PATH Program HMIS MANUAL

Transcription

1 PATH Prgram HMIS MANUAL A Guide fr HMIS Users and System Administratrs Released Nvember 2017 U.S. Department f Husing and Urban Develpment 2017 Versin 1.1

2 Cntents Release & Update Infrmatin... 1 Intrductin... 2 HMIS Related Dcuments... 2 HMIS Data Standard Dcuments... 3 Definitin f Terms... 4 HMIS Prject Setup... 5 Identify Prjects fr HMIS Participatin... 5 Identify Prject Funding Cmpnents... 6 PATH Prject Descriptr Data Elements... 6 PATH Data Cllectin Requirements... 9 Data Element P1 Services Prvided- PATH Funded Data Element P2 Referrals Prvided- PATH Special Data Cllectin Instructins PATH Reprting Ntes: PATH Data Cllectin Wrkflw HUD System Perfrmance Measures Attachment A: State PATH Cntact HMIS Data Cllectin Decisin Tl Intrductin: Sectin 1: SPC Decisin Pints Definitins: Sectin 2: SPC & CC Data Cllectin Crdinatin Definitins:... 24

3 Release & Update Infrmatin Versin Date Update 1 March 2015 First Release 1 December 2016 Secnd Release 1 September 2017 Third Release 1.1 Nvember 2017 Minr update in Cmmn Data Elements P1 and P2 cllectin pints 1 P a g e

4 Intrductin The PATH (Prjects fr Assistance in Transitin frm Hmelessness) Prgram HMIS Manual is intended t supprt data cllectin and reprting effrts f Hmeless Management Infrmatin System (HMIS) Lead Agencies, State PATH Cntacts and PATH Prgram grantees. PATH Prgram participatin in HMIS prvides fr client care crdinatin and the generatin f the PATH Annual Reprt, in additin t ther benefits t clients and PATH Prgram grantees. This manual prvides infrmatin n HMIS prject setup and data cllectin guidance specific t the PATH Prgram. The guidance prvided in this dcument aligns with requirements arund using HMIS as stated by the Substance Abuse and Mental Health Services Administratin (SAMHSA) and refers t the data elements required fr PATH t enter in an HMIS as established in the 2017 HMIS Data Standards Versin 1.2. This dcument is nt intended t replace the HMIS Data Dictinary r the HMIS Data Manual, but t cmplement them and relate PATH Prgram-specific requirements. This dcument is nt a replacement fr any specific prgram guidance, requirements, regulatins, ntices, and training materials n the PATH Prgram. This manual nly addresses the use f HMIS fr the PATH Prgram. Fr additinal assistance, please refer t the fllwing guidance abut the PATH Prgram and its requirements that can be fund n the PATH Prgram page: PATH Annual Reprt Manual PATH HMIS Participatin Guidance State PATH Cntact HMIS Self-Assessment PATH Data Exchange (PDX) T ask a questin abut any PATH Prgram HMIS requirement, g t the Ask A Questin sectin f the HUD Exchange. Please be sure t select HMIS fr yur questin under My Questin is Related T. Federal HMIS and PATH Prgram staff are wrking tgether t answer questins submitted n Ask A Questin related t PATH and HMIS. If yu encunter a PATH related questin that is specific t the PATH Data Exchange (PDX), then g t the Ask A Questin sectin f the HUD Exchange. Please be sure t select PDX fr yur questin under My Questin is Related T. HMIS Related Dcuments There are a variety f dcuments that cmprise the suite f HMIS Data Standard resurces. All HMIS Data Standard related dcuments updated and released in the fall f 2017 are labeled 2017 Versin 1.2 t supprt versin cntrl at all levels f use. Each f the dcuments has a specific purpse and intended audience. The HMIS Lead designated by each CC shuld be familiar with all f the dcuments and cllectively use them as their HMIS reference materials alng with specific materials prvided by the sftware vendr. A full listing f the HMIS Lead fr each CC can be fund n the HUD Exchange. 2 P a g e

5 HMIS Data Standard Dcuments The Data Standard Dictinary and Manual cntain the cre fundatins fr the data cntained within an HMIS. The PATH HMIS Manual builds upn infrmatin in the Data Dictinary t prvide further infrmatin fr an HMIS Lead n the elements required by PATH prjects fr set up in the HMIS. Manual Name & Link Intended Audience Cntents HMIS Data Standards Dictinary HMIS Data Standards Manual HMIS Standard Reprting Terminlgy Glssary HMIS Vendrs & HMIS Lead Agencies HMIS Lead Agencies & HMIS Users HMIS Lead Agencies The dictinary prvides the detailed infrmatin required fr system prgramming n all HMIS elements and respnses required t be included in HMIS sftware. It delineates data cllectin requirements, system lgic, and cntains the XML and CSV tables and numbers. The dictinary als includes critical infrmatin abut data cllectin stages, federal partner data cllectin required elements, and metadata data elements. The manual prvides a review f all f the Universal Data Elements, Prgram Specific Data Elements, and Prject Descriptr Data Elements. It cntains infrmatin n data cllectin requirements, instructins fr data cllectin, and descriptins that the HMIS User will find as a reference. The HMIS Standards Reprting Terminlgy Glssary is the standard reprt dcument fr HMIS implementatins. The glssary is designed t prvide HMIS and their prgrammers a fundatin fr HMIS-required reprts. 3 P a g e

