Preventive vs. Remedial Screening Tools The Economic Roundtable has developed five predictive screening tools to identify and prioritize high-need homeless individuals who will have high future public costs because of ongoing crises in their lives that are resolved in expensive institutional settings, including jails and hospitals.
This streamlined triage tool was developed for the Santa Clara County Center for Population Health Improvement (CPHI). It provides an empirical tool for prioritizing patients for permanent supportive housing using close-to-real-time data that is available to CPHI. In addition, an industry-wide switch in medical diagnostic classification systems necessitated a conversion of all diagnostic variables from the ICD-9 classification system to the ICD-10 system.
The current issue of HUD’s peer-reviewed journal, Cityscape, includes an article on the Silicon Valley Triage Tool that was developed by the Economic Roundtable. This statistical model provides a fair, objective tool for triage—prioritizing which individuals should have immediate access to permanent supportive housing. Santa Clara County voters have approved major investments in affordable housing for people experiencing homelessness, but the number of individuals who need housing still substantially exceeds the amount of housing that is available for them.
Why the Silicon Valley Triage Tool is Important: The number of homeless people needing housing far exceeds the available housing supply, and there is not a fair, objective system for prioritizing who gets to be housed. The triage tool addresses this problem by identifying individuals for whom the solution of housing costs less than the problem of homelessness.
This report identifies the characteristics of the most vulnerable, distressed and costly homeless residents of Santa Clara County to guide strategies for stabilizing their lives through housing and supportive services, improving their wellbeing and reducing public costs for their care. The county spent $520 million a year providing services for homeless residents over the six years covered by this study. Costs are heavily skewed toward a comparatively small number of frequent users of public and medical services. Individuals with costs in the top 5% accounted for 47 percent of all costs and had average costs of over $100,000 per year.