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

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

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

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

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

PAST DUE: PATH & HMIS Integration Chris Pitcher Mike Lindsay Ryan Burger SAMHSA Policy SAMHSA released formal HMIS participation guidance in 2015 https://www.hudexchange.info/news/technical-assistance-plan-for-path-program-participation-in-hmis/ 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

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)

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

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

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 1.1.2017 The new PATH Annual Report will: Correct known errors in the previous HMIS program specifications Implement SAMHSA reporting changes

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

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

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

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

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

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

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)

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

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.

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)

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”

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

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

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

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

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

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

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

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

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

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?

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

PAST DUE: PATH & HMIS Integration Chris Pitcher Mike Lindsay Ryan Burger Contact Information Chris Pitcher, Senior Technical Specialist ICF International (202) 374-3380 chris.pitcher@icfi.com Mike Lindsay, Senior Technical Specialist ICF International (724) 255-5180 michael.lindsay@icfi.com Ryan Burger, Technical Specialist ICF International (412) 354-0407 ryan.burger@icfi.com