1. Downtown Emergency Service Center www.desc.org Vulnerability Assessment for Chronically Homeless Individuals presented by Bill Hobson Annual Conference National Alliance to End Homelessness July 28-30, 2008 – Washington D.C.

2. Downtown Emergency Service Center www.desc.org Overview of DESC  supportive housing  licensed mental health services  licensed chemical dependency services  emergency shelter  high level of integration across programs

3. Downtown Emergency Service Center www.desc.org Kerner-Scott House experience (1997)‏ Tenant Selection Process  severe and persistent mental disorders  not connected to anyone  too disorganized to self-advocate  most at risk of living on the streets  based selection on key informant observation

4. Downtown Emergency Service Center www.desc.org DESC emergency shelter experience (1979-2003)‏ How to allocate limited beds in high-demand environment?  first come, first serve [1979-1984]  random selection (the “fish bowl”)‏ [1984-1994]  diagnosis [1994-2003]  scores on Vulnerability Assessment Tool [2003-present]‏

5. Downtown Emergency Service Center www.desc.org Common methods of tenant selection for permanent supportive housing  Wait lists with rule-out criteria  criminal hx, rental hx, behavioral issues  Housing readiness  sobriety, psychiatric stabilization, payeeships

6. Downtown Emergency Service Center www.desc.org High utilization (continued)‏  frequent use of hospital, jail, other institutions  “Million Dollar Murray” (2006)‏  DESC's 1811 Eastlake  Political power in using this method  Flaws  diminishing return  ignores vulnerability

7. Downtown Emergency Service Center www.desc.org DESC Vulnerability Assessment Tool  developed in 2003 to allocate limited shelter beds  began using as primary method for housing selection in 2005  have done 6,582 assessments since 2003  focuses on  vulnerability induced by behavioral health issues  who is at greatest risk if left on the streets  limited research shows high correlation with institutional use

8. Downtown Emergency Service Center www.desc.org

9. Downtown Emergency Service Center www.desc.org

10. Downtown Emergency Service Center www.desc.org