Public service programs often allocate limited resources under uncertainty about their benefits, creating a need for randomization to support credible evaluation. In practice, however, applicants commonly enter waitlists where resources are prioritized toward individuals judged to have higher need through tiered priority queues, making direct randomization difficult. Motivated by this, we develop an experimental design framework for learning treatment effects while treating those most in need where incoming applicants are randomized into priority queues based on their assessed risk scores. Treatments are then provided across queues in priority order and first-in-first-out within queue as budget becomes available. Our contributions are two-fold. First, we characterize what causal effects are identified under this priority-queue allocation. When arrivals are exogenous, treatments are conditionally randomized, and hence standard estimands are identified; when arrivals are endogenous, queue randomization instead provides an instrument for treatment, identifying local treatment effects induced by the queuing process. Second, we develop optimized queue-assignment designs that trade off statistical efficiency against prioritizing higher-need applicants. We show in the process that, despite dependence in treatment assignments induced by the design, usual iid efficiency bounds remain well-justified design objectives. We illustrate the proposed designs using data from a housing allocation program in a large U.S. county.