience with Coordinated Entry. Our respondents reported that the system was inadequate for their needs, and that the process was long and confusing. There are only enough resources to help a small minority of people experiencing homelessness, and limited availability meant that many of those who got housing were at risk of failing in their housing, for example by not making enough money to pay rent as their subsidy ended, because the longer term housing that they needed was not available. Those that did get prioritized for housing felt like it was a full time job to look for housing and coordinate with all the different providers assigned to different aspects of their case.

There were 17,111 people assessed through Coordinated Entry from when the program started in 2018 up until July 1, 2021. About a third of single adults who go through Coordinated Entry end up matched with housing, and about one fifth of families or youth. Those who do not get housing get “Problem Solving”, which is money to pay for things that might help someone stay housed, like for contributing to household utility bills, or for a bus ticket to move in with a family member who lives far away. Problem Solving only has a 5.4% success rate,^[1]Presentation by the San Francisco Department of Homelessness and Supportive Housing on problem solving, August 20, 2021. Success rate calculated based on total number of clients served and total … Continue reading meaning most of the homeless people who go through Coordinated Entry remain homeless.

Based on our research findings, we have a comprehensive list of recommendations around three themes:

PEOPLE NOT NUMBERS: Everyone who goes through Coordinated Entry is homeless, and therefore they all need housing. Coordinated Entry should be about connecting people to the correct resource, not about giving people a score to disqualify them from help because of limited resources.

KEEP IT SIMPLE: Getting housing through Coordinated Entry should not feel like a full time job. The process needs to be simple, and it needs to be clear to everyone where they are in the process and what they need to do next, as well as how much housing is necessary to meet the need.

MINIMIZE BUREAUCRACY: People shouldn’t have to go through the whole Coordinated Entry process to access shelter. People should only have to provide the minimum documentation necessary before they can move into their housing.

Many homeless and formerly homeless people contributed their time and their stories to provide the quotes and data in this report, sharing their experience of how city policies and processes are working for them. We hope you find this report informative.

Table of Contents

• Executive Summary
• What is Coordinated Entry?
  • Coordinated Entry by the numbers
• Why is it important?
• Data analysis
  • Data collection methodology
  • Analysis results
  • Feedback topics
    • Matches through Coordinated Entry are Inappropriate
    • Process too confusing or bureaucratic
    • Not enough time or support to find housing
    • Assessment uncomfortable
    • Requires knowing a good case manager
    • Coordinated Entry is unfair
    • Bad shelter conditions
• Feedback from interviews with service providers
• Policy Recommendations
  • Narrow Use of Coordinated Entry
  • Assessment
  • Accessibility
  • Comfort
  • Oversight and Transparency
  • Services Offered by Coordinated Entry
• Acknowledgements
• References
• Appendix
  • Resources that are NOT through Coordinated Entry include:
  • Interview methodology

What is Coordinated Entry?

Coordinated Entry is a centralized way for people to access certain homelessness resources, to have a coordinated entry into housing.^[2]Department of Housing and Urban Development. (n.d.). Coordinated Entry and Homeless Management Information Systems (HMIS). HUD Exchange. Retrieved 11 29, 2021, from … Continue reading It is mandated by the federal government as a prerequisite to applying for federal grants for housing resources, since 2018.^[3]Department of Housing and Urban Development. (n.d.). Coordinated Entry Core Elements. HUD Exchange. Retrieved 11 29, 2021, from … Continue reading In San Francisco, Coordinated Entry uses a Primary Assessment developed by the city that scores homeless people’s need for housing. For example, if you have a disability, your score may be higher. Housing goes to people with higher scores.

Resources that homeless people can get from High to Low assessment score

Because of limited housing resources, most homeless people only get problem solving. Examples include:

• A bus ticket to move in with a family member who lives far away
• Family therapy or mediation to help resolve a conflict with someone that the unhoused person can live with
• Money to help contribute to utility bills so that a friend will let the unhoused person keep living with them

San Francisco’s Department of Homelessness and Supportive Housing (HSH) has a goal of a 10% success rate for Problem Solving,^[4]San Francisco Department of Homelessness and Supportive Housing. (2020, July). San Francisco Problem Solving Guide. https://drive.google.com/file/d/1qdRaJpBb76WA2nTWJGi4NXtlJEzDGHsL/view?usp=sharing but the success rate is only 5.4% overall.^[5]Presentation by the San Francisco Department of Homelessness and Supportive Housing on problem solving, August 20, 2021. Relevant slide: … Continue reading

The Coordinated Entry process is customized for three different demographics:

• Families with children under the age of 18
• Single adults (25+)
• Youth (ages 18-27)

Access points, where homeless people can go to do the Coordinated Entry Primary Assessment, specialize in one of the three demographics, but anyone can get help at any access point. The Homeless Outreach Team also has a mobile unit that can do assessments. Assessment scoring and score requirements for housing differ based on demographic. There are also veteran-specific housing resources, so there is also a different threshold for veterans that is lower than for non-veteran single adults.

