Coordinated Entry and Permanent Supportive Housing: A National Perspective on Barriers and Opportunities

Executive Summary

The Harvard Kennedy School Government Performance Lab (GPL) Homelessness & Housing team seeks to provide actionable information that helps localities make the most of their housing resources, especially when capacity is limited. By improving data capacity and optimizing system management, we aim to empower system leaders to drive better outcomes for those experiencing homelessness.

Homelessness is a growing problem. According to the 2024 Annual Homeless Assessment Report (AHAR), approximately 770,000 people experienced homelessness on a single night, an increase of 18% from the prior year. This marks the highest increase in homelessness since the federal government began conducting an annual count in 2007.

The lack of deeply affordable housing is also growing. In 2022, only 7.2 million units rented for less than $600 per month — down from 9.3 million units in 2012. Cities and state leaders are grappling with long wait lists for housing, significant numbers of people who need behavioral health support in addition to housing support, and limited resources to meet those needs.

Significant expansions of deeply affordable housing, fully optimizing existing housing resources, and expanding access to behavioral health care has never been more important.

One of the most effective and evidence-based solutions for addressing homelessness is Permanent Supportive Housing (PSH), which combines deeply affordable housing assistance with behavioral and social health supports. This evidence-based approach has proven effective at reducing homelessness, improving behavioral health outcomes, and achieving cost-savings in other emergency systems such as jails, emergency rooms, and shelters.

To understand how Coordinated Entry Systems (CES) facilitate connections to Permanent Supportive Housing (PSH), the GPL conducted a national survey and interviewed CES leaders and PSH providers.

• The survey received 287 responses from 127 unique jurisdictions across 47 states.
• Respondents represented 151 Continuums of Care (CoC), government agencies, and coordinated entry staff, including some PSH providers who also hold leadership roles within their systems.
• The GPL also interviewed leaders from all levels of management, including directors, referral-making staff, and data and performance teams, from 26 CoCs, including four state- level CoCs.

This report offers insights from primarily Continuums of Care across the nation, highlighting challenges and opportunities related to optimizing PSH management. We recognize the vital role of other stakeholders such as housing providers, clients, developers, and communities in addressing homelessness, and will work to incorporate their perspectives into future research and collaborative efforts.

From these conversations and the GPL’s work with jurisdictions across the country, we identified four major field opportunities:

1. Tracking real-time data on system capacity, vacancies, and referral timelines can increase transparency, efficiency, and accuracy.
2. Staffing support through automated tools can free up staff capacity and facilitate systemwide improvements that benefit housing providers and clients.
3. Standardizing among providers to implement consistent and low-barrier housing processes can lead to more successful housing placements.
4. Unifying stakeholders outside CES mandates such as Public Housing Authorities (PHAs) and Veterans’ Affairs (VAs), and landlords can help CoCs can unlock more resources and serve more clients.

Within each field opportunity, we present several questions to help leaders work toward actionable steps. Taken as a whole, these 10 guiding questions can help leaders take meaningful steps toward strengthening their permanent supportive housing systems.

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