MDHI HMIS Community Meeting Creating the Vision for MDHI’s HMIS March 21, 2013

Abt Associates | pg 2 Who’s in the room?  Current use of HMIS –Enter data into the HMIS –Review reports from HMIS –Have no idea what HMIS is

Abt Associates | pg 3 Presentation Outline  Current status of the MDHI HMIS  HEARTH Requirements for HMIS  Community Examples  Creating the Vision for MDHI’s HMIS  Possibilities with Adsystech  Next Steps

Abt Associates | pg 4 Abt Associates Abt’s Mission  Abt Associates is committed to improving the quality of life and economic well-being of people worldwide.  We provide research, technical assistance, and consulting services to help our clients make better decisions and deliver better products and services. Abt’s Work  Sample Abt Homelessness Work –Annual Homeless Assessment Report –Annual Performance Report –Point-in-Time Count and Housing Inventory Count –Cost of Homelessness Evaluation

Abt Associates | pg 5 Acronyms  CoC: Continuum of Care  ESG: Emergency Solutions Grant  HEARTH Act: Homeless Emergency Assistance and Rapid Transition to Housing  HMIS: Homeless Management Information System  PCI: Priority Communities Initiative

Why Are We Here?

Abt Associates | pg 7 Denver is a “Priority Community”

Abt Associates | pg 8 Priority Communities Initiative (PCI)  Joint Initiative of US Interagency Council on Homelessness (USICH) & Housing and Urban Development (HUD)  Key strategy for implementation of Opening Doors, federal plan to end homelessness  Preparation for implementing Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act

Abt Associates | pg 9 Priority Communities Selection  25 communities selected  Communities with high levels of homelessness  Communities with ability to benefit from and commit to technical assistance  Work is aligned with Regional USICH Offices  Focus of work is to enhance the capacity of these communities to prevent and end homelessness  If we can move the needle on homelessness in these communities, we can have a large impact on homelessness for the nation

Abt Associates | pg 10 Priority Communities Technical Assistance Overall Purpose:  Strengthen CoC performance  Meet HEARTH responsibilities  Achieve goals of Opening Doors Two Types:  General TA (Focus on CoC rule responsibilities)  HMIS TA (Focus on HMIS)

History of and Changes for HMIS

Abt Associates | pg 12 What is HMIS?  Homeless Management Information System (HMIS) is a locally administered, electronic data collection system  HMIS is used to collect client-level information about persons who access the homeless service system  Often web-based software; there are several distinct HMIS software solution providers in the country 12

Abt Associates | pg 13 HUD Values HMIS  Key HUD reports are reliant on quality HMIS data (Annual Homeless Assessment Report and Annual Performance Report)  Every CoC is required to implement an HMIS and is scored on this obligation as part of the annual CoC Competition  A strong HMIS implementation is essential to meet current and future CoC rules 13

Abt Associates | pg 14 Community Database HUD funded homeless programs Mental Health, Human Services, Justice System, Healthcare Non-HUD funded homeless programs Philanthropy city and county government Additional community providers that serve homeless persons

Abt Associates | pg 15 Potential HMIS Benefits Advocates and Community Leaders Understand the scope of homelessness, and monitor for trends Generate an unduplicated count of clients served Inform systems design and policy decisions Measure the performance of the community system to prevent and end homelessness Case Managers and Program Managers Measure client outcomes Coordinate services across the CoC Prepare financial and programmatic reports Measure performance of programs Persons Experiencing Homelessness Decrease in duplicative intakes and assessments Streamlined referrals Coordinated case management and information on benefit eligibility

Abt Associates | pg 16 Group Activity #1: How do we all contribute to quality data? 1.Clients 2.Agency Staff 3.Agency Directors/Leadership 4.MDHI/CCH HMIS Staff 5.Community partners (funders, government, etc.)

Abt Associates | pg 17 MDHI HMIS By the Numbers  The Metro Denver Homeless Initiative serves the seven county region: Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson  There are currently 58 agencies using the MDHI HMIS.  There are 341 programs in MDHI’s HMIS.  There are 368 active users.  Four full time staff support the MDHI HMIS.

Abt Associates | pg 18 HMIS Roles Continuum of Care  The Metro Denver Homeless Initiative (MDHI) is an independently funded, non-profit organization whose mission includes the prevention and ending of homelessness in the seven county Metro Denver Region by facilitating, integrating and tracking cooperative, community-wide and regional systems of care for people who have become homeless, but seek to live in a stable home and maximize self- sufficiency.  MDHI is tasked with providing oversight for the region’s HMIS.

