This document discusses homelessness and housing programs. It notes that in 2010 over 400,000 individuals experienced homelessness in the US, with 10% experiencing chronic homelessness. It then describes the Housing First model, which places individuals in permanent housing first before requiring treatment compliance, unlike transitional housing models. The document outlines several housing programs through the VA and HUD. It also reviews research showing the health impacts of homelessness, including increased mortality, hospitalizations, and costs.
This document discusses mental health services and PTSD among veterans. It covers several topics:
1) Post-traumatic stress disorder (PTSD) rates and symptoms among veterans from different eras. Rates of PTSD are high and symptoms include flashbacks, nightmares, and suicidal ideation.
2) Legislation and policies aimed at improving access to mental healthcare for veterans, such as the Clay Hunt Act which requires annual evaluations of VA mental health programs and increased collaboration with outside organizations.
3) Questions around adequate funding for veteran mental healthcare, as funding amounts are unclear and appear insufficient to meet the high need for treatment.
POST - A better means for communicating end of life care wisheskatieSenior7
- The document discusses the need for more specific advance care planning and medical orders at the end of life compared to just living wills and advance directives. It outlines the Physician Orders for Scope of Treatment (POST) form and process, which has been implemented in Virginia to improve end-of-life care and ensure patients' wishes are honored across care settings.
- An example case is presented of a patient whose advance care wishes were not communicated between hospitals, resulting in overtreatment against his wishes and unnecessary suffering.
- The presentation argues that POST provides better guidance for care teams than advance directives alone by specifying treatment preferences and becoming medical orders that follow patients as they transfer between facilities.
The document discusses the fragmentation and costs of the mental health system in the US. It notes that mental illnesses lead to unnecessary disability, unemployment, homelessness, school failure and incarceration. The annual economic cost of mental illness in the US is estimated to be $79 billion. About 20% of jail populations have a serious mental illness. There is a lack of coordinated services across systems like law enforcement, treatment, housing, etc. This leads to poor outcomes for those with mental illnesses.
The goal of this webinar was to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care, including common misconceptions, typical diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the
benefits of advance care planning and early referrals.
The document discusses the impacts of the war on drugs and mass incarceration in the United States since the 1960s. It notes that incarceration rates dramatically increased from 1990 to 1999 while substance use rates did not decrease. Additionally, it states that individuals of color and those of lower socioeconomic status are disproportionately arrested and imprisoned. The document advocates for providing substance abuse treatment, mental health services, education and vocational training to incarcerated individuals to help break the cycles of addiction and recidivism.
The goal of this webinar is to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
This document discusses efforts to address mental illness, substance abuse, and homelessness in Bexar County, Texas. It outlines collaborative initiatives between various community agencies and stakeholders to divert individuals from the criminal justice system into treatment services through programs like the Crisis Care Center. Data is presented showing improvements in wait times and reductions in emergency room utilization and associated cost savings since implementing these diversion and jail diversion programs.
The document discusses implementing a public health approach to address drug abuse, mental illness, homelessness, and incarceration of those with mental illnesses or substance abuse issues. It notes the high economic and social costs of the current fragmented system and lack of treatment. Over 20% of jail and prison populations have a mental illness or were incarcerated due to lack of treatment options. The document calls for a national strategy with coordinated services across housing, employment, treatment, law enforcement, and other areas to improve outcomes and reduce costs to taxpayers.
This document discusses mental health services and PTSD among veterans. It covers several topics:
1) Post-traumatic stress disorder (PTSD) rates and symptoms among veterans from different eras. Rates of PTSD are high and symptoms include flashbacks, nightmares, and suicidal ideation.
2) Legislation and policies aimed at improving access to mental healthcare for veterans, such as the Clay Hunt Act which requires annual evaluations of VA mental health programs and increased collaboration with outside organizations.
3) Questions around adequate funding for veteran mental healthcare, as funding amounts are unclear and appear insufficient to meet the high need for treatment.
POST - A better means for communicating end of life care wisheskatieSenior7
- The document discusses the need for more specific advance care planning and medical orders at the end of life compared to just living wills and advance directives. It outlines the Physician Orders for Scope of Treatment (POST) form and process, which has been implemented in Virginia to improve end-of-life care and ensure patients' wishes are honored across care settings.
- An example case is presented of a patient whose advance care wishes were not communicated between hospitals, resulting in overtreatment against his wishes and unnecessary suffering.
- The presentation argues that POST provides better guidance for care teams than advance directives alone by specifying treatment preferences and becoming medical orders that follow patients as they transfer between facilities.
The document discusses the fragmentation and costs of the mental health system in the US. It notes that mental illnesses lead to unnecessary disability, unemployment, homelessness, school failure and incarceration. The annual economic cost of mental illness in the US is estimated to be $79 billion. About 20% of jail populations have a serious mental illness. There is a lack of coordinated services across systems like law enforcement, treatment, housing, etc. This leads to poor outcomes for those with mental illnesses.
The goal of this webinar was to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care, including common misconceptions, typical diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the
benefits of advance care planning and early referrals.
The document discusses the impacts of the war on drugs and mass incarceration in the United States since the 1960s. It notes that incarceration rates dramatically increased from 1990 to 1999 while substance use rates did not decrease. Additionally, it states that individuals of color and those of lower socioeconomic status are disproportionately arrested and imprisoned. The document advocates for providing substance abuse treatment, mental health services, education and vocational training to incarcerated individuals to help break the cycles of addiction and recidivism.
The goal of this webinar is to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
This document discusses efforts to address mental illness, substance abuse, and homelessness in Bexar County, Texas. It outlines collaborative initiatives between various community agencies and stakeholders to divert individuals from the criminal justice system into treatment services through programs like the Crisis Care Center. Data is presented showing improvements in wait times and reductions in emergency room utilization and associated cost savings since implementing these diversion and jail diversion programs.
