Science.gov

Sample records for va homeless providers

  1. 78 FR 28949 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (Rehabilitation)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... AFFAIRS Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (Rehabilitation) AGENCY... announces the availability of rehabilitation funds under VA's Homeless Providers Grant and Per Diem Program... local or state codes. Each rehabilitation funded program will submit quarterly reports to the Grant...

  2. 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...

  3. 75 FR 3970 - Fund Availability Under the VA Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-25

    ... country suffer from mental illness or substance abuse disorders or are dually diagnosed with both mental illness and substance abuse disorders. In addition, many homeless veterans have serious medical...

  4. 75 FR 3968 - Fund Availability Under the VA Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-25

    ... organizations should know that the vast majority of homeless veterans in this country suffer from ] mental illness or substance abuse disorders or are dually diagnosed with both mental illness and substance...

  5. 78 FR 12600 - VA Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... of Veterans Affairs. ACTION: Final rule. SUMMARY: This document adopts as a final rule, with changes, the proposed rule to amend the Department of Veterans Affairs (VA) regulations concerning...

  6. 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

    ... community; (2) Facilitate reintegration with the community and provide services that may optimize reintegration such as life-skills education, recreational activities, and follow up case management; (3)...

  7. 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

    ..., and plans for social engagement within the program and in the community; (3) Provide opportunities for... participants to engage in ``tasks of dying,'' or activities of ``getting things in order'' or other...

  8. 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

    ... a job description for the van operator that details the following: (a) Requirements of the position... will take for the van(s) acquisition to occur. Description of Need: The information you provide here...) for special disabled individual transportation? Description of Activity: Describe how the van(s)...

  9. 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

  10. 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.

  11. Homeless women's experiences of service provider encounters.

    PubMed

    Biederman, Donna J; Nichols, Tracy R

    2014-01-01

    Service providers are gatekeepers to health-sustaining services and resources, although little is known about service encounters from the perspective of homeless women. We conducted in-depth semistructured interviews with 15 homeless women to better understand their experiences of service encounters. Using a phenomenological method, 160 significant statements were extracted from participant transcripts; more positive than negative interactions were reported. The 10 themes that emerged fall along a dehumanizing/humanizing continuum primarily separated by the power participants experienced in the interaction and the trust they felt in the service provider. Implications for nursing practice and research are offered. PMID:24528122

  12. Homeless and nonhomeless VA service users likely eligible for Medicaid expansion.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2014-01-01

    Administrative data on the population of Department of Veterans Affairs (VA) service users in 2010 under the age of 65 (n = 3,841,225) were analyzed to identify the number and characteristics of homeless and nonhomeless VA service users who are likely to be eligible for the Medicaid expansion (LEME) option under the Affordable Care Act. Results showed that, estimating conservatively, about 1.2 million (21%) current VA users are LEME if all states implement the expansion. Homeless service users were twice as likely to be eligible than nonhomeless users (64% vs 30%). VA service users who are LEME, regardless of housing status, were physically healthier than those not LEME but were more likely to have substance use disorders and posttraumatic stress disorder. These findings suggest that many VA service users are LEME, particularly those who are homeless and/or have mental health needs. Cross-system use of VA and Medicaid-funded services may be advantageous for veterans with extensive medical and psychiatric needs but also risks fragmented care. Information and education for VA clinicians and their patients about possible implications of the Affordable Care Act may be important. PMID:25358031

  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. Homelessness: Programs and the People They Serve. Summary Report. Findings of the National Survey of Homeless Assistance Providers and Clients.

    ERIC Educational Resources Information Center

    Burt, Martha R.; Aron, Laudan Y.; Douglas, Toby; Valente, Jesse; Lee, Edgar; Iwen, Britta

    The National Survey of Homeless Assistance Providers and Clients (NSHAPC) was conducted to provide information about the providers of homeless assistance services and the characteristics of homeless clients who use them. This survey was conducted for use by federal agencies and other interested parties responsible for administering homeless…

  15. Barriers and facilitators to Veterans Administration collaboration with community providers: the Lodge Project for homeless veterans.

    PubMed

    Cretzmeyer, Margaret; Moeckli, Jane; Liu, William Ming

    2014-01-01

    Since 2009, the U.S. Veterans Administration has made concentrated efforts to end homelessness among veterans. As part of these efforts, the Iowa City, Iowa, VA Health Care System in collaboration with local community providers deployed a supportive housing program aimed at homeless veterans. Called the Lodge program, it is intended to serve a Mid-Western mid-size city and its surrounding rural communities. This article presents qualitative findings from a mixed-method, two-year formative evaluation of the Lodge's implementation. Primary barriers to the effectiveness of the Lodge program were regulations hindering cooperation between service programs, followed by problems regarding information sharing and client substance abuse. Facilitators included personal communication and cooperation between individuals within and among service groups. The feasibility of implementing a Lodge program in a more rural community than Iowa City was also discussed.

  16. Homeless health needs: shelter and health service provider perspective.

    PubMed

    Hauff, Alicia J; Secor-Turner, Molly

    2014-01-01

    The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.

  17. Providing Homeless Adults with Advantage: A Sustainable University Degree Program

    ERIC Educational Resources Information Center

    Sinatra, Richard; Lanctot, Melissa Kim

    2016-01-01

    A university partnered with the New York City Department of Homeless Services (NYC DHS) to provide cohorts of adults a 60-credit Associate Degree Program in Business Administration over a 2-year period. Results of two cohorts of 30 Advantage Academy Program graduates revealed significant improvement in College Board AccuPlacer (ACPL) Arithmetic…

  18. Homeless youths' interpersonal perspectives of health care providers.

    PubMed

    Hudson, Angela L; Nyamathi, Adeline; Sweat, Jeff

    2008-12-01

    In the United States, youth run away from home due to poor interpersonal relationships with parents or guardians; often times, they have been the recipients of parental neglect or abuse. As youth become increasingly entrenched in street-based living and problem substance use, their ability to rehabilitate their lives is incumbent upon trusting and engaging relationships with adult service providers. A total of 54 substance-using homeless youth (18-25 years) participated in focus groups to provide their perspectives on encounters and interpersonal relationships with health care providers. Participants were recruited from shelters in Hollywood, California, and from a drop-in shelter in Santa Monica, California. Four themes related to interpersonal barriers to care from service providers were identified: authoritative communication, one-way communication, disrespect, and empathy. Participants appreciate care providers who convey information in a helpful, meaningful manner and prefer providers who can, themselves, share similar life experiences. Implications point to the need for agencies and services specifically tailored to homeless, drug-using youth. These agencies should employ care providers who are trained to understand the developmental needs and histories of runaway youth. For proper reintegration of this vulnerable population into mainstream society, the narratives of these youth underscore the necessity of targeted services.

  19. Providing smoking cessation programs to homeless youth: the perspective of service providers.

    PubMed

    Shadel, William G; Tucker, Joan S; Mullins, Leslie; Staplefoote, Lynette

    2014-10-01

    There is almost no information available on cigarette smoking among homeless youth, whether they are currently receiving services for smoking cessation, and how to best help them quit. This paper presents data collected from a series of semi-structured telephone interviews with service providers from 23 shelters and drop-in centers serving homeless youth in Los Angeles County about their current smoking cessation programming, interest in providing smoking cessation services to their clients, potential barriers to providing this service, and ways to overcome these barriers. Results indicated that 84% of facilities did not offer smoking cessation services, although nearly all (91%) were interested in doing so. Barriers to implementing formal smoking cessation programs on site included lack of resources (e.g., money, personnel) to support the programs, staff training, and concern that smoking cessation may not be a high priority for homeless youth themselves. Overall, service providers seemed to prefer a less intensive smoking cessation program that could be delivered at their site by existing staff. Data from this formative needs assessment will be useful for developing and evaluating a smoking cessation treatment that could be integrated into the busy, complex environment that characterizes agencies that serve homeless youth. PMID:25012554

  20. Providing smoking cessation programs to homeless youth: the perspective of service providers.

    PubMed

    Shadel, William G; Tucker, Joan S; Mullins, Leslie; Staplefoote, Lynette

    2014-10-01

    There is almost no information available on cigarette smoking among homeless youth, whether they are currently receiving services for smoking cessation, and how to best help them quit. This paper presents data collected from a series of semi-structured telephone interviews with service providers from 23 shelters and drop-in centers serving homeless youth in Los Angeles County about their current smoking cessation programming, interest in providing smoking cessation services to their clients, potential barriers to providing this service, and ways to overcome these barriers. Results indicated that 84% of facilities did not offer smoking cessation services, although nearly all (91%) were interested in doing so. Barriers to implementing formal smoking cessation programs on site included lack of resources (e.g., money, personnel) to support the programs, staff training, and concern that smoking cessation may not be a high priority for homeless youth themselves. Overall, service providers seemed to prefer a less intensive smoking cessation program that could be delivered at their site by existing staff. Data from this formative needs assessment will be useful for developing and evaluating a smoking cessation treatment that could be integrated into the busy, complex environment that characterizes agencies that serve homeless youth.

  1. Payment for non-VA physician services associated with either outpatient or inpatient care provided at non-VA facilities--VA. Proposed rule.

    PubMed

    1997-07-22

    This document proposes to amend Department of Veterans Affairs (VA) medical regulations concerning payment for non-VA physician services that are associated with either outpatient or inpatient care provided to eligible VA beneficiaries at non-VA facilities. We propose that when a service specific reimbursement amount has been calculated under Medicare's Participating Physician Fee Schedule, VA would pay the lesser of the actual billed charge or the calculated amount. We also propose that when an amount has not been calculated, VA would pay the amount calculated under a 75th percentile formula or, in certain limited circumstances, VA would pay the usual and customary rate. In our view, adoption of this proposal would establish reimbursement consistency among federal health benefits programs, would ensure that amounts paid to physicians better represent the relative resource inputs used to furnish a service, and, would, as reflected by a recent VA Office of Inspector General (OIG) audit of the VA fee-basis program, achieve program cost reductions. Further, consistent with statutory requirements, the regulations would continue to specify that VA payment constitutes payment in full.

