Efficiency of the CE Process
Introduction to the Data
In evaluating the efficiency of Coordinated Entry for All, we look at three areas:
Length of Time in CE
Being housed through CE can be a very lengthy process, and length varies widely by household composition. The process tends to be longest for Single Adult households, for whom housing resources tend to be scarcest. For single adults who were prioritized, the median length of time between assessment and prioritization was 223 days, compared to 71 days for Family households that were prioritized and 79 days for prioritized Young Adult households. The mean length of time was much higher for all populations, meaning that while most households are prioritized within that number of days, there are some who end up waiting more than 4 years before being prioritized. The length of time between prioritization and referral was much shorter across the board, but longest again for prioritized Single Adult households.
Several factors contribute to the long length of time between assessment and prioritization. The first is the limited amount of housing resources that are available in the community. This significantly slows throughput in the priority pools. Without significant throughput, new households cannot be prioritized. So long as there is a scarcity of resources, it will be impossible to house all the households requesting assistance, and there will be households who have extremely long waits for housing (if they are housed at all).
Without a significant overhaul of the CE process, or a significant increase in housing stock, it is unlikely that the length of time between stages will change soon. With that in mind, the provider community needs to understand and communicate that there is no way to predict if a household will be prioritized for resources within a given timeframe, or at all. Informational materials for households being assessed should make this point clear as well.
Denials
Overall, denials are a major efficiency problem in the CE process. They occur frequently: 50% of clients who received a referral experienced at least one denial. Denials can be demoralizing and even traumatizing for households, and they cause delays that decrease the utilization of resources. Decreasing the number of denials should continue to be a priority for the Coordinated Entry System. In 2021, the most commonly reported reason for denials was 'refusal by the client', representing 45% of all denials. The next highest reason for denials was the inability to connect with or contact the client, accounting for 23% of denials.
Provider Reported Reasons for Denial by Household Type
Provider Reported 'Denial' Reasons
Households refuse housing resources for many different types of reasons. Among the most common are the location of the program relative to their job or support system, the type of accommodations provided by the program, and the type of services offered by the program. Many refusals do not list any explanatory information.
Explore the provider reported reasons for denials proportion by race/ethnicity, gender, household type, project type, and denial reason category below.
Denial Rates Among Referred by Race/Ethnicity
Denials occur very frequently. In total, 50% of clients who received a referral experienced at least one denial. When examining denials among referrals to a housing resource by race/ethnicity, we see that Hispanic/Latin(a)(o)(x) and Multiracial household heads experience a slightly smaller share of denials when compared to Black, African-American, or White heads of household. These data show that there is not a statistically significant difference in the likelihood of a referral ending in denial based on race/ethnicity.
External Fills
Not all resources that become available for placement through CE are actually filled during the case conferencing process. For example, a resource may have a very particular eligibility requirement based on household composition (e.g. “single woman under 30 who is fleeing domestic violence”) that is not aligned with the households currently on the priority list. Or the resource may not be desirable to the households in the priority pool, due to its location, offered services, or rules for residents. In such a case when the resource does not receive any referrals after two instances of case conferencing, it becomes eligible for an External Fill. The housing provider then gets to make their own choice of who to put in the resource rather than have the decision be made via the communal case conferencing decision structure. External Fills remain popular among much of the provider community due to the level of control they offer over a program’s enrollees, meaning that each provider’s values and concerns are considered as they fill the resources.
In this way, External Fills represent a misalignment between the composition of the priority pool (e.g. due to household composition, preferences, or service need) and the resources available in the community, including dedicated navigation capacity for prioritized households. While External Fills create a pathway to housing for households who would not otherwise be prioritized, agencies gain subjective decision-making power that may disadvantage case workers or providers with whom they do not have a strong relationship. Agencies also gain the power to choose a household that is “easier to work with” over one that is more vulnerable. They also advantage clients who have already formed connections with the area’s largest providers. For these reasons, External Fills represent a significant failure of the Coordinated Entry System and harm the regional response to the homelessness crisis.
Rate of Referrals Going to External Fill Over Time
Although prioritizations, referrals, and enrollments are down since 2019, the rate of External Fills is climbing. In 2021, 66% of referrals went to External Fill. The rate of referrals going to external fills is highest for single adults (72%) and lowest for youth and young adults (55%). For families, 66% of referrals went to external fill.
CE staff explain that the increasing rate of referrals going to External Fill results from several factors, including changes to external fill policy in response to the COVID-19 pandemic and lack of navigation support.
In 2020 at the beginning of the pandemic, the CE Policy Advisory Committee (PAC) expedited external fills. Previously, a housing resource could not be released to external fill after two weeks had elapsed. But, in mid-2020, the PAC voted to reduce this time to one week to expedite housing households amidst a pandemic. As a consequence, the rate of external fills increased. The PAC planned to end this policy in March 2021 but was delayed until November 2021. CE staff hope to see external fills decrease in 2022 with the reversal of this policy change.
The impact of the expedited external fill policy change was further compounded by service provider disengagement and a lack of navigation support, particularly for single adults. In 2019, 20-30 service provider staff attended case conferencing weekly. In 2021, it was five or fewer. With fewer navigators available to represent individuals experiencing homelessness at case conferencing, the size of the priority pool shrinks. A smaller Priority Pool results in lower success in finding households that are appropriate service matches for programs, which in turn results in more housing resources going to external fill.
CE staff shared that provider disengagement is likely explained by the rising influence of an alternative space for single adults known as the Single Adult Leadership Team (SALTe). Unlike Single Adult case conferencing, service provider engagement in SALTE is high and growing.
As suggested in the 2020 CE evaluation, expanding the size of the priority pool may lead to higher success in finding households that are an appropriate service match for programs and fewer external fills, but such an endeavor would require additional staff support in the form of housing navigation for prioritized households. CE staff are optimistic that the onboarding of the KCRHA System Advocate Workforce and By Name List may bring the necessary added navigation capacity to connect folks who are prioritized to housing referrals and enrollments, which would likely reduce the use of external fills.
In addition to navigation capacity and external fill policy changes, housing resources are more likely to go to external fill when the housing resources in the community do not align with the housing resources people experiencing homelessness seek. As a CE staff member explained:
“People would rather have a bathroom and kitchen, so they won’t take less desirable housing. These undesirable resources can go to external fills. Resources should be designed to be what people want…”
As explored in the previous section on Denials, the primary reason a referral results in a denial is because a client declines the offer. When a referral to a housing resource is unfilled, it then goes to external fill. As the KCRHA reimagines the crisis response system, staff should continue to prioritize the desires and wants of people experiencing homelessness in designing programs and housing resources. This would likely reduce the rate of denials and external fills, and better serve the community.
Race & Ethnicity of External Fill Enrollments
In past years, a strength of External Fills is that households of color tended to receive a greater proportion of External Fill enrollments as compared to CE enrollments. However, this trend shifted after CE introduced the COVID prioritization methodology. The rate of external fills received by households of color remained fairly consistent (between 70% - 74%), but the share of CE enrollments received by households grew from 64% in 2019 to 84% in 2021.
For more detailed information, explore the changing proportion of households receiving enrollments through External Fill by race/ethnicity, year, and household category.