The document discusses implementing a public health approach to address drug abuse, mental illness, homelessness, and incarceration of those with mental illnesses or substance abuse issues. It notes the high economic and social costs of the current fragmented system and lack of treatment. Over 20% of jail and prison populations have a mental illness or were incarcerated due to lack of treatment options. The document calls for a national strategy with coordinated services across housing, employment, treatment, law enforcement, and other areas to improve outcomes and reduce costs to taxpayers.
Southern African women living with HIV/AIDS face numerous challenges related to culture, gender inequality, lack of education, limited resources, adherence to antiretroviral therapy, and social stigmatization. Traditional healing practices can unintentionally spread HIV through the use of unclean tools. Gender norms prevent women from refusing sex or negotiating condom use. Limited access to education reduces knowledge about health issues. Shortages of healthcare workers and resources constrain treatment access and adherence. Social stigma deters women from seeking care and practicing prevention due to fear of discrimination.
A Change in Behavior: Delirium, Terminal Restlessness, or Dementia, A Pragmat...VITAS Healthcare
This webinar leverages evidence-based data to help physicians and healthcare professionals differentiate delirium, terminal restlessness and dementia-related agitation in patients as they near the end of life.
Rebuilding the Health Care System in New Orleans and the UScentralconference
The document discusses rebuilding the health care system in New Orleans post-Hurricane Katrina and applying Jewish principles of health care. It notes that pre-Katrina, Louisiana ranked 50th in health outcomes and had high rates of poverty, uninsured individuals, and health disparities. After Katrina, most hospitals and health infrastructure was destroyed, exacerbating access issues. The document advocates redesigning the system based on primary care-centered models shown to improve outcomes and lower costs through principles like comprehensive and coordinated care.
This document discusses harm reduction strategies and syringe exchange programs (SEPs). It provides evidence that SEPs are effective in preventing HIV and hepatitis C by allowing for safe disposal of used needles and connecting injection drug users to medical care. The document reviews how SEPs make communities safer by reducing improperly discarded syringes, protect first responders from needlestick injuries, and do not increase crime rates. SEPs are also cost-effective by saving millions in avoided healthcare costs from prevented infections. The discussion aims to increase support for SEPs by addressing common myths and concerns.
Emma Romberg Policy Brief (Final 2-22)Emma Romberg
The document discusses challenges faced by the transgender population in accessing quality healthcare. It notes that transgender individuals experience higher rates of poor health outcomes like HIV infection and suicide attempts compared to the general population. Access to healthcare is difficult due to provider discrimination, lack of provider experience, and insurance policies that deny coverage for transition-related care. While recent policies like the ACA have increased coverage, more needs to be done to improve the standard of care for transgender individuals and ensure access to necessary medical services. Recommendations include increasing provider education, creating more transgender-friendly healthcare environments, and implementing policies to establish a comprehensive standard of care.
The goal of this webinar was to educate healthcare professionals about the differences between palliative and curative care while exploring the history and philosophy of the hospice movement.
Speaker: Dave Nichols, Volunteer Manager & Workforce Manager, Public Health of Seattle & King
County
The MRC is a relative newcomer to the disaster response world. It is another tool in your emergency
management toolkit; but only if you know about it and how it works during a medical emergency or
disaster. This presentation has been designed to introduce, inform, and answer questions about the
Medical Reserve Corps program and how it fits into the disaster. I will also offer some ways that you
can involve them in your exercises to help them learn your area and your operation.
This document proposes a designated case worker position within a hospital setting to improve outcomes for homeless patients who overutilize the emergency department. The case worker would conduct assessments, develop individualized action plans, connect patients to community resources, and provide follow-up to ensure needs are being met. The goals are to improve patients' knowledge of and access to services, thereby reducing emergency department usage and costs while improving health outcomes for vulnerable homeless populations. Citizenship theory provides the framework to address individual needs within the larger community context.
Ce document de la National Coalition for LGBT Health américaine est le fruit du travail de son "Eliminating Disparities Working Group", publié en 2004.
Il présente les chantiers identifiés de sorte à faire reconnaître et mieux prendre en compte les enjeux de santé des trans. Il balaie un large spectre de déterminants de santé : violences, VIH/sida et des autres IST, usage abusif de produits psychoactifs, santé et bien-être mental, couverture maladie, traitements hormonaux, modifications corporelles auto-réalisées, formation des professionnels de santé, tabac etc.
This report analyzes emergency room (ER) usage data in Kansas City to identify "hot spots" of high ER use. The analysis found that 10 zip codes accounted for 38% of all ER admissions. These hot spots had higher rates of poverty, non-white populations, and preventable health conditions like asthma and influenza. They also had fewer primary care physicians and residents who were more likely to rely on Medicaid or uninsured care. The report concludes that over-reliance on the ER in these communities signals a failure of the healthcare system to provide adequate access to preventative primary care for low-income, minority populations.
This document discusses challenges faced by seniors in the Canadian healthcare system when being discharged from the hospital. It aims to raise awareness of issues like Alternate Level of Care (ALC) where patients no longer require acute care but face obstacles to leaving the hospital. It also discusses the "Home First" philosophy of supporting patients to transition home with high levels of home care rather than waiting in the hospital. Resources provided cover topics like hospital discharge planning, shaping attitudes towards seniors, and the role of communication in navigating patient choices and power dynamics during discharge.
