A Plan, Not A Dream: How to End Homelessness in Ten Years. Planning for Outcomes

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1 A Plan, Not A Dream: How to End Homelessness in Ten Years Planning for Outcomes Since the demographics of homelessness, and therefore its solutions, vary in every locality, ending homelessness will require the development of local plans to systematically and quickly re-house those who lose their housing. The replacement housing should be permanent -- having no artificial limits on how long a person can stay. If an individual or family requires some type of temporary housing such as residential treatment (for illness) or residential separation (for victims of domestic violence, for chronically homeless people, for people in recovery) such interim housing should be firmly linked to eventual placement in permanent housing. In order to develop local systems that do not tolerate homelessness, two things must happen. Accurate administrative data must be developed to understand the nature of homelessness and its solutions, and long range planning must take place with the goal of ending homelessness (defined as getting people into permanent housing). DATA Every jurisdiction needs solid information on who is homeless, why they became homeless, what homeless and mainstream assistance they receive and what is effective in ending their homelessness. This information is needed on a city- or state-wide basis, not just a program-by-program basis. This allows trends to be monitored to determine what is causing homelessness, to assess what types of assistance are available to address homelessness, and to fill the resulting gaps. Questions that can be answered with such data include: With what mainstream public systems have homeless people interacted, and did this interaction result in homelessness (example: poor discharge planning, inadequate after-care, etc.)? How many units of supportive housing are needed to eliminate chronic homelessness? For those who enter and exit the system fairly quickly, what assistance is most effective in facilitating their re-housing? What mainstream services do families need after they are housed so that they do not become homeless again? Columbus, Ohio faced the need to relocate two downtown shelters due to a redevelopment effort. The Community Shelter Board had developed a jurisdiction-wide data collection system which showed that some 300 men more or less lived in these shelters - the chronically homeless. Rather than relocate these individuals to new shelters, Columbus will create permanent supportive housing (housing with services) to house them. This will reduce the need for replacement shelter National HMIS Conference Page 1

2 Surprisingly, very few places have this kind of fundamental data upon which to base decisions. Accordingly, the approach to homelessness is more often intuitive and general than strategic and outcome driven. Planning At present, there is very little local planning to end homelessness, utilizing the full range of resources that is available at the local and state levels. A first step toward such an effort, the Continuum of Care process of applying for funds from the U.S. Department of Housing and Urban Development, has succeeded in increasing the level of cooperation and analysis at the local level. But genuine planning efforts are still rare. Local planning should go beyond the effort to create a full spectrum homeless assistance system which manages people's experience of homelessness. Local jurisdictions should develop long term plans whose goal is to immediately re-house anyone who becomes homeless. Such a system will involve agencies and programs far beyond the scope of the homeless assistance providers. The following agencies should be involved in local (and state) planning to end homelessness. State/local mental health department Mental health providers State/local public health department Health care providers State/local corrections department State/local veterans affairs department State/local labor or employment department Employment services providers Employers State/local substance abuse department Substance abuse providers Homeless assistance providers Governor's/Mayor's office County official(s) State/local public assistance department State/local housing department Nonprofit housing developers/operators For-profit housing developers/operators The San Francisco/Oakland Bay Area has undertaken a major planning effort to coordinate the response to homelessness. Mental health, public health, housing and other agencies - both public and nonprofit sector - have been involved. An integrated strategy for addressing homelessness has resulted. The Homeless Assistance Centers (HACs) in Miami/Dade County, Florida are replacing the area's shelter system. All homeless people go through intake and assessment in these large centers. Their immediate needs are met, but the goal is to assess and evaluate overall needs and re-house people immediately in either permanent housing or a residential service program - to reduce the length of their homeless experience. National HMIS Conference Page 2

