MDHI HMIS
Community Meeting
Creating the Vision for
MDHI’s HMIS
March 21, 2013
Who’s in the room?
 Current use of HMIS
– Enter data into the HMIS
– Review reports from HMIS
– Have no idea what HMIS is 
Abt Associates | pg 2
Presentation Outline
 Current status of the MDHI HMIS
 HEARTH Requirements for HMIS
 Community Examples
 Creating the Vision for MDHI’s HMIS
 Possibilities with Adsystech
 Next Steps
Abt Associates | pg 3
Abt Associates
Abt’s Mission
Abt’s Work


Abt Associates is committed to
improving the quality of life and
economic well-being of people
worldwide.
Sample Abt Homelessness
Work
– Annual Homeless Assessment
Report
– Annual Performance Report

We provide research, technical
assistance, and consulting
services to help our clients make
better decisions and deliver better
products and services.
– Point-in-Time Count and Housing
Inventory Count
– Cost of Homelessness Evaluation
Abt Associates | pg 4
Acronyms
 CoC: Continuum of Care
 ESG: Emergency Solutions Grant
 HEARTH Act: Homeless Emergency Assistance and
Rapid Transition to Housing
 HMIS: Homeless Management Information System
 PCI: Priority Communities Initiative
Abt Associates | pg 5
Why Are We
Here?
Denver is a “Priority Community”
Abt Associates | pg 7
Priority Communities Initiative (PCI)
 Joint Initiative of US Interagency Council on
Homelessness (USICH) & Housing and
Urban Development (HUD)
 Key strategy for implementation of
Opening Doors, federal plan to end
homelessness
 Preparation for implementing Homeless
Emergency Assistance and Rapid
Transition to Housing (HEARTH) Act
Abt Associates | pg 8
Priority Communities Selection
 25 communities selected
 Communities with high levels of homelessness
 Communities with ability to benefit from and commit
to technical assistance
 Work is aligned with Regional USICH Offices
 Focus of work is to enhance the capacity of these
communities to prevent and end homelessness
 If we can move the needle on homelessness in
these communities, we can have a large impact
on homelessness for the nation
Abt Associates | pg 9
Priority Communities Technical
Assistance
Overall Purpose:
 Strengthen CoC performance
 Meet HEARTH responsibilities
 Achieve goals of Opening Doors
Two Types:
 General TA (Focus on CoC rule responsibilities)
 HMIS TA (Focus on HMIS)
Abt Associates | pg 10
History of and
Changes for
HMIS
What is HMIS?
12
 Homeless Management Information System
(HMIS) is a locally administered, electronic
data collection system
 HMIS is used to collect client-level
information about persons who access the
homeless service system
 Often web-based software; there are several
distinct HMIS software solution providers in
the country
Abt Associates | pg 12
HUD Values HMIS
13
 Key HUD reports are reliant on quality HMIS
data (Annual Homeless Assessment Report
and Annual Performance Report)
 Every CoC is required to implement an HMIS
and is scored on this obligation as part of the
annual CoC Competition
 A strong HMIS implementation is essential to
meet current and future CoC rules
Abt Associates | pg 13
Community Database
Mental Health,
Human Services,
Justice System,
Healthcare
Additional
community
providers that
serve homeless
persons
HUD
funded
homeless
programs
Non-HUD
funded
homeless
programs
Philanthropy
city and
county
government
Abt Associates | pg 14
Potential HMIS Benefits
Persons Experiencing Homelessness
Decrease in duplicative intakes and
assessments
Streamlined referrals
Coordinated case management and
information on benefit eligibility
Case Managers and Program Managers
Measure client outcomes
Coordinate services across the
CoC
Prepare financial and
programmatic reports
Measure performance of
programs
Advocates and Community Leaders
Understand the scope of
homelessness, and monitor for
trends
Generate an unduplicated
count of clients served
Inform systems design and
policy decisions
Measure the performance of
the community system to
prevent and end homelessness
Abt Associates | pg 15
Group Activity #1: How do we all
contribute to quality data?
1. Clients
2. Agency Staff
3. Agency Directors/Leadership
4. MDHI/CCH HMIS Staff
5. Community partners (funders, government, etc.)
Abt Associates | pg 16
MDHI HMIS By the Numbers
 The Metro Denver Homeless Initiative serves the
seven county region: Adams, Arapahoe, Boulder,
Broomfield, Denver, Douglas, Jefferson
 There are currently 58 agencies using the MDHI
HMIS.
 There are 341 programs in MDHI’s HMIS.
 There are 368 active users.
 Four full time staff support the MDHI HMIS.
Abt Associates | pg 17
HMIS Roles
Continuum of Care
 The Metro Denver Homeless Initiative (MDHI) is an
independently funded, non-profit organization whose
mission includes the prevention and ending of
homelessness in the seven county Metro Denver
Region by facilitating, integrating and tracking
cooperative, community-wide and regional systems
of care for people who have become homeless, but
seek to live in a stable home and maximize selfsufficiency.
