Tradeoffs between equity and efficiency in Coordinated Entry of homeless housing systems

Coordinated Entry is designed to provide a single access point for people experiencing homelessness to enter a Continuum of Care. Some regions, including the County of San Francisco, offer a scoring assessment to potential program participants to determine their relative need for housing. This score is then used to route participants to the appropriate housing resource. The goal is to achieve equity in assigning the most intensive resources to the most vulnerable people, while balancing efficiency in quickly housing as many people as possible. We create a queueing simulation model to directly compare policies that attempt to balance tradeoffs between equity and efficiency. In particular, we model scoring threshold policies for routing participants, as well as jockeying policies for reallocating participants as additional housing inventory becomes available. Finally, we apply an extensive experimental design to rigorously compare the policies while incorporating wide-ranging input uncertainty. This produces recommendations on how effective routing policies can be designed under changing conditions, with applications to healthcare and other tiered service systems.