1. PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger

2. PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
Presenters:
Chris Pitcher, Senior Technical Specialist ICF International
Mike Lindsay, Senior Technical Specialist ICF International
Ryan Burger, Technical Specialist ICF International

3. PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
Learning Objectives
Review requirements and best practices for PATH participation in HMIS
Understand the complicated nature of collecting data in a street outreach environment
Provide common solutions for street outreach data collection including recording building protocols and data quality policies
Clarify HUD and SAMHSA policy of street outreach data collection
Provide community examples of street outreach data collection

4. PAST DUE PAST DUE: PATH & HMIS Integration Chris Pitcher Mike Lindsay
Ryan Burger
PAST DUE

5. PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
Deadline
PATH Providers are required to use HMIS by the end of State Fiscal Year 2016
The deadline has passed for all states

6. PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
SAMHSA Policy
SAMHSA released formal HMIS participation guidance in 2015
SAMHSA HMIS Goals:
Clients access permanent or temporary housing more effectively, efficiently through HMIS & CES
Clients can access a variety of supportive services that address their particular needs

7. SAMHSA Policy SAMHSA HMIS Considerations:
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
SAMHSA Policy
SAMHSA HMIS Considerations:
Sufficient number of data elements need to be entered into HMIS to facilitate PATH client referral to housing and services
PATH data elements must be entered to generate the PATH Annual Report
Client data entry into HMIS in a timely manner (according to local HMIS policy)

8. SAMHSA Policy Ideally, SAMHSA wants:
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
SAMHSA Policy
Ideally, SAMHSA wants:
Each PATH staff member should be an active and qualified HMIS user, have HMIS access, and attend all required HMIS trainings
Real-time data entry in the field resulting in seamless client care coordination
At least one PATH provider staff member who coordinates with HMIS staff
At least one PATH provider staff member is an active member of any HMIS committee

9. PATH Annual Report PAST DUE: PATH & HMIS Integration Chris Pitcher
Mike Lindsay
Ryan Burger
PATH Annual Report

10. PATH Annual Report SAMHSA has released a new PATH Annual Report
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH Annual Report
SAMHSA has released a new PATH Annual Report
HUD has prepared the “HMIS- Programming Specifications for the PATH Annual Report”
HMIS Solution Providers will receive the new programming specifications imminently
HMIS Solutions Providers will be expected to have the new PATH Annual Report programmed by
The new PATH Annual Report will:
Correct known errors in the previous HMIS program specifications
Implement SAMHSA reporting changes

11. PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH Annual Report
The new PATH Annual Report will not require additional data collection requirements for the PATH program
The new PATH Annual Report will:
Clarify the reporting needs for Type 4 (Street Outreach) and Type 6 (Services Only) projects
Report identical data for both Street Outreach and Services Only, Except for Questions #8 and #9
Change in reporting methodology for service and referral calculations on the report
Addition of outcome data

12. PATH Annual Report: Services
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH Annual Report: Services
The new PATH Annual Report change the methodology for service reporting
Old Methodology: count every service instance for each service category
New Methodology: count only 1 service for each service category
Threes are PATH funded sources
Service Category
Old
New
Community Mental Health 5 1
Substance Use Treatment 3
Case Management 15
Clinical Assessment

13. PATH Annual Report: Referrals
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH Annual Report: Referrals
The new PATH Annual Report change the methodology for referral reporting
Old Methodology: count every referral instance for each referral category
New Methodology: count only 1 referral for each referral category
Referral Category
Old
New
Primary Health/Dental Care 5 1
Temporary Housing
Permanent Housing 3
Medical Insurance

14. PATH Annual Report: Implications
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH Annual Report: Implications
The new PATH Annual Report changes the methodology for service and referral reporting will impact historical PATH data
Service Counts will go down
Referral Counts will go down
Number of contacts is the only measure that provide insight into level of effort
State PATH Contacts and PATH providers will uncertain about the drastic change in “numbers”
HMIS and HMIS Lead Organizations may be blamed for the decrease
This does not affect historical data, but will be reflected in the PATH annual report post-January 2017

15. PATH HMIS Program Manual
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Program Manual

16. PATH HMIS Program Manual
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Program Manual
The PATH HMIS Program Manual (Version 2) will be released to the public imminently
The PATH HMIS Program Manual will:
Clarify the program set up for Street Outreach and Services Only projects
Triple in length
Provide service and referral terminology
Clarify winter, night-by-night and data program data collection
Discuss street outreach programs and HUD System Performance Measures
Provide best practice guidance gathered over the past two years of PATH integration into HMIS

17. PATH HMIS Program Manual
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Program Manual
The PATH HMIS Program Manual (Version 2) aligns with the 2014 HMIS Data Standards v.5.1
Minor changes for the PATH program:
All data elements now required (except 4.8)

18. PATH HMIS Program Manual
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Program Manual
The PATH HMIS Program Manual (Version 2) will clarify program setup in HMIS
PATH Program Component
Population of Focus
HMIS Project Type
Street Outreach
Persons who generally reside in a place not meant for human habitation (e.g. streets, abandoned buildings, etc.)
Supportive Services
Persons who generally reside in a place meant for human habitation, or who are at risk of homelessness
Services Only