 MDHI is tasked with providing oversight for the
region’s HMIS.
Abt Associates | pg 18
HMIS Roles
HMIS Lead Agency
 In 2009, MDHI selected the Colorado Coalition for
the Homeless (CCH) to serve as the HMIS Lead
Agency.
HMIS Software Vendor
 In 2011, MDHI selected Adsystech as the new HMIS
software provider.
Abt Associates | pg 19
Accomplishments
Since 2009:
1. Designated a new HMIS Lead Agency
2. Selected and implemented a new HMIS software
3. Migrated
4. Submitted Useable data in 4 AHAR categories!
5. Developing plan for coordinated entry that includes use
of HMIS
Abt Associates | pg 20
Next Steps for MDHI’s HMIS
 Rollout of Version 5 of AES
 Trainings on Analysis of APRs (Staff and Agency
Leaders)
– Everything you wanted to know about APRs, but were afraid
to ask
 Coordinated Entry required for NOFA and ESG
participants
Abt Associates | pg 21
MDHI HMIS Action Plan
 Adds Action Steps and Timelines for MDHI and CCH,
to the Recommendations in the HMIS Assessment
Report
 Makes the process of implementing the HMIS
Assessment Report Recommendations more
transparent
 Available on MDHI’s website:
http://mdhi.org/wp-content/uploads/2013/02/HMIS-Work-Plan-February13-2013.pdf
Abt Associates | pg 22
Audience Question: Love Data?
 Why do we love data?
 Why don’t we love data?
Abt Associates | pg 23
Urban Peak Testimonial
 Brief presentation of how Urban Peak uses HMIS as
their sole database/runs reports out of HMIS
Abt Associates | pg 24
Key National Milestones for HMIS
1980’s and
1990’s
Local efforts
to collect
data on
homeless
persons
2004
2009
HUD
publishes
first HMIS
Data and
Technical
Standards
HEARTH Act is
signed into law
Homelessness
Prevention and
Rapid Re-Housing
Program (HPRP) is
launched
2001
2007
2010
Congressional
directive
First Annual
Homeless
Assessment Report
(AHAR) published
Revised HMIS
Data Standards
released to
account for
inclusion of HPRP
clients in HMIS
HMIS an eligible
activity
Congress updates
HMIS directive;
future funding tied
to HMIS and AHAR
participation
First HMIS vendor
programming
specifications
Abt Associates | pg 25
Key Change 1: 2009 HEARTH Act
 HEARTH Act underscores the importance of HMIS
data to drive local and national decisions
 Among the HEARTH Act requirements are:
– Coordinated assessment/centralized intake
– System-level Performance Measurement
Abt Associates | pg 26
System-Level Performance
Indicators
1. Length of time homeless
2. Returns to homelessness
3. Access/coverage (thoroughness in reaching persons
who are homeless)
4. Overall reduction in number of persons who experience
homelessness
5. Job and income growth for persons who are homeless
6. Reduction in first time homeless
7. Other accomplishments related to reducing
homelessness
Abt Associates | pg 27
Example 1: Columbus, OH
 Collecting data since 1989
 Implementation includes 17 agencies and 48
programs
 Community Shelter Board (CSB) serves as both the
HMIS and CoC Lead Agency
 CSB is also a funder to many of the organizations
entering data into HMIS
Abt Associates | pg 28
Columbus System Components
 Transparent: Operate an “open” HMIS, and have
done so since inception (i.e. data is shared among all
participating programs)
 Quality Assurances: Data quality reports are run by
agencies, submitted to and approved by CSB
 Data Quality Standards: Timeliness, Completeness,
Accuracy, and Consistency
 Regular Reporting: Annual performance evaluation,
Quarterly performance monitoring, Monthly
performance reports, Quality Improvement
Intervention reports
Abt Associates | pg 29
Data Driven Funding Decisions
 Program scoring has funding implications for NOFA,
city, county and other funders
 Issued to CSB Board of Trustees, Continuum of Care
Steering Committee and Funders
 Completed based on first half of FY for use in
following FY funding determination
 Program outcomes compared to planned outcomes
 Posted to www.csb.org
Abt Associates | pg 30
Model for Scoring of Programs
 High
– Achieve at least 75% of the measured outcomes and at least
one of the successful housing outcomes (either number or
percentage outcome)
 Medium
– Achieve at least 50% but less than 75% of the measured
outcomes
 Low
– Achieve less than 50% of the measured outcomes
 Low performers are invited to participate in a Quality
Improvement Intervention
Abt Associates | pg 31
Snapshot of Annual Report
Abt Associates | pg 32
Program Detail in Annual Report
Abt Associates | pg 33
Key Change 2: 2011 HMIS Requirements
Proposed Rule
 When final, the HMIS Standards and Notices will mark the
first time that best practices and procedures previously
encouraged by HUD will be mandatory
 Data Quality
 Privacy and Security
 Governance
 Central aim: “…provide for uniform technical requirements
of HMIS, for proper collection of data and maintenance of
the database, and to ensure the confidentiality of the
information in the database”
Abt Associates | pg 34
Impact of Revised Standards Data
Standards
Agency Data
Collection
Forms
HUD reports
(APR, AHAR,
etc.)
