1. 1 Homeless Management Information System (HMIS) Training for G&PD Staff and Community Agencies 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.comVAHMIS@abtassoc.com Sponsored by: U.S. Department of Veterans Affairs

2. 2 2 Training Objectives: Participants will… 1.understand core concepts of a Homeless Management Information System (HMIS) 2.be able to identify the intersections between HMIS and the work of the VA, including the VA’s Strategic Plan 3.know the necessary next steps to start HMIS participation, as well as the resources available to support participation

3. 3 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

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

5. 5 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

6. 6 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.

7. 7 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.

8. 8 8 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.

9. 9 9 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.

10. 10 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

11. 11 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

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

13. 13 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

14. 14 Existing Resources on HMIS HMIS.info ▫www.HMIS.infowww.HMIS.info ▫Historical information on HMIS, as well as technical resources HUD Homelessness Resource Exchange: www.HUDHRE.infowww.HUDHRE.info ▫Copies of presentations from 2010 HUD conference, many covering HMIS 2010 HMIS Data Standards ▫http://www.hudhre.info/documents/FinalHMISDataStandards_ March2010.pdfhttp://www.hudhre.info/documents/FinalHMISDataStandards_ March2010.pdf

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

16. 16 Strategic Efforts to End Veteran Homelessness 1.VA 5 Year Plan to End Veteran Homelessness 2.VA Strategic Plan for 2010-2014 3.United States Interagency Council on Homelessness’ (USICH) “Opening Doors: Federal Strategic Plan to End Homelessness” 4.Local Ten Year Plans to End Homelessness 5.National Center on Homelessness Among Veterans All of these efforts require accurate and timely data describing extent and scope of veteran homelessness.

17. 17 VA’s Five Year Plan to End Homelessness Among Veterans Announced on November 3 rd, 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

18. 18 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.”

19. 19 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

20. 20 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_Pla n.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

21. 21 Relationship of HMIS Projects to Local CoC

22. 22 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

23. 23 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

24. 24 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

25. 25 HMIS Data Standards

26. 26 Topics for this section Data Elements Privacy Security Data quality

27. 27 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

28. 28 HMIS Data Standards 2010 HMIS Data Standards are available at www.HUDHRE.info 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.infowww.HUDHRE.info

29. 29 HMIS Data Collection 1.Organization Identifier 2.Organization Name 3.Program Identifier 4.Program Name 5.Direct Service Code 6.Site Information 7.Continuum of Care Number 8.Program Type Code 9.Bed and Unit Inventory Information 9.Target Population A (optional) 10.Target Population B 11.Method for Tracking Residential Program Occupancy 12.Grantee Identifier Program Descriptor Data Elements (PDEs) must be entered in HMIS for all programs:

30. 30 HMIS Data Collection 1.Name 2.Social Security Number (SSN) 3.Date of Birth 4.Race 5.Ethnicity 6.Gender 7.Veteran Status 8.Disabling Condition 9.Residence Prior to Program Entrance 9.Zip Code of Last Permanent Residence 10.Housing Status 11.Program Entry Date 12.Program Exit Date 13.Personal Identifier (Unique ID) 14.Household Identifier Universal Data Elements (UDEs) must be entered in HMIS for all clients and include:

31. 31 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 11. Date of contact 12. Date of engagement 13. Financial Assistance Provided 14. Housing Relocation and Stabilization Services Program-Specific Data Elements (PSDEs) must be entered in HMIS by HUD funded programs required to generate an Annual Performance Report (APR) and include:

32. 32 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

33. 33 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

34. 34 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

35. 35 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

36. 36 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

37. 37 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/HUDDataQualityTool kit.pdfhttp://www.hudhre.info/documents/HUDDataQualityTool kit.pdf

38. 38 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 resourceswww.HUDHRE.info

39. 39 VA Data Collection Requirements

40. 40 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

41. 41 VA’s baseline expectation for data collection in HMIS… VAMC Homeless Liaison staff enter the following into HMIS: VASH = Universal Data Elements

42. 42 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

43. 43 VA Plan for HMIS

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

45. 45 VA Data Collection Strategy

46. 46 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.

47. 47 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.

48. 48 Process and Next Steps for Getting Started

49. 49 Next Steps: 1.Contact HMIS Staff Contact 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:www.hudhre.info http://www.hudhre.info/index.cfm?do=viewCocContacts

50. 50 Next Steps: 2.Assess Participation Costs HMIS project staff and CoC leadership must assess what the costs will be for adding VA- funded homeless assistance programs (similar to HPRP process).

51. 51 Next Steps: 3.Review federal HMIS participation requirements Review the 2010 HMIS Data Standards to understand the HMIS requirements for data collection Review the 2004 HMIS Data and Technical Standards to understand the security and privacy standards for HMIS Check the www.HUDHRE.info page for updates on HMIS, and to learn more about HMIS participation expecationswww.HUDHRE.info

52. 52 Next Steps: 4.Review locally-specific participation requirements Discuss the following with your HMIS implementation: ▫What are the participation costs? ▫Are software and/or reporting licenses required? ▫What training or technical support is available? ▫What participation agreements are required? ▫What are the local data collection, privacy, security, and data quality requirements beyond any federal baseline standards?

53. 53 Questions, Technical Assistance Resources, and a short Quiz!

54. 54 Resources Questions about HMIS participation of VA-funded programs should be submitted to the Virtual Help Desk on the HUD HRE (www.hudhre.info). Virtual Help Deskwww.hudhre.info

55. 55 Resources (cont’d) Questions about the VA’s Strategic Plan should be sent to John Kuhn at John.Kuhn2@med.va.gov John.Kuhn2@med.va.gov Questions about the VA’s HMIS Plans should be sent to the www.HUDHRE.info virtual help desk or you can email questions directly to VAHMIS@abtassoc.comwww.HUDHRE.info VAHMIS@abtassoc.com