6 Definitin f Terms PATH prviders cnducting street utreach may encunter challenges related t HMIS data cllectin due t factrs such as the infrequency f cntacts r the length f time it takes t cllect accurate infrmatin frm a client, amng thers. The data cllectin prcess is designed t supprt PATH prjects as they cnnect t individuals and families that are experiencing hmelessness, and as relatinships are built between the street utreach wrker and the client. A number f key terms specific t the PATH Prgram are defined belw: Prject Start Date: Is the date f first cntact between the PATH-funded wrker and the client. Cntact: An interactin between a PATH-funded wrker(s) and an individual wh is ptentially PATH eligible r enrlled in PATH. Cntacts may range frm a brief cnversatin between the PATH-funded wrker and the client abut the client s well-being r needs, t a referral t service. A cntact must always include the presence f the client the facilitatin f a referral between a PATH-funded wrker and anther case manager r service prvider withut the invlvement f the client wuld nt be cnsidered a cntact. A cntact may ccur in a street utreach setting r in a service setting such as an emergency shelter r drp-in center. Engagement: The pint at which an interactive client relatinship results in a deliberate client assessment r the beginning f a case plan. Engagement is a ne-time event, may ccur n r after the prject start date, and must ccur prir t PATH enrllment and prject exit. Clients cannt be enrlled in PATH withut being engaged. Althugh sme interactins with a client may result in a psitive utcme such as assisting a client t access a shelter bed, withut a deliberate client assessment r the beginning f a case plan, thse interactins are nt cnsidered t be an engagement. The assessment des nt have t be f a clinical nature, and neither HUD nr SAMHSA have established minimum criteria fr what the assessment must include, ther than the client deliberately engaging with the wrker(s) t reslve the husing crisis. Enrllment: The pint at which the PATH-funded wrker can determine if a persn is eligible fr the PATH Prgram. Only persns eligible fr PATH can receive a PATH-funded service r referral. Additinally, the PATH-eligible individual and a PATH prvider have mutually and frmally agreed t engage in services and the prvider has initiated an individual file r recrd fr that individual. HMIS Data Element P3 (frmerly PATH Status) prvides additinal infrmatin regarding PATH enrllment. Prject Exit: SAMHSA has nt established a plicy regarding the specific amunt f time that must pass frm the date f last cntact in rder fr the client t be cnsidered exited frm the PATH prject. Hwever, yur lcal State PATH Cntact (SPC) shuld set a lcal benchmark fr this. Please cntact yur SPC directly fr infrmatin n lcal standards fr prject entry. 4 P a g e

7 Prject Exit: N Cntact with Client Each State PATH Cntact is encuraged t set a standard length f time that must pass withut a client cntact befre the client is exited frm the PATH prject. In general, the perid f time that passes frm the date f last cntact until prject exit shuld be between 30 days and 90 days (r ther length f time as established by the State PATH Cntact). Reengagement may happen within this timeframe, but cannt ccur after prject exit has ccurred. In this case the Exit date will be dated as the date f last cntact. Reengagement: The prcess f reestablishing interactin with PATH-enrlled individuals wh are discnnected frm PATH services in rder t recnnect the client t services based n the previusly develped case management r gal plan. Reengagement must ccur after enrllment and prir t prject exit. Please see Page 19 f attachment A fr mre details n reengagement. Referral: Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATHenrlled individual t cnnect t an apprpriate agency, rganizatin, r service. Referrals are nly reprted fr PATH-funded referrals prvided t a PATH-enrlled individual. Referrals are nt services, if the PATH prvider des nt actually deliver the PATH-funded service it shuld be entered as a referral nt a service. Services: A specific PATH-funded assessment, benefit, r frm f assistance prvided t a PATHenrlled individual. PATH-funded services may include screening, clinical assessment, cmmunity-based mental health services, substance use treatment, and husing assistance. Services are nly reprted fr PATH-funded services prvided t a PATH-enrlled individual. Descriptins f PATH-funded services may be fund in the PATH Annual Reprt Manual. Services are nt the same as referrals, s if the PATH prvider des nt actually deliver the PATH-funded service it shuld be entered in HMIS as a referral, nt a service. Additinal terms related t the PATH Prgram wrkflw, referrals, and services may be fund in the PATH Annual Reprt Manual. HMIS Prject Setup It is imprtant t be sure that cmmunities understand the difference between a prgram and a prject because they have distinct meanings in this cntext. A prgram is the surce f funding that the rganizatin is receiving t run its prject (e.g., PATH Prgram funding fr ABC Street Outreach prject). A prject refers t a distinct unit f an rganizatin, which may r may nt be funded by HUD r the federal partners, that prvides services and/r ldging. Fr data cllectin purpses, HUD and its federal partners refer t categries f funding within a prgram as cmpnents. Identify Prjects fr HMIS Participatin Identify all the prjects within the HMIS implementatin that receive PATH funding. Each state r territry s State PATH Cntact can prvide specific infrmatin abut PATH prjects in each jurisdictin. 5 P a g e

