Public Services

The next UHIP? A flawed system is endangering Rhode Island’s homeless

“It’s November, and we’re dealing with folks who are going to end up dying,” said Barbara Freitas, executive director of the Rhode Island Homeless Advocacy Project (RIHAP). “It’s not, ‘they’re not going to get in for a few days and it’s no big deal.’ People are going to die.” This story originally appeared in the College Hill Independent, here. When
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It’s November, and we’re dealing with folks who are going to end up dying,” said Barbara Freitas, executive director of the Rhode Island Homeless Advocacy Project (RIHAP). “It’s not, ‘they’re not going to get in for a few days and it’s no big deal.’ People are going to die.

This story originally appeared in the College Hill Independent, here.

When Harry lost his home in October, he went to one of Rhode Island’s largest emergency shelters: Crossroads Rhode Island. He needed a safe place to stay the night, out of the cold and off the streets. Instead of a bunk and a locker, he was given a date two weeks out for an appointment with an assessment officer from the Coordinated Entry System (CES), an intake program initiated in 2018 that governs the majority of the shelters in Rhode Island. If he had chosen to, Harry could’ve stayed in the Crossroads lobby for 24 hours. After that, CES rules would’ve forced him outside again to wait for his appointment. The front desk at Crossroads was forthright: The Providence Rescue Mission – a Christian, night-to-night shelter operating outside of CES with thirty beds and a no-tolerance policy for drug and alcohol use – was his only option, because all other Rhode Island shelter beds are now bound by CES and its ‘shelter placement’ process.

“That just doesn’t work for me,” Harry said. “If I’m homeless and I’m trying to get into a shelter and I have to go through them and wait two or three weeks for a bed, by then I could be dead.” After staying at the Mission for three nights, Harry started sleeping in a tent instead, choosing not to continue with the assessment process.

Gerard had an appointment set up with CES for the end of October, but missed it after being jailed for a month after a domestic violence incident. Once he was released, he didn’t have a CES intake completed, so none of the shelters would let him in. On his first night sleeping outside, somebody stole all of his possessions: blankets, cash, documents, and insulin. “I had no place to go,” he told the College Hill Independent. “I’m 52 years old, diabetic, insulin-dependent, and I got no help … They just pushed me away.”

In late September, Lydia, a pregnant mother of seven, planned on sleeping in Roger Williams Park with her boyfriend and five kids, ranging in age from two to 12. In June, her landlord had more than doubled her rent, and the summer saw the family’s savings spent on lodging in a Providence hotel. By September, when the money ran out, Lydia was unable to get a spot in an emergency shelter for her and her children. If it weren’t for funds from a nightly outreach team from Housing Opportunities for People Everywhere (HOPE), a volunteer group from Brown University, Lydia would not have gotten into a hotel that night. In a interview with the Independent, Lydia phrased her problems with CES succinctly: “They didn’t help me.”

The stories of Lydia, Harry, and Gerard – whose identities the Independent has chosen to protect from repercussions with pseudonyms – mirror dozens of interactions that the authors of this piece, all outreach workers through HOPE, have had on and (mostly) off the record while working directly with people experiencing homelessness this fall. Our experiences with the system as outreach workers were frustrating and drove us to try to understand CES and how its successes and failures are gauged, often questionably, in the boardrooms responsible for implementing it.

Before the implementation of CES for families in May 2018 and for individuals in December 2018, those who needed a place to stay were able to walk into emergency shelters in Providence, Pawtucket, Westerly, and Woonsocket and get a spot for that night if one was open. What changed? New requirements for federal funding outlined by Housing and Urban Development (HUD) called on Continuums of Care, regionalized committees that oversee services such as case management and shelter, to institute a “standardized assessment tool” for the allocation of resources.

In the past, resources were distributed according to arbitrary lists and didn’t take into consideration immediate need and client vulnerability. The stated goal of CES was to cut out the potential for discrimination and to clarify the system, making finding shelter and housing easier. This coordinated intake approach should facilitate more comprehensive data collection, promote more accurately targeted resource distribution, and connect people to services specialized for their lived experiences. On the permanent housing side of the equation, run by the Rhode Island Coalition for the Homeless (RICH), the system seems to work well, allocating resources in an efficient and fair manner. But Rhode Island’s Continuums of Care split from most other states in extending the mandate to shelters. All emergency homeless shelters in the state have to operate under this new program, run by Crossroads Rhode Island, or risk losing funding.

In Rhode Island, those close to the ground say the system managing emergency shelter is failing.

