Sample records for homeless veterans notice

  1. 75 FR 22164 - Urban Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-27

    ... Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into Employment... addresses complex problems facing Homeless Female Veterans and/or Veterans with Families eligible to... (including job readiness, literacy training, and skills training) to expedite the reintegration of homeless...

  2. Military sexual trauma among homeless veterans.

    PubMed

    Pavao, Joanne; Turchik, Jessica A; Hyun, Jenny K; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-07-01

    Military sexual trauma (MST) is the Veteran Health Administration's (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. To estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men. National, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010. All variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization. Of homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST. A substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless

  3. Elderly homeless veterans in Los Angeles: chronicity and precipitants of homelessness.

    PubMed

    van den Berk-Clark, Carissa; McGuire, James

    2013-12-01

    We compared the characteristics of chronically homeless and acutely homeless elderly veterans to better understand precipitants of homelessness. We conducted interviews with 33 chronically and 26 acutely homeless veterans aged 65 years and older receiving transitional housing services in Los Angeles, California, between 2003 and 2005. We asked questions regarding their sociodemographic characteristics and other social status measures. Other precipitants of homelessness were acquired via observation and open-ended and structured questions. Both veterans groups were more similar than different, with substantial levels of physical, psychiatric, and social impairment. They differed significantly in homelessness history, with chronically homeless veterans having more homelessness episodes and more total time homeless. They were also less educated and had smaller social networks. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction to exacerbate homelessness. Assessment of a range of factors is needed to address risk factors and events leading to homelessness. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population.

  4. Elderly Homeless Veterans in Los Angeles: Chronicity and Precipitants of Homelessness

    PubMed Central

    van den Berk-Clark, Carissa; McGuire, James

    2013-01-01

    Objectives. We compared the characteristics of chronically homeless and acutely homeless elderly veterans to better understand precipitants of homelessness. Methods. We conducted interviews with 33 chronically and 26 acutely homeless veterans aged 65 years and older receiving transitional housing services in Los Angeles, California, between 2003 and 2005. We asked questions regarding their sociodemographic characteristics and other social status measures. Other precipitants of homelessness were acquired via observation and open-ended and structured questions. Results. Both veterans groups were more similar than different, with substantial levels of physical, psychiatric, and social impairment. They differed significantly in homelessness history, with chronically homeless veterans having more homelessness episodes and more total time homeless. They were also less educated and had smaller social networks. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction to exacerbate homelessness. Conclusions. Assessment of a range of factors is needed to address risk factors and events leading to homelessness. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population. PMID:24148059

  5. 77 FR 20849 - Homeless Veterans' Reintegration Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ... determines appropriate to provide job training, counseling, and placement services (including job readiness and literacy and skills training) to expedite the reintegration of homeless veterans into the labor... Training Service (VETS), Department of Labor. Announcement Type: New Notice of Availability of Funds and...

  6. Overrepresentation of Women Veterans Among Homeless Women

    PubMed Central

    Gamache, Gail; Rosenheck, Robert; Tessler, Richard

    2003-01-01

    Objectives. This study estimated the proportion of veterans among homeless women and their risk of homelessness relative to that of nonveterans. Methods. Data came from 2 surveys of homeless women (1 clinical and 1 nonclinical) and 1 survey of domiciled women. Results. The proportion of veterans (4.4%, 3.1%) among homeless women was greater than the proportion among domiciled women (1.3%, 1.2%). When we computed odds ratios for being a veteran among homeless women compared with nonhomeless women, homeless women were significantly more likely than nonhomeless women to be veterans. Conclusions. Women veterans are at greater risk for homelessness than are nonveterans. Further study is needed to determine whether increased risks for veterans are a product of military service or reflect volunteers’ self-selection into the armed forces. (Am J Public Health. 2003;93:1132–1136) PMID:12835198

  7. 77 FR 26069 - Advisory Committee on Homeless Veterans, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-02

    ... Veterans Affairs with an on-going assessment of the effectiveness of the policies, organizational structures, and services of the Department in assisting homeless Veterans. The Committee shall assemble and...

  8. 78 FR 6405 - Advisory Committee on Homeless Veterans, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... Veterans Affairs with an on-going assessment of the effectiveness of the policies, organizational structures, and services of the Department in assisting homeless Veterans. The Committee shall assemble and...

  9. Risk Factors for Homelessness Among US Veterans

    PubMed Central

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

  10. Barriers to Psychosocial Services among Homeless Women Veterans

    PubMed Central

    HAMILTON, ALISON B.; POZA, INES; HINES, VIVIAN; WASHINGTON, DONNA L.

    2015-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to services, and lack of coordination across services. Compared to non-veteran homeless women, women veterans potentially face additional challenges of trauma exposure during military service, post-military readjustment issues, and few services specific to women veterans. Understanding their service needs and experiences is critical to the development of relevant and appropriate services that move homeless women veterans away from vulnerability, into safety. PMID:26617471

  11. Risk factors for homelessness among US veterans.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  12. Unsheltered Homelessness Among Veterans: Correlates and Profiles.

    PubMed

    Byrne, Thomas; Montgomery, Ann Elizabeth; Fargo, Jamison D

    2016-02-01

    We identified correlates of unsheltered status among Veterans experiencing homelessness and described distinct subgroups within the unsheltered homeless Veteran population using data from a screening instrument for homelessness that is administered to all Veterans accessing outpatient care at a Veterans Health Administration (VHA) facility. Correlates of unsheltered homelessness included male gender, white race, older age, lower levels of VHA eligibility, substance use disorders, frequent use of VHA inpatient and infrequent use of VHA outpatient services, and residing in the West. We identified six distinct subgroups of unsheltered Veterans; the tri-morbid frequent users represented the highest need group, but the largest group was comprised of Veterans who made highly infrequent use of VHA healthcare services. Differences between sheltered and unsheltered Veterans and heterogeneity within the unsheltered Veteran population should be considered in targeting housing and other interventions.

  13. "Homelessness and trauma go hand-in-hand": pathways to homelessness among women veterans.

    PubMed

    Hamilton, Alison B; Poza, Ines; Washington, Donna L

    2011-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of women veterans' pathways into homelessness. Three focus groups were held in Los Angeles, California, with a total of 29 homeless women veterans. Five predominant "roots" (precipitating experiences) initiated pathways toward homelessness: 1) childhood adversity, 2) trauma and/or substance abuse during military service, 3) post-military abuse, adversity, and/or relationship termination, 4) post-military mental health, substance abuse, and/or medical problems, and 5) unemployment. Contextual factors, which promoted development of homelessness in the setting of primary roots, included women veterans' "survivor instinct," lack of social support and resources, sense of isolation, pronounced sense of independence, and barriers to care. These contextual factors also reinforced persistence of the roots of post-military adversity and mental health and substance abuse problems, serving to maintain cycles of chronic homelessness. Collectively, these multiple, interacting roots and contextual factors form a "web of vulnerability" that is a target for action. Multiple points along the pathways to homelessness represent critical junctures for VA and community-based organizations to engage in prevention or intervention efforts on behalf of women veterans. Considering the multiple, interconnected challenges that these women veterans described, solutions to homelessness should address multiple risk factors, include trauma-informed care that acknowledges women veterans' traumatic experiences, and incorporate holistic responses that can contribute to healing and recovery. Published by Elsevier Inc.

  14. Characteristics of the Highest Users of Emergency Services in Veterans Affairs Hospitals: Homeless and Non-Homeless.

    PubMed

    Gundlapalli, Adi V; Jones, Audrey L; Redd, Andrew; Suo, Ying; Pettey, Warren B P; Mohanty, April; Brignone, Emily; Gawron, Lori; Vanneman, Megan; Samore, Matthew H; Fargo, Jamison D

    2017-01-01

    Efforts are underway to understand recent increases in emergency department (ED) use and to offer case management to those patients identified as high utilizers. Homeless Veterans are thought to use EDs for non-emergent conditions. This study identifies the highest users of ED services in the Department of Veterans Affairs and provides descriptive analyses of these Veterans, the diagnoses for which they were seen in the ED, and differences based on their homeless status. Homeless Veterans were more likely than non-homeless Veterans to have >10 visits in the 2014 calendar year (12% vs. <1%). Homeless versus non-homeless Veterans with >10 visits were more often male, <age 60, and non-married. Non-homeless Veterans with >10 ED visits were often treated for chest and abdominal pain, and back problems, whereas homeless Veterans were frequently treated for mental health/substance use. Tailored case management approaches may be needed to better link homeless Veterans with high ED use to appropriate outpatient care.

  15. Pathways into homelessness among post-9/11-era veterans.

    PubMed

    Metraux, Stephen; Cusack, Meagan; Byrne, Thomas H; Hunt-Johnson, Nora; True, Gala

    2017-05-01

    Despite the scale of veteran homelessness and government-community initiatives to end homelessness among veterans, few studies have featured individual veteran accounts of experiencing homelessness. Here we track veterans' trajectories from military service to homelessness through qualitative, semistructured interviews with 17 post-9/11-era veterans. Our objective was to examine how veterans become homeless-including the role of military and postmilitary experiences-and how they negotiate and attempt to resolve episodes of homelessness. We identify and report results in 5 key thematic areas: transitioning from military service to civilian life, relationships and employment, mental and behavioral health, lifetime poverty and adverse events, and use of veteran-specific services. We found that veterans predominantly see their homelessness as rooted in nonmilitary, situational factors such as unemployment and the breakup of relationships, despite very tangible ties between homelessness and combat sequelae that manifest themselves in clinical diagnoses such as posttraumatic stress disorder. Furthermore, although assistance provided by the U.S. Department of Veterans Affairs (VA) and community-based organizations offer a powerful means for getting veterans rehoused, veterans also recount numerous difficulties in accessing and obtaining VA services and assistance. Based on this, we offer specific recommendations for more systematic and efficient measures to help engage veterans with VA services that can prevent or attenuate their homelessness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. Diagnoses Treated in Ambulatory Care Among Homeless-Experienced Veterans

    PubMed Central

    Gabrielian, Sonya; Yuan, Anita H.; Andersen, Ronald M.; Gelberg, Lillian

    2016-01-01

    Purpose: Little is known about how permanent supported housing influences ambulatory care received by homeless persons. To fill this gap, we compared diagnoses treated in VA Greater Los Angeles (VAGLA) ambulatory care between Veterans who are formerly homeless—now housed/case managed through VA Supported Housing (“VASH Veterans”)—and currently homeless. Methods: We performed secondary database analyses of homeless-experienced Veterans (n = 3631) with VAGLA ambulatory care use from October 1, 2010 to September 30, 2011. We compared diagnoses treated—adjusting for demographics and need characteristics in regression analyses—between VASH Veterans (n = 1904) and currently homeless Veterans (n = 1727). Results: On average, considering 26 studied diagnoses, VASH (vs currently homeless) Veterans received care for more (P < .05) diagnoses (mean = 2.9/1.7). Adjusting for demographics and need characteristics, VASH Veterans were more likely (P < .05) than currently homeless Veterans to receive treatment for diagnoses across categories: chronic physical illness, acute physical illness, mental illness, and substance use disorders. Specifically, VASH Veterans had 2.5, 1.7, 2.1, and 1.8 times greater odds of receiving treatment for at least 2 condition in these categories, respectively. Among participants treated for chronic illnesses, adjusting for predisposing and need characteristics, VASH (vs currently homeless) Veterans were 9%, 8%, and 11% more likely to have 2 or more visits for chronic physical illnesses, mental illnesses, and substance use disorder, respectively. Conclusion: Among homeless-experienced Veterans, permanent supported housing may reduce disparities in the treatment of diagnoses commonly seen in ambulatory care. PMID:27343544

  17. The association of military discharge variables with smoking status among homeless Veterans.

    PubMed

    Hammett, Patrick; Fu, Steven S; Lando, Harry A; Owen, Greg; Okuyemi, Kolawale S

    2015-12-01

    There is a dearth of research examining the health correlates of tobacco use within the homeless population, particularly with respect to homeless Veterans. An aim of the present study was to compare homeless Veteran and homeless non-Veteran smokers across a series of socio-demographic and health variables, and to determine whether any of these variables were independently associated with Veteran status. A subsequent aim was to compare the socio-demographic and health profiles of Veteran smokers and Veteran nonsmokers, and to determine whether any of these variables were independently associated with current smoking. Data were obtained from the 2009 Homelessness in Minnesota survey conducted by the Wilder Research Foundation. The final sample included 4750 homeless individuals living throughout Minnesota. The prevalence of smoking was greater among homeless Veterans (74%) than homeless non-Veterans (70%). The prevalence of physical and mental health problems was higher among homeless Veteran smokers than homeless non-Veteran smokers, although these variables were not independently associated with Veteran status after controlling for socio-demographics. Analyses of the homeless Veteran sample indicated that receipt of Veterans' benefits, type of discharge, and alcohol and/or chemical dependence were independently associated with current smoking. Homeless Veteran smokers exhibit heightened rates of physical and mental health problems compared to homeless non-Veteran smokers. Military service and discharge characteristics may contribute to this high smoking prevalence. Future efforts should focus on increasing Veterans' access to and knowledge of Veterans' health resources, and on developing innovative strategies to boost cessation in this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers.

    PubMed

    Molinari, Victor A; Brown, Lisa M; Frahm, Kathryn A; Schinka, John A; Casey, Roger

    2013-05-01

    To understand the needs and challenges encountered by older homeless veterans. We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs. Major themes for VA staff liaison/housing intervention providers: 1) belief that the transitional housing program has made a positive change; 2) need for individualized criteria to address the unique needs of veterans; 3) distinct differences between older and younger homeless veterans; 4) outreach services; 5) permanent housing issues; and 6) coordination of services. Compared with younger veterans, older veterans have less social support, greater employment and health challenges, and, perhaps greater motivation to change.

  19. Challenges of Providing End-of-Life Care for Homeless Veterans.

    PubMed

    Hutt, Evelyn; Whitfield, Emily; Min, Sung-Joon; Jones, Jacqueline; Weber, Mary; Albright, Karen; Levy, Cari; O'Toole, Thomas

    2016-05-01

    To describe challenges of caring for homeless veterans at end of life (EOL) as perceived by Veterans Affairs Medical Center (VAMC) homeless and EOL care staff. E-mail survey. Homelessness and EOL programs at VAMCs. Programs and their ratings of personal, structural, and clinical care challenges were described statistically. Homelessness and EOL program responses were compared in unadjusted analyses and using multivariable models. Of 152 VAMCs, 50 (33%) completed the survey. The VAMCs treated an average of 6.5 homeless veterans at EOL annually. Lack of appropriate housing was the most critical challenge. The EOL programs expressed somewhat more concern about lack of appropriate care site and care coordination than did homelessness programs. Personal, clinical, and structural challenges face care providers for veterans who are homeless at EOL. Deeper understanding of these challenges will require qualitative study of homeless veterans and care providers. © The Author(s) 2015.

  20. 75 FR 4453 - Advisory Committee on Homeless Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-27

    ... Lafayette Park Room at the Hamilton Crowne Plaza Hotel, 1001 14th Street, NW., Washington, DC. On February..., organizational structures, and services of the Department in assisting homeless Veterans. The Committee shall...

  1. Services Receipt Following Veteran Outpatients' Positive Screen for Homelessness.

    PubMed

    Montgomery, Ann E; Dichter, Melissa E; Thomasson, Arwin M; Roberts, Christopher B

    2016-03-01

    The Veterans Health Administration seeks to reduce homelessness among Veterans by identifying, and providing prevention and supportive services to, patients with housing concerns. The objectives of this study were to assess the proportion of Veterans Health Administration patients who received homeless or social work services within 6 months of a positive screen for homelessness or risk in the Veterans Health Administration and the demographic and clinical characteristics that predicted services utilization. Data were from a cohort of 27,403 Veteran outpatients who screened positive for homelessness or risk between November 1, 2012 and January 31, 2013. During 2013, AORs were calculated using a mixed-effects logistic regression to estimate the likelihood of patients' receipt of VHA homeless or social work services based on demographic and clinical characteristics. The majority of patients received services within 6 months post-screening; predictors of services utilization varied by gender. Among women, diagnosis of drug abuse and psychosis predicted receipt of services, being unmarried increased the odds of using services among those screening positive for homelessness, and a diagnosis of post-traumatic stress disorder increased the odds of receiving services for at-risk women. Among men, being younger, unmarried, not service-connected/Medicaid-eligible, and having a medical or behavioral health condition predicted receipt of services. Receipt of housing support services among Veterans post-homelessness screening differs by patient demographic and clinical characteristics. Future research should investigate the role that primary and secondary prevention interventions play in Veterans' resolution of risk for homelessness and experience of homelessness. Published by Elsevier Inc.

  2. Homelessness in a national sample of incarcerated veterans in state and federal prisons.

    PubMed

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; McGuire, James F

    2014-05-01

    The Veterans Health Administration (VHA) has been increasing efforts to reach out to assist incarcerated veterans. While previous studies have shown strong associations between incarceration and homelessness, few studies have examined distinctive characteristics of incarcerated homeless and non-homeless veterans. National administrative data on 30,348 incarcerated veterans served by the Health Care for Re-entry Veterans (HCRV) program were analyzed. Incarcerated veterans were classified into four groups based on their history of past homelessness: not homeless, transiently homeless, episodically homeless, and chronically homeless. Multinomial logistic regression was used to compare groups on sociodemographic characteristics, criminal justice status, clinical status, and their interest in using VHA services. Of the sample, 70 % were classified as not homeless, 8 % as transiently homeless, 11 % as episodically homeless, and 11 % as chronically homeless. Thus, 30 % of the sample had a homeless history, which is five times the 6 % rate of past homelessness among adult men in the general population. Compared to non-homeless incarcerated veterans, all three homeless groups reported significantly more mental health problems, more substance abuse, more times arrested in their lifetime, more likely to be incarcerated for a non-violent offense, and were more interested in receiving VHA services after release from prison. Together, these findings suggest re-entry programs, like HCRV, can address relevant mental health-related service needs, especially among formerly homeless veterans and veterans in need of services are receptive to the offer of assistance.

  3. Use of outpatient mental health services by homeless veterans after hurricanes.

    PubMed

    Brown, Lisa M; Barnett, Scott; Hickling, Edward; Frahm, Kathryn; Campbell, Robert R; Olney, Ronald; Schinka, John A; Casey, Roger

    2013-05-01

    Little is known about the impact of hurricanes on people who are homeless at the time a disaster occurs. Although researchers have extensively studied the psychosocial consequences of disaster produced homelessness on the general population, efforts focused on understanding how homeless people fare have been limited to a few media reports and the gray literature. In the event of a hurricane, homeless veterans may be at increased risk for negative outcomes because of their cumulative vulnerabilities. Health care statistics consistently document that homeless veterans experience higher rates of medical, emotional, substance abuse, legal, and financial problems compared with the general population. This study used the 2004 to 2006 Veterans Health Administration (VHA) Outpatient Medical Dataset to examine the effects of hurricanes on use of outpatient mental health services by homeless veterans. Homeless veterans residing in hurricane-affected counties were significantly more likely to participate in group psychotherapy (32.4% vs. 13.4%, p < .002), but less likely to participate in individual 30-40-min sessions with medical evaluations (3.5% vs. 17.3%, p < .001). The study findings have implications for homeless programs and the provision of VHA mental health services to homeless veterans postdisaster. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  4. Engagement in the Hepatitis C Care Cascade Among Homeless Veterans, 2015.

    PubMed

    Noska, Amanda J; Belperio, Pamela S; Loomis, Timothy P; O'Toole, Thomas P; Backus, Lisa I

    The Veterans Health Administration (VHA) is the largest provider of hepatitis C virus (HCV) care nationally and provides health care to >200 000 homeless veterans each year. We used the VHA's Corporate Data Warehouse and HCV Clinical Case Registry to evaluate engagement in the HCV care cascade among homeless and nonhomeless veterans in VHA care in 2015. We estimated that, among 242 740 homeless veterans in care and 5 424 712 nonhomeless veterans in care, 144 964 (13.4%) and 188 156 (3.5%), respectively, had chronic HCV infection. Compared with nonhomeless veterans, homeless veterans were more likely to be diagnosed with chronic HCV infection and linked to HCV care but less likely to have received antiviral therapy despite comparable sustained virologic response rates. Homelessness should not necessarily preclude HCV treatment eligibility with available all-oral antiviral regimens.

  5. VA Health Service Utilization for Homeless and Low-income Veterans

    PubMed Central

    Gabrielian, Sonya; Yuan, Anita H.; Andersen, Ronald M.; Rubenstein, Lisa V.; Gelberg, Lillian

    2016-01-01

    Background The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program—the VA’s Housing First effort—is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. Objectives We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. Research Design We performed a secondary database analysis of Veterans (n = 62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. Results HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Conclusions Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care. PMID:24714583

  6. Psychopharmacologic Services for Homeless Veterans: Comparing Psychotropic Prescription Fills Among Homeless and Non-Homeless Veterans with Serious Mental Illness.

    PubMed

    Hermes, Eric; Rosenheck, Robert

    2016-02-01

    Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p < .001) and for most individual classes of psychotropics. Greater use of residential/inpatient mental health services by the homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals.

  7. Homelessness among a nationally representative sample of US veterans: prevalence, service utilization, and correlates.

    PubMed

    Tsai, Jack; Link, Bruce; Rosenheck, Robert A; Pietrzak, Robert H

    2016-06-01

    To examine the prevalence of lifetime homelessness among veterans and use of Veterans Affairs (VA) homeless services, as well as their association with sociodemographic and clinical characteristics. A nationally representative sample of 1533 US veterans was surveyed July-August 2015. Among all veterans, 8.5 % reported any lifetime homelessness in their adult life, but only 17.2 % of those reported using VA homeless services. Prevalence of homelessness and VA homeless service use did not significantly differ by gender. Being low income, aged 35-44, and having poor mental and physical health were each independently associated with lifetime homelessness. Veterans who were White or lived in rural areas were significantly less likely to have used VA homeless services. Homelessness remains a substantial problem across different generations of veterans. The low reported uptake of VA homeless services suggests there are barriers to care in this population, especially for veterans who live in rural areas. Governmental resources dedicated to veteran homelessness should be supported, and obtaining accurate prevalence estimates are important to tracking progress over time.

  8. 75 FR 29366 - ``Homeless Veterans' Reintegration Program (HVRP) National Technical Assistance Center...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-25

    ... ``Homeless Veterans' Reintegration Program (HVRP) National Technical Assistance Center Cooperative Agreement...). Section 2021 authorizes programs to expedite the reintegration of homeless Veterans into the labor force... Technical Assistance Center (NTAC) for the Homeless Veterans' Reintegration Program (HVRP) to include the...

  9. A national evaluation of homeless and nonhomeless veterans' experiences with primary care.

    PubMed

    Jones, Audrey L; Hausmann, Leslie R M; Haas, Gretchen L; Mor, Maria K; Cashy, John P; Schaefer, James H; Gordon, Adam J

    2017-05-01

    Persons who are homeless, particularly those with mental health and/or substance use disorders (MHSUDs), often do not access or receive continuous primary care services. In addition, negative experiences with primary care might contribute to homeless persons' avoidance and early termination of MHSUD treatment. The patient-centered medical home (PCMH) model aims to address care fragmentation and improve patient experiences. How homeless persons with MHSUDs experience care within PCMHs is unknown. This study compared the primary care experiences of homeless and nonhomeless veterans with MHSUDs receiving care in the Veterans Health Administration's medical home environment, called Patient Aligned Care Teams. The sample included VHA outpatients who responded to the national 2013 PCMH-Survey of Health Care Experiences of Patients (PCMH-SHEP) and had a past-year MSHUD diagnosis. Veterans with evidence of homelessness (henceforth "homeless") were identified through VHA administrative records. PCMH-SHEP survey respondents included 67,666 veterans with MHSUDs (9.2% homeless). Compared with their nonhomeless counterparts, homeless veterans were younger, more likely to be non-Hispanic Black and nonmarried, had less education, and were more likely to live in urban areas. Homeless veterans had elevated rates of most MHSUDs assessed, indicating significant co-occurrence. After controlling for these differences, homeless veterans reported more negative and fewer positive experiences with communication; more negative provider ratings; and more negative experiences with comprehensiveness, care coordination, medication decision-making, and self-management support than nonhomeless veterans. Homeless persons with MHSUDs may need specific services that mitigate negative care experiences and encourage their continuation in longitudinal primary care services. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Veterans and Homelessness

    DTIC Science & Technology

    2013-11-29

    veterans in general (8.7% in 2010).25 • Both male and female veterans were married at a higher rate than veterans served in the VA’s homeless programs—68...42,858a 6,197b 759c 23,654d Year Data Collected FY2010 FY2010 FY2009 FY2008-FY2010 Average Age 51.0 49.8 48.6 50.4 Marital Status % Married 7.1 6.3...5.6 8.5 % Divorced/Separated/Widowed 63.4e 63.3 62.0 60.5 % Never Married 29.6 30.4 32.4 25.5 Gender % Men 94.3 95.1 95.4 88.5 % Women 5.7 4.9 4.6

  11. Latent homeless risk profiles of a national sample of homeless veterans and their relation to program referral and admission patterns.

    PubMed

    Tsai, Jack; Kasprow, Wesley J; Rosenheck, Robert A

    2013-12-01

    We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. We examined data from the VA's new Homeless Operations Management and Evaluation System on 120,852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class solution compared both referral and admission to VA homeless services. We identified 4 latent classes: relatively few problems, dual diagnosis, poverty-substance abuse-incarceration, and disabling medical problems. Homeless veterans in the first group were more likely to be admitted to the VA's permanent supportive housing program, whereas those in the second group were more likely to be admitted to more restrictive VA residential treatment. Homeless veterans in the third group were more likely to be admitted to the VA's prisoner re-entry program, and those in the fourth group were more likely to be directed to VA medical services. The heterogeneous risk and need profiles of homeless veterans supported the diversity of VA homeless services and encouraged the development of specialized services to meet their diverse needs.

  12. Screening for Homelessness in the Veterans Health Administration: Monitoring Housing Stability through Repeat Screening.

    PubMed

    Byrne, Thomas; Fargo, Jamison D; Montgomery, Ann Elizabeth; Roberts, Christopher B; Culhane, Dennis P; Kane, Vincent

    2015-01-01

    This study examined veterans' responses to the Veterans Health Administration's (VHA's) universal screen for homelessness and risk of homelessness during the first 12 months of implementation. We calculated the baseline annual frequency of homelessness and risk of homelessness among all veterans who completed an initial screen during the study period. We measured changes in housing status among veterans who initially screened positive and then completed a follow-up screen, assessed factors associated with such changes, and identified distinct risk profiles of veterans who completed a follow-up screen. More than 4 million veterans completed an initial screen; 1.8% (n=77,621) screened positive for homelessness or risk of homelessness. Of those who initially screened positive for either homelessness or risk of homelessness and who completed a second screen during the study period, 85.0% (n=15,060) resolved their housing instability prior to their second screen. Age, sex, race, VHA eligibility, and screening location were all associated with changes in housing stability. We identified four distinct risk profiles for veterans with ongoing housing instability. To address homelessness among veterans, efforts should include increased and targeted engagement of veterans experiencing persistent housing instability.

  13. Increased risk for substance use and health-related problems among homeless veterans.

    PubMed

    Dunne, Eugene M; Burrell, Larry E; Diggins, Allyson D; Whitehead, Nicole Ennis; Latimer, William W

    2015-10-01

    The first aim of this study was to compare self-reported causes of homelessness between veterans and nonveterans. A second aim examined whether homeless male veterans were more likely than homeless male nonveterans to experience current problems with addictions, mental health, and physical health. Additionally, a third aim was to compare frequency of emergency room visits and treatment needs between the two groups. Secondary data analyses compared male homeless veterans and nonveterans (N = 353) enrolled in the Alachua County Point in Time study in central Florida. Participants completed a questionnaire on demographics and health variables. Additional questions included recent emergency room visits and medical or other needs not being met. Veterans reported higher rates of substance use and mental health problems as a primary cause of homelessness when compared to nonveterans. Homeless veterans were more likely than nonveterans to report current problems with addictions (OR = 6.29, 95% CI: 3.43-11.53, p < .001), mental health problems (OR = 4.12, 95% CI: 2.28-7.42, p < .001), and physical problems (OR = 1.83, 95% CI: 1.08-3.67, p < .01). Finally, over half of homeless veterans (53.1%) reported an ER visit in the past year compared to only 40.9% of nonveterans (OR = 1.73, 95% CI: 1.07-2.80, p < .05). Veterans may be more likely to become homeless due to addiction and mental health and over half of homeless veterans are presenting to hospital emergency rooms. Given the greater utilization among homeless veterans, emergency rooms may serve as a prime opportunity to provide brief treatment and referrals for needed services. © American Academy of Addiction Psychiatry.

  14. Diagnoses Treated in Ambulatory Care Among Homeless-Experienced Veterans: Does Supported Housing Matter?

    PubMed

    Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M; Gelberg, Lillian

    2016-10-01

    Little is known about how permanent supported housing influences ambulatory care received by homeless persons. To fill this gap, we compared diagnoses treated in VA Greater Los Angeles (VAGLA) ambulatory care between Veterans who are formerly homeless-now housed/case managed through VA Supported Housing ("VASH Veterans")-and currently homeless. We performed secondary database analyses of homeless-experienced Veterans (n = 3631) with VAGLA ambulatory care use from October 1, 2010 to September 30, 2011. We compared diagnoses treated-adjusting for demographics and need characteristics in regression analyses-between VASH Veterans (n = 1904) and currently homeless Veterans (n = 1727). On average, considering 26 studied diagnoses, VASH (vs currently homeless) Veterans received care for more (P < .05) diagnoses (mean = 2.9/1.7). Adjusting for demographics and need characteristics, VASH Veterans were more likely (P < .05) than currently homeless Veterans to receive treatment for diagnoses across categories: chronic physical illness, acute physical illness, mental illness, and substance use disorders. Specifically, VASH Veterans had 2.5, 1.7, 2.1, and 1.8 times greater odds of receiving treatment for at least 2 condition in these categories, respectively. Among participants treated for chronic illnesses, adjusting for predisposing and need characteristics, VASH (vs currently homeless) Veterans were 9%, 8%, and 11% more likely to have 2 or more visits for chronic physical illnesses, mental illnesses, and substance use disorder, respectively. Among homeless-experienced Veterans, permanent supported housing may reduce disparities in the treatment of diagnoses commonly seen in ambulatory care. © The Author(s) 2016.

  15. Development and validation of an instrument to assess imminent risk of homelessness among veterans.

    PubMed

    Montgomery, Ann Elizabeth; Fargo, Jamison D; Kane, Vincent; Culhane, Dennis P

    2014-01-01

    Veterans are overrepresented within the homeless population compared with their non-veteran counterparts, particularly when controlling for poverty. The U.S. Department of Veterans Affairs (VA) aims to prevent new episodes of homelessness by targeting households at greatest risk; however, there are no instruments that systematically assess veterans' risk of homelessness. We developed and tested a brief screening instrument to identify imminent risk of homelessness among veterans accessing VA health care. The study team developed initial assessment items, conducted cognitive interviews with veterans experiencing homelessness, refined pilot items based on veterans' and experts' feedback and results of psychometric analyses, and assigned weights to items in the final instrument to indicate a measure of homelessness risk. One-third of veterans who responded to the field instrument reported imminent risk of homelessness (i.e., housing instability in the previous 90 days or expected in the next 90 days). The reliability coefficient for the instrument was 0.85, indicating good internal consistency. Veterans who had a recent change in income, had unpaid housing expenses, were living temporarily with family and friends, needed help to get or keep housing, and had poor rental and credit histories were more likely to report a risk of homelessness than those who did not. This study provides the field with an instrument to identify individuals and households at risk of or experiencing homelessness, which is necessary to prevent and end homelessness. In addition, it supports VA's investment in homelessness prevention and rapid rehousing services for veterans who are experiencing or are at risk for homelessness.

  16. Latent Homeless Risk Profiles of a National Sample of Homeless Veterans and Their Relation to Program Referral and Admission Patterns

    PubMed Central

    Kasprow, Wesley J.; Rosenheck, Robert A.

    2013-01-01

    Objectives. We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. Methods. We examined data from the VA’s new Homeless Operations Management and Evaluation System on 120 852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class solution compared both referral and admission to VA homeless services. Results. We identified 4 latent classes: relatively few problems, dual diagnosis, poverty–substance abuse–incarceration, and disabling medical problems. Homeless veterans in the first group were more likely to be admitted to the VA’s permanent supportive housing program, whereas those in the second group were more likely to be admitted to more restrictive VA residential treatment. Homeless veterans in the third group were more likely to be admitted to the VA’s prisoner re-entry program, and those in the fourth group were more likely to be directed to VA medical services. Conclusions. The heterogeneous risk and need profiles of homeless veterans supported the diversity of VA homeless services and encouraged the development of specialized services to meet their diverse needs. PMID:24148048

  17. Characteristics of traumatic brain injuries sustained among veterans seeking homeless services.

    PubMed

    Barnes, Sean M; Russell, Leah M; Hostetter, Trisha A; Forster, Jeri E; Devore, Maria D; Brenner, Lisa A

    2015-02-01

    This hypothesis-generating research describes the characteristics of traumatic brain injuries (TBIs) sustained among 229 Veterans seeking homeless services. Nearly all participants (83%) had sustained at least one TBI prior to their first episode of homelessness. Among participants with a TBI, assaults, transportation-related accidents, and falls were the most common causes of these injuries. Thirty percent of individuals sustained injuries with severity levels that would be expected to be associated with ongoing TBI-related deficits. Forty-three percent of the Veterans sustained at least one brain injury following their first episode of homelessness. Median lifetime number of TBIs was three. The severity of TBIs was similar among Veterans who sustained injuries before or after their first incident of homelessness. Findings suggest that future research should directly examine the potential bi-directional relationship between TBI and homelessness, as well as the impact of TBI-related deficits on Veterans' ability to benefit from homeless services and/or maintain stable housing.

  18. Homelessness and money mismanagement in Iraq and Afghanistan veterans.

    PubMed

    Elbogen, Eric B; Sullivan, Connor P; Wolfe, James; Wagner, Henry Ryan; Beckham, Jean C

    2013-12-01

    We examined the empirical link between money mismanagement and subsequent homelessness among veterans. We used a random sample of Iraq and Afghanistan War era veterans from the National Post-Deployment Adjustment Survey in 2009-2011. Veterans were randomly selected from a roster of all US military service members in Operation Iraqi Freedom or Operation Enduring Freedom who were separated from active duty or in the Reserves/National Guard. Veterans (n = 1090) from 50 states and all military branches completed 2 waves of data collection 1 year apart (79% retention rate). Thirty percent reported money mismanagement (e.g., bouncing or forging a check, going over one's credit limit, falling victim to a money scam in the past year). Multivariate analysis revealed money mismanagement (odds ratio [OR] = 4.09, 95% CI = 1.87, 8.94) was associated with homelessness in the next year, as were arrest history (OR = 2.65, 95% CI = 1.33, 5.29), mental health diagnosis (OR = 2.59, 95% CI = 1.26, 5.33), and income (OR = 0.30, 95% CI = 0.13, 0.71). Money mismanagement, reported by a substantial number of veterans, was related to a higher rate of subsequent homelessness. The findings have implications for policymakers and clinicians, suggesting that financial education programs offered by the US Departments of Defense and Veterans Affairs may be targeted to effectively address veteran homelessness.

  19. 75 FR 14633 - Homeless Veterans' Reintegration Into Employment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-26

    ... appropriate to provide job training, counseling, and placement services (including job readiness and literacy... DEPARTMENT OF LABOR Veterans' Employment and Training Service Homeless Veterans' Reintegration Into Employment AGENCY: Veterans' Employment and Training Service, Department of Labor. Announcement...

  20. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

    PubMed

    Peterson, Rachel; Gundlapalli, Adi V; Metraux, Stephen; Carter, Marjorie E; Palmer, Miland; Redd, Andrew; Samore, Matthew H; Fargo, Jamison D

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

  1. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria

    PubMed Central

    Peterson, Rachel; Gundlapalli, Adi V.; Metraux, Stephen; Carter, Marjorie E.; Palmer, Miland; Redd, Andrew; Samore, Matthew H.; Fargo, Jamison D.

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations. PMID:26172386

  2. An Analysis of Homeless Veterans Participating in the Homeless Veteran Reintegration Program

    ERIC Educational Resources Information Center

    Campbell, Katrina Lanelle

    2010-01-01

    The purpose of this study was to conduct an analysis on ex post facto data of the federal grant supported Homeless Veterans Reintegration Program (HVRP) administered at Goodwill Industries of Lower South Carolina. Pre-existing data on variables such as performance goals, training activities, support services, and demographics from program years…

  3. Homelessness and Money Mismanagement in Iraq and Afghanistan Veterans

    PubMed Central

    Sullivan, Connor P.; Wolfe, James; Wagner, Henry Ryan; Beckham, Jean C.

    2013-01-01

    Objectives. We examined the empirical link between money mismanagement and subsequent homelessness among veterans. Methods. We used a random sample of Iraq and Afghanistan War era veterans from the National Post-Deployment Adjustment Survey in 2009–2011. Results. Veterans were randomly selected from a roster of all US military service members in Operation Iraqi Freedom or Operation Enduring Freedom who were separated from active duty or in the Reserves/National Guard. Veterans (n = 1090) from 50 states and all military branches completed 2 waves of data collection 1 year apart (79% retention rate). Thirty percent reported money mismanagement (e.g., bouncing or forging a check, going over one’s credit limit, falling victim to a money scam in the past year). Multivariate analysis revealed money mismanagement (odds ratio [OR] = 4.09, 95% CI = 1.87, 8.94) was associated with homelessness in the next year, as were arrest history (OR = 2.65, 95% CI = 1.33, 5.29), mental health diagnosis (OR = 2.59, 95% CI = 1.26, 5.33), and income (OR = 0.30, 95% CI = 0.13, 0.71). Conclusions. Money mismanagement, reported by a substantial number of veterans, was related to a higher rate of subsequent homelessness. The findings have implications for policymakers and clinicians, suggesting that financial education programs offered by the US Departments of Defense and Veterans Affairs may be targeted to effectively address veteran homelessness. PMID:24148067

  4. Characteristics and service utilization of homeless veterans entering VA substance use treatment.

    PubMed

    Cox, Koriann B; Malte, Carol A; Saxon, Andrew J

    2017-05-01

    This article compares characteristics and health care utilization patterns of homeless veterans entering substance use disorder (SUD) treatment. Baseline self-report and medical record data were collected from 181 homeless veterans participating in a randomized trial of SUD/housing case management. Veterans, categorized as newly (n = 45), episodically (n = 61), or chronically homeless (n = 75), were compared on clinical characteristics and health care utilization in the year prior to baseline. Between-groups differences were seen in stimulant use, bipolar, and depressive disorders. A significant majority accessed VA emergency department services, and nearly half accessed inpatient services, with more utilization among chronically versus newly homeless. A majority in all groups attended VA primary care (73.5%) and mental health (56.9%) visits, and 26.7% newly, 32.8% episodically, and 56.0% chronically homeless veterans initiated multiple SUD treatment episodes (p = .002). A significant proportion of veterans struggling with homelessness and SUDs appear to remain unstable despite high utilization of VA acute and preventative services. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Understanding the health of veterans who are homeless: A review of the literature.

    PubMed

    Weber, Jillian; Lee, Rebecca C; Martsolf, Donna

    2017-09-01

    The United States Department of Housing and Urban Development estimates that almost 50,000 veterans are homeless on any given night. Homeless veterans are at greater risk of health disparities than their housed counterparts due to the multifactorial nature of their health and social needs. The Department of Veterans Affairs, in collaboration with more than a dozen other federal agencies, has concentrated efforts to improve the health of this vulnerable population while enacting a plan to eliminate veteran homelessness within the near future. Understanding the unique health needs of veterans who are homeless allows the profession of nursing to better support these efforts. The purpose of this literature review was to provide comprehensive knowledge to nurses about the health of homeless veterans for their use in clinical practice, research, and in contributing to the positive health outcomes for this vulnerable population. © 2017 Wiley Periodicals, Inc.

  6. Long-acting Reversible Contraception Among Homeless Women Veterans With Chronic Health Conditions: A Retrospective Cohort Study.

    PubMed

    Gawron, Lori M; Redd, Andrew; Suo, Ying; Pettey, Warren; Turok, David K; Gundlapalli, Adi V

    2017-09-01

    US women Veterans are at increased risk of homelessness and chronic health conditions associated with unintended pregnancy. Veterans Health Administration (VHA) provision of long-acting reversible contraception (LARC) can assist in healthy pregnancy planning. To evaluate perinatal risk factors and LARC exposure in ever-homeless women Veterans. A retrospective cohort study of women Veterans using VHA administrative data from fiscal years 2002-2015. We included 41,747 ever-homeless women Veterans age 18-44 years and 46,391 housed women Veterans matched by military service period. A subgroup of 7773 ever-homeless and 8674 matched housed women Veterans deployed in Iraq and Afghanistan [Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND)] conflicts comprised a second analytic cohort. Descriptive statistics compared demographic, military, health conditions, and LARC exposure in ever-homeless versus housed women Veterans. Multivariable logistic regression explored factors associated with LARC exposure in the OEF/OIF/OND subgroup. All health conditions were significantly higher in ever-homeless versus housed Veterans: mental health disorder in 84.5% versus 48.7% (P<0.001), substance abuse in 35.8% versus 8.6% (P<0.001), and medical conditions in 74.7% versus 55.6% (P<0.001). LARC exposure among all VHA users was 9.3% in ever-homeless Veterans versus 5.4% in housed Veterans (P<0.001). LARC exposure in the OEF/OIF/OND cohort was 14.1% in ever-homeless Veterans versus 8.2% in housed Veterans (P<0.001). In the OEF/OIF/OND cohort, homelessness along Veterans with medical and mental health indicators were leading LARC exposure predictors. The VHA is successfully engaging homeless women Veterans and providing LARC access. The prevalence of perinatal risk factors in ever-homeless women Veterans highlights a need for further programmatic enhancements to improve reproductive planning.