Abt Associates | pg 19 HMIS Roles HMIS Lead Agency  In 2009, MDHI selected the Colorado Coalition for the Homeless (CCH) to serve as the HMIS Lead Agency. HMIS Software Vendor  In 2011, MDHI selected Adsystech as the new HMIS software provider.

Abt Associates | pg 20 Accomplishments Since 2009: 1.Designated a new HMIS Lead Agency 2.Selected and implemented a new HMIS software 3.Migrated 4.Submitted Useable data in 4 AHAR categories! 5.Developing plan for coordinated entry that includes use of HMIS

Abt Associates | pg 21 Next Steps for MDHI’s HMIS  Rollout of Version 5 of AES  Trainings on Analysis of APRs (Staff and Agency Leaders) –Everything you wanted to know about APRs, but were afraid to ask  Coordinated Entry required for NOFA and ESG participants

Abt Associates | pg 22 MDHI HMIS Action Plan  Adds Action Steps and Timelines for MDHI and CCH, to the Recommendations in the HMIS Assessment Report  Makes the process of implementing the HMIS Assessment Report Recommendations more transparent  Available on MDHI’s website: pdf

Abt Associates | pg 23 Audience Question: Love Data?  Why do we love data?  Why don’t we love data?

Abt Associates | pg 24 Urban Peak Testimonial  Brief presentation of how Urban Peak uses HMIS as their sole database/runs reports out of HMIS

Abt Associates | pg 25 Key National Milestones for HMIS 1980’s and 1990’s Local efforts to collect data on homeless persons 2001 Congressional directive HMIS an eligible activity 2004 HUD publishes first HMIS Data and Technical Standards 2007 First Annual Homeless Assessment Report (AHAR) published Congress updates HMIS directive; future funding tied to HMIS and AHAR participation 2009 HEARTH Act is signed into law Homelessness Prevention and Rapid Re-Housing Program (HPRP) is launched 2010 Revised HMIS Data Standards released to account for inclusion of HPRP clients in HMIS First HMIS vendor programming specifications

Abt Associates | pg 26 Key Change 1: 2009 HEARTH Act  HEARTH Act underscores the importance of HMIS data to drive local and national decisions  Among the HEARTH Act requirements are: –Coordinated assessment/centralized intake –System-level Performance Measurement

Abt Associates | pg 27 System-Level Performance Indicators 1.Length of time homeless 2.Returns to homelessness 3.Access/coverage (thoroughness in reaching persons who are homeless) 4.Overall reduction in number of persons who experience homelessness 5.Job and income growth for persons who are homeless 6.Reduction in first time homeless 7.Other accomplishments related to reducing homelessness

Abt Associates | pg 28 Example 1: Columbus, OH  Collecting data since 1989  Implementation includes 17 agencies and 48 programs  Community Shelter Board (CSB) serves as both the HMIS and CoC Lead Agency  CSB is also a funder to many of the organizations entering data into HMIS

Abt Associates | pg 29 Columbus System Components  Transparent: Operate an “open” HMIS, and have done so since inception (i.e. data is shared among all participating programs)  Quality Assurances: Data quality reports are run by agencies, submitted to and approved by CSB  Data Quality Standards: Timeliness, Completeness, Accuracy, and Consistency  Regular Reporting: Annual performance evaluation, Quarterly performance monitoring, Monthly performance reports, Quality Improvement Intervention reports

Abt Associates | pg 30 Data Driven Funding Decisions  Program scoring has funding implications for NOFA, city, county and other funders  Issued to CSB Board of Trustees, Continuum of Care Steering Committee and Funders  Completed based on first half of FY for use in following FY funding determination  Program outcomes compared to planned outcomes  Posted to

Abt Associates | pg 31 Model for Scoring of Programs  High –Achieve at least 75% of the measured outcomes and at least one of the successful housing outcomes (either number or percentage outcome)  Medium –Achieve at least 50% but less than 75% of the measured outcomes  Low –Achieve less than 50% of the measured outcomes  Low performers are invited to participate in a Quality Improvement Intervention

Abt Associates | pg 32 Snapshot of Annual Report

Abt Associates | pg 33 Program Detail in Annual Report

Abt Associates | pg 34 Key Change 2: 2011 HMIS Requirements Proposed Rule  When final, the HMIS Standards and Notices will mark the first time that best practices and procedures previously encouraged by HUD will be mandatory  Data Quality  Privacy and Security  Governance  Central aim: “…provide for uniform technical requirements of HMIS, for proper collection of data and maintenance of the database, and to ensure the confidentiality of the information in the database”

Abt Associates | pg 35 Impact of Revised Standards Data Standards Data Standards Agency Data Collection Forms HMIS data entry screens HMIS vendor report programming HUD reports (APR, AHAR, etc.)