Minimum threshold scores to qualify for housing referral status in 2020

Demographic	Threshold
Families	40
Single Adults	123
Adults Eligible for HSH Care Fund Housing Partnership with County Adult Assistance Program (CAAP)	100-123
Veterans	40
Youth Rapid Rehousing	111-122 Note: Youth in this score range eligible for HSH Care Fund Housing have a choice between Care Fund PSH and Youth Rapid Rehousing

Adults and youth who don’t meet the housing referral threshold and “are unable to adequately self-report their barriers to housing, vulnerability, and chronicity of homelessness” are eligible for a Clinical Review, to review their priority status.

The most comprehensive data available about demographics of homeless people in San Francisco is the Point In Time count from before the pandemic, in January 2019.^[7]San Francisco Department of Homelessness and Supportive Housing. (2019). San Francisco HOMELESS COUNT & SURVEY COMPREHENSIVE REPORT. Retrieved Dec 1, 2021, from … Continue reading Out of 8,035 homeless people surveyed, 7.9% were a member of a family, and 14.3% were unaccompanied minors or youth. Only 208 families were counted. This is an underestimate, as there were over a thousand families that came into the Coordinated Entry system meeting the definition of homelessness.^[8]675  families went through problem solving in fiscal year 2020-2021 alone, based on this presentation by the San Francisco Department of Homelessness and Supportive Housing, August 20, 2021. … Continue reading Families who are sheltered (for example, staying doubled up with another family) are difficult to count, and may want to stay under the radar, for fear of the children being taken away by the state. HSH spends 10% on families and 10% on youth, while Prop C funds families at 25% and youth at 20%. We believe that the proportion of families and youth is closer to the proportion funded by Prop C.

Coordinated Entry by the numbers

• 17,111 people assessed through Coordinated Entry up until July 1, 2021
• 2.7% of all people assessed were referred for clinical review.^[9]2.7% of clients assessed from 1/1/2018 to 7/1/2021 were referred for clinical assessment (463 of 17111 assessment). Note that the Clinical Assessment process began around the Fall of 2019. Data from … Continue reading
• Average number of years homeless for those that got housing placements:^[10]This is for clients placed in housing with move-in dates from January 1, 2018 to July 1, 2021. It is only for programs and clients with data available in the ONE system — not all housing is … Continue reading
  • Families: 1.63 years
  • Youth: 1.71 years
  • Single adults: 6.12 years
• Average scores for all assessments done:^[11]Note that people may be assessed multiple times. Data received via Public Records request: ​​https://drive.google.com/file/d/1YUIaXrjm0b7QpGZjL9-S0yx_rL4A_z9I/view?usp=sharing
  • Families: 56.68 (12,593 assessments done)
  • Youth: 81.21 (3505 assessments done)
  • Single adults: 84.05 (22,627 assessments done)
• Percentage that qualified for housing status by client type, for July to September 2021:^[12]San Francisco Department of Homelessness and Supportive Housing. (2021, December 6). Director’s Report: Local Homeless Coordinating Board. Retrieved December 28, 2021, from … Continue reading
  • Families: 22% (76 out of 346)
  • Youth: 21% (44 out of 212)
  • Single adult: 33% (426 out of 1277)
• Percentage that qualified for housing by race, for July to September 2021:^[13]*To calculate these numbers, we have assumed that the percentage for each race out of those actively enrolled in CE is the same as the percentage of each race assessed in July to September 2021.Data … Continue reading*
  • White: 22%
  • Black, African American, or African: 23%
  • Asian or Asian American: 22%
  • American Indian, Alaskan Native, or Indigenous: 22%
  • Native Hawaiian or Pacific Islander: 16%
  • Multi-Racial: 19%
• Percentage that qualified for housing by gender, for July to September 2021:^[14]*To calculate these numbers, we have assumed that the percentage for each gender out of those actively enrolled in CE is the same as the percentage of each gender assessed in July to September … Continue reading
  • Female – 24%
  • Male – 22%
  • No Single Gender – 21%
  • Questioning – not enough data
  • Transgender – 10%
• Those that were unable to get housing got Problem Solving, which had the following success rates:^[15]Presentation by the San Francisco Department of Homelessness and Supportive Housing, August 20, 2021. Relevant slide: https://drive.google.com/file/d/11JJzOmp8FgEo0QviEwui-tY6IZdDHz1H/view?usp=sharing
  • 11.2% success rate for youth (94 out of 842)
  • 5% for single adults (228 out of 4,568)
  • 1% for families (7 out of 675)