  7. Predictors of Retention in a Homeless Veteran Intervention Program

    DTIC Science & Technology

    2012-12-01

    Educational Development /High School GPD Grant and Per Diem HCHV Health Care for Homeless Veterans HEARTH Homeless Emergency Assistance and...Planning and Public Affairs, University of Illinois at Chicago. The Homeless Emergency Assistance and Rapid Transition to Housing ( HEARTH ) Act (P.L. 111

  8. A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska: A Methodological Caveat.

    PubMed

    Tsai, Jack; Ramaswamy, Sriram; Bhatia, Subhash C; Rosenheck, Robert A

    2015-12-01

    This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff conducted structured interviews with homeless veterans. Results showed that compared to homeless veterans in metropolitans, those in micropolitans were more likely to be White, unmarried, living in transitional settings, and were far more transient but reported greater social support and housing satisfaction. Veterans in micropolitans also reported more medical problems, diagnoses of anxiety and personality disorders, and unexpectedly, were more likely to report using various health services and less travel time for services. Together, these findings suggest access to homeless and health services for veterans in micropolitan areas may be facilitated through Veterans Affairs facilities and community providers that work in close proximity to one another. Many homeless veterans in these areas are transient, making them a difficult population to study and serve. Innovative ways to provide outreach to homeless veterans in micropolitan and more rural areas are needed.

  9. Demographic characteristics associated with homelessness and risk among female and male veterans accessing VHA outpatient care.

    PubMed

    Montgomery, Ann Elizabeth; Dichter, Melissa E; Thomasson, Arwin M; Fu, Xiaoying; Roberts, Christopher B

    2015-01-01

    This study explored demographic influences on veterans' reports of homelessness or imminent risk of homelessness with a particular focus on gender. We analyzed data for a cohort of veterans who responded to the U.S. Department of Veterans Affairs (VA), Veterans Health Administration (VHA) universal screener for homelessness and risk during a 3-month period. Multinomial mixed effects models-stratified by gender-predicted veterans' reports of homelessness or risk based on age, race, marital status, and receipt of VA compensation. The proportion of positive screens-homelessness or risk-was 2.7% for females and 1.7% for males. Women more likely to report being at risk of homelessness were aged 35 to 54 years, Black, and unmarried; those more likely to experience homelessness were Black and unmarried. Among male veterans, the greatest predictors of both homelessness and risk were Black race and unmarried status. Among both genders, receiving VA disability compensation was associated with lesser odds of being homeless or at risk. The findings describe the current population of veterans using VHA health care services who may benefit from homelessness prevention or intervention services, identify racial differences in housing stability, and distinguish subpopulations who may be in particular need of intervention. Interventions to address these needs are described. Published by Elsevier Inc.

  10. 76 FR 33788 - Homeless Veterans' Reintegration Into Employment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-09

    ... contract, such programs as the Secretary determines appropriate to provide job training, counseling, and placement services (including job readiness and literacy and skills training) to expedite the reintegration... DEPARTMENT OF LABOR Veterans' Employment and Training Service Homeless Veterans' Reintegration...

  11. Rapid HIV testing experience at Veterans Affairs North Texas Health Care System's Homeless Stand Downs.

    PubMed

    Hooshyar, Dina; Surís, Alina M; Czarnogorski, Maggie; Lepage, James P; Bedimo, Roger; North, Carol S

    2014-01-01

    In the USA, 21% of the estimated 1.1 million people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) are unaware they are HIV-infected. In 2011, Veterans Health Administration (VHA)'s Office of Public Health in conjunction with VHA's Health Care for Homeless Veterans Program funded grants to support rapid HIV testing at homeless outreach events because homeless populations are more likely to obtain emergent rather than preventive care and have a higher HIV seroprevalence as compared to the general population. Because of a Veterans Affairs North Texas Health Care System (VANTHCS)'s laboratory testing requirement, VANTHCS partnered with community agencies to offer rapid HIV testing for the first time at VANTHCS' 2011 Homeless Stand Downs in Dallas, Fort Worth, and Texoma, Texas. Homeless Stand Downs are outreach events that connect Veterans with services. Veterans who declined testing were asked their reasons for declining. Comparisons by Homeless Stand Down site used Pearson χ², substituting Fisher's Exact tests for expected cell sizes <5. Of the 910 Veterans attending the Homeless Stand Downs, 261 Veterans reported reasons for declining HIV testing, and 133 Veterans were tested, where 92% of the tested Veterans obtained their test results at the events - all tested negative. Veterans' reported reasons for declining HIV testing included previous negative result (n=168), no time to test (n=49), no risk factors (n=36), testing is not a priority (n=11), uninterested in knowing serostatus (n=6), and HIV-infected (n=3). Only "no time to test" differed significantly by Homeless Stand Down site. Nonresponse rate was 54%. Offering rapid HIV testing at Homeless Stand Downs is a promising testing venue since 15% of Veterans attending VANTHCS' Homeless Stand Downs were tested for HIV, and majority obtained their HIV test results at point-of-care while further research is needed to determine how to improve these rates.

  12. Childhood antecedents of incarceration and criminal justice involvement among homeless veterans.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2013-10-01

    Although criminal justice involvement and incarceration are common problems for homeless veterans, few studies have examined childhood risk factors for criminal justice involvement among veterans. This study examined the association between three types of childhood problems, family instability, conduct disorder behaviors, and childhood abuse, and criminal justice involvement and incarceration in adulthood. Data from 1,161 homeless veterans across 19 sites participating in the Housing and Urban Development-Veterans Affairs Supportive Housing program were examined. After controlling for sociodemographics and mental health diagnoses, veterans who reported more conduct disorder behaviors during childhood tended to report more criminal charges of all types, more convictions, and longer periods of incarceration during adulthood. However, the variance explained in criminal behavior by childhood was not large, suggesting that there are other factors that affect the trajectory by which homeless veterans become involved in the criminal justice system. Further research is needed to intervene in the pathway to the criminal justice system and guide efforts to prevent incarceration among veterans. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  13. Prevalence of Human Immunodeficiency Virus, Hepatitis C Virus, and Hepatitis B Virus Among Homeless and Nonhomeless United States Veterans.

    PubMed

    Noska, Amanda J; Belperio, Pamela S; Loomis, Timothy P; O'Toole, Thomas P; Backus, Lisa I

    2017-07-15

    Veterans are disproportionately affected by human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV). Homeless veterans are at particularly high risk for HIV, HCV, and HBV due to a variety of overlapping risk factors, including high rates of mental health disorders and substance use disorders. The prevalence of HIV, HCV, and HBV among homeless veterans nationally is currently unknown. This study describes national testing rates and prevalence of HIV, HCV, and HBV among homeless veterans. Using data from the Department of Veterans Affairs (VA) Corporate Warehouse Data from 2015, we evaluated HIV, HCV, and HBV laboratory testing and infection confirmation rates and diagnoses on the Problem List for nonhomeless veterans and for veterans utilizing homeless services in 2015. Among 242740 homeless veterans in VA care in 2015, HIV, HCV, and HBV testing occurred in 63.8% (n = 154812), 78.1% (n = 189508), and 52.8% (n = 128262), respectively. The HIV population prevalence was 1.52% (3684/242740) among homeless veterans, compared with 0.44% (23797/5424685) among nonhomeless veterans. The HCV population prevalence among homeless veterans was 12.1% (29311/242740), compared with 2.7% (148079/5424685) among nonhomeless veterans, while the HBV population prevalence was 0.99% (2395/242740) for homeless veterans and 0.40% (21611/5424685) among nonhomeless veterans. To our knowledge this work represents the most comprehensive tested prevalence and population prevalence estimates of HIV, HCV, and HBV among homeless veterans nationally. The data demonstrate high prevalence of HIV, HCV, and HBV among homeless veterans, and reinforce the need for integrated healthcare services along with homeless programming. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  14. Characteristics and Use of Services Among Literally Homeless and Unstably Housed U.S. Veterans With Custody of Minor Children.

    PubMed

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; Kane, Vincent

    2015-10-01

    The study examined the number of homeless veterans with minor children in their custody ("children in custody"), compared sociodemographic and clinical characteristics among homeless veterans with and without children in custody, and observed differences in referral and admission patterns among veterans with and without children in custody for a variety of U.S. Department of Veterans Affairs (VA) programs for homeless veterans. Data were obtained from the VA Homeless Operations Management and Evaluation System for 89,142 literally homeless and unstably housed veterans. Sociodemographic, housing, health, and psychosocial characteristics of veterans were analyzed. Among literally homeless veterans, 9% of men and 30% of women had children in custody; among unstably housed veterans, 18% of men and 45% of women had children in custody. Both male and female veterans with children in custody were younger and less likely to have chronic general medical conditions and psychiatric disorders compared with other veterans, but, notably, 11% of homeless veterans with children in custody had psychotic disorders. Veterans with children in custody were more likely than other veterans to be referred and admitted to the VA's permanent supported housing program, and women were more likely than men to be admitted to the program. A substantial proportion of homeless veterans served by the VA have severe mental illness and children in custody, which raises concerns about the parenting environment for their children. Particular focus should be directed at VA's supported-housing program, and the practical and ethical implications of serving homeless parents and their children need to be considered.

  15. Differential Impact of Homelessness on Glycemic Control in Veterans with Type 2 Diabetes Mellitus.

    PubMed

    Axon, R Neal; Gebregziabher, Mulugeta; Dismuke, Clara E; Hunt, Kelly J; Yeager, Derik; Ana, Elizabeth J Santa; Egede, Leonard E

    2016-11-01

    Veterans with evidence of homelessness have high rates of mental health and substance abuse disorders, but chronic medical conditions such as diabetes are also prevalent. We aimed to determine the impact of homelessness on glycemic control in patients with type 2 diabetes mellitus. Longitudinal analysis of a retrospective cohort. A national cohort of 1,263,906 Veterans with type 2 diabetes. Subjects with evidence of homelessness were identified using a combination of diagnostic and administrative codes. Odds for poor glycemic control using hemoglobin A1C (HbA1C) cutoff values of 8 % and 9 %. Homeless defined as a score based on the number of indicator variables for homelessness within a veterans chart. Veterans with evidence of homelessness had a significantly greater annual mean HbA1C ≥ 8 (32.6 % vs. 20.43 %) and HbA1C ≥ 9 (21.4 % vs. 9.9 %), tended to be younger (58 vs. 67 years), were more likely to be non-Hispanic black (39.1 %), divorced (43 %) or never married (34 %), to be urban dwelling (88.8 %), and to have comorbid substance abuse (46.7 %), depression (42.3 %), psychoses (39.7 %), liver disease (18.8 %), and fluid/electrolyte disorders (20.4 %), relative to non-homeless veterans (all p < 0.0001). Homelessness was modeled as an ordinal variable that scored the number of times a homelessness indicator was found in the Veterans medical record. We observed a significant interaction between homelessness and race/ethnicity on the odds of poor glycemic control. Homelessness, across all racial-ethnic groups, was associated with increased odds of uncontrolled diabetes at a cut-point of 8 % and 9 % for hemoglobin A1C ; however, the magnitude of the association was greater in non-Hispanic whites [8 %, OR 1.55 (1.47;1.63)] and Hispanics [8 %, OR 2.11 (1.78;2.51)] than in non-Hispanic blacks [8 %, OR 1.22 (1.15;1.28)]. Homelessness is a significant risk factor for uncontrolled diabetes in Veterans, especially among non-Hispanic white

  16. Preliminary needs assessment of mobile technology use for healthcare among homeless veterans.

    PubMed

    McInnes, D Keith; Fix, Gemmae M; Solomon, Jeffrey L; Petrakis, Beth Ann; Sawh, Leon; Smelson, David A

    2015-01-01

    Background. Homeless veterans have complex healthcare needs, but experience many barriers to treatment engagement. While information technologies (IT), especially mobile phones, are used to engage patients in care, little is known about homeless veterans' IT use. This study examines homeless veterans' access to and use of IT, attitudes toward health-related IT use, and barriers to IT in the context of homelessness. Methods. Qualitative interviews were conducted with 30 homeless veterans in different housing programs in Boston, MA, ranging from emergency shelters to supportive transitional housing that allow stays of up to 2 years. Interviews were conducted in person, audio recorded and then transcribed. Three researchers coded transcripts. Inductive thematic analysis was used. Results. Most participants (90%) had a mobile phone and were receptive to IT use for health-related communications. A common difficulty communicating with providers was the lack of a stable mailing address. Some participants were using mobile phones to stay in touch with providers. Participants felt mobile-phone calls or text messages could be used to remind patients of appointments, prescription refills, medication taking, and returning for laboratory results. Mobile phone text messaging was seen as convenient, and helped participants stay organized because necessary information was saved in text messages. Some reported concerns about the costs associated with mobile phone use (calls and texting), the potential to be annoyed by too many text messages, and not knowing how to use text messaging. Conclusion. Homeless veterans use IT and welcome its use for health-related purposes. Technology-assisted outreach among this population may lead to improved engagement in care.

  17. When Health Insurance Is Not a Factor: National Comparison of Homeless and Nonhomeless US Veterans Who Use Veterans Affairs Emergency Departments

    PubMed Central

    Doran, Kelly M.; Rosenheck, Robert A.

    2013-01-01

    Objectives. We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. Methods. We used national VA administrative data from fiscal year 2010 for a cross-sectional study comparing homeless (n = 64 091) and nonhomeless (n = 866 621) ED users on sociodemographics, medical and psychiatric diagnoses, and other clinical characteristics. Results. Homeless veterans had 4 times the odds of using EDs than nonhomeless veterans. Multivariate analyses found few differences between homeless and nonhomeless ED users on the medical conditions examined, but homeless ED users were more likely to have been diagnosed with a drug use disorder (odds ratio [OR] = 4.12; 95% confidence interval [CI] = 3.97, 4.27), alcohol use disorder (OR = 3.67; 95% CI = 3.55, 3.79), or schizophrenia (OR = 3.44; 95% CI = 3.25, 3.64) in the past year. Conclusions. In a national integrated health care system with no specific requirements for health insurance, the major differences found between homeless and nonhomeless ED users were high rates of psychiatric and substance abuse diagnoses. EDs may be an important location for specialized homeless outreach (or “in” reach) services to address mental health and addictive disorders. PMID:24148061

  18. Persistent Super-Utilization of Acute Care Services Among Subgroups of Veterans Experiencing Homelessness.

    PubMed

    Szymkowiak, Dorota; Montgomery, Ann Elizabeth; Johnson, Erin E; Manning, Todd; O'Toole, Thomas P

    2017-10-01

    Acute health care utilization often occurs among persons experiencing homelessness. However, knowing which individuals will be persistent super-utilizers of acute care is less well understood. The objective of the study was to identify those more likely to be persistent super-utilizers of acute care services. We conducted a latent class analysis of secondary data from the Veterans Health Administration Corporate Data Warehouse, and Homeless Operations Management and Evaluation System. The study sample included 16,912 veterans who experienced homelessness and met super-utilizer criteria in any quarter between July 1, 2014 and December 31, 2015. The latent class analysis included veterans' diagnoses and acute care utilization. Medical, mental health, and substance use morbidity rates were high. More than half of the sample utilized Veterans Health Administration Homeless Programs concurrently with their super-utilization of acute care. There were 7 subgroups of super-utilizers, which varied considerably on the degree to which their super-utilization persisted over time. Approximately a third of the sample met super-utilizer criteria for ≥3 quarters; this group was older and disproportionately male, non-Hispanic white, and unmarried, with lower rates of post-9/11 service and higher rates of rural residence and service-connected disability. They were much more likely to be currently homeless with more medical, mental health, and substance use morbidity. Only a subset of homeless veterans were persistent super-utilizers, suggesting the need for more targeted interventions.

  19. New to care: demands on a health system when homeless veterans are enrolled in a medical home model.

    PubMed

    O'Toole, Thomas P; Bourgault, Claire; Johnson, Erin E; Redihan, Stephen G; Borgia, Matthew; Aiello, Riccardo; Kane, Vincent

    2013-12-01

    We compared service use among homeless and nonhomeless veterans newly enrolled in a medical home model and identified patterns of use among homeless veterans associated with reductions in emergency department (ED) use. We used case-control matching with a nested cohort analysis to measure 6-month health services use, new diagnoses, and care use patterns in veterans at the Providence, Rhode Island, Veterans Affairs Medical Center from 2008 to 2011. We followed 127 homeless and 106 nonhomeless veterans. Both groups had similar rates of chronic medical and mental health diagnoses; 25.4% of the homeless and 18.1% of the nonhomeless group reported active substance abuse. Homeless veterans used significantly more primary, mental health, substance abuse, and ED care during the first 6 months. Homeless veterans who accessed primary care at higher rates (relative risk ratio [RRR] = 1.46; 95% confidence interval [CI] = 1.11, 1.92) or who used specialty and primary care (RRR = 10.95; 95% CI = 1.58, 75.78) had reduced ED usage. Homeless veterans in transitional housing or doubled-up at baseline (RRR = 3.41; 95% CI = 1.24, 9.42) had similar reductions in ED usage. Homeless adults had substantial health needs when presenting for care. High-intensity primary care and access to specialty care services could reduce ED use.

  20. New to Care: Demands on a Health System When Homeless Veterans Are Enrolled in a Medical Home Model

    PubMed Central

    Bourgault, Claire; Johnson, Erin E.; Redihan, Stephen G.; Borgia, Matthew; Aiello, Riccardo; Kane, Vincent

    2013-01-01

    Objectives. We compared service use among homeless and nonhomeless veterans newly enrolled in a medical home model and identified patterns of use among homeless veterans associated with reductions in emergency department (ED) use. Methods. We used case–control matching with a nested cohort analysis to measure 6-month health services use, new diagnoses, and care use patterns in veterans at the Providence, Rhode Island, Veterans Affairs Medical Center from 2008 to 2011. Results. We followed 127 homeless and 106 nonhomeless veterans. Both groups had similar rates of chronic medical and mental health diagnoses; 25.4% of the homeless and 18.1% of the nonhomeless group reported active substance abuse. Homeless veterans used significantly more primary, mental health, substance abuse, and ED care during the first 6 months. Homeless veterans who accessed primary care at higher rates (relative risk ratio [RRR] = 1.46; 95% confidence interval [CI] = 1.11, 1.92) or who used specialty and primary care (RRR = 10.95; 95% CI = 1.58, 75.78) had reduced ED usage. Homeless veterans in transitional housing or doubled-up at baseline (RRR = 3.41; 95% CI = 1.24, 9.42) had similar reductions in ED usage. Conclusions. Homeless adults had substantial health needs when presenting for care. High-intensity primary care and access to specialty care services could reduce ED use. PMID:24148042

  1. Factors associated with receipt of pension and compensation benefits for homeless veterans in the VBA/VHA Homeless Outreach Initiative.

    PubMed

    Chen, Joyce H; Rosenheck, Robert A; Greenberg, Greg A; Seibyl, Catherine

    2007-03-01

    Public support payments may facilitate exit from homelessness for persons with mental illness. We examined data from 10,641 homeless veterans contacted from October 1, 1995 to September 30, 2002 in a collaborative outreach program designed to facilitate access to Department of Veterans Affairs (VA) disability benefits. Those who were awarded benefits (22% of contacted veterans) were more likely to report disability, poor to fair self-rated health, and were more likely to have used VA services in the past. Thus, this program achieved only modest success and was most successful with veterans who were already receiving VA services and who might have received benefits even without the outreach effort.

  2. One-year incidence and predictors of homelessness among 300,000 U.S. Veterans seen in specialty mental health care.

    PubMed

    Tsai, Jack; Hoff, Rani A; Harpaz-Rotem, Ilan

    2017-05-01

    The Department of Veterans Affairs (VA) is committed to preventing and ending homelessness among U.S. veterans, but there have been few estimates of the incidence of veteran homelessness and prospective studies to identify predictors of homelessness. This study examines the 1-year incidence of homelessness among veterans seen in VA specialty mental health clinics and identified sociodemographic and clinical predictors of homelessness. Using a retrospective cohort study design, data were extracted from the VA medical records of 306,351 veterans referred to anxiety and posttraumatic stress disorder clinics across 130 VA facilities from 2008-2012 and followed for 1 year after referral. Homeless incidence was defined as new use of any VA homeless services or a documented International Classification of Diseases (9th rev.) V60.0 (lack of housing) code during the year. Of the total sample, 5.6% (7.8% for women and 5.4% for men) experienced homelessness within 1 year after referral to VA specialty mental health care. Veterans who were unmarried or diagnosed with a drug use disorder were more than twice as likely to become homeless; those who were Black or had annual incomes less than $25,000 were more than one and a half times as likely to become homeless. Together, these findings suggest a notable and important percentage of veterans seen in VA specialty mental health clinics newly experience homelessness annually. Monitoring early signs of housing vulnerability and preventing homelessness in this vulnerable but treatment-engaged population may be important in the VA's efforts to end veteran homelessness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Exploring patterns in resource utilization prior to the formal identification of homelessness in recently returned veterans.

    PubMed

    Gundlapalli, Adi V; Redd, Andrew; Carter, Marjorie E; Palmer, Miland; Peterson, Rachel; Samore, Matthew H

    2014-01-01

    There are limited data on resources utilized by US Veterans prior to their identification as being homeless. We performed visual analytics on longitudinal medical encounter data prior to the official recognition of homelessness in a large cohort of OEF/OIF Veterans. A statistically significant increase in numbers of several categories of visits in the immediate 30 days prior to the recognition of homelessness was noted as compared to an earlier period. This finding has the potential to inform prediction algorithms based on structured data with a view to intervention and mitigation of homelessness among Veterans.

  4. Alcohol and drug use disorders among homeless veterans: prevalence and association with supported housing outcomes.

    PubMed

    Tsai, Jack; Kasprow, Wesley J; Rosenheck, Robert A

    2014-02-01

    This study examines the prevalence of alcohol and drug disorders among homeless veterans entering the Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program and its association with both housing and clinical outcomes. A total of 29,143 homeless veterans were categorized as either having: no substance use disorder, only an alcohol use disorder, only a drug use disorder, or both alcohol and drug use disorders. Veterans were compared on housing and clinical status prior to admission to HUD-VASH and a smaller sample of 14,086 HUD-VASH clients were compared on their outcomes 6 months after program entry. Prior to HUD-VASH, 60% of program entrants had a substance use disorder and 54% of those with a substance use disorder had both alcohol and drug use disorders. Homeless veterans with both alcohol and drug use disorders had more extensive homeless histories than others, and those with any substance use disorder stayed more nights in transitional housing or residential treatment in the previous month. After six months in HUD-VASH, clients with substance use disorders continued to report more problems with substance use, even after adjusting for baseline differences, but there were no differences in housing outcomes. These findings suggest that despite strong associations between substance use disorders and homelessness, the HUD-VASH program is able to successfully house homeless veterans with substance use disorders although additional services may be needed to address their substance abuse after they become housed. Published by Elsevier Ltd.

  5. Evaluating the Impact of Dental Care on Housing Intervention Program Outcomes Among Homeless Veterans

    PubMed Central

    Nunez, Elizabeth; Gibson, Gretchen; Jones, Judith A.; Schinka, John A.

    2013-01-01

    Objectives. In this retrospective longitudinal cohort study, we examined the impact of dental care on outcomes among homeless veterans discharged from a Department of Veterans Affairs (VA) transitional housing intervention program. Methods. Our sample consisted of 9870 veterans who were admitted into a VA homeless intervention program during 2008 and 2009, 4482 of whom received dental care during treatment and 5388 of whom did not. Primary outcomes of interest were program completion, employment or stable financial status on discharge, and transition to permanent housing. We calculated descriptive statistics and compared the 2 study groups with respect to demographic characteristics, medical and psychiatric history (including alcohol and substance use), work and financial support, and treatment outcomes. Results. Veterans who received dental care were 30% more likely than those who did not to complete the program, 14% more likely to be employed or financially stable, and 15% more likely to have obtained residential housing. Conclusions. Provision of dental care has a substantial positive impact on outcomes among homeless veterans participating in housing intervention programs. This suggests that homeless programs need to weigh the benefits and cost of dental care in program planning and implementation. PMID:23678921

  6. Homeless Veterans: Management Improvements Could Help VA Better Identify Supportive Housing Projects

    DTIC Science & Technology

    2016-12-01

    HOMELESS VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects Report to...VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects What GAO Found As of September 2016, for veterans who...disabled veterans. These supportive-housing EULs receive project -based HUD-VASH vouchers, which provide housing subsidies, on-site case management

  7. Posttraumatic Stress Disorder and Interpersonal Process in Homeless Veterans Participating in a Peer Mentoring Intervention: Associations With Program Benefit.

    PubMed

    Van Voorhees, Elizabeth E; Resnik, Linda; Johnson, Erin; O'Toole, Thomas

    2018-01-25

    Homelessness among veterans has dropped dramatically since the expansion of services for homeless veterans in 2009, and now engaging homeless veterans in existing programs will be important to continuing to make progress. While one promising approach for engaging homeless veterans in care is involving peer mentors in integrated services, posttraumatic stress disorder (PTSD) may diminish the effects of peer mentorship. This mixed methods study examined how interpersonal and emotional processes in homeless veterans with and without PTSD impacted their capacity to engage in relationships with peer mentors. Four focus groups of 5-8 homeless male veterans (N = 22) were drawn from a larger multisite randomized trial. Qualitative analysis identified five primary themes: disconnectedness; anger, hostility, or resentment; connecting with others; positive view of self; and feeling like an outsider. Thematic comparisons between participants with and without a self-reported PTSD diagnosis, and between those who did and did not benefit from the peer mentor program, were validated by using quantitative methods. Disconnectedness was associated with self-reported PTSD diagnosis and with lack of program benefit; feeling like an outsider was associated with program benefit. Results suggest that disruption to the capacity to develop and maintain social bonds in PTSD may interfere with the capacity to benefit from peer mentorship. Social rules and basic strategies for navigating interpersonal relationships may differ somewhat within the homeless community and outside of it; for veterans who feel disconnected from the domiciled community, a formerly homeless veteran peer may serve as a critical "bridge" between the two social worlds. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  8. Population-Tailored Care for Homeless Veterans and Acute Care Use, Cost, and Satisfaction: A Prospective Quasi-Experimental Trial

    PubMed Central

    Johnson, Erin E.; Borgia, Matthew; Noack, Amy; Yoon, Jean; Gehlert, Elizabeth; Lo, Jeanie

    2018-01-01

    Introduction Although traditional patient-centered medical homes (PCMHs) are effective for patients with complex needs, it is unclear whether homeless-tailored PCMHs work better for homeless veterans. We examined the impact of enrollment in a Veterans Health Administration (VHA) homeless-tailored PCMH on health services use, cost, and satisfaction compared with enrollment in a traditional, nontailored PCMH. Methods We conducted a prospective, multicenter, quasi-experimental, single-blinded study at 2 VHA medical centers to assess health services use, cost, and satisfaction during 12 months among 2 groups of homeless veterans: 1) veterans receiving VHA homeless-tailored primary care (Homeless-Patient Aligned Care Team [H-PACT]) and 2) veterans receiving traditional primary care services (PACT). A cohort of 266 homeless veterans enrolled from June 2012 through January 2014. Results Compared with PACT patients, H-PACT patients had more social work visits (4.6 vs 2.7 visits) and fewer emergency department (ED) visits for ambulatory care-sensitive conditions (0 vs 0.2 visits); a significantly smaller percentage of veterans in H-PACT were hospitalized (23.1% vs 35.4%) or had mental health–related ED visits (34.1% vs 47.6%). We found significant differences in primary care provider–specific visits (H-PACT, 5.1 vs PACT, 3.6 visits), mental health care visits (H-PACT, 8.8 vs PACT, 13.4 visits), 30-day prescription drug fills (H-PACT, 40.5 vs PACT, 58.8 fills), and use of group therapy (H-PACT, 40.1% vs PACT, 53.7%). Annual costs per patient were significantly higher in the PACT group than the H-PACT group ($37,415 vs $28,036). In logistic regression model of acute care use, assignment to the H-PACT model was protective as was rating health “good” or better. Conclusion Homeless veterans enrolled in the population-tailored primary care approach used less acute care and costs were lower. Tailored-care models have implications for care coordination in the US Department

  9. Preliminary needs assessment of mobile technology use for healthcare among homeless veterans

    PubMed Central

    Fix, Gemmae M.; Solomon, Jeffrey L.; Petrakis, Beth Ann; Sawh, Leon; Smelson, David A.

    2015-01-01

    Background. Homeless veterans have complex healthcare needs, but experience many barriers to treatment engagement. While information technologies (IT), especially mobile phones, are used to engage patients in care, little is known about homeless veterans’ IT use. This study examines homeless veterans’ access to and use of IT, attitudes toward health-related IT use, and barriers to IT in the context of homelessness. Methods. Qualitative interviews were conducted with 30 homeless veterans in different housing programs in Boston, MA, ranging from emergency shelters to supportive transitional housing that allow stays of up to 2 years. Interviews were conducted in person, audio recorded and then transcribed. Three researchers coded transcripts. Inductive thematic analysis was used. Results. Most participants (90%) had a mobile phone and were receptive to IT use for health-related communications. A common difficulty communicating with providers was the lack of a stable mailing address. Some participants were using mobile phones to stay in touch with providers. Participants felt mobile-phone calls or text messages could be used to remind patients of appointments, prescription refills, medication taking, and returning for laboratory results. Mobile phone text messaging was seen as convenient, and helped participants stay organized because necessary information was saved in text messages. Some reported concerns about the costs associated with mobile phone use (calls and texting), the potential to be annoyed by too many text messages, and not knowing how to use text messaging. Conclusion. Homeless veterans use IT and welcome its use for health-related purposes. Technology-assisted outreach among this population may lead to improved engagement in care. PMID:26246964

  10. Homeless and Unemployed Veterans. Hearing before the Subcommittee on Education, Training and Employment of the Committee on Veterans' Affairs. House of Representatives, Ninety-Ninth Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Veterans' Affairs.

    This congressional report contains the testimony that was presented at a hearing to examine the needs of homeless and unemployed veterans. Testimony was provided by representatives of the following agencies and organizations: the Vietnam Veterans Ensemble; the National Coalition for the Homeless; the various Veterans' Administration (VA)…

  11. In-vivo job development training among peer providers of homeless veterans supported employment programs.

    PubMed

    Gao, Ni; Dolce, Joni; Rio, John; Heitzmann, Carma; Loving, Samantha

    2016-06-01

    This column describes a goal-oriented, time-limited in vivo coaching/training approach for skills building among peer veterans vocational rehabilitation specialists of the Homeless Veteran Supported Employment Program (HVSEP). Planning, implementing, and evaluating the training approach for peer providers was intended, ultimately, to support veterans in their goal of returning to community competitive employment. The description draws from the training experience that aimed to improve the ability of peer providers to increase both rates of employment and wages of the homeless veterans using their services. Training peers using an in vivo training approach provided a unique opportunity for the veterans to improve their job development skills with a focus to support employment outcomes for the service users. Peers who received training also expressed that learning skills through an in vivo training approach was more engaging than typical classroom trainings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Tailoring Outreach Efforts to Increase Primary Care Use Among Homeless Veterans: Results of a Randomized Controlled Trial.

    PubMed

    O'Toole, Thomas P; Johnson, Erin E; Borgia, Matthew L; Rose, Jennifer

    2015-07-01

    Homeless individuals often have significant unmet health care needs that are critical to helping them leave homelessness. However, engaging them in primary and mental health care services is often elusive and difficult to achieve. We aimed to increase health-seeking behavior and receipt of health care among homeless Veterans. This was a multi-center, prospective, community-based, two-by-two randomized controlled trial of homeless Veterans. Homeless Veterans not receiving primary care participated in the study. An outreach intervention that included a personal health assessment and brief intervention (PHA/BI), and/or a clinic orientation (CO) was implemented. We measured receipt of primary care within 4 weeks of study enrollment. Overall, 185 homeless Veterans were enrolled: the average age was 48.6 years (SD 10.8), 94.6% were male, 43.0% were from a minority population, 12.0% were unsheltered, 25.5% were staying in a dusk-to-dawn emergency shelter, 26.1% were in transitional housing, while 27.7% were in an unstable, doubled-up arrangement. At one month, 77.3% of the PHA/BI plus CO group accessed primary care and by 6 months, 88.7% had been seen in primary care. This was followed by the CO-only group, 50.0% of whom accessed care in the first 4 weeks, the PHI/BI-only arm at 41.0% and the Usual Care arm at 30.6%. Chi-squared tests by group were significant (p < 0.001) at both 4 weeks and 6 months. There was no difference in attitudes about care at baseline and 6 months or in use patterns once enrolled in care. Our findings suggest that treatment-resistant/avoidant homeless Veterans can be effectively engaged in primary and other clinical care services through a relatively low intensity, targeted and tailored outreach effort.

  13. Serving homeless veterans in the VA Desert Pacific Healthcare Network: a needs assessment to inform quality improvement endeavors.

    PubMed

    Gabrielian, Sonya; Yuan, Anita; Rubenstein, Lisa; Andersen, Ronald M; Gelberg, Lillian

    2013-08-01

    This report describes a needs assessment of VA programs for homeless Veterans in Southern California and Nevada, the geographic region with the most homeless Veterans in the nation. The assessment was formulated through key informant interviews. Current service provisions are discussed, along with salient unmet needs for this vulnerable population.

  14. VA health service utilization for homeless and low-income Veterans: a spotlight on the VA Supportive Housing (VASH) program in greater Los Angeles.

    PubMed

    Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M; Rubenstein, Lisa V; Gelberg, Lillian

    2014-05-01

    The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program-the VA's Housing First effort-is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. We performed a secondary database analysis of Veterans (n=62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care.

  15. Evaluation of brief treatment of symptoms of psychological trauma among veterans residing in a homeless shelter by use of Accelerated Resolution Therapy.

    PubMed

    Kip, Kevin E; D'Aoust, Rita F; Hernandez, Diego F; Girling, Sue Ann; Cuttino, Barrett; Long, Mary Kathryn; Rojas, Paola; Wittenberg, Trudy; Abhayakumar, Alisha; Rosenzweig, Laney

    2016-01-01

    Posttraumatic stress disorder (PTSD) is prevalent in both homeless and nonhomeless veterans. To examine unique characteristics of being homeless that may influence PTSD treatment completion and clinical success. Twenty-three veterans who were homeless and residing in a homeless shelter, along with 94 veterans from the community, were enrolled to receive one to five sessions of Accelerated Resolution Therapy (ART), an emerging trauma-focused therapy for symptoms of PTSD. Rates of treatment completion with ART and acute and 6-month change in symptoms of PTSD were compared in an observational (nonrandomized) manner by housing status. Compared to veterans recruited from the community, veterans residing in the homeless shelter were older and presented with more extensive psychopathology yet had less combat exposure while being more likely to have experienced sexual assault. Rates of treatment completion were 52.2% (12 of 23) among homeless veterans compared to 81.9% (77 of 94) among veterans from the community (p = .005). Among treatment completers, both groups received an average of four sessions of ART. Reduction of symptoms of PTSD was substantial and nonsignificantly greater among homeless veterans vs. those treated from the community (p = .14), as were comorbidity reductions in depression, anxiety, sleep quality, pain, and improved quality of life. Results at 6-month posttreatment follow-up were similar. Although limited by small sample size and a nonrandomized design, ART appears to be an effective, brief treatment for symptoms of PTSD among veterans residing in a homeless shelter. However, development of effective strategies to maximize treatment completion among homeless veterans is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. History of co-occurring disorders and current mental health status among homeless veterans.

    PubMed

    Ding, Kele; Slate, Matthew; Yang, Jingzhen

    2018-06-18

    Homeless veterans are at high risk for co-occurring disorders (COD), defined as mental illnesses that include at least one alcohol or other drug use disorder and at least one non-drug related mental disorder. However, epidemiological studies examining the prevalence of COD and associated mental health status in this population are limited. The objectives of the study were: (1) to describe a history of diagnosed mental disorders among homeless veterans admitted to a transitional housing program, and (2) to examine the associations of the prior diagnosed COD and other mental disorders with current mental health status. Study participants were male homeless veterans admitted to a transitional housing program from July 2015 to September 2017 in a large municipal area in Northeast Ohio, the United States. Cross-sectional, self-reported data from the admission assessment were included and analyzed. History of mental disorder diagnoses were aggregated into five categories for the purpose of this study: no mental disorders, only alcohol or other drug use disorder(s), one non-drug related mental disorder, two or more non-drug related mental disorders, and COD. Current mental status were measured as empowerment, mental component summary score (MCS) and physical component summary score (PCS) of health related quality of life (VR-12), and perceived overall well-being. Sample distribution of the five categories and their associations with current mental status were examined using Generalized Linear Model test. Of all participants, 76.7% had at least one prior diagnosed mental disorder, including 47.4% with any drug-related disorders. Over one-third (37.2%) reported having COD. Compared to those with no mental disorder history, those with COD scored significantly lower on MCS and empowerment scores; those with any prior diagnosed non-drug related mental disorders also scored significantly lower on MCS. No significant differences, however, were found in current mental health

  17. Serving homeless Veterans in the VA Desert Pacific Healthcare Network: A needs assessment to inform quality improvement endeavors

    PubMed Central

    Gabrielian, Sonya; Yuan, Anita; Rubenstein, Lisa; Andersen, Ronald M.; Gelberg, Lillian

    2016-01-01

    This report describes a needs assessment of VA programs for homeless Veterans in Southern California and Nevada, the geographic region with the most homeless Veterans in the nation. The assessment was formulated through key informant interviews. Current service provisions are discussed, along with salient unmet needs for this vulnerable population. PMID:23974403

  18. VA Disability Compensation and Money Spent on Substance Use Among Homeless Veterans: A Controversial Association.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2015-06-01

    There has long been concern that public support payments are used to support addictive behaviors. This study examined the amount of money homeless veterans spend on alcohol and drugs and the association between public support income, including VA disability compensation, and expenditures on alcohol and drugs. Data were from 1,160 veterans from 19 sites on entry into the Housing and Urban Development-Veterans Affairs Supportive Housing program. Descriptive statistics and nonparametric analyses were conducted. About 33% of veterans reported spending money on alcohol and 22% reported spending money on drugs in the past month. No significant association was found between public support income, VA disability compensation, and money spent on alcohol and drugs. A substantial proportion of homeless veterans spend some income on alcohol and drugs, but disability income, including VA compensation, does not seem to be related to substance use or money spent on addictive substances.

  19. Impact of Supported Housing on Social Relationships Among Homeless Veterans.

    PubMed

    O'Connell, Maria J; Kasprow, Wesley J; Rosenheck, Robert A

    2017-02-01

    This study examined social network structure and function among a sample of 460 homeless veterans who participated in an experimental trial of the Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program. Participants were randomly assigned to HUD-VASH (housing subsidies and case management), case management only, or standard care. Mixed-model longitudinal analysis was used to compare treatment groups on social network outcomes over 18 months. Veterans in HUD-VASH reported significantly greater increases in social support than veterans in the two other groups, as well as greater frequency of contacts, availability of tangible and emotional support, and satisfaction with nonkin relationships over time. These gains largely involved relationships with providers and other veterans encountered in treatment. Supported housing may play a pivotal role in fostering constructive new relationships with persons associated with service programs but may have a more limited impact on natural support networks.

  20. Differential Risk for Homelessness Among US Male and Female Veterans With a Positive Screen for Military Sexual Trauma.

    PubMed

    Brignone, Emily; Gundlapalli, Adi V; Blais, Rebecca K; Carter, Marjorie E; Suo, Ying; Samore, Matthew H; Kimerling, Rachel; Fargo, Jamison D

    2016-06-01

    Military sexual trauma (MST) is associated with adverse physical and mental health outcomes following military separation. Recent research suggests that MST may be a determinant in several factors associated with postdeployment homelessness. To evaluate MST as an independent risk factor for homelessness and to determine whether risk varies by sex. A retrospective cohort study of US veterans who used Veterans Health Administration (VHA) services between fiscal years 2004 and 2013 was conducted using administrative data from the Department of Defense and VHA. Included in the study were 601 892 US veterans deployed in Iraq or Afghanistan who separated from the military between fiscal years 2001 and 2011 and subsequently used VHA services. Positive response to screen for MST administered in VHA facilities. Administrative evidence of homelessness within 30 days, 1 year, and 5 years following the first VHA encounter after last deployment. The mean (SD) age of the 601 892 participants was 38.9 (9.4) years, 527 874 (87.7%) were male, 310 854 (51.6%) were white, and 382 361 (63.5%) were enlisted in the Army. Among veterans with a positive screen for MST, rates of homelessness were 1.6% within 30 days, 4.4% within 1 year, and 9.6% within 5 years, more than double the rates of veterans with a negative MST screen (0.7%, 1.8%, and 4.3%, respectively). A positive screen for MST was significantly and independently associated with postdeployment homelessness. In regression models adjusted for demographic and military service characteristics, odds of experiencing homelessness were higher among those who screened positive for MST compared with those who screened negative (30-day: adjusted odds ratio [AOR], 1.89; 95% CI, 1.58-2.24; 1-year: AOR, 2.27; 95% CI, 2.04-2.53; and 5-year: AOR, 2.63; 95% CI, 2.36-2.93). Military sexual trauma screen status remained independently associated with homelessness after adjusting for co-occurring mental health and substance abuse diagnoses

  1. Veterans and Homelessness

    DTIC Science & Technology

    2011-04-01

    definition of “homeless individual” under McKinney-Vento. The Homeless Emergency Assistance and Rapid Transition to Housing ( HEARTH ) Act was enacted...as part of the Helping Families Save Their Homes Act of 2009 (P.L. 111-22) on May 20, 2009. The changes in the HEARTH Act were to take effect at the...definition of homelessness, continue in place.10 The HEARTH Act amended Section 103(a) of McKinney-Vento to broaden the definition of homeless individuals

  2. The potential for health-related uses of mobile phones and internet with homeless veterans: results from a multisite survey.