3 City of Philadephia HMIS History In 1991 Philadelphia initiated a data system to keep track of shelter use, utilizing the City s existing information technology. It initiated the program because it needed much more specific data on shelter use for billing purposes, and because it needed better information to improve program design. Information on homeless people and shelter use has been kept since that time, with periodic improvements in hardware, software and methods of data collection. Vision The Philadelphia system covers City-funded programs. The data that is currently collected about homeless clients is used to allocate resources, to conduct performance based contracting (and thus to look at client outcomes), and to look at trends in numbers and demographic characteristics. The City is constantly improving its HMIS system. Currently it is shifting to a system that better integrates data on homeless clients with data on other human service programs via what will be a social services data warehouse. This is in part to implement Mayor Street s vision for a collaborative case management system. Data Elements and Process The system is collecting two types of information: Client demographic information Shelter stay history With respect to confidentiality for specific groups (HIV/AIDS, domestic violence, etc.), the decision about how to handle the data in such cases is made through a due diligence process to determine an appropriate protocol. Philadelphia s system is based upon centralized intake. Potential users of the City shelter system come to one of two sites (or several off-hour sites). One site is for families and single women, and the other is for men. At these sites an intake is performed, and clients are assigned to a shelter. (The intake centers do not share their intake information with the shelters, so most shelters conduct another intake when the client arrives.) The demographic data, therefore, comes from the intake centers. The shelter stay history is received from the shelters. The shelters submit a summary report at the end of each month. This provides information on how many nights each individual has stayed at the shelter. This is the basis of billing for the shelter, and of course also provides the City with data. National HMIS Conference Page 3

4 People in transitional housing are not included in the data system being discussed here. There is another, similar, system that captures data from the City-funded transitional programs. However, many of the clients in the transitional system arrived there via the shelter system, and thus their demographic data is captured by the shelter data system. Agency Participation: All of the City-funded shelters participate. It is estimated that the majority of people who become homeless are included in the system. Staffing: Seven full time staff people work in the department that handles the data. Their job is to make sure the data comes in and is analyzed, maintain the mainframe, keep track of the hardware (some 300 computers), and ensure that everyone is trained. Staff includes a director, a programmer, a business analyst, and hardware technicians. In addition, there are several hundred people who collect data. Resources: The City pays for this system with its own funds supplemented by state and federal resources. Anyone who is involved in collecting or working with the data receives training arranged by the Information Technology office. Analysis and Interaction with Other Systems: The Information Technology office analyzes the data generally. However others, including researchers, also analyze the data. When data is given to researchers, either the clients are asked to sign research protocols, or the City blinds the data (make it anonymous). When the data is placed in the data warehouse, the City will be able to cross analyze it with other systems within the warehouse. At present this can only be done by cross-referencing identifiers, which is done under the provisions noted above. Lessons Learned: Having data helps with fundraising. Not only is the City able to provide ready data to funding processes such as the Continuum of Care, but grantors like the idea that the City is paying attention to how the money is being used. Centralized intake is helpful for data collection and purity, but you have to have good systems in place for security, because you have a larger universe of users. When setting up a system, do as much planning as you can. Find out in detail what businesses processes you need, what could be improved by automation, and what could not. Don t look at the software first and then try to fit your needs into it. Decide what your needs are first, and then go shopping for software. When dealing with software and hardware vendors, make sure that the roles and responsibilities are clearly delineated (installation, maintenance, etc.) The same is true after the system is up. Once the system is in place, make sure the technology people understand how the users are using it. This will ensure that the system is enhanced to meet real needs. Recognize that social services data is very fuzzy. Technology people who have not worked in the human services field will find this difficult at first. National HMIS Conference Page 4

5 For more information: Matthew Berg Information Technology Manager Office of Emergency Shelter and Services City of Philadelphia Massachusetts Housing and Shelter Alliance Census When seeking to prevent homelessness, it is important to know and quantify where homeless people come from. Such data would indicate where prevention efforts could be productive. One source of homeless people is public systems of care or custody. The Massachusetts Housing and Shelter Alliance (MHSA), which seeks to end homelessness for single adults in Massachusetts, has collected nightly census data from adult shelters in the state since Beginning in 1997, it began a Subpopulation Census: the collection of shelter based data on new guests entering from certain specific state systems of care, treatment and custody. This data indicates which public systems of care are discharging people into shelter. MHSA recommends this data collection system as an important tool to address homelessness. It is relatively simple, since shelters already collect the information -- MHSA simply collates it statewide. This subpopulation census provides the basis for much of MHSA's work in understanding the routes into homelessness from state systems without adequate or appropriate discharge planning practices, protocols, or residential resources. Attached is an example of the subpopulation outcomes and a sample data collection tool that can be adapted to local issues and circumstances. The MHSA form is changed only in January of each year and is kept to a one-page limit. Shelters complete it monthly and forward it to MHSA to be aggregated into monthly and annual reports. Providers receive an annual updated list of facilities and categories so that they can amplify answers self-reported by guests. For an example of the questionnaire used by MHSA, go to For am example of the report that can be generated with the data go to For more information, contact: Massachusetts Housing and Shelter Alliance 5 Park St. Boston, MA Phone: (617) Fax: (617) info@mhsa.net National HMIS Conference Page 5

