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Center for Social Policy
McCormack Graduate School
University of Massachusetts Boston
100 Morrissey Blvd.
Boston, MA 02125-3393
Phone: (617) 287 5550
Fax: (617) 287 5544
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HMIS-Tracking the Homeless: What It Is and What It Means
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Author(s):
Cynthia J. Baron
Source(s):
Spare Change News
Date: December 11, 2003
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Some homeless people do not want to give information about themselves when they stay at a shelter.
Some shelters don't want to spend scarce dollars and precious staff time to collect this data and
enter it into a specially programmed computer. But by the fall of 2004, as mandated by a
Congressional directive in 2001, all HUD funded homeless service providers in the US must
implement HMIS (homeless management information system), an integrated system for collection and
transmission of data on the homeless population in order to receive Housing and Urban Development
(HUD) funding (through the McKinney-Vento Act).
This means getting at the very least 17 pieces of information according to HUD's draft HMIS Data
and Technical standards on the homeless men, women and children participating in HUD funded
programs, information that includes such things as gender; race; age and living situation prior
to shelter stay. Some sample communities, including Boston, will be required to collect
additional information such as special needs, e.g., alcohol problem, mental health problem,
drug problem; health coverage and income.
I spoke with Julia Tripp and Nancy Sullivan both of whom work at the University of Massachusetts
Boston's (UMB) Center for Social Policy (CSP) at the McCormack Graduate School of Policy Studies.
CSP was chosen to set up HMIS for the state of Massachusetts. Julia Tripp, 11 years homeless
and a drug addict, has worked for 7 years with the HMIS project, starting long before it became
a mandated program, and gives the consumer perspective at all phases of the project. Nancy
Sullivan is the CSPTech (the same initials as the Center for Social Policy, but here CSP stands
for Connection, Service and Partnership through Technology) Project Manager. She gives the point
of view of the project's central focus. The two are sometimes on the same page and sometimes
quite divergent in their outlook.
Homeless people using shelters (and other service programs such as an outreach program) are asked
to give a staff person at least 17 pieces of information, but usually a good bit more than that.
At large shelters, like the Pine Street Inn, there is a feature called "the bed register"-when
the homeless person enters the shelter only a few pieces of basic information are collected, then
the person is checked into a bed. Later on a shelter staff person will get more detailed
information.
Homeless people may not want to give information for HMIS, but Sullivan says that according to
CSPTech's Policies and Procedures, homeless consumers have the right not to answer any question,
unless entry into a program requires it, but many consumers choose voluntarily to give
information. "Nonetheless," says Tripp, "I think there's a lot of feeling in the homeless
community that this is an invasive system, that it's not going to help them; it's going to make
them known to the powers that be … that the data will be made public and/or be used against
them." Sullivan stresses that there are important privacy protections in place to prevent these
fears from becoming a reality: No client records are shared with another agency without written
client consent and agencies must specify which pieces of information will be shared.
Furthermore, agency executive directors must sign an agreement to share information. In fact,
most agencies choose not to do this.
Clients do not have to answer any question if they don't want to and can still receive shelter
services. Only entry into a service program such as an outreach program, may require clients
to give personal information.
Only shelter staff can view identifying information, not UMB staff and not HUD. Agency staff
enter identifying information, but it travels over a secure encrypted connection, so that no
one can tell who the person is.
All shelters and other agencies using HMIS must have certificates installed on their computers
and must have a password and user name. This limits use of ServicePoint, the computer software
for UMB's HMIS, to computers that have certificates. Thus, "I can't go home, jump into
ServicePoint and start entering [or accessing] data-I can only do it at a computer where a
certificate was installed," says Sullivan.
In fact, Tripp was asked to join the HMIS project precisely because she didn't believe in
confidentiality and privacy-she felt "they didn't exist." "Would you," she was asked, "join
us and bring that perspective to our work." Her first task was to work with providers (shelter
representatives and people from other homeless service groups) and some homeless people and
look at the privacy protections policies and whether "HMIS questions were being framed
appropriately, and if they were the right questions to ask people to find out what their needs
were, where they were at, and what income they had," says Tripp. Later, Tripp formed a
consumer advisory committee made up of homeless and formerly homeless people involved in giving
input to various parts of the HMIS project.
Sullivan says the CSP wants to expand the consumer advisory committee and to go beyond the
committee to "have voices of many consumers … involved in the project and helping to shape that
project as we move forward. That's our goal. We're not there yet. We want to connect with
groups that may already be formed, connect with [homeless] people who want to be part of the
project and to figure out ways to make that happen."
Tripp is also on the project's approximately 25 member steering committee, which is made up of
consumers, advocates, providers and funders. She is one of the two consumers now part of this
committee, and wants to expand the number so more homeless people can participate. She gives
the caveat that before they join, homeless people must "come through some process that informs
them first so that the questions they can put to the steering committee are informed questions.
You need to understand what this damned thing is before you start fighting it. This could be
a powerful tool for people that are homeless." One example of homeless people's use of the
system is that they would be able to say, "I know you have this [and that] available; these
are the things I think I need-am I eligible [according to the information you have on me]?"
Tripp points out.
According to the privacy protections, homeless people don't have to answer any question if
they don't want to, and they will still receive shelter services. Why, then, would any of
them contribute personal information for HMIS. Sullivan says, "Our goal is that if we can
build trust, and we can explain what we are doing with the consumer population and they feel
more secure about the system, they might be more apt to give information that's accurate and
detailed, which would then help us with producing really good quality data."
