Frequently asked questions

Are there some people living on the streets who don’t want housing?  

For the most part, no.  That is a deadly myth. While there are, indeed, people living on the streets who refuse to enter temporary shelter or enter treatment, less than 5% decline permanent housing when offered, as long as the only requirement is to pay the rent and be a good tenant, just like you or me.  

There are some people living on the streets who are ambivalent about housing [which is entirely different from not wanting it at all], and we recommend that practitioners work with those individuals to enhance their motivation for housing using motivational interviewing techniques.  Some campaign communities have brought experts such as Ken Kraybill (ken.kraybill@gmail.com) to their community to teach Motivational Interviewing with much success.   

What does enrolling in the 100,000 Homes Campaign mean?  

What does endorsing the 100,000 Homes Campaign mean?  

How will the 100,000 Homes Campaign count the number of long-term and vulnerable homeless people housed?

Does the 100,000 Homes Campaign work with homeless families?  

Yes.  Our goal is for 10,000 families who are stuck in a cycle of homelessness to be housed through the efforts of the participating communities.  An affinity group of communities and providers working to house these “chronically homeless families” will connect via Webex on a quarterly basis to exchange promising practices and innovations.  

Washington, DC, pioneered an adaptation of the Vulnerability Index for families.  The Family Vulnerability Index prioritizes the same health conditions as the individual index, but also takes into account multiple prior incidents of homelessness and engagement with the Child Welfare system.  The Family Vulnerability Index and on-line scoring system will be available to campaign communities. 

How much does it cost to join 100,000 Homes Campaign?  

There is no cost to join 100,000 Homes.  If you decide to do a Registry Week, you will need to send members of your community to a Registry Week boot camp to learn all the nuts and bolts, which costs $500 per person. You can find dates for upcoming Registry Week boot camps on our Events page.

Who can join the campaign from our community?  

Any organization that will commit to finding and housing the most long-term and vulnerable homeless in their community can join the campaign.  It can be the city or county human services department, the business community, a non-profit organization, a hospital, the faith community, a student group, a housing provider, a foundation, or a broad coalition of all of the above. All are welcome!

We have a lot of different service providers in our community and we don’t have a coordinated strategy.  How can the Vulnerability Index help with this?  

This is very common.  The 100,000 Homes Campaign is an opportunity to bring a wide range of stakeholders to the table and begin working together on a shared goal.  Everyone in the community is invited to help create the registry.  We’ve heard that getting outside in the early morning hours, sitting down and really listening to people on the streets is a real eye-opener for everyone who experiences it. 

Do we have to have a Registry Week?  

The signature event of the 100,000 Homes Campaign is the Registry Week, during which you will bring your community together to create a by-name and photograph list of your homeless population,  rank-ordered by mortality risk.  The Registry Week has several benefits:  (1) it gives you an opportunity to build cohesion across multiple organizations in your local campaign team; (2) it frames homelessness accurately as a life or death issue, thereby making urgent the need to do whatever it takes  to house your most vulnerable neighbors; (3) it provides the data on exactly who is experiencing homelessness and what kind of housing and services they may be eligible for to allow communities to create housing placement strategies informed by facts, (4) it provides an opportunity to engage the ideas, energy and resources of volunteers and stakeholders from many parts of the community in finding solutions to the housing needs of the most vulnerable.   

That said, it is not mandatory that your community have a Registry Week.  If your community is confident that you already have a by-name listing of everyone experiencing homelessness, and you have already arrived at consensus on  how to define vulnerability and prioritize housing placement, you’ve accomplished much of what would be gained in a Registry Week. However, it may be worth doing anyway to mobilize broad community participation in your efforts.,If you do not have a comprehensive, by-name list of individuals experiencing homelessness or consensus on how to prioritize the most vulnerable, we cannot recommend a Registry Week highly enough.  

Do we have to use the Vulnerability Index?  

No, although most 100,000 Homes Campaign communities are using the Vulnerability Index as it is currently configured and the online Quickbase program (complementary for participating communities) to score it.  

There are some noteworthy exceptions.  Fort Worth conducted an exhaustive literature review and community-sensing session to arrive at a modified version of the Vulnerability Index that reflects the unique concerns of their community.  Other communities are especially concerned about specific public health issues and  ask additional questions.  

We have a frequent user initiative.  Would that count toward the 100,000?  

Definitely.  There is a Hospital to Home Affinity group for the campaign, in which all communities working closely with hospitals to find and house frequent users connect via WebEx every month to exchange promising practices and innovations.  To join this affinity group, contact Catherine Craig at ccraig@commonground.org.

What about homeless youth?  

A study in Montreal determined that three factors put homeless youth under 25 at a heightened mortality risk:  HIV+/AIDS, injection drug use, or drinking alcohol everyday for the past 30 days.  These questions are embedded into the Vulnerability Index and a separate report can be run for Vulnerable Youth.  

Interestingly, we’ve found that of the homeless youth surveyed in 20 cities, approximately 25% have the vulnerability characteristics specific to youth, and another 25% have the general population vulnerability factors.  

An Affinity group for groups solving homelessness for youth convenes every other month via WebEx.  

Can someone from the campaign team help us coordinate a registry week?  

Absolutely.  This is highly recommended.  There are two options to consider:

Bring two certified Registry Week Facilitators to your community who will mentor you through the preparation process then spend Monday – Friday with your community and ensure that you have a fantastic experience.  Covering their costs is roughly $7,500 for time, lodging and travel for the week.

Another option is for your community to send two leaders to a Registry Week happening near you. You would  work closely with the certified facilitators and lean how conduct a registry week then bring that back to your community.  

Do we need to have all the housing units lined up before we join the campaign or do a Registry Week?  