“It’s November, and we’re dealing with folks who are going to end up dying,” said Barbara Freitas, executive director of the Rhode Island Homeless Advocacy Project (RIHAP). “It’s not, ‘they’re not going to get in for a few days and it’s no big deal.’ People are going to die.”

Megan Smith, an outreach worker at House of Hope Community Development Corporation, a nonprofit that strives to fight homelessness in Rhode Island, is just as worried. As she explained to the Independent, Rhode Island’s implementation of CES is an unacceptable answer to a complicated problem. “There are no tweaks around the edges that will fundamentally fix [CES],” she said. “At its core, it doesn’t feel like it’s rooted in the right philosophy, which is hearing what people who are experiencing homelessness need, building up a system that connects people to resources as they exist, and using what is learned to advocate for additional resources from people who can provide them.” For Gerard, this would have meant an assessment before being released; if ‘coordination’ is truly the goal, then jails, prisons, and hospitals that temporarily hold people experiencing homelessness need to be integrated as well.

In other states, Continuums of Care have outlined coordinated entry systems that do not obstruct emergency shelter and emergency care, adhering more closely to HUD requirements which specify that the “coordinated entry process must allow emergency services…to operate with as few barriers to entry as possible.” Peter Kellerman, the co-director of an emergency shelter in Vermont, assured the Independent that, in his state, CES is primarily a data-collection system that does not delay immediate access to emergency shelter. The Vermont Continuums of Care empowerers localities and has built-in room for flexibility. “When someone’s health and safety is in play,” he told the Independent, “the rules can kind of go out the window.”

Theresa McDevitt, Coordinated Entry Manager for Diversion and Assessment at Crossroads, wrote to the Independent that the system is “identified by HUD, nationally, as a best practice.” But the Rhode Island variety of coordinated entry fails to meet the standards that it sets for itself. The Rhode Island Statewide CES procedure manual highlights the importance of CES assessments and referrals being readily accessible, yet the numbers show this isn’t the case.

Performance data obtained by the Independent in October from the Rhode Island Continuum of Care showed that the average wait time between initial assessment and shelter placement was 21 days for families, 15 days for transition-aged youth, and nine days for individuals. As of November 1, there were 67 individuals and 57 families on shelter waiting lists. While there is no data that gives the average wait time to get an initial appointment, Bill Chamberlain, associate director of RIHAP, said that assessments are often booked two weeks out. On November 25, the earliest CES assessment appointment that could be booked was for December 11, a 16-day wait. That can make the time from initial contact with CES to a placement in an emergency shelter in Rhode Island anywhere from three to four weeks for an individual and up to a month for a family. When the Independent spoke to Lydia on November 16, she said that she had not heard from CES regarding shelter placement since her assessment in late September. These lengthy wait times put families – like Lydia’s – and individuals in danger and defeat the purpose of emergency shelter.

Additionally, appointments are hard to schedule and hard to travel to. When they are booked so far in advance, keeping track of them becomes secondary to survival. As forces of racism, sexism, and ableism limit access to resources across the board, these barriers fall particularly hard on marginalized people. For people of color, already disproportionately over represented in Rhode Island’s homeless community, waiting outside for a shelter to open up carries a host of other consequences in a city that pursues petty crime along racialized lines. For women, staying outside alone is never safe, but is sometimes the only option.

Issues of access also disproportionately impact those with cognitive and physical disabilities. Answering detailed, personal questions about trauma precludes many from even considering the CES assessment, and the traumatic nature of shelters in America – Crossroads included – makes the primary point of assessment infeasible for some who have been there in the past. When these soft barriers (discomfort, alienation, and distance) prevent assessments, harder barriers (metal and plexiglass) shut individuals out physically. McDevitt told the Independent that “we need to do more, as a state, to ensure that the highest need clients are getting to the front door.” But the problem is the front door itself. If the system were to reflect the needs and demands of the people it serves, the “front door” of CES would be more accessible and would meet people where they are—whether that’s through assessments being administered by outreach workers, over the phone, or via clinics operated at meal sites.

Will Lawlor, another outreach worker with House of Hope CDC, echoed Smith, repeatedly pointing to his belief that the system doesn’t work for many, especially the most vulnerable. “You need an appointment to go to a shelter if you’re homeless,” said Lawlor. “That’s nuts. A shelter is supposed to be a safe haven.”