However, Julia argues cynically, "Although a lot of times homeless people don't realize the
connection between data collection and findings, [those who do might well ask] 'How does
that make me feel any more comfortable giving up all my information because I know that this
shelter that doesn't treat me right is going to get a whole lot of money to keep doing a
lousy job?'"
What homeless people may not realize is that UMB's CSP analyzes the data they collect to put
out comprehensive reports on the homeless population with the goal of impacting policy,
making it more likely, for example, that gaps in the system are clearly recognized and that
the system works more effectively to help transition consumers into permanent housing.
Tripp characterizes HMIS data analysis as a tool "that shows a picture, a snapshot, if you
will, of who is in the system, what services they're using, and so, what happens to them
as they move through the system. With HMIS the whole hope is that we will look at [and ask],
"Is the homeless service delivery system being effective-is it moving people out of
homelessness, if not, why not?'"
In general, Tripp agrees with Sullivan that trust is the issue about the homeless giving data
about themselves. She sees it as depending on a trusting relationship between the homeless
person and his/her case manager or other staff person at the shelter: "I think giving your
information up means developing a relationship of trust between you [the staff person] and
me [the consumer]. You're going to help me … there's a trust between me and the system …
those are different levels of trust that have to be learned …" She also notes that giving
information may now start at the shelters, but, in fact, to get an apartment or, as Tripp has
just done, to get a condominium, you must give up a lot of information about yourself.
Sullivan observes that according to HUD's data Data and Technical Standards, consumers may be
asked to divulge identifying information such as social security numbers. Tripp also fears
"the privilege of anonymity is coming to a close."
Actually, the Congressional mandate for HMIS implementation directed Continuums of Care
(CoCs) to give reports from member agencies. CoCs are groups of HUD funded agencies (including
some shelters) that meet throughout the year to determine what the needs are of their homeless
population and what are the gaps in services for them-they determine services needed to meet
these needs and apply for appropriate HUD funding. Since the mandate, HUD has added an HMIS
section to their applications for the funds. Massachusetts has 21 CoCs.
At this point CSP gets funding from a few CoCs and from the State. Over the years, state
funding has supported CSPTech's work with emergency shelters meaning that shelters have been
able to work with CSPTech free of charge. CSPTech is still awaiting notification of its
state funding award for this fiscal year. Shelters, however, must purchase a computer and
a high speed connection. (HMIS is an unfunded mandate so there are no additional funds
available for its implementation and maintenance.) They must also have a staff person who
can devote time to data collection and data entry. Although they know they need to implement
HMIS, some shelters don't want to take money from supplying services to their homeless
populations to support the directive. Some shelters have been collecting data for a number
of years already, while others are just starting now because they have to. It's a tough
situation for these shelters and they can be very reluctant contributors to data collection.
Tripp comments on this dilemma, saying, "Everyone's got to tow the line and a lot of people
don't want to do it, but it's a mandate [so] we've got to figure out how to get the best
effort out of this tool that's sucking up a lot of money but yet could actually show us the
right direction to head in around policy."
UMB's CSP took on the HMIS project because they wanted to analyze this data. "There was a
real interest here because the goal was to use data from HMIS to impact public policy. CSP
has a long history of doing research on issues affecting low-income people, for instance,
food stamps and welfare reform, and having a solid reputation for this work,, they
originally got funding from the City of Boston, then some funding by the State. As time
went on, they took on other HUD funded CoCs and grew naturally to be the statewide
organization for HMIS.
CSP puts out reports for CoCs they have a contract with, reports not widely circulated but
rather done specifically for them. However, they also put out comprehensive statewide
reports from analysis of their data, which, based on policies developed by the project's
steering committee, must represent at least 60 percent of those persons served in a region
before being released. Sullivan feels the data is good because it reaches the 60 percent
threshold but hopes for even better data in the future. Tripp, reviewing the as yet
unreleased statewide report for 2002 on characteristics of homeless individuals sees much
room for improvement. The report is not accurate, she says, "because it's not based on
every single shelter in the city and not every [homeless person] is giving their information,
so it produces a kind of picture-over time, that picture will get clearer." In fact, the
data for the statewide report for 2001 is based on information collected from 16 shelters,
which represent 62 percent of persons served by the shelter system in that year. Comparisons
are made with data collected for 1999 and 2000.
The data for 2001, in the latest report released, are quite interesting. The following are
a few of the many findings: 52 percent of homeless individuals in the shelter system are
white, 28 percent are African Americans and 14 percent are Latino. For education, many
individuals have some high school background, have a high school diploma or their GED,
Eighteen percent have some college, and 8 percent have a bachelor's degree. Among the
number of possibilities for residence prior to entering the shelter, only 6 percent come
from a detox or substance abuse center, only 2 percent come from a jail, prison or detention
center, and only 1 percent come from a mental health or other hospital. As for having
health insurance, only 61 percent have Medicaid or masshealth and 31 percent have no
insurance at all. Of those who have income, fully 41 percent have employment income when
they enter the shelter, and the average monthly income from employment is $1,115. Data
analyzed and compiled include figures for homeless individuals; for individual homeless men
and women; for youth, adults and the elderly, and geographic comparisons between those
served in Boston, and those served through the remainder of the State. The complete report
can be found on the CSP website:
www.mccormack.umb.edu/csp/index.jsp. Soon, you will be able
to see their statewide report for 2002. HUD wants data so they know what is happening with
their money, but beyond that, having a good picture of the actualities of the homeless
situation will hopefully enable policy to be directed more fundamentally toward the
abolition of homelessness.
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