This document discusses managing care for dual eligible patients through appropriate use of hospice and palliative care. Dual eligible patients are covered by both Medicare and Medicaid and have high medical needs. Hospice provides end-of-life care through a team approach focused on comfort. It reduces costs by decreasing hospitalizations. Palliative care extends hospice principles earlier in illness for relief of symptoms. Both hospice and palliative care improve quality of life for dual eligible patients.
The document summarizes key findings from a report on America's nonprofit community clinics, free clinics, and community health centers from 2006 to 2009. It finds that the total number of patients receiving services continues to rise, with a larger increase from 2008 to 2009 than previous years. The number of uninsured patients also continues to rise. While the proportion of uninsured patients decreased slightly, the proportion of Medicaid patients increased. Rates of chronic diseases like diabetes, hypertension, and asthma are increasing among patients at these safety net facilities.
Obstacles to maternity service use in Afghanistan: what do we know about cost...IDS
This presentation was given by Sundaram, Steinhardt, Peters and Rahman to the International Health Economics Association Conference 2009 in Beijing. It is research conducted as part of the Future Health Systems Research Programme Consortium www.futurehealthsystems.org.
There were 564,000 homeless individuals in the US in 2015. Homelessness increases health risks as the homeless experience barriers to healthcare access and are more likely to use emergency rooms for primary care. A proposed solution is a population-centered healthcare approach using a mobile medical unit that can screen, test and treat the homeless where they live. This reduces barriers by bringing healthcare directly to the homeless. It aims to increase preventative care, manage chronic conditions, and reduce emergency room visits and healthcare costs. Feedback from both patients and practitioners would be used to evaluate the model.
The document discusses homelessness and health care in Multnomah County, Oregon. It notes that homelessness remains a major public health challenge, leaving those without housing vulnerable to disease and health issues. The expansion of Medicaid under the Affordable Care Act in 2014 has the potential to significantly improve access to health care for the homeless population in Multnomah County. The document analyzes data on homelessness in the county, health outcomes for the homeless, the health care system prior to reform, implementation of the ACA, and initial outreach efforts to the homeless. It concludes with recommendations for maximizing health benefits for the homeless under health care reform.
Nonprofit community health centers and clinics that provide preventive and primary healthcare services for 24 million people – or one in 13 persons in the U.S. – report that the first year of the Affordable Care Act’s implementation had uneven effects, particularly between facilities in Medicaid expansion and non-expansion states.
The findings were released today by Direct Relief in The State of the Safety Net 2014, an annual report that examines issues and trends within the extensive network of nonprofit, community-based health centers and clinics, which are the principal point of access to healthcare and the medical home for persons with low incomes, without health insurance, and among the country’s most vulnerable. Such facilities include Federally Qualified Health Centers (FQHCs), nonprofit community-based health clinics, and free and charitable clinics.
Greg Jacobs, Tribal Administrator, described a series of Talking Circles held by various North Carolina tribes as momentous occasions marking a beginning of healing. The Talking Circles focused on behavioral health issues and included drumming, prayer, and presentations on substance abuse screening and resources. NC SBIRT trainings were also provided for tribal and local healthcare providers.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms for those who already suffer from conditions like anxiety and depression.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Southern African women living with HIV/AIDS face numerous challenges related to culture, gender inequality, lack of education, limited resources, adherence to antiretroviral therapy, and social stigmatization. Traditional healing practices can unintentionally spread HIV through the use of unclean tools. Gender norms prevent women from refusing sex or negotiating condom use. Limited access to education reduces knowledge about health issues. Shortages of healthcare workers and resources constrain treatment access and adherence. Social stigma deters women from seeking care and practicing prevention due to fear of discrimination.
A Change in Behavior: Delirium, Terminal Restlessness, or Dementia, A Pragmat...VITAS Healthcare
This webinar leverages evidence-based data to help physicians and healthcare professionals differentiate delirium, terminal restlessness and dementia-related agitation in patients as they near the end of life.
Rebuilding the Health Care System in New Orleans and the UScentralconference
The document discusses rebuilding the health care system in New Orleans post-Hurricane Katrina and applying Jewish principles of health care. It notes that pre-Katrina, Louisiana ranked 50th in health outcomes and had high rates of poverty, uninsured individuals, and health disparities. After Katrina, most hospitals and health infrastructure was destroyed, exacerbating access issues. The document advocates redesigning the system based on primary care-centered models shown to improve outcomes and lower costs through principles like comprehensive and coordinated care.
This document discusses harm reduction strategies and syringe exchange programs (SEPs). It provides evidence that SEPs are effective in preventing HIV and hepatitis C by allowing for safe disposal of used needles and connecting injection drug users to medical care. The document reviews how SEPs make communities safer by reducing improperly discarded syringes, protect first responders from needlestick injuries, and do not increase crime rates. SEPs are also cost-effective by saving millions in avoided healthcare costs from prevented infections. The discussion aims to increase support for SEPs by addressing common myths and concerns.
Emma Romberg Policy Brief (Final 2-22)Emma Romberg
The document discusses challenges faced by the transgender population in accessing quality healthcare. It notes that transgender individuals experience higher rates of poor health outcomes like HIV infection and suicide attempts compared to the general population. Access to healthcare is difficult due to provider discrimination, lack of provider experience, and insurance policies that deny coverage for transition-related care. While recent policies like the ACA have increased coverage, more needs to be done to improve the standard of care for transgender individuals and ensure access to necessary medical services. Recommendations include increasing provider education, creating more transgender-friendly healthcare environments, and implementing policies to establish a comprehensive standard of care.
The goal of this webinar was to educate healthcare professionals about the differences between palliative and curative care while exploring the history and philosophy of the hospice movement.