    PubMed

    McInnes, D Keith; Sawh, Leon; Petrakis, Beth Ann; Rao, Sowmya; Shimada, Stephanie L; Eyrich-Garg, Karin M; Gifford, Allen L; Anaya, Henry D; Smelson, David A

    2014-09-01

    Addressing the health needs of homeless veterans is a priority in the United States, and, although information technologies can potentially improve access to and engagement in care, little is known about this population's use of information technologies or their willingness to use technologies to communicate with healthcare providers and systems. This study fills this gap through a survey of homeless veterans' use of information technologies and their attitudes about using these technologies to assist with accessing needed healthcare services. Among the 106 homeless veterans surveyed, 89% had a mobile phone (one-third were smartphones), and 76% used the Internet. Among those with a mobile phone, 71% used text messaging. Nearly all respondents (93%) were interested in receiving mobile phone reminders (text message or phone call) about upcoming medical appointments, and a similar proportion (88%) wanted mobile phone outreach asking if they would like to schedule an appointment if they had not been seen by a health provider in over a year. In addition, respondents already used these technologies for information and communication related to health, housing, and jobs. These findings suggest new avenues for communication and health interventions for hard-to-reach homeless veterans.

  3. Applying the Chronic Care Model to Homeless Veterans: Effect of a Population Approach to Primary Care on Utilization and Clinical Outcomes

    PubMed Central

    Buckel, Lauren; Bourgault, Claire; Blumen, Jonathan; Redihan, Stephen G.; Jiang, Lan; Friedmann, Peter

    2010-01-01

    Objectives. We compared a population-tailored approach to primary care for homeless veterans with a usual care approach. Methods. We conducted a retrospective prolective cohort study of homeless veterans enrolled in a population-tailored primary care clinic matched to a historical sample in general internal medicine clinics. Overall, 177 patients were enrolled: 79 in the Homeless-Oriented Primary Care Clinic and 98 in general internal medicine primary care. Results. Homeless-oriented primary care–enrolled patients had greater improvements in hypertension, diabetes, and lipid control, and primary care use was higher during the first 6 months (5.96 visits per person vs 1.63 for general internal medicine) but stabilized to comparable rates during the second 6 months (2.01 vs 1.31, respectively). Emergency department (ED) use was also higher (2.59 vs 1.89 visits), although with 40% lower odds for nonacute ED visits than for the general internal medicine group (95% confidence interval = 0.2, 0.8). Excluding substance abuse and mental health admissions, hospitalizations were reduced among the homeless veterans between the 2 periods (28.6% vs 10.8%; P < .01) compared with the general internal medicine group (48.2% vs 44.4%; P = .6; difference of differences, P < .01). Conclusions. Tailoring primary care to homeless veterans can decrease unnecessary ED use and medical admissions and improve chronic disease management. PMID:20966377

  4. Differences in Experiences With Care Between Homeless and Nonhomeless Patients in Veterans Affairs Facilities With Tailored and Nontailored Primary Care Teams.

    PubMed

    Jones, Audrey L; Hausmann, Leslie R M; Kertesz, Stefan; Suo, Ying; Cashy, John P; Mor, Maria K; Schaefer, James H; Gundlapalli, Adi V; Gordon, Adam J

    2018-05-12

    Homeless patients describe poor experiences with primary care. In 2012, the Veterans Health Administration (VHA) implemented homeless-tailored primary care teams (Homeless Patient Aligned Care Team, HPACTs) that could improve the primary care experience for homeless patients. To assess differences in primary care experiences between homeless and nonhomeless Veterans receiving care in VHA facilities that had HPACTs available (HPACT facilities) and in VHA facilities lacking HPACTs (non-HPACT facilities). We used multivariable multinomial regressions to estimate homeless versus nonhomeless patient differences in primary care experiences (categorized as negative/moderate/positive) reported on a national VHA survey. We compared the homeless versus nonhomeless risk differences (RDs) in reporting negative or positive experiences in 25 HPACT facilities versus 485 non-HPACT facilities. Survey respondents from non-HPACT facilities (homeless: n=10,148; nonhomeless: n=309,779) and HPACT facilities (homeless: n=2022; nonhomeless: n=20,941). Negative and positive experiences with access, communication, office staff, provider rating, comprehensiveness, coordination, shared decision-making, and self-management support. In non-HPACT facilities, homeless patients reported more negative and fewer positive experiences than nonhomeless patients. However, these patterns of homeless versus nonhomeless differences were reversed in HPACT facilities for the domains of communication (positive experience RDs in non-HPACT versus HPACT facilities=-2.0 and 2.0, respectively); comprehensiveness (negative RDs=2.1 and -2.3), shared decision-making (negative RDs=1.2 and -1.8), and self-management support (negative RDs=0.1 and -4.5; positive RDs=0.5 and 8.0). VHA facilities with HPACT programs appear to offer a better primary care experience for homeless versus nonhomeless Veterans, reversing the pattern of relatively poor primary care experiences often associated with homelessness.

  5. Veterans and Homelessness

    DTIC Science & Technology

    2007-05-31

    increased visibility of the homeless was due, in part, to the decriminalization of actions such as public drunkenness, loitering, and vagrancy.2 Homelessness...a racial or ethnic minority, childhood poverty, parental mental illness, experience of physical or sexual abuse prior to age 18, other trauma

  6. Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration's "Homeless Patient Aligned Care Team" Program.

    PubMed

    O'Toole, Thomas P; Johnson, Erin E; Aiello, Riccardo; Kane, Vincent; Pape, Lisa

    2016-03-31

    Although the clinical consequences of homelessness are well described, less is known about the role for health care systems in improving clinical and social outcomes for the homeless. We described the national implementation of a "homeless medical home" initiative in the Veterans Health Administration (VHA) and correlated patient health outcomes with characteristics of high-performing sites. We conducted an observational study of 33 VHA facilities with homeless medical homes and patient- aligned care teams that served more than 14,000 patients. We correlated site-specific health care performance data for the 3,543 homeless veterans enrolled in the program from October 2013 through March 2014, including those receiving ambulatory or acute health care services during the 6 months prior to enrollment in our study and 6 months post-enrollment with corresponding survey data on the Homeless Patient Aligned Care Team (H-PACT) program implementation. We defined high performance as high rates of ambulatory care and reduced use of acute care services. More than 96% of VHA patients enrolled in these programs were concurrently receiving VHA homeless services. Of the 33 sites studied, 82% provided hygiene care (on-site showers, hygiene kits, and laundry), 76% provided transportation, and 55% had an on-site clothes pantry; 42% had a food pantry and provided on-site meals or other food assistance. Six-month patterns of acute-care use pre-enrollment and post-enrollment for 3,543 consecutively enrolled patients showed a 19.0% reduction in emergency department use and a 34.7% reduction in hospitalizations. Three features were significantly associated with high performance: 1) higher staffing ratios than other sites, 1) integration of social supports and social services into clinical care, and 3) outreach to and integration with community agencies. Integrating social determinants of health into clinical care can be effective for high-risk homeless veterans.

  7. Homeless Veterans' Use of Peer Mentors and Effects on Costs and Utilization in VA Clinics.

    PubMed

    Yoon, Jean; Lo, Jeanie; Gehlert, Elizabeth; Johnson, Erin E; O'Toole, Thomas P

    2017-06-01

    The study compared health care utilization and costs among homeless veterans randomly assigned to peer mentors or usual care and described contacts with peer mentors. Homeless patients at four Department of Veterans Affairs clinics were randomly assigned to a peer mentor (N=195) or to usual care (N=180). Administrative data on utilization and costs over a six-month follow-up were combined with peer mentors' reports of patient contacts. Most patients (87%) in the peer mentor group had at least one peer contact. Patients in this group spent the largest proportions of time discussing housing and health issues with peer mentors and had more outpatient encounters than those in usual care, although differences were not significant. No other between-group differences were found in utilization or costs. Although significant impacts of peer mentors on health care patterns or costs were not detected, some patients had frequent contact with peer mentors.

  8. Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration’s “Homeless Patient Aligned Care Team” Program

    PubMed Central

    Johnson, Erin E.; Aiello, Riccardo; Kane, Vincent; Pape, Lisa

    2016-01-01

    Introduction Although the clinical consequences of homelessness are well described, less is known about the role for health care systems in improving clinical and social outcomes for the homeless. We described the national implementation of a “homeless medical home” initiative in the Veterans Health Administration (VHA) and correlated patient health outcomes with characteristics of high-performing sites. Methods We conducted an observational study of 33 VHA facilities with homeless medical homes and patient- aligned care teams that served more than 14,000 patients. We correlated site-specific health care performance data for the 3,543 homeless veterans enrolled in the program from October 2013 through March 2014, including those receiving ambulatory or acute health care services during the 6 months prior to enrollment in our study and 6 months post-enrollment with corresponding survey data on the Homeless Patient Aligned Care Team (H-PACT) program implementation. We defined high performance as high rates of ambulatory care and reduced use of acute care services. Results More than 96% of VHA patients enrolled in these programs were concurrently receiving VHA homeless services. Of the 33 sites studied, 82% provided hygiene care (on-site showers, hygiene kits, and laundry), 76% provided transportation, and 55% had an on-site clothes pantry; 42% had a food pantry and provided on-site meals or other food assistance. Six-month patterns of acute-care use pre-enrollment and post-enrollment for 3,543 consecutively enrolled patients showed a 19.0% reduction in emergency department use and a 34.7% reduction in hospitalizations. Three features were significantly associated with high performance: 1) higher staffing ratios than other sites, 1) integration of social supports and social services into clinical care, and 3) outreach to and integration with community agencies. Conclusion Integrating social determinants of health into clinical care can be effective for high

  9. Retaining homeless veterans in outpatient care: a pilot study of mobile phone text message appointment reminders.

    PubMed

    McInnes, D Keith; Petrakis, Beth Ann; Gifford, Allen L; Rao, Sowmya R; Houston, Thomas K; Asch, Steven M; O'Toole, Thomas P

    2014-09-01

    We examined the feasibility of using mobile phone text messaging with homeless veterans to increase their engagement in care and reduce appointment no-shows. We sent 2 text message reminders to participants (n = 20) before each of their outpatient appointments at an urban Veterans Affairs medical center. Evaluation included pre- and postsurvey questionnaires, open-ended questions, and review of medical records. We estimated costs and savings of large-scale implementation. Participants were satisfied with the text-messaging intervention, had very few technical difficulties, and were interested in continuing. Patient-cancelled visits and no-shows trended downward from 53 to 37 and from 31 to 25, respectively. Participants also experienced a statistically significant reduction in emergency department visits, from 15 to 5 (difference of 10; 95% confidence interval [CI]  = 2.2, 17.8; P = .01), and a borderline significant reduction in hospitalizations, from 3 to 0 (difference of 3; 95% CI = -0.4, 6.4; P = .08). Text message reminders are a feasible means of reaching homeless veterans, and users consider it acceptable and useful. Implementation may reduce missed visits and emergency department use, and thus produce substantial cost savings.

  10. 77 FR 26027 - Privacy Act: Notification of a New Privacy Act System of Records, Veterans Homelessness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-02

    ... Files System AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notification of a New Privacy..., 2012. Jerry E. Williams, Chief Information Officer. HUD/PD&R.01 SYSTEM NAME: Veterans Homelessness..., assistance, or inquiry about the existence of records, contact Harold Williams, Acting Chief Privacy Officer...

  11. Gender Differences in Predictors of Suicidal Thoughts and Attempts Among Homeless Veterans that Abuse Substances

    ERIC Educational Resources Information Center

    Benda, Brent B.

    2005-01-01

    This study of 315 male and 310 female homeless military veterans in a V.A. inpatient program designed to treat substance abusers, many of whom also suffer psychiatric disorders, was designed to examine gender differences in factors associated with the odds of having suicidal thoughts, and of attempting suicide, in comparison to being nonsuicidal.…

  12. 76 FR 56881 - Advisory Committee on Homeless Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... of the policies, organizational structures, and services of the Department in assisting homeless..., Washington; and 1811 Housing Project, 11564 Southeast State Highway 160, Southworth, Washington. On September...

  13. Using network projections to explore co-incidence and context in large clinical datasets: Application to homelessness among U.S. Veterans.

    PubMed

    Pettey, Warren B P; Toth, Damon J A; Redd, Andrew; Carter, Marjorie E; Samore, Matthew H; Gundlapalli, Adi V

    2016-06-01

    Network projections of data can provide an efficient format for data exploration of co-incidence in large clinical datasets. We present and explore the utility of a network projection approach to finding patterns in health care data that could be exploited to prevent homelessness among U.S. Veterans. We divided Veteran ICD-9-CM (ICD9) data into two time periods (0-59 and 60-364days prior to the first evidence of homelessness) and then used Pajek social network analysis software to visualize these data as three different networks. A multi-relational network simultaneously displayed the magnitude of ties between the most frequent ICD9 pairings. A new association network visualized ICD9 pairings that greatly increased or decreased. A signed, subtraction network visualized the presence, absence, and magnitude difference between ICD9 associations by time period. A cohort of 9468 U.S. Veterans was identified as having administrative evidence of homelessness and visits in both time periods. They were seen in 222,599 outpatient visits that generated 484,339 ICD9 codes (average of 11.4 (range 1-23) visits and 2.2 (range 1-60) ICD9 codes per visit). Using the three network projection methods, we were able to show distinct differences in the pattern of co-morbidities in the two time periods. In the more distant time period preceding homelessness, the network was dominated by routine health maintenance visits and physical ailment diagnoses. In the 59days immediately prior to the homelessness identification, alcohol related diagnoses along with economic circumstances such as unemployment, legal circumstances, along with housing instability were noted. Network visualizations of large clinical datasets traditionally treated as tabular and difficult to manipulate reveal rich, previously hidden connections between data variables related to homelessness. A key feature is the ability to visualize changes in variables with temporality and in proximity to the event of interest. These

  14. 78 FR 18679 - Advisory Committee on Women Veterans, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2., that the Advisory Committee on Women Veterans will meet on April 9-11, 2013, in the G. V. ``Sonny...

  15. Retaining Homeless Veterans in Outpatient Care: A Pilot Study of Mobile Phone Text Message Appointment Reminders

    PubMed Central

    Petrakis, Beth Ann; Gifford, Allen L.; Rao, Sowmya R.; Houston, Thomas K.; Asch, Steven M.; O’Toole, Thomas P.

    2014-01-01

    Objectives. We examined the feasibility of using mobile phone text messaging with homeless veterans to increase their engagement in care and reduce appointment no-shows. Methods. We sent 2 text message reminders to participants (n = 20) before each of their outpatient appointments at an urban Veterans Affairs medical center. Evaluation included pre- and postsurvey questionnaires, open-ended questions, and review of medical records. We estimated costs and savings of large-scale implementation. Results. Participants were satisfied with the text-messaging intervention, had very few technical difficulties, and were interested in continuing. Patient-cancelled visits and no-shows trended downward from 53 to 37 and from 31 to 25, respectively. Participants also experienced a statistically significant reduction in emergency department visits, from 15 to 5 (difference of 10; 95% confidence interval [CI]  = 2.2, 17.8; P = .01), and a borderline significant reduction in hospitalizations, from 3 to 0 (difference of 3; 95% CI = −0.4, 6.4; P = .08). Conclusions. Text message reminders are a feasible means of reaching homeless veterans, and users consider it acceptable and useful. Implementation may reduce missed visits and emergency department use, and thus produce substantial cost savings. PMID:25100425

  16. 77 FR 12322 - Notice of Submission of Proposed Information Collection to OMB; Evaluation of the Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-29

    ... Proposed Information Collection to OMB; Evaluation of the Veterans Homelessness Prevention Demonstration... collection requirement described below has been submitted to the Office of Management and Budget (OMB) for... Paperwork Reduction Act requirements for the collection of information required to evaluate the Veterans...

  17. 77 FR 49488 - Advisory Committee on Women Veterans, Notice of Meeting Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-16

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans, Notice of Meeting Amendment The Department of Veterans Affairs (VA) is announcing an amendment to the notice of meeting of the Advisory Committee on Women Veterans on August 20-24, 2012, in the Dennis Auditorium, 2B-137, at the VA...

  18. Veterans and Homelessness

    DTIC Science & Technology

    2009-06-26

    was due, in part, to the decriminalization of actions such as public drunkenness, loitering, and vagrancy.2 Homelessness occurs among families with...51 The first category consisted of nine factors: year of birth, belonging to a racial or ethnic minority, childhood poverty, parental mental

  19. Homeless Status, Postdischarge Health Care Utilization, and Readmission After Surgery.

    PubMed

    Titan, Ashley; Graham, Laura; Rosen, Amy; Itani, Kamal; Copeland, Laurel A; Mull, Hillary J; Burns, Edith; Richman, Joshua; Kertesz, Stefan; Wahl, Tyler; Morris, Melanie; Whittle, Jeffery; Telford, Gordon; Wilson, Mark; Hawn, Mary

    2018-06-01

    Homeless Veterans are vulnerable to poor care transitions, yet little research has examined their risk of readmission following inpatient surgery. This study investigates the predictors of surgical readmission among homeless relative to housed Veteran patients. Inpatient general, vascular, and orthopedic surgeries occurring in the Veterans Health Administration from 2008 to 2014 were identified. Administrative International Classification of Diseases, Ninth Revision, Clinical Modification codes and Veterans Health Administration clinic stops were used to identify homeless patients. Bivariate analyses examined characteristics and predictors of readmission among homeless patients. Multivariate logistic models were used to estimate the association between homeless experience and housed patients with readmission following surgery. Our study included 232,373 surgeries: 43% orthopedic, 39% general, and 18% vascular with 5068 performed on homeless patients. Homeless individuals were younger (56 vs. 64 y, P<0.01), more likely to have a psychiatric comorbidities (51.3% vs. 19.4%, P<0.01) and less likely to have other medical comorbidities such as hypertension (57.1% vs. 70.8%, P<0.01). Homeless individuals were more likely to be readmitted [odds ratio (OR), 1.43; confidence interval (CI), 1.30-1.56; P<0.001]. Discharge destination other than community (OR, 0.57; CI, 0.44-0.74; P<0.001), recent alcohol abuse (OR, 1.45; CI, 1.15-1.84; P<0.01), and elevated American Society Anesthesiologists classification (OR, 1.86; CI, 1.30-2.68; P<0.01) were significant risk factors associated with readmissions within the homeless cohort. Readmissions are higher in homeless individuals discharged to the community after surgery. Judicious use of postoperative nursing or residential rehabilitation programs may be effective in reducing readmission and improving care transitions among these vulnerable Veterans. Relative costs and benefits of alternatives to community discharge merit

  20. 75 FR 61860 - Advisory Committee on Women Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans; Notice of Meeting The...) that the Advisory Committee on Women Veterans will meet October 26-28, 2010, at the Hilton Garden Inn... Veterans Affairs regarding the needs of women Veterans with respect to health care, rehabilitation...

  1. 75 FR 8789 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Research Advisory Committee on Gulf War Veterans' Illnesses will meet on...

  2. 77 FR 2353 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Research Advisory Committee on Gulf War Veterans' Illnesses will meet on...

  3. 76 FR 9407 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Research Advisory Committee on Gulf War Veterans' Illnesses will meet on...

  4. 77 FR 31071 - Research Advisory Committee on Gulf War Veterans' Illnesses, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-24

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Research Advisory Committee on Gulf War Veterans' Illnesses will meet on...

  5. 75 FR 28686 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Research Advisory Committee on Gulf War Veterans' Illnesses will meet on...

  6. 75 FR 65405 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-22

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Research Advisory Committee on Gulf War Veterans' Illnesses will meet on...

  7. 76 FR 31018 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Research Advisory Committee on Gulf War Veterans' Illnesses will meet on...

  8. 78 FR 36309 - Research Advisory Committee on Gulf War Veterans' Illnesses, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C. App., that the Research Advisory Committee on Gulf War Veterans' Illnesses will meet on...

  9. 78 FR 48789 - Veterans' Advisory Committee on Education, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-09

    ... DEPARTMENT OF VETERANS AFFAIRS Veterans' Advisory Committee on Education, Notice of Meeting The..., that the Veterans' Advisory Committee on Education will meet on August 13-14, 2013, in the First Floor... on the administration of education and training programs for Veterans, Servicepersons, Reservists...

  10. "Walking in a maze": community providers' difficulties coordinating health care for homeless patients.

    PubMed

    LaCoursiere Zucchero, Terri; McDannold, Sarah; McInnes, D Keith

    2016-09-07

    While dual usage of US Department of Veterans Affairs (VA) and non-VA health services increases access to care and choice for veterans, it is also associated with a number of negative consequences including increased morbidity and mortality. Veterans with multiple health conditions, such as the homeless, may be particularly susceptible to the adverse effects of dual use. Homeless veteran dual use is an understudied yet timely topic given the Patient Protection and Affordable Care Act and Veterans Choice Act of 2014, both of which may increase non-VA care for this population. The study purpose was to evaluate homeless veteran dual use of VA and non-VA health care by describing the experiences, perspectives, and recommendations of community providers who care for the population. Three semi-structured focus group interviews were conducted with medical, dental, and behavioral health providers at a large, urban Health Care for the Homeless (HCH) program. Qualitative content analysis procedures were used. HCH providers experienced challenges coordinating care with VA medical centers for their veteran patients. Participants lacked knowledge about the VA health care system and were unable to help their patients navigate it. The HCH and VA medical centers lacked clear lines of communication. Providers could not access the VA medical records of their patients and felt this hampered the quality and efficiency of care veterans received. Substantial challenges exist in coordinating care for homeless veteran dual users. Our findings suggest recommendations related to education, communication, access to electronic medical records, and collaborative partnerships. Without dedicated effort to improve coordination, dual use is likely to exacerbate the fragmented care that is the norm for many homeless persons.

  11. 75 FR 18026 - Advisory Committee on the Readjustment of Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-08

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on the Readjustment of Veterans; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory.... The meeting is open to the public. The purpose of the Committee is to review the post-war readjustment...

  12. 77 FR 48205 - Advisory Committee on Women Veterans, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-13

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans, Notice of Meeting The...) that the Advisory Committee on Women Veterans will meet on August 20-24, 2012, in the Dennis Auditorium... Affairs regarding the needs of women Veterans with respect to health care, rehabilitation, compensation...

  13. 76 FR 37896 - Advisory Committee on Women Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans; Notice of Meeting The...) that the Advisory Committee on Women Veterans will meet July 14, 2011, in The Connect Room, at The... on the needs of women Veterans with respect to health care, rehabilitation, compensation, outreach...

  14. National Coalition for Homeless Veterans

    MedlinePlus

    ... Conference Notes Corporate Connection HELP FOR VETERANS Locate Organization Immediate Help Step-by-Step Replacing Records Federal Benefits Women Veterans Incarcerated Veterans TA CENTER Guides & Resources Women ...

  15. Internalized stigma of mental illness and depressive and psychotic symptoms in homeless veterans over 6 months.

    PubMed

    Boyd, Jennifer E; Hayward, H'Sien; Bassett, Elena D; Hoff, Rani

    2016-06-30

    We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery. Published by Elsevier Ireland Ltd.

  16. 77 FR 7244 - Advisory Committee on Women Veterans, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans, Notice of Meeting The...) that the Advisory Committee on Women Veterans will meet on March 20-22, 2012, in room 230 at VA Central... regarding the needs of women Veterans with respect to health care, rehabilitation, compensation, outreach...

  17. 75 FR 4631 - Advisory Committee on Women Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans; Notice of Meeting The...) that a meeting of the Advisory Committee on Women Veterans will be held on February 9-11, 2010, in Room... Affairs regarding the needs of women Veterans with respect to health care, rehabilitation, compensation...

  18. 76 FR 64184 - Advisory Committee on Women Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans; Notice of Meeting The...) that the Advisory Committee on Women Veterans will meet October 25-27, 2011, in room 930 at VA Central... the needs of women Veterans with respect to health care, rehabilitation, compensation, outreach, and...

  19. 77 FR 69551 - Advisory Committee on Women Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans; Notice of Meeting The..., that the Advisory Committee on Women Veterans will meet on December 4-6, 2012, in room 230 at VA... regarding the needs of women Veterans with respect to health care, rehabilitation, compensation, outreach...

  20. 76 FR 6197 - Advisory Committee on Women Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans; Notice of Meeting The...) that the Advisory Committee on Women Veterans will meet March 29-31, 2011, in room 230 at VA Central... regarding the needs of women Veterans with respect to health care, rehabilitation, compensation, outreach...

  1. 78 FR 5871 - Research Advisory Committee on Gulf War Veterans' Illnesses, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Research Advisory [[Page 5872

  2. 75 FR 8789 - Veterans' Rural Health Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ... purpose of the Committee is to advise the Secretary of Veterans Affairs on health care issues affecting... DEPARTMENT OF VETERANS AFFAIRS Veterans' Rural Health Advisory Committee; Notice of Meeting The...) that the Veterans' Rural Health Advisory Committee will hold a meeting on March 2-3, 2010, in the...

  3. 76 FR 60965 - Veterans' Rural Health Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... DEPARTMENT OF VETERANS AFFAIRS Veterans' Rural Health Advisory Committee; Notice of Meeting The...) that the Veterans' Rural Health Advisory Committee will hold a meeting on October 13-14, 2011, at the... public. The purpose of the Committee is to advise the Secretary of Veterans Affairs on health care issues...

  4. Veterans Crisis Line: 1-800-273-8255

    MedlinePlus

    ... To Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - ... a confidential toll-free hotline, online chat, or text. Veterans and their loved ones can call 1- ...

  5. Providing intensive addiction/housing case management to homeless veterans enrolled in addictions treatment: A randomized controlled trial.

    PubMed

    Malte, Carol A; Cox, Koriann; Saxon, Andrew J

    2017-05-01

    This study sought to determine whether homeless veterans entering Veterans Affairs (VA) substance use treatment randomized to intensive addiction/housing case management (AHCM) had improved housing, substance use, mental health, and functional outcomes and lower acute health care utilization, compared to a housing support group (HSG) control. Homeless veterans (n = 181) entering outpatient VA substance use treatment were randomized to AHCM and HSG and received treatment for 12 months. AHCM provided individualized housing, substance use and mental health case management, life skills training, and community outreach. The control condition was a weekly drop-in housing support group. Adjusted longitudinal analyses compared groups on baseline to month 12 change in percentage of days housed and functional status, substance use, and mental health outcomes (36-Item Short-Form Health Survey; Addiction Severity Index [ASI]). Negative binomial regression models compared groups on health care utilization. Both conditions significantly increased percentage of days housed, with no differences detected between conditions. In total, 74 (81.3%) AHCM and 64 (71.1%) HSG participants entered long-term housing (odds ratio = 1.9, 95% confidence interval [0.9, 4.0], p = .088). HSG participants experienced a greater decrease in emergency department visits than AHCM (p = .037), whereas AHCM participants remained in substance use treatment 52.7 days longer (p = .005) and had greater study treatment participation (p < .001) than HSG. ASI alcohol composite scores improved more for HSG than AHCM (p = .006), and both conditions improved on ASI drug and psychiatric scores and alcohol/drug abstinence. AHCM did not demonstrate overarching benefits beyond standard VA housing and substance use care. For those veterans not entering or losing long-term housing, different approaches to outreach and ongoing intervention are required. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. 78 FR 77205 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-20

    ... DEPARTMENT OF VETERANS AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal... be Committee training and updates on the Department of Defense and VA Gulf War research initiatives...

  7. Predictors of homeless services re-entry within a sample of adults receiving Homelessness Prevention and Rapid Re-Housing Program (HPRP) assistance.

    PubMed

    Brown, Molly; Vaclavik, Danielle; Watson, Dennis P; Wilka, Eric

    2017-05-01

    Local and national evaluations of the federal Homelessness Prevention and Rapid Re-Housing Program (HPRP) have demonstrated a high rate of placement of program participants in permanent housing. However, there is a paucity of research on the long-term outcomes of HPRP, and research on rehousing and prevention interventions for single adults experiencing homelessness is particularly limited. Using Homeless Management Information System data from 2009 to 2015, this study examined risk of return to homeless services among 370 permanently housed and 71 nonpermanently housed single adult HPRP participants in Indianapolis, Indiana. Kaplan-Meier survival curves were conducted to analyze time-to-service re-entry for the full sample, and the homelessness prevention and rapid rehousing participants separately. With an average follow-up of 4.5 years after HPRP exit, 9.5% of the permanently housed HPRP participants and 16.9% of those nonpermanently housed returned to homeless services. By assistance type, 5.4% of permanently housed and 15.8% of nonpermanently housed homelessness prevention recipients re-entered services, and 12.8% of permanently housed and 18.2% of nonpermanently housed rapid rehousing recipients re-entered during the follow-up period. Overall, veterans, individuals receiving rapid rehousing services, and those whose income did not increase during HPRP had significantly greater risk of returning to homeless services. Veterans were at significantly greater risk of re-entry when prevention and rehousing were examined separately. Findings suggest a need for future controlled studies of prevention and rehousing interventions for single adults, aiming to identify unique service needs among veterans and those currently experiencing homelessness in need of rehousing to inform program refinement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. 76 FR 6170 - Federal Register Meeting Notice: Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... SMALL BUSINESS ADMINISTRATION Federal Register Meeting Notice: Advisory Committee on Veterans Business Affairs AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Advisory... for the next meeting of the Advisory Committee on Veterans Business Affairs. The meeting will be open...

  9. Prevalence of Homelessness in the Emergency Department Setting.

    PubMed

    Feldman, Brett J; Calogero, Cristina G; Elsayed, Kareem S; Abbasi, Osman Z; Enyart, Joshua; Friel, Timothy J; Abunamous, Yasir H; Dusza, Stephen W; Greenberg, Marna Rayl

    2017-04-01

    According to the National Alliance to End Homelessness, the national rate of homelessness has been cited as 17.7 homeless people/10,000 people in the general population, and 24.8 homeless veterans/10,000 veterans in the general population. However, it is unknown what the prevalence of homelessness is in the emergency department (ED) setting. We set out to determine the prevalence of homelessness or at risk for homelessness in the ED setting. Using a five-question screening tool derived from the U.S. Department of Housing and Urban Development, Health and Human Services and the Veterans Administration definition for homelessness, we surveyed all patients meeting inclusion/exclusion criteria on scheduled shifts in one of three EDs in Northeastern Pennsylvania. To participate, subjects had to be a registered patient in the ED, be 18 years or older, speak English, have the capacity to answer survey questions, not be critically ill, be willing to participate, and not have taken the survey before. We selected two survey periods to represent seasonal variations. We included 4,395 subjects in the analysis. The mean age of those who screened positive for homelessness or at risk for homelessness was 43.1 (SD 16.6). Overall, 136 (3.1%) participants screened positive for at risk for homelessness and 309 (7.0%) screened positive for homelessness. A total of 103 subjects (9.8%) screened positive for homelessness or at risk for homelessness on weekends and 312 (10.3%) on weekdays (p=0.64). The proportion of those screening positive for homelessness or at risk for homelessness varied by site: 145 (7.5%) at the trauma center, 151(9.1%) at the suburban site, and 149 (18.7%) at the center city site, p<0.001.There was no statistical significance to the difference between the trauma center and the suburban site (p=.088), but there was statistical significance between both the suburban and the trauma center when compared to the center city site (both p<0.0001). The proportion of those

  10. 77 FR 71471 - Interagency Task Force on Veterans Small Business Development; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-30

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development; Notice of Meeting AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency... agenda for its public meeting of the Interagency Task Force on Veterans Small Business Development. The...

  11. 48 CFR 52.219-27 - Notice of Service-Disabled Veteran-Owned Small Business Set-Aside.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Notice of Service-Disabled... Text of Provisions and Clauses 52.219-27 Notice of Service-Disabled Veteran-Owned Small Business Set-Aside. As prescribed in 19.1407, insert the following clause: Notice of Service-Disabled Veteran-Owned...

  12. 48 CFR 52.219-27 - Notice of Service-Disabled Veteran-Owned Small Business Set-Aside.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 2 2013-10-01 2013-10-01 false Notice of Service-Disabled... Text of Provisions and Clauses 52.219-27 Notice of Service-Disabled Veteran-Owned Small Business Set-Aside. As prescribed in 19.1407, insert the following clause: Notice of Service-Disabled Veteran-Owned...

  13. 48 CFR 52.219-27 - Notice of Service-Disabled Veteran-Owned Small Business Set-Aside.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 2 2012-10-01 2012-10-01 false Notice of Service-Disabled... Text of Provisions and Clauses 52.219-27 Notice of Service-Disabled Veteran-Owned Small Business Set-Aside. As prescribed in 19.1407, insert the following clause: Notice of Service-Disabled Veteran-Owned...

  14. Psychosis, Lack of Job Skills, and Criminal History: Associations With Employment in Two Samples of Homeless Men.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2016-06-01

    This study examined factors associated with employment among homeless men with mental illness, particularly history of criminal justice involvement. Data from 569 homeless men in the 11-site Collaborative Initiative to Help End Chronic Homelessness (2004-2009) and 1,101 homeless male veterans in the U.S. Department of Housing and Urban Development-Veterans Affairs Supportive Housing program at 19 sites (1992-2003) were analyzed. In neither sample was criminal or incarceration history significantly associated with job attainment or earnings for either black or white participants. In contrast, psychotic disorders and public-support income were negatively associated with job attainment and earnings. The majority of homeless veterans reported lifetime occupations as skilled or unskilled manual workers. These findings highlight the high rate of nonemployment among homeless men and suggest that employment among homeless men is not significantly impeded by a criminal record but by psychiatric problems and reliance on public-support income.

  15. 75 FR 33899 - Advisory Committee on Structural Safety of Department of Veterans Affairs Facilities; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... Construction & Facilities Management (00CFM1A), Department of Veterans Affairs, 810 Vermont Avenue, NW... Affairs Facilities; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public... Safety of Department of Veterans Affairs Facilities will be held on June 24-25, 2010, in Room 442, Export...

  16. 76 FR 21108 - Advisory Committee on Structural Safety of Department of Veterans Affairs Facilities; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-14

    ... Quality Service, Office of Construction and Facilities Management (00CFM1A), Department of Veterans... Affairs Facilities; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public... Safety of Department of Veterans Affairs Facilities will be held on May 12-13, 2011, in Room 442, at the...

  17. 77 FR 63437 - Advisory Committee on Structural Safety of Department of Veterans Affairs Facilities, Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-16

    ..., Office of Construction & Facilities Management (003C2B), Department of Veterans Affairs, 425 I Street NW... Affairs Facilities, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the... Safety of Department of Veterans Affairs Facilities will be held on October 29-30, 2012, in Room 6W405...

  18. 78 FR 21198 - Advisory Committee on Structural Safety of Department of Veterans Affairs Facilities; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-09

    ... Construction and Facilities Management (003C2B), Department of Veterans Affairs, 810 Vermont Avenue NW... Affairs Facilities; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the... Safety of Department of Veterans Affairs Facilities will be held on April 25-26, 2013, in Room 6W405, 425...

  19. Patterns and predictors of engagement in peer support among homeless veterans with mental health conditions and substance use histories.

    PubMed

    Ellison, Marsha Langer; Schutt, Russell K; Glickman, Mark E; Schultz, Mark R; Chinman, Matthew; Jensen, Kristina; Mitchell-Miland, Chantele; Smelson, David; Eisen, Susan

    2016-09-01

    Patterns and predictors of engagement in peer support services were examined among 50 previously homeless veterans with co-occurring mental health conditions and substance use histories receiving services from the Veterans Health Administration supported housing program. Veteran peer specialists were trained to deliver sessions focusing on mental health and substance use recovery to veterans for an intended 1-hr weekly contact over 9 months. Trajectories of peer engagement over the study's duration are summarized. A mixed-effects log-linear model of the rate of peer engagement is tested with three sets of covariates representing characteristics of the veterans. These sets were demographics, mental health and substance use status, and indicators of community participation and support. Data indicate that veterans engaged with peers about once per month rather than the intended once per week. However, frequency of contacts varied greatly. The best predictor of engagement was time, with most contacts occurring within the first 6 months. No other veteran characteristic was a statistically significant predictor of engagement. Older veterans tended to have higher rates of engagement with peer supporters. Planners of peer support services could consider yardsticks of monthly services up to 6 months. Peer support services need a flexible strategy with varying levels of intensity according to need. Peer support services will need to be tailored to better engage younger veterans. Future research should consider other sources of variation in engagement with peer support such as characteristics of the peer supporters and service content and setting. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Board of Veterans' Appeals: rules of practice--notice of appeal in simultaneously contested claim. Final rule.

    PubMed

    2001-12-03

    The Board of Veterans' Appeals (Board) adjudicates appeals from denials of claims for veterans' benefits filed with the Department of Veterans Affairs (VA). This document amends a Board Rule of Practice, pertaining to a type of notice given in simultaneously contested claim appeals, to eliminate an inconsistency between that Rule of Practice and an Appeals Regulation and to update a presumption related to communication of the notice.

  1. Effects of self-compassion workbook training on trauma-related guilt in a sample of homeless veterans: a pilot study.

    PubMed

    Held, Philip; Owens, Gina P

    2015-06-01

    The present pilot study examined the effects of a 4-week-long self-administered self-compassion training on trauma-related guilt and compared it to a stress inoculation control group. A total of 47 homeless male veterans who were living in transitional housing facilities volunteered to participate in this study. Participants were randomly assigned to either a self-compassion (N = 13) or a stress inoculation (N = 14) group and were asked to complete pre-, mid-, and postintervention assessments measuring changes in self-compassion, trauma-related guilt, and posttraumatic stress disorder severity. Participants in both interventions reported increased levels of self-compassion and equal reductions in trauma-related guilt. No other significant changes were noted. The results from this pilot study provide preliminary evidence for the use of self-compassion and stress inoculation trainings as effective interventions for trauma-related guilt. The findings also suggest that self-administered trainings in the form of workbooks may be a viable, cost-effective form of intervention for disadvantaged populations, such as homeless veterans in transitional housing, who may lack resources or access to professionals or paraprofessionals. The effects of both self-compassion training and stress inoculation training on the study variables and directions for future research on self-compassion and trauma-related guilt are discussed. © 2015 Wiley Periodicals, Inc.

  2. 76 FR 67023 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... and priority placement for homeless Veterans and Veterans at risk of homelessness and their families... Management (044), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461... business plan proposed by the Under Secretary for Health for applying the consideration under such a lease...

  3. 75 FR 69742 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Restoration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... Quarters. Lessee will also provide referral counseling services for homeless Veterans, and set aside at least one room in the Chapel to provide counseling and outreach services for homeless Veterans. Lessee...

  4. 75 FR 24514 - Supportive Services for Veteran Families Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ...This proposed rule would establish regulations concerning the Supportive Services for Veteran Families Program (SSVF Program) of the Department of Veterans Affairs (VA). This proposed rule is necessary to implement the provisions of section 604 of the Veterans' Mental Health and Other Care Improvements Act of 2008. The purpose of the SSVF Program is to provide supportive services grants to private non-profit organizations and consumer cooperatives who would coordinate or provide supportive services to very low-income veteran families who are residing in permanent housing, are homeless and scheduled to become residents of permanent housing within a specified time period, or after exiting permanent housing, are seeking other housing that is responsive to such very low-income veteran family's needs and preferences. The new SSVF Program is within the continuum of VA's homeless services programs.

  5. 75 FR 13141 - The Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO); Notice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ... Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO); Notice of Open Teleconference Meeting The Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO.... The ACVETEO is responsible for assessing employment and training needs of veterans; determining the...

  6. 48 CFR 52.219-27 - Notice of Total Service-Disabled Veteran-Owned Small Business Set-Aside.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-Disabled Veteran-Owned Small Business Set-Aside. 52.219-27 Section 52.219-27 Federal Acquisition... CONTRACT CLAUSES Text of Provisions and Clauses 52.219-27 Notice of Total Service-Disabled Veteran-Owned...-Disabled Veteran-Owned Small Business Set-Aside (MAY 2004) (a) Definition. Service-disabled veteran-owned...

  7. Chronic disease management for recently homeless veterans: a clinical practice improvement program to apply home telehealth technology to a vulnerable population.

    PubMed

    Gabrielian, Sonya; Yuan, Anita; Andersen, Ronald M; McGuire, James; Rubenstein, Lisa; Sapir, Negar; Gelberg, Lillian

    2013-03-01

    Although vulnerable populations may benefit from in-home health information technologies (HIT) that promote disease self-management, there is a "digital divide" in which these groups are often unlikely to use such programs. We describe the early phases of applying and testing an existing Veterans Affairs (VA) HIT-care management program, Care Coordination Home Telehealth (CCHT), to recently homeless Veterans in the US Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) program. Peers were used to support patient participation. CCHT uses in-home messaging devices to provide health education and daily questions about clinical indicators from chronic illness care guidelines, with patient responses reviewed by VHA nurses. Patients could also receive adjunctive peer support. We used medical record review, Veteran interviews, and staff surveys to "diagnose" barriers to CCHT use, assess program acceptability, explore the role of peer support, and inform future quality improvement. Fourteen eligible Veterans in HUD-VASH agreed to CCHT participation. Ten of these Veterans opted to have adjunctive peer support and the other 4 enrolled in CCHT usual care. Although barriers to enrollment/engagement must be addressed, this subset of Veterans in HUD-VASH was satisfied with CCHT. Most Veterans did not require support from peers to engage in CCHT but valued peer social assistance amidst the isolation felt in their scattered-site homes. HIT tools hold promise for in-home care management for recently housed Veterans. Patient-level barriers to enrollment must be addressed in the next steps of quality improvement, testing and evaluating peer-driven CCHT recruitment.

  8. Chronic disease management for recently homeless Veterans: a clinical practice improvement program to apply home telehealth technology to a vulnerable population

    PubMed Central

    Gabrielian, Sonya; Yuan, Anita; Andersen, Ronald M.; McGuire, James; Rubenstein, Lisa; Sapir, Negar; Gelberg, Lillian

    2013-01-01

    Background Though vulnerable populations may benefit from in-home health information technologies (HIT) that promote disease self-management, there is a “digital divide” in which these groups are often unlikely to use such programs. We describe the early phases of applying and testing an existing Veterans Administration (VA) HIT care management program, Care Coordination Home Telehealth (CCHT), to recently homeless Veterans in the U.S. Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) program. Peers were used to support patient participation. Methods CCHT uses in-home messaging devices to provide health education and daily questions about clinical indicators from chronic illness care guidelines, with patient responses reviewed by VA nurses. Patients could also receive adjunctive peer support. We used medical record review, Veteran interviews, and staff surveys to “diagnose” barriers to CCHT use, assess program acceptability, explore the role of peer support, and inform future quality improvement. Subjects Fourteen eligible Veterans in HUD-VASH agreed to CCHT participation. Ten of these Veterans opted to have adjunctive peer support and the other four enrolled in CCHT usual care. Results Though barriers to enrollment/engagement must be addressed, this subset of Veterans in HUD-VASH was satisfied with CCHT. Most Veterans did not require support from peers to engage in CCHT but valued peer social assistance amidst the isolation felt in their scattered-site homes. Conclusions HIT tools hold promise for in-home care management for recently housed Veterans. Patient-level barriers to enrollment must be addressed in the next steps of quality improvement, testing and evaluating peer-driven CCHT recruitment. PMID:23407011

  9. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  10. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  11. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  12. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  13. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  14. Clinical and cognitive correlates of unsheltered status in homeless persons with psychotic disorders.