  2. Providing Lifelines for Our Nation's Homeless Youth

    ERIC Educational Resources Information Center

    Duffield, Barbara

    2013-01-01

    This article discusses educational challenges for homeless children and explains how districts can and must meet their needs. According to the U.S. Department of Education Federal Data Collection, 1,065,794 homeless children and youth were enrolled in public schools for the school year 2010-2011, the highest number on record. After listing…

  3. Assessing the need for a medical respite: perceptions of service providers and homeless persons.

    PubMed

    Biederman, Donna J; Gamble, Julia; Manson, Marigny; Taylor, Destry

    2014-01-01

    For homeless persons, posthospitalization care is increasingly provided in formal medical respite programs, and their success is now reported in the literature. However, there is a dearth of literature on posthospitalization transitional care for homeless persons in the absence of a respite program. Through this formative study, we sought to understand the process of securing posthospitalization care in the absence of a formal homeless medical respite. Results demonstrated a de facto patchwork respite process that has emerged. We describe both human and monetary costs associated with patchwork respite and demonstrate opportunities for improvement in homeless health care transitions. PMID:25051320

  4. Assessing the need for a medical respite: perceptions of service providers and homeless persons.

    PubMed

    Biederman, Donna J; Gamble, Julia; Manson, Marigny; Taylor, Destry

    2014-01-01

    For homeless persons, posthospitalization care is increasingly provided in formal medical respite programs, and their success is now reported in the literature. However, there is a dearth of literature on posthospitalization transitional care for homeless persons in the absence of a respite program. Through this formative study, we sought to understand the process of securing posthospitalization care in the absence of a formal homeless medical respite. Results demonstrated a de facto patchwork respite process that has emerged. We describe both human and monetary costs associated with patchwork respite and demonstrate opportunities for improvement in homeless health care transitions.

  5. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... providers who provide temporary residential assistance for homeless persons with serious mental illness, and... in 48 CFR chapters 1 and 8. Such contracts will be awarded only after the quality, effectiveness...

  6. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... providers who provide temporary residential assistance for homeless persons with serious mental illness, and... in 48 CFR chapters 1 and 8. Such contracts will be awarded only after the quality, effectiveness...

  7. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... providers who provide temporary residential assistance for homeless persons with serious mental illness, and... in 48 CFR chapters 1 and 8. Such contracts will be awarded only after the quality, effectiveness...

  8. 78 FR 26250 - Payment for Home Health Services and Hospice Care to Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... November 21, 2011 (76 FR 71920), VA proposed to amend its regulations concerning the billing methodology... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care to Non-VA Providers... services and hospice care. Because the newly applicable methodology cannot supersede rates for which VA...

  9. Increasing School Stability for Students Experiencing Homelessness: Overcoming Challenges to Providing Transportation to the School of Origin

    ERIC Educational Resources Information Center

    Bowman, Diana; Barksdale, Katina

    2004-01-01

    The purpose of this monograph is to review the provisions of the McKinney-Vento Homeless Assistance Act as related to the provision of transportation of homeless children and youth to their school of origin and provide recommendations for implementing the transportation mandate. The National Center for Homeless Education (NCHE) in 2003-2004…

  10. 38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... rehabilitation counseling, in collaboration with VA programs and community resources. (c) Quality of life, room... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Duties of, and standards... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.15 Duties...

  11. 38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... rehabilitation counseling, in collaboration with VA programs and community resources. (c) Quality of life, room... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Duties of, and standards... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.15 Duties...

  12. 38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... rehabilitation counseling, in collaboration with VA programs and community resources. (c) Quality of life, room... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Duties of, and standards... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.15 Duties...

  13. 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

  14. Detecting earlier indicators of homelessness in the free text of medical records.

    PubMed

    Redd, Andrew; Carter, Marjorie; Divita, Guy; Shen, Shuying; Palmer, Miland; Samore, Matthew; Gundlapalli, Adi V

    2014-01-01

    Early warning indicators to identify US Veterans at risk of homelessness are currently only inferred from administrative data. References to indicators of risk or instances of homelessness in the free text of medical notes written by Department of Veterans Affairs (VA) providers may precede formal identification of Veterans as being homeless. This represents a potentially untapped resource for early identification. Using natural language processing (NLP), we investigated the idea that concepts related to homelessness written in the free text of the medical record precede the identification of homelessness by administrative data. We found that homeless Veterans were much higher utilizers of VA resources producing approximately 12 times as many documents as non-homeless Veterans. NLP detected mentions of either direct or indirect evidence of homelessness in a significant portion of Veterans earlier than structured data.

  15. Provider views of harm reduction versus abstinence policies within homeless services for dually diagnosed adults.

    PubMed

    Henwood, Benjamin F; Padgett, Deborah K; Tiderington, Emmy

    2014-01-01

    Harm reduction is considered by many to be a legitimate alternative to abstinence-based services for dually diagnosed individuals, yet there is limited understanding of how varying approaches affect front-line practice within services for homeless adults. This paper examines how front-line providers working with individuals who have experienced homelessness, serious mental illness, and addiction view policies of harm reduction versus abstinence within two different approaches to homeless services: the traditional or "treatment first" approach that requires abstinence, and the more recent housing first approach that incorporates harm reduction. As part of a federally funded qualitative study, 129 in-depth interviews conducted with 41 providers were thematically analyzed to understand how providers view harm reduction versus abstinence approaches. Themes included the following: (a) harm reduction as a welcomed alternative, (b) working with ambiguity, and (c) accommodating abstinence. Drawing on recovery principles, the authors consider the broader implications of the findings for behavioral health care with this population.

  16. College Access and Success for Students Experiencing Homelessness: A Toolkit for Educators and Service Providers

    ERIC Educational Resources Information Center

    Dukes, Christina

    2013-01-01

    This toolkit serves as a comprehensive resource on the issue of higher education access and success for homeless students, including information on understanding homeless students, assisting homeless students in choosing a school, helping homeless students pay for application-related expenses, assisting homeless students in finding financial aid…

  17. The Education of Homeless Children: Rules, Rights and Practical Solutions. A Training Manual for Shelter Providers, Staff, Advocates and Parents.

    ERIC Educational Resources Information Center

    Heybach, Laurene M.; Nix-Hodes, Patricia; Price, Sarah

    These training materials provide advocates with the tools needed to help families obtain a stable and effective education for their children despite the condition of homelessness and the trauma that accompanies it. Nine sections include: (1) "Introduction"; (2) "How Mobility Hurts Homeless Children and Schools"; (3) "Laws and Rules Governing the…

  18. Client-provider relationships in a community health clinic for people who are experiencing homelessness.

    PubMed

    Oudshoorn, Abe; Ward-Griffin, Catherine; Forchuk, Cheryl; Berman, Helene; Poland, Blake

    2013-12-01

    Recognizing the importance of health-promoting relationships in engaging people who are experiencing homelessness in care, most research on health clinics for homeless persons has involved some recognition of client-provider relationships. However, what has been lacking is the inclusion of a critical analysis of the policy context in which relationships are enacted. In this paper, we question how client-provider relationships are enacted within the culture of community care with people who are experiencing homelessness and how clinic-level and broader social and health policies shape relationships in this context. We explore these questions within a critical theoretical perspective utilizing a critical ethnographic methodology. Data were collected using multiple methods of document review, participant observation, in-depth interviews and focus groups. The participants include both clients at a community health clinic, and all clinic service providers. We explore how clients and providers characterized each other as 'good' or 'bad'. For providers, this served as a means by which they policed behaviours and enforced social norms. The means by which both providers' and clients' negotiated relationships are explored, but this is couched within both local and system-level policies. This study highlights the importance of healthcare providers and clients being involved in broader policy and systemic change.

  19. Health Care for Homeless Veterans program. Final rule.

    PubMed

    2015-05-01

    The Department of Veterans Affairs (VA) amends its medical regulations concerning eligibility for the Health Care for Homeless Veterans (HCHV) program. The HCHV program provides per diem payments to non-VA community-based facilities that provide housing, outreach services, case management services, and rehabilitative services, and may provide care and/or treatment to homeless veterans who are enrolled in or eligible for VA health care. The rule modifies VA's HCHV regulations to conform to changes enacted in the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012. Specifically, the rule removes the requirement that homeless veterans be diagnosed with a serious mental illness or substance use disorder to qualify for the HCHV program. This change makes the program available to all homeless veterans who are enrolled in or eligible for VA health care. The rule also updates the definition of homeless to match in part the one used by the Department of Housing and Urban Development (HUD). The rule further clarifies that the services provided by the HCHV program through non-VA community-based providers must include case management services, including non-clinical case management, as appropriate. PMID:25985477

  20. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... medical charges associated with non-VA outpatient care, provided under 38 CFR 17.52 or 17.120. 75 FR 78901.... See 75 FR 78901. We explained: Home Health Care and Hospice Care he pricing methodology adopted by...-day period was $2,537.40 in FY 2010. The average Medicare reimbursement level for skilled home...

  1. Medical Respite and Linkages to Outpatient Health Care Providers among Individuals Experiencing Homelessness.

    PubMed

    Zur, Julia; Linton, Sabriya; Mead, Holly

    2016-01-01

    Medical respite programs provide nursing care and case management to individuals experiencing homelessness following hospitalization for an acute medical problem. One goal of these programs is to link clients to outpatient providers to decrease their reliance on hospital services. Through qualitative interviews with staff members (n = 8) and clients (n = 14) at a medical respite program, we explored processes of, and challenges associated with, linking clients to outpatient care. Six themes were identified, which offer insight about important considerations when linking clients to outpatient providers and highlight the value of medical respite programs for this population. PMID:27074404

  2. 77 FR 12647 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... forced to find other housing in 24 months or less. This model does not support discharge planning that... NOFA, or implement a new ``transition in place'' housing model to facilitate housing stabilization... (see section E., below, for explanation of funding priorities). The maximum award of $1.2 million...