Speaker: Dave Nichols, Volunteer Manager & Workforce Manager, Public Health of Seattle & King
County
The MRC is a relative newcomer to the disaster response world. It is another tool in your emergency
management toolkit; but only if you know about it and how it works during a medical emergency or
disaster. This presentation has been designed to introduce, inform, and answer questions about the
Medical Reserve Corps program and how it fits into the disaster. I will also offer some ways that you
can involve them in your exercises to help them learn your area and your operation.
This document proposes a designated case worker position within a hospital setting to improve outcomes for homeless patients who overutilize the emergency department. The case worker would conduct assessments, develop individualized action plans, connect patients to community resources, and provide follow-up to ensure needs are being met. The goals are to improve patients' knowledge of and access to services, thereby reducing emergency department usage and costs while improving health outcomes for vulnerable homeless populations. Citizenship theory provides the framework to address individual needs within the larger community context.
Ce document de la National Coalition for LGBT Health américaine est le fruit du travail de son "Eliminating Disparities Working Group", publié en 2004.
Il présente les chantiers identifiés de sorte à faire reconnaître et mieux prendre en compte les enjeux de santé des trans. Il balaie un large spectre de déterminants de santé : violences, VIH/sida et des autres IST, usage abusif de produits psychoactifs, santé et bien-être mental, couverture maladie, traitements hormonaux, modifications corporelles auto-réalisées, formation des professionnels de santé, tabac etc.
This report analyzes emergency room (ER) usage data in Kansas City to identify "hot spots" of high ER use. The analysis found that 10 zip codes accounted for 38% of all ER admissions. These hot spots had higher rates of poverty, non-white populations, and preventable health conditions like asthma and influenza. They also had fewer primary care physicians and residents who were more likely to rely on Medicaid or uninsured care. The report concludes that over-reliance on the ER in these communities signals a failure of the healthcare system to provide adequate access to preventative primary care for low-income, minority populations.
This document discusses challenges faced by seniors in the Canadian healthcare system when being discharged from the hospital. It aims to raise awareness of issues like Alternate Level of Care (ALC) where patients no longer require acute care but face obstacles to leaving the hospital. It also discusses the "Home First" philosophy of supporting patients to transition home with high levels of home care rather than waiting in the hospital. Resources provided cover topics like hospital discharge planning, shaping attitudes towards seniors, and the role of communication in navigating patient choices and power dynamics during discharge.
This document discusses managing care for dual eligible patients through appropriate use of hospice and palliative care. Dual eligible patients are covered by both Medicare and Medicaid and have high medical needs. Hospice provides end-of-life care through a team approach focused on comfort. It reduces costs by decreasing hospitalizations. Palliative care extends hospice principles earlier in illness for relief of symptoms. Both hospice and palliative care improve quality of life for dual eligible patients.
The document summarizes key findings from a report on America's nonprofit community clinics, free clinics, and community health centers from 2006 to 2009. It finds that the total number of patients receiving services continues to rise, with a larger increase from 2008 to 2009 than previous years. The number of uninsured patients also continues to rise. While the proportion of uninsured patients decreased slightly, the proportion of Medicaid patients increased. Rates of chronic diseases like diabetes, hypertension, and asthma are increasing among patients at these safety net facilities.
Obstacles to maternity service use in Afghanistan: what do we know about cost...IDS
This presentation was given by Sundaram, Steinhardt, Peters and Rahman to the International Health Economics Association Conference 2009 in Beijing. It is research conducted as part of the Future Health Systems Research Programme Consortium www.futurehealthsystems.org.
There were 564,000 homeless individuals in the US in 2015. Homelessness increases health risks as the homeless experience barriers to healthcare access and are more likely to use emergency rooms for primary care. A proposed solution is a population-centered healthcare approach using a mobile medical unit that can screen, test and treat the homeless where they live. This reduces barriers by bringing healthcare directly to the homeless. It aims to increase preventative care, manage chronic conditions, and reduce emergency room visits and healthcare costs. Feedback from both patients and practitioners would be used to evaluate the model.
The document discusses homelessness and health care in Multnomah County, Oregon. It notes that homelessness remains a major public health challenge, leaving those without housing vulnerable to disease and health issues. The expansion of Medicaid under the Affordable Care Act in 2014 has the potential to significantly improve access to health care for the homeless population in Multnomah County. The document analyzes data on homelessness in the county, health outcomes for the homeless, the health care system prior to reform, implementation of the ACA, and initial outreach efforts to the homeless. It concludes with recommendations for maximizing health benefits for the homeless under health care reform.
Nonprofit community health centers and clinics that provide preventive and primary healthcare services for 24 million people – or one in 13 persons in the U.S. – report that the first year of the Affordable Care Act’s implementation had uneven effects, particularly between facilities in Medicaid expansion and non-expansion states.
The findings were released today by Direct Relief in The State of the Safety Net 2014, an annual report that examines issues and trends within the extensive network of nonprofit, community-based health centers and clinics, which are the principal point of access to healthcare and the medical home for persons with low incomes, without health insurance, and among the country’s most vulnerable. Such facilities include Federally Qualified Health Centers (FQHCs), nonprofit community-based health clinics, and free and charitable clinics.
Greg Jacobs, Tribal Administrator, described a series of Talking Circles held by various North Carolina tribes as momentous occasions marking a beginning of healing. The Talking Circles focused on behavioral health issues and included drumming, prayer, and presentations on substance abuse screening and resources. NC SBIRT trainings were also provided for tribal and local healthcare providers.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms for those who already suffer from conditions like anxiety and depression.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
This document analyzes several themes in William Shakespeare's play Macbeth, including ambition, supernatural elements, violence, guilt, the struggle between good and evil, and betrayal. It discusses how each of these themes is portrayed through the characters and events in the play. For example, it notes that ambition drives Macbeth and Lady Macbeth to murder King Duncan so Macbeth can become king. It also explains how the witches' prophecies introduce supernatural elements and influence Macbeth's actions.