Race of clients assessed for Coordinated Entry (17,111 total)

Gender of clients assessed for Coordinated Entry (17,111 total)

Only 16% of Coordinated Entry assessments were done for people who identify as LGBTQ+, compared to 27% in the 2019 Point In Time count. The Point In Time count also found that 46% of homeless youth identify as LGBTQ+.^[18]San Francisco Department of Homelessness and Supportive Housing. (2019). San Francisco HOMELESS COUNT & SURVEY COMPREHENSIVE REPORT. Retrieved Dec 1, 2021, from … Continue reading

Sexual orientation of clients assessed for Coordinated Entry (17,111 total)

Why is it important?

Coordinated Entry is required by the federal government, however, the city of San Francisco decides how to do it. So, we can advocate for improvements that make it more equitable. The city decided to use Coordinated Entry for all city-subsidized housing, even though most of it is not federally funded, which gives the city flexibility on how to distribute resources.

The city decided how they do Coordinated Entry by running focus groups with unhoused people and interviewing service providers. Yet, the service providers we spoke to felt that their input was not taken into consideration. Julia D’Antonio, who was involved in planning for Coordinated Entry as a representative of the Shelter Client Advocate Program, states “It was clear from the beginning the intent was to limit the amount of families considered homeless in order to say San Francisco had solved family homelessness…The consultants were completely disconnected from the issues… There was a moment …where…I asked everyone to raise their hand if they had ever experienced homelessness – I was the only one to raise my hand. Yet, the meetings were still never opened to include anyone else.” She reports that consultants “cherry-picked who to speak with” and “did not have a broad inclusive process for collecting data” and that though she asked, she wasn’t given sample sizes. From the beginning, the city made accessing Coordinated Entry “intricate and overly complicated”, including “dismantling… Compass and their drop-in services”, “basically forcing people… [to go] to the streets to access shelter, which was the only pathway to housing.” The city also created divisions between service organizations that sought resources by defining different types of homeless people (sheltered and unsheltered). Finally, the scoring system forces people such as domestic violence survivors to “divulge very personal experiences” that people are scared to do for “fear [of] their kids being taken away by mandated reporting.”^[20]Original quote: According to Julia D’Antonio, an appointee and Vice Chairperson of the Our City Our Home Prop C Oversight Committee which manages homeless dollars, and who was involved in the … Continue reading

Based on a phone call with Denny Machuca-Grebe, the Public Information Officer at the San Francisco Department of Homelessness and Supportive Housing, the Local Homelessness Coordinating Board’s (LHCB’s) Coordinated Entry Subcommittee is currently the forum where service providers and the public can request that changes be implemented to the Coordinated Entry process. However, according to Mary Kate Bacalao, the Director of External Affairs & Policy at Compass Family Services, this forum has not been widely messaged as the appropriate place for requesting changes. It is sometimes sparsely attended in comparison with other public meeting forums, and service providers have given lots of written and oral input on the Coordinated Entry process, usually directly to HSH senior leadership and in some cases to the manager of Coordinated Entry. Nevertheless, Ms. Bacalao “can’t cite more than a few instances over the last several years where providers requested changes to Coordinated Entry—even relatively minor changes—and the changes were implemented.” Overall, despite a federal requirement that counties have a written policy about how feedback about Coordinated Entry is collected and implemented,^[21]Department of Housing and Urban Development. (n.d.). Coordinated Entry Process Self-Assessment (1.1). HUD Exchange. Retrieved 12 1, 2021, from … Continue reading the City of San Francisco does not have a written policy,^[22]Confirmed by public records request. and it has not been responsive in implementing the feedback it does receive.

