California’s Project Roomkey Evaluation: State Needs Better Data Sharing Across Agencies

May 20, 2024
Evaluators of an innovative pandemic housing program ran into roadblocks trying to request and match up homeless service system data and healthcare data

An evaluation of an innovative pandemic housing program in California highlighted the need for data-sharing agreements to be created across state agencies and departments to further understand the homelessness crisis.

Project Roomkey (PRK) was a statewide effort in California in 2020 during the pandemic to provide people experiencing homelessness the option to stay temporarily in hotel and motel rooms and trailers as an alternative to staying on the streets or in shelters. A recently published evaluation of the program found that not only did PRK meet its original goal of saving lives but the program also enhanced how interim housing is designed and operated in some communities across California.

The California Health Care Foundation (CHCF) and the Conrad N. Hilton Foundation, in collaboration with  the California Department of Social Services, engaged Abt Associates to conduct an evaluation of the PRK program. The purpose of this evaluation was to understand its successes and challenges and the experiences and outcomes of PRK participants.

The researchers found that access to data is challenging across California state agencies and departments.

The evaluation team hoped to match identifiable Homeless Data Integration System (HDIS) data from the California Interagency Council on Homelessness (Cal ICH) with health data, including Medicaid (Medi-Cal) data from the Department of Health Care Services (DHCS) and death record data from the California Department of Public Health (CDPH) or the Department of Health Care Access and Information (HCAI). 

Due to data-sharing restrictions, Abt created a backup plan to collect person-level homeless services data. Abt’s backup plan was to obtain identifiable Homeless Management Information System (HMIS) data from local communities on PRK participants and match that data to state-level or local health data. To be able to request and analyze health system data, they first needed to obtain identifiable HMIS/HDIS data to identify who used PRK across the state. Unfortunately, there were roadblocks to both plans and the Abt team was not able to collect identifiable homeless service system data from the state or local communities and therefore could not request health systems data.

One of the evaluation report’s policy recommendations is that data-sharing agreements need to be created across state agencies and departments to further understand the homelessness crisis in California. “People experiencing homelessness use social and healthcare safety net programs that span many of the state’s agencies and departments. There needs to be a way for data sharing, analysis, and evaluation to occur while looking across programs and public benefits, which often exist in different data systems and are protected by different legalities,” the authors wrote. “To further understand the homelessness crisis across the state and evaluate what is working well, we need to understand how people are interacting with the many public systems, programs, and benefits; which combination of programs and benefits are best at preventing and resolving homelessness; and who is most at risk for homelessness."

Researchers found that the design, implementation, and demobilization of PRK programs across California offer some lessons for providing emergency and interim housing for populations with complex needs. “The continued use of hotels and motels along with existing residential buildings was critical for COVID-19 response and could prove useful in response to the ongoing homelessness crisis, to natural disasters, or to future public health emergencies.”

Another policy recommendation of the report is to encourage the use of funding from Medi-Cal Managed Care Plans (MCPs) and Medi-Cal waivers for supports and services for people experiencing homelessness in residential settings. 

The authors also suggest that MCPs should also invest in their local homeless response systems through incentive programs, community benefits, or flexible contracting. “Additionally, the state needs to expand the mechanisms that are already in place (e.g., Assisted Living Waiver and the Home & Community Based Alternative Waiver) to provide more supports and services for seniors and people with disabilities experiencing homelessness as they move into permanent housing.”

 

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