1. It’s Not Just Numbers: Implementing Point-in-Time Counts, Using HMIS, and Ensuring Data Accuracy Erin Wilson, Abt Associates Inc. Julie Eberbach, Iowa Institute for Community Alliances September 23, 2008

2. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 2 Overview Learning Objectives –Review basics of Point-in-Time (PIT) counts –Learn how to incorporate HMIS into PIT counts –Understand how to prepare HMIS for use in a PIT count –Learn simple data checks for population and subpopulation information reported to HUD

3. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 3 What Does It Mean to “Count” Homeless People? A “count” = collecting information about the sheltered and unsheltered homeless population in your community It is possible just to do a count, but preferable to gather descriptive information too Data on the number of homeless people + Descriptive information on those counted -Demographic -Service Use -Needs = Point-in-time count of homeless people

4. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 4 Why Count Homeless People? For planning and program development –Understand characteristics and needs –Develop programs based on need –Access resources for services and housing To measure progress in eliminating homelessness and to ensure accountability To raise public awareness

5. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 5 HUD Guidelines and Reporting Requirements According to HUD, PIT counts must be: –Actual counts or statistically reliable estimates of homeless persons in sheltered and unsheltered locations on one night –Conducted at least every other year during the last ten days of January (22-31) in odd calendar years –2009 is a required year! Designate one night for the count CoCs must count: –Sheltered and unsheltered adults, children and unaccompanied youth –Number of households with and without dependent children

6. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 6 HUD Guidelines and Reporting Requirements At a minimum, count homeless persons according to HUD definitions and guidelines –Unsheltered, emergency, transitional CoCs may also want to collect additional information for local program planning –Homeless persons according to local definitions –In-depth information about a specific subpopulation –Information about people at risk of homelessness or precariously housed Must be able to report data according to HUD definitions and requirements!

7. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 7 Homeless Population Data

8. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 8 Homeless Subpopulation Data

9. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 9 How does HUD Use PIT Data? Reporting –The Annual Homeless Assessment Report (AHAR) –Reporting the number of homeless persons in each CoC on HUD’s website To make funding decisions  Exhibit 1 –HUD scores PIT counts based on quality of methods and reliability of data It’s about accurate counts, not large numbers! –CoCs that conduct an annual PIT may receive additional credit

10. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 10 Counting Sheltered Homeless Persons Count people in emergency shelters and transitional housing programs –All programs listed on the e-HIC –Temporary emergency hotel/motel/apartment vouchers for homeless people –Faith-based providers and VA homeless programs Collect data using: –Homeless Management Information System Requires high provider coverage + excellent data quality All providers must enter/update information on all clients in a bed on the night designated for the count –Provider report or survey –Client-level survey using standardized instrument

11. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 11 Counting Unsheltered Homeless Persons Methods for counting unsheltered individuals: –Street count using observation/interviews Complete coverage (block-by-block) and/or known locations Probability sampling –Service-based count Non-shelter services (i.e. soup kitchens, healthcare centers) Can include outreach teams

12. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 12 Using HMIS for a PIT Count? Provides two components: –Count –Subpopulation information Typically used in combination with other data collection techniques to offset issues with low coverage HMIS

13. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 13 Benefits and Limitations of Using HMIS for PIT Count Benefits of HMIS –Requires fewer resources over time than a non- HMIS PIT count –Can reduce duplicate counting –Provides in-depth subpopulation data on persons who are counted without intrusive or repetitive interviews –Reinforces the value of the HMIS and contributes to year-round HMIS participation and data quality Limitations of HMIS –Requires high level of data quality and coverage

14. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 14 Key Considerations for Using HMIS Data quality Make sure information is gathered or extrapolated for each provider Start planning early –4 to 6 months prior to count –Leave adequate time to assess data quality, improve data quality, and decide whether and how to use HMIS

15. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 15 Key Considerations for Using HMIS (cont.) Uses universal and program-specific HMIS data elements, as established by HUD –HMIS Data and Technical Standards Final Notice (July 2004) FR 4848-N-02 –Revised HMIS Data and Technical Standards currently in public comment HMIS is a tool for gathering information about people who use services –More useful for sheltered count

16. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 16 Using HMIS Data for an Unsheltered Count Most communities will need to continue street and service-based counts even if outreach workers are using HMIS Potential uses for unsheltered counts –Provides an opportunity to populate the HMIS with information on unsheltered people –Helpful with de-duplicating street or service-based counts

17. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 17 HMIS Data Elements for the Population Chart Step 1: Determine if the individual was in the program on the night of the count… Step 2: Classify whether the individual is in an ES or TH program… 2.13 Program ID 2.10 Program Entry / 2.11 Program Exit To count number of people and number of households…

18. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 18 HMIS Data Elements for the Population Chart (cont.) Step 4: Determine whether the individuals should be counted as a single or as part of a household with children… Step 3: Determine whether the individual is an adult or child… 2.3 Date of Birth 2.14 Household ID

19. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 19 HMIS Data Elements for the Subpopulation Chart 3.6 Mental Health 3.7 Substance Abuse Severely Mentally Ill Chronic Substance Abuse 2.6 Veteran Status 3.5 HIV/AIDS Veterans Persons with HIV/AIDS 3.8 Domestic Violence Victims of Domestic Violence 2.3 DOB + 2.14 Household ID Unaccompanied Youth

20. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 20 HMIS Data Elements for Determining Chronic Homelessness A chronically homeless person is defined as: An unaccompanied homeless individual with a disabling condition who has either been continuously homeless for a year or more OR has had at least four episodes of homelessness in the past three years. 2.3 Date of Birth 2.14 Household ID 2.13 Program ID Determine if the individual is an adult Determine if the individual is unaccompanied Determine where the individual is living (ES) Step 1: Determine who is an unaccompanied homeless individual.

21. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 21 HMIS Data Elements for Determining Chronic Homelessness (cont.) Step 2: Determine disability. 2.7 Disability 3.6 Mental Health 3.7 Substance Abuse 3.5 HIV/AIDS 3.3 Physical Disability 3.4 Developmental Disability -OR- Disability

22. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 22 HMIS Data Elements for Determining Chronic Homelessness (cont.) Step 3: Determine chronicity. 2.10 Program Entry 2.11 Exit Across ES Programs and Stays 2.8 Residence Prior to Program Entry Also consider if the individual was unsheltered prior to entering the program.

23. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 23 Examples of Using HMIS for a Count HMIS Option 1: only – for count + subpopulation information 100% bed coverage required HMIS Option 2: for participating providers + extrapolation for non-participating providers Need 75% coverage rate for emergency shelter + transitional housing, both individuals + families Non-participating providers need to be similar to participating providers (program type and clients served)

24. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 24 Examples of Using HMIS for a Count (cont.) HMIS Option 3: for participating providers Option 4: Paper/ manual survey for non-participating providers HMIS for count Paper/ manual survey for subpopulation information Option 5: HMIS Participating providers complete paper/manual surveys using HMIS-generated reports Paper/ manual survey

25. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 25 Major Steps in Using HMIS for a PIT Count Planning Steps and Suggested Timeline 6 months before – Assess HMIS Data Quality 3-4 months before – Finalize data collection approach and request provider participation 2 weeks before – Remind providers 3-5 days before – final data quality check 1 week after – Assess results and follow-up In months after – Assemble findings In months after – Evaluate the process THE PIT COUNT January 22 nd – 31 st AugustOctoberSeptemberNovemberDecemberJanuary March February

26. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 26 6 Months – Assess HMIS Data Quality As a first step, assess data quality at the system-level –Provider participation –HMIS data coverage If you think you may be able to use HMIS: –Begin in-depth data quality assessment and correct data accuracy Assess data quality at program level Address data quality issues with providers Number of people staying in shelter on a single night with data reported in HMIS ÷ Number of homeless people served on that night overall X 100

27. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 27 Ongoing – Assess and Improve Data Quality Develop reports to assess data quality –Client roster report: Verifies current population and exit dates –Program and system-level occupancy reports: Ratio of clients to beds –Missing (null) value report: Missing data fields –Program and system-level report to check for duplicate records Develop a program and system-level Population and Subpopulation report Train program managers on using the reports

28. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 28 Ongoing – Assess and Improve Data Quality (cont.) Assess how programs are using the HMIS and adjust PIT reports as needed –Do some programs use a bed management system that would provide more accurate PIT occupancy information than the program entry/exit dates? –Are some programs exiting clients on the same day as entry? –Do some programs do all data entry only once per week? Work with program managers to implement steps to improve data quality and clean up data errors Continue to run data quality reports to ensure that managers follow through as planned

29. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 29 3 to 4 Months – Finalize the Data Collection Approach Make a final decision about how/if you will use HMIS for the count –For residential providers that are using HMIS: Are staff entering the necessary data fields on all clients for count and subpopulation information? Is complete data available for all clients? (e.g., are exit dates being entered regularly?) Is using HMIS for the count and subpopulation information a feasible strategy for all participating residential providers?

30. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 30 3 to 4 Months – Finalize the Data Collection Approach (cont.) Make a final decision about how/if you will use HMIS for the count (cont.) –For residential providers that are not using HMIS: Can you extrapolate from your existing HMIS data to cover these programs? Do you need to provide manual/paper surveys for non- participating providers to collect the required data? Establish a regular count meeting where the HMIS lead can coordinate with the point-in- time planning team

31. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 31 3 to 4 Months – Finalize the Data Collection Approach (cont.) Communicate with and secure the participation of providers –Work with the planning group to help ensure that every provider is reporting information via HMIS or manual/paper survey Develop procedures for integrating the HMIS sheltered data with other sheltered and street survey data –For example, residential providers that complete manual/paper surveys

32. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 32 2 Weeks – Remind Providers Remind program managers that the HMIS data is being used for the point-in-time count. Providers should: –Conduct a final data quality check during the days before the count –Enter information about each required data element for each client, including subpopulation information –Enter data on a daily basis, even if they don’t routinely do so Give providers a date by which they must enter the data – typically two to three days after the count

33. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 33 A Few Days Before – Final Data Quality Check 2 to 3 days before the count: –Ask providers to review their active client rosters one final time to ensure that all residents are reflected –Run a system-level occupancy report to conduct your own estimate of problems and follow-up with providers as needed 1 day before the count: –Run the missing values report to see if critical data elements are missing on current clients –Ask providers to collect and enter the information while clients are still accessible

34. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 34 The Week After – Assess Results and Follow-up Evaluate the completeness/accuracy of data De-duplicate transitional/shelter programs Produce draft system-wide HMIS count reports for discussion –System-occupancy report showing list of programs represented in the chart, along with client count and bed inventory for that night –Overall counts and subpopulation estimates –Missing value report on count fields and subpopulation fields to inform discussion on percent error

35. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 35 The Week After – Assess Results and Follow-up (cont.) Produce draft reports on the HMIS count for each program: –The count and subpopulation numbers –The client to bed ratio –The missing value % for each field Share these program reports with providers; work with providers to see if they can fill in any missing data Seeing the results may help providers realize the benefit of HMIS and may motivate them to work on improving their data quality

36. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 36 The Month(s) Following the Count – Assemble Findings Develop final HMIS count report –Population and Subpopulations Chart –Document the process / methodology –Document limitations/external influences (i.e. weather; barriers to achieving 100% accuracy) Merge HMIS sheltered count data with other data sources –Survey or extrapolated data from non-participating providers –Survey data on client characteristics not captured by HMIS (if HMIS used for count only) –Unsheltered count data Must de-duplicate with sheltered data

37. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 37 Evaluate the Process Should HMIS be used for future PITs? –For count data? For subpopulation data? Develop written recommendations on year- round and pre-count activities to improve the HMIS count for next year –Focus on year-round data quality –Identify critical providers to bring into the HMIS –Improve pre-count communication strategies –Define additional count-related report needs –Improve integration of data from other sources –Address other issues / concerns

38. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 38 Iowa Balance of State PIT Count One statewide HMIS implementation –The I-COUNT Network –Primarily rural, with some urban areas Strong data support structure –Iowa Council on Homelessness Research and Analysis Standing Committee plans PIT strategy Point in Time (Sheltered and Unsheltered) –Combined use of automated HMIS data and manual survey instruments

39. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 39 Iowa BoS PIT Count Execution Research/Analysis Committee develops Point In Time strategy and timeline (sets date) HMIS staff execute the plan –Design of HMIS network reports –Development of hard copy collection instruments –Provides state-wide trainings for both sheltered and unsheltered counts –Receives verified HMIS reports from participating agencies and tabulates “hard copy” reports –Produces final Point In Time report for each continua and the “state-wide” report

40. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 40 First Iowa Statewide Unsheltered Count Utilized “known locations” methodology Survey instruments were cooperatively developed State wide trainings provided for rural local Homeless Coordinating Boards

41. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 41 First Iowa Statewide Unsheltered Count (cont.) Iowa Department of Public Safety –Organized street count participation by law enforcement (state, county and city) Iowa Department of Education –Facilitated participation of school district homeless liaisons HMIS staff received survey summary documents and tabulated results for PIT inclusion –Staff also provided follow-up to “call-in” missing data and also investigate any “anomalies”

42. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 42 Example of Homeless Street Count Survey (Part 1)

43. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 43 Example of Homeless Street Count Survey (Part 2)

44. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 44 Sample Data Collection Form

45. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 45 Example Data Collection Form

46. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 46 Overview of PIT Data Checks HUD conducts several data checks on all PIT data submitted by CoCs CoCs can check PIT data to ensure accuracy before submitting it to HUD Simple checks for: –Households with dependent children –Households without dependent children –Ratio of unsheltered to sheltered households –Chronically homeless subpopulation numbers

47. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 47 PIT Data Checks – Households with Dependent Children # of Households # of Persons in Households is less than Average # of Persons per Household is typically greater than 2, but less than 6 For households with dependent children make sure: # of Persons in Households # of Households If = 0, then = 0 # of Persons in Households If = 0 = 0, then # of Households

48. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 48 PIT Data Checks – Households without Dependent Children For households without dependent children make sure: Average # of Persons per Household is typically less than 2 # of Persons in Households is less than or equal to # of Households

49. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 49 PIT Data Checks – Unsheltered to Sheltered Ratios Calculate ratio for households with dependent children and households without dependent children If either ratio is greater than 5, review the data. EXAMPLE CoC reports 205 unsheltered and 20 sheltered households without dependent children Ratio: 205 / 20 = 10.25 10.25 > 5 Check the data = # of Unsheltered Households ÷ # of Sheltered Households Ratio

50. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 50 PIT Data Checks – Chronically Homeless To check the number of chronically homeless make sure: # of Individuals in Emergency Shelter Is less than or equal to # Sheltered Chronically Homeless Persons Remember to follow the definition of chronically homeless! # of Unsheltered Persons Is less than or equal to # Unsheltered Chronically Homeless Persons

51. 2008 HMIS Training: Setting the Standard - U.S. Department of Housing and Urban Development 51 Additional Resources Revised HUD documents –A Guide to Counting Unsheltered Homeless People http://www.hudhre.info/documents/counting_unsheltered.pdf –A Guide to Counting Sheltered Homeless People http://www.hudhre.info/documents/counting_sheltered.pdf –Annual Homeless Assessment Report http://www.hudhre.info/documents/3rdHomelessAssessmentReport.pdf www.hmis.info www.hudhre.info PIT Technical Assistance –PITcounts@abtassoc.comPITcounts@abtassoc.com –1-877-789-2427