8 Identify Prject Funding Cmpnents Identify the cmpnent fr each prject funded by the PATH grantee (the state r territry). The PATH Prgram includes tw cmpnents: The Street Outreach cmpnent f PATH is used by PATH prjects that prvide utreach and engagement t thse living in places nt meant fr human habitatin. These PATH activities are designed t meet the immediate needs f unsheltered hmeless persns by cnnecting them with emergency shelter, husing, and/r critical health services. Examples f persns wh are living in places nt meant fr human habitatin are thse wh sleep n the streets, under bridges, in camps, camp grunds, abandned buildings, structure meant fr animals, vehicles, and public places. The Supprtive Services cmpnent is used by PATH prjects t prvide utreach and engagement t thse living in places meant fr human habitatin. This includes bth persns wh are residing in shelter, and thse dubled up in husing r at-risk f hmelessness. Nte: A single PATH prject in a lcal cmmunity may be funded t d bth Street Outreach and Supprtive Services. Natinally, the majrity f PATH prjects prvide bth Street Outreach and Supprtive Services and will need t have tw distinct prjects setup in HMIS. SAMHSA intends the PATH Prgram t be primarily used t prvide utreach t the mst vulnerable clients, including thse wh are least likely t seek ut and engage in prjects n their wn. PATH Prject Descriptr Data Elements Fr prjects new t HMIS, the HMIS Lead will need t fllw the usual prject setup prcedures that are required fr HMIS. Existing prjects in HMIS shuld be checked t make sure they meet the requirements utlined in this manual. All prjects with existing HMIS recrds shuld be checked fr accuracy and cnsistency with the 2017 HMIS Data Standards Versin 1.2 and this guidance. This must include setup f the fllwing Prject Descriptr Data Elements (PDDE): Organizatin Identifiers (2.1) The name f the agency r rganizatin receiving PATH funding that is perating the prject must be entered r identified with the PATH specific prject. An identificatin number will be generated by the HMIS. There shuld be a single recrd in HMIS fr each agency r rganizatin, regardless f hw many prjects they perate. Prject Identifiers (2.2) The name f the prject receiving PATH funding must be entered r identified with the PATH specific prject. An identificatin number will be generated by the HMIS. HMIS administratrs shuld nte that ften the name f the prject n the grant agreement is nt the same as the name the prject is called by the rganizatin and/r the cmmn name in the cmmunity and ften nt the same name as is used n the Husing Inventry Chart (HIC). System administratrs shuld maintain mapping infrmatin t crrelate grant names, HIC names, and cmmn names with the prject identifiers either within the HMIS itself r separately. Prjects that are perating mre than ne cmpnent serving tw different ppulatins may nt be set up in the HMIS as a single prject. Fr example, if yur prject is funded by bth PATH and ESG, each prject must be set up separately. Prjects in HMIS implementatins which crss state bundaries must be set up as separate prjects in rder t supprt prper PATH state reprting. 6 P a g e

9 Operating Start Date: Beginning in Octber 2017, the Operating Start Date f a prject must be cmpleted in the HMIS n all prjects. The Operating Start Date f the prject is defined as the first day the prject prvided services and/r husing. Thus, this date must be n later than the date the first client served in the prject was entered int the prject. Fr prjects which began perating prir t Octber 1, 2012, the perating start date may be estimated if nt knwn. Operating End Date: An Operating End Date must be entered when a prject clses. The Operating End Date must be the last day n which the last client received husing/services. The Operating End Date shuld be left empty if the prject is still in peratin (refer t the specific HMIS instructins n prject clse ut in an HMIS). Multi-State HMIS Implementatin The PATH Prgram funds states and territries which then distribute the funding t prjects thrughut their jurisdictin that perate PATH. If an HMIS implementatin includes mre than ne state in its implementatin (which is the exceptin), then tw separate prjects must be established in the HMIS (ne fr each state r territry) in rder t supprt prper PATH reprting. Cntinuum f Care (CC) Cde (2.3) Each CC is assciated with a gegraphic area and has a cde assigned by HUD. Select the CC Cde based n the lcatin in which the prject perates. A prject with multiple CC jurisdictins within its service area shuld list all applicable CC. Prject Type (2.4) Select the crrect prject type fr each prject. Each prject in an HMIS must be set up fr the crrect prject type. Althugh a single prject may be funded t prvide bth Street Outreach and Supprtive Services cmpnents, fr reprting purpses n single prject within an HMIS may have tw prject types. Therefre, n agency that receives an award cnsisting f multiple cmpnents may have bth cmpnents set up in the HMIS as the same prject. As mentined earlier, a single PATH prject that has bth Street Outreach and Supprtive Services cmpnent must have tw distinct prjects setup in HMIS. The PATH Prgram Cmpnents (Street Outreach and Supprtive Services) by themselves cannt be used fr HMIS Prject Typing. In rder t crrectly type a prject in an HMIS the HMIS Lead must cnsult the State PATH Cntact and the PATH prvider t determine if the prject serves persns wh reside in a place nt meant fr human habitatin r persns wh reside in a place meant fr human habitatin. Cntinuum Prject shuld be answered Yes fr all prjects funded under prgrams listed belw. Apprpriate prject types will be critical t the CC ability t prduce HUD System Perfrmance Measures. PATH prject types shuld be set up as fllws: 7 P a g e

10 PATH Prgram Cmpnent Ppulatin f Fcus HMIS Prject Type Street Outreach Supprtive Services Persns wh reside in a place nt meant fr human habitatin (e.g. streets, abandned buildings, etc.) Persns wh reside in a place meant fr human habitatin, r wh are at risk f hmelessness Street Outreach Supprtive Services Understanding and Identifying PATH Prject Type: PATH prjects are nt typed within an HMIS by where the client is cntacted by the prject, but rather by the client s primary place f residence at the pint f first cntact (which is the same as prject start). Fr example, a street utreach prject fcuses n utreaching t persns experiencing hmelessness wh are living n the streets and will cllect and enter data under the Street Outreach PATH Prgram Cmpnent. While the PATH-funded wrker may find it helpful t cntact these clients in places where it is easier t find the client, like health clinics, drp-in centers, r shelter lbbies, the client shuld still be entered int the Street Outreach prject because the client lives n the street. PATH prjects shuld use available data t determine the client s primary place f residence when selecting PATH Prject Type in HMIS. In sme instances, a client may be cntacted in a prject r living situatin that is the nt representative f their place f residence. T aid in the prper identificatin f a client s primary place f residence and assure that the client is entered int the crrect PATH Prgram and crrespnding HMIS prject type, use the belw guidance: Identify Client Primary Place f Residence HUD has prvided guidance n the questin f reside that directs the wrker at first cntact (Prject Start) t determine the client s primary place f residence by using the fllwing: Where did yu stay last night? If the client respnds with an answer cnsistent with a place nt meant fr human habitatin, then enter the client in the Street Outreach prject. If the client respnds with an answer cnsistent with a place meant fr human habitatin, including emergency shelters, then enter the client in the Supprtive Services prject. If the client des nt prvide an answer, wait until yu can get an answer, and enter the client in HMIS at that pint. 8 P a g e