  3. Diabetes in homeless persons: barriers and enablers to health as perceived by patients, medical, and social service providers.

    PubMed

    Elder, Nancy C; Tubb, Matthew R

    2014-01-01

    The ways homelessness and diabetes affect each other is not well known. The authors sought to understand barriers and enablers to health for homeless people with diabetes as perceived by homeless persons and providers. The authors performed semistructured interviews with a sample of participants (seven homeless persons, six social service providers, and five medical providers) in an urban Midwest community. Data analysis was performed with the qualitative editing method. Participants described external factors (chaotic lifestyle, diet/food availability, access to care, and medications) and internal factors (competing demands, substance abuse, stress) that directly affect health. Social service providers were seen as peripheral to diabetes care, although all saw their primary functions as valuable. These factors and relationships are appropriately modeled in a complex adaptive chronic care model, where the framework is bottom up and stresses adaptability, self-organization, and empowerment. Adapting the care of homeless persons with diabetes to include involvement of patients and medical and social service providers must be emergent and responsive to changing needs.

  4. 76 FR 52575 - Health Care for Homeless Veterans Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... homelessness. 75 FR 79323. We included a 60-day comment period and invited interested persons to submit written... homeless.'' One of VA's National priorities is a renewed effort to end homelessness for veterans. For this... disorder is a contributing cause of homelessness, then that disorder is serious; therefore, it...

  5. Teaching Our Homeless Children

    ERIC Educational Resources Information Center

    Sheldon, George H.

    2011-01-01

    This paper discusses some of the major concerns associated with the instructional process of our homeless children. The reader is provided with a brief overview of the prevalence of this population. According to the National Center on Family Homelessness the number of school children who are homeless is growing rapidly with 1.4 to 1.5 million…

  6. Homelessness: A General Information Packet.

    ERIC Educational Resources Information Center

    Homelessness Exchange, Washington, DC.

    This packet contains documents that provide general information about homelessness and the need for both Federal and local action to help the homeless people in America. Sections 1 and 2 contain the following articles released by the Homelessness Information Exchange: (1) "The Problem of Homelessness Nationwide"; and "Alternative Family Housing…

  7. VA Community Mental Health Service Providers' Utilization of and Attitudes toward Telemental Health Care: The Gatekeeper's Perspective

    ERIC Educational Resources Information Center

    Jameson, John Paul; Farmer, Mary Sue; Head, Katharine J.; Fortney, John; Teal, Cayla R.

    2011-01-01

    Context: Mental health (MH) providers in community-based outpatient clinics (CBOCs) are important stakeholders in the development of the Veterans Health Administration (VA) telemental health (TMH) system, but their perceptions of these technologies have not been systematically examined. Purpose: The purpose of this study was to investigate the…

  8. 38 CFR 17.120 - Payment or reimbursement for emergency treatment furnished by non-VA providers to certain...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Payment or reimbursement for emergency treatment furnished by non-VA providers to certain veterans with service-connected disabilities. 17.120 Section 17.120 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment and Reimbursement of...

  9. The New Homelessness Revisited.

    PubMed

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

    2010-08-01

    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

  10. 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.

  11. 77 FR 39342 - Proposed Information Collection (Homeless Providers Grant and Per Diem Program) Activity; Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ... Federal Docket Management System (FDMS) at www.Regulations.gov ; or to Cynthia Harvey-Pryor, Veterans... 20420; or email: cynthia.harvey-pryor@va.gov . Please refer to ``OMB Control No. 2900-0554'' in any... INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461-5870 or Fax (202) 273-9381. SUPPLEMENTARY...

  12. 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

  13. National Coalition for Homeless Veterans

    MedlinePlus

    ... Donate 1 2 3 4 NCHV will end homelessness among veterans by shaping public policy, promoting collaboration, ... providers. CFC #50917 You have helped reduce veteran homelessness by 70% since 2005. SITE SEARCH Search HEADLINES ...

  14. Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients☆

    PubMed Central

    Lapham, Gwen T.; Rubinsky, Anna D.; Shortreed, Susan M.; Hawkins, Eric J.; Richards, Julie; Williams, Emily C.; Berger, Douglas; Chavez, Laura J.; Kivlahan, Daniel R.; Bradley, Katharine A.

    2015-01-01

    Background Performance measures for brief alcohol interventions (BIs) are currently based on provider documentation of BI. However, provider documentation may not be a reliable measure of whether or not patients are offered clinically meaningful BIs. In particular, BI documented with clinical decision support in an electronic medical record (EMR) could appear identical irrespective of the quality of BI provided. We hypothesized that differences in how BI was implemented across health systems could lead to differences in the proportion of documented BI recalled and reported by patients across health systems. Methods Male outpatients with unhealthy alcohol use identified by confidential satisfaction surveys (2009–2012) were assessed for whether they reported receiving BI in the past year (patient-reported BI) and whether they had BI documented in the EMR during the same period (documented BI). We evaluated and compared the prevalence of documented BI to patient-reported BI across 21 VA networks to determine whether documented BI had a variable association with patient-reported BI across the networks. Results Of 9896 eligible male outpatients with unhealthy alcohol use, 59.0% (95% CI 57.4–60.5%) reported BI (50.4–64.9% across networks) and 37.4% (95% CI 36.0–38.9%) had BI documented in the EMR (28.0–44.2% across networks). Overall, 72.9% (95% CI 70.8–75.5%) of patients with documented BI also reported BI. The association between documented BI and patient-reported BI did not vary across VA networks in adjusted logistic regression models. Conclusions Performance measures of BI that rely on provider documentation in EMRs appear comparable to patient report for comparing care across VA networks. PMID:26072218

  15. 75 FR 79323 - Health Care for Homeless Veterans Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-20

    ... renewed effort to end homelessness for veterans. For this reason, we are proposing to establish... homelessness, then that disorder is serious; therefore, it is consistent to include such veterans in a program... therapeutic housing or other VA programs designed to end homelessness. The primary purposes of this...

  16. 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

  17. 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

  18. Homeless Students: A Search for Understanding.

    ERIC Educational Resources Information Center

    Robertson, Donna Friedman

    1998-01-01

    Describes a qualitative research project examining homelessness's effects on children's schooling, highlighting a South Carolina intervention program's success. Research disclosed an informal homelessness "caste system," the political unpopularity of providing homeless services, homeless kids' high rates of academic failure and problem behaviors,…

  19. People Experiencing Chronic Homelessness

    MedlinePlus

    ... Ending Family Homelessness Ending Youth Homelessness Setting a Path to End All Homelessness Solutions Solutions Housing Housing ... Ending Family Homelessness Ending Youth Homelessness Setting a Path to End All Homelessness Solutions Solutions Housing Housing ...

  20. 24 CFR 91.205 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Homeless needs. The plan must provide a concise summary of the nature and extent of homelessness (including rural homelessness and chronically homeless persons), addressing separately the need for facilities and...) who are currently housed but threatened with homelessness. The plan also must contain a...

  1. 24 CFR 91.205 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Homeless needs. The plan must provide a concise summary of the nature and extent of homelessness (including rural homelessness and chronically homeless persons), addressing separately the need for facilities and...) who are currently housed but threatened with homelessness. The plan also must contain 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. Homelessness and Hunger*

    PubMed Central

    Lee, Barrett A; Greif, Meredith J

    2014-01-01

    We employ data from the National Survey of Homeless Assistance Providers and Clients to examine the character and correlates of hunger among homeless people. Our analysis, couched in an adaptation framework, finds more support for the differentiation hypothesis than for the leveling hypothesis: Complex patterns of food insecurity exist at the individual level, and they vary with the resources available (e.g., higher monthly income, regular shelter use) and obstacles faced (e.g., alcohol, drug, and physical and mental health problems). The chronically homeless, who suffer from multiple deficits, appear particularly food-insecure, a finding that favors the desperation hypothesis over its street-wisdom alternative. We conclude that hunger is not uniformly experienced by members of the homeless population. Rather, some individuals are better situated than others to cope with the stressful nature of homelessness when addressing their sustenance needs. PMID:18418982

  4. 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

  5. For Homeless Veterans

    MedlinePlus

    ... families find and sustain permanent housing. How It Works Through public housing authorities, HUD provides rental assistance ... might remain homeless without this assistance. How It Works Through referrals and direct outreach, nonprofit agencies and ...

  6. Health care of homeless veterans.

    PubMed

    O'Toole, Thomas P; Conde-Martel, Alicia; Gibbon, Jeanette L; Hanusa, Barbara H; Fine, Michael J

    2003-11-01

    It is important to understand the needs of those veterans who are homeless. We describe characteristics of homeless male veterans and factors associated with needing VA benefits from a two-city, community survey of 531 homeless adults. Overall, 425 were male, of whom 127 were veterans (29.9%). Significantly more veterans had a chronic medical condition and two or more mental health conditions. Only 35.1% identified a community clinic for care compared with 66.8% of non-veterans (P <.01); 47.7% identified a shelter-based clinic and 59.1% reported needing VA benefits. Those reporting this need were less likely to report a medical comorbidity (58.7% vs 76.9%; P =.04), although 66.7% had a mental health comorbidity and 82.7% met Diagnosic Screening Manual (DSM)-IIIR criteria for substance abuse/dependence. They were also significantly more likely to access shelter clinics compared with veterans without this need. Homeless veterans continue to have substantial health issues. Active outreach is needed for those lacking access to VA services. PMID:14687279

  7. Report on Homeless Families in Virginia.

    ERIC Educational Resources Information Center

    Luongo, Gerardine M.; Zoller, Mary

    This report provides policymakers and advocates with information about the problems homeless families face and outlines short- and long-term solutions. Initial sections provide facts on homelessness in Virginia, an introduction, and an overview. Subsequent sections explore: (1) identification of the homeless and their characteristics; (2) causes…

  8. Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam

    PubMed Central

    2009-01-01

    during homelessness should be provided. PMID:19128448

  9. Development of the Primary Care Quality-Homeless (PCQ-H) Instrument: A Practical Survey of Patients' Experiences in Primary Care

    PubMed Central

    Kertesz, Stefan. G.; Pollio, David E.; Jones, Richard N.; Steward, Jocelyn; Stringfellow, Erin J.; Gordon, Adam J.; Johnson, Nancy K.; Kim, Theresa A.; Granstaff, Unita; Austin, Erika L.; Young, Alexander S.; Golden, Joya; Davis, Lori L.; Roth, David L.; Holt, Cheryl L.