Este documento presenta el proyecto de vida de Tatiana Vanesa Jimenez Serrano. Incluye una autobiografía, un análisis DAFO, un plan de gestión de tiempo, y metas a largo plazo como tener su propia empresa y ser un ejemplo para su familia. Detalla su visión, misión y un contrato de vida para lograr sus objetivos siendo una buena madre, esposa y dejando malas influencias.
Este documento presenta el proyecto de vida de Tatiana Vanesa Jimenez Serrano. Incluye una autobiografía, un análisis DAFO, un plan de gestión de tiempo, y metas como tener su propia empresa, ser una mujer profesional para lograr su felicidad y la de su familia, y comprometerse a ser una buena madre y esposa cuidando de su hija y dejando malas amistades.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
La Unión Europea ha acordado un embargo petrolero contra Rusia en respuesta a la invasión de Ucrania. El embargo prohibirá las importaciones marítimas de petróleo ruso a la UE y pondrá fin a las entregas a través de oleoductos dentro de seis meses. Esta medida forma parte de un sexto paquete de sanciones de la UE destinadas a aumentar la presión económica sobre Moscú y privar al Kremlin de fondos para financiar su guerra.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost feelings of calmness, happiness and focus.
A empresa de tecnologia anunciou um novo smartphone com câmera aprimorada, tela maior e bateria de longa duração por um preço acessível. O dispositivo tem como objetivo atrair mais consumidores em mercados emergentes com suas especificações equilibradas e preço baixo. Analistas esperam que as melhorias e o preço baixo impulsionem as vendas do novo aparelho.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
This document introduces different types of numbers. Real numbers include all numbers that can be expressed as decimals, and are divided into rational and irrational numbers. Rational numbers can be written as fractions with integer numerators and denominators not equal to zero, such as repeating decimals. Irrational numbers cannot be written as fractions, such as roots of non-perfect squares. The document provides examples of rational numbers like fractions and repeating decimals, as well as irrational numbers like pi. It also discusses how rational numbers include natural numbers, whole numbers, and integers.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
The atan2 function returns the angle between the positive x-axis and the point (x,y) in a plane, taking into account the signs of x and y to determine the correct quadrant. It is useful in applications involving vectors and rotations. Unlike the single-argument arctangent function, atan2 can distinguish between diametrically opposite angles and handles cases where x is zero.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms for those who already suffer from conditions like anxiety and depression.
Universal design aims to make learning accessible to all students by providing multiple means of representation, action and expression, and engagement. It focuses on ensuring marginalized students such as those with disabilities or who are English language learners can succeed. There are three broad principles: representing information through various formats, allowing different ways for students to demonstrate understanding, and employing multiple methods for engaging students. When implementing universal design, educators should consider goals, materials, teaching methods, and assessment.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
The document discusses the link between HIV/AIDS and homelessness. Key points include:
- Lack of affordable housing and discrimination can cause people with HIV/AIDS to become homeless as they may lose their jobs and ability to afford housing.
- Urban Solutions is a nonprofit that provides various services to over 100 low-income and underinsured individuals with HIV/AIDS each year, including medical care, housing assistance, and youth programs.
- The National Alliance to End Homelessness outlines a 10 step plan communities can take that includes strategies like emergency prevention, rapid re-housing, and ensuring access to permanent supportive housing and income for those in need.
The goal of this webinar was to educate healthcare professionals about the differences between palliative and curative care while exploring the history and philosophy of the hospice movement.
DataBrief No. 16: Residence Setting by Level of DisabilityThe Scan Foundation
Less than 40% of older Americans with moderate or severe disabilities reside in nursing homes. Most older adults with disabilities prefer to receive long-term services and supports (LTSS) in their own homes or in residential care facilities rather than nursing homes. As a result, states have significantly increased spending on community-based LTSS over the past few decades. According to 2006 data, 58% of older Americans with moderate to severe disabilities received assistance in either community or residential care settings, while only 38% resided in nursing homes.
Housing Vulnerability and Health: Canada’s Hidden EmergencyTheHomelessHub
A longitudinal study of the health of vulnerably housed and homeless adults in Vancouver, Toronto, and Ottawa
SIGNIFICANCE:This is the first study to report on longitudinal changes (i.e. changes over time) in the health and housing status of vulnerably housed and homeless people in Canada, and the first to compare their health outcomes.
FOCUS:This study is tracking the health and housing status of 1,200 vulnerably housed and homeless single adults in Vancouver, Toronto, and Ottawa over a two-year period. We recruited 200 vulnerably housed adults and 200 homeless adults in each city (1,200 total), from shelters, meal programs, single room occupancy hotels, and rooming houses.
WHAT’S NEXT:In 2009, we completed our first round of interviews with participants.
In 2010 and 2011, we’ll conduct follow-up interviews, to see how – and why – participants’ housing and health status have changed. This information will be useful to communities and decision-makers; our goal is to guide the development of effective programs and policies to prevent and end housing vulnerability and homelessness.
WHO’S INVOLVED:
Research partners from the Centre for Research on Inner City Health (St. Michael’s Hospital); Carleton University; Centre for Research on Educational and Community Services (University of Ottawa); Ottawa Inner City Health, Inc; PHS Community Services Society (Vancouver); Royal Ottawa Health Care Group; Street Health (Toronto); and University of British Columbia. HHiT is funded by the Canadian Institutes of Health Research.
The goal of this webinar was to educate healthcare professionals about the differences between palliative and curative care while exploring the history and philosophy of the hospice movement.
