Comprehensive HMIS Training for G&PD Staff and Agencies

Homeless Management Information System (HMIS) Training for G&PDStaff and Community Agencies Sponsored by: U.S. Department of Veterans Affairs Please Note – The audio portion of this training is available by dialing (800) 260-0712 and entering participant code 187 552 Questions can be directed to VAHMIS@abtassoc.com

Training Objectives: Participants will… understand core concepts of a Homeless Management Information System (HMIS) be able to identify the intersections between HMIS and the work of the VA, including the VA’s Strategic Plan know the necessary next steps to start HMIS participation, as well as the resources available to support participation 2

Training Agenda: • Overview and Context for HMIS • Role of HMIS in VA’s Strategic Planning • Relationship of HMIS Projects to CoC • HMIS Data Standards • VA Data Collection Requirements • VA Plan for HMIS • Getting Started with HMIS: Next Steps • Questions and TA Resources

Training Format: Call will last approximately 90 minutes Materials from today will be available online at www.va.gov/homeless 4

Overview and Context for HMIS • How are current data collection requirements changing? • HMIS • HOMES/Registry • Why are changes being made? • VA Strategic Plan • How does this impact me? • VAMC Homeless Liaison • GPD community partners

VA Participation Requirements • GPD, HUD-VASH, and SSVF will begin participating in local HMIS. • GPD must begin no later than March 31, 2011 • HUD-VASH and SSVF can start later • All other VA-funded homeless programs will participate in HOMES. • HMIS and HOMES data will be integrated.

Why are changes being made? • To measure the extent and scope of homelessness among veterans; • To assess the effectiveness of programs that serve homeless veterans; • To facilitate closer coordination of VA-funded homeless programs and improve local planning around veteran homelessness.

What is HMIS? A Homeless Management Information System (HMIS) is a locally administered, electronic data collection system that stores longitudinal person-level information about persons who access the homeless service system. Typically a web-based software application that homeless assistance providers use to coordinate care, manage their operations, and better serve their clients. Several HMIS software are currently on the market. HMIS is response to a Congressional Directive to capture better data on homelessness. 8

Why is HMIS Important? Every Continuum of Care (CoC) is required to implement an HMIS. Existing HMIS Data Standards ensure consistent and uniform data collection in a secure and protected setting. Local HMIS data is critical for the Annual Homeless Assessment Report (AHAR). Note that this year’s AHAR included the first ever “Veterans Supplemental Report”. Implementation of HMIS at the local level can support coordinated local enumeration efforts, system and program performance assessment, individual case planning and service coordination. 9

The History of HMIS Recognizing the importance of community efforts to capture better data, in 2001 Congress directed federal departments on the need for data and analysis on the extent of homelessness and the effectiveness of the McKinney-Vento Act Programs including: Developing unduplicated counts of clients served at the local level Analyzing patterns of use of people entering and exiting the homeless assistance system Evaluating the effectiveness of these systems 10 10

The History of HMIS (cont’d) Nearly all CoCs now have an HMIS HUD has been using HMIS data to produce regular reports each year (AHAR, APR, and Pulse) 2009: Homelessness Prevention and Rapid Re-Housing Program (HPRP) launched; data collected in HMIS; expanded use of system throughout the nation 2010: Revised HMIS Data Standards were published Expected in 2011: Updated HMIS Data Standards with VA-specific requirements

Key Components of HMIS Information and Referral (I&R) Client Intake Bed Management Case Management Service Tracking 12 12

Benefits from an HMIS Clients: Streamlined intake, coordinated case management Agency directors and program managers: Measuring outcomes, ability to produce reports for funders, boards and other stakeholders Policy makers and advocates: Understanding of the extent and scope of homelessness, informing systems design and policy decisions 13

Existing Resources on HMIS HMIS.info www.HMIS.info Historical information on HMIS, as well as technical resources HUD Homelessness Resource Exchange: www.HUDHRE.info Copies of presentations from 2010 HUD conference, many covering HMIS 2010 HMIS Data Standards http://www.hudhre.info/documents/FinalHMISDataStandards_March2010.pdf 14

Role of HMIS in VA’s Plan to End Homelessness Among Veterans 15

Strategic Efforts to End Veteran Homelessness VA 5 Year Plan to End Veteran Homelessness VA Strategic Plan for 2010-2014 United States Interagency Council on Homelessness’ (USICH) “Opening Doors: Federal Strategic Plan to End Homelessness” Local Ten Year Plans to End Homelessness National Center on Homelessness Among Veterans All of these efforts require accurate and timely data describing extent and scope of veteran homelessness.

