Subpopulation Trends
Introduction to the Data
Subpopulations
Within the CE System, assessment types, resources, and case conferencing are broken out by household type. The three main household types or populations are:
Single Adults - Single Adult age 18+ households overwhelmingly are composed of only one individual, and most resources are designated for only one individual. The group is referred to as “Single Adults” as a result, though some households have more than one member.
Young Adults - Young Adult only households 18-25 years of age.
Families - households with both adults and minors or a pregnancy in the household.
Additionally, CE co-facilitates case conferencing for Veteran and American Indian/Alaska Native (AIAN) households of all ages and sizes with leaders from those provider communities. The separate case conferencing sessions are held to facilitate matches to resources with Veteran or AIAN eligibility requirements. Because they make use of separate resources, referrals made to Veterans and AIAN households in those case conferencing spaces are separated out from the household-type breakouts above. These Case Conferencing spaces do not use COVID Prioritization, but work off an Active By Name List.
CE Stages
For this evaluation, and for ongoing analysis of the CE System, the stages of CE are defined as the following:
• Assessed: Head of household was newly assessed with a Housing Triage Tool during 2021. Households who had previously completed an assessment could remain eligible for prioritization during 2021, meaning that more people were eligible for CE referrals than just those who were assessed during the calendar year.
• Prioritized: The household was added to the Priority Pool and became eligible for referrals to resources through CE. Prioritized households were identified using the COVID prioritization methodology.
• Referred: The household received a referral to a housing resource through case conferencing in 2021. This does not include referrals made in Veterans or AIAN case conferencing, which do not require the household to be on the priority pool before a referral is made.
• Enrolled: The household was enrolled in the housing program in 2021 to which they were referred by CE according to the referral data in HMIS. Note, unlike other CE stages, the quality of this data point is dependent on providers updating the referral history in HMIS. Delayed or missing data may impact the data quality for enrollments.
CE Stages by Household Type
In 2021, the number of assessed households increased from 2020 (3,861 households up from 3,672) but was down significantly compared to 2019 (4,798). The number of households assessed in 2020 was impacted by the effects of COVID-19 on the Homelessness Crisis Response System, which likely continue to impact the numbers served and assessed in 2021. Despite gains in the number of households assessed in 2021, prioritizations, referrals, and enrollments continued a downward trend in 2021. While some contraction of the system may be due to fewer overall service connections during COVID, PME partners indicate that much of the contraction is likely due to provider disengagement. CE staff reports in 2019, 20-30 service provider staff attended case conferencing on a weekly basis. In 2021, it's 5 or fewer.
Of greatest concern, there were just 274 placements through CE in 2021, down from 782 in 2019. For every 100 households assessed for CE in 2021, only 7 enrolled in a housing program. Housing options available to CE are not meeting the demand, which means that CE is not able to place a majority of participants. This scarcity of housing resources is the greatest obstacle to a successful Coordinated Entry System, the effects of which are reflected throughout this evaluation.
Racial Disproportionality in the Experience of Homelessness
Relative to King County’s general population, we know homelessness disproportionately affects people of color. The chart below shows how homelessness disproportionately affects people of color compared to King County’s general population. This disproportionality is especially pronounced for the American Indian/Alaskan Native (AIAN) population and the Black/African American population. While comprising 1% and 7% of the general population respectively, they represent 6% and 27% of the population experiencing homelessness. By contrast, while the White population represents 58% of King County’s population, they represent only 43% of the population experiencing homelessness. The Asian population is also less likely to experience homelessness. However, Native Hawaiian/Other Pacific Islander (NHOPI) and Hispanic/Latino populations are more likely to experience homelessness than their representation in the general population.
In recognition of this injustice, our community is committed to ensuring that racial disparities and inequities in the experience of homelessness are eliminated in our homelessness crisis response system. Most recently, CE implemented COVID prioritization, which explicitly prioritizes households of color that have a disproportionately high risk for hospitalization and death from COVID-19. Further explanation of COVID prioritization and its impact on households navigating CE are examined below.
COVID Prioritization and Racial Equity
In 2020, HUD and the Washington State Department of Commerce issued guidance to identify characteristics of households most disproportionately impacted by COVID-19. In response, our community recognized race and ethnicity as leading characteristics contributing to the disproportionately high risk for hospitalization and death from COVID-19. This recognition is reflected in our community's new COVID Prioritization methodology, which explicitly prioritizes American Indian/Alaska Native, Black/African American, Hispanic/Latinx, and Native Hawaiian/Pacific Islander, as well as multiracial individuals who identify as at least one of those identities.
As designed, the new COVID Prioritization method prioritized a larger share of Black, Indigenous, and People of Color (BIPOC) households in 2021 relative to CE's previous prioritization methodology used in 2019. The new COVID prioritization methodology also contributed to higher proportions of referrals and enrollments for BIPOC households, as anticipated in the 2020 Coordinated Entry Evaluation. These changes were most pronounced for Black/African American and Hispanic/Latino households. We recommend further refinement of prioritization tools to ensure equitable enrollment, using existing administrative data to inform prioritization, including information regarding disability, behavioral health, gender identity, intimate partner violence, and criminal legal system involvement.
For more detailed information, explore the changing proportion of households at each stage of Coordinated Entry by race/ethnicity and gender in the following sections.
Single Adults
Gender
In 2021, women continue to represent a smaller share of single adults moving through the coordinated entry system relative to male-identifying individuals. In 2020, women received a proportionately greater share of referrals and enrollments compared to men. Though in 2021, women again received proportionately fewer referrals and enrollments resembling 2019 outcomes.
Conversely, men made up a larger share of prioritizations relative to their representation, and were more likely to be referred and enrolled in 2021 than the year prior. Men also make up the majority of individuals in the single adult population.