    PubMed

    Llerena, Katiah; Gabrielian, Sonya; Green, Michael F

    2018-02-24

    Homeless persons with psychosis are particularly susceptible to unsheltered homelessness, which includes living on the streets, in cars, and other places not meant for human habitation. Homeless persons with psychosis have distinct barriers to accessing care and comprise a high-need and hard-to-serve homeless subpopulation. Therefore, this study sought to understand unsheltered homelessness in persons with psychosis and its relationship to cognitive impairment, clinical symptoms, and community functioning, examined both categorically and dimensionally. This study included 76 homeless participants with a history of a psychotic diagnosis who were enrolled in a supported housing program but had not yet received housing. This study used two different housing stability thresholds (literally homeless at any point vs. literally homeless >20% of days) for comparing homeless Veterans with psychosis living in sheltered versus unsheltered situations on cognition, clinical symptoms, and community integration. Dimensional analyses also examined the relationship between percentage of days spent in unsheltered locations and cognition, clinical symptoms, and community integration. Sheltered and unsheltered Veterans with psychosis did not differ on clinical symptoms or community integration, but there was an inconsistent group difference on cognition depending on the threshold used for determining housing stability. In the unsheltered group, cognitive deficits in overall cognition, visual learning, and social cognition were related to more days spent in unsheltered locations. Rehabilitation efforts targeting specific cognitive deficits may be useful to facilitate greater access to care and successful interventions in this population. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Legislation on Homelessness. Wisconsin Legislative Council Report No. 12 to the 1991 Legislature.

    ERIC Educational Resources Information Center

    Rose, Laura; Matthias, Mary

    The components of Wisconsin's 1991 Assembly Bill 680 that considers homelessness are discussed in this document. The Bill itself addresses: (1) surplus state lands; (2) transitional housing grants; (3) prevention of homelessness; (4) establishing a low-income housing income and franchise tax credit; (5) veterans lacking a permanent address; (6)…

  16. 77 FR 56712 - Agency Information Collection (Homeless Providers Grant and Per Diem Program) Activities Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0554] Agency Information Collection (Homeless...-7316. Please refer to ``OMB Control No. 2900-0554'' in any correspondence. FOR FURTHER INFORMATION... . Please refer to ``OMB Control No. 2900-0554.'' SUPPLEMENTARY INFORMATION: Titles: a. Homeless Providers...

  17. Incarcerated Veterans Outreach Program.

    PubMed

    Schaffer, Bradley J

    2016-01-01

    The objective of this study is to identify and facilitate re-entry services for military veterans in the Criminal Justice System through the Incarcerated Veteran Outreach Program. Veterans are explored as a subgroup of the general inmate jail populations in southern Ohio based upon veteran's status, military discharges, service-related injuries, treatment needs, pre-release planning, and re-entry services. Veterans reported having psycho-social problems, diverse levels of criminality, criminogenic needs, and significant episodes of homelessness. A sample of 399 incarcerated veterans in state prison, county jails, and community corrections setting were identified and completed the psycho-social pre-release assessment. Their average age was 44.6; they were more likely to be White males, divorced, most honorably discharged, and were represented in the following eras: 34% Vietnam, 35% post-Vietnam, 26% Persian Gulf War, and 5% Operation Iraqi Freedom/Operation Enduring Freedom. The findings encourage the development of a re-entry outreach model and strategies to prevent episodes of criminal recidivism.

  18. Aversion to injection limits acceptability of extended-release naltrexone among homeless, alcohol-dependent patients.

    PubMed

    Friedmann, Peter D; Mello, Dawn; Lonergan, Sean; Bourgault, Claire; O'Toole, Thomas P

    2013-01-01

    Ending homelessness is a major priority of the Department of Veteran Affairs (VA), and alcohol use can be a barrier to stable housing. Clinical trials suggest that depot extended-release naltrexone (XR-NTX) is efficacious in reducing alcohol consumption among alcohol-dependent subjects. An open-label, randomized pilot study sought to examine the feasibility and effectiveness of XR-NTX versus oral naltrexone to improve alcohol consumption and housing stability among homeless, alcohol-dependent veterans at the Providence Veteran Affairs Medical Center. Of 215 potential candidates approached over a 16-month recruitment period, only 15 agreed to consider study entry and 7 were randomized. The primary reasons given for refusal were not wanting an injection; fear of needles; and not wanting to change drinking habits. Only 1 participant in the XR-NTX group returned after the first injection. Three participants in the oral naltrexone group attended all 7 visits and had good outcomes. Although XR-NTX has demonstrated efficacy in reducing heavy drinking, limited acceptance of the injection might reduce its effectiveness among homeless, alcohol-dependent patients.

  19. 77 FR 27252 - Veterans' Employment and Training; Veterans Workforce Investment Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-09

    ... DEPARTMENT OF LABOR Veterans' Employment and Training; Veterans Workforce Investment Program AGENCY: Veterans' Employment and Training Service, Department of Labor. Announcement Type: New Notice of... applications is June 15, 2012. Funding Opportunity Description The U.S. Department of Labor (USDOL), Veterans...

  20. Onward and Upward Bound: Military Veterans Charge toward Higher Education

    ERIC Educational Resources Information Center

    Stewart, Reginald L.

    2014-01-01

    In this article, Reginald L. Stewart asks: "What is the true value of higher education to military veterans?" Military veterans may be underrepresented in higher education due to life adversities including homelessness, medical disabilities, substance abuse, family hardships, and deficient academic skills, however, with the transition of…

  1. 48 CFR 852.219-11 - VA notice of total veteran-owned small business set-aside.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false VA notice of total veteran-owned small business set-aside. 852.219-11 Section 852.219-11 Federal Acquisition Regulations System... owned by one or more veterans; (ii) The management and daily business operations of which are controlled...

  2. 75 FR 44007 - Notice of Availability: Notice of Fiscal Year (FY) 2009 Implementation of the Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-27

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5403-N-01] Notice of Availability... conduct the demonstration. Consistent with this authority, HUD has coordinated with the Department of Veterans Affairs and the Department of Labor in selecting a limited number of urban and rural sites in...

  3. 48 CFR 852.219-11 - VA notice of total veteran-owned small business set-aside.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... owned by one or more veterans; (ii) The management and daily business operations of which are controlled...-owned small business set-aside. 852.219-11 Section 852.219-11 Federal Acquisition Regulations System... Provisions and Clauses 852.219-11 VA notice of total veteran-owned small business set-aside. As prescribed in...

  4. 75 FR 39623 - Advisory Committee on Women Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-09

    ... should notify Michelle Spivak, Director, Public Relations and Public Affairs, at (202) 745-4037. Members... Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act... for America, at Arlington National Cemetery, Washington, DC. The meeting is open to the public. Those...

  5. 78 FR 37278 - Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-20

    ... (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV) Pilot Surveys) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity...

  6. 48 CFR 52.219-27 - Notice of Total Service-Disabled Veteran-Owned Small Business Set-Aside.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... management and daily business operations of which are controlled by one or more service-disabled veterans or...-Disabled Veteran-Owned Small Business Set-Aside. 52.219-27 Section 52.219-27 Federal Acquisition... Small Business Set-Aside. As prescribed in 19.1407, insert the following clause: Notice of Total Service...

  7. Homeless Veterans Prevention Act of 2013

    THOMAS, 113th Congress

    Sen. Sanders, Bernard [I-VT

    2013-04-25

    Senate - 05/09/2013 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 113-203. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  8. 77 FR 64851 - Announcement Date Postponed for the Grand Prize Winner Announcement for the America COMPETES...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-23

    ...On March 22, 2012, the Department of Veterans Affairs (VA) published a notice in the Federal Register (77 FR 16895) to announce the launch of VA's Project REACH Homelessness Mobile App Contest, authorized under section 105 of the America COMPETES Reauthorization Act of 2011. Project REACH leadership has decided to postpone announcement of the Grand Prize Winner until no later than 11 p.m. on December 31, 2012. Postponing the announcement will provide participants with a greater opportunity to receive recognition for their dedication and efforts to end Veteran homelessness. This notice serves as an update to the original notice affecting only the announcement date for the Grand Prize Winner. All rules and requirements outlined in the March 22, 2012, Federal Register notice will remain in effect.

  9. End Veteran Homelessness Act of 2010

    THOMAS, 111th Congress

    Rep. Filner, Bob [D-CA-51

    2010-03-10

    Senate - 03/23/2010 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  10. 76 FR 61150 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... for homeless and at-risk Veterans. FOR FURTHER INFORMATION CONTACT: Edward L. Bradley, III, Office of Asset Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington...

  11. 76 FR 71439 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420...; provide preference and priority placement for homeless and/or at-risk Veterans and their families; and...

  12. 76 FR 72045 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ..., Office of Asset Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue NW... required to give preference and priority placement for homeless, at-risk, disabled, and senior Veterans and...

  13. Comparing homeless persons' care experiences in tailored versus nontailored primary care programs.

    PubMed

    Kertesz, Stefan G; Holt, Cheryl L; Steward, Jocelyn L; Jones, Richard N; Roth, David L; Stringfellow, Erin; Gordon, Adam J; Kim, Theresa W; Austin, Erika L; Henry, Stephen Randal; Kay Johnson, N; Shanette Granstaff, U; O'Connell, James J; Golden, Joya F; Young, Alexander S; Davis, Lori L; Pollio, David E

    2013-12-01

    We compared homeless patients' experiences of care in health care organizations that differed in their degree of primary care design service tailoring. We surveyed homeless-experienced patients (either recently or currently homeless) at 3 Veterans Affairs (VA) mainstream primary care settings in Pennsylvania and Alabama, a homeless-tailored VA clinic in California, and a highly tailored non-VA Health Care for the Homeless Program in Massachusetts (January 2011-March 2012). We developed a survey, the "Primary Care Quality-Homeless Survey," to reflect the concerns and aspirations of homeless patients. Mean scores at the tailored non-VA site were superior to those from the 3 mainstream VA sites (P < .001). Adjusting for patient characteristics, these differences remained significant for subscales assessing the patient-clinician relationship (P < .001) and perceptions of cooperation among providers (P = .004). There were 1.5- to 3-fold increased odds of an unfavorable experience in the domains of the patient-clinician relationship, cooperation, and access or coordination for the mainstream VA sites compared with the tailored non-VA site; the tailored VA site attained intermediate results. Tailored primary care service design was associated with a superior service experience for patients who experienced homelessness.

  14. 76 FR 18231 - Federal Property Suitable as Facilities To Assist the Homeless

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-01

    ...-101 and 15-115 Olympic Nat'l Park Lake Crescent WA 98362 Landholding Agency: Interior Property Number... National Coalition for the Homeless v. Veterans Administration, No. 88-2503-OG (D.D.C.). Properties...-based paint [[Page 18232

  15. 77 FR 12697 - VA Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ...We propose to revise and reorganize regulations which contain the Department of Veterans Affairs' (VA) Homeless Providers Grant and Per Diem Program. This rulemaking would update our current regulations, implement and authorize new VA policies, and generally improve the clarity of part 61.

  16. Health Disparities in Veterans: A Map of the Evidence.

    PubMed

    Kondo, Karli; Low, Allison; Everson, Teresa; Gordon, Christine D; Veazie, Stephanie; Lozier, Crystal C; Freeman, Michele; Motu'apuaka, Makalapua; Mendelson, Aaron; Friesen, Mark; Paynter, Robin; Friesen, Caroline; Anderson, Johanna; Boundy, Erin; Saha, Somnath; Quiñones, Ana; Kansagara, Devan

    2017-09-01

    Goals for improving the quality of care for all Veterans and eliminating health disparities are outlined in the Veterans Health Administration Blueprint for Excellence, but the degree to which disparities in utilization, health outcomes, and quality of care affect Veterans is not well understood. To characterize the research on health care disparities in the Veterans Health Administration by means of a map of the evidence. We conducted a systematic search for research studies published from 2006 to February 2016 in MEDLINE and other data sources. We included studies of Veteran populations that examined disparities in 3 outcome categories: utilization, quality of health care, and patient health. We abstracted data on study design, setting, population, clinical area, outcomes, mediators, and presence of disparity for each outcome category. We grouped the data by population characteristics including race, disability status, mental illness, demographics (age, era of service, rural location, and distance from care), sex identity, socioeconomic status, and homelessness, and created maps illustrating the evidence. We reviewed 4249 citations and abstracted data from 351 studies which met inclusion criteria. Studies examining disparities by race/ethnicity comprised by far the vast majority of the literature, followed by studies examining disparities by sex, and mental health condition. Very few studies examined disparities related to lesbian, gay, bisexual, or transgender identity or homelessness. Disparities findings vary widely by population and outcome. Our evidence maps provide a "lay of the land" and identify important gaps in knowledge about health disparities experienced by different Veteran populations.

  17. Homeless Veterans Assistance Improvement Act of 2012

    THOMAS, 112th Congress

    Sen. Murray, Patty [D-WA

    2012-06-18

    Senate - 06/27/2012 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 112-668. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  18. Comparing Homeless Persons’ Care Experiences in Tailored Versus Nontailored Primary Care Programs

    PubMed Central

    Holt, Cheryl L.; Steward, Jocelyn L.; Jones, Richard N.; Roth, David L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa W.; Austin, Erika L.; Henry, Stephen Randal; Kay Johnson, N.; Shanette Granstaff, U.; O’Connell, James J.; Golden, Joya F.; Young, Alexander S.; Davis, Lori L.; Pollio, David E.

    2013-01-01

    Objectives. We compared homeless patients’ experiences of care in health care organizations that differed in their degree of primary care design service tailoring. Methods. We surveyed homeless-experienced patients (either recently or currently homeless) at 3 Veterans Affairs (VA) mainstream primary care settings in Pennsylvania and Alabama, a homeless-tailored VA clinic in California, and a highly tailored non-VA Health Care for the Homeless Program in Massachusetts (January 2011-March 2012). We developed a survey, the “Primary Care Quality-Homeless Survey," to reflect the concerns and aspirations of homeless patients. Results. Mean scores at the tailored non-VA site were superior to those from the 3 mainstream VA sites (P < .001). Adjusting for patient characteristics, these differences remained significant for subscales assessing the patient–clinician relationship (P < .001) and perceptions of cooperation among providers (P = .004). There were 1.5- to 3-fold increased odds of an unfavorable experience in the domains of the patient–clinician relationship, cooperation, and access or coordination for the mainstream VA sites compared with the tailored non-VA site; the tailored VA site attained intermediate results. Conclusions. Tailored primary care service design was associated with a superior service experience for patients who experienced homelessness. PMID:24148052

  19. 77 FR 17125 - Federal Property Suitable as Facilities To Assist the Homeless

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ... December 12, 1988 Court Order in National Coalition for the Homeless v. Veterans Administration, No. 88...: office; restricted access Bldg 1803 403 Olympic Blvd. Cannon NM 88103 Landholding Agency: Air Force..., recent use: AF trailer court, property limitation: local Bedford Zoning By-Laws (Industrial Park District...

  20. 76 FR 71443 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... preference and priority placement for homeless and/or at-risk Veterans and their families; and provide a supportive services program. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461...

  1. Adults Experiencing Homelessness in the US–Mexico Border Region: A Photovoice Project

    PubMed Central

    Moya, Eva Margarita; Chavez-Baray, Silvia M.; Loweree, Jacqueline; Mattera, Brian; Martinez, Nahomi

    2017-01-01

    Homelessness is a social, economic, and political crisis in the United States. In particular, the US–Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, 12 persons in El Paso, TX, with experience of being homeless used the photovoice methodology to participate in a project titled, “The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the Identity and Challenges Homeless Adults Face on the Border Region.” The project was led by faculty from the Department of Social Work and facilitated by graduate students from the Departments of Social Work, Sociology, and Anthropology at the University of Texas at El Paso. In partnership with the Opportunity Center for the Homeless, a community-based organization, a gallery of photographs with respective narratives was produced along with a video documentary. The participants identified four themes: broken systems, invisibility, opportunities and what works, and growth and determination. These themes represent participants’ life experiences with homelessness and their aspirations. In addition to the photo gallery, participants supported the development of a Call to Action asking the community, policy, and decision makers to commit to changing the current social, economic, and political conditions affecting individuals experiencing homelessness. The gallery, Call to Action, and overall participant experiences with photovoice were shared during local, regional, and national conferences and events, including three State of the Homeless Conferences led by the Opportunity Center for the Homeless in partnership with the university. PMID:28580355

  2. Homelessness, cigarette smoking and desire to quit: results from a US national study.

    PubMed

    Baggett, Travis P; Lebrun-Harris, Lydie A; Rigotti, Nancy A

    2013-11-01

    We determined whether or not homelessness is associated with cigarette smoking independent of other socio-economic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. We analyzed data from 2678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using US federally funded community health centers. We used multivariable logistic regression to examine the association between homelessness and (i) current cigarette smoking among all adults, and (ii) past-year desire to quit among current smokers, adjusting for demographic, socio-economic and behavioral health characteristics. Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57 versus 27%, P < 0.001). In multivariable models, a history of homelessness was associated independently with current smoking [adjusted odds ratio (AOR) 2.09; 95% confidence interval (CI) = 1.49-2.93], even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness and alcohol and drug abuse. Housing status was not associated significantly with past-year desire to stop smoking in unadjusted (P = 0.26) or adjusted (P = 0.60) analyses; 84% of currently homeless, 89% of formerly homeless and 82% of never homeless smokers reported wanting to quit. Among patients of US health centers, a history of homelessness doubles the odds of being a current smoker independent of other socio-economic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. © 2013 Society for the Study of Addiction.

  3. Homelessness, Cigarette Smoking, and Desire to Quit: Results from a U.S. National Study

    PubMed Central

    Baggett, Travis P.; Lebrun-Harris, Lydie A.; Rigotti, Nancy A.

    2013-01-01

    Aims We determined whether homelessness is associated with cigarette smoking independent of other socioeconomic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. Design, Setting, and Participants We analyzed data from 2,678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using U.S. federally-funded community health centers. Measurements We used multivariable logistic regression to examine the association between homelessness and (1) current cigarette smoking among all adults, and (2) past-year desire to quit among current smokers, adjusting for demographic, socioeconomic, and behavioral health characteristics. Findings Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57% vs. 27%, p<0.001). In multivariable models, a history of homelessness was independently associated with current smoking (AOR 2.09; 95% CI 1.49-2.93), even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness, and alcohol and drug abuse. Housing status was not significantly associated with past-year desire to stop smoking in unadjusted (p=0.26) or adjusted (p=0.60) analyses; 84% of currently homeless, 89% of formerly homeless, and 82% of never homeless smokers reported wanting to quit. Conclusions Among patients of U.S. health centers, a history of homelessness doubles the odds of being a current smoker independent of other socioeconomic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. PMID:23834157

  4. 76 FR 60965 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... homelessness and their families; and provide a supportive services program that guides resident Veterans toward... Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420... business plan proposed by the Under Secretary for Health for applying the consideration under such a lease...

  5. Strategies for Implementing New HUD Homeless Assistance Requirements to Collaborate with Schools

    ERIC Educational Resources Information Center

    National Association for the Education of Homeless Children and Youth, 2013

    2013-01-01

    The U.S. Department of Housing and Urban Development (HUD) recently announced the release of its 2010 Notice of Funding Availability for the Homeless Assistance Programs that it administers. As a result of the passage of the HEARTH Act, there are four new requirements for HUD-funded homeless service programs related to education. These…

  6. A Hybrid III stepped wedge cluster randomized trial testing an implementation strategy to facilitate the use of an evidence-based practice in VA Homeless Primary Care Treatment Programs.

    PubMed

    Simmons, Molly M; Gabrielian, Sonya; Byrne, Thomas; McCullough, Megan B; Smith, Jeffery L; Taylor, Thom J; O'Toole, Tom P; Kane, Vincent; Yakovchenko, Vera; McInnes, D Keith; Smelson, David A

    2017-04-04

    Homeless veterans often have multiple health care and psychosocial needs, including assistance with access to housing and health care, as well as support for ongoing treatment engagement. The Department of Veterans Affairs (VA) developed specialized Homeless Patient Alignment Care Teams (HPACT) with the goal of offering an integrated, "one-stop program" to address housing and health care needs of homeless veterans. However, while 70% of HPACT's veteran enrollees have co-occurring mental health and substance use disorders, HPACT does not have a uniform, embedded treatment protocol for this subpopulation. One wraparound intervention designed to address the needs of homeless veterans with co-occurring mental health and substance use disorders which is suitable to be integrated into HPACT clinic sites is the evidence-based practice called Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking-Veterans Edition, or MISSION-Vet. Despite the promise of MISSION-Vet within HPACT clinics, implementation of an evidence-based intervention within a busy program like HPACT can be difficult. The current study is being undertaken to identify an appropriate implementation strategy for MISSION-Vet within HPACT. The study will test the implementation platform called Facilitation and compared to implementation as usual (IU). The aims of this study are as follows: (1) Compare the extent to which IU or Facilitation strategies achieve fidelity to the MISSION-Vet intervention as delivered by HPACT homeless provider staff. (2) Compare the effects of Facilitation and IU strategies on the National HPACT Performance Measures. (3) Compare the effects of IU and Facilitation on the permanent housing status. (4) Identify and describe key stakeholders' (patients, providers, staff) experiences with, and perspectives on, the barriers to, and facilitators of implementing MISSION. Type III Hybrid modified stepped wedge implementation comparing IU to Facilitation

  7. 76 FR 55570 - Per Diem Payments for the Care Provided to Eligible Veterans Evacuated From a State Home as a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    .... Hayes, MPH, RN, Office of Patient Care Services (114), Veterans Health Administration, Department of... health care in State home facilities that are recognized and certified by VA. Section 1742 specifically... programs-- veterans, Health care, Health facilities, Health professions, Health records, Homeless, Medical...

  8. 78 FR 43221 - Federal Property Suitable as Facilities To Assist the Homeless

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-19

    ... speech-impaired (202) 708-2565 (these telephone numbers are not toll-free), or call the toll-free Title V... the Homeless v. Veterans Administration, No. 88-2503-OG (D.D.C.). Properties reviewed are listed in... Assistant Secretary for Special Needs. TITLE V, FEDERAL SURPLUS PROPERTY PROGRAM FEDERAL REGISTER REPORT FOR...

  9. Experience of primary care among homeless individuals with mental health conditions.

    PubMed

    Chrystal, Joya G; Glover, Dawn L; Young, Alexander S; Whelan, Fiona; Austin, Erika L; Johnson, Nancy K; Pollio, David E; Holt, Cheryl L; Stringfellow, Erin; Gordon, Adam J; Kim, Theresa A; Daigle, Shanette G; Steward, Jocelyn L; Kertesz, Stefan G

    2015-01-01

    The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.

  10. Experience of Primary Care among Homeless Individuals with Mental Health Conditions

    PubMed Central

    Chrystal, Joya G.; Glover, Dawn L.; Young, Alexander S.; Whelan, Fiona; Austin, Erika L.; Johnson, Nancy K.; Pollio, David E.; Holt, Cheryl L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa A.; Daigle, Shanette G.; Steward, Jocelyn L.; Kertesz, Stefan G

    2015-01-01

    The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons’ needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers. PMID:25659142

  11. Automatic address validation and health record review to identify homeless Social Security disability applicants.

    PubMed

    Erickson, Jennifer; Abbott, Kenneth; Susienka, Lucinda

    2018-06-01

    Homeless patients face a variety of obstacles in pursuit of basic social services. Acknowledging this, the Social Security Administration directs employees to prioritize homeless patients and handle their disability claims with special care. However, under existing manual processes for identification of homelessness, many homeless patients never receive the special service to which they are entitled. In this paper, we explore address validation and automatic annotation of electronic health records to improve identification of homeless patients. We developed a sample of claims containing medical records at the moment of arrival in a single office. Using address validation software, we reconciled patient addresses with public directories of homeless shelters, veterans' hospitals and clinics, and correctional facilities. Other tools annotated electronic health records. We trained random forests to identify homeless patients and validated each model with 10-fold cross validation. For our finished model, the area under the receiver operating characteristic curve was 0.942. The random forest improved sensitivity from 0.067 to 0.879 but decreased positive predictive value to 0.382. Presumed false positive classifications bore many characteristics of homelessness. Organizations could use these methods to prompt early collection of information necessary to avoid labor-intensive attempts to reestablish contact with homeless individuals. Annually, such methods could benefit tens of thousands of patients who are homeless, destitute, and in urgent need of assistance. We were able to identify many more homeless patients through a combination of automatic address validation and natural language processing of unstructured electronic health records. Copyright © 2018. Published by Elsevier Inc.

  12. 75 FR 16577 - Gulf War Veterans' Illnesses Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION: Notice with request for comments. SUMMARY: The Secretary Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to...

  13. 78 FR 28292 - Gulf War Veterans' Illnesses Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION: Notice with request for comments. SUMMARY: The Secretary, Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to...

  14. 76 FR 65321 - Gulf War Veterans' Illnesses Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION: Notice with request for comments. SUMMARY: The Secretary, Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to...

  15. Homeless Veterans Reintegration Program Reauthorization Act of 2009

    THOMAS, 111th Congress

    Rep. Boozman, John [R-AR-3

    2009-02-25

    Senate - 03/31/2009 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  16. 76 FR 48204 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-08

    ... homeless veteran populations: Women, including women who have care of minor dependents; Frail elderly; Terminally ill; or Chronically mentally ill. Definitions of women and women who have care of minor dependents... service, operation, or personnel to facilitate the following with regard to the targeted group: Women...

  17. 77 FR 18307 - Gulf War Veterans' Illnesses Task Force Report

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force Report AGENCY: Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Secretary Department of Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive...

  18. Implementation of Rocking Chair Therapy for Veterans in Residential Substance Use Disorder Treatment [Formula: see text].

    PubMed

    Cross, Rene' L; White, Justin; Engelsher, Jaclyn; O'Connor, Stephen S

    Substance use disorder (SUD) and mental health diagnosis negatively affect Veteran homelessness. Assess the acceptance and feasibility of rocking chair therapy as a self-implemented intervention for mood and substance cravings. For homeless Veterans in SUD treatment, how does adding vestibular stimulation by use of a rocking chair compared with treatment as usual affect levels of anxiety and substance cravings? Two significant findings were observed. First, a greater number of minutes spent rocking was associated with significantly greater scores on the Expectancy scale of the Alcohol Craving Questionnaire (ACQ; p = .05), suggesting participants experiencing higher urges and desires to drink rocked to self-soothe. Second, a significant association was observed between a greater number of minutes spent rocking and lower scores on the ACQ Purposefulness subscale ( p = .03), indicating greater time rocking was associated with fewer urges and desires that are connected with the intent and plan to drink. Vestibular stimulation by rocking in a rocking chair may increase the ability to self-regulate mood and substance cravings, thereby potentially reducing risk of relapse and recurrent chronic homelessness.

  19. 78 FR 53011 - Proposed Information Collection (Supportive Services for Veteran Families (SSVF) Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-27

    ... (Supportive Services for Veteran Families (SSVF) Program) Application for Supportive Services Grant) Activity... families residing in permanent housing, are homeless and scheduled to become residents of permanent housing... collection of information through Federal Docket Management System (FDMS) at www.Regulations.gov ; or to...

  20. Becoming homeless, being homeless, and resolving homelessness among women.

    PubMed

    Finfgeld-Connett, Deborah

    2010-07-01

    The purpose of this investigation was to more comprehensively articulate the experiences of homeless women and make evidence-based inferences regarding optimal social services. This study was conducted using qualitative meta-synthesis methods. As youth, homeless women experience challenging circumstances that leave them ill-prepared to prevent and resolve homelessness in adulthood. Resolution of homelessness occurs in iterative stages: crisis, assessment, and sustained action. To enhance forward progression through these stages, nurses are encouraged to promote empowerment in concordance with the Transtheoretical and Harm Reduction Models. Services that are highly valued include physical and mental health care and child care assistance.

  1. 76 FR 72047 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... and priority placement for senior, disabled, homeless and/or at-risk Veterans and their families. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044), Department of...

  2. 76 FR 72046 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... of Asset Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue NW... lessee will also be required to provide preference and priority placement for homeless and at-risk...

  3. 76 FR 71442 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... priority placement for homeless and at-risk Veterans and their families; and provide a supportive services program. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044...

  4. Check the Box for Homeless Veterans Act of 2013

    THOMAS, 113th Congress

    Sen. Boxer, Barbara [D-CA

    2013-01-22

    Senate - 05/09/2013 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 113-203. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  5. Ensuring Safe Shelter for Homeless Veterans Act of 2013

    THOMAS, 113th Congress

    Sen. Begich, Mark [D-AK

    2013-10-28

    Senate - 10/30/2013 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 113-280. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  6. 77 FR 58442 - Fund Availability Under the Supportive Services for Veteran Families Program; Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-20

    ... Families Program; Amendment AGENCY: Department of Veterans Affairs. ACTION: Amendment to notices. SUMMARY... Veteran Families (SSVF) Program. VA published two Notices in the Federal Register on December 17, 2010 (75... Services for Veteran Families Program.'' Under ``Requirements for the Use of Supportive Services Grant...

  7. Partnerships Between Health Care and Legal Providers in the Veterans Health Administration.

    PubMed

    Tsai, Jack; Middleton, Margaret; Retkin, Randye; Johnson, Cindy; Kenneally, Kevin; Sherman, Scott; Rosenheck, Robert A

    2017-04-01

    Medical-legal partnerships (MLPs) represent an innovative service model in which lawyers are integrated into health care teams to address diverse legal problems that affect vulnerable populations. The Veterans Health Administration (VHA) operates the largest safety-net health care system in the country and serves many low-income and disabled veterans who could benefit from MLP services. In this column, the authors describe the development and operations of MLPs at four VHA medical centers that serve veterans who are homeless or who have serious mental illness. The authors also briefly report on the characteristics of 700 veterans served by these MLPs from 2014 to 2016. MLPs can fit within the interdisciplinary, comprehensive system of care provided by VHA, and they offer opportunities to expand VHA-community partnerships to address social determinants of health.

  8. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS...'s death. If the veteran dies before the maturity of the loan, the amount of the unpaid principal and..., upon notice of the death, present them to the Secretary, who shall pay to the bank, in full...

  9. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS...'s death. If the veteran dies before the maturity of the loan, the amount of the unpaid principal and..., upon notice of the death, present them to the Secretary, who shall pay to the bank, in full...

  10. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS...'s death. If the veteran dies before the maturity of the loan, the amount of the unpaid principal and..., upon notice of the death, present them to the Secretary, who shall pay to the bank, in full...

  11. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS...'s death. If the veteran dies before the maturity of the loan, the amount of the unpaid principal and..., upon notice of the death, present them to the Secretary, who shall pay to the bank, in full...

  12. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS...'s death. If the veteran dies before the maturity of the loan, the amount of the unpaid principal and..., upon notice of the death, present them to the Secretary, who shall pay to the bank, in full...

  13. 78 FR 28947 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (VANS)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... Certified Public Accountant (CPA) or letter from the United Way stating they are a member in good standing... cash and in-kind resources from other public (including Federal and State) and private sources that are... public transportation available to homeless veterans in your project. (b) Project location (e.g., is the...

  14. Are the mentally ill homeless a distinct homeless subgroup?

    PubMed

    North, C S; Smith, E M; Pollio, D E; Spitznagel, E L

    1996-09-01

    The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is

  15. Racial Differences in Chronic Conditions and Sociodemographic Characteristics Among High-Utilizing Veterans.

    PubMed

    Breland, Jessica Y; Chee, Christine Pal; Zulman, Donna M

    2015-06-01

    African-Americans are disproportionally represented among high-risk, high-utilizing patients. To inform program development for this vulnerable population, the current study describes racial variation in chronic conditions and sociodemographic characteristics among high-utilizing patients in the Veterans Affairs Healthcare System (VA). We identified the 5 % most costly Veterans who used inpatient or outpatient care at the VA during fiscal year 2010 (N = 237,691) based on costs of inpatient and outpatient care, pharmacy services, and VA-sponsored contract care. Patient costs and characteristics were abstracted from VA outpatient and inpatient data files. Racial differences in sociodemographic characteristics (age, sex, marital support, homelessness, and health insurance status) were assessed with chi-square tests. Racial differences in 32 chronic condition diagnoses were calculated as relative risk ratios. African-Americans represented 21 % of high-utilizing Veterans. African-Americans had higher rates of homelessness (26 vs. 10 %, p < 0.001) and lower rates of supplemental health insurance (44 vs. 58 %, p < 0.001). The mean number of chronic conditions was similar across race. However, there were racial differences in the prevalence of specific chronic conditions, including a higher prevalence of HIV/AIDS (95 % confidence interval (CI) 4.86, 5.50) and schizophrenia (95 % CI 1.94, 2.07) and a lower prevalence of ischemic heart disease (95 % CI 0.57, 0.59) and bipolar disorder (95 % CI 0.78, 0.85) among African-American high-utilizing Veterans. Racial disparities among high-utilizing Veterans may differ from those found in the general population. Interventions should devote attention to social, environmental, and mental health issues in order to reduce racial disparities in this vulnerable population.

  16. 77 FR 7243 - Proposed Information Collection (Operation Enduring Freedom/Operation Iraqi Freedom Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0728] Proposed Information Collection... Review AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY... announces that the Veterans Health Administration, Department of Veterans Affairs, will submit the...

  17. 75 FR 26683 - Hospital and Outpatient Care for Veterans Released From Incarceration to Transitional Housing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-12

    ... practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug [[Page 26685... care, Health facilities, Health professions, Health records, Homeless, Medical and dental schools... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN41 Hospital and Outpatient Care for...

  18. 78 FR 27882 - VA Veteran-Owned Small Business (VOSB) Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... Verification Self-Assessment Tool that walks the veteran through the regulation and how it applies to the...) Verification Guidelines AGENCY: Department of Veterans Affairs. ACTION: Advanced notice of proposed rulemaking... regulations governing the Department of Veterans Affairs (VA) Veteran-Owned Small Business (VOSB) Verification...

  19. 75 FR 79323 - Health Care for Homeless Veterans Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... to the Director, Regulations Management (02REG), Department of Veterans Affairs, 810 Vermont Ave., NW... received will be available for public inspection in the Office of Regulation Policy and Management, Room... period, comments may be viewed online through the Federal Docket Management System (FDMS) at http://www...

  20. Opioid and Other Substance Misuse, Overdose Risk, and the Potential for Prevention Among a Sample of OEF/OIF Veterans in New York City

    PubMed Central

    Bennett, Alex S.; Elliott, Luther; Golub, Andrew

    2013-01-01

    This paper describes veterans' overdose risks and specific vulnerabilities through an analysis of qualitative data collected from a sample of recently separated, formerly enlisted OEF/OIF veterans in the New York City area. We illustrate how challenges to the civilian readjustment process such as homelessness, unemployment, and posttraumatic stress disorder can render veterans at increased risk for negative health consequences and then present veterans' perspectives as they outline several innovative solutions to these obstacles. We conclude by discussing several overdose prevention efforts currently underway and how they might be adapted to meet the opioid and substance misuse challenges veterans face. PMID:23869461

  1. Causes of homelessness prevalence: Relationship between homelessness and disability.

    PubMed

    Nishio, Akihiro; Horita, Ryo; Sado, Tadahiro; Mizutani, Seiko; Watanabe, Takahiro; Uehara, Ryosuke; Yamamoto, Mayumi

    2017-03-01

    Many studies have reported that the prevalence of mental illness and cognitive disability is higher among homeless individuals compared to the general population, and the rates of mental illness among the homeless population have recently increased. This study: (i) compares causes of homelessness or barriers to escaping homelessness for people with/without mental illness/cognitive disability; (ii) reveals problems with the Japanese homeless policy; and (iii) proposes an effective and necessary support system. The participants were 114 homeless individuals. A psychiatric diagnostic interview and the Wechsler Adult Intelligence Scale, version III were used to measure participants' mental health and cognitive abilities. A questionnaire was administered comprising 17 items related to the causes of their homelessness and barriers to escaping from it. Participants were divided into four groups - with/without mental illness or cognitive disability - and Fisher's exact test was used to compare the questionnaire results. Individuals with cognitive disabilities considered bad relationships with their family members to be the cause of their homelessness. Conversely, normal individuals considered their homelessness to be the result of debt more so than did individuals with mental problems. Individuals with mental illness had more difficulties escaping homelessness than did either normal individuals or individuals with cognitive disability. This tendency was observed most strongly among individuals with both mental illness and cognitive disability. Most homeless individuals considered economic problems to be the cause of their homelessness; however, difficulties with human relationships were also important factors and were more difficult for participants to acknowledge. Furthermore, these difficulties were exacerbated among those individuals with mental problems. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  2. Financial Well-Being and Post-Deployment Adjustment among Iraq and Afghanistan War Veterans

    PubMed Central

    Elbogen, Eric B.; Johnson, CAPT Sally C.; Wagner, H. Ryan; Newton, Virginia M.; Beckham, Jean C.

    2012-01-01

    Research has yet to examine the relationship between financial well-being and community reintegration of veterans. To address this, we analyzed data from n=1,388 Iraq and Afghanistan War Era Veterans who completed a national survey on post-deployment adjustment. The results indicated that probable major depressive disorder, posttraumatic stress disorder, and traumatic brain injury were associated with financial difficulties. However, regardless of diagnosis, veterans who reported having money to cover basic needs were significantly less likely to have post-deployment adjustment problems such as criminal arrest, homelessness, substance abuse, suicidal behavior, and aggression. Statistical analyses also indicated that poor money management (e.g. incurring significant debt or writing bad checks) was related to maladjustment, even among veterans at higher income levels. Given these findings, efforts aimed at enhancing financial literacy and promoting meaningful employment may have promise to enhance outcomes and improve quality of life among returning veterans. PMID:22730842

  3. 77 FR 18258 - Federal Property Suitable as Facilities To Assist the Homeless

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ..., DC 20410; telephone (202) 708-1234; TTY number for the hearing- and speech-impaired (202) 708-2565.... McKinney Homeless Assistance Act (42 U.S.C. 11411), as amended, HUD is publishing this Notice to identify...

  4. Attributions about homelessness in homeless and domiciled people in Madrid, Spain: "Why are they homeless people?".

    PubMed

    Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

    2018-01-01

    Causal attributions of homelessness may affect both the design and acceptance of public policies aimed at improving the situation of homeless people and the strategies that homeless people themselves decide to adopt in order to cope with their situation. This article analyzes the differences in causal attributions of homelessness based on gender, age, nationality, educational background, perceived social class, evolution of personal economic situation, and future expectations between the members of 2 groups: (a) "homeless group", consisting of a representative sample of homeless people in Madrid, Spain (n = 188); and (b) "domiciled group", consisting of a sample of people in Madrid at no risk of homelessness (n = 180), matched for sex, age and nationality. Results show that among domiciled population, women, older people, those without university education, those considering themselves to belong to lower income social classes, those who considered their economic situation to have worsened, and those who expressed negative expectations for the future attributed homelessness to individualistic courses to a greater extent. Meanwhile, among homeless group, younger people, those without university education, those considering themselves to belong to higher social classes, those who perceived their economic situation as having improved in recent years, and those who expressed positive expectations for the future generally attributed homelessness to individualistic courses to a greater extent. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  5. 75 FR 79087 - Fund Availability Under the Supportive Services for Veteran Families Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ... DEPARTMENT OF VETERANS AFFAIRS Fund Availability Under the Supportive Services for Veteran... Veterans Affairs (VA) is announcing the availability of funds for supportive services grants under the Supportive Services for Veteran Families Program (SSVF Program). This Notice contains information concerning...

  6. Women service members, veterans, and their families: What we know now.

    PubMed

    Mankowski, Mariann; Everett, Joyce E

    2016-12-01

    The purpose of this paper is to highlight what we know now about female service members, veterans, and their families. The experiences of U.S. female service members and veterans are more complex than previous eras and significant demographic changes have taken place. U.S. female veterans are more likely to be younger, come from ethnic and racial minority groups, have children, and combat exposure. U.S. female service members report high rates of sexual violence and they are more vulnerable to homelessness and unemployment when compared to previous female military cohorts. U.S. female service members and veterans are also at higher risk for significant mental and health issues. Children and adolescents of women service members and veterans may also carry a heavy burden as a result of lengthy deployments. A majority of female service members and veterans will utilize community based healthcare and social services, therefore, it is essential that all healthcare providers understand the unique needs of this cohort of women. Practice implications at the micro, mezzo, and macro levels are discussed. Qualitative and quantitative studies that expand our understanding of women's experience in the military and as veterans are encouraged. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Supported Employment for Veterans With Traumatic Brain Injury: Patient Perspectives.

    PubMed

    Carlson, Kathleen F; Pogoda, Terri K; Gilbert, Tess A; Resnick, Sandra G; Twamley, Elizabeth W; O'Neil, Maya E; Sayer, Nina A

    2018-02-01

    To quantify the need for, and interest in, supported employment (SE) among recent military veterans with traumatic brain injury (TBI); and to examine characteristics associated with veterans' interest in SE. Stratified random sample of Iraq and Afghanistan War veterans confirmed to have TBI through the Veterans Health Administration (VHA) screening and evaluation system. Community-based via mailed survey. We recruited 1800 veterans with clinician-confirmed TBI (mild TBI: n=1080; moderate/severe TBI: n=720) through multiple mailings. Among 1451 surveys that were not returned undeliverable, N=616 (42%) responded. Not applicable. Veterans rated their interest in SE after reading a script describing the program. Additional measures assessed mental health and pain-related comorbidities, employment, financial/housing difficulties, demographics, and military service characteristics. Estimates were weighted to represent the population of veterans with VHA clinician-confirmed TBI. Unemployment was reported by 45% (95% confidence interval [CI], 43-47) of veterans with TBI. Although 42% (95% CI, 40-44) reported they would be interested in using SE if it were offered to them, only 12% had heard of SE (95% CI, 11-14) and <1% had used it. TBI severity and comorbidities were not associated with veterans' interest in SE. However, those who were unemployed, looking for work, experiencing financial strain, or at risk for homelessness were more likely to be interested in SE. Our research highlights an important gap between veterans' vocational needs and interests and their use of SE. Systematically identifying and referring those with employment and financial/housing difficulties may help close this gap. Published by Elsevier Inc.

