PCHS Steve Day Presentation for 04-23 Work Group.pptPresentation Transcript
Presented by Technical Assistance Collaborative, Inc. April 23, 2009
Des Moines is developing a long range action plan for people who are homeless.
Access to health, substance abuse, and mental health services is critical to the success of permanent supportive housing and other strategies to end and prevent homelessness.
There are three steps in the planning process:
Define essential elements of a good services system based on what people actually need.
Use the above definition to identify and document gaps and problems in the current service system
Develop strategies and action steps to close the gaps and move towards the defined good services system. This includes definition of the roles, responsibilities, and interrelationships among the components of the system, and the access points to benefits and services.
Same as everyone else, but more serious because of health risks of homelessness and inadequate access to care
Also more serious because of multiple and long-term disabilities requiring multiple different interventions and supports
Health risks made more serious by:
Mental illness – 25 year difference in life expectancy
Exposure to bad weather – damp, cold, etc.
Systemic barriers to access to health, mental health and substance abuse care
People who are homeless need access to:
Psychiatric treatment and mental health supports
Substance abuse treatment and on-going supports
primary health care (prevention, screening for risk factors, assessment, wellness)
Acute care (health emergencies, trauma care)
specialty health care (OBGYN, Orthopedics, Endocrinology)
Long term care for chronic health conditions (Diabetes, COPD)
Rehabilitative care (PT, OT, etc.)
May need community supports to facilitate access to and utilization of any of the above
Crisis response and stabilization
Psychiatric evaluation and treatment
Community supports – skill building
Peer supports – peer counseling
Crisis response and stabilization
Detoxification (social, non-medical, and medical)
Motivational interviewing and engagement
Opiate treatment – methadone
Other medications (Naltrexone)
Peer supports, AA, NA, etc.
Need different services and approaches for children, youth, parents, single adults
Need competency in co-occurring conditions
Need competency in trauma
Need cultural/linguistic competence
Need services geared to difficult to reach people, including those who are homeless (outreach and engagement, mobile services, harm reduction, flexible community supports, etc.)
Need immediate/timely access to services
Primary Health Care – Health Care for Homeless
Best source of primary and specialty health
Provides screening, care coordination, follow up
Could assist with access to benefits
Emergency Departments (MH and SA, as well as general acute health conditions and trauma care)
Center for Behavioral Health
Bernie Lorenz Recovery House for Women
Crisis team – 20/7/365 phone + limited mobile response
Cross system competency building on co-occurring disabilities, co-morbidity of medical conditions, trauma, cultural competence, transitioning youth, etc.
Single “front door” to multiple benefits and services: “no wrong door”
One stop and be defined as a set of functions that could be implemented in several places, including shelters, rather than in a single building or location (PCHS does this with designated access points)
The functions might include: facilitation of multiple benefit eligibility determinations; facilitation of access to service resources from multiple agencies and funding sources; direct support for people going through the application process; advocacy for priority status for access to community services and other resources; etc.