Data
Standards
HMIS data
entry screens
HMIS vendor
report
programming
Abt Associates | pg 35
Key Change 3: ESG and CoC
Program Interim Rules
 CoCs must be able to report outcomes and performance at both
the program and system level
 CoCs must be able to look at a client’s data across the entire
CoCs HMIS
 Data quality will be critical to the success of reporting on
outcomes and performance
– Bed and unit capacity and coverage
– Bed and unit utilization rates
– Client lengths of stay
– Returns to homelessness
– Income and employment outcomes
Abt Associates | pg 36
Coordinated Assessment
 ESG and CoC Program Interim Rules also require
CoCs to implement coordinated access systems
 Coordinated assessment must be done
collaboratively between CoC and ESG recipients
 HMIS will be a crucial part of this
– Track availability of inventory
– Share data across programs
Abt Associates | pg 37
Example 2: Cincinnati, OH
 CoC wide implementation of HMIS
 Utilizes a locally developed HMIS software (Vesta)
 Software developer (Partnership Center, Ltd.) also
serves as the HMIS Lead Agency for the CoC
 Agencies pay a fee to participate in HMIS, based on
their annual budget
Abt Associates | pg 38
Cincinnati System Components
 Investment in System: The fees paid by agencies
have the potential to ensure that they are “bought in”
to the HMIS
 Regular Reporting: HMIS data is regularly reported
on the HMIS Lead Agency’s website
 Virtual Trainings: “Just-in-time” trainings available
on the HMIS Lead Agency’s website, make training
accessible to users at all times
Abt Associates | pg 39
Central Access Point (CAP)
 In 2008, the CoC developed a program (CAP) to
implement a coordinated access system for the
community
 Focus is on prevention and rapid re-housing screening
 Intake workers complete an initial assessment to start
process of confirming program eligibility
 HMIS is used to track bed availability, and to start client
records (intake workers)
 HUD and philanthropic funding were secured to
implement CAP
Abt Associates | pg 40
Example 3: State of Michigan
 Statewide HMIS implementation (MSHMIS)
 Michigan Coalition Against Homelessness (MCAH)
partners with Michigan State Housing Development
Authority (MSHDA) to manage MSHMIS
 Over 600 agencies participate in the MSHMIS,
including dozens of agencies that do not receive
HUD funding for providing services to homeless
assistance
 MSHMIS covers 83 counties
Abt Associates | pg 41
Michigan System Components
 Robust Reporting Capacity: Implemented one of
the nation’s first HMIS Data Warehouses
 Virtual Training Programs: Given the reach of the
HMIS, the state has invested in creating virtual
trainings for users
 Flexible Sharing: Allow for agencies to opt in to
data sharing, and for clients to select which data
elements they’d like to share
 System of Support: Local HMIS System
Administrators regularly meet and attempt to triage
problems prior to tickets being logged with MCAH
Abt Associates | pg 42
Data Warehouse: SHADoW
 Received HUD funding to create Statewide Homeless
Assistance Data Online Warehouse (SHADoW)
 Combines data from statewide HMIS and Michigan
Human Services Data Warehouse
 Combines de-identified client data to examine homeless
use of state mainstream systems. Data is used to help
determine:
1.
Cost of homelessness
2.
Impact of state program changes
3.
Patterns of state service usage relating to homelessness
4.
Extent homeless are benefiting from state services
Abt Associates | pg 43
Results of SHADoW
 In 2010, used data to analyze effectiveness of
prevention services, finding an overall 4% failure rate
 Have data from 2006 to present
 Found a high level of matches between HMIS and
Medicaid records (80%)
Abt Associates | pg 44
Questions?
Any questions on the HEARTH Act
requirements? HMIS? Other topics?
Abt Associates | pg 45
Potential of MDHI
HMIS Software
Adsystech HMIS Demo
 Demo and discussion of what the Adsystech HMIS
software’s current capabilities are for the MDHI CoC
Abt Associates | pg 47
Group Exercise #2: Creating the
Vision for MDHI’s HMIS
 Let’s design the ideal HMIS
 Where do we want to be in 5 years?
Abt Associates | pg 48
Wrap Up and Next Steps
 HMIS Committee Recruitment
 Coordinated Entry Bridge Group
 Follow-up survey to meeting attendees
 Quarterly user survey
 Compile and distribute priorities identified today
Abt Associates | pg 49
THANK YOU!
Abt Associates | pg 50