11 If the client des nt prvide an answer t Where did yu stay last night?, and yu never encunter the client again, yu shuld enter them int the Supprtive Service Only prject. This will keep the client frm being cunted in the HUD System Perfrmance Measure 7A. Prject types such as winter shelter, temprary shelter, night-by-night shelter (with n guaranteed bed), mbile utreach, mbile health clinic, hmeless htline, 211, and crdinated entry prjects d nt clearly equate t a client s primary place f residence and shuld prmpt the questin, Where did yu stay last night? If the PATH prject initially enters a client in a prject type based n the identificatin f client s primary place f residence, but later learns additinal infrmatin abut the client s primary place f residence that indicates that anther PATH HMIS Prject Type mre apprpriately represents that client s living situatin, the PATH prject is nt required t exit the client frm the prject r therwise alter the client s recrd in HMIS. When Supprtive Services Only is selected as a PATH Prject Type, the respnse t the dependent field Affiliated with a residential prject shuld be n, unless the prject is funded as a Street Outreach cmpnent and is perating within an emergency shelter. Then the affiliatin wuld be yes and the shelter(s) the prject perates with wuld be listed. Methd fr Tracking Emergency Shelter Utilizatin (2.5) This element is nt relevant since the PATH Prgram des nt fund emergency shelter prjects. Federal Partner Funding Surces (2.6) Prjects funded in whle r in part by PATH funds are t be identified as HHS: PATH Street Outreach & Supprtive Services Only. The grant identifier fr a PATH prject may be the grant number r any ther identificatin system the lcal HMIS system elects t use. There are n requirements by PATH fr this t be the state grant number received frm SAMHSA r the lcal grant number received frm the State. Bed and Unit Inventry Infrmatin (2.7) This element is nt relevant since the PATH Prgram des nt fund husing prjects. Additinal Prject Infrmatin (2.8) This element recrds lcatin data required by each prject entering data int HMIS, as well as any cntinuum prjects nt participating in HMIS. This infrmatin is relevant fr HIC and AHAR reprting purpses. PATH Data Cllectin Requirements All PATH prjects are required t cllect all f the Universal Data Elements and the relevant Prgram-Specific Data Elements. The Prgram-Specific Data Elements t be cllected by each PATH prject are as shwn belw: 9 P a g e

12 Element Number HMIS Prgram Specific Data Element Street Outreach Services Only 4.2 Incme and Surces x x 4.3 Nn-Cash Benefits x x 4.4 Health Insurance x x 4.5 Physical Disability x x 4.6 Develpmental Disability x x 4.7 Chrnic Health Cnditin x x 4.8 HIV/AIDS 4.9 Mental Health Prblem x x 4.10 Substance Abuse x x 4.12 Cntact x x 4.13 Date f Engagement x x P1 Services Prvided PATH Funded x x P2 Referrals Prvided - PATH x x P3 PATH Status x x P4 Cnnectin with SOAR x x X = data cllectin required = data cllectin is nt required but encuraged SAMHSA has recently updated several key terms and definitins related t services and referrals. An verview f these changes is listed belw. In 2017, the HMIS Data Standards made significant changes t 4.5, 4.6, 4.7, 4.9 and 4.10 by remving cnditinal questins regarding service, severity and dcumentatin. Data Element P1 Services Prvided- PATH Funded The HMIS data element P1 Services Prvided PATH Funded is used t determine the PATH-funded services that are prvided t a client during prject enrllment, fllwing prject enrllment and prir t prject exit. The PATH Annual Reprt nly requires that yu cllect ne respnse fr each service prvided, hwever PATH prviders may chse t cllect multiple instances f each service. PATH prviders are nt required, but encuraged t recrd each instance f PATH-funded services prvided t PATH-enrlled clients, this is allwable as lng as it des nt create duplicative service data in the PATH Annual Reprt (The HMIS Data Dictinary and the PATH Annual Reprt Prgramming Specificatins direct HMIS slutins t allw multiple service ccurrences withut affecting the PATH Annual Reprt). 10 P a g e

13 PATH-Funded Service Re-engagement Screening Clinical assessment Habilitatin/rehabilitatin Cmmunity mental health Substance use treatment Case management Residential supprtive services Husing minr renvatin Husing mving assistance Husing eligibility determinatin Security depsits One-time rent fr evictin preventin Definitin The prcess f engaging with PATH-enrlled individuals wh are discnnected frm PATH services. An in-persn prcess during which a preliminary evaluatin is made t determine a persn s needs and hw they can be addressed thrugh the PATH Prgram. A clinical determinatin f psychscial needs and cncerns. Services that help a PATH client learn r imprve the skills needed t functin in a variety f activities f daily living. A range f mental health and/r c-ccurring services and activities prvided in nn-institutinal settings t facilitate an individual s recvery. Nte: This categry des nt include case management, alchl r drug treatment, habilitatin, r rehabilitatin, as they are standalne services with distinct definitins. Preventive, diagnstic, and ther services and supprts prvided fr peple wh have a psychlgical and/r physical dependence n ne r mre substances. A cllabratin between a service recipient and prvider in which advcacy, cmmunicatin, and resurce management are used t design and implement a wellness plan specific t a PATH-enrlled individual s recvery needs. Services that help PATH-enrlled individuals practice the skills necessary t maintain residence in the least restrictive cmmunitybased setting pssible. Services, resurces, r small repairs that ensure a husing unit is physically accessible and/r that health r safety hazards have been mitigated r eliminated. Funds and ther resurces prvided n behalf f a PATH- enrlled individual t help establish that individual s husehld. Nte: This excludes security depsits and ne-time rental payments, which have specific definitins. The prcess f determining whether an individual meets financial and ther requirements t enter int public r subsidized husing. Funds prvided n behalf f a PATH-enrlled individual t pay up t tw mnths rent r ther security depsits in rder t secure husing. One-time payment n behalf f PATH-enrlled individuals wh are at risk f evictin withut financial assistance. 11 P a g e

