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    Final presentation Final presentation Presentation Transcript

    • HIV/AIDS & HOMELESSNESS By Pauline Ansine
    • HIV/AIDS & Homelessness
      • HIV/AIDS is a global epidemic.
      • Lack of affordable housing is a critical problem facing a growing number of people living with HIV/AIDS.
      • People with HIV/AIDS may lose their jobs because of discrimination or because of the fatigue and periodic hospitalization caused by HIV/AIDS illness.
      • (National Coalition for the Homeless)
    • Prevalence
      • An estimated 3.5 million people are homeless in the United States every year(National Coalition for the Homeless).
      • A Philadelphia study found 44% of persons living with HIV/AIDS were unable to afford housing (http://www.nationalhousing.org).
      • 12,000 people living with HIV/AIDS surveyed by AIDS housing of Washington, 40% report having been homeless at least once in the past.
    • Prevalence Cont.
      • Homeless women are more likely to be victims of domestic violence and sexual abuse of which both have been linked to HIV(National Coalition for the Homeless).
      • Many homeless adolescence find that exchanging sex for food, clothing, and shelter is their only chance of survival on the streets.
      • Homeless women and adolescence are particularly at risk (Song,2003).
    • Barriers to care
      • Lack of insurance
      • Transportation
      • Housing
      • Lack of comprehensive services
      • Concern about confidentiality
      • Compassion.
      • Incarceration.
      • Special population.
    • Prevention
      • Primary prevention stops people from becoming homeless, or being evicted.
      • Primary prevention of HIV/AIDS is abstinence, condoms, or an effort to reduce all new infections.
    • Prevention cont.
      • Secondary prevention of homelessness includes people in temporary shelter.
      • An early intervention
      • Secondary prevention of HIV/AIDS is to detect the risk factors in asymptomatic patients.
      • To ID and minimizing risk behaviors so as to decrease any further advancement of the disease.
    • Prevention cont.
      • Tertiary prevention of homelessness is aimed at minimizing suffering and maximizing quality of life.
      • Stable housing for the homeless.
      • Tertiary prevention of HIV/AIDS is detecting risk factors or pre-clinical complication in a symptomatic patient.
      • Reduces the negative challenging effects of the illness and maximize quality of life.
    • AGENCY
      • Imagine a company that seeks out and helps individuals through health education, outreach, counseling, and referral services
    • Look no Further
                                                           
    • Urban Solutions
      • Mrs. Jones Yvonne RN BSN, founder and CEO of Urban Solution.
      • Founded in 1993 in response to the rapidly growing need for community- based health and education.
      • Provides care for over 100 HIV patients annually.
      • Most of the patients are African American who are financially distressed.
      • Daily viral load testing.
      • Daily Highly Active Anti – Retroviral Therapy (HAART)
      • Daily Rapid HIV Testing
    • Urban Solution
      • Will continue to provide comprehensive medical treatment for patients with HIV/AIDS to a projected expansion in 2008-2009.
      • The service will include: HIV testing, counseling, outpatient HIV primary care, patient advocacy and referrals for accessing required services.
    • Urban Solutions
      • Provides a wide range of additional services including:
      • HIV care for youth and adults
      • Daily walk-in rapid testing
      • Youth services, including health and education programs and summer employment.
      • After school walk-in adolescent clinic
      • Family planning services/pediatric services.
      • Disease prevention such as, diabetes, hypertension, asthma, obesity, and HIV/STD’s
      • CATCH elementary school educational programs for mentally challenged children in public school in South Philadelphia.
    • Urban Solutions
      • Added an HIV+, MSM patient advocate to its staff who will conduct patient relations and advocacy weekly with co-owner, Yvonne Jones RN.