    2015-01-01

    Background Homeless patients face unique challenges in obtaining primary care responsive to their needs and context. Patient experience questionnaires could permit assessment of patient-centered medical homes for this population, but standard instruments may not reflect homeless patients' priorities and concerns. Objectives This report describes (a) the content and psychometric properties of a new primary care questionnaire for homeless patients and (b) the methods utilized in its development. Methods Starting with quality-related constructs from the Institute of Medicine, we identified relevant themes by interviewing homeless patients and experts in their care. A multidisciplinary team drafted a preliminary set of 78 items. This was administered to homeless-experienced clients (n=563) across 3 VA facilities and 1 non-VA Health Care for the Homeless Program. Using Item Response Theory, we examined Test Information Function curves to eliminate less informative items and devise plausibly distinct subscales. Results The resulting 33-item instrument (Primary Care Quality-Homeless, PCQ-H) has four subscales: Patient-Clinician Relationship (15 items), Cooperation among Clinicians (3 items), Access/Coordination (11 items) and Homeless-Specific Needs (4 items). Evidence for divergent and convergent validity is provided. Test Information Function (TIF) graphs showed adequate informational value to permit inferences about groups for 3 subscales (Relationship, Cooperation and Access/Coordination). The 3-item Cooperation subscale had lower informational value (TIF<5) but had good internal consistency (alpha=0.75) and patients frequently reported problems in this aspect of care. Conclusions Systematic application of qualitative and quantitative methods supported the development of a brief patient-reported questionnaire focused on the primary care of homeless patients and offers guidance for future population-specific instrument development. PMID:25023918

  10. Social Supports among the Homeless.

    ERIC Educational Resources Information Center

    Solarz, Andrea

    The homeless have long been considered a disaffiliated and socially isolated group. Research has indicated that most of the homeless are single and have no family relationships or friends to provide support. A study was conducted to gather information on both objective and subjective measures of social support from 125 individuals residing at a…

  11. Lessons learned from a quality improvement intervention with homeless veteran services.

    PubMed

    Chinman, Matthew; Hannah, Gordon; McCarthy, Sharon

    2012-08-01

    Homeless veterans are a vulnerable population, with high mortality and morbidity rates. Evidence-based practices for homelessness have been challenging to implement. This study engaged staff members from three VA homeless programs to improve their quality using Getting-To-Outcomes (GTO), a model and intervention of trainings and technical assistance that builds practitioner capacity to plan, implement, and self-evaluate evidence-based practices. Primarily used in community-based, non-VA settings, this study piloted GTO in VA by creating a GTO project within each homeless program and one across all three. The feasibility and acceptability of GTO in VA is examined using the results of the projects, time spent on GTO, and data from focus groups and interviews. With staff members averaging 33 minutes per week on GTO, each team made significant programmatic changes. Homeless staff stated GTO was helpful, and that high levels of communication, staff member commitment to the program, and technical assistance were critical.

  12. Making the Grade: Challenges and Successes in Providing Educational Opportunities for Children and Youth in Homeless Situations. Bridging the Gap between Home and School. A Position Document.

    ERIC Educational Resources Information Center

    National Association of State Coordinators for the Education of Homeless Children and Youth.

    Profiles of the 1995-96 implementation of the Stewart B. McKinney Act's Education for Homeless Children and Youth (EHCY) Programs in 37 states are presented in this document. In these 37 states, at least 173,082 homeless children and youth were served through programs funded by the McKinney Act, and at least 465 local education agencies received…

  13. Predictors of treatment interest and treatment initiation in a VA outpatient trauma services program providing evidence-based care.

    PubMed

    Lamp, Kristen; Maieritch, Kelly P; Winer, E Samuel; Hessinger, Jonathan D; Klenk, Megan

    2014-12-01

    The present study explored interest in treatment and treatment initiation patterns among veterans presenting at a VA posttraumatic stress disorder (PTSD) clinic. U.S. veterans who were referred for treatment of posttraumatic stress symptoms (N = 476) attended a 2-session psychoeducation and orientation class where they completed measures of demographic variables, PTSD and depression symptom severity, and interest in treatment. Consistent with previous literature and our hypotheses, Vietnam (OR = 1.78) and Persian Gulf veterans (OR = 2.05) were more likely than Iraq and Afghanistan veterans to initiate treatment. Veterans reporting more severe PTSD and depression symptoms were more likely to initiate treatment than not (OR for PTSD = 1.02, OR for depression = 1.02). Interest in treatment emerged as a strong predictor of treatment initiation. Specifically, interest in trauma-focused treatment showed a significant independent predictive effect on initiation such that veterans who expressed interest in trauma-focused treatment were significantly more likely to initiate treatment than those who did not express interest (OR = 2.13). Building interest in trauma-focused treatment may be a vital component for engaging veterans in evidence-based trauma-focused therapy. PMID:25418632

  14. Jobs, Welfare and Homelessness.

    ERIC Educational Resources Information Center

    Einbinder, Susan; And Others

    This report provides objective information about the relationship of poverty, welfare, and homelessness to California's regional economy and about the design of programs that help people in poverty build working lives. California does not have enough jobs for its workforce, and welfare caseloads are consequently determined by the economy. The…

  15. 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

  16. Education for Homeless Children and Youth Program: Title VII, Subtitle B of the McKinney-Vento Homeless Assistance Act. Report to Congress, Fiscal Year 2000.

    ERIC Educational Resources Information Center

    Office of Elementary and Secondary Education (ED), Washington, DC.

    This report compiles data submitted by state educational agencies in accordance with the McKinney-Vento Homeless Assistance Act. States are required to provide an estimate of: total number of homeless children and youth by grade level, number of homeless children and youth enrolled in public school by grade level, number of homeless children and…

  17. Homelessness and health in adolescents.

    PubMed

    Haldenby, Amy M; Berman, Helene; Forchuk, Cheryl

    2007-11-01

    Despite an abundance of resources, many of the world's wealthiest nations have a large homeless population. People at all stages of development are affected by this problem, but adolescents who are homeless face a unique set of challenges. In this critical narrative study the authors examined the experiences of homeless adolescents with particular attention to the role of gender and public policy, health experiences and perceptions, and barriers to health care services. Six girls and 7 boys participated in semistructured dialogic interviews. Their stories revealed that living without a home had a substantial impact on their health and wellness. The findings from this study support the need for health care professionals to work in collaboration with homeless youth so that more effective care that is sensitive to their unique health needs can be provided.

  18. What Kind of School Board Member Would Help Homeless Children?

    ERIC Educational Resources Information Center

    Harrington-Lueker, Donna

    1989-01-01

    Homelessness is a growing problem in every part of the United States. Federal legislation requires state plans for educating homeless children, but will provide less than $23 per child. Summarizes some of the state plans and suggests steps school boards can take to provide homeless children with public education. (MLF)

  19. VA Residential Provider Perceptions of Dissuading Factors to the Use of Two Evidence-Based PTSD Treatments

    PubMed Central

    Cook, Joan M.; Dinnen, Stephanie; Simiola, Vanessa; Thompson, Richard; Schnurr, Paula P.

    2014-01-01

    Providers (N = 198) from 38 Department of Veterans Affairs residential posttraumatic stress disorder treatment programs across the United States completed qualitative interviews regarding implementation of 2 evidence-based treatments: prolonged exposure and cognitive processing therapy. As part of this investigation, providers were asked how they decide which patients are appropriate for these treatments. Many indicated that they did not perceive any patient factors that dissuade their use of either evidence-based treatment. However, 3 broad categories emerged surrounding reasons that patients were perceived to be less suitable candidates for the treatments: the presence of psychiatric comorbidities, cognitive limitations, and low levels of patient motivation. Interestingly, providers’ perceived reasons for limited or nonuse of a treatment did not correspond entirely to those espoused by treatment developers. Possible solutions to address provider concerns, including educational and motivational interventions, are noted. PMID:25309031

  20. 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) "The Causes of Homelessness"…

  1. Homelessness in Public Libraries

    ERIC Educational Resources Information Center

    Wong, Yi Ling

    2009-01-01

    This paper takes a theoretical and practical approach in defining the "problem" of homelessness in libraries. The author examines three fundamental problems on homelessness. The three fundamental questions are: (a) Who are the homeless? (b) Why are they homeless? (c) What are their information needs in libraries? These questions are important in…

  2. Victimization of the elderly homeless.

    PubMed

    Dietz, Tracy; Wright, James D

    2005-01-01

    Using data from the National Survey of Homeless Assistance Providers and Clients (NSHAPC), this article examines the applicability of Felson's Routine Activities Theory to a national probability sample of older homeless individuals. Results indicate that the relative protection that women often have from most crimes is not transferred to the older homeless woman who is more likely than her male counterparts to be the victim of sexual assault but equally as likely to be the victim of theft and physical assault. Likewise, the protection often noted afforded by age against victimization is also not seen among the homeless. The research demonstrates that being male and having mental and physical health problems as well as substance abuse problems increases the likelihood of victimizations among the homeless population, in general When predictors of victimization were considered for the 50 and older sample, these predictors remained the same except that the gender remained significant only for sexual assault. These findings are consistent with and supportive of utilizing Felson's Routine Activities Theory to understand and explain victimization among the older homeless population. PMID:16447853

  3. Education Rights of Homeless Students: A Guide for Advocates

    ERIC Educational Resources Information Center

    Education Law Center, 2005

    2005-01-01

    There is no question that students who are homeless, like all students, are entitled to be educated. A federal law, known as the McKinney-Vento Homeless Assistance Act, requires states to provide homeless children and youth with the same access to free public education as is available to other students. The Act also requires states to eliminate…