14 Data Element P2 Referrals Prvided- PATH The HMIS data element P2 Referrals Prvided PATH is used t determine the referrals that are prvided t a client during prject enrllment. A referral has been attained nce the PATH-enrlled client begins receiving services as the result f PATH assistance. PATH prviders are nt required, but encuraged t recrd each instance f PATH-funded referrals prvided t PATH-enrlled clients. This transactinal apprach t data cllectin is allwable as lng as it des nt create duplicative referral data in the PATH Annual Reprt (The HMIS Data Dictinary and the PATH Annual Reprt Prgramming Specificatins direct HMIS slutins t allw multiple referral ccurrences withut affecting the PATH Annual Reprt). A PATH referral is recrded each time a referral is made. If a PATH-funded wrker makes three referrals fr the same service between prject start and exit, then all three referrals shuld be recrded. Each referral shuld be marked as Attained, Nt attained r Unknwn as f prject exit. Attained means the client was cnnected and received the service (if the referral is fr husing, it is nt attained until the husing placement starts). Nt attained means the client was referred t, but may nt have ever been cnnected with, the service r did nt actually receive the service. Unknwn means the status f the client s cnnectin r receipt f service is unknwn t the prvider entering the data. PATH Referral Cmmunity mental health Substance use treatment Primary health/dental care Jb training Educatinal services Definitin Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that stabilizes, supprts, r treats peple fr mental health disrders r c-ccurring mental health and substance use disrders. Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that ffers preventive, diagnstic, and ther services and supprts fr individuals wh have psychlgical and/r physical prblems with use f ne r mre substances. Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that ffers physical and/r dental health care services. Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that helps prepare an individual t gain and maintain the skills necessary fr paid r vlunteer wrk. Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that ffers academic instructin and training. 12 P a g e

15 PATH Referral Husing services Permanent husing Temprary husing Incme assistance Emplyment assistance Medical insurance Definitin Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that ffers assistance with attaining and sustaining living accmmdatins. Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that ffers residence in a stable setting where length f stay is determined by the individual r family withut time limitatins, as lng as they meet the basic requirements f tenancy. Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that ffers shelter in a time-limited setting. Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that ffers benefits that prvide financial supprt. Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that ffers assistance designed t lead t cmpensated wrk. Active and direct PATH staff supprt n behalf f r in cnjunctin with a PATH-enrlled individual t cnnect t an apprpriate agency, rganizatin, r service that ffers cverage that prvides payment fr wellness r ther services needed as a result f sickness, injury, r disability. Only PATH-funded services and referrals are required t be cllected in HMIS. Many PATH prjects and HMIS Lead Agencies, hwever, may find value in cllecting the services and referrals prvided t a client prir t enrllment r funded by a surce ther than PATH, fr lcal reprting needs. The HMIS implementatin may be cnfigured t allw these services and referrals t be cllected. Hwever, any service r referral prvided t a client prir t enrllment, r prvided t the client pst enrllment that are nt PATH-funded, must be excluded frm the PATH Annual Reprt. PATH Services and Referrals are prvided t enrlled clients nly. The nly service that shuld be prvided befre enrllment is utreach, which is recrded as cntact. PATH prviders may prvide referrals withut enrlling smene in PATH and recrd that referral in HMIS. Hwever, a referral t a PATH-funded service may nt be prvided until the persn is enrlled in PATH. Fr example, a PATH prvider can prvide referrals such as a referral t anther prject the client may be eligible fr, t the lcal sup kitchen, and the day shelter, hwever, a PATH prvider cannt prvide a PATH referral (where the PATH-funded wrker plays an active part in making the referral) t smene wh is nt enrlled in the PATH prject. Additinal infrmatin n the ratinale, cllectin pint, subjects, and instructins fr each element can be fund in the HMIS Data Standards Manual. 13 P a g e

