How one region consolidated homelessness data to improve care

Homelessness in San Diego County rose by 14% this year, according to a point-in-time count conducted in January by a regional task force. Overall, more than 10,260 people in the area are experiencing homelessness.

As these individuals go between service providers, housing specialists and other government agencies, outreach workers are having to ask repeatedly for the same routine data, like their name, date of birth or Social Security number. Having to gather this information again and again was not only forcing homeless people to relive traumatic moments in their lives over and over, but it was also hampering caseworkers ability to actually get them help.

To confront the growing crisis and move these individuals off the streets and into housing faster, San Diego County is looking to streamline how it collects and shares that data among the more than 75 different organizations and agencies that interact and provide services to the homeless in the region. One way the county is doing that is migrating the data to the cloud.

The groups that work with the homeless in San Diego County report to the Regional Task Force on Homelessness in the area, which is designated as the area’s Continuum of Care, a collective representative body committed to the goal of ending homelessness to which grant funding is distributed by the U.S. Department of Housing and Urban Development.

The task force maintains San Diego County’s Homeless Management Information System, or HMIS, which keeps track of clients, services and outcomes. And by adopting the system and migrating the data to the cloud, caseworkers are able to pull up integrated data on one individual, even as they engage with different service providers across the region.

Those various service providers can now access the system on an iPad or other mobile device when an individual experiencing homelessness comes to register for services. Caseworkers can pull up their profile and see, among other things, what services they have used already. That avoids making people repeatedly relive traumatic experiences and helps keep track of their progress towards housing.

Tamera Kohler, CEO of the task force, calls it a “longitudinal” approach to homelessness. “We're tracking their progress through the system,” she said. “That may mean they touch multiple programs, multiple providers to really exit to a housing outcome. The only goal that we're looking for is that these folks are connected to housing in some very intentional way.”

The migration of data to the cloud represents a major departure from how things were done before, when each service provider would collect their own data on clients that may or may not be standardized. Often the data wasn’t, which meant regional officials would have to reconcile the data afterwards to ensure compliance with the terms of state or federal grants. With tens of thousands of people coming through the system each year, it meant a lot of data to keep on top of.

The cloud software and standardized data helps task force officials do more effective data analysis to see how programs are performing, not just for elected officials and agencies that award grants, but also for the public. For example, for every 10 homeless individuals that found housing last year in San Diego County, 13 more became homeless for the first time. This statistic, said Kohler, was generated from the integrated HMIS data.

“We need to be able to pull that up into a higher level of simplicity to really educate not only the general public, but also our politicians,” Kohler said. “It is really powerful for those in my county government, for those in state government, to be able to know you've got a robust system.”

Integrated data also helps Continuum of Care programs reduce the “bureaucratic burden” and allow caseworkers to focus on what matters, said Cameron Shorkey, director of business development at Bitfocus, which provided the HMIS software used by the county and runs on the Amazon Web Services cloud. “Everything is immediately accessible to whoever is working with the client to make sure that no time is wasted and making sure that they get the intervention they need.”

An implementation guide produced for HUD by the Center for Social Policy at the John W. McCormack Institute of Public Affairs at the University of Massachusetts Boston said without a management system in place, communities have “no consistent means to identify service needs, barriers to accessing services, and program-, region-, and system-wide results.”

To encourage adoption of such systems, the guide offers information on various streams of government grants available. But the guide also notes that it can be difficult to prioritize funding for HMIS software given other budgetary needs and constraints. 

Kohler said adequately funding HMIS is the best way governments at all levels can support their work, especially as that allows organizations and agencies to hire and train the staff needed to properly administer services.

Beyond that, she said staff need to be insulated from outside political pressure and have leaders willing to publicize their data, which is likely to be far more revealing given how integrated it is across service providers, even if the numbers may make for difficult reading sometimes.

“We're known for having a large unsheltered population,” Kohler said. “But I can't imagine how much worse it would be if we didn't have the coordination, the strong utilization of HMIS, the ability to analyze the data and put back out into the community what is really happening. It turns the heat down a little bit to be able to share this kind of information about who's experiencing what.”