HMIS 301: Advanced HMIS

1. HMIS 301: Advanced HMIS Improvement through Innovation

2. Agenda • Program Evaluation • Client Level Database • Self Sufficiency Matrix • Innovative ways to collect data • AIRS Taxonomy/data mapping • Other questions?

3. Innovation in Program Evaluation • Show what works to improve PATH participant outcomes • Showcase effectiveness of program to community and funders • Improve staff to client interaction • Help plan for the future • Build knowledge of program, outcomes and processes • Identify unmet needs and gaps in service delivery • Inadequate funding for services, lack of service coverage in rural areas

4. HMIS Client Database • Detailed, client level data about everyone served • Track program entries/exits and PATH project interventions • Ability to look at client data individually, in aggregate and longitudinally • Current status and trends • Develop detailed and customized reports, charts • Develop report libraries for reuse • Produce PATH Annual Report

5. Innovation in Data Quality • Computers will unquestionably process the nonsensical data (garbage in) and produce nonsensical output (garbage out) • Data Good – Bad Data Bad: its all about data quality • Produce an accurate story of annual PATH program activity • Example Strategies: • Provider data quality report card, published so all providers can see who is most successful • Link payment to HMIS data • Reporting Tools:  Missing data reports (name, demographics, services provided) • Develop required fields that must be completed • On-going training and technical assistance – 30% staff turnover in PATH reporting staff from 2008 to 2009

6. Evaluation measures • Length of Stay (LOS) • Exit destination - positive destination • Demographic (age, race, gender) analysis • Income and employment • Funding and availability of services and supports • Service bundles provided leading to positive outcomes  • Enhanced case management and follow up • Recidivism rates for people returning back to homelessness

7. Advanced features of HMIS for Monitoring Programs • Detailed client based information on everyone served by PATH • Real-time access to data for reporting and analysis • Record detailed client profiles, assessments, referral, historical information, and outcome measurements • Generate reports for internal use, reporting to funders and community organizations • . 

8. Self Sufficiency Matrix Two key features • 18 domains in the Matrix • Client's status on each domain is measured on a 5 point scale • Provides standardized outcomes measurement • Measurement taken at program entry and periodically to measure progress

9. Self Sufficiency Matrix History Developed by the Arizona Homeless Evaluation project, the Self Sufficiency Matrix has been tested for validity and reliability A matrix is completed for each adult in the household who is age 18 or older Data is analyzed to measure participants progress In use for more than six years

10. Domain Scale 1. Income 1 = In Crisis 2 = Vulnerable 3 = Safe 4 = Building Capacity 5 = Empowered 2. Employment 3. Housing 4. Food 5. Childcare 6. Children’s Education 7. Adult Education 8. Legal 9. Health Care 10. Life Skills 11. Mental Health 12. Substance Abuse 13. Family Relations 14. Mobility 15. Community Involvement 16. Safety 17. Parenting Skills 18. Credit (Optional)

11. Example Using the Matrix 17 Domains of Participant Self-sufficiency When Data Are Collected: Upon any program entry and at program exit. Transitional housing programs must also collect the information every 3 months after entry. Permanent housing programs must collected the data set every 6 months after entry. Subjects: All persons over the age of 16

12. Self-Determination and Skills - Income Income 1. No Income 2. Inadequate income and/or spontaneous or inappropriate spending. 3. Can meet basic needs with subsidy; appropriate spending. (If the client is receiving income supports like SSI, but still lacks enough income to meet all basic expenses use a 3 rating) 4. Can meet basic needs and manage debt without assistance. (If the client is receiving income supports like SSI, and is able to balance their budget use 4) 5. Income is sufficient, well managed; has discretionary income and is able to save.

13. Does the client have income? #1 No Self-Determination and Skills - Income Is the income adequate to at least meet basic needs? #2 No Can client meet basic needs without assistance? #3 No Does client have discretionary income and can save? #4 No #5

14. Innovative ways to collect data • How to collect data out of doors, under bridges, and other places not computer friendly: • Scannable forms processing:  design scannable paper form that can be faxed and converted to electronic format. • Portable computers (laptops, netbooks, smartphones) to collect data and transmit to central database • Wireless connection to database for real-time collection using portable computers • Digital imaging • Client Id cards for clients

15. AIRS Taxonomy - What is it? • AIRS = Alliance for Information and Referral Systems, a national association, develops standards and definitions for information and referral agencies. • Taxonomy is a standard used by agencies to communicate human services in a standard language across program areas. • Each service has a term, code and description: • Term:  rent payment assistance • Code:  BH-3800.7000 (B= Basic Need, H=Housing/Shelter, 3800=Housing Expense Assistance) • Description: "Programs that make rental payments for people who are at risk of eviction without assistance.  Rent payment assistance programs may have age, income, disablility, need or other eligibility requirements."

16. Required by HMIS implementations Standardizes reporting across programs for better analysis, accountability and reporting. No more apples and oranges  Supports accreditation and certification Improves program quality through better data and reporting Allows for measurement of PATH activities within programs and across jurisdictions Updated and supported on a regular basis Why use AIRS?

17. Michigan's Use of AIRS for PATH

18. PATH Outreach Services (Ca) Outreach Programs (TJ-6500.6300) Street Outreach Programs (PH-8000) Information and Referral (TJ-3000) PATH Screening and Diagnostic (Cb) Mental Health Evaluation (RR-5000) Habilitation and Rehabilitation (Cc) Rehabilitation/Habilitation Services (LR) Community MH Services (Cd) Psychiatric/Mental Health Support Services (RR) Alcohol or drug treatment (Ce) Substance abuse Services (LX) Staff Training (Cf) Job Training Formats (ND-2000.3500) PATH Report to AIRS Mapping

19. PATH Case Management (Cg) Case/Care Management (PH-100.450) Psychiatric Case Management (RR-6500) PATH Supportive/supervisory services (Ch) Basic Needs (B) PATH Referrals (Ci) Health Care Referrals (LH-2600) Housing Search and Information (BH-3900) Job Training Resource Lists (ND-2000.3510) Educational Support Services (HL) PATH Housing services (Cj1) Home Rehabilitation Services (BH-3000.3550.390) PATH Housing services (Cj2) Housing Counseling (BH-3700) Mapping continued

20. Questions? • David Youngs • dave@dynsinc.com • James McNemar • jmcnemar@center4si.com