Data analysis

Data collection methodology

We held 14 listening sessions with a total of 82 respondents. 45 respondents represented a family, 17 were youth, and 20 were single adults.

We coded the responses by topic, and counted the unique number of respondents who mentioned each topic. Some of our responses were from service providers who were present at the listening sessions (for example, staff running a community meeting where a listening session was held), and we excluded these responses.

The two questions we asked at the listening session were:

1. What has your experience been trying to access shelter and housing?
2. What would you most like to see in an ideal system for accessing shelter and housing?

We did not code responses separately based on the question asked, as respondents spoke freely about their experience with and their ideals for Coordinated Entry in answering either question.

Separately, we conducted six in-depth interviews with homeless or formerly homeless people, as well as interviews with 14 service providers from 10 different organizations serving homeless people in San Francisco. These responses were used for in-depth qualitative feedback about Coordinated Entry, and not counted in the data analysis. The methodology for these interviews is detailed in the Appendix, and participant quotes in this report will say if they are from a listening session respondent or an interview.

Analysis results

Feedback topics

Listening session responses were coded into 10 topics over two categories.

For feedback about the Coordinated Entry process, the topics were:

• Matches through Coordinated Entry are inappropriate
• Process too confusing or bureaucratic
• Not enough time or support to find housing
• Assessment uncomfortable
• Requires knowing a good case manager
• Coordinated Entry is unfair
• Assessment comfortable
• Process was quick and easy

For feedback about services offered through Coordinated Entry, the topics were:

• Bad shelter conditions
• Need more wraparound services

Responses that were not the same topic as any other response were coded as Other. There were 8 of these, and they were left out of the analysis. 

Number of individuals who mentioned each topic concerning the Coordinated Entry process (out of 82)

Number of individuals who mentioned each topic concerning the services offered through Coordinated Entry (out of 82)

Over half of the single adults who participated in the listening sessions said that the process was too confusing or bureaucratic. Families were overrepresented in saying that the assessment process was uncomfortable. Youth were overrepresented in feeling that they didn’t have enough time or support to find housing.

Percentage of respondents from each client demographic, per feedback topic

Matches through Coordinated Entry are Inappropriate

I did the assessment three times and never got any housing.

— Family listening session participant

They make you sign a year lease, and the year is already up. I have to start all over again. Makes you want to do bad stuff… They help you for that one year, then [they’re] gone. You have to pay your groceries, your life’s bills, with that one check.

— Youth listening session participant

I’m a single grandmother. I got a subsidy but for only 2 years, and have a disability. I want permanent help.

— Family listening session participant

They have all of these intermediate housing set ups. I have a friend who’s been in intermediate housing for 20 years. Transitional housing is just a pit. This is the city’s answer? BS.

— Single adult listening session participant

The number one feedback, stated by over a quarter of participants, was that the resources that they were matched with were inappropriate for their situation. This response was broken into subtopics:

• Insufficient housing resources: Some participants felt that the subsidies they received were not enough, and others were unable to get any housing resources at all.^[23]Note that since many of our participants were living in shelters, they likely score higher on the Coordinated Entry assessment than average. Only homeless people are qualified to take the Coordinated … Continue reading
• The housing that people do receive is for an insufficient time period.
• The options for housing and shelter offered were not diverse enough. For example, some participants wanted shelter, but not the congregate shelter they were offered, because of the pandemic. A family may have no path to increase their income, but be put in the time-limited Rapid Rehousing subsidy because there isn’t Permanent Supportive Housing available.
• Subsidies are not sufficient for staying in San Francisco
• A lack of geographic diversity: Both permanent supportive housing and housing that is cheap enough for people to be able to afford with the housing subsidy tends to be in the Tenderloin. Participants felt this was inappropriate and unfair.
• Long waits due to not enough housing resources: Getting housing took a long time, and for some participants, the opportunity never materialized.

Coordinated Entry itself cannot solve the issue of insufficient housing resources.^[24]For example, a family that needs Permanent Supportive Housing may only receive Rapid Rehousing and go back to being homeless when the subsidy expires, and prevent a family that could use Rapid … Continue reading Yet the way Coordinated Entry is currently designed lets the supply of resources determine what category of resource a person will be matched with, rather than their own need. This leads to inappropriate use of resources, cycles of housing insecurity, and an obfuscation of the true need for housing resources in San Francisco. 

Process too confusing or bureaucratic

I went through a lot trying to access services. I went through eviction. They sent me this way, go this way, this way. My ideal system is for the people who work to get housing to work at the same place. So they can say to each other, this person has been here this long, they need to get housing.

