Linking Assessment Tools to Housing Placements and Successful Outcomes for Youth Experiencing Homelessness

Introduction: Youth homelessness has reached an epidemic level in the United States. Many communities have attempted to address this problem by creating coordinated community responses, typically referred to as Coordinated Entry Systems (CES). In such systems, most agencies within a community pool their housing resources in a centralized system. Youth seeking housing are first assessed for eligibility and vulnerability and then linked to appropriate housing resources. The most widely adopted tool for assessing youth vulnerability is the TAY-VI-SPDAT: Next step tool for homeless youth (NST). To date, no evidence has been amassed to support the value of using this tool or its proposed scoring schematic to prioritize housing resources. Similarly, there is little evidence on the outcomes of youth whose placements are informed by the tool. Objective: This paper presents the first comprehensive and rigorous evaluation of the connection between vulnerability scores, housing placements, and stability of housing outcomes.  Methods: This study used data (n = 10922) from the Homeless Management Information System (HMIS) collected between 2015 and 2017 from 16 communities across the United States. Results: High vulnerability scores at intake were associated with higher odds of continued homelessness without housing intervention, suggesting that the tool performs well in predicting youth that need to be prioritized for housing services in the context of limited resources. Only low scoring youth (NST of 4 or less) appear to return home or self-resolve and remain stably exited from homelessness. Youth placed in permanent supportive housing (PSH) had low recorded returns to homelessness, regardless of NST score. Youth with vulnerability scores up to 10 who were placed in rapid rehousing (RRH) also had low returns to homelessness, but success was much more variable for higher-scoring youth. Conclusions: Ultimately, as youth service providers contend with the abhorrent reality of how to prioritize and place young people in the precious few spots available in housing programs, this study elucidates the importance of using an evidence-informed triage tool like the TAY-VI-SPDAT: Next Step Tool for Homeless Youth (NST) to assess vulnerability to facilitate more efficient and informed decision-making at the local level.