Breaking the Cycle of Chronic Homelessness (Patricia Tooker)Wagner College
This monograph was written for Wagner College's Hugh L. Carey Institute for Government Reform in January 2020 by Patricia Tooker, DNP, Dean of the Evelyn L. Spiro School of Nursing at Wagner College and Research Fellow for the Carey Institute.
- Supportive housing provides permanent affordable housing combined with flexible voluntary services to help people live stable lives and reduce cycling between homelessness, incarceration, hospitals and shelters.
- Research shows supportive housing reduces recidivism and costs to criminal justice systems while improving health outcomes for tenants. It is an effective approach for people leaving incarceration who often face homelessness and other challenges.
- The document advocates for investing in supportive housing as part of comprehensive reentry efforts to improve lives and more efficiently use public resources.
This document discusses palliative care in Virginia. It defines palliative care in Virginia law and federal regulations. It describes how palliative care differs from hospice care in focusing on symptom relief rather than being limited to terminal patients. The document discusses the growing need for palliative care due to an aging population living longer with chronic conditions. It provides examples of how palliative care can help patients with cancer and cardiovascular disease.
CFPHD Guest Speaker Dr. Chisholm: Nursing Home Quality and Financial PerformanceCFPHD
This study examined the relationship between nursing homes' racial composition of residents and financial performance, and whether financial performance influenced the relationship between racial composition and quality of care. The results showed that nursing homes with no black residents had better financial outcomes and quality outcomes than homes with high proportions of black residents. Financial performance partially influenced the relationship between racial composition and quality. The study recommends increasing Medicaid payments to homes with many minority residents, implementing pay-for-performance programs, and addressing trends like residential segregation and occupancy rates.
Qualitative Research on Health as a Human Right in Lewis & Clark County, Mont...Purvi P. Patel
The final presentation of my Applied Learning Experience Presentation (ALE), the thesis requirement for my Masters of Public Health degree. The National Economic and Social Rights Initiative (NESRI) served as the host organization for my project. The final community presentation/defense was presented to the Tufts Medical School community in December 2009.
The goal of this webinar is to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care, including common misconceptions, typical diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the
benefits of advance care planning and early referrals.
Innovative practices programs 3 susan leeIBHPartners
This document discusses a project in Los Angeles County that provides intensive case management and supportive housing to homeless frequent users of hospitals. It notes that the target population is the top 10% of homeless individuals who use the most crisis services and have complex health issues. The program aims to improve lives, maximize public resources, and strengthen communities. It provides data showing high homeless populations and costs in LA County. The program has shown success in reducing hospital utilization and costs by 79% on average for those enrolled by providing permanent supportive housing and intensive case management services. The document also discusses how the program aligns with the Affordable Care Act's Health Home option and California's efforts to implement health homes through Medi-Cal.
Clinica Esperanza/Hope Clinic "International Healthcare on the local bus line...Annie De Groot
Clínica Esperanza/Hope Clinic (CEHC) provides primary healthcare to uninsured Rhode Island residents. CEHC aims to offer high-quality and culturally competent care with an emphasis on prevention. It is run by volunteer healthcare providers and staff, with support from community donations. The document discusses CEHC's services, patient demographics, outcomes in managing chronic conditions, and initiatives like the CHEER walk-in clinic and Navegantes program to improve healthcare access and navigation. It also notes ongoing challenges around increasing demand and reducing emergency room use.
These slides give an overview of public health and the role of local public health departments in keeping people healthy, presents housing, health and some of the vulnerable populations who are the primary focus of our work, and shows the Healthy Chicago Public Health Agenda - the blueprint for our work at the Chicago Department of Public Health. Lastly, it highlights some of our work and accomplishments with vulnerable groups.
The goal of this webinar was to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care.
HIV and Primary Care Transformation baltimore 5 21sbromer
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This document is a submission from Phil Brown, General Manager of Shelter, Support and Housing Administration at the City of Toronto, to the Ontario Government's Select Committee on Mental Health and Addictions. Brown argues that housing is the most important issue and "first medicine" to address for those who are homeless and mentally ill or have addictions. He provides data about long-term shelter residents in Toronto having high rates of mental illness and addictions. Brown advocates for the "housing first" approach and cites evidence that providing housing and supports results in improved health, reduced substance use, and is more cost effective than emergency services. He asks the committee to provide sustainable funding for shelters and support innovative housing programs.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
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In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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Homeless PACT (PCMH)
David I. Rosenthal MD
Medical Director – Homeless PACT, VA Asst
Prof, Section of General Internal Medicine,
Yale School of Medicine
2010 HUD Report on Homelessness
10. Background
• On a typical night in 2010, more than 400,000
homeless individuals in the US (1)
• ~10% experienced chronic homelessness
– Defined as homelessness >1 year or 4 episodes in
the past 3 years
(1) The 2010 Annual Homeless Assessment Report to Congress. Department of Housing and Urban Development
(US), Office of Community Planning and Development.
Available at http://www.hudhre.info/documents/2010HomelessAssessmentReport.pdf
12. Housing First - Core Principles
Consumer choice and empowerment
Separation of services and housing
Services are voluntary and flexible
Community integration
Harm reduction and recovery oriented
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Housing Services OverviewHousing Services Overview
13. Homeless
Shelter
placement
Transitional
housing
Permanent
housing
Levelofindependence
Treatment compliance + psychiatric stability + abstinence
Underlying theory and values:
•Transitional placements provide
for stabilization and learning.
•Individual change is required
through treatment.
