The Need/Use Framework: A New Framework for Increasing Equity in Homeless and Housing Service Provision

Evidence-based interventions to prevent and address homelessness are increasingly well-documented. Yet the demand for services far exceeds dedicated resources. In this context, prioritization strategies, such as the Vulnerability Index and Service Prioritization Decision Assistance Tool (VI-SPDAT), have been used to assess need and distribute limited resources. However, communities are phasing out the VI-SPDAT due to embedded biases. We asked how homeless service providers conceptualized and distinguished between their clients’ needs and service utilization. Using template analysis to analyze focus group transcripts from 58 Arizona homeless service providers and administrators, we integrated Critical Race Theory and an equity lens and developed the Need/Use Framework. Our findings highlight that need and use are not synonymous and that assuming a direct association risks obscuring important disparities in access and outcomes. Systemic barriers, eligibility criteria, and system responses shape access to and engagement with services. The Need/Use Framework is a practical tool for communities that can support more equitable prioritization strategies. We suggest future research: (1) offer practical examples of the Need/Use Framework in use, and (2) gather perspectives of people experiencing homelessness on the distinctions between their needs and service use and what more should be done to align the two.