16 Special Data Cllectin Instructins HMIS System Administratrs and HMIS users shuld be aware f several special data cllectin issues that apply t PATH-funded prjects. Data Cllectin Challenges: A street utreach prject is likely t encunter difficulty engaging persns experiencing hmelessness. Street Outreach prjects may recrd a prject start with limited infrmatin abut the client and imprve n the accuracy and cmpleteness f client data ver time by editing data in an HMIS as they engage the client. The initial entry may be as basic as the prject start date, an alias r ther made-up name (e.g., Redhat Tenthstreetbridge) that wuld be identifiable fr retrieval by the PATH-funded wrker in the system. Over time, the data must be edited fr accuracy (e.g., replacing Redhat with Rbert ) as the wrker learns that detail. De-Duplicatin f Client Recrds: It is pssible in a street utreach setting that a single client may be cntacted by multiple street utreach wrkers ver a perid f time in different lcatins. Lcal prtcls shuld be established t determine hw crdinatin amng PATH prjects and ther street utreach prjects effectively manage the identificatin and data cllectin f clients. In smaller CC, it may be pssible t crdinate street utreach effrts and reduce duplicatin f client recrds thrugh case cnferences r ther effrts t crdinate utreach services. In all CC, client search functinality may be made available in HMIS s that street utreach wrkers can perfrm queries r client searches by made-up name r alias, r ther infrmal identifier shared with street utreach wrkers in rder t manage the identificatin f clients. The use f temprary made-up names shuld nt be an excuse fr excessive de-identified clients r pr data quality. PATH prjects and lcal HMIS leadership shuld wrk tgether t minimize the use f made-up names and attain high data quality. Cntacts: All PATH Prgram cmpnents must recrd every cntact made with each client in the HMIS. In 2017, Cntact was changes t include a new cnditinal data element Staying n Street, ES r SH. Fr PATH, a cntact is defined as an interactin between a PATH-funded wrker r wrkers and an individual wh is ptentially PATH eligible r enrlled in PATH. Cntacts may include activities such as a cnversatin between the PATH-funded wrker and the client abut the client s well-being r needs, an ffice visit t discuss their husing plan, r a referral t anther cmmunity service. A cntact must be recrded anytime a client is met, including during in-reach r when the client is cntacted in anther service setting. Cntacts must als be recrded if an engagement date r prject start date is recrded n the same day. PATH prviders shuld refer t the PATH Annual Reprt Manual fr PATH reprting guidance and t review the PATH definitin f a cntact. PATH prviders that cmmunicate with ther service prviders n behalf f their client (3 rd Party Cntact) wuld nt recrd a cntact because the interactin is nt between the PATH-funded wrker and the client. These 3 rd party cntacts may be recrded as a PATH-funded service r referral depending n the nature f the cntact (remember that PATH-funded referrals and services are nly fr enrlled clients). 14 P a g e

17 Engagements: Per the HMIS Data Standards and by agreement acrss all federal partners, an engagement date is the date n which an interactive client relatinship results in a deliberate client assessment r the beginning f a case plan. The date f engagement shuld be entered int HMIS at the pint that the client has been engaged by the PATH-funded wrker. This date may be n r after the prject start date and must be prir t date f enrllment and prject exit. If the client exits withut becming engaged, the engagement date shuld be left blank. The date f engagement will als be recrded as a cntact with the same date. Data Quality: Reprting n data quality fr all PATH Prgram cmpnents is limited t clients with a date f engagement. Therefre, it is imprtant that PATH-funded wrkers recrd the engagement date and als review all f the Universal Data Elements and applicable Prgram Specific Data Elements fr cmpleteness and accuracy. The Date f Engagement is the pint at which data quality begins t be measured fr the PATH Prgram, therefre all Universal Data Elements shuld be entered int HMIS at r befre the Date f Engagement. PATH grantees are encuraged t wrk cllabratively with their HMIS Lead Organizatins t understand and cmply with lcal data quality requirements and expectatins. Enrllments: An enrllment date is the date when a PATH-eligible individual and a PATH prvider have mutually and frmally agreed t engage in services and the prvider has initiated an individual file r recrd fr that individual. The date f PATH enrllment shuld be entered int the HMIS at the pint that the client has becme enrlled, using the PATH Status element (P3). It may be n r after the prject start date r engagement date and prir t prject exit. If the client exits withut becming enrlled, the PATH Status element (P3) needs t be cmpleted, indicating that the client was nt enrlled and the reasn the client was nt enrlled. If the client was cntacted n the date that PATH Status was determined, a cntact must als be entered fr that date. SAMHSA GPRA-MA Measure The Gvernment Perfrmance and Results Act- Mdernizatin Act (GPRA-MA) has set the threshld f utreached, eligible clients that becme enrlled in the PATH Prgram at 58% fr FY2017. That means that f all persns cntacted by the PATH Prgram, 58% f thse wh are determined t be eligible will ultimately becme enrlled by agreeing t participate in services. Prject Exit: Prject exit represents the end f a client s participatin with a prject. Fr nnresidential prjects, prject exit will be the last day a service was prvided. Fr PATH prjects, the exit date shuld cincide with the date that the client is n lnger cnsidered t be participating in the prject. This standard shuld be applied cnsistently acrss all PATH prjects. Reasns t exit a client include: The client has entered anther prject type (e.g., TH, PSH) r therwise fund husing; The client is engaged with anther utreach wrker r prject; The client is deceased; r 15 P a g e

18 The utreach wrker has been unable t lcate the client fr an extended perid f time and there are n recrded cntacts (length f time defined by the State PATH Cntact, typically days). Once this perid f time is defined fr the State r Territry, the date f last cntact becmes the exit date fr the PATH prject, nt days (r ther length f time defined by the State PATH Cntact) fllwing date f last cntact, which may result in artificially inflated lengths f enrllment. If this situatin arises, and the client is t be exited frm the prject due t a lack f regular cntact the prject exit (3.12) shuld be listed as N Exit Interview Cmpleted. The pssibility that the client may nt be seen again is nt a reasn t exit a client frm a prject, and prject exit shuld nly be recrded nce prject participatin has ended, r after the lcally-determined perid f time has passed withut a cntact with the client. SAMHSA Autmatic Exit Plicy SAMHSA has set a plicy regarding PATH data cllectin and the use f an autmatic exit functin. This plicy is a cllabratin between SAMHSA and HUD and attempts t balance the data cllectin guidance f SAMHSA with the data quality framewrk f HUD. PATH prviders shuld wrk with their State PATH Cntact t understand the specific Autmatic Exit plicy fr the state where PATH-funded services are prvided (a current list f State PATH Cntacts can be accessed here). Each State PATH Cntact has been empwered by SAMHSA t set the statewide plicy n Autmatic Exit; hwever, the plicy shuld be n mre than 90 days t be cnsistent with HMIS and CC plicies and best practices. SAMHSA has defined Autmatic Exit as: Autmatic Exit: The maximum amunt f time that is allwed t pass withut cntact with the client befre the client is exited frm the PATH prject nt t exceed 90 days. PATH clients can be discnnected frm services fr varius reasns and varius lengths f time. Discnnectin fr sme length f time is a nrmal part f the client relatinship, but discnnectin fr lnger perids f time indicates that the client needs t be exited frm the prject. This decisin pint is intended t allw the State PATH Cntact t set the amunt f time that must pass withut client cntact, up t 90 days, befre the client is exited frm the prject. 16 P a g e