      • Plans to expand referral agreements with Health District 1 and 2
      • Plans to work closely with AACO to further expand its referral base and take additional patients as resources may permit
    • HIV Expertise Report Urban Solutions 30 hrs. Registered Nurse BSN Intake assessment–all patients 125 patients-2007 146 patients -2008 Yvonne Jones RN 25 hrs. Certified Pediatric Nurse Practitioner 5 patients (co-manage with Dr. Sewell) Christina Sweeney CPNP 20 hrs. American Academy of Pediatrics Supervises Nurse Practitioner –5 patients Linda Martin M.D. 50 hrs. National Certification for Physician Assistants 75 patients Michelle Fuller PA-C 50 hrs. American Board of Internal Medicine 50 patients/ hospital rounds/call Myron Sewell M.D. 70 hrs. American Board of Internal Medicine 20 patients/hospital rounds/call Eileen Carpenter M.D. 210 hrs. American Board of Internal Medicine Supervises care of all patients/hospital rounds/call 125 patients-2006-07 146 patients-2007-08 Noble Jones M.D. Education hours in the Past 12 months Board Certifications Ongoing caseload size in past 24 months Name of Individuals
    • Population
      • Uninsured and underinsured
      • Low income
      • 97% African American men
      • 3%Latino/a, white and Asian.
      • 92% of those men are men sex men (MSN).
      • Of the 97% African American, 84% are men, and 16% are female, partners of HIV patients.
      • There is a smaller population of injection drug use (IDU).
      • All pts. Are low income, and 95% have no insurance
    • National Alliance to End Homelessness
    • National Alliance
      • STEP 1: PLAN
      • Your community has a set of strategies focused on ending homelessness. A wide range of players has made funding and implementation commitments to these strategies. A New Vision: What is in Community Plans to End Homelessness? Community Plans to End Homelessness
    • National Alliance
      • STEP 2: DATA
      • Your community has a homelessness management information system that can be analyzed to assess how long people are homeless, what their needs are, what the causes of homelessness are, how people interact with mainstream systems of care, the effectiveness of interventions, and the number of homeless people.
    • National Alliance
      • STEP 3 : EMERGENCY PREVENTION
      • Your community has in place an emergency homelessness prevention program that includes rent, mortgage, and utility assistance, case management, landlord or lender intervention, and other strategies to prevent eviction and homelessness.
    • National Alliance
      • STEP 4: SYSTEMS PREVENTION
      • Mainstream programs that provide care and services to low-income people consistently assess and respond to their housing needs. Ensuring that public institutions (hospitals, prisons, jails, mental health facilities) are discharging people into housing is equally important .
    • National Alliance
      • STEP 5: OUTREACH
      • Your community has an outreach and engagement system designed to reduce barriers and encourage homeless people to enter appropriate housing linked with appropriate services.
    • National Alliance
      • STEP 6: SHORTEN HOMELESSNESS
      • The shelter and transitional housing system in your community is organized to minimize the length of time people remain homeless, and the number of times they become homeless. Outcome measures are a key component of this effort.
    • National Alliance
      • STEP 7: RAPID RE-HOUSING
      • Your community has housing search and housing placement services available to rapidly re-house all people losing their housing or who are homeless and who want permanent housing.
    • National Alliance
      • STEP 8: SERVICES
      • Once households are re-housed, they have rapid access to services. Mainstream programs―TANF, SSI, Medicaid, and others― provide the bulk of these services.
    • National Alliance
      • STEP 9: PERMANENT HOUSING
      • Your community has a sufficient supply affordable housing and permanent supportive housing to meet the needs of extremely low-income households and chronically homeless people.
    • National Alliance
      • STEP 10: INCOME
      • When it is necessary in order to obtain housing, your community assists homeless people to secure enough income to afford rent, by rapidly linking them with employment and/or benefits. It also connects them to opportunities for increasing their incomes after housing placement (opportunities provided primarily by mainstream programs).
    • Plan of care
      • Contact local government for funding to start outreach project.
      • Offer on-site service at shelter/soup kitchen where homeless people usually visit.
      • Do initial assessment: physical/mental, barriers to housing and healthcare.
      • Females
      • PPD
      • Viral load testing
      • Pap test.
    • Plan of Care cont.
      • Males
      • Digital rectal exam
      • Viral load testing
      • PPD
      • Assist with obtaining housing and insurance for all HIV/AIDS clients. Make any necessary referrals.
      • Try to develop good rapport.