Examining the Validity and Reliability of the Houston Prioritization Tool through a Critical Race Theoretical Framework

Abstract

Homelessness is a complex social issue affecting millions of people worldwide, and the number of homeless people has increased by 12% since 2022 in the United States alone (de Sousa, 2023). The current approach to the problem of homelessness in the US relies on housing vouchers and services operating within a housing-first model (HUD, 2009a). As part of an amendment to the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009, HUD required all Continuums of Care (CoCs) to implement policies and procedures by which persons experiencing homelessness would be prioritized for assistance by agencies. This amendment led to the adoption of standardized vulnerability assessments. The Vulnerability Index – Service Prioritization Assistance Tool (VI-SPDAT) is a vulnerability index previously used in the US, Canada, and Australia to assess the mortality risk in homeless individuals (OrgCode, 2015b), and was once recognized as a best practice in identifying and assisting agencies in prioritizing the most vulnerable for existing resources (Brown et al., 2018). Recent research has found that it lacks validity and reliability and shows evidence of racial and gender bias (Brown et al., 2018; Cronley, 2022; B. T. King, 2018; Salim, 2020). In response, and in part to their own independent findings of racial and gender biases in VI-SPDAT scores, the local CoC in Knox County, Tennessee, has adopted the Housing Prioritization Tool (HPT) as an intermediate replacement for the VI-SPDAT. However, further testing is needed to ensure the validity and reliability of the HPT, as there has been little research on this tool.

Utilizing a Critical Race Theoretical framework and in partnership with the Knoxville Homeless Information Management System (KnoxHMIS), this research proposal seeks to use data gathered between November 2022 and February 2024 from the Knox County, Tennessee Continuum of Care (CoC) to assess the construct validity, test-retest reliability, and internal consistency of the Housing Prioritization Tool. Additionally, this study aims to investigate how race and gender, and the intersection of race and gender, may explain the variability of assigned Housing Prioritization Tool scores.

Keywords: Housing Prioritization Tool, vulnerability, homelessness, HPT