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Linking HMIS With Mainstream Healthcare Databases

Linking HMIS With Mainstream Healthcare Databases. Evan Scully , Homeward Michael Shank, Virginia DMHMRSAS. Greater Richmond Continuum of Care. Planning District 15 Independent City of Richmond and counties of Charles City, Chesterfield, Goochland, Hanover, Henrico, New Kent, and Powhatan.

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Linking HMIS With Mainstream Healthcare Databases

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  1. Linking HMIS With Mainstream Healthcare Databases Evan Scully, Homeward Michael Shank, Virginia DMHMRSAS

  2. Greater Richmond Continuum of Care Planning District 15 Independent City of Richmond and counties of Charles City, Chesterfield, Goochland, Hanover, Henrico, New Kent, and Powhatan Population ≈ 1 million: 84% urban, 16% rural 1,158 people found homeless January 25th, 149 found unsheltered

  3. Commonwealth of Virginia • Factors in Virginia: • Little government funding for housing issues • Independent cities isolate urban issues from surrounding counties • Medicaid won’t cover primary diagnosis of Substance Abuse Richmond Population ≈200,000 million, 100% urban

  4. Homeward Richmond’s Regional Response to Homelessness • Non-profit founded in 1998 following the report of a city Task Force on Homelessness • Original funding included HHS ACCESS demonstration grant • Small planning and coordinating agency - no direct services • Diverse board • Manages the HMIS • Coordinates the annual Point In Time count • Convenes Continuum of Care committee and generates COC application

  5. Early Findings Comparable to cities of similar size • Most persons who are homeless in Greater Richmond have lived in the area for ten years or more. Under 1 year (21%), 1-10 years (28%), 11-20 years (11%), 21-30 years (9%), Over 30 years (31%) • A high proportion of homeless adults, especially single men, have at least one felony conviction. All persons (37%), Adults in families (12%), Single adults (41%), Single Men (48%), Single women (17%) Local governments need local data! (National statistics don’t vote)

  6. Homeward Community Information System (HCIS) - Gender

  7. Homeward Community Information System (HCIS) - Race

  8. Linking HMIS With Mainstream Healthcare Databases • Homeward Community Information System (HMIS) • HMIS identifies 7,649 Richmond-area individuals enrolled in homeless services • 9,218 records less 1,439 missing or invalid SSNs less 130 duplicate entries (from 1/1/2003 through 6/30/2006) • Records the date of enrollment as documentation of an episode of homelessness • Virginia Health Information (VHI) Database • VHI identifies 231,275 Richmond-area individuals in inpatient hospital care (from 1/1/2001 through 3/31/2006) • Includes 21,115 people in inpatient psychiatric care

  9. Non-HMIS Hospital Stays – Patients & Bed Days

  10. HMIS Hospital Stays – Patients & Bed Days

  11. Overlap found between HMIS and VHIDatabases PD 15 Homeless Services Local Hospital 2,540 7,649 231,275 20% of General Population In PD15 33% Of Homeless Population

  12. Length of Hospital Stay (LOS) Avg. Bed Days Used Over 5 year period Statewide = 10.0 PD 15 Non-HMIS = 11.7 HMIS = 21.0

  13. Non-HMISHospital Use by Major Diagnostic Category

  14. HMISHospital Use by Major Diagnostic Category

  15. HMIS Hospital Use Pre- and Post- HMIS Entry

  16. Linking HMIS With Mainstream Healthcare Databases • Homeward Community Information System (HMIS) • HMIS identifies 7,649 people enrolled in homeless services • Virginia Health Information (VHI) Database • VHI identifies 231,275 people in inpatient hospital care • Includes 21,115 people in inpatient psychiatric care • Community Services Boards (CSB) Database (CCS) • CCS identifies 33,507 people enrolled Richmond-Area Behavioral Healthcare • Consumers of Mental Health and Substance Abuse services

  17. Overlap found between HMIS, CSB and VHIDatabases PD 15 CSB Services Local Psych Hospital 7,300 33,507 21,115 660 1,479 1,123 CSB Consumers with Local Psych Hospital Non-HMIS = 22.8% HMIS = 44.6% PD 15 Homeless Services 7,649

  18. HMIS – by MDC – Pre- and Post- HMIS Entry

  19. PD15 Hospital Cost - 4 Quarters Surrounding HMIS EntryMental Health and Co-occurring Illnesses (n=208)

  20. PD15 Hospital Cost - 4 Quarters Surrounding HMIS EntryMental Health and Substance Abuse, or Mental Health and Respiratory Illness, or Mental Health and Trauma and Infections

  21. PD15 Hospital Cost – 4 Quarters Surrounding HMIS Entry“Revolving Door” Psychiatric Admissions

  22. DMH Funding for Housing First February 8, 2007 George Braunstein Executive Director Chesterfield CSB PO Box 92 Chesterfield, VA 23832 Dear Mr. Braunstein: We are pleased to announce that the DMHMRSAS will support the Region IV Housing First project, A Place to Start, with a $50,000 challenge grant that was matched through private fundraising efforts and with an additional one time grant of $400,000 to support that program’s start up costs. These funds are provided through Virginia’s Federal Mental Health Block Grant (MHBG).

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