VA’s Five Year Plan to End Homelessness Among Veterans Announced on November 3rd, 2009 at the National Summit on Homeless Veterans Based on six strategic pillars: Outreach/Education Prevention Income/Employment/Benefits Treatment Housing/Supportive Services Community Partnerships “Objective 2: Strengthen the capacity of public and private organizations by increasing knowledge about collaboration, homelessness, and successful interventions to prevent and end it.” 17 17

VA’s Strategic Plan Released in June 2010 Names 13 goals, including “eliminate veteran homelessness” Among the key statements made in discussing the goal to eliminate veteran homelessness: “Robust management system: We will hold ourselves accountable with a system to monitor outcomes for individual Veterans as well as the outcomes of our programs so that the homeless are not nameless to us.”

National Center on Homelessness Among Veterans • Center’s Goals • Promote the development of policy & practice • Develop new empirical knowledge • Provide education /training for VA & community partners & disseminate evidence-based/emerging best practices • Support implementation of relevant research findings into clinical practice • Partnership between • Department of Veteran’s Affairs • University of Pennsylvania and University of Southern Florida • UMass Medical School and the Yale School of Medicine 19 19

For More Information VA’s 5 Year Plan to End Homelessness http://www.oregon.gov/ODVA/TASKFORCE/reintegration/FiveYearPlan-PPT.pdf?ga=t VA’s Strategic Plan http://www1.va.gov/op3/Docs/StrategicPlanning/VA_2010_2014_Strategic_Plan.pdf USICH Federal Plan to End Homelessness http://www.ich.gov/PDF/OpeningDoors_2010_FSPPreventEndHomeless.pdf Local Ten Year Plans to End Homelessness http://www.usich.gov/slocal/plans/index.html National Center on Homelessness Among Veterans http://www1.va.gov/homeless/NationalCenter.asp

Relationship of HMIS Projects to Local CoC 21

Implementation Models • There are 3 typical implementation models: • Statewide • Multi-CoC and/or Regional • Single CoC • Geographical jurisdiction of the HMIS project does not always align with the same region that the CoC covers • Each model has its own pros and cons 22 22

HMIS: Who is Responsible? The Continuum of Care (CoC) is responsible for HMIS implementation including planning, software selection, and compliance with HMIS Standards The HMIS Lead Agency (or grantee) is an agent of the CoC. Manages HMIS operations and provides HMIS administration functions at the direction of the CoC 23 23

Governance Structure • CoC is responsible for: • HMIS planning and software selection • Selection of HMIS administering agency/grantee • Establishing HMIS policies/protocols • Accurate data reporting in CoC Application • Contributing data to the Annual Homeless Assessment Report (AHAR) • Typical oversight of the HMIS is designated to a subcommittee or working group of the CoC 24 24

HMIS Data Standards 25

Topics for this section Data Elements Privacy Security Data quality 26

HMIS Data and Technical Standards • Homeless Management Information Systems Data and Technical Standards (HMIS Standards) published via Federal Register in 2004 and 2010 define standards for: • Data collection (universal and program data elements) • Privacy • Security • The HMIS Standards define baseline requirements, but also encourage additional Security and Privacy measures. • HMIS Data Standards were revised in 2010; Technical Standards from 2004 are still in place 27 27

HMIS Data Standards 2010 HMIS Data Standards are available at www.HUDHRE.info The source for official HUD guidance on: Definitions of data elements and response categories Frequency with which data must be collected Which clients (adults, children, etc.) data must be collected from Can ask for clarification on the Standards via the HUD Virtual Help Desk at www.HUDHRE.info

HMIS Data Collection Organization Identifier Organization Name Program Identifier Program Name Direct Service Code Site Information Continuum of Care Number Program Type Code Bed and Unit Inventory Information Program Descriptor Data Elements (PDEs) must be entered in HMIS for all programs: • Target Population A (optional) • Target Population B • Method for Tracking Residential Program Occupancy • Grantee Identifier 29 29

HMIS Data Collection Name Social Security Number (SSN) Date of Birth Race Ethnicity Gender Veteran Status Disabling Condition Residence Prior to Program Entrance Universal Data Elements (UDEs) must be entered in HMIS for all clients and include: • Zip Code of Last Permanent Residence • Housing Status • Program Entry Date • Program Exit Date • Personal Identifier (Unique ID) • Household Identifier 30 30

HMIS Data Collection 1. Income and Sources 2. Non-Cash Benefits 3. Physical Disability 4. Developmental Disability 5. Chronic Health Condition 6. HIV/AIDS 7. Mental Health 8. Substance Abuse 9. Domestic Violence 10. Destination Program-Specific Data Elements (PSDEs) must be entered in HMIS by HUD funded programs required to generate an Annual Performance Report (APR) and include: 11. Date of contact 12. Date of engagement 13. Financial Assistance Provided 14. Housing Relocation and Stabilization Services 31 31