19. PATH HMIS Program Manual
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Program Manual
Define more clearly “Generally Reside”
HUD and SAMHSA are developing data collection policy to aid in determination
At first contact and Project Entry determine the client’s primary place of residence by using the following:
Where did you sleep last night?
If the client responds with an answer consistent with a place not meant for human habitation, then enter the client in the Street Outreach Program
If the client responds with an answer consistent with a place meant for human habitation, then entre the client in the Supportive Service Program
If the client does not provide an answer, wait until you can get an answer and enter the client in HMIS at that point
Determining a client’s primary place of residence should be carefully considered for the following programs: winter shelter, temporary shelter, night-by-night shelter (with no guaranteed bed), mobile outreach, mobile health clinic, homeless hotline, 211 and coordinated entry projects. These project types do not clearly equate to a client’s primary place of residence and should prompt the question “where did you sleep last night”.
If the PATH project initially enters a client in a project type based on the identification of client’s primary place of residence, but later learns additional information about the client’s primary place of residence that indicates that another PATH HMIS Project Type more appropriately represents that client’s population of focus, the PATH project is not required to exit the client from the program or otherwise alter the client’s record in HMIS.
It is possible for one PATH funded project to serve two separate populations of focus. In such cases, the PATH project must have two projects set up in their HMIS – one as a Street Outreach project type for the street homeless clients and another as a Supportive Services Only project type for the sheltered or at risk homeless clients.
When Supportive Services Only is selected as a PATH Project Type, the response to the dependent field “Affiliated with a residential project” should be “no,” unless the project is funded as a Street Outreach component and is operating within an emergency shelter. Then the affiliation would be “yes” and the shelter(s) the project operates with would be listed.

20. PATH HMIS Program Manual
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Program Manual
SAMHSA has not established a policy regarding the specific amount of time that must pass from date of last contact in order for the client to be considered reengaged
The State PATH Contact is encouraged to set a standard length of time for reengagement and align local practices regarding reengagement with the policies that govern the length of time that must pass without a client contact before the client exits the PATH project
The period of time that passes from the date of last contact until reengagement should between 30 days and 90 days (or other length of time as established locally)

21. PATH HMIS Program Manual
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Program Manual
Provide guidance on Street Outreach projects and HUD System Performance Measures
HUD System Performance Measure 7a: Successful Placement from Street Outreach
Client Universe: Persons In Street Outreach Projects that exited from Street Outreach during the reporting period
Data Collection Issue: Data Quality does not count for the PATH program until “Date of Engagement” HOWEVER HUD System Performance Measures capture clients before and after “Date of Engagement”

22. PATH HMIS Data Collection
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection

23. PATH HMIS Data Collection Workflow
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection Workflow

24. PATH HMIS Data Collection
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection
A client may move between staying on the street and in an emergency shelter but will remain in the same original project in HMIS
The Game Changer
Street Outreach data is not held to a data quality standard until the Date Of Engagement
The Balancing Act
Need to balance the client relationship vs. data collection
Without the client relationship there is not data
Without the data the program may not be funded

25. PATH HMIS Data Collection
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection
Develop Record Building Protocols
Allow outreach workers to enter data on clients as the relationship evolves
Outreach is not conducive to timely, accurate and complete data collection
Often there is never enough data to create a complete HMIS client record
Adopt a consistent policy for street outreach data collection

26. PATH HMIS Data Collection
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection
Outreach programs need to collect client-level data over time
Outreach programs may initially enter records that are non-identifiable
Outreach programs shall continue to engage the client to obtain client-identifiable data
Outreach data will not affect overall data quality until the Date of Engagement

27. PATH HMIS Data Collection
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection
Non-identifiable Data
Outreach programs need to keep track of the non-identified client and alias information as not create a new record if one already exists
Record building protocols allow outreach workers to enter data on clients as the relationship evolves
HUD and SAMHSA set general parameters for outreach data collection policy in the PATH Program HMIS Manual
It is recommended that States adopt a consistent policy for PATH street outreach data collection

28. PATH HMIS Data Collection
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection
Engagement & enrollment:
All client records should be accurate and complete, meaning that they are expected to contain all UDE and applicable PSDE
Data quality will be monitored for all clients for whom a date of engagement has been entered

29. PATH HMIS Data Collection
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection
Project exit:
Clients should be exited from the project when:
They achieve stable permanent housing
They are enrolled in another appropriate housing project and/or mainstream services that does not require continued provision of outreach
They leave the project

30. PATH HMIS Data Collection
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection
Auto exit date:
Set an exit date for clients that have not been seen for a specified period of time
PATH programs are encouraged to standardize this time frame statewide to ensure consistent data across providers
These exits should be configured to produce an exit date equal to the date of the last encounter

31. PATH HMIS Data Collection
PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
PATH HMIS Data Collection
Data Quality
Though data quality does not count until Date of Engagement, it is still critical
Policies:
How long does the client remain in the project without any contact?
When will un-identifiable data be considered inactive/exited/purged?

32. Questions PAST DUE: PATH & HMIS Integration Chris Pitcher Mike Lindsay
Ryan Burger
Questions

33. PAST DUE: PATH & HMIS Integration
Chris Pitcher
Mike Lindsay
Ryan Burger
Contact Information
Chris Pitcher, Senior Technical Specialist ICF International (202)
Mike Lindsay, Senior Technical Specialist ICF International (724)
Ryan Burger, Technical Specialist ICF International (412)