How Do We Know What We Know? - The Final Installment of the CoC Strategic Work Plan Online Learning Clinic

In this final installment of our Continuum of Care Strategic Work Plan, we touch on Goal V: Drive Decision-making with HMIS Data, zeroing in on Objective VIIII: Increase Homeless Management Information System (HMIS) participation rates to no less than 86% of all beds and housing types.
 
In a recent blog post we talked about the idea of ending veteran homelessness, and how more than fifty communities have achieved just that. Now, you might ask: Are you trying to say that there are no homeless veterans in any of those communities? Well, no, that is not what we are trying to say. Indeed, the quote from the U.S. Interagency Council on Homelessness (USICH) in that blog post talks about those communities bringing down the number of veterans experiencing homelessness not to zero, but as close as possible to zero. So, what is it? What do we mean by ending veteran homelessness?
 
USICH helpfully defines this for us in a document that is worth reading in full. Basically, it means that all veterans experiencing homelessness are and continue to be identified, that shelter is provided immediately to all who request it, that traditional transitional housing is rarely used, and instead all are offered and provided with permanent housing, as swiftly as possible. Most importantly, that community must not have done all of this on an ad hoc basis, but show that it, “has resources, plans, partnerships, and system capacity in place should any Veteran become homeless or be at risk of homelessness in the future.”


Governor Dan Malloy, of Connecticut,

discussing his state being the second to end veteran homelessness

(Courtesy of WNPR)

The importance of knowing that more than fifty communities have done this is, as we pointed out in that previous blog post, that this is doable. We often assume that what is, always was, and will always continue to be. Perhaps this is a result of our evolution, which before modern times granted us extremely short life spans. Indeed, the forty years of the modern homelessness crisis is longer than the life expectancy of our prehistorical ancestors roaming the African savannah. That is just it, though, this crisis is a new phenomenon in American Life.

What we aim to return to, through the development of effective homeless response systems across the country, is not full housing, with no one ever becoming homeless. What we aim to return to is a reality that existed in our country prior to the mid-seventies of the last century, when homelessness was rare, brief and nonrecurring. And so, when we speak of ending homelessness, what we really mean is bringing about an end to the modern homelessness crisis.

(Parenthetically, this is not to say that full housing is not a desirable outcome. As Dr. Barbara DiPietro pointed out in her visit mid-October, it is extremely desirable, and it too is very doable. However, this would require a realignment of resources, across our society on a much broader level. At the minimum, it would likely require that housing vouchers be made available to all who qualify for them, and that refusing to accept them as payment be outlawed across the land.)

But, how will we know when we get there? This might seem like a simple question. If only. In fact, one might ask a broader philosophical question, “How do we know what we know?” The study of how we know what we know, epistemology, has become extremely important, as our society further fractures and sources of information multiply. We are forced to ask ourselves, “What are the necessary and sufficient conditions of knowledge? What are its sources? What is its structure, and what are its limits?”

This is especially true regarding homelessness, where, “our failures are the most visible and our successes the most hidden." In this type of environment, it becomes difficult not to fall into the trap of assuming that data is just the plural of anecdote, and that the latest sensational headline negates evidence based practices.

The only hope for truly knowing what we know is the painstaking continuous and relentless collection and analysis of data in one shared open system, which everyone reports into. That word everyone is the crux of this proposition. As we mentioned in a previous post on this blog, “In early 2015, only 3%(!) of the shelter beds available to Dallas’ homeless population were reported into the (homeless management information) system… It was… analogous to Schrödinger’s Cat… the cat was 97% sealed within the box.”

 

We have come a long way since that 3% mark in 2015, partnering with PCCI and now Pieces Tech to develop and over the last few months implement, that single open state-of-the-art HMIS for Dallas, gradually and continuously increasing the number of beds in the system. We are determined under this plan to break that 86% mark, the minimum acceptable to the Federal Government, and keep on pushing until we get as close as possible to 100%. That alone is bringing us that much closer to achieving an end to not only veteran homelessness, but all types of homelessness, making this societal ill, once again, rare, brief and nonrecurring, and keeping it that way.

Schrödinger’s Homeless Cat*

The Thought Experiment

Perhaps the most famous quantum physics experiment is the thought experiment known as Schrödinger’s Cat. Erwin Schrödinger disagreed with a model of quantum mechanics. That model held that a particle exists in multiple states until observed. He used his thought experiment to disprove that model.

