Shelter Access Workgroup

Participatory Action Research (PAR)

Participants= Mayors office, service providers, community members, 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 Intervention Approach. Journal Of Community Practice, 20(3), 260-273. doi:10.1080/10705422.2012.699871

Presenting Problem

6,544 — Population of homeless people in San Francisco (Others report about 15,000 homeless and LSYS reports 4,105 youth served in ‘12)

1,134 —  Total beds in single adult shelter system funded by taxpayers

75% — Percentage of homeless people with a chronic medical ailment

55% — Percentage of shelter clients reporting a disabling condition

12 to 14% — Percentage of beds used by clients aged 60 or older (3/09 to 3/11- increased)

ONLY 9 CASE MANAGERS!!!!!!!

*Sources: San Francisco Human Services Agency, Department of Public Health

Phase Two of the Shelter Access Workgroup focusing on improving

outcomes in the Adult Shelter system.

Recommendations address 3 categories.

Improving Health Outcomes in Shelters.

Cultural Competency / Special Populations.  

Access to and quality of case management and service connection.

Intervention/Analysis

Shelter Recommendations: Increase accessibility and education for residents

about available 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!

Housing First, Consumer Choice, and Harm Reduction for

Homeless Individuals With a Dual Diagnosis

Provider Perspective: Housing 1st vs. Traditional

Programs

This study revealed that providers working within Treatment First programs were consumed with the pursuit of housing, whereas Housing First providers focused more on clinical concerns since clients already had housing.

How programs position permanent housing has very different implications for how providers understand their work, the pressures they encounter, and how they prioritize client goals.

*Henwood BF, Stanhope V, Padgett DK. The role of housing: a comparison of front-line provider views in housing first and traditional programs. Adm Policy Ment Health. 2011 Mar;38(2):77-85. doi: 10.1007/s10488-010-0303-2.

Think Out of the Box- Wet House

San Francisco spends around $13.5 million per year caring for its top 225 “chronic public inebriates.”

The average individual in a Seattle wet housing program cost the city more than $4,000 per month prior to their intake, but only $958 per month afterwards. Residents averaged 20 drinks per day at the time of

their intake, 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 chronically homeless persons with severe alcohol problems. JAMA. 2009 Apr 1;301(13):1349-57. doi: 10.1001/jama.2009.414. PubMed PMID: 19336710.

*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-Care Deficit Nursing Theory. Nursing Science Quarterly, 24(1), 48-56. doi:10.1177/0894318410389059

Regular spiritual practice &incorporating contemplation

into ones daily routine is an antidote to stress.

Healthy self-care not only helps prevent compassion fatigue, but also helps one relax and clear one's mind of thoughts and feelings, and experience warmth, love and goodness.