19 SAMHSA has decided that in the event that an autmatic exit is used fr a client recrd that the exit date shuld be set as the date f last cntact. This data cllectin plicy will affect the HMIS Data Quality Framewrk measure f data entry timeliness. Bth SAMHSA and HUD understand this impact and encurage the CC t analyze this prtin f the HMIS Data Quality Framewrk in light f this plicy. SAMHSA intends fr the PATH Prgram prviders acrss the cuntry t wrk diligently s that n client exits the prject with an autmatic exit, a marker f discnnectin frm service. While aut-exits are nt entirely avidable due t the transient nature f sme PATH clients, SAMHSA recmmends sparing use f the autmatic exit. In the cases where an Autmatic Exit is used by a PATH prvider, the exit will appear t be entered mre than 11+ days n the data quality framewrk (Q6). This is an accurate representatin f hw the data was cllected, and bth HUD and SAMHSA understand the impact n timeliness. Data Cllectin fr Husehld Members: HMIS Universal Data Elements and PATH Prgram Specific Data Elements are required t be cllected fr heads f husehlds. Mst PATH Prgram Specific Data Elements (PSDE) are required t be cllected fr bth head f husehlds and adults in the husehld. In sme instances, PATH-funded wrkers may cntact husehlds with mre than ne individual. PATH-funded wrkers shuld be aware f which data elements are required fr heads f husehlds nly and which data elements are required t be cllected fr all adults. 17 P a g e

20 Dcumenting Chrnic Hmelessness: The Defining Chrnically Hmeless Final Rule specifies that a written bservatin by an utreach wrker f the cnditins where the individual was living may serve as evidence that the individual lives in a place nt meant fr human habitatin, a safe haven, r an emergency shelter, fr the time which the bservatin was made. Additinally, third-party dcumentatin f a single cntact with a hmeless service prvider n a single day within ne mnth is sufficient t cnsider an individual as hmeless and living r residing in a place nt meant fr human habitatin, a safe haven, r an emergency shelter fr an entire calendar mnth (e.g., an encunter n May 5 cunts fr May 1 May 31), unless there is evidence that there have been at least 7 cnsecutive nights nt living r residing in a place nt meant fr human habitatin, a safe haven, r an emergency shelter during that mnth. Specific dcumentatin f chrnic hmelessness may be necessary t bth priritize clients fr husing and t dcument eligibility fr certain permanent husing resurces. If necessary, PATH-funded wrkers are expected t prvide evidence f a client s chrnic hmeless status thrugh participatin in the CC. As such, PATH-funded wrkers shuld crdinate clsely with their CC and participate in the lcal crdinated entry system t ensure that clients have access t the apprpriate permanent husing resurces. PATH Reprting Ntes: The PATH Annual Reprt des nt require the name f PATH enrllees r cntacts; hwever, the name f PATH clients will be necessary fr the HMIS t determine an accurate cunt f client cntacts and enrllees thrugh a de-duplicatin prcess within HMIS. The PATH Annual Reprt des nt reprt each service that is prvided t the client, but rather if each service categry is prvided r nt. PATH prviders may wish t cllect every instance f service, which is allwable as lng as the PATH reprt des nt return duplicative service data. The PATH Annual Reprt details clients with c-ccurring substance use and mental health disrders. The 2017 HMIS Data Standards Versin 1.2 cllect data, that when cmbined, can determine whether r nt a client has a c-ccurring substance use and mental health disrder. The PATH Annual Reprt requires that clients receiving services be enrlled in PATH and that services reprted upn are PATH-funded (4.14 A Services Prvided PATH Funded). The PATH Annual Reprt requires that clients receiving assisted referrals be enrlled in PATH (4.16 A Referrals Prvided PATH). Bth a Street Outreach and Supprtive Services Only prject setup shuld be identical. All Universal Data Elements and Prgram Specific Data Elements are the same. Sme State PATH Cntacts may require additinal quarterly reprts fr the PATH Prgram, but these quarterly reprts cannt be cmbined t ppulate the PATH Annual Reprt. 18 P a g e

21 PATH Data Cllectin Wrkflw PATH data cllectin wrkflw is designed t supprt the interactins and develpment f relatinships with clients ver time. As such, HMIS data quality des nt begin until the date f engagement, r the pint at which an interactive client relatinship results in a deliberate client assessment. The date f enrllment may be n r after the prject start date and n r after the date f engagement. It is pssible that prject start, engagement, enrllment, and prject exit may all ccur during a single cntact at a single pint in time. Hwever, it is much mre likely that prject start will be fllwed by multiple cntacts prir t date f engagement. The chart belw illustrates the necessary sequence f data cllectin, which may happen in a day, r ver a number f days, weeks, r even mnths, depending n the client s willingness t engage with the PATH prject, eligibility fr PATH-funded services and referrals, and cntinued cnnectin t the prject. SAMHSA has created a vide that details the PATH data cllectin wrkflw lcated here. The nly data that must be captured prir t Date f Engagement is: Prject start Date, Cntact Date (all cntacts frm Prject start/first Cntact t Date f Engagement) and sme frm f name/alias that allws the street utreach prject t identify the client in HMIS. Any data cllectin beynd that, whether it be data nt cllected r refused r a default categry that details the data has nt yet been cllected is a lcal cmmunity decisin and nt a HUD requirement. 19 P a g e