Imagine a sealed box containing a cat, a bottle of poison and a radioactive sample. The box is rigged, so once the sample has decayed, the bottle shatters, which kills the cat. Opening the box will allow us to detect if this has happened yet or not, but what about when the box is still sealed? According to the model Schrödinger was trying to disprove, the cat would be both alive and dead at the same time! Since that is obviously impossible, that model cannot be true. QED.

Now what remains true, and what undergirds the entire thought experiment, is that until we open the box, we don’t know if our furry feline friend is alive or dead. This is a perfect analogy for two different problems MDHA has been working on for the last two years.

(Courtesy of NobelPrize.org)

The Homeless Count

In early 2015, MDHA told the community, that regarding the number of unsheltered homeless persons counted in the annual homeless count, we had this type of Schrödinger’s Cat problem. We knew there were unsheltered homeless, and we were counting them every year, but we could not be confident we were finding everyone that could be found. We had what was, at least partially, a sealed box.

We needed to improve our count methodology, and we needed more volunteers. We explained that the experiences of other communities showed that you needed a ratio of 1:1, i.e. one volunteer per one unsheltered person, to find and count everyone.  We suggested that likely there were about 1,000 unsheltered persons in our jurisdiction, Dallas and Collin Counties.

Indeed, in 2016, in our first count conducted under our new counting regime, we had about 750 volunteers, and we found about 750 unsheltered homeless persons. (In 2015 we had found only about half as many.) We still were not able to cover all the routes we had carefully plotted in 2016, so we continued to suspect that we were not finding everyone who could be found.

In 2017, we set our target at 1,000 volunteers, and we ended up with about 1,375. We covered 99.5% of our routes, and we found 1,087 unsheltered persons. The box was unsealed, the cat was fully in view, and our two-year-old prediction had proven true. This is why in the 2017 State of Homeless Address we suggested that this number be the benchmark for our work moving forward.

 
The Homeless Management Information System

There was one more Schrödinger’s Cat problem we pointed out in early 2015. Communities in the United States are required under Federal Law to maintain Homeless Management Information Systems, commonly known as HMIS. Organizations like MDHA are tasked with operating these systems. Most organizations receiving Federal funding for housing programs for the homeless are required to report crucial data into these systems. This is not an issue of bureaucratic compliance. The only way we can and do help individual organizations and the community at large improve in our fight against homelessness is through collecting this data, analyzing it, and using it to drive improvement.

The problem was that in early 2015, only 3%(!) of the shelter beds available to Dallas’ homeless population were reported into the system. The data reported into the system from Federally funded housing programs is tremendously valuable, but it is data about the “back-end” of a person’s journey from homelessness to housing. The shelter environment is the “front-end” of homelessness, and we had very little data about it. It was more analogous to Schrödinger’s Cat, than the annual count ever was. In this regard, the cat was 97% sealed within the box.

 

 

During the last State of the Homeless Address, we had the audience go through our own thought experiment to drive this point home. We asked everyone to stand up to represent 100% of the homeless population. Then we gradually had sections of the audience sit down, leaving only a small section standing. We explained that we could not possibly, with a straight face, contend that the data we collect about the small section standing, was representative of the entire audience.

Already back in 2015, we stated that one of the most important things Dallas needed to do was move from 11(!) separate data systems to a single open state-of-the-art HMIS system, with at least 86% of shelter beds reported into it. The Federal Government does not really consider data from a system that does not have, at least 50%, to have any meaningful validity. Only at 86% does it consider the data to be comprehensive and reliable enough to award the community points on its collective grant application for homeless housing programs. The Federal Government cut the funding for homeless housing programs in Dallas twice over the last few years, because of this very problem. That cut did not affect the shelters; it affected the housing programs.    

 

We have been working on this problem for the last two years, early on partnering with PCCI and now Pieces Tech to develop that single open state-of-the-art HMIS for Dallas. In the meantime, we have increased the number of shelter beds reported into HMIS from 3% almost eleven-fold, but that is still just 32%. We are excited to be on the cusp of transitioning to the Pieces Tech HMIS, and even more excited that more service providers will be signing on to be a part of it. We are determined, this year, 2017, to break that 86% mark, and finally bid Schrödinger’s Cat adieu. We owe our homeless neighbors nothing less.   

* MDHA wishes to assure readers that no cats were harmed during the writing of this blog post, though one rabbit gave me a dirty look.