  4. Homeless and in Need of Special Education. Exceptional Children at Risk: CEC Mini-Library.

    ERIC Educational Resources Information Center

    Heflin, L. Juane; Rudy, Kathryn

    This booklet examines the plight of homeless families who have children who need special educational services. It explores the magnitude of homelessness among families, provides empirical descriptions of homeless populations, and identifies factors contributing to the rising incidence of homelessness in the United States. Specific effects of…

  5. Discrimination and Exiting Homelessness among Homeless Adolescents

    PubMed Central

    Milburn, Norweeta G.; Ayala, George; Rice, Eric; Batterham, Philip; Rotheram-Borus, Mary Jane

    2008-01-01

    This paper examines how newly homeless adolescents’ discrimination experiences were associated with exiting homelessness after six months. A sample of 262 homeless adolescents, aged 12 to 20 years, were recruited and followed longitudinally (six-month retention rate = 88%). Discrimination was related to being gay, lesbian, or bisexual (LGB). Discrimination from family was related to exiting homelessness. Other than those who were LGB, adolescents who reported discrimination from their families were more likely to exit homelessness than adolescents who did not report such discrimination. Suggestions for future research include focusing on the experiences of LGB homeless adolescents, the role of families in the lives of homeless adolescents, and other aspects of discrimination, including salience, frequency, intensity, and duration. PMID:17087527

  6. Tapping into the Culture of Homelessness.

    ERIC Educational Resources Information Center

    Davis, Ruth E.

    1996-01-01

    Findings of a qualitative study of three health and human services agencies determined that strategies of survival inherent in the culture of homelessness are rarely considered by those agencies in providing services to homeless people. Programs should develop cultural sensitivity and use a cultural perspective in planning. (JOW)

  7. A Rural County's Response to Homelessness.

    ERIC Educational Resources Information Center

    Loughran, Elizabeth Lee; White, Priscilla

    This paper describes the response of one locality, a rural county in Western Massachusetts, to the reality of rural homelessness. Jessie's House, in Hampshire County, Massachusetts, is a short-term emergency shelter providing meals, housing, and advocacy to homeless families and individuals. The shelter has a staff of three full-time residents and…

  8. Working to End Family Homelessness. Annual Report

    ERIC Educational Resources Information Center

    National Center on Family Homelessness (NJ1), 2012

    2012-01-01

    The National Center on Family Homelessness is determined to end family homelessness. Sheltering families provides a temporary safe haven. Connecting families to permanent housing, essential services, and critical supports can change their lives forever. Through research the Center learns what families need to rebound from the housing, economic,…

  9. Addressing the Problems of Homeless Adolescents

    ERIC Educational Resources Information Center

    Murphy, Joseph F.; Tobin, Kerri

    2012-01-01

    Homeless adolescents, known as "unaccompanied youth," constitute a small but important portion of the overall homeless population, one that needs particular attention at school. In this article, we review existing literature to provide a background for educational leaders, researchers, and policymakers hoping to understand the phenomenon of…

  10. 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,…

  11. The New Poverty: Homeless Families in America.

    ERIC Educational Resources Information Center

    Nunez, Ralph da Costa

    This book discusses homeless families in the United States and advocates the efforts of residential educational and employment training centers--American Family Inns--which provide comprehensive services education, job training, and parenting and life skills to address the poverty-related conditions that contribute to homelessness. Chapters of the…

  12. Educational Services for Homeless Children and Youth.

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Education, Boston. Office of Homeless Children and Youth.

    As provided by the Stewart B. McKinney Homeless Assistance Act, the Massachusetts State Department of Education (MSDE) has developed this plan to attempt to meet the educational needs of homeless children and to supply them with resources to meet those needs. The plan contains a section delineating federal and state laws and state policies…

  13. Hurricane Sandy's impact on the predisaster homeless and homeless shelter services in New Jersey.

    PubMed

    Settembrino, Marc R

    2016-01-01

    Presently, there is little research on how people experiencing homelessness prepare for, respond to, and recover from disasters. Existing emergency management literature does not provide an understanding of how disasters affect homeless shelter services. The present study seeks to fill these gaps by examining how Hurricane Sandy impacted homeless shelters and their guests in New Jersey. Presenting findings from ethnographic research in Atlantic City and Hoboken, this study identifies several areas in which homeless shelters and their guests may be able to assist in emergency response and disaster recovery such as preparing meals for victims, sorting and processing donated items, and assisting victims in filing for emergency assistance. PMID:26963226

  14. Hurricane Sandy's impact on the predisaster homeless and homeless shelter services in New Jersey.

    PubMed

    Settembrino, Marc R

    2016-01-01

    Presently, there is little research on how people experiencing homelessness prepare for, respond to, and recover from disasters. Existing emergency management literature does not provide an understanding of how disasters affect homeless shelter services. The present study seeks to fill these gaps by examining how Hurricane Sandy impacted homeless shelters and their guests in New Jersey. Presenting findings from ethnographic research in Atlantic City and Hoboken, this study identifies several areas in which homeless shelters and their guests may be able to assist in emergency response and disaster recovery such as preparing meals for victims, sorting and processing donated items, and assisting victims in filing for emergency assistance.

  15. 77 FR 70967 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-28

    ..., Alcoholism, Claims, Day care, Dental health, Drug abuse, Government contracts, Grant programs--health... its regulation governing payment by VA for non-VA outpatient care under VA's statutory authority to provide non-VA care. Under this authority, VA may contract for certain hospital care (inpatient care)...

  16. Correlates of adult assault among homeless women.

    PubMed

    Hudson, Angela L; Wright, Kynna; Bhattacharya, Debika; Sinha, Karabi; Nyamathi, Adeline; Marfisee, Mary

    2010-11-01

    The purpose of this study was to assess predictors of sexual and physical assault among homeless women. A multivariate, correlation design was utilized to identify independent correlates of adult physical and sexual assault. The sample consisted of 202 homeless women residing in shelters or living on the street in the Skid Row area of Los Angeles. Respondents reporting a history of child sexual abuse were almost four times more likely to report being sexually assaulted as adults and were almost two and one third times more likely to report being physically assaulted as adults. A range of factors increase homeless women's risk of adult physical and sexual victimization, including child sexual abuse, substance use, lifetime sex trade activity, and previous incarceration. It is important for homeless service providers to develop an individual risk profile for homeless women and to intervene in order to decrease their risk of re-victimization. PMID:21099076

  17. The Data Dilemma in Family Homelessness.

    PubMed

    Brush, Barbara L; Gultekin, Laura E; Grim, Elizabeth C

    2016-01-01

    Current estimates of homelessness in the U.S. are biased toward counts of sheltered or visibly unsheltered individuals. Those who remain out of sight during counts and/or live in places or circumstances that elude the United States Department of Housing and Urban Development's (HUD) definition of homelessness remain undercounted. Underreporting the unique characteristics associated with subgroups of people experiencing homelessness also limits access to the services that best meet their needs. As national counts drive policy and funding for housing-related services, front-line providers have too few resources to treat less visible and understood populations. We argue that homeless families are particularly vulnerable to these trends and explore how current data collection and reporting approaches thwart family homelessness interventions and prevention. PMID:27524750

  18. 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

  19. 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.

  20. Feeding the homeless.

    PubMed

    Hales, A; Magnus, M H

    1991-12-01

    Nurses have a unique role in addressing homelessness, an issue of vital national concern. The management and organizational expertise of nurses can be key elements to coordinating community resources to assist the homeless. The authors describe the design and implementation of a community meal program for the homeless.

  1. 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, they can…

  2. Feeding the homeless.

    PubMed

    Hales, A; Magnus, M H

    1991-12-01

    Nurses have a unique role in addressing homelessness, an issue of vital national concern. The management and organizational expertise of nurses can be key elements to coordinating community resources to assist the homeless. The authors describe the design and implementation of a community meal program for the homeless. PMID:1744733

  3. 38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... physician service, procedure, test, supply, or other medical service. ICU means Intensive Care Unit... of this section, standard room and board days and ICU room and board days are mutually exclusive: VA will bill either a standard room and board per diem charge or an ICU room and board per diem charge,...

  4. 38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... physician service, procedure, test, supply, or other medical service. ICU means Intensive Care Unit... of this section, standard room and board days and ICU room and board days are mutually exclusive: VA will bill either a standard room and board per diem charge or an ICU room and board per diem charge,...

  5. 38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... physician service, procedure, test, supply, or other medical service. ICU means Intensive Care Unit... of this section, standard room and board days and ICU room and board days are mutually exclusive: VA will bill either a standard room and board per diem charge or an ICU room and board per diem charge,...

  6. 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

  7. The homeless: help from hotels and restaurants.

    PubMed

    Hales, A; Eyster, J J; Ford, J L

    1993-07-01

    Specific examples and information are given to service providers to address the needs of homeless people. Together nurses and restaurant and hotel managers combined their expertise to assist local agencies in their community kitchens and shelters.

  8. Care of the homeless: an overview.

    PubMed

    Maness, David L; Khan, Muneeza

    2014-04-15

    Homelessness affects men, women, and children of all races and ethnicities. On any given night, more than 610,000 persons in the United States are homeless; a little more than one-third of these are families. Homeless persons are more likely to become ill, have greater hospitalization rates, and are more likely to die at a younger age than the general population. The average life span for a homeless person is between 42 and 52 years. Homeless children are much sicker and have more academic and behavioral problems. Insufficient personal income and the lack of affordable housing are the major reasons for homelessness. Complex, advanced medical problems and psychiatric illnesses, exacerbated by drug and alcohol abuse, in combination with the economic and social issues (such as the lack of housing and proper transportation) make this subset of the population a unique challenge for the health care system, local communities, and the government. An integrated, multidisciplinary health care team with an outreach focus, along with involvement of local and state agencies, seems best suited to address the components needed to ensure quality of care, to help make these patients self-sufficient, and to help them succeed. Family physicians are well suited to manage the needs of the homeless patient, provide continuity of care, and lead these multidisciplinary teams. PMID:24784122

  9. If you provide the test, they will take it: factors associated with HIV/STI Testing in a representative sample of homeless youth in Los Angeles.