— Single adult listening session participant

When I came to [shelter], I had two jobs. I was working my butt off. I was ready to get a subsidy, but they took too long. They took too long and my time passed and I couldn’t– [participant tears up] So now, I got a whole new job, and I have to go through the process again. I don’t want to be here forever.

— Family listening session participant

Participants talked about how difficult it was to figure out where to go to get resources, and how complicated the process and paperwork was. Two participants mentioned the homelessness verification process. Other participants mentioned that when aspects of their life or job changed, it felt like they had to start over with the paperwork, even after they had already gotten housing referral status.

Not enough time or support to find housing

Multiple participants felt that 90 days was not enough time to find housing, after getting housing referral status. People expressed frustration about how they had to find their own housing leads, and how difficult it was.

Assessment uncomfortable

The questions themselves were so specific and personal and intimate. When you’re asked them, you are embarrassed that way. Overall, I hardly know this person and they’re asking me about sex? … I think the questions might be kind of misleading. [People] Thinking that sharing might penalize them, rather than help them. I kind of said what was happening, but in a very general way. I didn’t necessarily convey the weight of what was happening.

— Single adult listening session participant

Some participants felt uncomfortable during the assessment process and with the assessment questions. Other participants felt that they were discriminated against.

Requires knowing a good case manager

Participants had the sense that getting housing resources depended on knowing the right people, and many found it difficult to get in touch with support services.

Coordinated Entry is unfair

Participants felt that aspects of the prioritization were unfair.

My score isn’t high enough even though I was vulnerable. Luckily I got the clinical review but if that doesn’t work I’m screwed.

— Youth listening session participant

Mentions per subtopic within the category of “Matches through Coordinated Entry are inappropriate” (Out of 46)

Bad shelter conditions

You can’t bring food in… Fine, I won’t come in. Bag of chips I spent my money on. Why do my brother and I have to sneak food in? And you get in trouble if you get caught. They give you little tray food stuff. It’s not very good. It’s so stressful, it should be positive and excited, [but it’s like], fuck, I got to go over there.

— Single adult listening session participant

Feedback from interviews with service providers

We talked with 14 service providers from 10 organizations. Five provided shelter or housing for single adults, two worked with organizations serving families, four provided services for youth, and two worked with households of all different types.

Providers echoed folks experiencing homelessness in repeatedly saying that people aren’t being matched with appropriate resources: The score thresholds are too high, people are failing in their housing because there isn’t enough housing stock for each type of housing to fit different situations, and most of the units are in the Tenderloin which wasn’t appropriate for many people. Coordinated Entry was meant to decrease vacancies through coordination, but service providers reported higher vacancies during Coordinated Entry,^[25]Most of these vacancies (one service provider said 75%) were actually vacant, as opposed to having been matched to someone who was getting document-ready. and complained about inappropriate placements, such as receiving younger clients for a housing project meant for seniors, or clients who needed an in-unit bathroom when there wasn’t one. Many providers said that Coordinated Entry made it so that the guests they were receiving were more high acuity, meaning that they needed more services than could be provided because of age, disability, or mental illness. Wraparound services such as therapy did not follow clients to their new housing. An eviction was felt to be the only option for difficult client situations, but clients who were evicted did not get more housing options that would fit their situation better, and providers didn’t want their clients back out on the street. Limited housing resources means that most clients are relegated to problem solving status, which was helpful for clients about to lose housing but had a low success rate otherwise. The exception was younger youth, who hadn’t necessarily exhausted all of their housing options. Youth providers wished for more flexibility in problem solving spending, and more staffing resources, since it takes multiple sessions to get a resolution.

Providers wanted more transparency and discretion. For clients, providers wished there were ways to track appointments, or tell clients where they were on the list, as well as who sensitive client data was being shared with. For the public, providers wanted to see data on how many households needed help, data on how equitable the process was, and whether or not those who did get housing were able to stay in it. For themselves, providers wanted to be able to see what factors contributed to scores, so that they could report issues with the scoring system. Aspects of Coordinated Entry were felt to be unfair, such as families living doubled-up and youth with any income not qualifying, people from the Bayview not qualifying for any units in the Bayview, and SIP hotel residents getting prioritized over other people who had been waiting longer. Feedback and issues that were reported were not implemented. Providers felt that they should have some discretion over which people were placed, so long as it could be documented and tracked.