6 The City of Spokane Homeless Management Information System To effectively address the needs of their homeless population, communities must be able to count the number of homeless individuals and gain a better understanding of the challenges those individuals face. In 1995, the Human Services Department of the city of Spokane, WA took on the challenge of counting the homeless and began developing a Homeless Management Information System (HMIS) that contains a database and a Homeless Coalition Web site. Spokane's HMIS was designed to achieve an accurate count of homeless individuals living in the city in order to better understand their needs and to improve communication among homeless providers. Spokane's Human Services Department has now received nationwide attention for its success in developing the database. In 1998, the system received the John J. Gunther Best Practices Blue Ribbon Award from HUD and the Association of Washington Cities Municipal Achievement Award. Since 1999, the Human Services Department has worked with the University of Pennsylvania on numerous reports about the prevalence of homelessness, and on a report on the effects of welfare reform. Developing the System From the beginning, the Spokane's Human Services Department collaborated with organizations that help the homeless to develop Spokane's data intake system. The collaboration resulted in the installation of a networked, computerized system and the creation of standardized forms - intake, assessment, discharge, and follow-up - that homeless providers use when working with each homeless client or household. When a homeless person seeks services at any of the participating organizations, she must complete an intake form or a contact log form. Those who participate in more intensive services, such as case management or sheltering, must complete the detailed assessment form at intake and again at discharge. All forms are then entered into Spokane's centralized system. The data is used to measure needs and outcomes over time as the homeless transition through the various services. To include those who do not routinely connect to services, multi-agency outreach teams systematically canvass places where homeless people gather, complete contact log forms for those they meet, and enter the information in the database. The Human Services Department also maintains a Web site that provides professionals with updated client data from the intake system and information about specific homeless services available to clients. For example, the Web site provides information on the target population of certain service providers and on daily shelter vacancies. National HMIS Conference Page 6

7 The Core and Unique Features Since its inception in 1995, the number of organizations reporting to the database has increased steadily, enabling the system to capture and track more information about the homeless population in Spokane. In 2001, Spokane made significant improvements to the system that included updating the intake and assessment forms to add specific geographic information and to track needs within specific communities and neighborhoods. Some of the core and unique features of the system are as follows: To ensure confidentiality and build trust, no names are used in the system; client information is matched by birthday, initials, and gender. The HMIS methodology allows the user to create unduplicated counts and household and demographic descriptions based on user-defined parameters. Further, Spokane has developed strategies for generating both "time interval" and "single point in time" unduplicated counts. Survey forms are not static and are designed for use in a variety of settings. The committee that regularly reviews and redesigns the forms is comprised of people from organizations that provide a variety of services to the homeless. The HMIS has been used successfully to respond to a wide variety of public policy needs, as well as planning, reporting, and evaluation at both the provider and the government levels. The city routinely uses HMIS data to complete HUD's Annual Progress Report forms and annual reporting for other grants received, as well as to provide support for various community development plans. The HMIS uses Microsoft Access for the development of the forms and the database, making it a highly flexible and simple system that does not require ongoing consultant support to modify and update. Spokane's system can be implemented and maintained at a lower cost than a more technologically complex system. Still, the database accommodates a wide range of sophistication among participating organizations. Capabilities of the System Using HMIS, Spokane can generate statistics like these, which were gathered for calendar year 2001: 8,817 individuals and 5,989 households were homeless during ,074 homeless adults, 311 youth living independently, and 2,432 children were counted. 2,244 homeless individuals represented ethnic or racial minorities. Native Americans constituted the greatest percentage of homeless individuals by ethnicity. 4,248 households did not report income or reported having no income, 524 received Technical Assistance for Needy Families or Assistance for Families with Dependent Children, and 356 households were employed. 417 homeless households reported having served in the military. National HMIS Conference Page 7

8 In addition to demographic information, Spokane's HMIS provides housing, employment, education, training, health care, and employment exit and outcome data that can be used by community planners, government officials, and funders. Measuring homelessness has traditionally been either incomplete or largely anecdotal. The Spokane Human Services Department has taken a large step in counting the homeless and quantifying poverty in their region-the first step toward understanding the needs of this community and providing appropriate services to help them out of homelessness and into a more stable situation. For more information, contact: City of Spokane Human Services Department, (509) National HMIS Conference Page 8