•Consumers must ‘earn’
permanent housing
Treatment First Model
Tsemberis slide, 2010
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Housing Services OverviewHousing Services Overview
16. The Eleanor and Franklin
Formerly Park City--Bridgeport, CT
Permanent Supportive Housing
55 Elderly & 49 Homeless Mentally Ill
Legion Woods, New Haven,
CT
Permanent Supportive
Housing- 20 Units
Transitional—14 Beds
Harkness House, West Haven, CT
Kossuth Street—New Haven, CT
Yale School
of Architecture
Homeownership
Community
Partnerships
16
19. Why Housing First?
1. It ends homelessness
2. Housing First eliminates the need for costly shelter care,
transitional and short term treatment services aimed at
preparing Veterans to be housing ready.
3. Studies demonstrate the Housing First reduces ER visits,
unscheduled mental health and medical hospitalization
4. Decreases the frequency and duration of homelessness
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Housing Services OverviewHousing Services Overview
20. VA Housing Programs
Domiciliary Care for Homeless Veterans
The Domiciliary Care Program is a clinical rehabilitation and
treatment program for male and female Veterans. The Domiciliary
Care Program addresses goals of rehabilitation, recovery, health
maintenance, improved quality of life, and community integration in
addition to specific treatment of medical conditions, mental
illnesses, addictive disorders, and homelessness.
Department of Housing and Urban Development/Department of
Veterans Affairs Supportive Housing (HUD-VASH)
Through the HUD-VASH Program, HUD and VA, through a
cooperative partnership, provide long-term case management,
supportive services and permanent housing support for Veterans
who require these supports in order to live independently.
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Housing Services OverviewHousing Services Overview
21. VA Housing Programs, cont.
Grant and Per Diem (GPD)
The Grant and Per Diem (GPD) Program funds community-based
agencies providing transitional housing or service centers for
homeless Veterans. A Veteran can typically reside in a GPD Program
for up to 2 years.
Supportive Services for Veteran Families Program
The Supportive Services for Veteran Families (SSVF) Program is a
new VA program that will provide supportive services to very low-
income Veterans and their families who are in or transitioning to
permanent housing. VA awards grants to private non-profit
organizations and consumer cooperatives that assist very low-
income Veterans and their families by providing a range of
supportive services designed to promote housing stability.
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Housing Services OverviewHousing Services Overview
22. The challenge of keeping homeless people
in housing
• High rate of recidivism from grant per diem housing
• Substance abuse relapse is the most commonly cited reason
– Chart review of 50 “early departure” veterans found secondary
reasons of pain management, untreated mental illnesses, and
relationship problems involved
– Participation in a Homeless-Oriented Primary Care model (Providence
VA) reduced GPD “early departure” rate to 16%
Used with permission from Dr. O’Toole, from HPACT Cyberseminar
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Housing Services OverviewHousing Services Overview
23. Health impact of homelessness
Barrow SM, Herman DB, Córdova P,
Struening EL. Mortality among homeless
shelter residents in New York City. Am J
Public Health. 1999 Apr;89(4):529-34
1260 NYC
homeless
Shelter
residents
24. Health impact of homelessness
Barrow SM, Herman DB, Córdova P,
Struening EL. Mortality among homeless
shelter residents in New York City. Am J
Public Health. 1999 Apr;89(4):529-34
In a 7 year follow up period
~2-4x increased risk of mortality
27. • Large, nationwide, prospective, register-based
cohort study 1999-2009 in Demark
• 32,711 in study population
• Overall SMR (Standardized Mortality Ratio)
5-6x in Men, 6-7x in Women
Highest in Substance abuse disorder, higher than dual
diagnosisNielsen SF, Hjorthøj CR, Erlangsen A, Nordentoft M. Psychiatric disorders and mortality
among people in homeless shelters in Denmark: a nationwide register-based cohort
study. Lancet. 2011 Jun 25;377(9784):2205-14
28. • Boston Health Care for the Homeless:
Case control study of 558 deaths 1988-1993
29. Homeless Vulnerability Index
• For individuals who have been homeless for at least six months, one or more following
markers place them at heightened risk of mortality:
– more than three hospitalizations or emergency room visits in a year
– more than three emergency room visits in the previous three months
– aged 60 or older
– cirrhosis of the liver
– end-stage renal disease
– history of frostbite, immersion foot, or hypothermia
– HIV+/AIDS
– tri-morbidity: co-occurring psychiatric, substance abuse, and chronic medical
condition
In Boston, 40% of those with these conditions died prematurely, underscoring the need
for housing and appropriate support for this group.
Developed by Jim O’Connell, Boston Health Care for the Homeless
used in practice by Common Ground, NYC
30. Salit SA, Kuhn EM, Hartz AJ, Vu JM, Mosso AL. Hospitalization costs associated
with homelessness in New York City. N Engl J Med 1998; 338: 1734-1740
•Hospital discharge data from public hospital system of NYC
1992-1993, and private hospital data of medicaid admissions
•Of 354,494 persons discharges, identified 18,864 patients as
homeless
31. Salit SA, Kuhn EM, Hartz AJ, Vu JM, Mosso AL. Hospitalization costs associated with
homelessness in New York City. N Engl J Med 1998; 338: 1734-1740
32. Salit SA, Kuhn EM, Hartz AJ, Vu JM, Mosso AL. Hospitalization costs associated with homelessness in
New York City. N Engl J Med 1998; 338: 1734-1740
•Average LOS
3.1 -5.1 days longer
•∆Cost in 1997 $s
$4094 per discharge
for psychiatric
primary diagnosis
$3370 per pt with
AIDS as primary
diagnosis
$2414 per pt of
all causes
~rough cost of
monthly NYC
apt
34. VERA Sustainability Capacity
• New Multiple Medical and Chronic Mental Illness classes
specifically for homeless Veterans
• Homelessness diagnosis (V.60) in combination with medical
conditions managed utilizing at least 7 RVUs qualify for Class
5 Price Group (Multiple Problems) VERA
• No RVU credit for ER or inpatient encounters
• Price Group Differential:
– Non-reliant care: $813
– Multiple Problem care: $27,686
35. Ku BS, Scott KC, Kertesz SG, Pitts SR. Factors associated with use of urban emergency departments by the U.S. homeless
population. Public Health Rep. 2010 May-Jun;125(3):398-405
36.