In terms of access, providers mentioned having more access sites, making it more well known to homeless people how to access Coordinated Entry, and having more street outreach that was able to do Coordinated Entry assessments, as well as language accessibility. Many providers cited trust as an issue, and some suggested that clients be allowed to take an advocate with them for the assessment. This was worse during the pandemic, when clients had to be assessed over the phone instead of in person. Providers also wished that the process was simpler, with less appointments, paperwork requirements (such as getting docs-ready before being allowed to move into housing), stronger relationships between case managers and clients (for example, to be able to locate the client to visit a prospective apartment), and less people that a client had to go through to get help. There was pressure to match people to openings faster, even though people who are docs-ready quickly aren’t necessarily the most vulnerable. A rule that clients fell off the housing referral list after 90 days also created administrative burden. All of these challenges made it difficult for clients to stay engaged and hopeful about being able to get something out of all of this process.

Policy Recommendations

All homeless people should be matched with appropriate help. We need to use Prop C money to build enough housing to meet the need, and remove bureaucratic barriers to housing.

Narrow Use of Coordinated Entry

• Remove Coordinated Entry for shelter.
  • Currently families must go through Coordinated Entry for most shelters, which is overly arduous for staff and clients. It also results in empty beds even as families are requesting shelter from providers. 
  • There is also a dire lack of shelter and housing beds for families, resulting in long waits for families on the list for individual-room shelter. There is a need to expand family shelter capacity significantly.
  • Ensure that the Oasis has drop in overnight beds and that hotel vouchers are available for overflow. 
  • Put San Francisco’s shelter system in line with national standards for shelter access. This means using a first come, first serve system that is clear and easily accessible via phone or drop-in without barriers such as eligibility requirements. Shelter is an emergency service and should be treated as such. 
  • Ensure individuals and families can directly access shelter themselves (known as self referral) through a system modeled after the 311 system, with direct placement by shelter providers for urgent situations for a portion of the beds (in addition to existing set asides, such as those for the VA and SFUSD). Any unused beds must be released for the night and an easy system to access them must be put in place, such as calling 311.  
• Develop a separate system for Transitional Housing which includes eligibility criteria and direct placements from providers. 
• Stop using eligibility criteria to weed people out of the queue for housing; instead, use inclusive eligibility criteria and the assessment process to identify what type of housing the individual or family needs: that way, the system can show us where the gaps are, when the inventory is insufficient for the numbers of people targeted for particular housing types. All unhoused people should be considered eligible for housing.
• Give providers authority/discretion to make housing placements and fill vacancies (see below).Currently DHSH controls supportive housing placements and this creates a logjam. There should be multiple agencies who do housing placements.

Assessment

• Develop an assessment tool that categorizes people according to what type of housing would be the most suitable for their situation, instead of assigning them an eligibility score. This will tell us what type of housing and assistance is needed, versus how much housing we have. Understating need is hurting us, as public perception is that there is funding wasted or too much funding.  The Coordinated Entry system should truly identify the need for housing and gaps, moving us from a system of scarcity to a true picture of housing needed.
• Change from a system of prioritization to a system of targeting individuals to appropriate services. Targeting should take into account the level of service, such as supportive housing where there is a unit readily available, permanent private market subsidies where individuals must find a landlord to rent to them, and short term subsidies that are time limited. Information collected in ONE should include specifications about each unit and information from clients to ensure good matches. Relevant information includes disability accommodation needs, such as the need for a bathroom or elevator, and “no-go” neighborhoods that will pre determine whether an individual can accept a unit offer. Housing seekers will be informed that the more restrictions they have in terms of what housing they will accept, the longer their wait may be.
• Distribute 1/3rd of units that have been vacant for 30 days to community providers with instructions to quickly find clients for those units.
  • This system will be rotating so that units are distributed equitably and include geographic equity. Communities should be able to place clients directly into housing in their own community to ensure cultural and racial equity. 
  • This shall be a real-time housing placement system, meaning units will be given out and clients identified immediately.  An organization is allocated units with eligibility descriptions and then does placements with existing clients.  
  • This will only apply to supportive housing units where there are units on hand, as opposed to programs where you have to find a landlord to rent to you, such as scattered site and flex pool.
  • The providers will determine the most in need from those who have already been assessed through Coordinated Entry and categorized as appropriate for non-scattered site permanent supportive housing.
  • HSH shall conduct post placement reviews to ensure equity and eligibility requirements are being followed correctly.
  • The remaining units will be first come, first serve for each category of housing with which the client was matched.

