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San Francisco homelessness. Housing First model.

San Francisco homelessness. Housing First model.

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  • 1. Shelter AccessWorkgroupParticipatory Action Research (PAR)Participants= Mayors office, service providers, communitymembers, shelter residents, people who are homeless, etc. Diagnose the situation (focus groups/brainstorming) Recommendations to Improve/Action Plan Research to Assess Effectiveness*Branom, C. (2012). Community-Based Participatory Research as a Social Work Research and InterventionApproach. Journal Of Community Practice, 20(3), 260-273. doi:10.1080/10705422.2012.699871
  • 2. Presenting Problem 6,544 — Population of homeless people in SanFrancisco (Others report about 15,000 homelessand LSYS reports 4,105 youth served in ‘12) 1,134 — Total beds in single adult shelter systemfunded by taxpayers 75% — Percentage of homeless people with achronic medical ailment 55% — Percentage of shelter clients reporting adisabling condition 12 to 14% — Percentage of beds used by clientsaged 60 or older (3/09 to 3/11- increased) ONLY 9 CASE MANAGERS!!!!!!!*Sources: San Francisco Human Services Agency, Department of Public Health
  • 3. PhaseTwo of the Shelter AccessWorkgroup focusingon improving outcomes in the Adult Shelter system.Recommendations address3 categories.Improving HealthOutcomes in Shelters.Cultural Competency /Special Populations.Access to and quality ofcase management andservice connection.
  • 4. Intervention/AnalysisShelter Recommendations: Increase accessibility and education for residents aboutavailable services. Improve staff training and increase staffing resources. Improve shelter conditions. Provide medical and mental healthcare services on-site. Permanent housing, employment, & DIGNITY!Building more shelters is NOT the answer!
  • 5. Housing First, Consumer Choice, and HarmReduction for Homeless Individuals With aDual Diagnosis
  • 6. Provider Perspective: Housing 1stvs.Traditional ProgramsThis study revealed that providers working withinTreatment First programs were consumed with the pursuitof housing, whereas Housing First providers focused moreon clinical concerns since clients already had housing. How programs position permanent housing has verydifferent implications for how providers understand theirwork, the pressures they encounter, and how theyprioritize client goals.*Henwood BF, StanhopeV, Padgett DK.The role of housing: a comparison of front-line provider views in housing first andtraditional programs. Adm Policy Ment Health. 2011 Mar;38(2):77-85. doi: 10.1007/s10488-010-0303-2.
  • 7. Think Out of the Box- Wet HouseSan Francisco spends around $13.5 million per year caringfor its top 225 “chronic public inebriates.”The average individual in a Seattle wet housing programcost the city more than $4,000 per month prior to theirintake, but only $958 per month afterwards. Residents averaged 20 drinks per day at the time of theirintake, and within two years, that number fell to 12.*Larimer ME, Malone DK, Garner MD, Atkins DC, Burlingham B, Lonczak HS,Tanzer K, Ginzler J, Clifasefi SL, Hobson WG,Marlatt GA. Health care and public service use and costs before and after provision of housing for chronicallyhomeless persons with severe alcohol problems. JAMA. 2009 Apr 1;301(13):1349-57. doi: 10.1001/jama.2009.414.PubMed PMID: 19336710.
  • 8. *Stuart, R. (2012). Practicing Contemplation for Healthy Self-care. Chaplaincy Today, 28(1), 33-36.*White, M. L., Peters, R., & Schim, S. (2011). Spirituality and Spiritual Self-Care: Expanding Self-CareDeficit Nursing Theory. Nursing Science Quarterly, 24(1), 48-56. doi:10.1177/0894318410389059Regular spiritual practice &incorporating contemplationinto ones daily routine is an antidote to stress.Healthy self-care not only helps prevent compassion fatigue, but also helps one relax and clear ones mind of thoughts and feelings, and experience warmth, love and goodness.