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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.com

Sponsored by:U.S. Department of Veterans Affairs

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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

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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

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Training Format:

• Call will last approximately 90 minutes• Materials from today will be available

online at www.va.gov/homeless

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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

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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.

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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.

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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.

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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.

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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

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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

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Key Components of HMIS

• Information and Referral (I&R)

• Client Intake

• Bed Management

• Case Management

• Service Tracking

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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

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Existing Resources on HMIS

• HMIS.info▫ www.HMIS.info▫ Historical information on HMIS, as well as technical

resources

• HUD Homelessness Resource Exchange: www.HUDHRE.info▫ Copies of presentations from 2010 HUD conference,

many covering HMIS

• 2010 HMIS Data Standards▫ http://www.hudhre.info/documents/

FinalHMISDataStandards_March2010.pdf

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

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Strategic Efforts to End Veteran Homelessness

1. VA 5 Year Plan to End Veteran Homelessness2. VA Strategic Plan for 2010-20143. United States Interagency Council on

Homelessness’ (USICH) “Opening Doors: Federal Strategic Plan to End Homelessness”

4. Local Ten Year Plans to End Homelessness5. National Center on Homelessness Among

VeteransAll of these efforts require accurate and timely

data describing extent and scope of veteran homelessness.

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

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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.”

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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

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For More Information• VA’s 5 Year Plan to End Homelessnesshttp://www.oregon.gov/ODVA/TASKFORCE/reintegration/FiveYearPlan-

PPT.pdf?ga=t

• VA’s Strategic Planhttp://www1.va.gov/op3/Docs/StrategicPlanning/

VA_2010_2014_Strategic_Plan.pdf

• USICH Federal Plan to End Homelessnesshttp://www.ich.gov/PDF/

OpeningDoors_2010_FSPPreventEndHomeless.pdf

• Local Ten Year Plans to End Homelessnesshttp://www.usich.gov/slocal/plans/index.html

• National Center on Homelessness Among Veteranshttp://www1.va.gov/homeless/NationalCenter.asp

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Relationship of HMIS Projects to Local CoC

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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

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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

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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

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HMIS Data Standards

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Topics for this section

•Data Elements•Privacy•Security•Data quality

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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

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HMIS Data Standards

• 2010 HMIS Data Standards are available at 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.info

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HMIS Data Collection

1. Organization Identifier2. Organization Name3. Program Identifier4. Program Name 5. Direct Service Code6. Site Information7. Continuum of Care Number8. Program Type Code9. Bed and Unit Inventory

Information

9. Target Population A (optional)10. Target Population B11. Method for Tracking

Residential Program Occupancy

12. Grantee Identifier

Program Descriptor Data Elements (PDEs) must be entered in HMIS for all programs:

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HMIS Data Collection

1. Name2. Social Security Number (SSN)3. Date of Birth4. Race 5. Ethnicity6. Gender 7. Veteran Status 8. Disabling Condition9. Residence Prior to Program

Entrance

9. Zip Code of Last Permanent Residence

10. Housing Status11. Program Entry Date12. Program Exit Date13. Personal Identifier (Unique ID)14. Household Identifier

Universal Data Elements (UDEs) must be entered in HMIS for all clients and include:

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HMIS Data Collection

1. Income and Sources2. Non-Cash Benefits3. Physical Disability4. Developmental Disability5. Chronic Health Condition6. HIV/AIDS 7. Mental Health8. Substance Abuse9. Domestic Violence10. 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:

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HMIS Data Collection

15A. Employment15B. Education15C. General Health Status15D. Pregnancy Status15E. Veteran’s Information15F. Children’s Education15G. Reason for Leaving15H. Services Provided

Optional Program-Specific Data Elements (PSDEs) can be entered in HMIS by HUD funded programs

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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

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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

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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

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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

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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/

HUDDataQualityToolkit.pdf

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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 resources

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VA Data Collection Requirements

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VA’s baseline expectation for data collection in HMIS…

Community-based VA grantees enter the following into HMIS:

GPD = Universal Data ElementsSSVF = Universal Data Elements +

Income and sources Non-cash benefits Destination Financial assistance provided Housing relocation & stabilization services

provided

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VA’s baseline expectation for data collection in HMIS…

VAMC Homeless Liaison staff enter the following into HMIS:

VASH = Universal Data Elements

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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

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VA Plan for HMIS

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Topics for this section

▫VA Data Collection Strategy▫HOMES ▫VA Homeless Registry

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VA Data Collection Strategy

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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.

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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.

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Process and Next Steps for Getting Started

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Next Steps:

1. Contact HMIS StaffContact 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:

http://www.hudhre.info/index.cfm?do=viewCocContacts

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Next Steps:

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

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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 expecations

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Next Steps:

4. Review locally-specific participation requirementsDiscuss 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?

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Questions, Technical Assistance Resources, and a short Quiz!

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Resources

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

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Resources (cont’d)

•Questions about the VA’s Strategic Plan should be sent to John Kuhn at 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.com