37. “First Stops” when becoming
homeless
• Community-based survey of 230 homeless adults
• Question: “Where do you go first after becoming homeless
and for what?”
• Top 5 sites:
– Soup kitchen
– Welfare office
– Detox center
– Homeless outreach team
– Emergency Department
• 62.6% of individuals with a chronic medical/mental health
condition went to a health care site
• 46.4% of individuals with alcohol abuse went to a health care
site
O’Toole, et al. Health Soc Care Community. 2007
38. Physical health concerns, homelessness and
behavior change
• N=370 adults presenting to an emergency department (266
homeless; 104 housed)
• 80% of homeless adults seeking substance abuse treatment
reported physical health concerns as a major reason.
• More homeless were in an action stage for wanting substance
abuse treatment
• Homeless adults were almost 2.5 times more likely to report
their living arrangement as a major motivation for seeking
treatment
O’Toole et al. JSAT. 2008
40. “The painfully obvious lesson for me has been the
futility of solving this complex social problem solely
with new approaches to medical or mental health
care...I dream of writing a prescription for an
apartment, a studio, an SRO, or any safe housing
program, good for one month, with 12 refills.”
-Dr. Jim O’Connell
Boston Health Care
for the Homeless
41. •Large Health Survey 1999 with
N=559,985
•Serious mental illnesses (schizophrenia,
bipolar d/o) is associated
with lower utilization of primary care.
42. Co-located Primary Care?
Adm Policy Ment Health. 2009 Jul;36(4):255-64. Epub 2009 Mar 12.
In Los Angeles VA, usual VA care (n=130) vs. integrated care group (n=130),
received more prevention services, primary care visits, fewer ED visits, but no
difference in inpatient utilization or health status at 18 months.
43. December 2010, Vol 100, No. 12 | American Journal of Public Health O’Toole et al. | Peer Reviewed | Research
and Practice | 2493
•Providence VA System
• retrospective cohort study of 177 Vets in Specialized homeless-
oriented primary clinic (79) vs. traditional primary care Model (98)
49. TODAY’S CARE MEDICAL HOME CARE
My patients are those who make
appointments to see me
Our patients are those who are
registered in our medical home
Patients’ chief complaints or reasons
for visit determines care
We systematically assess all our
patients’ health needs to plan care
Care is determined by today’s
problem and time available today
Care is determined by a proactive plan
to meet patient needs without visits
Care varies by scheduled time and
memory or skill of the doctor
Care is standardized according to
evidence-based guidelines
Patients are responsible for
coordinating their own care
A prepared team of professionals
coordinates all patients’ care
I know I deliver high quality care
because I’m well trained
We measure our quality and make
rapid changes to improve it
It’s up to the patient to tell us what
happened to them
We track tests & consultations, and
follow-up after ED & hospital
Clinic operations center on meeting
the doctor’s needs
A multidisciplinary team works at the
top of our licenses to serve patients
Acute care is delivered in the next
available appointment and walk-ins
Acute care is delivered by open access
and non-visit contacts
Used with Permission; Daniel Duffy, MD, MACP, School of Community Medicine, Tulsa, Oklahoma.
50. 7 Core elements of
Patient Aligned Care Teams
• Patient-driven – focus on the patient rather than the disease
• Team-based - care delivered by interdisciplinary team
• Efficient – deliver care the patient needs when they need it
• Comprehensive – delivering while person-oriented care
• Continuous – long-term, longitudinal relationship between pt & team
• Communication – honest, respectful, reliable, culturally sensitive
• Coordination – across all elements of the health care system
Used with permission from Dr. O’Toole, from HPACT Cyberseminar
51. Key features of Special Population
PACTs
• Access - Accommodates barriers, challenges to routine
care
• Care tailored to specific needs of a population
– Readiness to respond to “treatable moments”
• Case management/Care coordination
– Expanded team members/communities
– Capacity to address competing needs
• Care team equipped with specialized
knowledge and skills
O’Toole, et al. Journal Gen Intern Med 2011
Used with permission from Dr. O’Toole, from HPACT Cyberseminar
52. Homeless PACT goals: PACT-PLUS
• To provide comprehensive, continuity care to a
population of patients (Homeless Veterans) who
have multiple deferred care needs complicated by
their living arrangements
• To integrate housing objectives with clinical care
objectives in care planning and delivery
• To build knowledgeable compassionate teams
equipped and prepared to provide care needed by
this population of patients
Used with permission from Dr. O’Toole, from HPACT Cyberseminar
Editor's Notes
Success breeds success. “Once a continuum is established, the outcomes and strength of the continuum, and its partnership resources will allow you a much stronger position in pursuing grants and leveraging of your resources.” Each new partner reaffirms and strengthens our resources and our mission. VA Connecticut has received over 18+ million dollars to better meet the needs of our veterans struggling with substance abuse, mental illness &/or homelessness. 10/15/2010 Yale Innovation Award
In epidemiology , the standardized mortality ratio or SMR , is a quantity, expressed as either a ratio or percentage quantifying the increase or decrease in mortality of a study cohort with respect to the general population.Specifically, it is the ratio of observed deaths in the study group to expected deaths in the general population. This ratio can be expressed as a percentage simply by multiplying by 100.