22 Universal Data Elements At Prject Start By Date f Engagement At Date f Enrllment At Prject Exit 3.1 Name X 3.2 Scial Security Number X 3.3 Date f Birth X 3.4 Race X 3.5 Ethnicity X 3.6 Gender X 3.7 Veteran Status X 3.8 Disabling Cnditin X 3.10 Prject Start Date X 3.11 Prject Exit Date X 3.12 Destinatin X 3.15 Relatinship t Head f Husehld X 3.16 Client Lcatin X Living Situatin X X 3.917A Living Situatin X 3.917B Living Situatin X Cmmn Data Elements At Prject start By Date f Engagement At Date f Enrllment At Prject Exit 4.2 Incme and Surces X 4.3 Nn-Cash Benefits X 4.4 Health Insurance X 4.5 Physical Disability X 4.6 Develpmental Disability X 4.7 Chrnic Health Cnditin X 4.8 HIV/AIDS X 4.9 Mental Health Prblem X 4.10 Substance Abuse X 4.12 Cntact X X X X 4.13 Date f Engagement X P1 Services Prvided: PATH Funded X X P2 Referrals Prvided: PATH X X 20 P a g e

23 Cmmn Data Elements At Prject start By Date f Engagement At Date f Enrllment At Prject Exit P3 PATH Status X P4 Cnnectin with SOAR X X X HUD System Perfrmance Measures Data cllected fr PATH prjects in HMIS affects the HUD System Perfrmance Measures that are reprted fr the entire CC. Belw is a brief explanatin f the HUD System Perfrmance Measures that affect Street Outreach and Supprtive Services Only prjects. Measure 7a: Successful Placement frm Street Outreach Client Universe: Persns In Street Outreach Prjects that exited frm Street Outreach during the reprting perid. Measure 7a evaluates hw successful street utreach prjects are at helping peple mve ff the street and twards permanent husing, recgnizing this prcess may be direct r may invlve ther temprary situatins alng the way. This is imprtant because we knw that peple living n the street and ther places nt meant fr human habitatin are at an increased risk f death. Measure 7a des nt require a Date f Engagement fr a client recrd t be included in the perfrmance measure, nly a prject exit. Additinally, while data quality is nly measured fllwing the Date f Engagement, System Perfrmance Measure 7a measures placement frm street utreach beginning at the first cntact/prject start. This means that HMIS leadership and PATH prviders need t wrk tgether t assure that street utreach data is f high quality at the time the HUD System Perfrmance Measures are calculated regardless f the Date f Engagement. 21 P a g e

24 Attachment A: State PATH Cntact HMIS Data Cllectin Decisin Tl Intrductin: This tl was develped by the Department f Husing and Urban Develpment (HUD) and the Substance Abuse Mental Health Services Administratin (SAMHSA) t assist State PATH Cntacts (SPC) t set Hmeless Management Infrmatin System (HMIS) data cllectin plicy fr their PATH-funded prviders and t crdinate with lcal Cntinuum f Care (CC), HMIS leadership and ther lcal data cmmittees in crdinating street utreach data cllectin (including PATH). The tl is brken dwn int tw sectins 1. SPC Decisin Pints 2. SPC & CC Data Cllectin Crdinatin. Sectin 1: SPC Decisin Pints There are a number f instances within the HMIS data cllectin prcess fr SAMSHA s PATH Prgram that are nt frmally defined by HUD r SAMHSA. Withut clear and unifrm decisins frm each State PATH Cntact regarding hw the PATH prviders enter this data int HMIS, there will be wide variatin in hw this infrmatin is bth cllected and reprted t SAMHSA. Therefre, SAMHSA requests that each SPC review and act n the decisin pints that are listed belw. The SPC decisin pints shuld be shared with all PATH prviders. Definitins: 1. Reside: The PATH HMIS Prgram Manual (December 2016), changed hw t determine which prject a client is entered int by requiring PATH prviders t ask clients Where did yu stay last night?. That guidance als stated if a client des nt knw where they stayed last night that the PATH prvider is t delay data entry int HMIS until an answer t that questin can be ascertained. This decisin pint is intended t allw the SPC t set the amunt f time that a PATH prvider is allwed t determine which prject the PATH client is t be entered in. Sample SPC Plicy: PATH prviders have a maximum f 7 days t identify a respnse t the questin Where did yu stay last night? After which time the PATH Prvider is t enter the client int the mst apprpriate prject based n the knwledge gained t date. 2. Re-engagement Minimum: The minimum amunt f time that must pass frm date f last cntact befre the service f Re-engagement can be prvided. PATH clients can be discnnected frm services fr varius reasns and fr varius lengths f time. Sme length f time is a nrmal part f the client relatinship while lnger perids f time is nt nrmal and requires effrt t recnnect the client t PATH-funded services. This decisin pint is intended t allw the SPC t set the minimum amunt f time that must pass withut client cntact befre the service f Re-engagement can be prvided. Sample SPC Plicy: T be cnsidered re-engaged, PATH clients must have nt received a cntact, service r referral with the lcal PATH prject fr a minimum f 15 days. 3. Autmatic Exit: The maximum amunt f time that is allwed t pass withut cntact with the client befre the client is exited frm the PATH prject. PATH clients can be discnnected frm services fr varius reasns and varius lengths f time. Sme length f time is a nrmal part f the client relatinship while an extensive length f time is nt nrmal and the client needs t be 22 P a g e