Accessibility

• Analyze paperwork requirements of housing providers and remove any that are not required by law.
• Ensure that if people are in jail their place within Coordinated Entry is preserved and that they are not moved to the back of the line when they exit jail. Adult family members should be able to access housing while the individual is incarcerated, so that the incarcerated individual is able to move into housing upon exit.
• Remove the requirement of third-party verifications of homeless status, as is currently required for unsheltered families. This creates barriers to shelter.
• Ensure no wrong door – allow all community organizations, public health clinics and so forth to conduct assessments. This would address issues of trust, staff turnover, phone access, continuity, and quality service because clients would have greater choice of where to go. They could do their assessment with someone who they already have a relationship with. Providers have the relationships, expertise, and the ability to assess support needed to maintain housing once placed.This would build on resources we already have in the community similar to the subsidized childcare system, where individuals can put their names on a list at many different locations. Access should be coordinated but not centralized.
• Have a single point of open door contact, such as a website, to update people on their status and place on the waitlist after signing up through Coordinated Entry. It should work like a medical MyChart, where clients or social service agencies can look up a client’s status in Coordinated Entry and send messages such as “missing paperwork,” “time to update your assessment – it’s been 6 months,” and “document ready – waiting for a unit.”

There was times where I would pick up the phone to talk to my case manager and she wouldn’t be in the office or she would be gone for days or weeks on end and I can’t talk to her and I have to go through someone else that don’t know nothing about my case. That was my number one thing that made me mad about Coordinated Entry is their communication with their clients.

— Single adult with housing referral status, who we interviewed

• Remove the rule that individuals are dropped from housing referral after 90 days and have a simple recertification process for them instead.
• Allow clients to bring anyone they choose to advocate on their behalf. 
• Use a broad definition of homelessness that includes doubled-up households, especially since conditions are frequently worse than those in shelters.

For people that are living in SROs, especially Chinese families, housing is the first necessity that they will pull resources into. Even if it means neglecting food. This is cultural. It’s a choice that they make. But that’s not to say that they are not in hardship. It’s similar to folks living in an RV, in the sense that it’s a small space. People in an RV may have their own bathroom, but in an SRO people have to share bathrooms. The Coordinated Entry system should account for those cultural differences and choices that people make as to what necessity they would go without.

— Family without housing referral status, who we interviewed

• Remove bottom income limits and stop requiring clients to have public assistance income before they are placed in housing, as this creates yet another barrier.  
• Create more flexibility in problem solving to allow providers to increase success rates.
• Services should begin when someone enters the door.
  • Help with kids, education, and job training while working on housing.

Comfort

• Rework offensive, invasive, and unnecessary questions to make it more likely that people will be comfortable answering truthfully. Make sure from an equity lens that we are asking the right questions (to identify vulnerabilities) in the right (trauma-informed) ways.
• Include a written assessment option instead of having to speak about issues.

Oversight and Transparency

• Ensure that the Local Homeless Coordinating Board subcommittee that oversees Coordinated Entry has its agenda controlled by the community and that regular voting takes place by all attendees on recommendations.
• Develop a public dashboard that includes how many households requested help, demographics of those placed and not placed in what types of housing, and housing retention.  
• Ensure providers have full transparency on scoring and why individuals receive their scores.

Services Offered by Coordinated Entry

• Fully implement the Prop C investment plan and fill all vacancies to ensure we can move away from a scarcity based system.
• Implement geographic priorities for units located in disenfranchised neighborhoods for their residents. For example, clients from the Bayview should be able to access housing in the Bayview.
• Prioritize keeping San Francisco households in San Francisco.  
• Ensure only a limited number of people, with a goal of approximately 10%, are falling into the Problem Solving Category, and improve the efficacy of Problem Solving. It is a huge problem that Problem Solving has such low success rates when it is a key intervention for everyone who is not prioritized for housing. Everyone else should be in the appropriate housing level category with financial assistance services available to them.
  • Give providers more authority/discretion in Problem Solving spending, and more staffing resources, since it takes multiple sessions to get a resolution.
• Increase spending on housing quality improvement and for meeting the capital needs of buildings, such as ventilation and free wifi.
• Ensure that those with extremely high needs who require additional support beyond supportive housing are referred to the appropriate level of housing available through DPH. Have a clear pipeline to access placement in that form of housing.
• Expand housing resources: treat housing as a human right and ensure that everyone has a safe place to stay.
• Geographic diversity: housing needs to be in many different neighborhoods.
• Target Section 8 vouchers towards people who are in rapid rehousing subsidies that are running out and won’t be able to take over the rent.
• Develop incentives for landlords to accept subsidies or require them to accept subsidies.
• Conduct an outreach program in multiple languages to landlords that explains the process and benefits of housing subsidies.
• Provide more support for households receiving private market subsidies to find housing, such as assistance with transportation, the housing search, and credit reports.

