A Rapid Assessment of Rhode Island’s Crisis Assessment Tool for Emergency Shelter Prioritization

Bannister, William

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Year:: 2024
Contributor:: Bannister, William (creator); Collins, Alexandra (Advisor); Goedel, William (Reader); Darby, Benjamin (Reader); Brown University. School of Public Health (sponsor)
Genre:: theses
Subject:: Homelessness; People Experiencing Homelessness--Services for; Coordinated Entry System
Extent:: 5, 36 p.

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Description

Abstract:: Background: In 2023, Rhode Islanders faced continual challenges in securing housing stability amidst rising housing costs, eviction rates, and competition for limited housing and emergency shelter availability. Increases by almost 64% in the estimated number of people experiencing homelessness in Rhode Island (RI) since the beginning of the COVID pandemic, showed the need to ensure effectiveness and equity in the state's housing programs. In efforts to improve programming, the Rhode Island Coordinated Entry System (RICES) implemented a revised version of its crisis assessment tool that aims to prioritize unhoused for emergency shelter beds determined by acuity scores accessing vulnerability. Introduced in June of 2023, the revised tool aimed to address previously identified gaps in hopes to better capture the vulnerability of people actively experiencing homelessness. Aims: This multi-methods project aimed to: 1) Characterize persons experiencing homelessness and emergency shelter utilization in Rhode Island and how this varies across populations. 2)Document the experiences of outreach workers with the new coordinated entry assessment tool and its impact on the ability to connect with people experiencing housing instability. 3)Identify what factors may be important to capture in the new assessment tool to more effectively place individuals in shelters. Methods: Key stakeholder interviews (n=4) were conducted with housing outreach workers to understand their perceptions of the tool and the utility of the tool at measuring client acuity compared to the previous version. Qualitative data was analyzed using NVivo software. Client data obtained from RI Continuum of Care’s Homeless Management Information System (HMIS) was assessed to examine the impacts of factors including client location, client assessment scores, and demographic variables on shelter prioritization during the previous version compared to the current crisis assessment tool. Two Prentice–Williams–Peterson’s (PWP) conditional models, PWP-counting process (PWP-CP) and PWP-gap time (PWP-GT), analyzed the impacts of unique client factors (assigned assessment score, age, gender, race, and veteran status) on wait times from enrollment to emergency shelter placement for clients, while accounting for the impacts of client drop-out to expiration of cases. Results: Initial results from key stakeholder interviews identify improvements with the updated assessment tool, ongoing challenges impacting client prioritization, and persistent structural barriers impeding access to emergency shelter placement. Although RICES can work to improve the quality and delivery of the crisis assessment tool, state officials must prioritize further investment in the expansion of emergency shelter programs and acknowledge the consequences of harmful rhetoric for change to occur. PWP-CP and PWP-GT modeling indicate potential impacts of gender and race on the risk of experiencing subsequent enrollments into RICES. Conclusion: Findings from this analysis informed recommendations for the RICOC regarding tool modifications to better assist people experiencing homelessness in RI. It also furthered current discussions on the broader implications of the impacts of Rhode Island’s policies and stances for people experiencing homelessness.
Notes:: Thesis (M. P. H.)--Brown University, 2024

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Citation

Bannister, William, "A Rapid Assessment of Rhode Island’s Crisis Assessment Tool for Emergency Shelter Prioritization" (2024). Public Health Theses and Dissertations. Brown Digital Repository. Brown University Library. https://repository.library.brown.edu/studio/item/bdr:pjk2yghh/

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Public Health Theses and Dissertations

Theses and Dissertations for the Public Health department.
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