    PubMed

    Ober, Allison J; Martino, Steven C; Ewing, Brett; Tucker, Joan S

    2012-08-01

    Homeless youth are at high risk for human immunodeficiency virus (HIV) and other sexually transmitted infections (STI), yet those at greatest risk may never have been tested for HIV or STI. In a probability sample of sexually active homeless youth in Los Angeles (n = 305), this study identifies factors associated with HIV/STI testing status. Most youth (85%) had ever been tested and 47% had been tested in the past 3 months. Recent testing was significantly more likely among youth who self-identified as gay, were Hispanic, injected drugs, and used drop-in centers, and marginally more likely among youth with more depressive symptoms. Drop-in center use mediated the association of injection drug use with HIV/STI testing. HIV/STI testing was unrelated to sexual risk behavior. Drop-in centers can play an important role in facilitating testing, including among injection drug users, but more outreach is needed to encourage testing in other at-risk subgroups. PMID:22827904

  10. Lifetime and five-year prevalence of homelessness in the United States.

    PubMed Central

    Link, B G; Susser, E; Stueve, A; Phelan, J; Moore, R E; Struening, E

    1994-01-01

    OBJECTIVE. Intense debate exists concerning the number of homeless people in the United States. Previous studies, counting currently homeless people, have provided point-prevalence estimates of homelessness but have been criticized on methodological grounds. This study reports lifetime and 5-year prevalence estimates of homelessness using a different methodological approach. METHODS. Random-digit dialing was used to interview 1507 adults living in households with telephones in the 48 contiguous states in the fall of 1990. Respondents were asked whether they had ever been homeless and if so, where they had slept while homeless. RESULTS. Lifetime and 5-year prevalence of all types of homelessness combined were 14.0% (26 million people) and 4.6% (8.5 million people), respectively. Lifetime "literal homelessness" (sleeping in shelters, abandoned buildings, bus and train stations, etc.) was 7.4% (13.5 million people). Five-year (1985 through 1990) prevalence of self-reported homelessness among those who had ever been literally homeless was 3.1% (5.7 million people). CONCLUSIONS. The magnitude of the problem of homelessness is much greater than most previous attempts to enumerate homeless people have led us to believe. This finding requires reconsideration of inferences about the causes of homelessness that were derived from point-prevalence studies of currently homeless people. PMID:7998628

  11. The Education for Homeless Children and Youth Program: Learning To Succeed. Volume I: Reducing Barriers for Homeless Children and Youth for Access and Achievement. Final Report.

    ERIC Educational Resources Information Center

    Phillips, Clarenda M.; Wodatch, Jessica K.; Kelliher, Catherine T.

    A 1984 amendment to the Stewart B. McKinney Homeless Assistance Act instructs states to ensure that homeless students have equal access to the same free and appropriate public education as nonhomeless students. It provides local educational authorities increased flexibility to use funds, specify the rights of homeless preschoolers, give parents of…

  12. [Evidence-based treatment of mentally ill homeless persons].

    PubMed

    Larsen, Maja; Nordentoft, Merete

    2010-05-31

    A systematic review of the literature shows that it is possible to reduce homelessness among mentally ill homeless persons, partly by offering access to housing and partly by providing intensive care through Assertive Community Treatment. Assertive Community Treatment can, to some extent, decrease psychiatric symptoms and increase quality of life. It is evident that by offering housing, homelessness may be reduced, but the comparison of independent housing and group living did not reveal big differences.

  13. Homelessness Assistance and Resources

    MedlinePlus

    ... a Program Affordable Housing Community Development Consolidated Planning Economic Development Environmental Review Financial Management Homelessness Assistance Rural Systems News News Feed Email Updates Training & Events All ...

  14. Proposals Relating to Increasing Housing Opportunities for Homeless Persons. Discussion Paper 91-1.

    ERIC Educational Resources Information Center

    Rose, Laura; Matthias, Mary

    This paper provides a basis for discussion of housing proposals relating to increasing housing opportunities for homeless persons in Wisconsin. Six major topics relating to housing for homeless and potentially homeless persons are presented. Issues are listed under each topic. For each issue, background information is provided and alternatives for…

  15. Voices of the Homeless: An Emic Approach to the Experiences of Health Disparities Faced by People Who Are Homeless.

    PubMed

    Hsieh, Elaine

    2016-07-01

    People who are homeless are particularly vulnerable to health disparities. Rather than using population statistics to highlight the prevalence or severity of the suffering of people who are homeless, 28 undergraduate students each conducted an in-depth interview with an individual who relied on a local homeless shelter to cope with everyday life. The interview explored the participants' health concerns and strategies for health management. Due to equipment failure and incomplete recording, only 16 interviews are included in this study. The author adopted thematic analysis while focused on preserving the richness of the interactions between the participants who are homeless and the undergraduate students. The author's goal is to provide emic, intimate insights about the struggles and challenges faced by the people who are homeless. The author concluded the study by situating the findings in the larger literature of health disparities experienced by people who are homeless. PMID:27093127

  16. Homelessness: Recommendations for State Action.

    ERIC Educational Resources Information Center

    Maryland Governor's Advisory Board on the Shelter, Nutrition, and Service Programs for Homeless Persons, Annapolis.

    This report identifies the following objectives in the State of Maryland's efforts to prevent and substantially reduce homelessness: (1) expand resources for the prevention of homelessness, and investigate possible changes in policies contributing to homelessness; (2) establish a strong emergency response to homelessness throughout the State; (3)…

  17. 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…

  18. Experiences of being homeless or at risk of being homeless among Canadian youths.

    PubMed

    Miller, Pamela; Donahue, Peter; Este, Dave; Hofer, Marvin

    2004-01-01

    A qualitative study was undertaken with four groups--immigrants, youths, Aboriginal people, and landlords--in order to explore, compare, and contrast diversity issues among the homeless population and those at risk of homelessness in a larger Canadian city (Calgary, Alberta) with a smaller city (Lethbridge, Alberta), to better understand their and to needs make recommendations for improvement in service delivery and policy formation. This paper focuses on the findings from our sample of youths who shared information on a range of factors that contributed to their being homeless or at risk of being homeless. The youths in this study also shared their positive as well as negative experiences with educators, peers, family members, and social service providers. Canada's homeless include growing numbers of young people, families, women, and members of various ethnic communities, including Aboriginal people and immigrants. Today it is no longer possible to articulate a single silhouette of the homeless, but rather a diversity of profiles is needed. It was in the light of this reality that a study, "Diversity Among the Homeless and Those At Risk," was carried out. It was undertaken with four groups--immigrants, youths, Aboriginal people, and landlords. PMID:15727411

  19. Water, sanitation and hygiene for homeless people.

    PubMed

    Uddin, Sayed Mohammad Nazim; Walters, Vicky; Gaillard, J C; Hridi, Sanjida Marium; McSherry, Alice

    2016-02-01

    This short communication provides insights into water, sanitation and hygiene (WASH) for homeless people through a scoping study conducted in Dhaka, Bangladesh. It investigates homeless access to WASH through the lens of a rights-based approach. It demonstrates that homeless people's denial of their right to WASH reflects their marginal position in society and an unequal distribution of power and opportunities. The study ultimately suggests a rights-based approach to work toward dealing with the root causes of discrimination and marginalisation rather than just the symptoms. For the homeless, who not only lack substantive rights, but also the means through which to claim their rights, an integrated rights-based approach to WASH offers the possibility for social inclusion and significant improvements in their life conditions. Given the unique deprivation of homelessness it is argued that in addressing the lack of access to adequate WASH for homeless people the immediate goal should be the fulfilment and protection of the right to adequate shelter. PMID:26837829

  20. 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…

  1. The Faces of Homelessness.

    ERIC Educational Resources Information Center

    Hope, Marjorie; Young, James

    Homelessness affects a wide cross-section of society. Causes of homelessness, attempted remedies, and potential solutions for the future are presented. Descriptions of the experiences of men, women, and children who have fallen through the "safety net" of social services are included from cities throughout the country. Support is given for the…

  2. Hope for the Future: The State Plan for Educating Homeless Children and Youth.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Office of Compensatory Education.

    This report contains the California state plan for educating homeless children and youth required by the Stewart B. McKinney Homeless Assistance Act of 1987. The plan is designed to raise the level of awareness of schools and school districts to the needs of homeless children and to provide ideas and suggestions for meeting those needs. It is…

  3. Educational Rights of Homeless Children and Youth: Legal and Community Advocacy

    ERIC Educational Resources Information Center

    de Bradley, Ann Aviles

    2008-01-01

    Many homeless children and youth have difficulty in school due to their loss of stable housing, and lack of consistent contact with family and friends. When a child becomes homeless, schools are federally mandated to identify these students and provide the same access to a free and appropriate education as their non-homeless counterparts. Within a…

  4. Comprehensive Substance Abuse Services for Homeless Persons with Alcohol and Other Drug Problems.

    ERIC Educational Resources Information Center

    Kirby, Michael W., Jr.; Braucht, G. Nicholas

    Homeless people with alcohol and other drug problems present the traditional substance abuse services delivery provider with special challenges. This paper discusses the optimal designs of comprehensive treatment services for homeless persons with alcohol and other drug problems. Most importantly, the homeless must have immediate access to a safe…

  5. 76 FR 61150 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ..., manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be... priority placement for homeless Veterans and Veterans at risk of homelessness; and provide a supportive... for applying the consideration under such a lease for the provision of medical care and services...