Abt Associates | pg 36 Key Change 3: ESG and CoC Program Interim Rules  CoCs must be able to report outcomes and performance at both the program and system level  CoCs must be able to look at a client’s data across the entire CoCs HMIS  Data quality will be critical to the success of reporting on outcomes and performance –Bed and unit capacity and coverage –Bed and unit utilization rates –Client lengths of stay –Returns to homelessness –Income and employment outcomes

Abt Associates | pg 37 Coordinated Assessment  ESG and CoC Program Interim Rules also require CoCs to implement coordinated access systems  Coordinated assessment must be done collaboratively between CoC and ESG recipients  HMIS will be a crucial part of this –Track availability of inventory –Share data across programs

Abt Associates | pg 38 Example 2: Cincinnati, OH  CoC wide implementation of HMIS  Utilizes a locally developed HMIS software (Vesta)  Software developer (Partnership Center, Ltd.) also serves as the HMIS Lead Agency for the CoC  Agencies pay a fee to participate in HMIS, based on their annual budget

Abt Associates | pg 39 Cincinnati System Components  Investment in System: The fees paid by agencies have the potential to ensure that they are “bought in” to the HMIS  Regular Reporting: HMIS data is regularly reported on the HMIS Lead Agency’s website  Virtual Trainings: “Just-in-time” trainings available on the HMIS Lead Agency’s website, make training accessible to users at all times

Abt Associates | pg 40 Central Access Point (CAP)  In 2008, the CoC developed a program (CAP) to implement a coordinated access system for the community  Focus is on prevention and rapid re-housing screening  Intake workers complete an initial assessment to start process of confirming program eligibility  HMIS is used to track bed availability, and to start client records (intake workers)  HUD and philanthropic funding were secured to implement CAP

Abt Associates | pg 41 Example 3: State of Michigan  Statewide HMIS implementation (MSHMIS)  Michigan Coalition Against Homelessness (MCAH) partners with Michigan State Housing Development Authority (MSHDA) to manage MSHMIS  Over 600 agencies participate in the MSHMIS, including dozens of agencies that do not receive HUD funding for providing services to homeless assistance  MSHMIS covers 83 counties

Abt Associates | pg 42 Michigan System Components  Robust Reporting Capacity: Implemented one of the nation’s first HMIS Data Warehouses  Virtual Training Programs: Given the reach of the HMIS, the state has invested in creating virtual trainings for users  Flexible Sharing: Allow for agencies to opt in to data sharing, and for clients to select which data elements they’d like to share  System of Support: Local HMIS System Administrators regularly meet and attempt to triage problems prior to tickets being logged with MCAH

Abt Associates | pg 43 Data Warehouse: SHADoW  Received HUD funding to create Statewide Homeless Assistance Data Online Warehouse (SHADoW)  Combines data from statewide HMIS and Michigan Human Services Data Warehouse  Combines de-identified client data to examine homeless use of state mainstream systems. Data is used to help determine: 1.Cost of homelessness 2.Impact of state program changes 3.Patterns of state service usage relating to homelessness 4.Extent homeless are benefiting from state services

Abt Associates | pg 44 Results of SHADoW  In 2010, used data to analyze effectiveness of prevention services, finding an overall 4% failure rate  Have data from 2006 to present  Found a high level of matches between HMIS and Medicaid records (80%)

Abt Associates | pg 45 Questions? Any questions on the HEARTH Act requirements? HMIS? Other topics?

Potential of MDHI HMIS Software

Abt Associates | pg 47 Adsystech HMIS Demo  Demo and discussion of what the Adsystech HMIS software’s current capabilities are for the MDHI CoC

Abt Associates | pg 48 Group Exercise #2: Creating the Vision for MDHI’s HMIS  Let’s design the ideal HMIS  Where do we want to be in 5 years?

Abt Associates | pg 49 Wrap Up and Next Steps  HMIS Committee Recruitment  Coordinated Entry Bridge Group  Follow-up survey to meeting attendees  Quarterly user survey  Compile and distribute priorities identified today

Abt Associates | pg 50 THANK YOU!