Vulnerability Index: A New Tool for Ending Homelessness

The Vulnerability Index is one way that Common Ground translates research into innovative tools and strategies that save lives and end homelessness. From the early successes of our Street to Home program, Common Ground has found that putting names and faces— and now medical conditions— to homeless people living on the street inspires action. Through the Common Ground Institute our Innovations Team has worked with Los Angeles County, the City of Santa Monica, New Orleans, Washington, DC, Portland, Oregon, and Nashville, to implement the Vulnerability Index in their communities.

The Vulnerability Index is a person-by-person survey that allows communities to create a health registry of those at the highest risk of dying on the streets. It reminds communities of the urgency of finding stable homes for those trapped in homelessness and provides a clear process for prioritizing assistance. The survey captures a homeless individual’s health and social status, the Vulnerability Index uses risk factors and length of homelessness to identify and rank the most vulnerable in a community. This simple and replicable tool— rooted in research— helps mobilize communities to action.

  • Over 800 of the most vulnerable individuals, who have been homeless the longest, have been placed into housing by the communities that have implemented the Vulnerability Index this year – Los Angeles County, Santa Monica, New Orleans, and Washington, DC, and NYC.
  • UNITY of Greater New Orleans used the Vulnerability Index to organize housing assistance for over 150 homeless individuals living in encampments, and to build the case for securing 3,000 federal rental vouchers for New Orleans’ homeless.
  • In Washington, DC, the Department of Human Services surveyed over 1,000 homeless individuals using the Vulnerability Index and is securing housing for the 800 most vulnerable by October 2009. So far, over 375 vulnerable individuals have been placed into housing. 300 vulnerable homeless people were placed into housing in just three weeks.
  • In Los Angeles, the Vulnerability Index supported the County’s “Project 50” initiative, which created a health registry of individuals living on Skid Row. 42 of the most vulnerable individuals from Skid Row have been placed into housing with an average of 14 days from the first outreach contact to the day the person moves into housing. One individual moved into permanent housing the same day that he was identified on the streets.
  • In Brooklyn, Queens and the Bronx, outreach teams routinely survey each new person they encounter on the streets to identify the most vulnerable and expedite their placement into housing. Over 200 people have been placed into housing using the Vulnerability Index.
  • The City Council of Santa Monica used the Vulnerability Index to assess those living on the streets and has pledged to secure housing for all 110 of the most vulnerable. To date, 38 of the most vulnerable individuals have been placed into housing.
  • In Portland, Oregon, the City’s Bureau of Housing and Community Development used the Vulnerability Index to prioritize housing and assistance for the most vulnerable among the 645 individuals surveyed.
  • In Nashville, Tennessee, the Park Center and Metropolitan Homelessness Commission has pledged to use the findings from 320 Vulnerability Index Surveys to drive their planning process.
  • Common Ground Institute has developed a secure on-line database that allows participating cities to score the surveys and produce reports of the most chronic and vulnerable on an on-going basis.
  • With support from the Jacob and Valeria Langeloth Foundation, Common Ground Institute is seeking communities that are interested in participating in a three-year study to investigate whether or not housing with social and health supports is a life-saving intervention for the most chronic and vulnerable among the homeless.

To learn more about bringing the Vulnerability Index to your community, contact:
Becky Kanis
Director of Innovations
bkanis@commonground.org

The Vulnerability Index is a tool for identifying individuals at risk of dying on the street and prioritizing them for housing. Dr. Jim O’Connell of Boston’s Healthcare for the Homeless conducted the original research on the health conditions of the homeless. He identified eight markers that place the street homeless at a heightened risk of mortality:
  • More than three hospitalizations or emergency room visits in a year
  • More than three emergency room visits in the previous three months
  • Aged 60 or older
  • Cirrhosis of the liver
  • End-stage renal disease
  • History of frostbite, immersion foot, or hypothermia
  • HIV/AIDS
  • Tri-morbidity: co-occurring psychiatric, substance abuse, and chronic medical conditions