  6. Homelessness: A Common Vocabulary Could Help Agencies Collaborate and Collect More Consistent Data. Report to Congressional Requesters. GAO-10-702

    ERIC Educational Resources Information Center

    Cackley, Alicia Puente

    2010-01-01

    Multiple federal programs provide homelessness assistance through programs targeted to those experiencing homelessness or through mainstream programs that broadly assist low-income populations. Programs' definitions of homelessness range from including primarily people in homeless shelters or on the street to also including those living with…

  7. United States Interagency Council on Homelessness

    MedlinePlus

    ... for USICH Agency Reports Contact Us Ending Family Homelessness Leveraging Mainstream Resources Families experiencing homelessness need a ... to open map → United States Interagency Council ON HOMELESSNESS The U.S. Interagency Council on Homelessness leads the ...

  8. Lessons Learned: A "Homeless Shelter Intervention" by a Medical Student

    ERIC Educational Resources Information Center

    Owusu, Yasmin; Kunik, Mark; Coverdale, John; Shah, Asim; Primm, Annelle; Harris, Toi

    2012-01-01

    Objective: The authors explored the process of implementing a medical student-initiated program designed to provide computerized mental health screening, referral, and education in a homeless shelter. Method: An educational program was designed to teach homeless shelter staff about psychiatric disorders and culturally-informed treatment…

  9. Nowhere to Run: HIV Prevention for Runaway and Homeless Youth.

    ERIC Educational Resources Information Center

    Posner, Marc

    This volume is a guide to providing effective Human Immunodeficiency Virus (HIV) and substance abuse prevention services to runaway and homeless youth. The guide is based on current research and the best programs in this field. Chapters 1 and 2 summarize what is known about runaway and homeless youth, the services these youth require if they are…

  10. 24 CFR 576.103 - Homelessness prevention component.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Homelessness prevention component... and Eligible Activities § 576.103 Homelessness prevention component. ESG funds may be used to provide... paragraph (1) of the “homeless” definition in § 576.2. This assistance, referred to as...

  11. 24 CFR 576.103 - Homelessness prevention component.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Homelessness prevention component... and Eligible Activities § 576.103 Homelessness prevention component. ESG funds may be used to provide... paragraph (1) of the “homeless” definition in § 576.2. This assistance, referred to as...

  12. 24 CFR 576.103 - Homelessness prevention component.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false Homelessness prevention component... and Eligible Activities § 576.103 Homelessness prevention component. ESG funds may be used to provide... paragraph (1) of the “homeless” definition in § 576.2. This assistance, referred to as...

  13. American Nightmare: A Decade of Homelessness in the United States.

    ERIC Educational Resources Information Center

    National Coalition for the Homeless, Washington, DC.

    A 1989 national survey of the dimensions of homelessness found that at least three million Americans are homeless and that the shortage of affordable housing was cited as the chief cause. Information was gathered from a telephone survey of emergency shelter providers, housing advocacy organizations, and local governments in 26 communities, ranging…

  14. Homelessness in America: What Should We Do? Public Talk Series.

    ERIC Educational Resources Information Center

    Niedergang, Mark; McCoy, Martha, Ed.

    This program guide provides a forum for discussing the different beliefs that influence public policy about homelessness as well as policy goals. The central question is addressed in two parts: (1) what society ought to do for homeless people; and (2) laying out a range of possible answers for part 1. Four possible answers are discussed: help only…

  15. Strengthening At-Risk and Homeless Young Mothers and Children

    ERIC Educational Resources Information Center

    Medeiros, Debra; Vaulton, Wendy

    2010-01-01

    The Strengthening At Risk and Homeless Young Mothers and Children Initiative, funded by the Conrad N. Hilton Foundation, aims to improve the housing, health, and development of homeless and at-risk young families. This article describes the services provided in four program sites (Pomona, CA; Antelope Valley, CA; Minneapolis, MN; and Chicago, IL)…

  16. 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…

  17. VA telemental health: suicide assessment.

    PubMed

    Godleski, Linda; Nieves, J Edwin; Darkins, Adam; Lehmann, Laurent

    2008-01-01

    The Department of Veterans Affairs (VA) encompasses one of the largest telemental health networks in the world, with over 45,000 videoconferencing and over 5,000 home telemental health encounters annually. Recently, the VA designated suicide prevention as a major priority, with telehealth modalities providing opportunities for remote interventions. Suicide risk assessments, using videoconferencing, are now documented in the literature, as are current studies that find telemental health to be equivalent to face-to-face treatment. Remote assessment of suicidality, however, involves complex legal issues: licensing requirements for remote delivery of care, legal procedures for involuntary detainment and commitment of potentially harmful patients, and liability questions related to the remote nature of the mental health service. VA best practices for remote suicide risk assessment include paradigms for establishing procedures in the context of legal challenges (licensing and involuntary detainment/commitment), for utilizing clinical assessment and triage decision protocols, and for contingency planning to optimize patient care and reduce liability.

  18. 45 CFR 1351.10 - What is the purpose of the Runaway and Homeless Youth Program grant?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... existing or proposed community-based runaway and homeless youth projects to provide temporary shelter and care to runaway or otherwise homeless youth who are in need of temporary shelter, counseling...

  19. Characteristics of Mothers Caring for Children During Episodes of Homelessness.

    PubMed

    Welch-Lazoritz, Melissa L; Whitbeck, Les B; Armenta, Brian E

    2015-11-01

    This study provides a description of the physical, psychological, and substance use problems of adult homeless women who are and are not caring for children. We also examined differences in the characteristics of these two groups of women. Interviews were conducted with 148 homeless women from three mid-sized U.S. cities, 24.3 % of whom were caring for at least one child. Our results showed that women caring for children were more likely to be sheltered and have health insurance. Homeless women caring for children and solitary homeless women were generally similar in terms of substance abuse problems. However, rates of Borderline Personality Disorder were higher among women caring for children than among solitary homeless women. Our results are somewhat consistent with previous research, with the exception of substance abuse problems and mental health problems, which were shown to be equally problematic for all women, regardless of current caregiving status.

  20. Characteristics of Mothers Caring for Children During Episodes of Homelessness

    PubMed Central

    Whitbeck, Les B.; Armenta, Brian E.

    2016-01-01

    This study provides a description of the physical, psychological, and substance use problems of adult homeless women who are and are not caring for children. We also examined differences in the characteristics of these two groups of women. Interviews were conducted with 148 homeless women from three mid-sized U.S. cities, 24.3 % of whom were caring for at least one child. Our results showed that women caring for children were more likely to be sheltered and have health insurance. Homeless women caring for children and solitary homeless women were generally similar in terms of substance abuse problems. However, rates of Borderline Personality Disorder were higher among women caring for children than among solitary homeless women. Our results are somewhat consistent with previous research, with the exception of substance abuse problems and mental health problems, which were shown to be equally problematic for all women, regardless of current caregiving status. PMID:25536936

  1. Aging on the Street: Homeless Older Adults in America.

    PubMed

    Sorrell, Jeanne M

    2016-09-01

    Older adults are at greater risk for homelessness today than at any time in recent history. Approximately one half of homeless individuals in America are older than 50, which has created serious challenges for how cities, governments, and health care providers care for homeless populations. Systems established in the 1980s to help care for homeless individuals were not designed to address problems of aging. It is critical that nurses and all health professionals have a better understanding of the unique needs and concerns of homeless older adults. Nurses can be an important part of the solution, not only through direct patient care but by advocating for improvements in care for this vulnerable population. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 25-29.]. PMID:27576225

  2. Increasing access--a qualitative study of homelessness and palliative care in a major urban center.

    PubMed

    Krakowsky, Yonah; Gofine, Mirriam; Brown, Pnina; Danziger, Jana; Knowles, Holly

    2013-05-01

    Rates of morbidity and mortality are significantly higher in homeless populations. Homeless people experience many barriers to receive adequate palliative care. This qualitative study examines how a major urban city's palliative care resources can be improved to increase access and better serve the homeless. Audiotaped interviews were preformed with 7 homeless care providers in Toronto, Canada, and their transcripts were analyzed using thematic analysis. The findings of the study suggest that in order to increase access and to serve the city's terminally ill homeless better, the following 4 areas must be addressed: (1) increasing positive interaction between the health care system and the homeless, (2) training staff to deal with the unique issues confronting the homeless, (3) providing patient-centered care, and (4) diversifying the methods of delivery.

  3. National Center on Family Homelessness

    MedlinePlus

    ... You are here Home National Center on Family Homelessness Center A staggering 2.5 million children are ... raise awareness of the current state of child homelessness in the United States, documents the number of ...

  4. Telephone Enrollment in the VA Healthcare System. Interim final rule.

    PubMed

    2016-03-16

    This rulemaking amends VA's medical regulations to allow veterans to complete applications for health care enrollment by telephone by providing application information to a VA employee, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided over the phone. This action will make it easier for veterans to apply to enroll and will speed VA processing of applications. PMID:26987128

  5. Twenty-Five Years of Child and Family Homelessness: Where Are We Now?

    PubMed Central

    Gracy, Delaney; Goldsmith, Grifin; Shapiro, Alan; Redlener, Irwin E.

    2013-01-01

    Family homelessness emerged as a major social and public health problem in the United States during the 1980s. We reviewed the literature, including journal articles, news stories, and government reports, that described conditions associated with family homelessness, the scope of the problem, and the health and mental health of homeless children and families. Much of this literature was published during the 1980s and 1990s. This raises questions about its continued applicability for the public health community. We concluded that descriptions of the economic conditions and public policies associated with family homelessness are still relevant; however, the homeless family population has changed over time. Family homelessness has become more prevalent and pervasive among poor and low-income families. We provide public health recommendations for these homeless families. PMID:24148055

  6. 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. PMID:15068577

  7. Down and out: social marginality and homelessness.

    PubMed

    Schnabel, P

    1992-01-01

    In the last ten years the problem of homelessness has been on the increase. Compared to the situation about sixty years ago the homeless of today congregate more in the centres of the big cities, adhere to a different lifestyle and are socially, culturally and ethnically more diverse. Some indications of the scale of the problem in the Netherlands are given, but the focus of the paper is on the role of psychiatry: on the one hand, in providing services to the mentally ill among the homeless and, on the other hand, in protecting communities against people who are considered bothersome or unfit for civil life. The development of systems of comprehensive care for different categories of socially marginal people is discussed.