HMIS Data Collection 15A. Employment 15B. Education 15C. General Health Status 15D. Pregnancy Status 15E. Veteran’s Information 15F. Children’s Education 15G. Reason for Leaving 15H. Services Provided Optional Program-Specific Data Elements (PSDEs) can be entered in HMIS by HUD funded programs 32 32

Privacy Standards Framework Standards apply to Personal Protected Information (PPI) Includes name, SSN, program entry/exit, zip code of last permanent address, system/program ID, program type; and various combinations of these data in truncated form. Allow for reasonable, responsible data disclosures Derived from principles of fair information practices Borrowed from HIPAA - Health Insurance Portability and Accountability Act 33 33

Baseline Privacy Standards Must comply with other federal, state, and local confidentiality law Must comply with limits to data collection (relevant, appropriate, lawful, specified in privacy notice) Must have written privacy policy - and post it on your web site Must post sign at intake or comparable location with general reasons for collection and reference to privacy policy May infer consent for uses in the posted sign and written privacy policy 34 34

System Security Requirements Common set of baseline security requirements for all HMIS implementations HMIS staff manage most security requirements Security protections include requirements such as passwords, virus protection, firewalls, encryption, and backup and disaster recovery plans. Some local HMIS implementations have additional local requirements. Contact your HMIS administrator for details 35 35

Data Quality Each year the CoC reports to HUD data quality status for HUD required data elements Missing data are elements that have not been entered for a particular client Coverage and Utilization Rates indicate if programs are participating in HMIS and if clients are accurately entered into systems Data quality must be monitored throughout the year, and not just when the CoC reports to HUD 36

Data Quality Resources Based on the practical experiences of CoCs over the last several years, HUD has developed an HMIS Data Quality Toolkit Provides information on data quality best practices, and ideas for processes that could be implemented to improve data quality http://www.hudhre.info/documents/HUDDataQualityToolkit.pdf

Summary of HMIS Standards HUD expects every HMIS to meet the baseline requirements HMIS Data Standards are the source for official guidance on what data must be collected Additional VA specific guidance will be released in 2011 Regularly reviewing data quality is key to a successful HMIS www.HUDHRE.info has several HMIS resources 38 38

VA Data Collection Requirements 39

VA’s baseline expectation for data collection in HMIS… Community-based VA grantees enter the following into HMIS: GPD = Universal Data Elements SSVF = Universal Data Elements + • Income and sources • Non-cash benefits • Destination • Financial assistance provided • Housing relocation & stabilization services provided

VA’s baseline expectation for data collection in HMIS… VAMC Homeless Liaison staff enter the following into HMIS: VASH = Universal Data Elements

VA HMIS Requirements (cont’d) All VA-funded homeless assistance programs will continue to submit client-level data to the VA. VA will provide additional information in the coming months about the periodic extracts of HMIS data about persons served by VA-funded programs. These extracts will be integrated into existing VA data systems. HUD does not expect CoCs to disclose client-level data to the VA about Veterans served in non VA funded programs

VA Plan for HMIS 43

Topics for this section VA Data Collection Strategy HOMES VA Homeless Registry 44

VA Data Collection Strategy

Homeless Operations Management and Evaluation System (HOMES) • The VA recently began development of HOMES to facilitate and integrate the collection of standardized client-level case management and detailed health services information from programs that serve homeless veterans. • The goal of HOMES is to enable the centralized management of data from all homeless veterans served in VA-funded programs and to make those data accessible for analysis and reporting.

VA’s Homeless Registry • VA’s Homeless Registry will serve as a data warehouse for veteran homeless services, identifying and monitoring the utilization and outcomes for VA funded homeless services. • Registry will enhance VA’s capacity to monitor program effectiveness and the long term outcomes of veterans who have utilized VA programs and other federally funded services.

Process and Next Steps for Getting Started 48

Next Steps: Contact HMIS StaffContact your local CoC and HMIS project staff. VAMC Homeless Liaison as well as GPD partners must contact the appropriate CoC HMIS point of contact to determine necessary next steps to begin HMIS participation. A list of local CoC HMIS points of contact can be found at the following www.hudhre.info website: http://www.hudhre.info/index.cfm?do=viewCocContacts

Next Steps: • Assess Participation CostsHMIS project staff and CoC leadership must assess what the costs will be for adding VA-funded homeless assistance programs (similar to HPRP process).

Comprehensive HMIS Training for G&PD Staff and Agencies