This study mainly involved interviews with program officials knowledgeable about the four homeless-serving programs that were the main focus of this study, along with review of existing documentation. Interviews were conducted both by telephone and in-person. In addition, the research team conducted telephone interviews with program officials at four mainstream programs that are profiled in Chapter 5 of this report Medicaid, the Substance Abuse Prevention and Treatment Program (SAPT), Head Start, and the Health Care Clusters programs. Project staff also reviewed documents and interviewed program officials that operated homeless administrative data systems (HADS) or homeless registry systems in several localities across the country. Each chapter includes additional details about specific data collection methods undertaken and the appendices to this report contain discussion guides used during interviews.
The remainder of this report is divided into four chapters. Chapter 2 of this report synthesizes the results of interviews with administrators and a review of relevant program documentation at the four DHHS homeless programs that are the focus of this study: (1) Programs for Runaway and Homeless Youth (RHY) Program, (2) the Health Care for the Homeless (HCH) Program, (3) Projects for Assistance in Transition from Homelessness (PATH), and (4) the Treatment for Homeless Persons Program. The chapter provides an overview of the basic operations of these four DHHS homeless-serving programs, with a particular focus on each programs performance measure systems and prospects for enhanced tracking of homeless individuals served.
Chapter 3 synthesizes the results of interviews with administrators and a review of relevant background documentation on the operations of homeless administrative data systems (HADS) in five localities (1) New York City, NY; (2) Madison, WI; (3) Kansas City, KS; (4) Columbus, OH; and (5) Honolulu, HI. This chapter provides an overview of the operations of these five HADS and analyzes the potential that the data collection methods and measures employed in these systems might have for enhancing performance measurement in the DHHS homeless-serving programs.
Chapter 4 identifies a potential core set of performance measures that could be common across homeless-serving programs of DHHS. The measures including both process and outcome measures suggested in this chapter are intended to enhance DHHS tracking of services and outcomes for homeless individuals served in DHHS homeless-serving and non-homeless-serving programs. This chapter includes discussion of several of the constraints in creating core performance measures, identifies a potential core set of homeless measures, and examines the technical implications for incorporating such measures into the current performance reporting approaches utilized by DHHS.
Chapter 5 assesses the potential applicability of the core set of suggested measures to four mainstream DHHS programs that serve both homeless and non-homeless populations: (1) Medicaid, (2) the Health Centers Cluster, (3) the Substance Abuse Prevention and Treatment (SAPT) Block Grant, and (4) Head Start. A key focus of this chapter is on assessing the capability and willingness of other mainstream DHHS programs to collect basic data relating to the number and types of homeless individual served, and moving beyond counts of homeless individuals served to adopting other suggested core performance measures.
(5) U.S. Department of Health and Human Services, Ending Chronic Homelessness: Strategies for Action: Report from the Secretarys Work Group on Ending Chronic Homelessness, March 2003, p. 5.
(6)J. Trutko, B. Barnow, S. Beck, S. Min, and K. Isbell, Employment and Training for Americas Homeless: Final Report on the Job Training for the Homeless Demonstration Report to Congress, Research and Evaluation Report Series 98-A, prepared for the Employment and Training Administration, U.S. Department of Labor, 1998.
(7) Initially, the study was also had a third objective to determine if an index of chronic homelessness could be developed that helps both in treatment planning and documentation of program success but during the project a DHHS advisory group developed such an index independent of this study.
(8) The Treatment for Homeless Persons Program was formerly referred to as the Addiction Treatment for Homeless Persons Program.
(9) The Government Performance and Results Act (GPRA) of 1993 seeks to shift the focus of government decision making and accountability away from a preoccupation with the activities that are undertaken such as grants dispensed or inspections made to a focus on the results of those activities, such as real gains in employability, safety, responsiveness, and program quality. Under GPRA, agencies are to develop multi-year strategic plans, annual performance plans, and annual performance reports.