  8. 76 FR 60135 - Proposed Information Collection (Appeal to Board of Veterans' Appeals) Activity Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-28

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0085] Proposed Information Collection (Appeal to Board of Veterans' Appeals) Activity Comment Request AGENCY: Board of Veterans' Appeals, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Board of Veterans' Appeals (BVA), Department of...

  9. 76 FR 64430 - Notice of Performance Review Board Members

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... DEPARTMENT OF VETERANS AFFAIRS Corporate Senior Executive Management Office Notice of Performance Review Board Members AGENCY: Department of Veterans Affairs. ACTION: Notice. SUMMARY: Under the..., Corporate Senior Executive Management Office, Department of Veterans Affairs, 810 Vermont Avenue, NW...

  10. Long-term and chronic homelessness in homeless women and women with children.

    PubMed

    Zlotnick, Cheryl; Tam, Tammy; Bradley, Kimberly

    2010-09-01

    The Chronic Homelessness initiative has directed millions of federal dollars to services for single "unaccompanied homeless" individuals, specifically excluding women living with their children. Using a data set with a nationally representative sample of homeless adults, we calculated the prevalence rates and profiles of long-term homelessness in homeless women (n = 849). With the exception of the criterion of being a single "unaccompanied individual," many women, including women with children, met the criteria for chronic homelessness including having a disability of mental health or substance abuse problems. Our findings suggest that the federal definition of chronic homelessness needs to be revised.

  11. 75 FR 39618 - Proposed Information Collection (Request for Identifying Information Re: Veteran's Loan Records...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-09

    ..., benefits will not be paid or furnished by reason of an incomplete application. Affected Public: Individuals... Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits....Regulations.gov or to Nancy J. Kessinger, Veterans Benefits Administration (20M35), Department of Veterans...

  12. 77 FR 52379 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... SMALL BUSINESS ADMINISTRATION Advisory Committee on Veterans Business Affairs AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Advisory Committee meeting. SUMMARY: The SBA is... Committee on Veterans Business Affairs. The meeting will be open to the public. DATES: September 10, 2012...

  13. 78 FR 70088 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-22

    ... SMALL BUSINESS ADMINISTRATION Advisory Committee on Veterans Business Affairs AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Advisory Committee meeting. SUMMARY: The SBA is... Committee on Veterans Business Affairs. The meeting will be open to the public. DATES: December 5, 2013 from...

  14. 75 FR 22434 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-28

    ... SMALL BUSINESS ADMINISTRATION Advisory Committee on Veterans Business Affairs AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Advisory Committee Meeting. SUMMARY: The SBA is... Committee on Veterans Business Affairs. The meeting will be open to the public. DATES: Tuesday, May 25, 2010...

  15. Health Correlates of Criminal Justice Involvement in 4,793 Transgender Veterans.

    PubMed

    Brown, George R; Jones, Kenneth T

    2015-12-01

    Transgender (TG) persons are overrepresented in prison settings and in the U.S. veteran population. Health disparities studies of large populations of transgender people involved with the criminal justice system have not been published to date. We studied a large cohort of TG veterans who received care in Veterans Health Administration (VHA) facilities during 2007-2013 (n = 4,793) and a 3:1 matched control group of veterans without known TG identification (n = 13,625). Three hundred twenty six (n = 138 TG, 188 non-TG) had received VHA services in programs designed to address the needs of justice involved (JI) veterans. We linked patients in each of the three groups to their medical and administrative data. TG veterans were more likely to be justice involved than controls (2.88% vs. 1.38%; P < .0001). Compared to non-TG JI veterans, TG JI veterans were more likely to have a history of homelessness (80% vs. 67%; P < .05) and to have reported sexual trauma while serving in the military (23% vs. 12%; P < .01). Significant health disparities were noted for TG JI veterans for depression, hypertension, obesity, posttraumatic stress disorder, serious mental illness, and suicidal ideation/attempts. These data suggest that TG veterans experience a number of health risks compared to non-TG veterans, including an increased likelihood of justice involvement. TG veterans involved with the criminal justice system are a particularly vulnerable group and services designed to address the health care needs of this population, both while incarcerated and when in the community, should take these findings into account in the development of health screenings and treatment plans.

  16. Desired Destinations of Homeless Women: Realizing Aspirations Within the Context of Homelessness.

    PubMed

    Biederman, Donna J; Forlan, Nicole

    2016-08-01

    Despite recent decreases, homelessness remains a substantial problem in the United States. Homelessness is associated with poor health, and homeless women experience earlier mortality than their housed counterparts. Understanding the aspirations of homeless women may offer service providers avenues for intervention to increase well-being among this vulnerable population. This study, a secondary analysis of transcribed interviews (n = 20), provides insight into the aspirations of homeless women. Opportunities for service providers to intervene on these aspirations within the context of homelessness are offered.

  17. Youth Homelessness 2006

    ERIC Educational Resources Information Center

    MacKenzie, David; Chamberlain, Chris

    2008-01-01

    The third national census of homeless school students, conducted in 2006, found that the number of homeless students had decreased since 2001. There were 9,389 homeless students in 2006 compared with 12,227 in 2001. Three groups were over-represented in the homeless population: Indigenous students, young people from single parent and blended…

  18. 75 FR 6227 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-08

    ... Business Administration. ACTION: Notice of open Federal Advisory Committee meeting. SUMMARY: The SBA is... Committee on Veterans Business Affairs. The meeting will be open to the public. DATES: Thursday, February 18... Affairs. The Advisory Committee on Veterans Business Affairs serves as an independent source of advice and...

  19. 76 FR 4125 - Notice of Proposed Information Collection for Public Comment: Notice of Funding Availability for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ... Information Collection for Public Comment: Notice of Funding Availability for the Transformation Initiative... Proposal: Notice of Funding Availability for the Transformation Initiative: Homeless Families Small Grant..., HUD-2993, HUD-96010 and HUD-96011. Members of the Affected Public: Institutions of higher education...

  20. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

    PubMed

    Brown, Rebecca T; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B

    2016-01-01

    Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18-25), and middle adulthood (ages 26-49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

  1. Risk factors associated with recurrent homelessness after a first homeless episode.

    PubMed

    McQuistion, Hunter L; Gorroochurn, Prakash; Hsu, Eustace; Caton, Carol L M

    2014-07-01

    Alcohol and drug use are commonly associated with the experience of homelessness. In order to better understand this, we explored the prevalence of drug and alcohol use as it related to successful re-housing within a sample of first-time single homeless adults at municipal shelters. From within this sample, we compared the features of recurrent homelessness with those of chronic homelessness and of being stably housed. We interviewed 344 subjects upon shelter entry and followed each one every six months for 18 months using standardized social and mental health measures. We analyzed baseline assessments relative to housing experiences during follow-up using Chi square and multinomial logistic regression. Eighty-one percent (N = 278) obtained housing over 18 months, of which 23.7 % (N = 66) experienced homelessness again. Recurrent homelessness was more common among those with a high school education and if initially re-housed with family. Bivariate analysis resulted in the observation of the highest rate of alcohol and other drug use among this recurrent group and multinomial logistic regression supported this only with the coupling of arrest history and diagnosed antisocial personality disorder. With relatively high rates of recurrent homelessness, there were differences between subjects who experienced recurrent homelessness compared to those who were stably housed and with chronic homelessness. That alcohol and other substance use disorders were associated with recurrent homelessness only if they were linked to other risk factors highlights the complexity of causes for homelessness and a resultant need to organize them into constellations of causal risk factors. Consistent with this, there should be initiatives that span bureaucratic boundaries so as to flexibly meet multiple complex service needs, thus improving outcomes concerning episodes of recurrent homelessness.

  2. A cluster randomized Hybrid Type III trial testing an implementation support strategy to facilitate the use of an evidence-based practice in VA homeless programs.

    PubMed

    Smelson, David A; Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Sawh, Leon; Glickman, Mark

    2015-05-28

    The Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program is one of the largest initiatives to end Veteran homelessness. However, mental health and substance use disorders continue to reduce client stability and impede program success. HUD-VASH programs do not consistently employ evidence-based practices that address co-occurring mental health and substance use disorders. This paper presents a study protocol to evaluate the implementation of an evidence-based, co-occurring disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) in HUD-VASH using an implementation strategy called Getting To Outcomes (GTO). In three large VA Medical Centers, this Hybrid Type III trial will randomize case managers and their clients by HUD-VASH sub-teams to receive either MISSION-Vet Implementation as Usual (IU-standard training and access to the MISSION-Vet treatment manuals) or MISSION-Vet implementation augmented by GTO. In addition to testing GTO, effectiveness of the treatment (MISSION-Vet) will be assessed using existing Veteran-level data from the HUD-VASH data monitoring system. This project will compare GTO and IU case managers and their clients on the following variables: (1) fidelity to the MISSION-Vet intervention; (2) proportion of time the Veteran is housed; (3) mental health, substance use, and functional outcomes among Veterans; and (4) factors key to the successful deployment of a new treatment as specified by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model. This project is an important step for developing an implementation strategy to increase adoption of evidence-based practice use in VA homeless programs, and to further examine efficacy of MISSION-Vet in HUD-VASH. This project has important implications for program managers, policy makers, and researchers within the homelessness field. VA Central IRB approval

  3. 77 FR 33229 - Notice of Proposed Information Collection for Public Comment; Continuum of Care Homeless...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... Information Collection for Public Comment; Continuum of Care Homeless Assistance Grant Application--Continuum of Care Application AGENCY: Office of Assistant Secretary for Community Planning and Development... collection for public comment entitled Continuum of Care of Homeless Assistance Grant Application- Continuum...

  4. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study

    PubMed Central

    Brown, Rebecca T.; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B.

    2016-01-01

    Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18–25), and middle adulthood (ages 26–49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs. PMID:27163478

  5. 76 FR 72977 - Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... DEPARTMENT OF LABOR Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting AGENCY: Veterans' Employment and Training Service, Labor. ACTION: Notice of open meeting... Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO). The ACVETEO will discuss...

  6. 77 FR 20436 - Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-04

    ... DEPARTMENT OF LABOR Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting AGENCY: Veterans' Employment and Training Service, Labor. ACTION: Notice of open meeting... Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO). The ACVETEO will discuss...

  7. 75 FR 24748 - Office of the Assistant Secretary for “Incarcerated Veterans Transition Program”

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ... DEPARTMENT OF LABOR Veterans' Employment and Training Office of the Assistant Secretary for ``Incarcerated Veterans Transition Program'' AGENCY: Veterans' Employment and Training Service, Department of Labor. Announcement Type: New Notice of Availability of Funds and Solicitation for Grant Applications...

  8. Actors, observers, and causal attributions of homelessness: Differences in attribution for the causes of homelessness among domiciled and homeless people in Madrid (Spain).

    PubMed

    Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

    2017-01-01

    The study analyzes the differences in causal attributions of homelessness and attributions of responsibility among the members of 3 groups: homeless group, consisting of a representative sample of homeless people in Madrid, Spain (n = 188); domiciled service-users group, consisting of people at risk of homelessness (n = 164); and domiciled nonservice-users group, consisting of people at no imminent risk of homelessness (n = 180). The domiciled service-users group and domiciled nonservice-users group were matched to the homeless group or sex, age, and nationality. The article also analyzes homeless people's causal attributions as regards their own situation. The results show that compared with the domiciled nonservice-users group, a higher percentage of members of the homeless group and domiciled service-users group attributed homelessness to individualistic causes and they blamed homeless people for their situation to a greater extent. The results also show that there was no "actor-observer bias" in causal attributions for homelessness in Madrid. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. 77 FR 30330 - Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-22

    ... Department of Labor's Veterans' Employment and Training Services' (VETS) core programs and new initiatives... DEPARTMENT OF LABOR Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting AGENCY: Veterans' Employment and Training Service, Labor. ACTION: Notice of open meeting...

  10. 77 FR 51579 - Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-24

    ... Department of Labor's Veterans Employment and Training Services' (VETS) core programs and new initiatives... DEPARTMENT OF LABOR Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting AGENCY: Veterans' Employment and Training Service, Labor. ACTION: Notice of Open Meeting...

  11. 77 FR 76074 - Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... Department of Labor's Veterans' Employment and Training Services' (VETS) core programs and new initiatives... DEPARTMENT OF LABOR Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO): Meeting AGENCY: Veterans' Employment and Training Service, Labor. ACTION: Notice of open meeting...

  12. 77 FR 17562 - Advisory Committee on Veterans Business Affairs; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-26

    ...: Small Business Administration. ACTION: Notice of Open Federal Advisory Committee Meeting. SUMMARY: The... the Advisory Committee on Veterans Business Affairs. The meeting will be open to the public. DATES... Veterans Business Affairs serves as an independent source of advice and policy recommendation to the...

  13. 76 FR 25400 - Advisory Committee on Veterans Business Affairs Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-04

    .... Small Business Administration. ACTION: Notice of open Federal Advisory Committee Meeting. SUMMARY: The... the Advisory Committee on Veterans Business Affairs. The meeting will be open to the public. DATES... Committee on Veterans Business Affairs serves as an independent source of advice and policy recommendation...

  14. 75 FR 53007 - Advisory Committee on Veterans Business Affairs; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    .... Small Business Administration. ACTION: Notice of open Federal Advisory Committee meeting. SUMMARY: The... the Advisory Committee on Veterans Business Affairs. The meeting will be open to the public. DATES... Affairs. The Advisory Committee on Veterans Business Affairs serves as an independent source of advice and...

  15. Life Shocks and Homelessness

    PubMed Central

    Corman, Hope; Noonan, Kelly; Reichman, Nancy E.

    2014-01-01

    We exploited an exogenous health shock—namely, the birth of a child with a severe health condition—to investigate the effect of a life shock on homelessness in large cities in the United States as well as the interactive effects of the shock with housing market characteristics. We considered a traditional measure of homelessness, two measures of housing instability thought to be precursors to homelessness, and a combined measure that approximates the broadened conceptualization of homelessness under the 2009 Homeless Emergency Assistance and Rapid Transition to Housing Act (2010). We found that the shock substantially increases the likelihood of family homelessness, particularly in cities with high housing costs. The findings are consistent with the economic theory of homelessness, which posits that homelessness results from a conjunction of adverse circumstances in which housing markets and individual characteristics collide. PMID:23868747

  16. 76 FR 8402 - Public Availability of the Department of Veterans Affairs FY 2010 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-14

    ... DEPARTMENT OF VETERANS AFFAIRS Public Availability of the Department of Veterans Affairs FY 2010 Service Contract Inventory AGENCY: Department of Veterans Affairs. ACTION: Notice of public availability... Consolidated Appropriations Act of 2010 (Pub. L. 111-117), Department of Veterans Affairs (VA) is publishing...

  17. 78 FR 23970 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force Meeting. SUMMARY: This document corrects the SBA's Interagency Task Force on Veterans Small Business Developments...

  18. 77 FR 49823 - Federal Property Suitable as Facilities To Assist the Homeless

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-17

    ... suitability for use to assist the homeless. HUD generally publishes this weekly report each Friday. Today's notice announces that due to the size of HUD's next report, the Office of the Federal Register has informed HUD that it cannot accommodate HUD's request to schedule publication of the report on Friday...

  19. Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China.

    PubMed

    Fu, Yan-Nan; Cao, Xiao-Lan; Hou, Cai-Lan; Ng, Chee H; Ungvari, Gabor S; Chiu, Helen F K; Lin, Yong-Qiang; Wang, Lihui; Zheng, Xiaocong; Jia, Fu-Jun; Xiang, Yu-Tao

    2017-09-01

    There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  20. Homelessness as culture: How transcultural nursing theory can assist caring for the homeless.

    PubMed

    Law, Kate; John, William

    2012-11-01

    The concepts of culture and homelessness are both complex and contested. This paper examines homelessness through the lens of transcultural nursing theory, increasing understanding of both homelessness and transcultural theory. We argue that homelessness can be usefully conceptualised as a culture and that the application of transcultural theory to caring for homeless people will add further to the utility of these theories. The application of transcultural theory can add to the repertoire of skills the nurse needs to care for not only homeless clients, but, for a diverse range of client groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. 75 FR 59282 - Notice of Availability: Notice of Funding Availability (NOFA) for Fiscal Year (FY) 2010 Continuum...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... and the HUD's Fiscal Year 2010 Notice of Funding Availability (NOFA) Policy Requirements and General...: Notice of Funding Availability (NOFA) for Fiscal Year (FY) 2010 Continuum of Care (CoC) Homeless... (Pub. L. 111-117, approved December 16, 2009). Carried over or recaptured funds from previous fiscal...

  2. 75 FR 62611 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be...

  3. 78 FR 7849 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force Meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

  4. 77 FR 41472 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-13

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be...

  5. 78 FR 70087 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-22

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

  6. 76 FR 8393 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-14

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be...

  7. 78 FR 45996 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-30

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

  8. 78 FR 21492 - Interagency Task Force on Veterans Small Business Development

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force Meeting... meeting of the Interagency Task Force on Veterans Small Business Development. The meeting will be open to...

  9. Homelessness: Recent Statistics, Targeted Federal Programs, and Recent Legislation

    DTIC Science & Technology

    2005-05-31

    submit semiannual financial and program reports, as well as a final report 90 days after the end of the project period. Transitional Living Program. (42...costs. To prevent homelessness, financial assistance may be given to families who have received eviction or termination of utility service notices if...assistance. Centers must also be equipped to provide job training, counseling and placement services (including job readiness and literacy and skills

  10. Homelessness in America.

    ERIC Educational Resources Information Center

    Baumohl, Jim, Ed.

    This book about homelessness in the United States offers 16 chapters in three parts. Part 1, "History Definitions, and Causes," includes: (1) "Redefining the Cursed Word: A Historical Interpretation of American Homelessness" (Kim Hopper and Jim Baumohl); (2) "Homelessness: Definitions and Counts" (Martha R. Burt); (3)…

  11. Homelessness and the Homeless: Responses and Innovations. A Canadian Contribution to IYSH 1987.

    ERIC Educational Resources Information Center

    Oberlander, H. Peter; Fallick, Arthur L.

    This report presents descriptions of successful Canadian public and private programs to aid the homeless and alleviate homelessness as part of participation in the International Year of Shelter for the Homeless (IYSH). Part 1, "The International Year of Shelter for the Homeless," includes the following: (1) objectives; (2) global…

  12. 76 FR 11855 - Advisory Committee on Disability Compensation; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-03

    ..., and give advice on the most appropriate means of responding to the needs of Veterans relating to... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Disability Compensation; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory...

  13. Double Jeopardy: Homeless & Illiterate.

    ERIC Educational Resources Information Center

    BCEL Newsletter for the Business Community, 1988

    1988-01-01

    For the first time, federal funding for literacy services will focus new attention on the plight of the homeless. Under the McKinney Homeless Assistance Act, each state will receive funds for literacy for the homeless. Although there are no firm estimates on how many persons are homeless, a number of indicators point to a problem of major and…

  14. 78 FR 21962 - Federal Property Suitable as Facilities To Assist the Homeless

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-12

    ...-1264 Directions: two buildings, an office & garage/storage facility; totaling approx. 4,320 sf. Comments: 12 months vacant; good conditions [FR Doc. 2013-08242 Filed 4-11-13; 8:45 am] BILLING CODE 4210... homeless use for a period of 60 days from the date of this Notice. Where property is described as for ``off...

  15. 75 FR 62438 - Interagency Task Force on Veterans Small Business Development Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-08

    ... SMALL BUSINESS ADMINISTRATION Interagency Task Force on Veterans Small Business Development Meeting AGENCY: U.S. Small Business Administration. ACTION: Notice of open Federal Interagency Task Force... first public meeting of the Interagency Task Force on Veterans Small Business Development. The meeting...

  16. 78 FR 68503 - Advisory Committee on Disability Compensation, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ..., and give advice on the most appropriate means of responding to the needs of Veterans relating to... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Disability Compensation, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C...

  17. Educating Homeless Students.

    ERIC Educational Resources Information Center

    Berliner, BethAnn

    2002-01-01

    Over the past decade, the number of homeless children in America has more than doubled. Educators, however, are still legally obligated to enroll and support them, because of the passage of the "No Child Left Behind" Act of 2001, which reauthorized the McKinney-Vento Homeless Assistance Act. Although schools cannot solve homelessness,…

  18. 75 FR 68007 - Office of the Assistant Secretary; The Advisory Committee on Veterans' Employment, Training and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-04

    ...; The Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO); Notice of Open Meeting The Advisory Committee on Veterans' Employment, Training and Employer Outreach (ACVETEO.... The ACVETEO is responsible for assessing employment and training needs of veterans; determining the...

  19. 77 FR 7243 - Agency Information Collection (Survey of Post-Deployment Adjustment Among OEF and OIF Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-10

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0727] Agency Information Collection (Survey... Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with the... Administration, Department of Veterans Affairs, will submit the collection of information abstracted below to the...

  20. 78 FR 75936 - Federal Property Suitable as Facilities To Assist the Homeless

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-13

    ... 4: 986 sf.; storage: 7,488 sf.; office 5: 12,250 sf.; office 6: 3,720 sf.; Two Gatehouses: 507 sf....; storage; moderate conditions; 60+ months vacant; asbestos & lead Wisconsin Wausau Army Reserve Ctr. 1300... homeless use for a period of 60 days from the date of this Notice. Where property is described as for ``off...

  1. Homeless, Not Hopeless. An Informational Guide for School Personnel: Understanding and Educating Homeless Students.

    ERIC Educational Resources Information Center

    Seifert, Elli; Stauffer, Carol

    This guide explains how to educate homeless students within the public schools, focusing on the Saint Paul, Minnesota, public schools. Section 1 defines homelessness. Section 2 presents data on the increasing numbers of homeless students in the area. Section 3 describes common problems faced by homeless students, including family mobility,…

  2. Recognizing the Needs of the Homeless.

    ERIC Educational Resources Information Center

    France, Joseph B.

    This paper summarizes reports and research on the homeless in the United States, presents findings of a survey of Red Cross chapters on services to the homeless, and describes programs for the homeless of selected Red Cross chapters. Section 1 discusses definitions of homelessness and methodologies used to count homeless people. The homeless are…

  3. A modified therapeutic community for homeless persons with co-occurring disorders of substance abuse and mental illness in a shelter: an outcome study.

    PubMed

    Skinner, Darren C

    2005-01-01

    This article reports on a study conducted to determine the effectiveness of a modified therapeutic community (MTC) shelter on client outcomes. The seven-study hypotheses focused on whether greater effectiveness in the MTC would be demonstrated in longer periods of sobriety, fewer days of psychiatric hospitalization, shorter lengths of stay in a shelter, positive discharge from the shelter, medication compliance, housing placement within the first year, and appropriate housing placement according to level of functioning. The study utilized a quasi-experimental design with two groups: 1) an experimental group (E) homeless persons with co-occurring disorders (COD) of substance abuse/dependence and mental illness who reside in a modified therapeutic community (N = 70); and 2) a comparison group (C) of veterans with CODs living in a general shelter (N = 70). The data collection procedures involved a retrospective review of closed case records for subjects in the facilities from September 1, 1998-June 1, 2000 for the MTC shelter, and from June 1, 1999-June 1, 2000 for the general shelter. Baseline differences between the E and C groups were found in age, length of homelessness, years of education, years of work experience, veteran status, marital status, and psychiatric diagnosis; all except for veteran status were unrelated to outcomes and were controlled in subsequent analyses. Significant difference was found on medication compliance when controlled for both groups. Overall, this study showed some promise for the MTC approach. The study also raised a question as to the contribution of veteran status to the differences between groups and to treatment of CODs.

  4. 76 FR 30244 - Veterans' Rural Health Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-24

    ... Integrated Service Network (VISN) 19 Women Veterans Healthcare Coordinator, Montana and surrounding region rural health project managers, the Veterans Rural Health Resource Center--Western Region Native Domain... Network Director, VISN 19 Telehealth Manager, Veterans Health Administration (VHA) lead for the Supporting...

  5. Induced abortion among women veterans: data from the ECUUN study.

    PubMed

    Schwarz, Eleanor Bimla; Sileanu, Florentina E; Zhao, Xinhua; Mor, Maria K; Callegari, Lisa S; Borrero, Sonya

    2018-01-01

    We compared rates of induced abortion among women veterans receiving Veterans Affairs (VA) healthcare to rates in the general US population, as current policy prohibits VA provision of abortion counseling or services even when pregnancy endangers a veteran's life. We analyzed data from 2298 women veterans younger than 45 years who completed a telephone-based, cross-sectional survey of randomly sampled English-speaking women from across the United States who had received VA healthcare. We compared lifetime, last-5-year and last-year rates of unintended pregnancy and abortion among participants to age-matched data from the National Survey of Family Growth. As few abortions were reported in the last year, we used multivariable logistic regression to examine associations between abortion in the last 5 years and age, race/ethnicity, income, education, religion, marital status, parity, geography, deployment history, housing instability, and past medical and mental health among VA patients. Women veterans were more likely than matched US women to report ever having an abortion [17.7%, 95% confidence interval (CI): 16.1%-19.3% vs. 15.2% of US women]. In the last 5 years, unintended pregnancy and abortion were reported by veterans at rates similar to US women. In multivariable models, VA patients were more likely to report abortion in the last 5 years if their annual income was less than $40,000 (adjusted odds ratio (OR) 2.95, 95% CI 1.30-6.70), they had experienced homelessness or housing instability (adjusted OR 1.91, 95% CI 1.01-3.62), they were single (adj. OR 2.46, 95% CI 1.23-4.91) and/or they had given birth (adjusted OR 2.29, 95% CI 1.19-4.40). Women veterans face unintended pregnancy and seek abortion as often as the larger US population. The Veterans Health Care Act, which prohibits provision of abortion services, increases vulnerable veterans' out-of-pocket healthcare costs and limits veterans' reproductive freedom. Copyright © 2017. Published by Elsevier Inc.

  6. Rates and correlates of tobacco cessation service use nationally in the Veterans Health Administration.

    PubMed

    Kelly, Megan M; Sido, Hannah; Rosenheck, Robert

    2016-05-01

    Tobacco use is a substantial problem for veterans using Veterans Health Administration (VHA) services, but relatively little is known about the association of specific patient characteristics, patterns of service use, the amount of such services, and the frequency of their use. Analysis of national VHA administrative data (N = 5,531,379) from fiscal year 2012 (FY2012) were used to identify use of tobacco cessation counseling services among veterans with a diagnosed tobacco use disorder, and to examine correlates of such use. Only 3.8% of veterans diagnosed with a tobacco use disorder used VHA tobacco cessation services, and only 0.9% met U.S. Public Health Service clinical practice guidelines for the recommended amount of counseling (i.e., 4 or more sessions). Veterans who used intensive tobacco cessation counseling services were more likely to be homeless, had comorbid mental health and substance use disorders, and used more VHA services overall than veterans who did not use tobacco cessation services. An analysis of the supply of tobacco cessation services (counseling visits provided per 100 veteran users of any services at each facility) showed that increasing the supply by just 1 visit for every 100 veterans would increase the percentage of veterans involved in tobacco cessation counseling by 35%. Veterans diagnosed with tobacco use disorder substantially underuse VHA tobacco cessation counseling services, and use is greatest at facilities that provide more tobacco cessation counseling services. Future efforts should focus on increasing the amount of VHA tobacco cessation services and encouraging veterans' awareness of and motivation to use these services. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Medical-Legal Partnerships At Veterans Affairs Medical Centers Improved Housing And Psychosocial Outcomes For Vets.

    PubMed

    Tsai, Jack; Middleton, Margaret; Villegas, Jennifer; Johnson, Cindy; Retkin, Randye; Seidman, Alison; Sherman, Scott; Rosenheck, Robert A

    2017-12-01

    Medical-legal partnerships-collaborations between legal professionals and health care providers that help patients address civil legal problems that can affect health and well-being-have been implemented at several Veterans Affairs (VA) medical centers to serve homeless and low-income veterans with mental illness. We describe the outcomes of veterans who accessed legal services at four partnership sites in Connecticut and New York in the period 2014-16. The partnerships served 950 veterans, who collectively had 1,384 legal issues; on average, the issues took 5.4 hours' worth of legal services to resolve. The most common problems were related to VA benefits, housing, family issues, and consumer issues. Among a subsample of 148 veterans who were followed for one year, we observed significant improvements in housing, income, and mental health. Veterans who received more partnership services showed greater improvements in housing and mental health than those who received fewer services, and those who achieved their predefined legal goals showed greater improvements in housing status and community integration than those who did not. Medical-legal partnerships represent an opportunity to expand cross-sector, community-based partnerships in the VA health care system to address social determinants of mental health.

  8. 77 FR 51113 - Letter of Intent To Apply for Funding Available Under the Supportive Services for Veteran...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-23

    ... and renewal supportive services grant application processes, and amount of funding available. DATES... Supportive Services for Veteran Families Program AGENCY: Department of Veterans Affairs. ACTION: Notice... entities interested in applying for funding under the Supportive Services for Veteran Families (SSVF...

  9. The Rights of Homeless Students.

    ERIC Educational Resources Information Center

    Strong, Penny

    This booklet presents information concerning homelessness and the education of homeless children nationwide and in Illinois. Estimates of the number of homeless children vary widely. Reasons for homeless children's failure to attend school include school residency requirements, delays in transfer of documents, and lack of transportation. The…

  10. Intellectual disability and homelessness.

    PubMed

    Mercier, C; Picard, S

    2011-04-01

    The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a team dedicated to homeless persons. (1) To describe the characteristics, history and current situation of these persons; and (2) to report within-group differences as a function of gender and current residential status. The data were collected from files using an anonymous chart summary. Descriptive statistics on the whole sample (n = 68) and inferential statistics on cross-tabulations by gender and residential status were performed. Persons with ID exhibited several related problems. Some of these persons, primarily women, experienced relatively short periods of homelessness and their situations stabilised once they were identified and followed up. Other persons with ID experienced chronic homelessness that appeared to parallel the number and severity of their other problems. When compared with a previous epidemiological study of the homeless in Montreal, the population of homeless persons with ID differed from the overall homeless population in a number of respects. The results suggest prevention and intervention targets. The need for epidemiological research appears particularly clear in light of the fact that below-average intellectual functioning has been identified as a risk factor for homelessness and a predisposing factor for vulnerability among street people. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

  11. The New Homelessness Revisited

    PubMed Central

    Lee, Barrett A.; Tyler, Kimberly A.; Wright, James D.

    2014-01-01

    The ‘new homelessness’ has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since the mid-1990s differentiate among types of homelessness, provide credible demographic estimates, and show how being homeless affects a person's life chances and coping strategies. Agreement also exists about the main macro- and micro-level causes of homelessness. Active lines of inquiry examine public, media, and governmental responses to the problem as well as homeless people's efforts to mobilize on their own behalf. Despite the obstacles faced when studying a stigmatized population marked by high turnover and weak anchors to place, recent investigations have significantly influenced homelessness policy. A greater emphasis on prevention should further strengthen the research-policy nexus. PMID:24910495

  12. 78 FR 48543 - Veterans Health Administration Fund Availability Under the VA's Homeless Providers Grant and Per...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ..., Department of Veterans Affairs, 10770 N. 46th Street, Suite C-200, Tampa, FL 33617; (toll-free) (877) 332... vocational development, benefits management, fiduciary or money management services, medication compliance..., Department of Veterans Affairs, 10770 N. 46th Street, Suite C-200, Tampa, FL 33617; (toll- free) (877) 332...

  13. Housing and Homelessness: A Report.

    ERIC Educational Resources Information Center

    National Alliance to End Homelessness, Washington, DC.

    This report focuses on options for rehousing the individuals and families who are currently homeless in America, and on strategies for preventing homelessness of additional people. As many as 736,000 persons are estimated to be homeless on any given night, and between 1.3 million and 2 million different individuals may experience homelessness at…

  14. 75 FR 13212 - Advisory Committee on Women Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ...) that a meeting of the Advisory Committee on Women Veterans will be held on March 30-April 1, 2010, at... Administration initiatives targeting women Veterans. On March 31, the Committee will meet in the South American AB Room and the session will include an update on VA's outreach to women Veterans, VA's contract exam...

  15. Pennsylvania's Rural Homeless Reality.

    ERIC Educational Resources Information Center

    Center for Rural Pennsylvania, Harrisburg.

    The Center for Rural Pennsylvania analyzed data from the Pennsylvania Department of Public Welfare concerning rural homelessness for fiscal years 1997 through 1999. Findings indicate that rural Pennsylvania has a homeless population and it is growing. In 1999, more than 21,700 clients received homeless assistance in rural areas, 44 percent of whom…

  16. 75 FR 4632 - Voluntary Service National Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... Awards, VAVS Award for Excellence, and the NAC Volunteer of the Year Awards. The April 8 business session... volunteers, cultural transformation, and assisting homeless veterans. On April 9, the educational workshops will be repeated in the morning and the business session will be held in the afternoon and will include...

  17. "Not Homeless Yet. I'm Kind of Couch Surfing": Finding Identities for People at a Homeless Shelter.

    PubMed

    Terui, Sachiko; Hsieh, Elaine

    2016-01-01

    The meanings of homelessness are fluid and socially constructed, providing resources and limitations for individuals to negotiate their identities and relationships in everyday life. In this study, we examine the strategies and corresponding resources utilized by people who are homeless to cope with the labeling of a homeless identity and to redefine their identities. We used constant comparative analysis to examine in-depth interviews with 16 participants (male = 11, female = 5) who access a local homeless shelter in the southwest United States for resources. We identified three strategies that homeless people adopt to cope with the labeling of homeless identity: (a) differentiating oneself from others who are homeless, (b) prioritizing certain aspects of life, and (c) embracing the status of homelessness. Although these strategies have been identified in previous literature, the authors extend this line of research by identifying the common resources people who are homeless utilize when adopting these strategies, which entail important implications for theory development and practical implications.

  18. 77 FR 31915 - National Research Advisory Council, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-30

    ... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the National Research Advisory Council will hold a meeting on Wednesday, June 13, 2012, in...

  19. 77 FR 9302 - National Research Advisory Council; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-16

    ... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the National Research Advisory Council will hold a meeting on Wednesday, February 22, 2012, in...

  20. 76 FR 15055 - National Research Advisory Council; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the National Research Advisory Council will hold a meeting on Monday, April 18, 2011, in...

  1. 77 FR 49060 - National Research Advisory Council, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the National Research Advisory Council will hold a meeting on Wednesday, September 19, 2012, in...

  2. 75 FR 3539 - National Research Advisory Council; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-21

    .... The purpose of the Council is to provide external advice and review for VA's research mission. The... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act...

  3. Comparisons of family environment between homeless and non-homeless individuals with schizophrenia in Xiangtan, Hunan.

    PubMed

    Chen, Jinliang; Chen, Jindong; Li, Shuchun; Liu, Jun; Ouyang, Guohua; Luo, Wenxuan; Guo, Xiaofeng; Li, Ting; Li, Kaijie; Li, Zhenkuo; Wang, Gan

    2015-06-25

    Homelessness is an increasingly important problem for individuals with serious mental illness in China. Identify the characteristics of families that are associated with homelessness among individuals with schizophrenia. Participants were 1856 homeless individuals with schizophrenia (defined as those who had no place of residence or involved caregivers for 7 consecutive days) and 1728 non-homeless individuals with schizophrenia from Xiangtan, Hunan. The self-completion Family Environment Scale-Chinese Version (FES-CV) was administered to these participants after their acute psychotic symptoms resolved. Compared to individuals in the non-homeless group, those in the homeless group were older and more likely to be non-locals (i.e., from outside of Xiangtan), be residents of rural (versus urban) communities, have temporary (versus permanent) jobs, be married, and have a low level of education. After controlling for demographic differences using multivariate logistic regression models, homelessness was independently associated higher scores in the FES-CV intellectual-cultural orientation, organization, achievement orientation, and control subscales and with lower scores in the FES-CV cohesion, moralreligious emphasis, independence, and active-recreational orientation subscales. After controlling for sociodemographic factors, certain aspects of the family environment areassociated with being homeless among patients with schizophrenia in China. Further work is needed to identify interventions that can reduce the risk of homelessness in high-risk individuals.

  4. 76 FR 71441 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... DEPARTMENT OF VETERANS AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development of Permanent Housing Facilities in Augusta, ME AGENCY: Department of Veterans Affairs. ACTION: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The...

  5. 77 FR 76170 - National Academic Affiliations Council, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... enhancements and implications for mental health education. On January 11, the Council will hear from officials... DEPARTMENT OF VETERANS AFFAIRS National Academic Affiliations Council, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2...

  6. 78 FR 36644 - National Research Advisory Council, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C., App. 2, that the National Research Advisory Council will hold a meeting on Wednesday, June 19, 2013, in...

  7. 77 FR 70548 - National Research Advisory Council, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C., App. 2, that the National Research Advisory Council will hold a meeting on Wednesday, December 5, 2012, in...

  8. 75 FR 55634 - National Research Advisory Council; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-13

    ... provide external advice and review for VA's research mission. The agenda will include a review of the VA... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act...

  9. 78 FR 18680 - National Research Advisory Council, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C., App. 2, that the National Research Advisory Council will hold a meeting on Thursday, March 28, 2013, in...

  10. 75 FR 56661 - Agency Information Collection (Request for Identifying Information Re: Veteran's Loan Records...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-16

    ... Benefits Administration (VBA), Department of Veterans Affairs, will submit the collection of information... one year form the date of such notification, benefits will not be paid or furnished by reason of an... Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with the...

  11. Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy.

    PubMed

    Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Byrne, Thomas Hugh; Smelson, David A

    2017-03-09

    Incorporating evidence-based integrated treatment for dual disorders into typical care settings has been challenging, especially among those serving Veterans who are homeless. This paper presents an evaluation of an effort to incorporate an evidence-based, dual disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) into case management teams serving Veterans who are homeless, using an implementation strategy called Getting To Outcomes (GTO). This Hybrid Type III, cluster-randomized controlled trial assessed the impact of GTO over and above MISSION-Vet Implementation as Usual (IU). Both conditions received standard MISSION-Vet training and manuals. The GTO group received an implementation manual, training, technical assistance, and data feedback. The study occurred in teams at three large VA Medical Centers over 2 years. Within each team, existing sub-teams (case managers and Veterans they serve) were the clusters randomly assigned. The trial assessed MISSION-Vet services delivered and collected via administrative data and implementation barriers and facilitators, via semi-structured interview. No case managers in the IU group initiated MISSION-Vet while 68% in the GTO group did. Seven percent of Veterans with case managers in the GTO group received at least one MISSION-Vet session. Most case managers appreciated the MISSION-Vet materials and felt the GTO planning meetings supported using MISSION-Vet. Case manager interviews also showed that MISSION-Vet could be confusing; there was little involvement from leadership after their initial agreement to participate; the data feedback system had a number of difficulties; and case managers did not have the resources to implement all aspects of MISSION-Vet. This project shows that GTO-like support can help launch new practices but that multiple implementation facilitators are needed for successful execution of a complex evidence

  12. 76 FR 67022 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... DEPARTMENT OF VETERANS AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development of a Permanent Housing Facility in Northampton, MA AGENCY: Department of Veterans Affairs. ACTION: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The...

  13. Addressing Homelessness: Recent Happenings--Iowa, 2004

    ERIC Educational Resources Information Center

    Iowa Department of Education, 2004

    2004-01-01

    This guide provides information on the following resources available to the homeless in Iowa: (1) Funding Sources for School District Programs Serving Homeless Students; (2) Local Educational Liaison for Homeless Children and Youth; (3) Homeless Advisory Committee; (4) Identification, Counting, and Maintaining Data at the Local School District…

  14. 78 FR 54733 - National Research Advisory Council; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-05

    ... p.m. The purpose of the Council is to provide external advice and review for VA's research mission... DEPARTMENT OF VETERANS AFFAIRS National Research Advisory Council; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C., App. 2...

  15. 76 FR 27388 - Special Medical Advisory Group; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... DEPARTMENT OF VETERANS AFFAIRS Special Medical Advisory Group; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Special Medical Advisory Group will meet on May 26, 2011, in Room 830 at VA Central Office, 810 Vermont...

  16. Homelessness in Augusta, Georgia. Preliminary Report.

    ERIC Educational Resources Information Center

    George, Shirley A.; Bennett, Gerald

    Two studies examined homelessness in Augusta, Georgia. The Key Informant Survey, conducted in 1987, involved interviewing individuals (N=42) knowledgeable about homeless people in the community. In the Shelter and Street Surveys of homeless people, conducted in March (N=51) and July (N=71) of 1988, homeless subjects were interviewed concerning…

  17. 78 FR 38099 - Notice of Intent To Grant An Exclusive License

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ... Research and Development, Department of Veterans Affairs. ACTION: Notice of intent. SUMMARY: Notice is hereby given that the Department of Veterans Affairs (VA), Office of Research and Development (ORD), intends to grant to Somahlution, Inc., a Delaware corporation, doing business at 3401 Fiechtner Drive...

  18. 75 FR 31842 - Advisory Committee on Disability Compensation; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-04

    ... assessment of the effectiveness of the rating schedule and give advice on the most appropriate means of... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Disability Compensation; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory...

  19. 77 FR 58913 - Genomic Medicine Program Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-24

    ... DEPARTMENT OF VETERANS AFFAIRS Genomic Medicine Program Advisory Committee, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Genomic Medicine Program Advisory Committee will meet on October 16, 2012, at the American...

  20. 75 FR 61861 - Genomic Medicine Program Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... DEPARTMENT OF VETERANS AFFAIRS Genomic Medicine Program Advisory Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Genomic Medicine Program Advisory Committee will meet on October 22, 2010, at the Embassy...