Evidence from the streets is overwhelming: caseworkers, service providers, and homeless people have said that more people are sleeping outside this winter, the wait times for shelters are long, and making assessment appointments by phone is difficult. But to Crossroads, and the CES bureaucracy, the data leads them in a different direction. In a presentation to community partners last month at RICH, Alex Moore, the Director of Program Outcomes and Evaluations at Crossroads, discussed how Crossroads tracks clients after they exit coordinated entry. Moore claimed that a rise in the “self-resolution of homelessness” and a drastic drop in entry to shelters were clear successes of the system. By running CES entry and exit data through a set of self-derived formulas and filters, he has categorized some 42 percent of families and 16 percent of individuals that have lost contact with the system as having “likely self-resolved their cases.”

What does it mean for someone to be placed in this category? CES removes a “client” from the system if there is no contact over 30 or more days, during which time (according to protocol) CES attempts to reach a client three times. When no contact is made, and when there are no updates in the central HMIS database (filled in by caseworkers and other accredited individuals), CES labels a client as self-resolved. But Crossroads does not confirm whether people have ended contact for other reasons, such as if they’ve left the state, been jailed (like Gerard), or fallen through the cracks. A victim of domestic violence diverted back home to their abuser is counted as “likely self-resolved.” As of November, if someone who is homeless dies, the formula marks them as being “likely self-resolved.” Harry and Gerard would all be counted as “likely self-resolved” by CES standards, but both are currently living outside. Lydia is also counted as a success, regardless of the fact that CES has not reached out to help her.

Moore’s presentation also noted the abrupt drop in entry to Harrington Hall, the largest shelter for men in Rhode Island. From December 2018, when CES kicked in for individuals, until April 2019, entry into the Hall fell sharply from 214 to 98 clients. For the 98 men who still have a reliable bed, the drop in entry and rise in stability is a good thing: more case working, less fighting, better services. Moore seemed to take this exodus, during a month where average nighttime temperatures hovered around the low twenties, at face value. Members of other organizations at the meeting, however, weren’t satisfied. Where did 116 men go? Did they all suddenly find affordable apartments? Was there a rapture in Rhode Island? Moore seemed confused by their questions. “The data doesn’t lie,” he repeated, then pointed to the content of his previous slides, arguing that a lot of them had “likely self-resolved” their homelessness. The severity of the plunge in entry numbers, and its timing, call into question the possibility that these men could have faced diversion to any state other than homelessness during the most dangerous time to be sleeping outside.

In effect, the wide reach of this data filter labels those failed by CES – the disenfranchised, the incarcerated, and the dead – as success stories. With this filter, Crossroads is looking at their work through rose-tinted glasses. If CES and Crossroads are convinced that the only way to do right by 98 men in Harrington Hall is to lock the door on 116 others, they cannot be allowed to pretend that they are helping the latter group, whose calls pile up in jam-packed answering machines and whose tents crowd the Providence River.

CES and Crossroads are not solely to blame for wait times and closed doors. A staff member’s sudden departure in October left them short in the communication department. In terms of supply, Crossroads also consistently references the fact that there are no ‘empty’ beds in the shelters operating under CES, and so the wait times for shelter are out of their control.

However, while every bed is assigned by CES to a person, if this person doesn’t show up to the shelter the bed remains unfilled for the entirety of the night. Smith told the Independent that on any given night there are empty beds at Harrington Hall, and that she’s heard of numerous men who have been turned away. There are 112 spots in Harrington Hall, but the data put forth by Moore says that only 98 men stayed in the shelter this April, and that from April to October, the monthly inflow never climbed above 108 men.

Additionally, according to Chamberlain, Crossroads has cut 75 emergency winter spaces over the last fifteen years. This decline is in part due to a stricter adherence to fire codes and health and safety concerns, but is also indicative of winter shelters growing increasingly inflexible. Crossroads chose not to apply for Winter Overflow funding this year, meaning that the dining hall will not serve as a backup emergency shelter for clients, as it has previously. This decision is antithetical to Freitas’ conception of the shelter network, which she thinks should act as an “accordion” that grows and expands to meet the community’s immediate needs on dangerously cold nights.

Rigidity in the shelter system is a departure from years past. “In the old days, if you walked into the shelter and there was a spot, you got a spot,” said Chamberlain of RIHAP, who experienced homelessness himself in 2012. “Five years ago, you would walk into Harrington Hall and you would get a spot, and this is recent memory.” Shelters are, inarguably, un-ideal places to stay, and many people – some of whom are scared, some of whom have been traumatized by or in specific shelters in the past, some of whom are incapable of living in such close quarters with other people – choose to instead sleep outside and only rely on shelters during dangerous weather conditions and other unscheduled events. These people are still operating under the assumption that the lobby of Crossroads will be open to them when they need it this winter, and they are not going to be ready with a completed CES assessment and shelter referral when the first big snowstorm hits.

