Homeless Management Helps Community Care for Indigent Citizens | Article

homeless manOn the outskirts of Raleigh, North Carolina, a converted warehouse serves as the South Wilmington Street Center, a men’s shelter that helped almost 2,000 men in 2004. The homeless begin gathering outside around noon, even though the doors don’t open until four. Workers assign beds for up to 234 homeless people each evening, even more on the coldest winter nights when sleeping mats are placed in meeting rooms and the cafeteria to handle last-minute overflow.

This is a snapshot of the challenges many metropolitan areas face in managing a growing number of disenfranchised citizens. Census data indicate that over 15,000 Wake County residents live with friends or family because they can’t afford a place of their own. Studies suggest this larger group is at extreme risk for homelessness. Many drift in and out of shelters and transitional housing. Family homelessness in Wake County rises 11 percent annually (and overall homelessness by about 20 percent a year). Nationwide estimates state that over two million Americans are homeless or at-risk according to US Census figures.

Many suggest that number is low, but can’t be certain because there are few ways to manage programs accessible to the homeless, not to mention count them. And face-to-face counts (the only heretofore option) have long been the only way, which are far from precise due to the nature of homeless transience.

In order to get a more accurate sense of its homeless and learn how to manage and help them properly, Wake County officials, area nonprofit representatives, and faith-based organizations worked with Softscape, an outsourcing provider of integrated people-management software, to develop one of the first homeless management information systems (HMIS).

County government and non-governmental groups alike now use this HMIS to create a single view of each homeless person in Wake County and improve collaboration among these entities that serve the county’s homeless, jobless, poor, and all who are at risk. This partnership between Wake County’s collaborators and their outsourcing provider created a solution that’s now replicated in other communities.

The HMIS has been in place since 2004, and all agency participants say it has not only saved time and money, but improved the level of care they provide. It has also helped Wake County retain millions of dollars in annual HUD grants that it may otherwise have lost and reveals data in seconds that previously took hours to prepare or access. This in turn allows users to spot trends more quickly and marshal resources sooner.

“This enables us to integrate our services across our complete continuum of care,” says Wake County’s IT manager, David Stratton. “It allows our staff to coordinate services and better meet the needs of our citizens.”

Wake County officials now have real numbers from the HMIS they can use to obtain the appropriate level of resources from government and private sector contributors. Sixteen organizations use the HMIS, and more organizations, including local schools and hospitals, will be part of the system soon.

“Any executive officer in a public hospital will tell you that a hospital’s major financial issue surrounds indigent care costs,” says Mary Scott Nabers, President/CEO of Strategic Partnerships, Inc. “Getting hospitals to become part of the solution is a benefit for the homeless, the hospital, and the taxpayers. But coordinating data necessary for all government offices to efficiently work together in order to break the homeless cycle can do nothing but benefit any community and its citizens.”

This didn’t happen without overcoming major hurdles, the most prominent surrounding personal data of the county’s homeless and at-risk homeless, primarily over privacy and who has access to this information.

Collaboration Generates Public/Private Sector Harmony

The Wake County/Softscape partnership leverages the company’s primary people management framework, which was tailored to serve the public sector in the management and hosting of human services data.

The plan called for a Web-based application that all the agencies could use. Each homeless or at-risk person in the system has a unique ID in order to avoid duplication. Service providers at different agencies can access information about the client generated at other participating agencies. It’s hosted by Softscape, which relieves Wake County’s need to maintain it.

Most of the funds that drive all programs designed to help homeless and similar “at-risk” groups come from federal Housing and Urban Development (HUD) grants. HUD requires that metropolitan areas form Continuums of Care (CoC) “umbrellas” to include all departments (public and private) of the overall continuum. This requires all organizations dealing with the homeless within each community to demonstrate collaboration in order to be considered for these federal grants. Now county officials have real numbers from the HMIS they can use to obtain the appropriate level of resources from government and private-sector contributors.

The Wake County CoC has 30 members, ranging in size from the county’s Human Services department, which has 1,700 employees and nine buildings, to the Interfaith Food Shuttle, which has only one case manager and some volunteer drivers. But a 2001 HUD mandate requiring that CoCs implement information systems capable of tracking at least 50 percent of a community’s beds by October 2004 was the nudge toward better collaboration.

“When I first saw the mandate, I thought, ‘This is wonderful in theory because it will help end the controversy on the number of homeless people we have,'” says Rev. James Galloway, former Executive Director of the PLM Families Together, which offers transitional housing for single mothers and their children. “My practical response, however, was, ‘Oh, bleep.'”

The Ten Ton Gorilla: Data Security and Privacy

Galloway was concerned about the confidentiality of homeless people it would manage and their distrust of some county departments that led the project. While many of these concerns predated the HMIS, the project’s leaders knew they had to allay these fears before they could make any progress. Rather than forcing a system on reluctant users, the project leaders designed the system to meet these concerns. “A system can be an easy scapegoat,” says David Stratton, the IT manager for Wake County’s Human Services Department. “Projects like this tend to be a lightning rod for any unresolved issues in a community.”

“For many of the nation’s homeless, all they may have left is their privacy, something they are going to safeguard at all costs,” says Nabers. “They are not likely to share personal information, even if it means access to services and benefits, if they can’t be assured that their information remains private.”

With that in mind, the agencies compiled information into 11 comprehensive categories, such as health, mental health, substance abuse history, job status, and education. Softscape designed the system so that the most sensitive personal information captured in each of these categories was a separate data element that could not be shared independently from the other 10 elements.

Larger Communities Realize HMIS Benefits

The effect on management and the partnership that helped it evolve is all-encompassing, and best illustrated by the difference at the South Wilmington Street Center. Shelter director Carson Dean wanted the homeless check-in process to be fast because men in line are easily agitated by waiting. Initially, it took 30 seconds but wasn’t fast enough. The Softscape developers, after observing the check-in process, redesigned the system so that it took only two steps and ten seconds: Enter the name, then click on a bed number. Pop-up alerts notify a worker if there is new information about the client, if he has mail, or if he was involved in a violent episode the previous night.

“The architecture that this HMIS relies on is extremely flexible and easily modified for a diverse number of human capital initiatives,” says Christopher Faust, Executive Vice President for Global Strategy with Softscape.

Since Wake County unveiled its HRIS, New York City’s Department of Homeless Services CIO Dilip Kulkarni says that his CoC, by far the largest in the country, looked at Wake County’s HMIS before deciding to use it there. And recently, Chicago also implemented the solution.

Not long ago, the Wake County CoC voted unanimously to incorporate as its own entity, which will allow it to make payments and accept donations directly. “Six months ago everyone thought incorporating was a ridiculous idea,” says Galloway. But the HMIS has brought them closer together. Members of the CoC also say that the data they glean from the HMIS and the benchmarks and metrics it provides, help attract private-sector donors who can now make contributions to a central organization.

Lessons from the Outsourcing Journal:

  • With over two million US homeless, having an HRIS to manage available services can empower all agencies who serve them to know what everyone else is doing, paint detailed pictures of just what services each person needs and secure as much funding as possible because the data derived can be used for that task as well
  • Keeping each homeless person’s data secure from “prying eyes and agencies” creates trust and encourages them to seek the care they need in order to break the homeless cycle.
  • The outsourcing of such tasks enables communities to save money in managing its homeless initiatives and, if the data is hosted remotely, relieves the community from those responsibilities too.

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