There are a number of advantages to this option:
- Data collection systems are in place in most CoCs in the country;
- There is the ability to maximize the existing HMIS data for study purposes; and
- The cost and burden are relatively low since CoCs are already required to collect this information.
There are also limitations to this option.
Extent of Coverage of Providers Within a Community. Not all homeless service providers necessarily need to participate in the HMIS, and it may take a while for some CoCs to get the participation of most, if not all, providers. To the extent that the HMIS system does not cover all homeless providers, it may miss some homeless families. In particular, there may be biases in the information available because of the lack of participation by certain types of providers. Many domestic violence shelters, for example, have expressed concerns regarding security and client privacy within the HMIS.
Extent of Coverage of Families. The HMIS is limited to providing information on families that receive services from homeless service providers. While it is likely to include most, if not all, families who live in shelters, the HMIS could miss families living in motels, living on the streets, or those who are doubled-up.
Variation in Data Quality. The Federal guidelines provide sites with a great deal of flexibility in how data are collected, including interviews with clients, interviews with staff, review of staff notes, and the like. In addition, many complex variables, such as disability or mental health status, are only grossly measured (Yes/No) and may or may not be based on solid, clinical information. The data also provide little indication of the level of services needed. Finally, the degree to which complete information is available on every person would need to be assessed on a case-by-case basis.
Data May not be Readily Available. As noted earlier, any study that relies on HMIS data would need to negotiate with each individual CoC for access to client-level data. Obtaining approval from multiple CoCs could well be a very cumbersome process and there is no guarantee that any selected CoC will agree to participate in a study. Providing adequate time and resources to establish a good working relationship with any selected CoC is thus likely to be an important aspect of any study involving HMIS records. Furthermore, there is likely going to be a tradeoff in the number of CoCs from which data can be obtained and the depth of information that can be collected. The most detailed studies, those that take advantage of both rich HMIS databases and the ability to link to other databases, can probably be conducted in only a handful of sites at one time, limiting the national representativeness of the study. Conversely, studies that try to use the large number of CoCs operating or developing will likely need to be satisfied with using only the more basic, universal data elements.