Homeless Response System Online Learning Clinic 2018 – Part V: Building Dallas’ Homeless Response System – 2015-2017 – Data Transparency
All homeless service
providers must practice full transparency, by reporting all data into the
Homeless Management Information System (HMIS), the federally-mandated
community wide database, that drives improvement of homeless services programs,
without exception (barring issues of safety). Reporting into HMIS is not simply
an issue of bureaucratic compliance. This is the only way we know if and how
much progress our community is making. More importantly, this is the only way
we can improve and self-correct, where we are not[i].
In the last three years, Dallas made huge strides,
specifically, in this area. For instance, as late as 2014, no emergency
shelter beds were reported into HMIS. It is impossible to assess system performance,
in the absence of data on the point of entry into homelessness. Therefore,
communities that do not have that data in their HMIS are routinely penalized
for it, as Dallas
was. However, unlike the housing programs, funded through the Continuum of Care
(CoC) Program, MDHA cannot simply require shelters to enter their data. MDHA
methodically worked with each of the major shelters, and over the last three
years brought most of them into the system. As of December 2017, with the
Salvation Army adding all of their 700 beds into the system, 57% of shelter
beds are now entered into HMIS. In 2018, we will meet and exceed the
standard set by the Federal Government, 86%.
These simple numbers,
important as they are, bely a more fundamental shift in the HMIS, here
in Dallas. In
early 2015, MDHA and its partners began a discovery process that led the Continuum
of Care (CoC) to adopt a new HMIS system, built from the ground up, by a
non-profit founded by the Parkland
Health and Hospital System, PCCI[ii],
and its for-profit affiliate, Pieces Tech[iii].
This system was designed to be part of a larger ecosystem tracking individuals
as they move through the healthcare system and social service organizations, Pieces
Iris.
Pieces Iris was born out of the recognition that limited
communication between the healthcare system and social service organizations,
may cause vital information to slip through the cracks. The idea was to create
a seamless system that connects healthcare and community-based organizations,
allowing for smart sharing of information that makes a tangible difference in
the lives of the most vulnerable populations[iv].
As PCCI President and CEO, Dr. Steve Miff, told the Becker Hospital Review[v],
in September 2017, “Up to 50 percent of clinical outcomes are driven by social,
economic or environmental factors, and not necessarily related to the direct
care the individual received. That has basically set the stage and created the
need for this solution to connect communities, and through that, to drive
personalized medicine."
Over the course of the last
three years, MDHA, PCCI and Pieces Tech worked hand in hand to launch the new
HMIS, which went live in mid-2017. As Politico Magazine[vi]
wrote in December 2017, Pieces Iris is already, “having a powerful impact on
overwhelmed homeless organizations in Dallas…
The availability of data showed… that homeless people were 167% more likely to
have emergency room visits than the non-homeless population, and that from 300
to 400 homeless were arrested in Dallas
each month. Neither of these pieces of information was shocking, but they gave
[MDHA President and CEO, Cindy J.] Crain data she could take to officials to
try to influence policy on homelessness. If she could show that housed people
needed fewer EMS transports, ER visits and less time in jail, then, she
reasoned, ‘I can make a business case to say, it’s not only the moral thing to
bring housing to these homeless, mentally ill people. It’s going to save you
money. If you don’t serve these people they’ll die in the street or eat you
alive with these public response systems.’”
Finally, one glaring fact
that “jumps out” at anyone who analyzes the data on homelessness in Dallas, is the overrepresentation
of African Americans in the homeless population. Since late 2016, with the
support of the United Way of Metropolitan Dallas[vii] Unite Dallas Relief Fund[viii], we are
partnering with six other cities, towards establishing more racial equity in
homeless services, through SPARC (Supporting Partnerships
for Anti-Racist Communities)[ix],
a new research and action program from the Center
for Social Innovation (C4)[x].
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