  1. 77 FR 16898 - Genomic Medicine Program Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ... DEPARTMENT OF VETERANS AFFAIRS Genomic Medicine Program Advisory Committee, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Genomic Medicine Program Advisory Committee will meet on April 17, 2012, at the Sheraton...

  2. Educating Homeless Youth in Texas: The McKinney-Vento Homeless Education Assistance Improvements Act of 2001.

    PubMed

    Windsor, Liliane Cambraia; Thompson, Sanna J

    2008-07-01

    This paper discusses homeless youth in the US focusing on educational issues addressed by the implementation of the McKinney-Vento Homeless Education Assistance Improvements Act of 2001. This law requires that states ensure each homeless child has equal access to public education. Moreover, the law requires states to identify and remove barriers to homeless children's education, such as requirements for previous school records and proof of residency. Following description of homelessness, educational issues, and barriers for homeless youth, the McKinney-Vento Act is described as it is applied in Texas. Finally, the paper concludes that further development, education, and commitment from service providers in schools and other community agencies will be needed to improve outcomes for these highly vulnerable youth.

  3. 34 CFR 303.17 - Homeless children.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Homeless children. 303.17 Section 303.17 Education... DISABILITIES General Definitions Used in This Part § 303.17 Homeless children. Homeless children means children who meet the definition given the term homeless children and youths in section 725 (42 U.S.C. 11434a...

  4. 34 CFR 303.17 - Homeless children.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Homeless children. 303.17 Section 303.17 Education... DISABILITIES General Definitions Used in This Part § 303.17 Homeless children. Homeless children means children who meet the definition given the term homeless children and youths in section 725 (42 U.S.C. 11434a...

  5. 34 CFR 303.17 - Homeless children.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Homeless children. 303.17 Section 303.17 Education... DISABILITIES General Definitions Used in This Part § 303.17 Homeless children. Homeless children means children who meet the definition given the term homeless children and youths in section 725 (42 U.S.C. 11434a...

  6. Perceived reasons for loss of housing and continued homelessness among homeless persons with mental illness.

    PubMed

    Mojtabai, Ramin

    2005-02-01

    The objective of this study was to examine the reasons for the most recent loss of housing and for continued homelessness as perceived by homeless persons with mental illness. A total of 2,974 currently homeless participants in the 1996 National Survey of Homeless Assistance Providers and Clients (NSHAPC) were asked about the reasons for their most recent loss of housing and continued homelessness. The responses of participants who had mental illness, defined both broadly and narrowly, were compared with responses of those who were not mentally ill. The broad definition of mental illness was based on a set of criteria proposed by NSHAPC investigators. The narrow definition included past psychiatric hospitalization in addition to the NSHAPC criteria. A total of 1,620 participants (56 percent) met the broad definition of mental illness, and 639 (22 percent) met the narrow definition; 1,345 participants (44 percent) did not meet any of these criteria and were categorized as not having a mental illness. Few differences in reasons for the most recent loss of housing were noted between the participants with and without mental illness. Both groups attributed their continued homelessness mostly to insufficient income, unemployment, and lack of suitable housing. Homeless persons with mental illness mostly report the same reasons for loss of housing and continued homelessness as those who do not have a mental illness. This finding supports the view that structural solutions, such as wider availability of low-cost housing and income support, would reduce the risk of homelessness among persons with mental illness, as among other vulnerable social groups.

  7. Homeless Health Concerns

    MedlinePlus

    ... make it worse. That's why the health of homeless people in the United States is worse than that of the general population. Common health problems include Mental health problems Substance abuse ... and skin infections Many homeless women are victims of domestic or sexual abuse. ...

  8. Housing as an intervention on hospital use: access among chronically homeless persons with disabilities.

    PubMed

    Parker, David

    2010-12-01

    A study examining demographics and hospital utilization for chronically homeless persons with disabilities was conducted at pre-housing enrollment and at 6 months post-housing. Of the 20 participants, 70% (n = 14) were Black American and 30% (n = 6) were White; 100% (n = 20) were non-Hispanic; 90% (n = 18) were men; 40% (n = 8) were veterans; Median years since last permanent housing and total homelessness were 7 and 10.5 respectively. The following increases were observed: employment (0 to 1); income (20%, n = 4 to 35%, n = 7); primary care (25%, n = 5 to 95%, n = 19); and mental health service use (25%, n = 5 to 60%, n = 12). Known disabilities included HIV (15%, n = 3); hepatitis C (45%, n = 9); mental illness (60%, n = 12) and substance abuse (80%, n = 16) with 45% (n = 9) dually diagnosed. Over the course of the study, Emergency department visits and inpatient hospitalization use decreased. While these differences were not statistically significant (p = 0.14 and p = 0.31, respectively), they translate to an estimated $250,208 savings.

  9. 77 FR 70549 - Advisory Committee on Disability Compensation, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... ongoing assessment of the effectiveness of the rating schedule, and give advice on the most appropriate... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Disability Compensation, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C...

  10. 78 FR 32710 - Advisory Committee on Disability Compensation, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    ... Armed Forces, provide an ongoing assessment of the effectiveness of the rating schedule, and give advice... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Disability Compensation, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C...

  11. 75 FR 27385 - Advisory Committee on Disability Compensation; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... effectiveness of the rating schedule and give advice on the most appropriate means of responding to the needs of... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Disability Compensation; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory...

  12. 76 FR 24573 - Genomic Medicine Program Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ... DEPARTMENT OF VETERANS AFFAIRS Genomic Medicine Program Advisory Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Genomic Medicine Program Advisory Committee will meet on May 20, 2011, at the St. Regis Hotel...

  13. Faces of Homelessness: A Teacher's Guide.

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Education, Quincy.

    A brief teacher's guide supplements a videotape of two 15-minute segments on homelessness. The stated objective of the video is to cover the issues of homelessness as they exist today and to dispel the stereotypes of homelessness leftover from earlier eras. A family which has found itself homeless is introduced and then aspects of the phenomenon…

  14. 77 FR 70210 - Agency Information Collection (VA Subcontracting Report for Service Disabled Veteran-owned Small...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... Subcontracting Report for Service Disabled Veteran-owned Small Business and Veteran-owned Small Business Concerns) Activities Under OMB Review AGENCY: Office of Small and Disadvantaged Business Utilization, Department of... U.S.C. 3501-3521), this notice announces that the Office of Small and Disadvantaged Business...

  15. Testing Alternative Definitions of Chronic Homelessness.

    PubMed

    Byrne, Thomas; Culhane, Dennis P

    2015-09-01

    This study examined the potential impact of a proposed change to the official federal definition of chronic homelessness. Using administrative data from the emergency shelters in a large U.S. city, this study estimated the number of persons identified as chronically homeless under the current definition of chronic homelessness, a proposed new federal definition, and two alternative definitions and examined shelter utilization for each group. Fewer than half as many people were considered chronically homeless under the proposed new federal definition compared with the current definition. Persons considered chronically homeless by the proposed new definition and, to a lesser extent, by the two alternative definitions, made heavier use of shelter compared with persons who met the current definition. A proposed new and two alternative definitions of chronic homelessness are better suited than the existing federal definition for identifying persons with the most protracted experiences of homelessness.

  16. 78 FR 68503 - Advisory Committee on Minority Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... Cemetery Administration (NCA), Center for Women Veterans, Veteran Employment Services Office, Office of... 10:00 a.m. to 10:15 a.m. After public comment, the Committee will continue to work on their report. A...

  17. 78 FR 23333 - Special Medical Advisory Group, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-18

    ... DEPARTMENT OF VETERANS AFFAIRS Special Medical Advisory Group, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Special Medical Advisory Group will meet on May 1, 2013, in Room 830 at VA Central Office, 810 Vermont...

  18. 77 FR 77186 - Advisory Committee on Disability Compensation; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-31

    ... effectiveness of the rating schedule, and give advice on the most appropriate means of responding to the needs... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Disability Compensation; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C...

  19. 78 FR 58612 - Genomic Medicine Program Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-24

    ... DEPARTMENT OF VETERANS AFFAIRS Genomic Medicine Program Advisory Committee, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Genomic Medicine Program Advisory Committee will meet on October 16, 2013, at the Sheraton...

  20. Are social network correlates of heavy drinking similar among black homeless youth and white homeless youth?

    PubMed

    Wenzel, Suzanne L; Hsu, Hsun-Ta; Zhou, Annie; Tucker, Joan S

    2012-11-01

    Understanding factors associated with heavy drinking among homeless youth is important for prevention efforts. Social networks are associated with drinking among homeless youth, and studies have called for attention to racial differences in networks that may affect drinking behavior. This study investigates differences in network characteristics by the racial background of homeless youth, and associations of network characteristics with heavy drinking. (Heavy drinking was defined as having five or more drinks of alcohol in a row within a couple of hours on at least one day within the past 30 days.) A probability sample of 235 Black and White homeless youths ages 13-24 were interviewed in Los Angeles County. We used chi-square or one-way analysis of variance tests to examine network differences by race and logistic regressions to identify network correlates of heavy drinking among Black and White homeless youth. The networks of Black youth included significantly more relatives and students who attend school regularly, whereas the networks of White youth were more likely to include homeless persons, relatives who drink to intoxication, and peers who drink to intoxication. Having peers who drink heavily was significantly associated with heavy drinking only among White youth. For all homeless youth, having more students in the network who regularly attend school was associated with less risk of heavy drinking. This study is the first to our knowledge to investigate racial differences in network characteristics and associations of network characteristics with heavy drinking among homeless youth. White homeless youth may benefit from interventions that reduce their ties with peers who drink. Enhancing ties to school-involved peers may be a promising intervention focus for both Black and White homeless youth.

  1. Homeless youth: a concept analysis.

    PubMed

    Washington, Philisie Starling

    2011-07-01

    INTRODUCTION. A variety of terms have been used to describe the homeless youth population. PURPOSE. The purpose of this article is to analyze the conceptual meanings of the term homeless youths by examining the evolution of the concept and its related terms in the current literature. Method. Online databases from 1990-2010 were analyzed using the Rodgers evolutionary approach. RESULTS. The 6 attributes relating to homeless youth were physical location, age, health, behavior, choice, and survival. CONCLUSION. The analysis provided insight and clarification of homeless youth from a variety of related terms in the literature.

  2. Health-Seeking Challenges Among Homeless Youth

    PubMed Central

    Hudson, Angela L.; Nyamathi, Adeline; Greengold, Barbara; Slagle, Alexandra; Koniak-Griffin, Deborah; Khalilifard, Farinaz; Getzoff, Daniel

    2010-01-01

    Background Approximately 1.5 to 2 million homeless young persons live on the streets in the United States. With the current economic situation, research is needed on quality of services geared toward homeless young adults. Objectives The objective of this study was to explore homeless young adults' perspectives on barriers and facilitators of health-care-seeking behavior and their perspectives on improving existing programs for homeless persons. Methods This article is a descriptive qualitative study using focus groups, with a purposeful sample of 24 homeless drug-using young adults. Results Identified themes were failing access to care based on perceived structural barriers (limited clinic sites, limited hours of operation, priority health conditions, and long wait times) and social barriers (perception of discrimination by uncaring professionals, law enforcement, and society in general). Discussion Results provide insight into programmatic and agency resources that facilitate health-seeking behaviors among homeless young adults and include implications for more research with providers of homeless health and social services. PMID:20404776

  3. 41 CFR 60-250.64 - Show cause notices.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Show cause notices. 60-250.64 Section 60-250.64 Public Contracts and Property Management Other Provisions Relating to Public... SPECIAL DISABLED VETERANS, VETERANS OF THE VIETNAM ERA, RECENTLY SEPARATED VETERANS, AND OTHER PROTECTED...

  4. 41 CFR 60-250.64 - Show cause notices.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Show cause notices. 60-250.64 Section 60-250.64 Public Contracts and Property Management Other Provisions Relating to Public... SPECIAL DISABLED VETERANS, VETERANS OF THE VIETNAM ERA, RECENTLY SEPARATED VETERANS, AND OTHER PROTECTED...

  5. 41 CFR 60-250.64 - Show cause notices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Show cause notices. 60-250.64 Section 60-250.64 Public Contracts and Property Management Other Provisions Relating to Public... SPECIAL DISABLED VETERANS, VETERANS OF THE VIETNAM ERA, RECENTLY SEPARATED VETERANS, AND OTHER PROTECTED...

  6. 41 CFR 60-250.64 - Show cause notices.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Show cause notices. 60-250.64 Section 60-250.64 Public Contracts and Property Management Other Provisions Relating to Public... SPECIAL DISABLED VETERANS, VETERANS OF THE VIETNAM ERA, RECENTLY SEPARATED VETERANS, AND OTHER PROTECTED...

  7. 75 FR 66385 - Notice of Availability: Notice of Funding Availability (NOFA) for Fiscal Year 2010; Special Needs...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-28

    ... programs, Homeless Management Information System (HMIS) data collection, reporting and research, including..., HUD. ACTION: Notice. SUMMARY: HUD announces the availability of the applicant information, deadline information, and other requirements for the Fiscal Year (FY) 2010 Special Needs Assistance Programs Technical...

  8. Physical and Mental Health Issues among Homeless Youth in British Columbia, Canada: Are they Different from Older Homeless Adults?

    PubMed

    Saddichha, Sahoo; Linden, Isabelle; Krausz, Michael Reinhardt

    2014-09-01

    Youth homelessness is on the rise in North America, yet this vulnerable population is rarely studied and compared with adults. This paper aimed to study the homeless youth and identify specific vulnerabilities, which rendered them different from the adult homeless population. It also aimed to describe the youth homeless population and their significant co-morbidities. DATA WAS DERIVED FROM THE BC HEALTH OF THE HOMELESS STUDY (BCHOHS), CARRIED OUT IN THREE CITIES IN BRITISH COLUMBIA, CANADA: the large urban centre Vancouver (n=250); the mid-sized city and capital of the province Victoria (n=150). Measures included socio-demographic information, the Maudsley Addiction Profile (MAP), the Childhood Trauma Questionnaire (CTQ) and the Mini International Neuropsychiatric Interview (MINI) Plus. Youth constituted 16.5% (n=82) of the homeless population. Compared to the adult homeless, the homeless youth were more often female (55%), were Aboriginal (47.6%), had greater substance abuse of alcohol (70.7%), amphetamines (8.5%) and cannabis (75.6%). A lower prevalence of sexually transmitted diseases (0.2%) and psychotic disorders (13.4%) was also observed. The prevalence of traumatic experiences, other psychiatric disorders and physical illnesses were similar between the adult and homeless youth. Homeless youth have high rates of physical and psychiatric comorbidity, similar to the adult homeless, despite being 20 years younger. An urgent need for interventions that go beyond the standardized ones being offered to homeless populations as a whole, and to derive specific strategies that target this vulnerable population is required.

  9. 38 CFR 20.300 - Rule 300. Place of filing Notice of Disagreement and Substantive Appeal.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Rule 300. Place of filing Notice of Disagreement and Substantive Appeal. 20.300 Section 20.300 Pensions, Bonuses, and Veterans... § 20.300 Rule 300. Place of filing Notice of Disagreement and Substantive Appeal. The Notice of...

  10. Are Social Network Correlates of Heavy Drinking Similar Among Black Homeless Youth and White Homeless Youth?

    PubMed Central

    Wenzel, Suzanne L.; Hsu, Hsun-Ta; Zhou, Annie; Tucker, Joan S.

    2012-01-01

    Objective: Understanding factors associated with heavy drinking among homeless youth is important for prevention efforts. Social networks are associated with drinking among homeless youth, and studies have called for attention to racial differences in networks that may affect drinking behavior. This study investigates differences in network characteristics by the racial background of homeless youth, and associations of network characteristics with heavy drinking. (Heavy drinking was defined as having five or more drinks of alcohol in a row within a couple of hours on at least one day within the past 30 days.) Method: A probability sample of 235 Black and White homeless youths ages 13–24 were interviewed in Los Angeles County. We used chi-square or one-way analysis of variance tests to examine network differences by race and logistic regressions to identify network correlates of heavy drinking among Black and White homeless youth. Results: The networks of Black youth included significantly more relatives and students who attend school regularly, whereas the networks of White youth were more likely to include homeless persons, relatives who drink to intoxication, and peers who drink to intoxication. Having peers who drink heavily was significantly associated with heavy drinking only among White youth. For all homeless youth, having more students in the network who regularly attend school was associated with less risk of heavy drinking. Conclusions: This study is the first to our knowledge to investigate racial differences in network characteristics and associations of network characteristics with heavy drinking among homeless youth. White homeless youth may benefit from interventions that reduce their ties with peers who drink. Enhancing ties to school-involved peers may be a promising intervention focus for both Black and White homeless youth. PMID:23036205

  11. No Homeless Child Left behind

    ERIC Educational Resources Information Center

    Saxberg, David

    2011-01-01

    Although it is difficult to determine the precise number of homeless children, the National Coalition for the Homeless reports that there are more than 1.3 million children lacking a permanent residence on any given night. Further, 39 percent of the homeless population was comprised of children under the age of 18 in July 2009, the most recent…

  12. 75 FR 17771 - Comment Request for Information Collection for Jobs for Veterans Act Priority of Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-07

    .... Affected Public: Administrators of qualified job training programs, as defined in the Jobs for Veterans Act... DEPARTMENT OF LABOR Comment Request for Information Collection for Jobs for Veterans Act Priority... Training Administration. ACTION: Notice. SUMMARY: The Department of Labor, as part of its continuing effort...

  13. Characteristics, clinical course, and outcomes of homeless and non-homeless patients admitted to ICU: A retrospective cohort study

    PubMed Central

    Kaur, Maninder; Ashraf, Said

    2017-01-01

    Background Little is known about homeless patients in intensive care units (ICUs). Objectives To compare clinical characteristics, treatments, and outcomes of homeless to non-homeless patients admitted to four ICUs in a large inner-city academic hospital. Methods 63 randomly-selected homeless compared to 63 age-, sex-, and admitting-ICU-matched non-homeless patients. Results Compared to matched non-homeless, homeless patients (average age 48±12 years, 90% male, 87% admitted by ambulance, 56% mechanically ventilated, average APACHE II 17) had similar comorbidities and illness severity except for increased alcohol (70% vs 17%,p<0.001) and illicit drug(46% vs 8%,p<0.001) use and less documented hypertension (16% vs 40%,p = 0.005) or prescription medications (48% vs 67%,p<0.05). Intensity of ICU interventions was similar except for higher thiamine (71% vs 21%,p<0.0001) and nicotine (38% vs 14%,p = 0.004) prescriptions. Homeless patients exhibited significantly lower Glasgow Coma Scores and significantly more bacterial respiratory cultures. Longer durations of antibiotics, vasopressors/inotropes, ventilation, ICU and hospital lengths of stay were not statistically different, but homeless patients had higher hospital mortality (29% vs 8%,p = 0.005). Review of all deaths disclosed that withdrawal of life-sustaining therapy occurred in similar clinical circumstances and proportions in both groups, regardless of family involvement. Using multivariable logistic regression, homelessness did not appear to be an independent predictor of hospital mortality. Conclusions Homeless patients, admitted to ICU matched to non-homeless patients by age and sex (characteristics most commonly used by clinicians), have higher hospital mortality despite similar comorbidities and illness severity. Trends to longer durations of life supports may have contributed to the higher mortality. Additional research is required to validate this higher mortality and develop strategies to improve outcomes

  14. Vision Problems in Homeless Children.

    PubMed

    Smith, Natalie L; Smith, Thomas J; DeSantis, Diana; Suhocki, Marissa; Fenske, Danielle

    2015-08-01

    Vision problems in homeless children can decrease educational achievement and quality of life. To estimate the prevalence and specific diagnoses of vision problems in children in an urban homeless shelter. A prospective series of 107 homeless children and teenagers who underwent screening with a vision questionnaire, eye chart screening (if mature enough) and if vision problem suspected, evaluation by a pediatric ophthalmologist. Glasses and other therapeutic interventions were provided if necessary. The prevalence of vision problems in this population was 25%. Common diagnoses included astigmatism, amblyopia, anisometropia, myopia, and hyperopia. Glasses were required and provided for 24 children (22%). Vision problems in homeless children are common and frequently correctable with ophthalmic intervention. Evaluation by pediatric ophthalmologist is crucial for accurate diagnoses and treatment. Our system of screening and evaluation is feasible, efficacious, and reproducible in other homeless care situations.

  15. 76 FR 65563 - Genomic Medicine Program Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-21

    ... DEPARTMENT OF VETERANS AFFAIRS Genomic Medicine Program Advisory Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Genomic Medicine Program Advisory Committee will meet on November 2, 2011, at the Hamilton Crowne Plaza, 14th and K Streets, NW.,...

  16. 78 FR 50145 - Advisory Committee on Women Veterans, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... will include overview briefings from the Atlanta VA Medical Center leadership and the VA Southeast... on the Million Veteran Program, the Women Veterans Health Committee, the Women's Health Collaborative.... A briefing from local Memorial Affairs leadership will also be presented. On August 23, the...

  17. Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders.

    PubMed

    Brown, Rebecca T; Thomas, M Lori; Cutler, Deborah F; Hinderlie, Mark

    2013-01-01

    The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent supportive housing programs are presented as a potential solution to elder homelessness, and Hearth, an outreach and permanent supportive housing model in Boston, is described. Finally, specific policy changes are presented that could promote access to housing among the growing older homeless population.

  18. Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders

    PubMed Central

    Brown, Rebecca T.; Thomas, M. Lori; Cutler, Deborah F.; Hinderlie, Mark

    2014-01-01

    The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent supportive housing programs are presented as a potential solution to elder homelessness, and Hearth, an outreach and permanent supportive housing model in Boston, is described. Finally, specific policy changes are presented that could promote access to housing among the growing older homeless population. PMID:24729832

  19. Addressing the health needs of the homeless.

    PubMed

    John, William; Law, Kate

    2011-03-01

    Several authors have alluded to the complex health needs of the homeless population in the UK. The correlation between homelessness and a wide range of health problems has been explored in the literature. This paper presents a literature review exploring the biological, psychosocial and sexual health needs of single homeless people. The relationship between health and homelessness is analysed in relation to theories of health inequalities, which suggest that being homeless may be both a cause and a consequence of ill health. The contemporary nurse can play a vital role in helping to overcome the barriers that homeless people face when accessing health services. This paper explores the skills and approaches that nurses in a wide variety of settings can employ in addressing the health issues of homeless clients.

  20. The effects of the therapeutic workplace and heavy alcohol use on homelessness among homeless alcohol-dependent adults.

    PubMed

    Carlson, Emily; Holtyn, August F; Fingerhood, Michael; Friedman-Wheeler, Dara; Leoutsakos, Jeannie-Marie S; Silverman, Kenneth

    2016-11-01

    A clinical trial demonstrated that a therapeutic workplace could promote alcohol abstinence in homeless, alcohol-dependent adults. This secondary-data analysis examined rates of homelessness and their relation to the therapeutic workplace intervention and alcohol use during the trial. In the trial, homeless, alcohol-dependent adults could work in a therapeutic workplace for 6 months and were randomly assigned to Unpaid Training, Paid Training, or Contingent Paid Training groups. Unpaid Training participants were not paid for working. Paid Training participants were paid for working. Contingent Paid Training participants were paid for working if they provided alcohol-negative breath samples. Rates of homelessness during the study were calculated for each participant and the three groups were compared. Mixed-effects regression models were conducted to examine the relation between alcohol use (i.e., heavy drinking, drinks per drinking day, and days of alcohol abstinence) and homelessness. Unpaid Training, Paid Training, and Contingent Paid Training participants did not differ in the percentage of study days spent homeless (31%, 28%, 17%; respectively; F(2,94)=1.732, p=0.183). However, participants with more heavy drinking days (b=0.350, p<0.001), more drinks per drinking day (b=0.267, p<0.001), and fewer days of alcohol abstinence (b=-0.285, p<0.001) spent more time homeless. Reducing heavy drinking and alcohol use may help homeless, alcohol-dependent adults transition out of homelessness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. 77 FR 76170 - Presumption of Exposure to Herbicides for Blue Water Navy Vietnam Veterans Not Supported

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... DEPARTMENT OF VETERANS AFFAIRS Presumption of Exposure to Herbicides for Blue Water Navy Vietnam Veterans Not Supported ACTION: Notice. SUMMARY: On May 20, 2011, at the request of the Department of... during the Vietnam War. After careful review of the IOM report, the Secretary determines that the...

  2. Psychological distress among homeless adults.

    PubMed

    Gelberg, L; Linn, L S

    1989-05-01

    Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

  3. Remote eye care screening for rural veterans with Technology-based Eye Care Services: a quality improvement project.

    PubMed

    Maa, April Y; Wojciechowski, Barbara; Hunt, Kelly; Dismuke, Clara; Janjua, Rabeea; Lynch, Mary G

    2017-01-01

    Veterans are at high risk for eye disease because of age and comorbid conditions. Access to eye care is challenging within the entire Veterans Hospital Administration's network of hospitals and clinics in the USA because it is the third busiest outpatient clinical service and growing at a rate of 9% per year. Rural and highly rural veterans face many more barriers to accessing eye care because of distance, cost to travel, and difficulty finding care in the community as many live in medically underserved areas. Also, rural veterans may be diagnosed in later stages of eye disease than their non-rural counterparts due to lack of access to specialty care. In March 2015, Technology-based Eye Care Services (TECS) was launched from the Atlanta Veterans Affairs (VA) as a quality improvement project to provide eye screening services for rural veterans. By tracking multiple measures including demographic and access to care metrics, data shows that TECS significantly improved access to care, with 33% of veterans receiving same-day access and >98% of veterans receiving an appointment within 30 days of request. TECS also provided care to a significant percentage of homeless veterans, 10.6% of the patients screened. Finally, TECS reduced healthcare costs, saving the VA up to US$148 per visit and approximately US$52 per patient in round trip travel reimbursements when compared to completing a face-to-face exam at the medical center. Overall savings to the VA system in this early phase of TECS totaled US$288,400, about US$41,200 per month. Other healthcare facilities may be able to use a similar protocol to extend care to at-risk patients.

  4. Can Better National Policy End Family Homelessness?

    ERIC Educational Resources Information Center

    Roman, Nan

    2010-01-01

    An understanding of the close link between federal policy and family homelessness is critical for ensuring that one day no child in the United States is homeless. This article discusses the nature of family homelessness, the national policy framework that exists to help vulnerable families, the homeless assistance system that federal policy has…

  5. A Comparison of Weight-Related Behaviors among High School Students Who Are Homeless and Non-Homeless

    ERIC Educational Resources Information Center

    Fournier, Mary E.; Austin, S. Bryn; Samples, Cathryn L.; Goodenow, Carol S.; Wylie, Sarah A.; Corliss, Heather L.

    2009-01-01

    Background: Previous research has shown that youth who are homeless engage in high-risk behaviors. However, there has been little information published on nutritional and physical activity behaviors in this population, and studies comparing homeless youth in school with their non-homeless peers are scarce. This study compares weight-related risk…

  6. Nutrition and health services needs among the homeless.

    PubMed Central

    Wiecha, J L; Dwyer, J T; Dunn-Strohecker, M

    1991-01-01

    This review discusses nutrition and related health problems among homeless Americans, summarizes recent information, and identifies needs for services and future research. The nature of homelessness today provides a context for the discussion. Many homeless persons eat fewer meals per day, lack food more often, and are more likely to have inadequate diets and poorer nutritional status than housed U.S. populations. Yet many homeless people eligible for food stamps do not receive them. While public and private agencies provide nutritious food and meals for homeless persons, availability of the services to homeless persons is limited. Many homeless people lack appropriate health care, and certain nutrition-related health problems are prevalent among them. Compared with housed populations, alcoholism, anemia, and growth problems are more common among homeless persons, and pregnancy rates are higher. The risks vary among homeless persons for malnutrition, nutrition-related health problems, drug and alcohol abuse, and mental illness. For example, among homeless persons, fewer heads of families than single adults are substance abusers, and mental illness varies in prevalence among single men, single women, and parents in homeless families. Homeless persons need improved access to food, nutrition, and health services. More nutrition education needs to be available to them and to service providers. Use of representative samples and validation of self-reported nutrition and health data will help future investigators to clarify the relationships between the characteristics of the homeless and their nutritional status. PMID:1908587

  7. 75 FR 62448 - Advisory Committee on Former Prisoners of War; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-08

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Former Prisoners of War; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Advisory Committee on Former Prisoners of War has scheduled a meeting on October 25...

  8. 76 FR 68524 - Advisory Committee on Former Prisoners of War, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-04

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Former Prisoners of War, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Advisory Committee on Former Prisoners of War has scheduled a meeting on November 14...

  9. Parenting while Being Homeless

    ERIC Educational Resources Information Center

    Swick, Kevin J.; Williams, Reginald; Fields, Evelyn

    2014-01-01

    This article explores the dynamics of parenting while being in a homeless context. The mosaic of stressors involved in this homeless parenting process are explicated and discussed. In addition, resources and strategies that may support parenting are presented and discussed.

  10. 77 FR 40591 - Applications for New Awards; Veterans Upward Bound Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-10

    ...: Regular UB grants, UB Math and Science (UBMS) grants, and Veterans UB (VUB) grants. This notice announces... who in the first year of postsecondary education placed into college-level math and English without...

  11. Understanding the Homeless: From Research to Action.

    ERIC Educational Resources Information Center

    Baumann, Donald; Grigsby, Charles

    A study was conducted to examine the homeless population of Austin, Texas and to determine who the homeless were, how they became homeless, how they saw themselves and others, what their needs were, and how they were being served by agencies. Survey data were collected from 500 homeless persons. This document summarizes findings from 3 years of…

  12. The lived experiences of homeless men.

    PubMed

    Lafuente, C R; Lane, P L

    1995-01-01

    To investigate the phenomenon of social disaffiliation in homeless men, a qualitative study was conducted that used a framework of Bahr's (1973) social disaffiliation theory. Ten homeless men were interviewed to determine their reasons for becoming homeless, their feelings about being homeless, and the specific resources they used for maintaining life on the streets. Using a semistructured interview, audiotapes were made of the responses of the 10 men, 20 to 61 years old, who were using a shelter for the homeless in a U.S. southern city. For data analysis, Giorgi's phenomenological approach (cited in Omery, 1983) was used. Activities and resources that the men used to meet their social, economic, and other needs were described. The following three major themes were identified: rejection, uncertainty, and social isolation. Recommendations include changing nursing curricula and conducting staff development programs, testing interventions to alleviate social isolation, and assisting the homeless to return to the societal mainstream.

  13. 77 FR 13390 - Veterans' Rural Health Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-06

    ...) that the Veterans' Rural Health Advisory Committee will hold a meeting on March 29-30, 2012, at the... services for these Veterans. In the morning of March 29, the Committee will hear from its Chairman; the... March 30, the Committee will hear opening remarks from its Chairman; receive briefings on the South...

  14. Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics.

    PubMed

    Krupski, Antoinette; Graves, Meredith C; Bumgardner, Kristin; Roy-Byrne, Peter

    2015-11-01

    The present study of homeless non-treatment-seeking problem drug users was designed to complement and extend previous studies which focused exclusively on treatment-seeking homeless problem drug users. Data were available for 866 primary care patients with drug problems, 30% homeless and 70% housed. In the 2 years prior to baseline, homeless participants had less chronic medical co-morbidity than problem drug users who were housed yet were significantly more likely to have used emergency department services, to have used them more frequently, and at higher cost. Compared to their housed counterparts, homeless participants were also more likely to have been admitted to specialized chemical dependency treatment and/or detoxification services, to have been arrested for a felony or gross misdemeanor, and to report having psychiatric problems in the prior 30 days. Additional support may be necessary for homeless patients presenting in primary care to benefit from substance abuse treatment given their more severe drug use problems coupled with their co-morbid health, psychiatric, and psychosocial problems. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. 77 FR 19058 - Advisory Committee on Former Prisoners of War, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-29

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Former Prisoners of War, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Advisory Committee on Former Prisoners of War has scheduled a meeting on April 9-11...

  16. Homelessness and Its Effects on Children.

    ERIC Educational Resources Information Center

    Hart-Shegos, Ellen

    Homelessness influences every facet of children's lives, inhibiting their physical, emotional, cognitive, social, and behavioral development. Homeless women face such obstacles to healthy pregnancies as chemical abuse, chronic health problems, and lack of prenatal care. Homeless infants are more likely to have low birth weights and are at greater…

  17. 34 CFR 300.19 - Homeless children.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

  18. 34 CFR 300.19 - Homeless children.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

  19. 34 CFR 300.19 - Homeless children.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

  20. 34 CFR 300.19 - Homeless children.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

  1. 34 CFR 300.19 - Homeless children.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Homeless children. 300.19 Section 300.19 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.19 Homeless children. Homeless children has the...

  2. Tuberculosis among the homeless, United States, 1994-2010.

    PubMed

    Bamrah, S; Yelk Woodruff, R S; Powell, K; Ghosh, S; Kammerer, J S; Haddad, M B

    2013-11-01

    1) To describe homeless persons diagnosed with tuberculosis (TB) during the period 1994-2010, and 2) to estimate a TB incidence rate among homeless persons in the United States. TB cases reported to the National Tuberculosis Surveillance System were analyzed by origin of birth. Incidence rates were calculated using the US Department of Housing and Urban Development homeless population estimates. Analysis of genotyping results identified clustering as a marker for transmission among homeless TB patients. Of 270,948 reported TB cases, 16,527 (6%) were homeless. The TB incidence rate among homeless persons ranged from 36 to 47 cases per 100,000 population in 2006-2010. Homeless TB patients had over twice the odds of not completing treatment and of belonging to a genotype cluster. US- and foreign-born homeless TB patients had respectively 8 and 12 times the odds of substance abuse. Compared to the general population, homeless persons had an approximately 10-fold increase in TB incidence, were less likely to complete treatment and more likely to abuse substances. Public health outreach should target homeless populations to reduce the excess burden of TB in this population.

  3. Housing as an Intervention on Hospital Use: Access among Chronically Homeless Persons with Disabilities

    PubMed Central

    2010-01-01

    A study examining demographics and hospital utilization for chronically homeless persons with disabilities was conducted at pre-housing enrollment and at 6 months post-housing. Of the 20 participants, 70% (n = 14) were Black American and 30% (n = 6) were White; 100% (n = 20) were non-Hispanic; 90% (n = 18) were men; 40% (n = 8) were veterans; Median years since last permanent housing and total homelessness were 7 and 10.5 respectively. The following increases were observed: employment (0 to 1); income (20%, n = 4 to 35%, n = 7); primary care (25%, n = 5 to 95%, n = 19); and mental health service use (25%, n = 5 to 60%, n = 12). Known disabilities included HIV (15%, n = 3); hepatitis C (45%, n = 9); mental illness (60%, n = 12) and substance abuse (80%, n = 16) with 45% (n = 9) dually diagnosed. Over the course of the study, Emergency department visits and inpatient hospitalization use decreased. While these differences were not statistically significant (p = 0.14 and p = 0.31, respectively), they translate to an estimated $250,208 savings. PMID:21125341

  4. The Second Student-Run Homeless Shelter

    ERIC Educational Resources Information Center

    Seider, Scott C.

    2012-01-01

    From 1983-2011, the Harvard Square Homeless Shelter (HSHS) in Cambridge, Massachusetts, was the only student-run homeless shelter in the United States. However, college students at Villanova, Temple, Drexel, the University of Pennsylvania, and Swarthmore drew upon the HSHS model to open their own student-run homeless shelter in Philadelphia,…

  5. Newly homeless youth typically return home.

    PubMed

    Milburn, Norweeta G; Rosenthal, Doreen; Rotheram-Borus, Mary Jane; Mallett, Shelley; Batterham, Philip; Rice, Eric; Solorio, Rosa

    2007-06-01

    Newly homeless adolescents from Melbourne, Australia (n = 165) and Los Angeles, United States (n = 261) were surveyed and followed for 2 years. Most newly homeless adolescents returned home (70% U.S., 47% Australia) for significant amounts of time (39% U.S., 17% Australia more than 12 months) within 2 years of becoming homeless.

  6. Homeless Students at the School Door.

    ERIC Educational Resources Information Center

    Pawlas, George E.

    1994-01-01

    The United States has about 225,000 to 500,000 homeless children. In 1987, Congress passed a comprehensive law to provide emergency and long-term assistance for homeless persons. Under the Stewart B. McKinney Act, states receive funding to investigate homeless children's needs, identify education obstacles, and develop plans to overcome them. Tips…

  7. 48 CFR 5.206 - Notices of subcontracting opportunities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... subcontracts, to increase participation by qualified HUBZone small business, small, small disadvantaged, women-owned small business, veteran-owned small business and service-disabled veteran-owned small business.... (b) The notices must describe— (1) The business opportunity; (2) Any prequalification requirements...

  8. 48 CFR 5.206 - Notices of subcontracting opportunities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... subcontracts, to increase participation by qualified HUBZone small business, small, small disadvantaged, women-owned small business, veteran-owned small business and service-disabled veteran-owned small business.... (b) The notices must describe— (1) The business opportunity; (2) Any prequalification requirements...

  9. 48 CFR 5.206 - Notices of subcontracting opportunities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... subcontracts, to increase participation by qualified HUBZone small business, small, small disadvantaged, women-owned small business, veteran-owned small business and service-disabled veteran-owned small business.... (b) The notices must describe— (1) The business opportunity; (2) Any prequalification requirements...

  10. 48 CFR 5.206 - Notices of subcontracting opportunities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... subcontracts, to increase participation by qualified HUBZone small business, small, small disadvantaged, women-owned small business, veteran-owned small business and service-disabled veteran-owned small business.... (b) The notices must describe— (1) The business opportunity; (2) Any prequalification requirements...

  11. 48 CFR 5.206 - Notices of subcontracting opportunities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... subcontracts, to increase participation by qualified HUBZone small business, small, small disadvantaged, women-owned small business, veteran-owned small business and service-disabled veteran-owned small business.... (b) The notices must describe— (1) The business opportunity; (2) Any prequalification requirements...

  12. 78 FR 16364 - Advisory Committee on Former Prisoners of War, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-14

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Former Prisoners of War, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Advisory Committee on Former Prisoners of War will meet on March 25-27, 2013, in Room...

  13. The Allegheny initiative for mental health integration for the homeless: integrating heterogeneous health services for homeless persons.

    PubMed

    Gordon, Adam J; Montlack, Melissa L; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer

    2007-03-01

    The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment.

  14. The Allegheny Initiative for Mental Health Integration for the Homeless: Integrating Heterogeneous Health Services for Homeless Persons

    PubMed Central

    Gordon, Adam J.; Montlack, Melissa L.; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer

    2007-01-01

    The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment. PMID:17267708

  15. The psychosocial profile of adolescent risk of homelessness.

    PubMed

    Bearsley-Smith, Cate A; Bond, Lyndal M; Littlefield, Lyn; Thomas, Lyndal R

    2008-06-01

    To contrast the psychosocial profile of adolescents with risk factors for homelessness, identified using Chamberlain and MacKenzie's self-report scale, compared to the profiles of homeless adolescents. Multinomial logistic regression analyses were conducted contrasting profiles for (a) 137 homeless adolescents, (b) 766 secondary students reporting risk factors for homelessness, and (c) 4,844 students not reporting risks for homelessness. Fourteen percent of a representative population of at-school adolescents, from Victoria, Australia, showed elevated risk of homelessness. These adolescents showed depressive symptoms at least equivalent to homeless adolescents (RR 6.0, 95% CI: 4.9, 7.3, and RR 3.5, 95% CI: 2.1, 5.8, respectively). In multivariate analyses, homeless and at risk adolescents reported equivalent levels of family conflict, early problem behaviour and low opportunities and rewards for family involvement. Compared to adolescents not at risk, at risk adolescents were more likely to be female and to show poorer social skills/assertiveness and depressive symptoms. Compared to at risk adolescents, homeless adolescents showed additional family, school, peer and individual risks, but lower depressive symptomatology. The findings highlight the potential we have to quickly and simply detect adolescents showing significant risk of homelessness. This sizable minority of adolescents report risks often equivalent to homeless adolescents. It is hoped that stakeholders working with young people will utilise this screening potential to identify and intervene effectively with this significant subpopulation of youth, and their families, while they are still at home and school.

  16. Immediate Enrollment under McKinney-Vento: How Schools Can Keep Homeless Students Safe. Best Practices in Homeless Education

    ERIC Educational Resources Information Center

    National Center for Homeless Education at SERVE, 2007

    2007-01-01

    Children and youth in homeless situations, particularly unaccompanied youth and survivors of domestic violence, are at a high risk for experiencing violence and victimization. Frequently, unaccompanied youth become homeless after leaving abusive or destructive home environments. In turn, their homelessness, which often involves "couch…

  17. Measuring pain in the context of homelessness

    PubMed Central

    Matter, Rebecca; Kline, Susan; Cook, Karon F.; Amtmann, Dagmar

    2009-01-01

    Purpose The primary objective of this study was to inform the development of measures of pain impact appropriate for all respondents, including homeless individuals, so that they can be used in clinical research and practice. The secondary objective was to increase understanding about the unique experience of homeless people with pain. Methods Seventeen homeless individuals with chronic health conditions (often associated with pain) participated in cognitive interviews to test the functioning of 56 pain measurement items and provided information about their experience living with and accessing treatment for pain. Results The most common problems identified with items were that they lacked clarity or were irrelevant in the context of homelessness. Items that were unclear, irrelevant and/or had other identified problems made it difficult for participants to respond. Participants also described multiple ways in which their pain was exacerbated by conditions of homelessness and identified barriers to accessing appropriate treatment. Conclusions Results suggested that the majority of items were problematic for the homeless and require substantial modifications to make the pain impact bank relevant to this population. Additional recommendations include involving homeless in future item bank development, conducting research on the topic of pain and homelessness, and using cognitive interviewing in other types of health disparities research. PMID:19582592

  18. 76 FR 41553 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-14

    ... Business Administration. ACTION: Notice of open Federal Advisory Committee Meeting. SUMMARY: The SBA is... Committee on Veterans Business Affairs. The meeting will be open to the public. DATES: July 28, 2011 from 9... Business Affairs serves as an independent source of advice and policy recommendation to the Administrator...

