CSH Initiatives and Products: Data

Health centers individually and collectively manage large amounts of data. Patients at health centers are asked to fill and refill out paperwork, surveys, and assessments. Many patients and providers report that the repetition of collecting the same data points can be discouraging, even appearing to undervalue their experiences. In some cases, repeating patient medical, housing, and personal histories can create harm and re-traumatization.

In this webinar we explored why and how lived expertise must be sought after and valued by health centers and allied organizations to improve every stage of the data management process from collection and analysis to data sharing, access, and decision-making, including discussion about Information Blocking rules and navigating the tension between reporting and regulations.

We discussed the nexus of racial equity and lived expertise in data management, and how data collected or used improperly or carelessly have the potential to harm. This webinar took place on November 21, 2024.

This webinar took place on November 9, 2023. It explored why and how lived expertise must be sought after and valued by health centers and allied organizations to improve every stage of the data management process from collection and analysis to data sharing, access, and decision-making, including discussion about Information Blocking rules and navigating the tension between reporting and regulations.

Additionally, this webinar covered the nexus of racial equity and lived expertise in data management. How data collected or used improperly or carelessly have the potential to harm. The webinar incorporated recommendations and practices that can be implemented in the short, medium, and long term to use data to reduce and limit the chances of re-traumatization.

The New York City Frequent Users System Engagement program (FUSE) was part of the CSH’s Returning Home Initiative, a multi-year effort of public, inter-agency collaboration and investment that provided supportive housing for people cycling between incarceration and homelessness. NYC FUSE targeted persons with recurring homelessness and incarceration, most of whom challenged also by health, mental health, and/or substance use issues.

Columbia University researchers evaluated FUSE by comparing program participants with a closely matched comparison group of “frequent users.” This evaluation found that supportive housing significantly reduced participants’ (re)admissions to and time spent in jail and homeless shelters and their use of crisis healthcare services. These reductions resulted in significantly lower costs for publicly supported services, offsetting housing and other program costs. Results have inspired jurisdictions throughout the US to launch similar efforts.

Now, 10 years later, the FUSE Long Term Study presents a unique opportunity to examine stable housing as a critical component of successful community reentry, not simply in the short term but over people’s lives.

FOR IMMEDIATE RELEASE

Experts recognize that the Governor’s budget maintains the level of investment in addressing homelessness during a difficult budget year, and call on legislators to lay a foundation based on the state’s housing needs.

Sharon Rapport, Director, California State Policy, Corporation for Supportive Housing, made the following statement in response to the release of the Governor’s 2023-24 Budget:

“In a difficult budget year, it’s reassuring to see that 2022 spending on homelessness was not cut for the 2023 budget. However, no additional investments were made.

“The budget prioritizes unsheltered homelessness, but we can reduce unsheltered homelessness through long-term investment in housing. Shelter is critical in offering people a safe place to stay while waiting for permanent housing—but only homes end homelessness, and permanent housing must be the central focus of our strategy.

“The governor’s summary calls for increased accountability from local governments. This is correct—but it should be matched by accountability from the state for a budget plan that is predictable and grows over the coming budget cycles to meet the established needs of people experiencing homelessness in California.

“As the Legislature responds to this budget, it should lay the foundation for a year-over-year approach that uses data to meet the state’s needs with adequate housing, services and shelter—and that asserts the state’s leadership in ending a crisis rooted in our failure to build enough housing in California for decades.”

The Corporation for Supportive Housing (CSH) and the California Housing Partnership, with the support of the Conrad N. Hilton Foundation, issued the first-ever California Homeless Housing Needs Assessment last month to determine the level of public investment that would solve homelessness in California. 

It concludes that California must invest an average of $8.1 billion every year for the next 12 years to create the housing, shelter and supportive services needed to solve homelessness. 

