By Betsy DeGeorge

Homelessness. To many of us in this affluent nation, sleeping in a car, camping under a bridge, eating at a homeless shelter, and carrying belongings in a paper sack is a far cry from our ideal of the American dream. Yet, homelessness is a national crisis and a dilemma in our own community. About ten percent of America’s poorest citizens, our neighbors, spend some days and nights each year without a place to call home.

Is there a way to end homelessness, or at least improve the lives of people in this dire situation? David Patterson, professor in UT’s College of Social Work, would like to think so. For the past five years he has been working with the U.S. Department of Housing and Urban Development (HUD) and the Knoxville community to find out more about homelessness in the United States and to devise ways for support systems to work more effectively.

In the mid-1990s HUD set out to explore the nature and extent of homelessness across the nation, to develop tools for electronic data collection and analysis, and to increase the efficiency of local support systems for the homeless.

From this effort grew the Homeless Management Information System, or HMIS, a computerized data collection tool designed to capture client-level and system-wide information on the characteristics and needs of homeless men, women, and children.

Not Just More Bureaucratic Red Tape

Federal programs are often viewed as clunky, inefficient, or counterproductive. However, HMIS was designed to dramatically increase the effectiveness of services to the homeless.

Since 2004 Patterson, the director of KnoxHMIS, has managed the local implementation grant from HUD. The grant has put in place a community-wide internet-based system connecting the local agencies that provide services to the homeless. KnoxHMIS—a veritable electronic safety net—collects and shares data about client services in shelters and other homeless service agencies. It then generates information, for the use of service agencies, about who the homeless are and how they are being served across the community.

The goals of the HMIS system are multi-faceted: to make client intake more efficient; to eliminate duplication of services; to track availability and use of services (such as shelter beds); to plan, schedule, and follow delivery of services; to provide for online referrals and benefit applications; and to coordinate case management across the various service agencies.

As the information from this system is maintained over the years, a profile of homelessness patterns will emerge. This information will help service providers anticipate and meet needs in ways they have not been able to before.

Listen to David Patterson discuss KnoxHMIS with WUOT’s Chrissy Keuper.

How the System Works

HMIS immediately and effectively enhances services to homeless clients. A homeless individual can go to any agency and provide information to a caseworker at an intake interview. This information is fed into the HMIS system. The agency then provides its services to the new client.

If the client needs further assistance from another city agency, he or she is referred—within the system—to another service provider. An essential component is an ID card that allows the client to go to other participating agencies and gain immediate access. Since intake information is already complete, the second agency simply records services rendered.

Gabrielle Cline, director of case management for the Volunteer Ministry Center in Knoxville, explains, “HMIS allows us to share case notes with other service providers. This enhances coordination of care; it’s a very convenient way to track services that we provide and makes reporting to funders quite straightforward.”

Success of KnoxHMIS

In 2004, working with Roger Nooe, now professor emeritus in the College of Social Work, Patterson received initial funding and authorization to become partners with the Knoxville Homeless Coalition, the City of Knoxville, and Knox County, and to implement this system in the community. The development and operation of databases to serve the homeless have taken place so successfully that every major local agency is now using KnoxHMIS. Each homeless agency has access to a secure, web-based data system that is administered by the UT Social Work Office of Research and Public Service.

Mark Buckingham, assistant director of the KnoxHMIS project, reports that implementation of the database is continuing in the service community. “Use of KnoxHMIS has notably increased over the past year, with improvements in the rate of new client entry, collection of services delivery information, data quality, and casework documentation.”

Research Serving Clients and Agencies

From the perspective of the research team at UT, one of the amazing long-term benefits of this system is the valuable data that can be drawn from it. For example, Courtney Cronley, a doctoral student in the UT College of Social Work—along with Elizabeth Strand, director of UT’s Veterinary Social Work program; Sarah Gwaltney, a fellow student who has since graduated; and Patterson—was interested in the effects of pets on the homeless. In her study, Cronley asked the question, “How does having an animal affect the need for services among the homeless population?” The data revealed that only a small percentage of homeless individuals have animals; however, many of that group are victims of domestic violence, and their bonds with their animals are very important. Many clients answered “no” when asked, “Would you accept housing that doesn’t allow pets?” Encouraging sensitive questioning when dealing with this sub-population may allow for better, more complete and healing service.

Patterson and Cronley have worked together in broader studies as well. With a grant from HUD’s Office of University Partnerships, they assessed the relationship between organizational social context and technology utilization among service providers. They discovered that the organizational climate of an agency determines how effectively the agency adapts to the new technology-based data collection system. Statistically, organizations with a clear set of policies and procedures have an easier time implementing technology changes than organizations with less rigid systems in place. Workers in more organized settings are less resistant to change; and when change is required and accompanied by clear instruction and training, these workers are able to adopt new procedures more efficiently than staff who work in more flexible and non-policy-driven environments.

Having completed the study of technology use and organizational culture, Cronley met with the agencies that had provided data for the investigation. Information had been collected from the community, so at the conclusion of the research project the data results were presented back to the community. “Ideally, research begins and ends with the community,” states Cronley. “People own the information that researchers seek, collect, and analyze, and their answers belong to the community. The knowledge gained through research doesn’t mean anything until people can make sense of it and use it. They are the ones who can harness the information and use it in their world.”

This study used the Organizational Social Context Scale developed by UT’s Children’s Mental Health Services Research Center, directed by Charles Glisson. Patterson points out, “Both the theoretical and the empirical work that the center is doing is especially instructive. They have enlightened our thinking about organizational climates. We’re trying to diffuse informational technology to agencies serving a particular population, and we’re helping these agencies speak to each other through technology.

“Glisson’s work has given us a means to understand what is happening on the organizational level. His work on organizational climate and culture is internationally recognized. Courtney Cronley’s research has begun to expand our understanding of these organizations and how actions are mediated by the climate of the organization.”

Community Response

It has taken a number of years for some agencies to fully adopt the conceptual and technological framework of HMIS. Though some agencies are required to use the system because of federal funding, others do not receive these funds and therefore are under no pressure to participate. Still, KnoxHMIS has become an invaluable tool of practice throughout the homeless service community.

Burt Rosen, chief executive officer of Knox Area Rescue Ministries, expresses it this way: “HMIS allows us to quickly identify the services a person is receiving and from whom, and to very specifically target our efforts. It also allows us to focus on those with greater needs and improves collaboration with other providers. Bottom line: it’s a great tool for identifying, addressing, and meeting the myriad needs of the homeless.”

Karen Sowers, dean of the UT College of Social Work, agrees. “The data shows that almost 400 new homeless people per month are seeking services. This is startling for a city the size of Knoxville. We often assume that these people are transient, but actually they are from our own community. There has been a dramatic increase in services from 2007 to 2008. This project becomes increasingly important as the economy worsens and unemployment rises. We must continue to promote effective services to our neediest children and families.”

Tags: Charles Glisson • David Patterson • Homeless • Social Work