Currently, there are three beds in Harrington Hall that are reserved for emergency referral by street outreach workers. The front lobby of the Crossroads location on Broad Street has five available benches in the lobby, and the community room has space for 25 mats. Conversations with people experiencing homelessness make it clear: Occasionally shelter staff will will bend or break CES rules for you, but most of the time they won’t.

Ultimately, CES has stifled the flexibility of Providence’s shelters. Smith recounted a story of a client who was threatened with ejection from Harrington Hall over weekly absences. Policy dictates that clients cannot be absent more than two nights a month, but Smith’s client was leaving on Sundays to spend time with a family member. Smith argued that the new rules are often used as a crutch to justify inhumane treatment of people. “Why wouldn’t we want someone to maintain connection with their family?” she said. “And when I asked that question and asked that question, what I got was that ‘these are the rules. This is the system.’ But we have created the system. You don’t get to create the rules and the system and then fall back on the rules and the system.”

Crossroads says that it is underfunded, understaffed, and drowning in CES calls and assessment appointments. It says that more money needs to be invested into CES in order to hire more people to staff the hotline, to provide more resources for diversion, and to pay to train other service providers. (Amos House is the only other service provider currently trained for giving assessments.) Outreach workers and case managers are eager to be trained to do CES assessments to lessen the burden on Crossroads, but the trainings have not occurred. “We, the House of Hope outreach team, among others, have been asking when can we get trained,” said Smith. “We keep getting told different things. At first they were updating their rollout, now it’s data standards… I understand data standards, but doesn’t that put the cart before the horse here – that we can’t get people into shelter as fast as we should because we are missing demographic information in a database?”

When asked about the lack of training for other organizations, McDevitt said by email that staff at Crossroads and RICH are “discussing training schedules,” but that trainings have been delayed because of “system processes and implementation changes” and new HMIS (Homeless Management Information System) standards for data collection. She stressed that CES wanted to be confident in the “process and procedure before training other service providers.”

The struggles of CES don’t take place in a vacuum. That hundreds of people in Rhode Island are living outside without a place to call home is indicative of a wider housing crisis in the state, with people unable to afford rising rents due to stagnant wages and a lack of government support for affordable housing and rent control. Righting larger systemic inequities so no one lives out on the streets is a longer-term goal, but current logistical problems with CES – such as wait times – are endangering people now, and the back load and dangers will only get worse in the winter months ahead.

But even with shorter-term fixes, the question remains of whether Rhode Island’s iteration of CES is the right system to help homeless people in Rhode Island. “Unfortunately, I think CES is an entrenchment of some challenging narratives around homelessness – namely, that if we push people hard enough into the shape of our system as it is, or push them hard to make the formal economy and the housing market work for them, that’s going to solve things,” said Smith. “I think that’s false. It makes me sad that we’re entrenching that system, and not having their needs take the center.”

CES as implemented in Rhode Island has created a system that demands compliance to stringent data standards and assessments in order to access basic resources, and in doing so has prioritized data collection over sheltering people. To those running CES, the numbers tell them that the way they are operating right now is acceptable, and that they are making a primarily positive impact. This centralized data lets Crossroads more clearly articulate, at least internally, a resume of success that doesn’t clearly exist. There is always a need for more shelter beds, but Crossroads’ interpretation of the data belies just how acute, and urgent, this shortage is. Their formulas are at odds with the actual experiences of those experiencing homelessness and the community partners engaged in on-the-ground work. “Nobody likes to admit that they are doing a bad job, but they are,” said Freitas, who also sits on the Rhode Island Continuum of Care Board. “We are doing a bad job.”

While we at the Independent can’t accurately guess at CES’s future, we do know what will happen this winter if the system doesn’t change. Rhode Island’s homeless population will continue to live without adequate emergency access to shelter. Each night without a warm, safe place to sleep is another night exposed to the elements and another night at risk of theft and violence. We also know what has already happened, to people like Harry, Lydia, Gerard, and so many others like them who have faced the barriers built by CES. That harm cannot be fully undone, and, as Lawlor told the Independent, homeless folks can’t wait for the rest of us to figure out how to get it right. CES needs to hire more staff, train more people to do the assessments, and place the needs of people experiencing homeless at the center of the system—creating a CES that works for everyone.

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