  19. 77 FR 31420 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ... Business Administration. ACTION: Notice of open Federal Advisory Committee Meeting. SUMMARY: The SBA is... Committee on Veterans Business Affairs. The meeting will be open to the public. DATES: June 4, 2012 from 9 a... Business Affairs serves as an independent source of advice and policy recommendation to the Administrator...

  20. Tuberculosis and homelessness in the United States, 1994-2003.

    PubMed

    Haddad, Maryam B; Wilson, Todd W; Ijaz, Kashef; Marks, Suzanne M; Moore, Marisa

    2005-06-08

    Tuberculosis (TB) rates among US homeless persons cannot be calculated because they are not included in the US Census. However, homelessness is often associated with TB. To describe homeless persons with TB and to compare risk factors and disease characteristics between homeless and nonhomeless persons with TB. Cross-sectional analysis of all verified TB cases reported into the National TB Surveillance System from the 50 states and the District of Columbia from 1994 through 2003. Number and proportion of TB cases associated with homelessness, demographic characteristics, risk factors, disease characteristics, treatment, and outcomes. Of 185,870 cases of TB disease reported between 1994 and 2003, 11,369 were among persons classified as homeless during the 12 months before diagnosis. The annual proportion of cases associated with homelessness was stable (6.1%-6.7%). Regional differences occurred with a higher proportion of TB cases associated with homelessness in western and some southern states. Most homeless persons with TB were male (87%) and aged 30 to 59 years. Black individuals represented the highest proportion of TB cases among the homeless and nonhomeless. The proportion of homeless persons with TB who were born outside the United States (18%) was lower than that for nonhomeless persons with TB (44%). At the time of TB diagnosis, 9% of homeless persons were incarcerated, usually in a local jail; 3% of nonhomeless persons with TB were incarcerated. Compared with nonhomeless persons, homeless persons with TB had a higher prevalence of substance use (54% alcohol abuse, 29.5% noninjected drug use, and 14% injected drug use), and 34% of those tested had coinfection with human immunodeficiency virus. Compared with nonhomeless persons, TB disease in homeless persons was more likely to be infectious but not more likely to be drug resistant. Health departments managed 81% of TB cases in homeless persons. Directly observed therapy, used for 86% of homeless patients

  1. Intellectual Disability and Homelessness

    ERIC Educational Resources Information Center

    Mercier, C.; Picard, S.

    2011-01-01

    Background: The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a…

  2. Where Do You Go from Nowhere: Homelessness in Maryland.

    ERIC Educational Resources Information Center

    Health and Welfare Council of Central Maryland, Inc., Baltimore.

    This report assesses the extent of homelessness in Maryland. Data are provided in the following areas: (1) the number of homeless people; (2) causes of homelessness; (3) distribution of the homeless and characteristics of those sheltered; (4) shelter beds available; (5) what is needed to address the problems of homelessness; (6) the extent of the…

  3. 38 CFR 36.4709 - Notice of servicer's identity.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... identity. 36.4709 Section 36.4709 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... servicer's identity. (a) Notice requirement. When the Secretary makes, increases, extends, renews, sells... the identity of the servicer of the loan. The Director of FEMA has designated the insurance provider...

  4. 38 CFR 36.4709 - Notice of servicer's identity.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... identity. 36.4709 Section 36.4709 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... servicer's identity. (a) Notice requirement. When the Secretary makes, increases, extends, renews, sells... the identity of the servicer of the loan. The Director of FEMA has designated the insurance provider...

  5. 38 CFR 36.4709 - Notice of servicer's identity.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... identity. 36.4709 Section 36.4709 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... servicer's identity. (a) Notice requirement. When the Secretary makes, increases, extends, renews, sells... the identity of the servicer of the loan. The Director of FEMA has designated the insurance provider...

  6. 38 CFR 36.4709 - Notice of servicer's identity.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... identity. 36.4709 Section 36.4709 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... servicer's identity. (a) Notice requirement. When the Secretary makes, increases, extends, renews, sells... the identity of the servicer of the loan. The Director of FEMA has designated the insurance provider...

  7. 38 CFR 36.4709 - Notice of servicer's identity.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... identity. 36.4709 Section 36.4709 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... servicer's identity. (a) Notice requirement. When the Secretary makes, increases, extends, renews, sells... the identity of the servicer of the loan. The Director of FEMA has designated the insurance provider...

  8. Homelessness in the U.S.: A Historical Analysis

    ERIC Educational Resources Information Center

    Murphy, Joseph; Tobin, Kerri

    2014-01-01

    In this article, the authors examine homelessness across time and examine, in an introductory way, homelessness today. The authors start by examining important themes that ribbon homelessness in America over the last 300 years. Next, they provide a period analysis of homelessness from the birth of the country through the late 1970s. In the last…

  9. An Examination of Criminal Behavior among the Homeless.

    ERIC Educational Resources Information Center

    Solarz, Andrea

    Homelessness is a significant social problem in the United States, with an estimated 2.5 million homeless people in this country today. While criminal activity may become a means for the homeless to obtain resources needed for basic survival, little is known about the level of criminal activity among the homeless or about the types of crimnal…

  10. Increasing Access to Higher Education for Unaccompanied Homeless Youth: Information for Colleges and Universities. Best Practices in Homeless Education Brief Series

    ERIC Educational Resources Information Center

    National Center for Homeless Education at SERVE, 2012

    2012-01-01

    Each year, more than a million young people in the United States experience homelessness; some of these young people, known as unaccompanied homeless youth, will face the challenges of homelessness while living on their own without the support of a caring adult. Unaccompanied homeless youth face the same struggles as other young people: trying to…

  11. Young and Homeless: Exploring the Education, Life Experiences and Aspirations of Homeless Youth

    ERIC Educational Resources Information Center

    Byrom, Tina; Peart, Sheine

    2017-01-01

    Why do young people become homeless, and what might be done about it? This new study is important reading for academics and students of education, sociology or social work who wish to explore and understand the experiences of homeless young people. Their stories about their aspirations, experiences of schooling and the family breakdowns that…

  12. Immediate Enrollment under McKinney-Vento: How Local Liaisons Can Keep Homeless Students Safe. Best Practices in Homeless Education

    ERIC Educational Resources Information Center

    National Center for Homeless Education at SERVE, 2007

    2007-01-01

    Children and youth in homeless situations, particularly unaccompanied youth and survivors of domestic violence, are at a high risk for experiencing violence and victimization. Frequently, unaccompanied youth become homeless after leaving abusive or destructive home environments. In turn, their homelessness, which often involves "couch…

  13. Homelessness and Housing Insecurity Among Former Prisoners

    PubMed Central

    HERBERT, CLAIRE W.; MORENOFF, JEFFREY D.; HARDING, DAVID J.

    2016-01-01

    The United States has experienced dramatic increases in both incarceration rates and the population of insecurely housed or homeless persons since the 1980s. These marginalized populations have strong overlaps, with many people being poor, minority, and from an urban area. That a relationship between homelessness, housing insecurity, and incarceration exists is clear, but the extent and nature of this relationship is not yet adequately understood. We use longitudinal, administrative data on Michigan parolees released in 2003 to examine returning prisoners’ experiences with housing insecurity and homelessness. Our analysis finds relatively low rates of outright homelessness among former prisoners, but very high rates of housing insecurity, much of which is linked to features of community supervision, such as intermediate sanctions, returns to prison, and absconding. We identify risk factors for housing insecurity, including mental illness, substance use, prior incarceration, and homelessness, as well as protective “buffers” against insecurity and homelessness, including earnings and social supports. PMID:26913294

  14. Tuberculosis among the homeless, United States, 1994–2010

    PubMed Central

    Bamrah, S.; Yelk Woodruff, R. S.; Powell, K.; Ghosh, S.; Kammerer, J. S.; Haddad, M. B.

    2016-01-01

    SUMMARY OBJECTIVES 1) To describe homeless persons diagnosed with tuberculosis (TB) during the period 1994–2010, and 2) to estimate a TB incidence rate among homeless persons in the United States. METHODS TB cases reported to the National Tuberculosis Surveillance System were analyzed by origin of birth. Incidence rates were calculated using the US Department of Housing and Urban Development homeless population estimates. Analysis of genotyping results identified clustering as a marker for transmission among homeless TB patients. RESULTS Of 270 948 reported TB cases, 16 527 (6%) were homeless. The TB incidence rate among homeless persons ranged from 36 to 47 cases per 100 000 population in 2006–2010. Homeless TB patients had over twice the odds of not completing treatment and of belonging to a genotype cluster. US- and foreign-born homeless TB patients had respectively 8 and 12 times the odds of substance abuse. CONCLUSIONS Compared to the general population, homeless persons had an approximately 10-fold increase in TB incidence, were less likely to complete treatment and more likely to abuse substances. Public health outreach should target homeless populations to reduce the excess burden of TB in this population. PMID:24125444

  15. Substance use and homelessness among emergency department patients.

    PubMed

    Doran, Kelly M; Rahai, Neloufar; McCormack, Ryan P; Milian, Jacqueline; Shelley, Donna; Rotrosen, John; Gelberg, Lillian

    2018-05-22

    Homelessness and substance use often coexist, resulting in high morbidity. Emergency department (ED) patients have disproportionate rates of both homelessness and substance use, yet little research has examined the overlap of these issues in the ED setting. We aimed to characterize alcohol and drug use in a sample of homeless vs. non-homeless ED patients. A random sample of urban hospital ED patients were invited to complete an interview regarding housing, substance use, and other health and social factors. We compared substance use characteristics among patients who did vs. did not report current literal (streets/shelter) homelessness. Additional analyses were performed using a broader definition of homelessness in the past 12-months. Patients who were currently homeless (n = 316, 13.7%) versus non-homeless (n = 1,993, 86.3%) had higher rates of past year unhealthy alcohol use (44.4% vs. 30.5%, p < .0001), any drug use (40.8% vs. 18.8%, p < .0001), heroin use (16.7% vs. 3.8%, p < .0001), prescription opioid use (12.5% vs. 4.4%, p < .0001), and lifetime opioid overdose (15.8% vs. 3.7%, p < .0001). In multivariable analyses, current homelessness remained significantly associated with unhealthy alcohol use, AUDIT scores among unhealthy alcohol users, any drug use, heroin use, and opioid overdose; past 12-month homelessness was additionally associated with DAST-10 scores among drug users and prescription opioid use. Patients experiencing homelessness have higher rates and greater severity of alcohol and drug use than other ED patients across a range of measures. These findings have implications for planning services for patients with concurrent substance use and housing problems. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Posthumously Assessing a Homeless Population: Services Use and Characteristics.

    PubMed

    Metraux, Stephen; Manjelievskaia, Janna; Treglia, Dan; Hoffman, Roy; Culhane, Dennis P; Ku, Bon S

    2016-12-01

    Data on services use, characteristics, and geographic distribution of homeless individuals who died in Philadelphia from 2009 to 2011 provided perspective on assessments of the homeless population that rely on conventional counts and surveys. Data from the City of Philadelphia Medical Examiner's Office were used to parse homeless decedents into three groups on the basis of use of homelessness services (known users, occasional users, and nonusers), and differences among the groups were assessed by using descriptive and multivariate methods. Of 141 adult decedents, 49% made substantial use of the homelessness services system (known users), 27% made occasional use of these services (occasional users), and 24% had no record of use of homelessness services (nonusers). Compared with known users, nonusers and occasional users were less likely to have had a severe mental illness diagnosis or to have received either disability benefits or Medicaid coverage and were more likely to be white. Nonusers and occasional users were also more likely than known users to have died in outlying parts of the city. More conventional homeless surveys and enumerations miss a substantial portion of the homeless population. Including these "hidden homeless" persons would alter perceptions about the composition of Philadelphia's homeless population, lowering estimates of the incidence of psychiatric disability and increasing estimates of racial diversity.

  17. 76 FR 36526 - Notice of Submission for OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... DEPARTMENT OF EDUCATION Notice of Submission for OMB Review AGENCY: Department of Education... the Office of Information and Regulatory Affairs, Attention: Education Desk Officer, Office of... Development Type of Review: New. Title of Collection: Evaluation of the Education for Homeless Children and...

  18. The Invisible Homeless: A New Urban Ecology.

    ERIC Educational Resources Information Center

    Ropers, Richard H.

    Contemporary homelessness is the result of increasing social and economic inequality faced by those in American society who are most vulnerable to individual, family, and economic instability. This case study of the homeless population of Los Angeles (California), based on two surveys conducted in 1984, views the homeless as a segment of the…

  19. Refugees and Homeless: Nomads of the World.

    ERIC Educational Resources Information Center

    Steiner, Stanley F.; Cobiskey, Lane

    1998-01-01

    The United States has the most homeless people of the industrialized nations, and children are the fastest growing segment of the homeless. This article discusses refugees and homeless persons and presents an annotated bibliography of picture books, fiction, and nonfiction for grades K-12. Suggests class activities in drama, language arts, and…

  20. Education for Homeless Adults: Strategies for Implementation.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of Workplace Preparation and Continuing Education.

    This instructional guide is intended for use by adult education teachers who deal with homeless students either on an occasional or an exclusive basis. An introduction defines homelessness, describes how education can help, and offers a mission statement. The second section focuses on what teachers of the homeless need. It defines categories of…

  1. Prescription drug misuse among homeless youth.

    PubMed

    Rhoades, Harmony; Winetrobe, Hailey; Rice, Eric

    2014-05-01

    Prescription drug misuse (PDM) is highly prevalent among youth in the U.S., and can have serious health consequences. Homeless youth are a particularly vulnerable population with high rates of substance use. However, PDM has not been studied in a sample comprised exclusively of homeless youth. A sample of 451 homeless youth recruited from drop-in centers in Los Angeles, CA, provided information on substance use, mental health, service utilization, trauma, and sexual risk behavior. Multivariable logistic regression assessed correlates of past month PDM. Nearly 50% reported lifetime PDM and 21.6% reported PDM in the past month. The most frequently used prescriptions in the past month were: opioids only (24.5%), sedatives only (23.4%), and stimulants only (10.6%); 14.9% used some combination of these three types of prescription medications. Homeless youth reported that prescriptions were most commonly obtained for free from friends or relatives (24.5%). Foster care involvement was associated with decreased PDM, while hard drug use, suicidal ideation, and unprotected sex were associated with increased PDM. Homeless youth report high rates of PDM, and access these medications most frequently from friends and family. PDM among homeless youth clusters with other risk factors, including hard drug use, unprotected sex, and suicidal ideation. Surprisingly, foster care history was associated with decreased PDM. Programs aimed at preventing PDM among homeless youth should recognize the clustering of risk behaviors, assess prescription use/access when providing mental health services, and educate the general public about proper disposal of prescriptions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Delirium tremens and alcohol withdrawal nationally in the Veterans Health Administration.

    PubMed

    Moore, David Thomas; Fuehrlein, Brian Scott; Rosenheck, Robert Alan

    2017-10-01

    Alcohol withdrawal-especially delirium tremens (DT)-is a potentially life-threatening condition. While short-term treatment regimens and factors that predispose to more severe symptomatology have been extensively studied, little attention has been paid to the clinical epidemiology and long-term care of the chronic medical, addictive, psychiatric, and psychosocial problems faced by these patients. National Veterans Health Administration data from fiscal year 2012 were examined to identify veterans diagnosed with DT; with withdrawal but not DT (WNDT); and with Alcohol Use Disorder (AUD) but neither DT nor WNDT. They were compared on sociodemographic characteristics, psychiatric and medical co-morbidities, and health service and psychotropic medication use, first with bivariate analyses and then multiple logistic regression. Among the 345,297 veterans diagnosed with AUD, 2,341 (0.7%) were diagnosed with DT and 6,738 (2.0%) with WNDT. Veterans diagnosed with either WNDT or DT were more likely to have been homeless, had more comorbid medical and psychiatric disorders, were more likely to be diagnosed with drug use disorders, utilized more health services, received more psychotropic medications, and were more likely to receive naltrexone. They were more likely to receive specialized legal, housing, vocational, and psychosocial rehabilitation services, as well as intensive case management. Adults with WNDT and DT suffer from multiple chronic conditions and long-term service models are needed to coordinate the work of multiple specialists and to assure continuity of care. This national study identifies sociodemographic characteristics, comorbidities, and service utilization patterns associated with WNDT and DT.(Am J Addict 2017;26:722-730). © 2017 American Academy of Addiction Psychiatry.

  3. Treatment preferences for resuscitation and critical care among homeless persons.

    PubMed

    Norris, Wendi M; Nielsen, Elizabeth L; Engelberg, Ruth A; Curtis, J Randall

    2005-06-01

    Homeless people are at increased risk of critical illness and are less likely to have surrogate decision makers when critically ill. Consequently, clinicians must make decisions independently or with input from others such as ethics committees or guardians. No prior studies have examined treatment preferences of homeless to guide such decision makers. Interviewer-administered, cross-sectional survey of homeless persons. Homeless shelters in Seattle, WA. Two hundred twenty-nine homeless individuals with two comparison groups: 236 physicians practicing in settings where they are likely to provide care for homeless persons and 111 patients with oxygen-dependent COPD. Participants were asked whether they would want intubation with mechanical ventilation or cardiopulmonary resuscitation in their current health, if they were in a permanent coma, if they had severe dementia, or if they were confined to bed and dependent on others for all care. Homeless men were more likely to want resuscitation than homeless women (p < 0.002) in coma and dementia scenarios. Homeless men and women were both more likely to want resuscitation in these scenarios than physicians (p < 0.001). Nonwhite homeless were more likely to want resuscitation than white homeless people (p < 0.033), and both were more likely to want resuscitation than physicians (p < 0.001). Homeless are also more likely to want resuscitation than patients with COPD. The majority (80%) of homeless who reported not having family or not wanting family to make medical decisions prefer a physician make decisions rather than a court-appointed guardian. Homeless persons are more likely to prefer resuscitation than physicians and patients with severe COPD. Since physicians may be in the position of making medical decisions for homeless patients and since physicians are influenced by their own preferences when making decisions for others, physicians should be aware that, on average, homeless persons prefer more aggressive care

  4. 76 FR 76917 - Homeless Management Information Systems Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-09

    ...-P-01] Homeless Management Information Systems Requirements AGENCY: Office of the Assistant Secretary... for the establishment of regulations for Homeless Management Information Systems (HMIS), which are the... community development, Homeless, Information technology system, Management system, Nonprofit organizations...

  5. Youth Homelessness and Individualised Subjectivity

    ERIC Educational Resources Information Center

    Farrugia, David

    2011-01-01

    This article aims to contribute to understandings of youth homelessness and subjectivity by analysing identity construction in terms of young people's negotiation of the structural and institutional environment of youth homelessness. I suggest that while existing literature on this topic concentrates mainly on micro-social encounters, the…

  6. Homeless youth: Barriers and facilitators for service referrals.

    PubMed

    Black, Emma B; Fedyszyn, Izabela E; Mildred, Helen; Perkin, Rhianna; Lough, Richard; Brann, Peter; Ritter, Cheryl

    2018-06-01

    Young people who are homeless and experiencing mental health issues are reluctant to use relevant services for numerous reasons. Youth are also at risk of disengaging from services at times of referral to additional or alternative services. This study aimed to identify barriers and facilitators for inter-service referrals for homeless youth with mental health issues who have already engaged with a service. Qualitative, semi-structured interviews were conducted with homeless youth (n = 10), homelessness support workers (n = 10), and mental health clinicians (n = 10). Barriers included: resource shortages; programs or services having inflexible entry criteria; complexity of service systems; homeless youth feeling devalued; and a lack of communication between services, for example, abrupt referrals with no follow up. Referral facilitators included: services providers offering friendly and client-centred support; supported referrals; awareness of other services; and collaboration between services. Relationships with service providers and inter-service collaboration appeared essential for successful referrals for homeless youth. These facilitating factors may be undermined by sector separation and siloing, as well as resource shortages in both the homelessness and mental health sectors. Service transitions may be conceptualised as a genuine service outcome for homeless youth, and as a basis for successful future service provision. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Creating a science of homelessness during the Reagan era.

    PubMed

    Jones, Marian Moser

    2015-03-01

    POLICY POINTS: A retrospective analysis of federally funded homeless research in the 1980s serves as a case study of how politics can influence social and behavioral science research agendas today in the United States. These studies of homeless populations, the first funded by the National Institute of Mental Health, demonstrated that only about a third of the homeless population was mentally ill and that a diverse group of people experienced homelessness. This groundbreaking research program set the mold for a generation of research and policy characterizing homelessness as primarily an individual-level problem rather than a problem with the social safety net. A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences' role in the policy response to homelessness and how politics has shaped the federal research agenda. Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness. Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding "social research," together

  8. 38 CFR 77.12 - Notice of funding availability.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Notice of funding... FORCES § 77.12 Notice of funding availability. When funds are available for grants, VA will publish a... required to be in notices of funding opportunities in 2 CFR part 200; (b) The location for obtaining grant...

  9. Tuberculosis and Homelessness in the United States, 1994–2003

    PubMed Central

    Haddad, Maryam B.; Wilson, Todd W.; Ijaz, Kashef; Marks, Suzanne M.; Moore, Marisa

    2017-01-01

    Context Tuberculosis (TB) rates among US homeless persons cannot be calculated because they are not included in the US Census. However, homelessness is often associated with TB. Objectives To describe homeless persons with TB and to compare risk factors and disease characteristics between homeless and nonhomeless persons with TB. Design and Setting Cross-sectional analysis of all verified TB cases reported into the National TB Surveillance System from the 50 states and the District of Columbia from 1994 through 2003. Main Outcome Measures Number and proportion of TB cases associated with homelessness, demographic characteristics, risk factors, disease characteristics, treatment, and outcomes. Results Of 185 870 cases of TB disease reported between 1994 and 2003, 11 369 were among persons classified as homeless during the 12 months before diagnosis. The annual proportion of cases associated with homelessness was stable (6.1%–6.7%). Regional differences occurred with a higher proportion of TB cases associated with homelessness in western and some southern states. Most homeless persons with TB were male (87%) and aged 30 to 59 years. Black individuals represented the highest proportion of TB cases among the homeless and nonhomeless. The proportion of homeless persons with TB who were born outside the United States (18%) was lower than that for non-homeless persons with TB (44%). At the time of TB diagnosis, 9% of homeless persons were incarcerated, usually in a local jail; 3% of nonhomeless persons with TB were incarcerated. Compared with nonhomeless persons, homeless persons with TB had a higher prevalence of substance use (54% alcohol abuse, 29.5% noninjected drug use, and 14% injected drug use), and 34% of those tested had coinfection with human immunodeficiency virus. Compared with nonhomeless persons, TB disease in homeless persons was more likely to be infectious but not more likely to be drug resistant. Health departments managed 81% of TB cases in homeless

  10. Meeting the Needs of Homeless Youth. A Report of the Homeless Youth Steering Committee.

    ERIC Educational Resources Information Center

    Frawley, Robert; Zafonte, Suzanne M.

    This report examines the unique aspects of homelessness among youth ages 16 to 21. Section I reviews existing literature and data on the size, characteristics, and needs of homeless youth. Section II summarizes New York State's current efforts on their behalf. Section III analyzes obstacles to serving this population. Section IV outlines an action…

  11. Supporting College Completion for Students Experiencing Homelessness. Best Practices in Homeless Education Brief Series

    ERIC Educational Resources Information Center

    National Center for Homeless Education at SERVE, 2015

    2015-01-01

    Since the College Cost Reduction and Access Act ([CCRAA], 20 U.S.C. § 1001 et seq.) was signed into law in September of 2007, the issue of college access for youth experiencing homelessness has garnered increased attention. Among other provisions, the CCRAA confers independent student status on unaccompanied homeless youth. This status allows…

  12. Educating Homeless Students: Promising Practices.

    ERIC Educational Resources Information Center

    Stronge, James H., Ed.; Reed-Victor, Evelyn, Ed.

    This book is for educators who serve homeless students or students temporarily sharing houses with other families. It describes many promising strategies for working with these students. The chapters are: (1) "Educating Homeless Children and Youth: An Introduction" (James H. Stronge); (2) "Meeting the Developmental and Educational Needs of…

  13. Homelessness, Unsheltered Status, and Risk Factors for Mortality: Findings From the 100    000 Homes Campaign.

    PubMed

    Montgomery, Ann Elizabeth; Szymkowiak, Dorota; Marcus, Jessica; Howard, Paul; Culhane, Dennis P

    2016-11-01

    People who live in unsheltered situations, such as the streets, often have poorer health, less access to health care, and an increased risk of premature mortality as compared with their sheltered counterparts. The objectives of this study were to (1) compare the characteristics of people experiencing homelessness who were sleeping primarily in unsheltered situations with those who were accessing homeless shelters and other sheltered situations, (2) identify correlates of unsheltered status, and (3) assess the relationship between unsheltered status and increased risk of mortality. Using primary data collected as part of the 100    000 Homes Campaign-a national effort to help communities find homes for vulnerable and chronically homeless Americans-we estimated 2 generalized linear mixed models to understand the correlates of unsheltered status and risk factors for mortality. Independent variables included demographic characteristics; history of homelessness, incarceration, foster care, and treatment for mental illness or substance use; sources of income; and past and present medical conditions. The study sample comprised 25489 people experiencing homelessness who responded to an assessment of their housing and health as part of the 100    000 Homes Campaign from 2008 to 2014. In the full model, the following characteristics were associated with unsheltered status: being a veteran (adjusted odds ratio [aOR] = 1.10); having homelessness (aOR = 1.36 for 1-5 years, aOR = 1.95 for >5 years), incarceration (aOR = 1.32), or substance use (aOR = 1.10 for ever abusing drugs or alcohol, aOR = 1.13 for ever using intravenous drugs, aOR = 1.98 for drinking alcohol every day for past month). Being unsheltered (aOR = 1.12), being female (aOR = 1.22), or receiving entitlements (aOR = 1.63) increased respondents' odds of having risk

  14. Transitional care challenges of rehospitalized veterans: listening to patients and providers.

    PubMed

    Stephens, Caroline; Sackett, Nathan; Pierce, Read; Schopfer, David; Schmajuk, Gabriela; Moy, Nicholas; Bachhuber, Melissa; Wallhagen, Margaret I; Lee, Sei J

    2013-10-01

    Readmissions to the hospital are common and costly, often resulting from poor care coordination. Despite increased attention given to improving the quality and safety of care transitions, little is known about patient and provider perspectives of the transitional care needs of rehospitalized Veterans. As part of a larger quality improvement initiative to reduce hospital readmissions, the authors conducted semi-structured interviews with 25 patients and 14 of their interdisciplinary health care providers to better understand their perspectives of the transitional care needs and challenges faced by rehospitalized Veterans. Patients identified 3 common themes that led to rehospitalization: (1) knowledge gaps and deferred power; (2) difficulties navigating the health care system; and (3) complex psychiatric and social needs. Providers identified different themes that led to rehospitalization: (1) substance abuse and mental illness; (2) lack of social or financial support and homelessness; (3) premature discharge and poor communication; and (4) nonadherence with follow-up. Results underscore that rehospitalized Veterans have a complex overlapping profile of real and perceived physical, mental, and social needs. A paradigm of disempowerment and deferred responsibility appears to exist between patients and providers that contributes to ineffective care transitions, resulting in readmissions. These results highlight the cultural constraints on systems of care and suggest that process improvements should focus on increasing the sense of partnership between patients and providers, while simultaneously creating a culture of empowerment, ownership, and engagement, to achieve success in reducing hospital readmissions.

  15. East London's Homeless: a retrospective review of an eye clinic for homeless people.

    PubMed

    D'Ath, Penny J; Keywood, Laura J; Styles, Elaine C; Wilson, Clare M

    2016-02-16

    There is very little published work on the visual needs of homeless people. This paper is the first study to investigate the visual needs of homeless people in the UK. Although similar work has been done in other countries, this study is unique because the United Kingdom is the only country with a National Health Service which provides free healthcare at the point of access. This study analysed the refractive status of the sample used, determined the demographics of homeless people seeking eye care and established if there is a need for community eye health with access to free spectacle correction in East London. This retrospective case study analysed the clinical records of 1,141 homeless people using the Vision Care for Homeless People services at one of their clinics in East London. All eye examinations were carried out by qualified optometrists and, where appropriate, spectacles were dispensed to patients. Data captured included age, gender, ethnicity and refractive error. Results were analysed using two-sample t-tests with Excel and Minitab. Demographics of age, gender and ethnicity are described. Spherical equivalents (SE) were calculated from prescription data available for 841 clinic users. Emmetropia was defined as SE-0.50DS to +1DS, myopia as SE < -0.50DS, and hyperopia as SE > +1DS. The majority of clinic users were male (79.2 %, n = 923). Approximately 80 % (n = 583) of clinic users were white, 10 % (n = 72) were 'black', 4 % (n = 29) 'Asian' and the remaining 5.6 % (n = 40) were of 'mixed ethnicity' and 'other' groups. The mean age of females attending the clinic was significantly lower than that of males (45.9 years, SD = 13.8 vs' 48.4 years, SD = 11.8) when analysed using a two-sample t-test (t (317) = 2.44, p = 0.02). One third of service users were aged between 50-59 years. Myopia and hyperopia prevalence rates were 37.0 % and 21.0 % respectively. A total of 34.8 % of homeless people were found

  16. Perceived racial, sexual identity, and homeless status-related discrimination among Black adolescents and young adults experiencing homelessness: Relations with depressive symptoms and suicidality.

    PubMed

    Gattis, Maurice N; Larson, Andrea

    2016-01-01

    There is a dearth of empirical evidence that addresses how racial minority, sexual minority, and homeless statuses, with their accompanying experiences of stigma and discrimination, are related to mental health in adolescent and young adult populations. The current study addresses this gap by examining the associations between multiple forms of discrimination, depressive symptoms, and suicidality in a sample of 89 Black adolescents and young adults (52% female; 47% nonheterosexual, ages 16-24) experiencing homelessness. Results from a series of ordinary least squares and logistic regressions suggested that perceived homelessness stigma and racial discrimination were associated with higher levels of depressive symptoms, controlling for gender, age, and other types of discrimination, while perceived sexual identity discrimination showed no association. Having ever spent a homeless night on the street, an indicator of homelessness severity, accounted for a substantial amount of the association between homelessness stigma and depressive symptoms. In contrast, suicidality was not significantly associated with any measure of discrimination, homelessness severity, or personal characteristics. We also found no indication that the associations between perceived discrimination targeted at racial and homelessness statuses and mental health differed by sexual minority status. Our results suggest that depressive symptoms and suicidality are prevalent among Black homeless youth, and that depressive symptoms are particularly associated with racial discrimination and indicators of homelessness. The roles of discrimination and a lack of safe housing may be taken into account when designing programs and policies that address the mental health of Black adolescents and young adults experiencing homelessness. (c) 2016 APA, all rights reserved).

  17. Homelessness in the state and federal prison population.

    PubMed

    Greenberg, Greg A; Rosenheck, Robert A

    2008-01-01

    This study sought to investigate the rates and correlates of homelessness (i.e. living on the street or in a homeless shelter), including mental illness, among US adult state and federal prison inmates (ASFPIs). Data from a national survey of ASFPIs based on a random sampling survey (N = 17,565) were used to compare the homelessness rate among AFSPIs with that in the general population. Logistic regression was then used to examine the association of homelessness among ASFPIs with factors including symptoms, treatment of mental illness, previous criminal justice involvement, specific crimes, and demographic characteristics. Nine percent of ASFPIs reported an episode of homelessness in the year prior to arrest, 4-6 times the estimated rate in the general US adult population after allowing for age, race/ethnicity, and gender. In comparison to other inmates, these homeless inmates were more likely to be currently incarcerated for a property crime, but also to have had previous criminal justice system involvement for both property and violent crimes, to suffer from mental health and/or substance abuse problems, and to be more likely to have been unemployed and with a low income. Recent homelessness is far more common among ASFPIs than the general population. Prior incarceration, mental illness, substance abuse and disadvantageous socio-demographic characteristics were all found to be associated with homelessness among prison inmates, suggesting that there are several important factors in addition to efforts to survive with limited resources through criminal acts that influence the rates of homelessness among incarcerated individuals.

  18. Risk factors for homelessness among women with schizophrenia.

    PubMed Central

    Caton, C L; Shrout, P E; Dominguez, B; Eagle, P F; Opler, L A; Cournos, F

    1995-01-01

    A study of risk factors for homelessness among the severely mentally ill was extended to include women, and a case-control study of 100 indigent women with schizophrenia meeting criteria for literal homelessness and 100 such women with no history of homelessness was conducted. Subjects were recruited from shelters, clinics, and inpatient psychiatric programs in New York City. Clinical interviewers used standardized research instruments to probe three domains of risk factors: severity of mental illness, family background, and prior mental health service use. Findings adjusted for ethnicity revealed that homeless women had higher rates of a concurrent diagnosis of alcohol abuse, drug abuse, and antisocial personality disorder. Homeless women also had less adequate family support. PMID:7625518

  19. The health of homeless immigrants

    PubMed Central

    Chiu, Shirley; Redelmeier, Donald A.; Tolomiczenko, George; Kiss, Alex; Hwang, Stephen W.

    2009-01-01

    Background This study examined the association between immigrant status and current health in a representative sample of 1,189 homeless people in Toronto, Canada. Methods Multivariate regression analyses were performed to examine the relationship between immigrant status and current health status (assessed using the SF-12) among homeless recent immigrants (≤10 years since immigration), non-recent immigrants (>10 years since immigration), and Canadian-born individuals recruited at shelters and meal programs (response rate 73%). Results After adjusting for demographic characteristics and lifetime duration of homelessness, recent immigrants were significantly less likely to have chronic conditions (RR 0.7, 95% CI 0.5 to 0.9), mental health problems (OR 0.4, 95% CI 0.2 to 0.7), alcohol problems (OR 0.2, 95% CI 0.1 to 0.5), and drug problems (OR 0.2, 95% CI 0.1 to 0.4) compared to non-recent immigrants and Canadian-born individuals. Recent immigrants were also more likely to have better mental health status (+3.4 points, SE ±1.6) and physical health status (+2.2 points, SE ±1.3) on scales with a mean of 50 and a standard deviation of 10 in the general population. Conclusion Homeless recent immigrants are a distinct group who are generally healthier and may have very different service needs compared to other homeless people. PMID:19654122

  20. 76 FR 64368 - Notice of Submission of Proposed Information Collection to OMB Homelessness Prevention Study

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... Proposed Information Collection to OMB Homelessness Prevention Study AGENCY: Office of Policy Development... automated collection techniques or other forms of information technology that will reduce burden (e.g... INFORMATION CONTACT: Elizabeth Rudd, Department of Housing and Urban Development, 451 7th Street, SW., Room...

  1. Creating a Science of Homelessness During the Reagan Era

    PubMed Central

    JONES, MARIAN MOSER

    2015-01-01

    Policy Points: A retrospective analysis of federally funded homeless research in the 1980s serves as a case study of how politics can influence social and behavioral science research agendas today in the United States. These studies of homeless populations, the first funded by the National Institute of Mental Health, demonstrated that only about a third of the homeless population was mentally ill and that a diverse group of people experienced homelessness. This groundbreaking research program set the mold for a generation of research and policy characterizing homelessness as primarily an individual-level problem rather than a problem with the social safety net. Context A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences’ role in the policy response to homelessness and how politics has shaped the federal research agenda. Methods Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness. Findings Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding

  2. The Homeless in Contemporary Society.

    ERIC Educational Resources Information Center

    Bingham, Richard D.; And Others

    This book consists of 15 chapters on understanding and helping the homeless. The first seven chapters present the "new" homeless in historical context and describe this population and its situation. The remaining eight chapters discuss policy and program options of the government and other organizations in attempting to alleviate the problems of…

  3. 38 CFR 21.4250 - Course and licensing and certification test approval; jurisdiction and notices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Course and licensing and certification test approval; jurisdiction and notices. 21.4250 Section 21.4250 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Administration of Educational Assistance...

  4. Florida's Adult Homeless Literacy Training & Basic Skills Assistance Project.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee. Div. of Vocational, Adult, and Community Education.

    Some facts about the homeless population in Florida are the following: (1) 40,000 persons in Florida are homeless on any given day, with 40 percent of the total being families; (2) 65 percent are new homeless (not chronic); (3) 30 percent of the homeless are addicted to drugs or alcohol and 20 percent are mentally ill; (4) causes of homelessness…

  5. Ethical issues in research with homeless youths.

    PubMed

    Ensign, Josephine; Ammerman, Seth

    2008-05-01

    This paper is a report of a study to document researcher, healthcare provider and programme administrators' experiences with ethical issues in research with homeless youths in North America. While there are legal and ethical guidelines for research with adolescents and with vulnerable populations in general, there are no specific guidelines for the ethical conduct of research with homeless youths. Using a web-based questionnaire, healthcare and social service providers, programme administrators and researchers working with homeless young people throughout the United States of America and Canada were surveyed in 2005. The survey group consisted of 120 individuals; a total of 72 individuals completed the survey. Survey questions included experiences with using incentives in research with homeless youths, consent and experiences with ethics review boards. Numerical data were analysed using frequencies and cross-tabulations. Text data were analysed qualitatively. Researchers doing mental health and/or substance use research tended to use money as a research incentive, whereas healthcare providers and programme administrators tended to use non-monetary incentives. The majority of respondents reported using written consent for research from homeless youths, including minors. Respondents reporting difficulties with ethics review boards were mainly involved with intervention research. Consensus is needed from a variety of stakeholders, including homeless youths and service providers, on use of various types of research incentives for different types of research, as well as use of consent for homeless youths who are minors.

  6. Suicidal behavior among homeless people in Japan.

    PubMed

    Okamura, Tsuyoshi; Ito, Kae; Morikawa, Suimei; Awata, Shuichi

    2014-04-01

    The purpose of this study is to investigate the frequency and correlates of suicidal behavior among homeless people in Japan. A face-to-face survey was conducted in two districts of Tokyo, Japan, with 423 subjects who resided on streets and riversides and in urban parks and stations (street homeless) or who were residents of shelters, cheap hotels, or welfare homes for homeless people (sheltered homeless). When questioned about suicidal ideation in the previous 2 weeks, 51 subjects (12.2% of valid responses) had a recurring wish to die, 29 (6.9%) had frequent thoughts of suicide, and 22 (5.3%) had made suicide plans. In addition, 11 (2.9%) subjects had attempted suicide in the previous 2 weeks and 74 (17.7%) reported that they had ever attempted suicide. In univariate logistic regression analyses, street homelessness, lack of perceived emotional social support, poor subjective health perception, visual impairment, pain, insomnia, poor mental well-being, and current depression were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Among these, current depression had the greatest significance. In multivariate logistic regression analyses after controlling for depression, street homelessness and lack of perceived emotional social support were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Comprehensive interventions including housing and social support as well as mental health services might be crucial as effective strategies for suicide prevention among homeless people.

  7. 75 FR 54446 - Voluntary Service National Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-07

    ...-four national voluntary organizations, advises the Secretary, through the Under Secretary for Health... DEPARTMENT OF VETERANS AFFAIRS Voluntary Service National Advisory Committee; Notice of Meeting... Committee Act) that the Executive Committee of the Department of Veterans Affairs Voluntary Service (VAVS...

  8. 76 FR 63357 - VA National Academic Affiliations Council; Notice of Establishment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... DEPARTMENT OF VETERANS AFFAIRS VA National Academic Affiliations Council; Notice of Establishment... Academic Affiliations Council. The Secretary of Veterans Affairs has determined that establishing the... Secretary for Health on matters affecting partnerships between VA and its academic affiliates. The Council...

  9. 38 CFR 12.20 - Posting of notice provisions of Pub. L. 382.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... provisions of Pub. L. 382. 12.20 Section 12.20 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS DISPOSITION OF VETERAN'S PERSONAL FUNDS AND EFFECTS Under Pub. L. 382, 77th Congress, December 26, 1941, Amending the Act of June 25, 1910 (24 U.s.c. 136) § 12.20 Posting of notice provisions of Pub. L...

  10. 78 FR 44553 - Agency Information Collection Activities; Comment Request; Veterans Upward Bound Annual...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ... DEPARTMENT OF EDUCATION [Docket No. ED-2013-ICCD-0095] Agency Information Collection Activities; Comment Request; Veterans Upward Bound Annual Performance Report AGENCY: Office of Postsecondary Education (OPE), Department of Education (ED). ACTION: Notice. SUMMARY: In accordance with the Paperwork...

  11. Homelessness and the Public's Health: Legal Responses.

    PubMed

    Hodge, James G; DiPietro, Barbara; Horton-Newell, Amy E

    2017-03-01

    This commentary addresses public health issues underlying homelessness and related law, policy, and advocacy options. After framing public health issues for affected individuals and the community, legal and policy approaches and related barriers are assessed. Major topics include deficits in housing availability, the role of state-based Medicaid programs, criminalization of homelessness, and the use of emergency declarations seeking to address particular issues related to homelessness in select states and localities.

  12. Mental Health, Substance Abuse, and Suicide Among Homeless Adults.

    PubMed

    Lee, Kyoung Hag; Jun, Jung Sim; Kim, Yi Jin; Roh, Soonhee; Moon, Sung Seek; Bukonda, Ngoyi; Hines, Lisa

    2017-01-01

    This study explored the role of mental health and substance abuse problems on the suicidal ideation and suicide attempts of 156 homeless adults. The logistic regression results indicated that homeless adults with anxiety were significantly more likely than those without anxiety to have both suicidal ideation and suicide attempts. Also, homeless adults with drug abuse were significantly more likely than those without drug abuse to have suicidal ideation. The study suggests that to reduce the suicide of the homeless, case managers need to screen mental health and substance abuse issues and to provide appropriate treatment services at homeless shelters.