Acknowledgements

This report was written by Ruth Grace Wong, with contributions from Ian James and Jennifer Friedenbach.

Thanks to the following organizations who helped us host listening sessions.

• Western Regional Advocacy Project
• Saint Joseph’s Family Shelter
• Oasis Inn
• Clara House
• Jelani House
• Compass Family Services
• Polk Nav Center
• Huckleberry Youth Programs
• Young Womens’ Freedom Center
• Dolores Street Community Meeting
• Next Door
• Moscone Adult Shelter

Thanks to the following individuals and organizations for contributing input.

• Mary Kate Bacalao, Director of external affairs and policy at Compass Family Services and Co-Chair of HESPA, the Homeless Emergency Service Providers Association
• Kelly Cutler, Human Rights Organizer at the Coalition on Homelessness
• TJ Johnston, Assistant Editor at Street Sheet
• Patricia Ayala, Care Coordinator at Hospitality House
• Kim Whatley, Shelter Care Coordinator at Hospitality House
• Tramecia Garner, Co-chair of the Supportive Housing Providers Network
• Tracey Mixon, Peer Organizer at the Coalition on Homelessness
• Sara Shortt, Director of Public Policy & Community Organizing at HomeRise
• Douglas Styles
• Katie Reisinger
• Christy Saxton
• Sonia Batres
• Georgetta Lovett, Property Supervisor at Delivering Innovation in Supportive Housing (DISH)
• Gwendolyn Westbrook, United Council of Human Services
• Larkin Street Youth Services

Thanks to staff and volunteers for facilitating listening sessions, taking notes, and translating

• Tracey Mixon
• Olivia Glowacki
• Carlos Wadkins
• Miguel Carrera
• Yessica Hernandez
• Solange Cuba
• Emmett House
• Tyler Kyser
• Mateo Friedenbach Condon
• Quiver Watts
• Dominique Griffin

Thanks to our volunteer translators

• Spanish translation: Sonia Batres
• Cantonese translation: Flora Luo, Community Organizer at the Chinese Progressive Association

This report is produced by the Coalition on Homelessness.

References

Appendix

Resources that are NOT through Coordinated Entry include:

• Low income housing (lottery)
• DAHLIA affordable housing
• Shelter for single adults 
• Public Housing
• Section 8/Housing Choice Vouchers

Interview methodology

These responses were used for in-depth qualitative feedback about Coordinated Entry, and not counted in the data analysis.

Individuals selected to be interviewed represented a family with and without housing referral status, a single adult with and without housing referral status, and a youth with and without housing status. We also interviewed 14 service providers from 10 different organizations serving homeless people in San Francisco.

Interviews were prefaced with an explanation of the research project, followed by questions:

Hi, I’m [INTERVIEWER NAME], and I’m working with the Coalition on Homelessness. I’m studying coordinated entry by interviewing people, researching policy, and then we are going to write a report with recommendations for what we think should be improved about the coordinated entry system. I’ll be typing notes on my computer during this call.

1. Tell me about your role / yourself
2. Tell me about how you interface with the coordinated entry system / how it affects you
3. Tell me some stories about coordinated entry that stand out to you
4. Is there anything you would change if you could about coordinated entry
   1. If they don’t mention transparency. Something we’ve heard other people say is that transparency in the coordinated entry system is an issue. What are your thoughts on that?
   2. If they don’t mention scoring tool, Something we’ve heard other people say is that people you would think should get a high priority don’t.  Do you have thoughts on the scoring ?
   3. If they don’t mention inappropriate placements.  We have heard that folks get offered units that are inappropropriate placements, such as not meeting disability needs.  Do you have experience with that?
5. We have a coordinated entry system. We also don’t have enough housing. Do you think there’s a relationship between the two?
6. How has your understanding of the coordinated entry system changed over time?