Absolutely not.  In fact, in many cases, it is the act of bringing together the community and getting person-specific data about who is in most urgent need of housing that opens the door for negotiating resources that might not otherwise be made available.

Can VASH vouchers be used to house the most vulnerable?  How can we best work with our local VA office?

Several communities have created strong partnerships with their local VAs to match VASH vouchers with the most vulnerable veterans identified during Registry Week.  This is a priority for the campaign nationally.  Please let us know if you want to work on this with us!

How can people maintain housing if they haven’t first addressed their substance abuse problems?

Our priority is to help the most vulnerable homeless get into housing first, then work with each person to improve their health, including addressing substance abuse problems that would interfere with their ability to remain housed.  There is a great tradition of success with “housing first” programs, beginning with the pioneering work of Pathways to Housing, with well over 80% of individuals maintaining their housing even as they work to overcome   problems related to addictions.

How many of the most long-term and vulnerable homeless have been able to keep their housing?  

A sample of  vanguard campaign communities found an average 91% retention rate in housing over one year.    

Won’t housing 100,000 long-term and vulnerable homeless people cost taxpayers a lot of money?  

Numerous studies have demonstrated that public costs associated with homelessness decline precipitously after the first year in housing.  With an average of 91% of the people in the vanguard campaign communities maintaining their housing for a year or longer, the potential for taxpayer costs savings is substantial.  In fact, in many cases, not housing the homeless costs taxpayers more than providing those who struggle on the streets or in shelters with housing and the supports they need to succeed as tenants.   Street homelessness can be especially expensive because people often end up in  hospitals and  jails at thousands of dollars per night.  Even a typical shelter usually costs more per night than an average apartment linked to support.  

How accurate is self-report of medical conditions?

The San Francisco Department of Public Health recently compared the self-reported information collected in the Vulnerability Index against the  actual medical records of  500 people.  The results are not yet published, but they found that self-report was accurate for all but kidney disease and cancer. They did not have enough data to test the validity of the cold/wet weather indicator or the number of hospitalizations in the prior year, but all other health questions were found to be valid.     

What percent of people agree to participate in the survey?

Between 85% to 90% of individuals sleeping on the streets who are approached to participate in the Vulnerability Index survey agree to do so.  75% of respondents allow their photograph to be taken for the purpose of finding them later.  All participants sign a release authorizing the use of this information.

Can you incorporate the Vulnerability Index into the annual HMIS point-in-time count?

The survey takes approximately 10 minutes to complete.  If your area does a full count of all areas, the Vulnerability Index could be administered to all street homeless; however, if a random stratified sample is your count methodology, many vulnerable people will not have the opportunity to be surveyed.  

Why is it important that we take pictures as part of the survey process?

We cannot emphasize strongly enough the importance of capturing a photograph of each participant.  

As a practical matter, most cities have several hundred people sleeping on their streets, many of whom are not known even by homeless services organizations.  Once the Vulnerability Index Surveys are complete, participants are rank ordered from most vulnerable to least, then prioritized for housing placement.  Local outreach and case management teams will be assigned to find them and expedite their placement into housing.  Without the clarity of a photograph, it is very difficult to locate the individuals who are highly vulnerable in order to assist them.   For example, Skid Row committed to house the 50 most vulnerable individuals.  They were able to take 40 pictures among the 50 respondents who were the most vulnerable.  In the months that followed, as they attempted to locate then house the 50 most vulnerable, they were not able to locate any of the 10 for whom they had names but not photographs.  

Why do you recommend that we start surveying people early in the morning?  Isn’t it mean to wake people up so early?  

Our primary concern is to make sure that every single person sleeping outside has the opportunity to be surveyed, and therefore to be considered for prioritization for housing.  There are several benefits to surveying in the early morning hours:

The ideal hours are after the last curfew for the shelter and before police or business improvement districts begin to wake people in the morning.  Surveying in the early morning hours keeps the focus on those who have opted out of shelter and are facing the greatest  health risks on the street.

Late at night is not ideal because there is more foot-traffic than in the early morning, making it difficult  to discern who is homeless and who is not.  It is very easy to tell who is homeless in the early morning hours as individuals are observed sleeping on the street.  

It is also the case that early in the morning, anyone abusing substances will more likely be sober at that hour, therefore able to give an informed consent  to participate in the survey.  

In most cities we’ve worked with, outreach workers suggest they already know everyone sleeping outside, and in every city we’ve worked with, outreach workers are surprised to find during the Registry process people who had been sleeping outside for years that they did not know.  

While getting up really early in the morning is admittedly miserable, it typically ends up being a bonding experience for all involved, including the homeless, who we find generally get up at that time anyway.

We’re a warm weather climate and the research behind the VI was done in a Boston.  Is the history of frostbite question a valid one for our city?  What about including heat injury?  

The research on which this is based was a medical records review of 14,000 people who were seen by Boston’s Healthcare for the Homeless.  Among the reviewed records, there were, in fact, many people with a history of heat stroke or heat exhaustion during the summer, but that was not found to be statistically significant enough to include among the 8 highest risk factors.

We do find that even in warm weather climates –Los Angeles County, for example, and New Orleans, 7% of participants say they have a history of cold or wet weather injuries.  We suspect they got injured somewhere cold then moved somewhere warm!  So it’s still a valid question, even in warm places.  In cold weather communities,  an average of 14% of participants reported histories of cold or wet weather injuries.  

Because many people have this concern, we’ve included a question on heat injury in the survey. Answering affirmatively on the survey does not go into the “vulnerable” calculation for our formula, but the information is captured so that any community that wants to prioritize people who’ve had heat injuries, or wants to look into that more deeply, is able to do so. 

Please feel free to email us with additional questions at: kjohnson@commonground.org.