Tucson outreach workers are using a locally designed questionnaire this summer to decide which unhoused residents should move first in a scarce housing queue. The central question is unusually direct: who is most likely to die while living outside?
The assessment, developed by the Tucson Pima Collaboration to End Homelessness with local service organizations, replaces a national tool that Tucson used for about a decade. It began operating partway through last summer, making 2026 its first full hot season. The change does not add an apartment, shelter bed, or cooling center. It changes how the city and its partners rank urgent need when there are too few placements for everyone.
Mortality Becomes a Priority Measure
The previous questionnaire, known as VI-SPDAT, was widely used across the country to assess vulnerability. Critics increasingly argued that some of its questions could reproduce racial inequities or frame survival behavior as personal failure. Tucson’s replacement asks about danger in a different way. For example, it treats pressure to exchange sex for food, shelter, money, or protection as coercion and exposure to harm, rather than simply recording a risky choice.
Developers used records from the Pima County medical examiner to identify patterns associated with death among people living outside. The scale behind that work is stark. Of the deaths investigated by the office in 2024, 195 involved people experiencing homelessness, about 10 percent of the total. In 2025, 201 of 2,103 investigated deaths involved people who were homeless, again about 10 percent.
The team also consulted a council of people with lived experience and piloted the survey with 10 assessors who interviewed more than 270 people between November 2023 and May 2024. According to the local reporting, the pilot did a better job than VI-SPDAT of elevating the group researchers believed faced the greatest risk of dying outside. Factors connected to violence and other vulnerabilities can also serve as tiebreakers.
Answers place a person on Tucson’s By Name List, which providers use to match people with housing openings. That makes the questionnaire consequential. When a placement becomes available, an outreach worker must still find the person. Someone who cannot be reached after three attempts using three methods can lose that immediate position and may need to complete the assessment again.
Extreme Heat Raises the Stakes
The new ranking system arrives during a dangerous heat year. Tucson recorded its earliest 100-degree day in March. By early August, Pima County had counted 26 heat-related deaths for the season, including five before May, according to Arizona Public Media. Those figures are preliminary rather than a final annual total, but they show why waiting outside is not a neutral condition.
Pima County has expanded its immediate response. It now lists 48 cooling centers, 15 more than two years ago, offering air conditioning, water, and other services during operating hours. By July 29, those locations had recorded more than 60,000 visits in 2026, roughly 25,000 more than during all of the previous summer.
Availability, however, changes by the day and by the hour. Only nine locations were open on Sundays, and most centers closed by 4 p.m., when summer temperatures can remain above 100 degrees. Twenty-six library branches are included in the cooling network, but the libraries close on Sundays. Only eight of the 48 centers accepted pets other than service animals, a practical barrier for people unwilling to leave a companion outside.
These gaps matter because a risk score is useful only if a person can remain alive, reachable, and connected to outreach while waiting. Cooling centers can reduce immediate exposure, but restricted hours, transportation needs, and pet rules can determine whether a listed service is actually usable.
A Better Queue Is Still a Queue
The Tucson approach addresses a real administrative problem. When housing is scarce, agencies must choose an order. A locally tested tool based on mortality data may make that order more responsive to extreme heat, violence, chronic illness, and the conditions people face on the street. Reframing coercion also reduces the chance that a survival response is mistaken for an individual moral failure.
But the designers and local providers are clear about the limit: changing the assessment does not create more housing. It redistributes priority inside a zero-sum system. That raises questions worth watching. Officials will need to examine whether the new tool actually reduces deaths, whether different racial and demographic groups receive fair access, how often people lose a place because outreach cannot find them, and whether the score remains accurate as conditions change.
For residents, the development is a reminder to separate three public functions that are often collapsed into one headline. Cooling sites provide immediate protection. Outreach keeps people connected to services. Permanent housing ends the exposure that made emergency triage necessary. Tucson has changed the logic of the queue. The harder test is whether the community can shorten it.
Sources
- Arizona Luminaria (2026-08-03): Reports the new Tucson assessment, mortality data, pilot design, By Name List process, contact rule, and limits created by scarce housing.
- Arizona Public Media (2026-08-03): Documents the 2026 heat deaths, cooling-center count and visits, Sunday hours, library participation, and pet-access gaps.