  13. Tuberculosis Containment among the Homeless in Metropolitan Jackson, Mississippi.

    PubMed

    Azevedo, Mario J; Conwill, David E; Lawrence, Shonda; Jackson, Ann; Bhuiyan, Azad R; Hall, Dianne; Anderson, Brian; Franklin, Donald; Brown, David; Wilkerson, Patricia; Beckett, Gloria

    2015-08-01

    Preventing tuberculosis among the homeless has emerged as an especially difficult challenge. We assessed a 2008-2009 tuberculosis (TB) outbreak ad subsequent prevention strategies among homeless persons in metropolitan Jackson, Hinds County, Mississippi. We compared data about cases and subclinical TB infections (LTBI) among homeless persons during the outbreak and post-outbreak years, interviewed involved homeless persons, compiled observations from visits to Jackson homeless shelters and conducted literature reviews on homelessness and infectious diseases. We reviewed homeless shelter TB prevention methods adopted by other municipalities, guidelines developed by the Centers for Disease Control and Prevention (CDC), and recommendations from other official and ad hoc groups and considered their applicability to metropolitan Jackson. The Mississippi State Department of Health TB Program assisted by the CDC and other agencies, contained the Jackson-area outbreak by the end of 2009 as reflected by progressively lower TB rates among homeless persons thereafter. However, some follow-up activities and enforcement of shelter preventive measures have not been consistently maintained. Resources to prevent further outbreaks continue to be inadequate, and over-reliance on private organizations has continued. In the process, appreciation of the dynamic interaction enhancing TB risk among the homeless and incarcerated persons has emerged. Major outbreak contributors were lack of periodic TB screening among homeless shelter clients, preventive treatment compliance and follow-up difficulties among those with subclinical tuberculosis infections, interrupted preventive measures among infected persons incarcerated in local correctional facilities who disproportionately re-join Jackson's homeless community when released, inadequate attention to shelter environmental preventive strategies such as ultraviolet light germicidal irradiators and proper air-exchange/ventilation, costs of

  14. Psychopathology in Young People Experiencing Homelessness: A Systematic Review

    PubMed Central

    Shelton, Katherine H.; van den Bree, Marianne B. M.; Los, Férenc J.

    2013-01-01

    Understanding mental health issues faced by young homeless persons is instrumental to the development of successful targeted interventions. No systematic review of recent published literature on psychopathology in this group has been completed. We conducted a systematic review of published research examining the prevalence of psychiatric problems among young homeless people. We examined the temporal relationship between homelessness and psychopathology. We collated 46 articles according to the PRISMA Statement. All studies that used a full psychiatric assessment consistently reported a prevalence of any psychiatric disorder from 48% to 98%. Although there was a lack of longitudinal studies of the temporal relationship between psychiatric disorders and homelessness, findings suggested a reciprocal link. Supporting young people at risk for homelessness could reduce homelessness incidence and improve mental health. PMID:23597340

  15. Promoting Resilience in Youth Experiencing Homelessness through Implementation of the McKinney-Vento Homeless Assistance Act

    ERIC Educational Resources Information Center

    Clemens, Elysia; Hess, Robyn S.; Strear, Molly M.; Rue, Lisa; Rizzolo, Sonja; Henninger, Janessa

    2018-01-01

    This Consensual Qualitative Research study explored experiences of youth, families, and homeless liaisons to better understand how educational environments can foster resilience among youth experiencing homelessness. The purpose of the study was to provide educational stakeholders with guidance on how to actualize the McKinney-Vento Homeless…

  16. Hosting a Tent City: Student Engagement and Homelessness

    ERIC Educational Resources Information Center

    McKinney, Jennifer; Snedker, Karen A.

    2017-01-01

    In response to increasing homelessness in our city, Seattle Pacific University invited a homeless encampment (Tent City) to reside on our university campus for three months. This provided an opportunity to engage students on issues of poverty and inequality. Building from a service-learning model, we devised course work around homelessness and…

  17. 77 FR 60507 - Voluntary Service National Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ... meeting is open to the public. The Committee, comprised of 57 national voluntary organizations, advises... DEPARTMENT OF VETERANS AFFAIRS Voluntary Service National Advisory Committee; Notice of Meeting... Committee Act) that the Executive Committee of the Department of Veterans Affairs Voluntary Service (VAVS...

  18. 75 FR 26846 - Genomic Medicine Program Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-12

    ... DEPARTMENT OF VETERANS AFFAIRS Genomic Medicine Program Advisory Committee; Notice of Meeting The...) that the Genomic Medicine Program Advisory Committee will meet on May 21, 2010, at the Westin... appropriate ethical oversight and protecting the privacy of Veterans; presentations on genomic medicine...

  19. The reality of homeless mobility and implications for improving care.

    PubMed

    Parker, R David; Dykema, Shana

    2013-08-01

    Homeless persons are perceived as a highly mobile population, and have high rates of co-morbid conditions, including mental health and substance use issues. This study sought to determine the characteristics of the mobility and reported health conditions of homeless persons. The sample for this cross sectional study (n = 674) accounted for 88 % of the homeless population in a medium sized southern city in the United States. Participants were recruited from a homeless shelter operating during the winter season. Homeless persons were less mobile than the general state population (46.11 % were born in-state vs. 40.7 % of the general population) and less transient than the general state population (78 % reported an in-state zip code for the last permanent residence). 31.9 % reported a disabling condition of a serious and long term nature. These findings challenge the concept that homeless persons are primarily a mobile population. Furthermore, homeless persons in this sample were more likely to remain in the state where they lived after becoming homeless. Thus, provider perceptions that homeless persons would not benefit from referral to a regular source of outpatient care may be misinformed. As homeless persons often seek care in emergency departments for conditions that could be addressed through outpatient care, if a medical care system implemented standard practices specifically for homeless patients, this could decrease recidivism. Such interventions represent significant opportunities to reduce costs, conserve resources, and improve care through policy modification that ensures a focus on a successful, active linkage to outpatient care and programs specific to the homeless population.

  20. Art messaging to engage homeless young adults.

    PubMed

    Nyamathi, Adeline; Slagle, Alexandra; Thomas, Alexandra; Hudson, Angela; Kahilifard, Farinaz; Avila, Glenna; Orser, Julie; Cuchilla, Manuel

    2011-01-01

    Art has been shown to be an empowering and engaging entity with numerous benefits to vulnerable populations, including the homeless persons and young adults. However, little is known how homeless young adults perceive the use of art as messages that can communicate the danger of initiating or continuing drug and alcohol use. The purpose of this study was to solicit perspectives of homeless, drug-using young adults as to how art can be used to design messages for their peers about the danger of initiating or continuing drug and alcohol use. Qualitative methodology via focus group discussions was utilized to engage 24 homeless young adults enrolled from a drop-in site in Santa Monica, California. The findings revealed support for a myriad of delivery styles, including in-person communication, flyers, music, documentary film, and creative writing. The young adults also provided insight into the importance of the thematic framework of messages. Such themes ranged from empowering and hopeful messages to those designed to scare young homeless adults into not experimenting with drugs. The findings indicate that in addition to messages communicating the need to prevent or reduce drug and alcohol use, homeless young adults respond to messages that remind them of goals and dreams they once had for their future, and to content that is personal, real, and truthful. Our research indicates that messages that reinforce protective factors such as hope for the future and self-esteem may be as important to homeless young adults as information about the risks and consequences of drug use.

  1. Homeless Children: Addressing the Challenge in Rural Schools. ERIC Digest.

    ERIC Educational Resources Information Center

    Vissing, Yvonne M.

    Despite stereotypes to the contrary, homelessness is as prevalent in rural as urban areas. This digest examines the implications of homelessness for rural children and youth and discusses possible actions by rural educators. An estimated half of the rural homeless are families with children. Compared to urban counterparts, rural homeless families…

  2. Homeless Children and Youth: A New American Dilemma.

    ERIC Educational Resources Information Center

    Kryder-Coe, Julee H., Ed.; And Others

    These 11 reports focus on policy responses to the needs of very young children who are part of a homeless family, and older young people who are homeless but on their own. The following chapters are included: (1) J. M. Molnar's introduction to the relationship between chronic poverty and homelessness; (2) "Beyond the Numbers: Homeless…

  3. Tuberculosis and homelessness in Montreal: a retrospective cohort study

    PubMed Central

    2011-01-01

    Background Montreal is Canada's second-largest city, where mean annual tuberculosis (TB) incidence from 1996 to 2007 was 8.9/100,000. The objectives of this study were to describe the epidemiology of TB among homeless persons in Montreal and assess patterns of transmission and sharing of key locations. Methods We reviewed demographic, clinical, and microbiologic data for all active TB cases reported in Montreal from 1996 to 2007 and identified persons who were homeless in the year prior to TB diagnosis. We genotyped all available Mycobacterium tuberculosis isolates by IS6110 restriction fragment length polymorphism (IS6110-RFLP) and spoligotyping, and used a geographic information system to identify potential locations for transmission between persons with matching isolates. Results There were 20 cases of TB in homeless persons, out of 1823 total reported from 1996-2007. 17/20 were Canadian-born, including 5 Aboriginals. Homeless persons were more likely than non-homeless persons to have pulmonary TB (20/20), smear-positive disease (17/20, odds ratio (OR) = 5.7, 95% confidence interval (CI): 1.7-20), HIV co-infection (12/20, OR = 14, 95%CI: 4.8-40), and a history of substance use. The median duration from symptom onset to diagnosis was 61 days for homeless persons vs. 28 days for non-homeless persons (P = 0.022). Eleven homeless persons with TB belonged to genotype-defined clusters (OR = 5.4, 95%CI: 2.2-13), and ten potential locations for transmission were identified, including health care facilities, homeless shelters/drop-in centres, and an Aboriginal community centre. Conclusions TB cases among homeless persons in Montreal raise concerns about delayed diagnosis and ongoing local transmission. PMID:22034944

  4. [Alcohol dependence in homeless men. Incidence, development and determinants].

    PubMed

    Dufeu, P; Podschus, J; Schmidt, L G

    1996-11-01

    Against the background of the complex relationship of alcoholism and homelessness, we investigated the question of whether homeless alcoholics and those with homes differed regarding biographical and clinical variables. Therefore, 49 of 72 (68.1%) homeless male visitors to a city kitchen in the center of Berlin, who had fulfilled the ICD-10 criteria for the alcohol-dependence syndrome, were compared with 141 outpatients of the addiction research unit of the Department of Psychiatry of the Free University of Berlin. It was found that homeless alcoholics had more psychosocial disadvantages than other alcoholics. They had been raised more frequently in families with an alcoholic father or mother and a higher number of children. The level of education and job qualification was lower in the homeless alcoholics. Early homelessness was predicted by a lack of sexual behavior (no partnership experienced) and a family history of alcoholism. In the interview, homeless alcoholics reported fewer symptoms of alcohol-dependence syndrome than other alcoholics; however, the first symptoms had been experienced earlier. Alcohol-related somatic and psychological consequences were reported more frequently in alcoholics with homes, whereas social problems were more common in the homeless subjects. The results are discussed in the light of methodological limitations and other reports on the topic.

  5. Chronically homeless women report high rates of substance use problems equivalent to chronically homeless men.

    PubMed

    Edens, Ellen Lockard; Mares, Alvin S; Rosenheck, Robert A

    2011-01-01

    The U.S. federal government recently committed itself to ending chronic homelessness within 5 years. Women constitute one out of four chronically homeless adults and represent a particularly vulnerable group, but have been little studied. To identify potentially unique needs in this group, we report characteristics and 2-year outcomes in a large sample of male and female chronically homeless adults participating in a multisite, supportive housing program. Men and women participating in the outcome evaluation of the 11-site Collaborative Initiative on Chronic Homelessness (n = 714) supportive housing program and who received at least one follow-up assessment were compared on baseline characteristics and up to 2-year follow-up outcomes. Mixed model multivariate regression adjusted outcome findings for baseline group differences. Few significant baseline differences existed between males and females, with both sexes self-reporting very high rates of lifetime mental health (83% women, 74% men) and substance use (68% women, 73% men) problems. Throughout the 2-year follow-up, both men and women dramatically increased the number of days housed, showed minimal changes in substance use patterns, and had modest improvements in mental health outcomes, without significant differences between genders. Unlike other U.S. populations, chronically homeless adults do not demonstrate substantial gender differences on mental health or addiction problems. Policy and service delivery must address these remarkably high rates of substance use and mental illness. Published by Elsevier Inc.

  6. Cross-National Variations in Behavioral Profiles Among Homeless Youth

    PubMed Central

    Milburn, Norweeta G.; Rotheram-Borus, Mary Jane; Rice, Eric; Mallet, Shelley; Rosenthal, Doreen

    2010-01-01

    Cross-national comparisons of homeless youth in Melbourne, Australia, and Los Angeles, CA, United States were conducted. Newly (n = 427) and experienced (n = 864) homeless youth were recruited from each site. Compared to Australia, homeless youth in the United States were younger, more likely to be in school or jail, demonstrated fewer sexual and substance use risk acts, fewer suicidal acts, and reported less need for social services. Across sites, experienced homeless youth were more likely to be older, male, engage in sexual and substance use, report greater need for social services, and make greater use of work, substance use, and health-related services. Homeless youth have different behavioral profiles in Australia and the United States, reflecting differences in the effectiveness of service systems in the two countries in keeping youth with fewer problems out of homelessness. PMID:16680537

  7. Cross-national variations in behavioral profiles among homeless youth.

    PubMed

    Milburn, Norweeta G; Rotheram-Borus, Mary Jane; Rice, Eric; Mallet, Shelley; Rosenthal, Doreen

    2006-03-01

    Cross-national comparisons of homeless youth in Melbourne, Australia, and Los Angeles, CA, United States were conducted. Newly (n = 427) and experienced (n = 864) homeless youth were recruited from each site. Compared to Australia, homeless youth in the United States were younger, more likely to be in school or jail, demonstrated fewer sexual and substance use risk acts, fewer suicidal acts, and reported less need for social services. Across sites, experienced homeless youth were more likely to be older, male, engage in sexual and substance use, report greater need for social services, and make greater use of work, substance use, and health-related services. Homeless youth have different behavioral profiles in Australia and the United States, reflecting differences in the effectiveness of service systems in the two countries in keeping youth with fewer problems out of homelessness.

  8. Where do people go when they first become homeless? A survey of homeless adults in the USA.

    PubMed

    O'Toole, Thomas P; Conde-Martel, Alicia; Gibbon, Jeanette L; Hanusa, Barbara H; Freyder, Paul J; Fine, Michael J

    2007-09-01

    The longer a person is homeless, the more likely he or she is to experience poor health and be placed at higher risk for premature death. This makes interventions early in one's homelessness an important prevention strategy. However, little is known about where someone goes for help when they first become homeless and how well those sites are prepared to address the multitude of issues facing a homeless person. In order to address this question, we conducted a cross-sectional community-based survey in two US cities in 1997 using population proportionate sampling of homeless persons identified at 91 sites to identify 'first-stop' access sites and reasons for seeking help at those sites. A total of 230 persons participated in the face-to-face interview (93% response rate). From a list of 20 possible 'first-stop' sites, 105 (45.7%) reported going to a soup kitchen, 71 (30.9%) went to a welfare office, 64 (27.8%) sought admission to a detoxification centre, 60 (26.1%) met with a homeless outreach team, 57 (24.8%) went to a family member, and 54 (23.5%) went to an emergency room. Individuals with a chronic medical or mental health condition were significantly more likely to access a healthcare site (medical: 62.6% vs. 47.6%, P = 0.02; mental health: 62.4% vs. 38.8%, P < 0.01) or social service agency (medical: 64.0% vs. 43.3%, P = 0.02; mental health: 59.1% vs. 40.7%, P < 0.01). Those persons reporting a need for alcohol treatment were significantly more likely to first go to a healthcare site (46.4% vs. 29.1%, P < 0.01) and those with alcohol abuse/dependence were less likely to seek help from family or friends (66.7% vs. 81.9%, P < 0.01). Most respondents sought assistance for concerns directly associated with an immediate need as opposed to seeking care for issues causing their actual homelessness. These findings suggest the need to expand and integrate the availability of services at 'first-stop' access sites that facilitate early exits from homelessness.

  9. Active Tuberculosis among Homeless Persons, Toronto, Ontario, Canada, 1998–2007

    PubMed Central

    Rea, Elizabeth; McDermaid, Cameron; Stuart, Rebecca; Chambers, Catharine; Wang, Jun; Chan, Angie; Gardam, Michael; Jamieson, Frances; Yang, Jae; Hwang, Stephen W.

    2011-01-01

    While tuberculosis (TB) in Canadian cities is increasingly affecting foreign-born persons, homeless persons remain at high risk. To assess trends in TB, we studied all homeless persons in Toronto who had a diagnosis of active TB during 1998–2007. We compared Canada-born and foreign-born homeless persons and assessed changes over time. We identified 91 homeless persons with active TB; they typically had highly contagious, advanced disease, and 19% died within 12 months of diagnosis. The proportion of homeless persons who were foreign-born increased from 24% in 1998–2002 to 39% in 2003–2007. Among foreign-born homeless persons with TB, 56% of infections were caused by strains not known to circulate among homeless persons in Toronto. Only 2% of infections were resistant to first-line TB medications. The rise in foreign-born homeless persons with TB strains likely acquired overseas suggests that the risk for drug-resistant strains entering the homeless shelter system may be escalating. PMID:21392424

  10. 38 CFR 18b.30 - Notice of hearing or opportunity for hearing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Notice of hearing or opportunity for hearing. 18b.30 Section 18b.30 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PRACTICE AND PROCEDURE UNDER TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 AND PART 18 OF THIS CHAPTER Proceedings Before Hearin...

  11. 38 CFR 21.4213 - Notice of hearing by Committee on Educational Allowances.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Committee on Educational Allowances. 21.4213 Section 21.4213 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Administration of Educational Assistance Programs Schools § 21.4213 Notice of hearing by Committee on Educational Allowances. (a...

  12. 75 FR 4632 - Advisory Committee on Disability Compensation; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Disability Compensation; Notice of Meeting... Committee Act) that the Advisory Committee on Disability Compensation will meet on February 22-23, 2010, in... Veterans Affairs on the maintenance and periodic readjustment of the VA Schedule for Rating Disabilities...

  13. 78 FR 18680 - Genomic Medicine Program Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ... DEPARTMENT OF VETERANS AFFAIRS Genomic Medicine Program Advisory Committee, Notice of Meeting The..., that the Genomic Medicine Program Advisory Committee will meet on April 11, 2013, in Suite 1000 at the... ongoing Million Veteran Program, as well as the clinical Genomic Medicine Service. The emerging...

  14. Alcoholism, Drug Abuse, and the Homeless.

    ERIC Educational Resources Information Center

    McCarty, Dennis; And Others

    1991-01-01

    Reviews policies that address substance abuse among the homeless. Recommends that the changing needs of the homeless require an integration of alcoholism and drug abuse recovery services with programs for various groups, substance-free housing, and psychological knowledge incorporated into programs for those struggling with addiction and…

  15. Residential patterns in older homeless adults: Results of a cluster analysis.

    PubMed

    Lee, Christopher Thomas; Guzman, David; Ponath, Claudia; Tieu, Lina; Riley, Elise; Kushel, Margot

    2016-03-01

    Adults aged 50 and older make up half of individuals experiencing homelessness and have high rates of morbidity and mortality. They may have different life trajectories and reside in different environments than do younger homeless adults. Although the environmental risks associated with homelessness are substantial, the environments in which older homeless individuals live have not been well characterized. We classified living environments and identified associated factors in a sample of older homeless adults. From July 2013 to June 2014, we recruited a community-based sample of 350 homeless men and women aged fifty and older in Oakland, California. We administered structured interviews including assessments of health, history of homelessness, social support, and life course. Participants used a recall procedure to describe where they stayed in the prior six months. We performed cluster analysis to classify residential venues and used multinomial logistic regression to identify individual factors prior to the onset of homelessness as well as the duration of unstable housing associated with living in them. We generated four residential groups describing those who were unsheltered (n = 162), cohabited unstably with friends and family (n = 57), resided in multiple institutional settings (shelters, jails, transitional housing) (n = 88), or lived primarily in rental housing (recently homeless) (n = 43). Compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Cohabiters and renters were significantly more likely to be women and have experienced a shorter duration of homelessness. Cohabiters were significantly more likely than unsheltered participants to have experienced abuse prior to losing stable housing. Pre-homeless social support appears to protect against street homelessness while low levels of social support may increase the risk for becoming homeless immediately after

  16. The Changing Character of Homelessness in the United States.

    ERIC Educational Resources Information Center

    Axelson, Leland J.; Dail, Paula W.

    1988-01-01

    Describes new form of homeless persons, a growing population of homeless individuals and families who are not mentally ill, not wanderers, and may be employed. Examines changing character of homelessness and makes recommendations for a public policy response to the problem. (Author/NB)

  17. The health encounter as a treatable moment for homeless substance-using adults: the role of homelessness, health seeking behavior, readiness for behavior change and motivation for treatment.

    PubMed

    O'Toole, Thomas P; Pollini, Robin A; Ford, Daniel E; Bigelow, George

    2008-09-01

    Substance-using homeless persons frequent emergency departments and hospitals often. However, little is known about how homelessness affects when they seek care and their motivation for substance abuse treatment (SAT). We surveyed homeless (N=266) and non-homeless (N=104) substance-using adults sequentially admitted to an urban hospital medicine service, comparing demographics, readiness for change (URICA), and motivating reasons for SAT. Homeless respondents were more likely to be younger, uninsured, have hepatitis B/C, and <12th grade education. The majority in both groups were in either a precontemplative or contemplative stage of change, although more homeless respondents were in an action stage. They also had similar motivating reasons for wanting SAT, although being homeless was an additional motivator for the majority of homeless respondents. Almost half reported that being homeless caused them to delay seeking health care; paradoxically those citing physical health as a SAT motivator were 3.4 times more likely to have delayed care. While acutely ill homeless persons were at least as motivated for SAT, these data suggest the challenge is getting them to care in a timely manner and tailoring interventions during the care episode to avail of this motivation.

  18. Quality of Health Care: The Views of Homeless Youth

    PubMed Central

    Ensign, Josephine

    2004-01-01

    Objective To develop homeless-youth-identified process and outcome measures of quality of health care. Data Sources/Study Setting Primary data collection with homeless youth from both street and clinic settings in Seattle, Washington, for calendar year 2002. Study Design The research was a focused ethnography, using key informant and in-depth individual interviews as well as focus groups with a purposeful sample of 47 homeless youth aged 12–23 years. Data Collection/Extraction Methods All interviews and focus groups were tape-recorded, transcribed, and preliminarily coded, with final coding cross-checked and verified with a second researcher. Principal Findings Homeless youth most often stated that cultural and interpersonal aspects of quality of care were important to them. Physical aspects of quality of care reported by the youth were health care sites separate from those for homeless adults, andsites that offered a choice of allopathic and complementary medicine. Outcomes of health care included survival of homelessness, functional and disease-state improvement, and having increased trust and connections with adults and with the wider community. Conclusions Homeless youth identified components of quality of care as well as how quality of care should be measured. Their perspectives will be included in a larger follow-up study to develop quality of care indicators for homeless youth. PMID:15230923

  19. 75 FR 23848 - Special Medical Advisory Group; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... DEPARTMENT OF VETERANS AFFAIRS Special Medical Advisory Group; Notice of Meeting The Department of... Special Medical Advisory Group will meet on May 14, 2010, in Room 830 at VA Central Office, 810 Vermont... the Group is to advise the Secretary of Veterans Affairs and the Under Secretary for Health on the...

  20. 75 FR 28858 - Agency Information Collection (Special Notice) Activities Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-24

    .... 3501-3521), this notice announces that the Office of Acquisition and Materiel Management, Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0588] Agency Information Collection (Special...

  1. 78 FR 42593 - Agency Information Collection (Special Notice) Activities Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    .... 3501-3521), this notice announces that the Office of Acquisition and Materiel Management, Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0588] Agency Information Collection (Special...

  2. Challenges to immunization: the experiences of homeless youth.

    PubMed

    Doroshenko, Alexander; Hatchette, Jill; Halperin, Scott A; MacDonald, Noni E; Graham, Janice E

    2012-07-04

    Homelessness is a critical social issue, both a product of, and contributing to, poor mental and physical health. Over 150,000 young Canadians live on the streets. Homeless youth experience a high incidence of infectious diseases, many of which are vaccine preventable. Early departure from school and limited access to public health services makes them a particularly vulnerable high-risk group. This study explores challenges to obtaining essential vaccines experienced by homeless youth. A qualitative research study to explore knowledge, attitudes, beliefs, and experiences surrounding immunization of hard-to-reach homeless youth was designed. Participants were recruited for focus groups from Phoenix House and Shelter, a non-profit, community-based organization assisting homeless youth in Halifax, Nova Scotia, Canada. An experienced facilitator guided the recorded discussions. Transcripts of audiotapes were analyzed using a constant comparative method until data revealed a set of exemplars and themes that best captured participants' knowledge, attitudes, beliefs and experiences surrounding immunization and infectious diseases. Important themes emerged from our analysis. Considerable variability in knowledge about immunization and vaccine preventable diseases was found. The homeless youth in the study had limited awareness of meningitis in contrast to a greater knowledge about sexually transmitted infections and influenza, gained during the H1N1/09 public health campaign. They recognized their poverty as a risk for contracting infectious diseases, along with their inability to always employ known strategies to prevent infectious diseases, due to circumstances. They showed considerable insight into the detrimental effects of poor hygiene, sleeping locations and risk behaviour. Interviewed homeless youth regarded themselves as good compliers of health professional advice and offered valuable suggestions to improve immunization in their population. To provide effective

  3. Challenges to immunization: the experiences of homeless youth

    PubMed Central

    2012-01-01

    Background Homelessness is a critical social issue, both a product of, and contributing to, poor mental and physical health. Over 150,000 young Canadians live on the streets. Homeless youth experience a high incidence of infectious diseases, many of which are vaccine preventable. Early departure from school and limited access to public health services makes them a particularly vulnerable high-risk group. This study explores challenges to obtaining essential vaccines experienced by homeless youth. Methods A qualitative research study to explore knowledge, attitudes, beliefs, and experiences surrounding immunization of hard-to-reach homeless youth was designed. Participants were recruited for focus groups from Phoenix House and Shelter, a non-profit, community-based organization assisting homeless youth in Halifax, Nova Scotia, Canada. An experienced facilitator guided the recorded discussions. Transcripts of audiotapes were analyzed using a constant comparative method until data revealed a set of exemplars and themes that best captured participants’ knowledge, attitudes, beliefs and experiences surrounding immunization and infectious diseases. Results Important themes emerged from our analysis. Considerable variability in knowledge about immunization and vaccine preventable diseases was found. The homeless youth in the study had limited awareness of meningitis in contrast to a greater knowledge about sexually transmitted infections and influenza, gained during the H1N1/09 public health campaign. They recognized their poverty as a risk for contracting infectious diseases, along with their inability to always employ known strategies to prevent infectious diseases, due to circumstances. They showed considerable insight into the detrimental effects of poor hygiene, sleeping locations and risk behaviour. Interviewed homeless youth regarded themselves as good compliers of health professional advice and offered valuable suggestions to improve immunization in their

  4. Hope as seen through the eyes of homeless children.

    PubMed

    Herth, K

    1998-11-01

    Children now constitute the largest segment of the homeless population. Multiple studies have identified the adverse effects of homelessness on children's health, development, academic success, and behaviour. Minimal literature exists that describes homeless children from the perspective of their strengths. The purpose of this study was to investigate the meaning of hope in homeless children and to identify strategies that children use in fostering and maintaining their hope. Using the technique of methodological triangulation (semi-structured interviews and drawings) the investigator collected data on a convenience sample of 60 homeless children (6 to 16 years old) currently residing in homeless shelters. Transcriptions of the audio-taped interviews were analysed following Colaizzi's method of analysis. Transcript statements were compared with the drawings. Five themes representing hope emerged from the data: connectedness, internal resources, cognitive strategies, energy, and hope objects. School age children drew story book tale characters, pre-adolescents drew real life situations, and adolescents drew future plans to represent their hopes. An understanding of hope from the perspective of homeless children could provide a basis upon which to develop interventions that engender hope and to develop programmes that build on the hopes that children had already developed.

  5. Involving homeless persons in the leadership of a health care organization.

    PubMed

    Buck, David S; Rochon, Donna; Davidson, Harriett; McCurdy, Sheryl

    2004-04-01

    Consumer advisory boards (CABs) are a way of involving patients in their health care. To engage the homeless in the administration of a health care organization for the homeless, a service agency formed such a board comprising homeless and formerly homeless individuals. The purpose was to integrate experiences of homelessness into programmatic design and research efforts of the organization, and to promote participatory research among the homeless. A content analysis and member checking revealed four distinct themes relating to committee goals, identity definition, power, and issues and needs of the homeless. Findings indicate that participatory research provided a useful structure in which the CAB could improve self-sufficiency and self-efficacy, and contribute to the direction of the health care agency.

  6. Local Homeless Education Liaisons: Important Information for New Liaisons. Best Practices in Homeless Education Brief Series

    ERIC Educational Resources Information Center

    National Center for Homeless Education at SERVE, 2015

    2015-01-01

    Homeless children and youth experience many challenges in enrolling and attending school and achieving educational success. The McKinney-Vento Homeless Assistance Act (reauthorized under Title X, Part C of the No Child Left Behind Act of 2001, and subsequently referred to as the McKinney-Vento Act in this brief) ensures rights and services for…

  7. Supporting Children and Families Experiencing Homelessness: CCDF State Guide

    ERIC Educational Resources Information Center

    Bires, Carie; Garcia, Carmen; Zhu, Julia

    2015-01-01

    Homelessness has a devastating impact on children. Research has shown that homelessness puts children at increased risk of health problems, developmental delays, academic underachievement and mental health problems. Homelessness also has a disproportionate impact on the youngest children, who account for more than half of all children in…

  8. Down and Out in London: Addictive Behaviors in Homelessness

    PubMed Central

    Sharman, Steve; Dreyer, Jenny; Clark, Luke; Bowden-Jones, Henrietta

    2016-01-01

    Backgrounds and aims Problem gambling occurs at higher levels in the homeless than the general population. Past work has not established the extent to which problem gambling is a cause or consequence of homelessness. This study sought to replicate recent observations of elevated rates of problem gambling in a British homeless sample, and extend that finding by characterizing (a) the temporal sequencing of the effect, (b) relationships with drug and alcohol misuse, and (c) awareness and access of treatment services for gambling by the homeless. Methods We recruited 72 participants from homeless centers in Westminster, London, and used the Problem Gambling Severity Index to assess gambling involvement, as well as DSM-IV criteria for substance and alcohol use disorders. A life-events scale was administered to establish the temporal ordering of problem gambling and homelessness. Results Problem gambling was evident in 23.6% of the sample. In participants who endorsed any gambling symptomatology, the majority were categorized as problem gamblers. Within those problem gamblers, 82.4% indicated that gambling preceded their homelessness. Participants displayed high rates of substance (31.9%) and alcohol dependence (23.6%); these were not correlated with PGSI scores. Awareness of treatment for gambling was significantly lower than for substance and alcohol use disorders, and actual access of gambling support was minimal. Discussion and conclusions Problem gambling is an under-recognized health issue in the homeless. Our observation that gambling typically precedes homelessness strengthens its role as a causal factor. Despite the elevated prevalence rates, awareness and utilization of gambling support opportunities were low compared with services for substance use disorders. PMID:27348556

  9. Young Children and Families Experiencing Homelessness

    ERIC Educational Resources Information Center

    Wilson, Allison B.; Squires, Jane

    2014-01-01

    The increasing prevalence of homelessness among young children and families in the United States is described, as is the developmental impact on young children and cost to society. Although services are mandated for this population under the McKinney­-Vento Act, Education of Homeless Children and Youth Program, and the Individuals With…

  10. Viral hepatitis in a homeless shelter in Hawai'i.

    PubMed

    Boyce, Daniel E C; Tice, Alan D; Ona, Fernando V; Akinaka, Kenneth T; Lusk, Heather

    2009-06-01

    It is estimated that as many as 21,000 people in the state of Hawai'i may be infected with HCV Most of those infected with viral hepatitis are unaware they are infected. Complications from viral hepatitis include liver cirrhosis and hepatocellular carcinoma. Hawai'i has the highest incidence of hepatocellular carcinoma in the United States. In 2003 there were over 6000 homeless and over 155,000 people at-risk of becoming homeless living in the state of Hawai'i. Risk factors for hepatitis, such as drug use, tattoos, sexual contact, and sharing of personal hygiene equipment are more prevalent in the homeless population. To determine the incidence of hepatitis B and C among a population of homeless individuals, a health fair was held at a Honolulu area homeless shelter with approximately 200 residents. The incidence of hepatitis B and C was determined by anti-HCV and HBsAg blood tests. A survey was also conducted regarding risk factors and basic demographics. Fifty-nine homeless adults volunteered for testing and took the survey. Thirty-one (52%) volunteers were born in Micronesia, twenty-four (41%) were born in the United States, two (3%) were born in Samoa, one (2%) was born in the Philippines, and one (2%) was born in the Marshall Islands. Forty adults were tested for Hepatitis C antibody, three of which tested positive. The primary risk factor among this group was jail time (100%), followed by illegal drug injection (67%), tattoos (67%), ear/body piercing (67%), snorting drugs (33%), blood transfusions (33%), and a sex partner with hepatitis (33%). Forty adults were also tested for HBsAg, One of which tested positive. This was a recent immigrant from Micronesia. Homeless people in Hawai'i are more likely to have hepatitis B or C because risk factors are common among this population. Additionally a large proportion of Hawai'i's homeless people come from the Pacific Islands, where the prevalence of hepatitis B is one of the highest in the world. In addition there

  11. Chronic Bartonella quintana bacteremia in homeless patients.

    PubMed

    Brouqui, P; Lascola, B; Roux, V; Raoult, D

    1999-01-21

    Infection with Bartonella quintana can cause trench fever, endocarditis, bacillary angiomatosis, and peliosis. An outbreak of bacteremia due to B. quintana has been reported among homeless people in Seattle, and the seroprevalence is high among homeless people in both the United States and Europe. Body lice are known to be the vectors of B. quintana. We studied all the homeless people who presented in 1997 to the emergency departments of the University Hospital, Marseilles, France. Blood was collected for microimmunofluorescence testing for antibodies against B. quintana and for culture of the bacterium. Body lice were collected and analyzed by the polymerase chain reaction and sequencing of a portion of the citrate synthase gene of B. quintana. In 10 of 71 homeless patients (14 percent), blood cultures were positive for B. quintana, and 21 of the patients (30 percent) had high titers of antibody against the organism. A total of 17 patients (24 percent) had evidence of recent infection (bacteremia or seroconversion). Tests of lice from 3 of the 15 patients from whom they were collected were positive for B. quintana. The homeless people with B. quintana bacteremia were more likely to have been exposed to lice (P=0.002), were more likely to have headaches (P=0.03) and severe leg pain (P<0.001), and had lower platelet counts (P=0.006) than the homeless people who were seronegative for B. quintana and did not have bacteremia; 8 of the 10 patients with bacteremia were afebrile. Five patients had chronic bacteremia, as indicated by positive blood cultures over a period of several weeks. In an outbreak of urban trench fever among homeless people in Marseilles, B. quintana infections were associated with body lice in patients with nonspecific symptoms or no symptoms.

  12. The U.S. Homeless Student Population: Homeless Youth Education, Review of Research Classifications and Typologies, and the U.S. Federal Legislative Response

    ERIC Educational Resources Information Center

    Rahman, Mai Abdul; Turner, J. Fidel; Elbedour, Salman

    2015-01-01

    Background: The drastic surge in the number of homeless families in the United States (U.S.) has resulted in an increase in the number of homeless students attending U.S. public schools. Meanwhile, the U.S. public school system is struggling to meet the educational needs of their homeless students. Objective: This study examined the historical…

  13. A Review of the Literature on LGBTQ Adults Who Experience Homelessness.

    PubMed

    Ecker, John; Aubry, Tim; Sylvestre, John

    2017-12-05

    Little is known about lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults who experience homelessness. The current review critically analyzes the scant literature on LGBTQ adults who experience homelessness, with a particular focus on: (1) pathways into homelessness; (2) support needs; (3) targeted programming; and (4) exits out of homelessness. A total of 143 articles were identified, and 16 articles met the criteria of appropriate age range, article quality, and relevance of topic. Results from this review demonstrate that homeless LGBTQ adults have unique physical and mental health challenges, largely concerning HIV and substance use. Transgender and gender non-conforming adults who experience homelessness encounter several challenges in the homelessness system, particularly in regard to safety and gender-affirming supports. Recommendations focus on practical implications for support and suggestions for future research.

  14. Homeless Adolescents' Perceptions of Positive Development: A Comparative Study

    ERIC Educational Resources Information Center

    Nott, Brooke Dolenc; Vuchinich, Samuel

    2016-01-01

    Background: While some recent research has addressed homeless youth from a strengths-based approach, comparative studies of homeless and non-homeless youth from a strengths perspective are few; research that includes youth's views on positive youth development are also limited. Objective: Addressing these gaps and using an inductive approach,…

  15. Employment and Other Income Sources Among Homeless Youth.

    PubMed

    Slesnick, Natasha; Zhang, Jing; Yilmazer, Tansel

    2018-05-12

    Homeless youth report high rates of unemployment. While homeless serving agencies usually offer employment services, most homeless youth are disengaged from homeless service agencies, and a limited number of studies have examined employment and other income sources among service disconnected youth. Our study examined income sources and change in income among service disconnected youth, all of whom received Strengths-Based Outreach and Advocacy (SBOA, N = 79). Findings revealed that over time employment and legal income from non-survival behaviors increased (e.g., governmental assistance and receiving income from friends and relatives), while income from survival behaviors decreased (e.g., prostitution, stealing, selling possessions, selling blood or plasma). Although unemployment among these youth remained high (62%), income from survival behaviors reduced most drastically. Findings also suggest that employment is linked to housing stability and mental health, as is substance use and income, which suggests that mental health, housing, and substance use treatment services are important components in income stabilization for homeless youth.

  16. Occupation-based practices and homelessness: A scoping review.

    PubMed

    Roy, Laurence; Vallée, Catherine; Kirsh, Bonnie H; Marshall, Carrie Anne; Marval, Rebecca; Low, Alissa

    2017-04-01

    Persons experiencing or at risk of homelessness have occupational needs that are seldom addressed in the Canadian system of care. The lack of documented evidence on occupational therapy practices in this field hinders the development of the profession. This article identifies current and potential practices that aim to enable or support the occupations of persons experiencing or at risk of homelessness. A scoping review was conducted, including evidence from both occupational therapy and non-occupational therapy sources. One hundred and seventy-eight papers were selected in the areas of occupational performance skills training, enrichment of occupational repertoire, employment/education, physical rehabilitation services, child/family services, community building, occupational transition from homeless to housed, literacy, and disaster relief. Occupational therapists can build environments and create opportunities that facilitate occupational engagement of individuals experiencing homelessness. Gaps in knowledge include the evaluation of occupational therapy practices, the Canadian context of family homelessness, and the cultural safety of occupational therapy interventions.

  17. The mental health needs of military service members and veterans.

    PubMed

    Lazar, Susan G

    2014-09-01

    The prevalence in active duty military service members of 30-day DSM-IV psychiatric disorders, including posttraumatic stress disorders and major depressive disorder, is greater than among sociodemographically-matched civilians. Only 23-40% of returning military who met strict criteria for any mental health problem in 2004 had received professional help in the past year. One-fourth of Regular Army soldiers meet criteria for a 30-day DSM-IV mental disorder, two-thirds of whom report a pre-enlistment age of onset. Both pre- and post-enlistment age of onset are predictors of severe role impairment which was reported by 12.8% of respondents. In addition, three-fifths of those with severe role impairment had at least one psychiatric diagnosis. The number of deployments, especially three or more, is positively correlated with all disorders, especially major depressive disorder, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, and intermittent explosive disorder. Patients with posttraumatic stress disorder and major depressive disorder frequently have comorbidity with other psychiatric diagnoses and an increased death rate from homicide, injury, and cardiovascular disease, and are at increased risk of medical illness, smoking and substance abuse, decreased employment and work productivity, marital and family dysfunction and homelessness. Active duty suicides have increased from a rate lower than among civilians to one exceeding that in civilians in 2008. Suicides among veterans climbed to 22 per day in 2010 with male veterans having twice the risk of dying from suicide as their civilian counterparts. Associated extremely high costs of psychiatric illness in decreased productivity and increased morbidity and mortality can be ameliorated with appropriate treatment which is not yet fully available to veterans in need. In addition, Veterans Administration/Department of Defense treatment guidelines to date do not recognize the need for intensive

  18. The Relationship between Literacy and Depression and Anxiety in Homeless Adults

    ERIC Educational Resources Information Center

    Holland, Mark Edward

    2014-01-01

    Homelessness is a problem that has correlating social, psychological, and health problems. The pathways that lead to homelessness are plentiful and varied, as are the risk factors that are associated with chronic homelessness. Much of the research that has been completed with homeless individuals has focused on substance use or psychological…

  19. Youth Homelessness: The Impact of Supportive Relationships on Recovery.

    PubMed

    Gasior, Sara; Forchuk, Cheryl; Regan, Sandra

    2018-03-01

    Background Homeless youth are the fastest growing sub-group within the homeless population. They face impaired access to health services and are often left unsupported. They lack social and family support or relationships with service providers. Unsupported homeless youth often become homeless adults. Purpose To test a model based on Peplau's Theory of Interpersonal Relations, examining the influence of a network of service providers, perceptions of social supports, and family relations on a homeless youth's perceptions of recovery. Methods This study is a secondary analysis and used a sample (n = 187) of data collected as part of the original Youth Matters in London study. A cross-sectional design was used to analyze the relationship between variables. Participants were interviewed at 6-month intervals over a 2.5-year period. Hierarchical multiple regression analysis was used. Results Network of service providers, perceived social supports, and perceived family relations explained 21.8% of the variance in homeless youth perceptions of recovery. Perceived social support and family relations were significantly, positively correlated to perceptions of recovery. Network of service providers was not significantly correlated to perceptions of recovery. Conclusions The findings suggest that stronger social supports and family relations may contribute to increased perceptions of recovery among homeless youth.

  20. Homeless Housing: HUD's Shelter Programs. Updated.

    ERIC Educational Resources Information Center

    Vanhorenbeck, Susan M.

    This paper briefly discusses new housing programs for the homeless sponsored by the Department of Housing and Urban Development (HUD), the funding provided by the 100th Congress, and two additional HUD programs to aid the homeless. The following four programs are discussed: (1) the Emergency Shelter Program; (2) the Transitional Housing Program,…