In 2021, transgender and gender nonbinary single adults were assessed at rates comparable to their representation in HMIS. Though, they represent disproportionately smaller shares of prioritizations, referrals, and enrollments. This lack of representation in CE is worth continued investigation.
Race/Ethnicity
CE prioritized, referred, and enrolled Black or African American households at rates greater than their share of representation in the Single Adults active HMIS population. This is due at least in part to the implementation of the COVID Prioritization methodology, which CE implemented in October 2020. As predicted in the 2020 evaluation, Black/African American households continued to comprise a proportionate share of referrals and enrollments relative to those prioritized under the new methodology as they made their way through the later stages of coordinated entry.
American Indian/Alaska Native households also continued to constitute a larger share of prioritizations, referrals, and enrollments relative to their share of assessments and representation in the Single Adults population.
White households received fewer prioritizations, referrals, and enrollments relative to their representation in CE. Compared to 2020, they were referred and enrolled in a closer proportion as they were prioritized.
Asian households received smaller shares of services at all stages of the CE process relative to their representation in the Single Adult population. This trend is consistent across populations: single adults, families, and youth and young adults. Asian people were not identified as having a disproportionately high risk for hospitalization and death from COVID-19 and are not among the prioritized racial and ethnic identities under the COVID Prioritization methodology.
Families
Gender
Most Family households in HMIS and every step of the CE process have a female head of household. Several factors may contribute to this including domestic violence as a driver of family homelessness and the impact of the gender wage gap on single mothers.
Families with a male head of household moving through the CE process receive progressively diminishing shares of assessments, prioritizations, and referrals relative to their representation in HMIS.
Race/Ethnicity
Families with a Black/African American, Multiracial, Hispanic/Latino, or NHOPI heads of household received proportionally more services at each stage of the CE process relative to their representation in HMIS. For families with a Black/African American head of household, this marks a departure from trends in 2019 which saw these households receiving a disproportionately small share of prioritizations and referrals. As referenced previously, this shift may be partially due to the COVID prioritization methodology implemented in October 2020.
AIAN families received mostly proportional access to CE resources relative to their representation in HMIS. They received a slightly higher share of prioritizations and assessments, but ultimately slightly fewer shares of enrollments compared to their share of the HMIS active population.
Families with an Asian or White head of household received disproportionately fewer services in each step of the CE process relative to their proportion of the HMIS population.
Youth and Young Adults
Gender
Young men received mostly proportional access to CE resources relative to their representation in HMIS. They received a slightly higher share of assessments, but ultimately slightly fewer shares of enrollments compared to their share of the HMIS active population.
Unlike 2020, young women comprised a greater share of referrals relative to their representation in HMIS as well as their share of assessments and prioritizations. And consistent with the past, they represent a relatively higher share of enrollments compared to their youth and young adult counterparts.
At 7%, transgender and nonbinary youth and youth adults make up a greater share of the HMIS active population compared to 3 and 4% in previous years. But they receive proportionately fewer services at each stage for coordinated entry. As recommended for the transgender and nonbinary single adult population, this lack of representation in CE is worth continued investigation.
Race/Ethnicity
Opposite of 2020, Black or African American youth and young adults received a disproportionately greater share of services at every stage of the CE process relative to their representation in the HMIS active population. As predicted in the 2020 evaluation, the positive effects of COVID prioritization on referrals and enrollments appeared in 2021 as the households prioritized under this new methodology made their way through the later stages of coordinated entry.
Asian youth and young adults received smaller shares of services at all stages of the CE process relative to their representation in HMIS. While this disparity has been true in past evaluations, it is even more pronounced in 2021; no Asian youth or young adult received a referral or enrollment through CE. The lack of representation and progress for Asian youth and young adults through later stages of CE is worth continued investigation.
Compared to previous years, White youth and young adults’ shares of services along the stages decreased. Though they received slightly greater shares of assessments, they ultimately received fewer prioritizations, referrals, and enrollments relative to their representation in HMIS as well as their peers of color.
Same as 2020, Hispanic/Latinx and Multiracial youth and young adults continued to receive greater shares of prioritizations, referrals, and enrollments relative to their representation in the population.
Non-Prioritized Case Conferencing
There are two other “non-prioritized” ways that CE facilitates housing referrals – Veterans Case Conferencing and American Indian/Alaska Native Case Conferencing. These case conferencing meetings operate in much the same way as the Single Adult, Youth/Young Adult, and Family case conferencing meetings do. The main difference is that rather than only allowing referrals for households on the Priority Pool, any household that includes a United States military veteran or any household expressing interest in AIAN culturally specific resources may be nominated for a resource at their respective case conferencing spaces. Tie-breaking is then done within the case conferencing space, and those providers who are present decide as a group which household receives the referral.
Veterans Case Conferencing
In 2021, 122 households received referrals via Veterans Case Conferencing. They were overwhelmingly male (92%) and from Single Adult households (95%). Slightly more than half (50%) were households of color, a slightly higher percentage than the number of Veteran households of color active in HMIS in a given month (46%, as of December 2021).
American Indian/Alaskan Natives Case Conferencing
From American Indian/Alaska Native Case Conferencing, 17 households received referrals compared to 10 in 2020. This increase is a result of AIAN Case Conferencing resuming in March 2021 after being on hold in 2020 due to diminished staff capacity of AIAN providers as a result of the pandemic. Of the 17 referrals, most were pending as of December 2021 with the remaining 4 resulting in denials. The majority (58%) of referrals went to women, which is a reversal of 2020 when 80% went to men. All referrals were for Single Adults except for 3 young people. 10 out of the 17 households referred through AIAN Case Conferencing were identified in HMIS data as being AIAN, with the remaining households identified as Multi-Racial or Hispanic/Latinx.