1. Vulnerability Index: Prioritizing Outreach & Housing Placement by Mortality Risk

2. Why? Homelessness is lethal Scarce resources + lethality compels –hard data to justify more resources –renewed sense of urgency from policymakers –prioritization of outreach and housing placement in the meantime

6. Vulnerability Index Based on Dr. Jim O’Connell’s research Presence of a risk factor indicates a 40% mortality rate over 7 years Most Vulnerable = individuals with the most co-occurring risk factors who have been homeless the longest

8. Vulnerability Index More than 6 months homeless AND at least one of the following: End Stage Renal Disease History of Cold Weather Injuries Liver Disease or Cirrhosis HIV+/AIDS Over 60 years old Three of more emergency room visits in prior three months Three or more ER or hospitalizations in prior year Tri-morbid (mentally ill+ abusing substances+ medical problem)

9. Vulnerability Guides Outreach & Housing Placement Every person encountered during outreach is offered survey – most agree Create on-going name and photo registry Prioritize by mortality risk and length of homelessness Direct outreach workers efforts on a weekly basis Next vacancy offered to next most vulnerable person

12. Basic Steps to Implement VI: 1.Convene community stakeholders 2.Identify an area of focus 3.Train surveyors 4.Conduct baseline count 5.Administer surveys 6.Analyze data 7.Brief community on findings 8.Develop housing action plan based on results

13. Vulnerability in Action Santa Monica: 260 Skid Row: 350 New Orleans: 150 NYC: 500 Washington, DC: 1,100

14. Project 50

17. Reframing & Rapid Transformation 35/50 most vulnerable from Skid Row Realignment and new resources for Santa Monica Humanitarian closure of encampment in New Orleans NYC and Washington, DC using techniques city-wide – will house 800 most vulnerable by September 2009

18. Prevalence of Risk Indicators Risk indicatorAverage Sample Size2422 Tri-morbid22% 3x hospital last year12% > 60 years old12% Liver Disease9% 3x ER last 3 months8% Frostbite/Cold Weather8% Kidney Disease4% HIV+/AIDS2% % vulnerable42%

19. Mental Health & Substance Abuse

20. % Veterans

21. Insurance

22. Health Care Services

23. Hospitalizations 50 Most Vulnerable Report 124 hospitalizations over past year

24. For more information on CG Vulnerability Index Becky Kanis Director of Innovations Common Ground bkanis@commonground.org (917) 957-7104