To see the full needs assessment, visit calneeds.csh.org

Corporation for Supportive Housing (CSH) is the national champion for supportive housing, demonstrating its potential to improve the lives of individuals and families who face complex barriers to housing by helping communities create more than 385,000 affordable homes paired with supportive services. CSH funding, expertise, and advocacy have provided $1.5 billion in direct loans and grants for supportive housing across the country. Building on more than 30 years of success developing multiple and cross-sector partnerships, CSH engages broader systems to fully invest in solutions that drive equity, help people thrive, and harness data to generate concrete and sustainable results. By aligning affordable housing with services and other sectors, CSH helps communities move away from crisis, optimize their public resources, and ensure a better future for everyone. Visit us at www.csh.org.

Media Contact: 

Josh Kamensky
Ocean & Mountain
(323) 326-7438
josh@oceanmo.com   

Often the Frequent Users Systems Engagement (FUSE) approach is developed in a single community for a single program. In Montana, FUSE developed statewide across seven different communities. While these communities have much in common, each has its own diverse set of characteristics from geography and population, to partnerships and capacity. This case study offers an interesting perspective on the statewide approach to FUSE in Montana.

In 2019, the Corporation for Supportive Housing (CSH) released a U.S. Department of Housing and Urban Development (HUD) data matching policy brief outlines the reasons and methods for matching health system data with Homeless Management Information Systems (HMIS) data. Building on that work, CSH and the National Health Care for the Homeless Council (NHCHC) led two focus groups at NHCHC’s October 2019 Summit in Nashville. This report includes observations and background on the homeless services system, its data collection infrastructure, and recommendations on how to establish and improve relationships with other sectors within a Federally Qualified Health Center (FQHC) context. This guidance will help health centers evaluate and make decisions regarding data collection, utilization, and sharing to improve health outcomes for vulnerable patients.

CSH sought to apply a Racial Disparities and Disproportionality Index to local systems in order to identify disparities in system involvement and outcomes based on race or ethnicity. In doing so, CSH worked with existing local efforts to address racial disparities in the community. Ultimately, the results of the RDDI analysis were used to foster community conversations, leveraging the experiences of people directly impacted by homelessness, to develop systems change recommendations.

These recommendations are intended to improve intervention design and delivery, and local policy, so as to reduce disparities across systems. Further, CSH worked with Hudson County around developing a timeline to secure funding for and plan a county-wide data warehouse.

In 2017 Truman Medical Centers Behavioral Health, now known as University Health Behavioral Health, or UHBH, launched the 500 in Five campaign that committed to developing and/or securing 500 units of
housing over five years.

In partnership with University Health Behavioral Health (UHBH) staff, the Corporation for Supportive Housing (CSH) and University of Missouri – Kansas City (UMKC) Department of Psychology reviewed health care utilization, behavioral health services, and court data on 80 supportive housing tenants housed through the 500 in Five housing initiative launched
by UHBH in late 2017. The study group included people housed by UHBH between November 1, 2017, and February 25, 2020, a timeframe that allowed one year after housing elapses for each person before initiating a comprehensive records review of University Health (UH) health care utilization among these individuals in April 2021. The purpose of the analysis was to see what effect if any, housing had on tenants’/patients’ utilization of UH health care services and UHBH outpatient services.

The data presented in this report suggest that enrollment in UHBH’s behavioral health services combined with subsidized housing had a significant effect on how patients utilized health care at the hospital. Looking at utilization by subtype group yielded several statistically significant results that demonstrated changes in health utilization from pre-housing to post-housing. Most notably, there was a steep decline in both the number of psychiatric inpatient events (down to less than one on average per person from nearly five in the pre-period for those psychiatrically hospitalized in the year prior to housing) and the cost of those hospitalizations (decreased by 98%).

This result is consistent with several studies of permanent supportive housing that show significant decreases in psychiatric emergency department visits and psychiatric inpatient hospitalizations.

Data are a powerful tool, but many times health centers struggle with collecting and accessing the right data to make meaningful decisions and impact addressing patients’ SDOH. This webinar explores the how-to and the what-type of SDOH data collection and provide best practices for health centers wanting to collect and use SDOH data in organizational planning and advocacy.