# Presentation: 134406

## Michigan Statewide HMIS

- Outcomes Project

## About Michigan

***Michigan Statewide HMIS***
- 2.5 years old
- 57 CoCs including Detroit
- 370+ agencies with 1,322 programs
- 3 State Departments (DHS, DCH, DOE)
- 90,000+ unique clients

## Michigan Vertical Configuration

## Measurement:An Ongoing Collaboration

- Funding organizations
- Program leadership
- Staff members who collect information and enter data

## Selecting What to Measure

- Mix of measures
- Process indicators
- Time to referral or placement in housing
- Percentage returning for ongoing services
- Short-term or intermediate objectives – measure critical processes
- Positive housing placement at discharge
- Improved income at discharge
- Linked with needed supportive services
- Percent readmissions
- Outcomes – measures sustained change
- Stable housing
- Stable employment

## Coordinating the Process of Measurement

- How do we know what success looks like?
- Client characteristics/who is served
- When measurement occurs
- Establishing baselines
- Benchmarking/comparing performance
- Improving performance
- The environment/contextual variables
- Evaluate outcomes

## Defining the Population Served

- Developing shared screening questions. Data standards plus:
- Have they had a lease in their own name?
- Were they homeless as children?
- What is their housing history?
- What is their education history?
- What is their employment history?
- What is their health history?
- Are there disabilities of long duration?

## When Measurement Occurs

- Intermediate Outcomes
- Measured during care or at discharge
- Reflect stable and optimized program processes
- Customer satisfaction

- Followup Outcomes
- Measured after discharge for some period of time
- Were changes achieved in care sustained
- Did we impact other long-term primary outcomes

## Baselines and Targets

- Critical for evaluating change and optimizing performance
- Realistic/honest targets
- Stabilized processes
- Percentiles are consistent across time
- Systematic and routine measurement
- Before
- During
- After program change

## Benchmarking

- Working with “like” programs to:
- Identify realistic targets
- Identify performance that is off norm
- Share ideas to improve
- Address measurement problems
- Build transparency

## Example Control Chart: School Attendance 

## Defining the Measure

- Purpose: Measure the program’s ability to support the educational plan of children in care
- A client is considered to have met their individual education plan for the day if they participated for 75% or more of the time they were scheduled to be involved in education activities
- Available education days reflect only days when it was possible for the client to participate in their individual education plan
- For example, if the resident’s educational plan is to attend school, only those days that the school was open during the reporting period are counted
- Excused absences do not count as possible days
- If a client was excused due to illness, a pass, or an appointment, these days are not considered available education days

## Interpretation

- This measure is unique because of the difficulty of comparing individualized plans across children who present with differing levels of disability
- For example, a floridly psychotic adolescent may tolerate only half days at school – for that youth, the plan will include fewer possible hours, but the same number of days
- Members of the QM team felt that this was a critical outcome of care and represented a positive measure of program function
- In addition to compatibility across individualized plans, a special challenge was to deal with summer school since information is submitted monthly
- Only ORGs 3 and 4 run year-round schooling
- ORG 2 developed summer educational enrichment programs in order to participate in this measure
- ORG 1 was unable to implement a summer plan
- ORG 4 received a Gates Grant in late 2000 to automate the classroom – education attendance was nearly 100% when the automation was new and has sustained very high attendance levels since the implementation stage

## The Context of Services

- Lack of affordable housing
- Vacancy rates
- Unemployment rates
- Lack of access to supporting services
- Long waiting lists
- No insurance or pay source
- Barriers to success or community assets

## What Will the Project Do?

- Support the development of initial measures (indicators, objectives, and outcomes) and targets through meetings with funders, program leaders, and staff members
- Provide a menu of measures from which program leaders may select

## Project Activities, Continued

- Provide reports that may be run monthly with a click of the button on all selected measures; the reports will aggregate data that is viewable through the HMIS for programs, agencies, and CoCs and statewide
- Convene routine benchmarking meetings to discuss measurement issues as well as performance ideas

## Project Activities, Continued

- Maintain, _with local support_, a database of contextual variables
- Share/problem-solve measurement issues; support the evolution of measures
- Provide data for statewide analysis as defined in contracts

## Data Warehouse Project

- SHADoW
- Routinely refreshing deidentified dataset linking mainstream data (Medicaid, DCH, Support Enforcement, DOC) with HMIS data
- Using the data to measure effectiveness
- From the State agency perspective, falling into homelessness is a negative outcome
- From a homeless provider perspective, accessing mainstream benefits is a positive outcome
- Longitudinal view of the intersection between public/private services for clients

## Contact Information

- Barbara Ritter
- 	517-230-7146
- 	_[britter@mihomeless.org](mailto:britter@mihomeless.org)_
- MCAH WEB SITE:
- www.mihomeless.org