The Case for Integrated Client Histories: Homelessness in Boston

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This August, the City of Boston slipped $200,000 worth of code into the internet’s free box. More specifically, they licensed and copylefted their Coordinated Access System under GPL3, and we donated developer hours to get it up on Github.

While we’ve had projects go into the open source before, Boston surprised us. It was clear from the beginning that they saw forfeiting their proprietary rights to all that code as a gain rather than a loss. Now, their solution can spread. Any town, city, or general municipality anywhere in the world can use Boston’s code to install a CAS of their own. This is gainful to Boston because their number one objective is to end homelessness. Decisively, their tool can now go towards ending it outside of city lines.

Money speaks volumes, and there are many statements being made with this open source listing. What comes across the loudest to us is that Boston sees a different role for information technology (IT) in social services.

Though they’re engineered to support human services, most data systems aren’t built to keep people healthy or housed, they’re built to track lines in an invoice. Put simply, they are built to bill. While this isn’t an outright evil, it’s a design flaw that has become a real wrench in the collective gears. As we move from paying for providing service, to paying to keep people from not needing service, this invoice engineering will die out. Today, though, it is aggravatingly alive. Providers in one human service area can’t get the information they need from another area. This means quite simply that clients of the human services aren’t being properly served.

From where we sit, the human service industry landscape looks broken. There are informational and communicational dead zones all over the map. But when applied correctly, IT can be a brilliant corrective cartographer.

Imagine someone leaving prison. Up until the moment of discharge, their information is accounted for by the prison system. Once they are released, those records are all but void. If they end up after a series of unfortunate events without a home, and a homelessness service provider adopts them into their records, there’s no guarantee they’ll disclose that they just came from prison. In this case, what becomes a homelessness problem is actually (and originally) a prisoner discharge problem. Reentry programs often require parole for reasons just like this. However, if the parole system isn't’ hooked in with homelessness management information, there’s no way to keep newly re-entered citizens from slipping off the radar.

If the data systems between services could coordinate, Boston could get faster to their goal of ending homelessness. Today, these dislocated systems are built around single encounters rather than human beings. To re-orient them around people, we’ve got to connect the threads between encounters. For people don’t live by singular instances. Human beings travel, backtrack, relapse, disappear and show up again. All along, they’re having one continuous experience. A system calibrated for instances can’t account for the continuity of human life.

Especially in urban settings, homelessness is just one symptom in a suite of continuous human and systemic problems. Many people know this, so why don’t our social service softwares see it?

We need integrated client histories. A Coordinated Access System is just one example of the IT tools that could help make this happen. If our systems could talk to one another, providers could track clients across service silos –– ferrying their information seamlessly from one repository to the next. The more you know about a client (where they’ve been, what they’ve struggled through) the better you can place them in a program or a housing unit that truly meets their needs.

At risk of making a trite comparison, we’ll say that the CAS we built for Boston is like OKCupid for housing. OKCupid and hundreds of other softwares have been matching humans to humans in dating apps for years now. Unsurprisingly, matchmaking is useful elsewhere, and the algorithms are only getting better.

The CAS assists in matching chronically homeless humans to appropriate housing opportunities. Placing these individuals into the correct situation for their needs results in a much more efficient homelessness system overall. Removed from the temporary shelters where they otherwise would reside long term, the chronically homeless escape the homelessness cycle, and the temporary housing is freed up for those who need it temporarily.

In closing, we’ll share a provocation. Big Data is very much here. And yet, while advertisers can lace you up in cookies and trace your every click, needful people’s information is seeping through the cracks. If we could transfer a modicum of the “follow power” that’s exerted on consumers to the far less exploitative purpose of footprinting people in need of social services, we might have a chance at “solving” urban crises.

Read more about the OpenPath platform, the Coordinated Access System and HMIS Data Warehouse.