  8. Homelessness: From the Clients' Perspectives.

    ERIC Educational Resources Information Center

    Hertzberg, Edwina L.

    Although homelessness is not a new phenomenon, the number of homeless people today has fostered mobilization on their behalf by public and private sectors. Principal factors accepted as contributing to homelessness are inadequate low-cost housing, unemployment, chemical dependency, family violence, and inadequate community services for the…

  9. 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.…

  10. Access to women's health care: a qualitative study of barriers perceived by homeless women.

    PubMed

    Gelberg, Lillian; Browner, C H; Lejano, Elena; Arangua, Lisa

    2004-01-01

    Homelessness is an escalating national problem and women are disproportionately affected. Nevertheless, few studies have focused on the special circumstances associated with being a homeless woman. For instance, while both genders experience serious barriers to obtaining health care, homeless women face an additional burden by virtue of their sexual and reproductive health needs. The current study was conducted as the first stage of a qualitative/quantitative investigation of homeless women's access and barriers to family planning and women's health care. We interviewed 47 homeless women of diverse ages and ethnic backgrounds. A qualitative approach was initially taken to explore the factors homeless women themselves perceive as barriers to their use of birth control and women's health services, and factors they believe would facilitate their use. Key findings are that health is not a priority for homeless women, that transportation and scheduling can be particularly burdensome for homeless women, and that being homeless leads some to feel stigmatized by health care providers. Despite being homeless, having children was extremely important to the women in our study. At the same time, those interested in contraception confronted significant barriers in their efforts to prevent pregnancies. We conclude with suggested interventions that would make general, gynecological, and reproductive health care more accessible to homeless women.

  11. A Different Kind of Smart: A Study of the Educational Obstacles Confronting Homeless Youth in New England.

    ERIC Educational Resources Information Center

    Wilson, Melanie; Houghton, Alison

    This study provides information on obstacles facing homeless youth in school. Research occurred in four diverse New England cities. Researchers collected detailed case histories on youth age 10-15 years who were currently homeless or who had recently been homeless. Data came from staff of local youth agencies, government officials, and youths…

  12. Part II, Provider perspectives: should patients be activated to request evidence-based medicine? a qualitative study of the VA project to implement diuretics (VAPID)

    PubMed Central

    2010-01-01

    Background Hypertension guidelines recommend the use of thiazide diuretics as first-line therapy for uncomplicated hypertension, yet diuretics are under-prescribed, and hypertension is frequently inadequately treated. This qualitative evaluation of provider attitudes follows a randomized controlled trial of a patient activation strategy in which hypertensive patients received letters and incentives to discuss thiazides with their provider. The strategy prompted high discussion rates and enhanced thiazide-prescribing rates. Our objective was to interview providers to understand the effectiveness and acceptability of the intervention from their perspective, as well as the suitability of patient activation for more widespread guideline implementation. Methods Semi-structured phone interviews were conducted with 21 primary care providers. Interviews were transcribed verbatim and reviewed by the interviewer before being analyzed for content. Interviews were coded, and relevant themes and specific responses were identified, grouped, and compared. Results Of the 21 providers interviewed, 20 (95%) had a positive opinion of the intervention, and 18 of 20 (90%) thought the strategy was suitable for wider use. In explaining their opinions of the intervention, many providers discussed a positive effect on treatment, but they more often focused on the process of patient activation itself, describing how the intervention facilitated discussions by informing patients and making them more pro-active. Regarding effectiveness, providers suggested the intervention worked like a reminder, highlighted oversights, or changed their approach to hypertension management. Many providers also explained that the intervention 'aligned' patients' objectives with theirs, or made patients more likely to accept a change in medications. Negative aspects were mentioned infrequently, but concerns about the use of financial incentives were most common. Relevant barriers to initiating thiazide treatment

  13. Homelessness and the response to emerging infectious disease outbreaks: lessons from SARS.

    PubMed

    Leung, Cheryl S; Ho, Minnie M; Kiss, Alex; Gundlapalli, Adi V; Hwang, Stephen W

    2008-05-01

    During the 2003 severe acute respiratory syndrome (SARS) outbreak in Toronto, the potential introduction of SARS into the homeless population was a serious concern. Although no homeless individual in Toronto contracted SARS, the outbreak highlighted the need to develop an outbreak preparedness plan that accounts for unique issues related to homeless people. We conducted key informant interviews with homeless service providers and public health officials (n = 17) and identified challenges specific to the homeless population in the areas of communication, infection control, isolation and quarantine, and resource allocation. Planning for future outbreaks should take into account the need to (1) develop systems that enable rapid two-way communication between public health officials and homeless service providers, (2) ensure that homeless service providers have access to infection control supplies and staff training, (3) prepare for possible homeless shelter closures due to staff shortages or high attack rates among clients, and (4) plan for where and how clinically ill homeless individuals will be isolated and treated. The Toronto SARS experience provided insights that are relevant to response planning for future outbreaks in cities with substantial numbers of homeless individuals. PMID:18347991

  14. Representation of the governed: leadership building for people with behavioral health disorders who are homeless or were formerly homeless.

    PubMed

    Rowe, Michael; Benedict, Patricia; Falzer, Paul

    2003-01-01

    Many organizations that provide services to individuals with behavioral health disorders are required to include people with psychiatric disabilities on their boards and action groups, yet this requirement rarely results in successful, ongoing representation. We report on a pilot project that trained people who were homeless and formerly homeless, most of whom were diagnosed with behavioral health disorders, for internships on boards and action groups that provide services to people who are homeless. We relate the project's goals to the theme of empowerment, present our findings, discuss key implementation issues, and offer recommendation for future program efforts and research.

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

    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

  16. Homeless Houston Youth Find Refuge in Schools.

    ERIC Educational Resources Information Center

    Penning, Nick

    1989-01-01

    To attack their community's homeless student problem, the Houston Board of Education last February opened a "lighted schoolhouse" as a temporary shelter. Houston's superintendent, Joan Raymond, is convinced that more school districts will need to provide residential care. The 20 children using the shelter were turned over to Children's Protective…

  17. Transitional Living Programs for Homeless Adolescents.

    ERIC Educational Resources Information Center

    Jarvis, Sara V.; Robertson, Robert M., Jr.

    This report presents a conceptual framework for developing, reviewing, and evaluating transitional living programs (TLPs) for homeless adolescents. It is designed to be used by those in the field who are or will be developing such programs. All TLPs share basic elements and each of these is described so that TLP providers can understand what their…

  18. Adapting an Evidence-Based Intervention for Homeless Women: Engaging the Community in Shared Decision-making

    PubMed Central

    Cederbaum, Julie A.; Song, Ahyoung; Hsu, Hsun-Ta; Tucker, Joan S.; Wenzel, Suzanne L.

    2014-01-01

    As interest grows in the diffusion of evidence-based interventions (EBIs), there is increasing concern about how to mitigate implementation challenges; this paper concerns adapting an EBI for homeless women. Complementing earlier focus groups with homeless women, homeless service providers (n = 32) were engaged in focus groups to assess capacity, needs, and barriers with implementation of EBIs. Deductive analyses of data led to the selection of four EBIs. Six consensus groups were then undertaken; three each with homeless women (n = 24) and homeless service providers (n = 21). The selected EBI was adapted and pretested with homeless women (n = 9) and service providers (n = 6). The structured consensus group process provided great utility and affirmed the expertise of homeless women and service providers as experts in their domain. Engaging providers in the selection process reduced the structural barriers within agencies as obstacles to diffusion. PMID:25418227

  19. Extreme weather-related health needs of people who are homeless.

    PubMed

    Cusack, Lynette; van Loon, Antonia; Kralik, Debbie; Arbon, Paul; Gilbert, Sandy

    2013-01-01

    To identify the extreme weather-related health needs of homeless people and the response by homeless service providers in Adelaide, South Australia, a five-phased qualitative interpretive study was undertaken. (1) Literature review, followed by semi-structured interviews with 25 homeless people to ascertain health needs during extreme weather events. (2) Identification of homeless services. (3) Semi-structured interviews with 16 homeless service providers regarding their response to the health needs of homeless people at times of extreme weather. (4) Gap analysis. (5) Suggestions for policy and planning. People experiencing homelessness describe adverse health impacts more from extreme cold, than extreme hot weather. They considered their health suffered more, because of wet bedding, clothes and shoes. They felt more depressed and less able to keep themselves well during cold, wet winters. However, homeless service providers were more focussed on planning for extra service responses during times of extreme heat rather than extreme cold. Even though a city may be considered to have a temperate climate with a history of very hot summers, primary homeless populations have health needs during winter months. The experiences and needs of homeless people should be considered in extreme weather policy and when planning responses.

  20. Where There Is No Hope: A Teacher's Experience with Homelessness

    ERIC Educational Resources Information Center

    Nath, Veena; Hallett, Ronald E.

    2015-01-01

    Stereotypical notions of who experiences homelessness frame how educational institutions approach policy and program development. This life history of a teacher challenges assumptions by providing an in-depth look at a mother's struggle to find stability.

  1. African-American homeless and low-income housed mothers: comparison of parenting practices.

    PubMed

    Koblinsky, S A; Morgan, K M; Anderson, E A

    1997-01-01

    The child-rearing practices of homeless and low-income housed mothers of preschool children in Head Start were compared. Overall, homeless mothers provided less learning and academic stimulation, less variety in social and cultural experiences, less warmth and affection, and a less positive physical environment for their children than did housed mothers. Mothers in both living arrangements provided more language stimulation to daughters than to sons. Implications of the findings for working with homeless families are discussed. PMID:9034020

  2. Readings in Homelessness.

    ERIC Educational Resources Information Center

    Matuszowicz, Peter F.

    Researchers have documented links between a number of behavioral issues and homelessness, including the following: limited/no social networks; social isolation; proneness of victimization; history of emotional, physical, sexual, and substance abuse; lack of education; and anxiety resulting from inadequate physical space. The possible benefits of…

  3. The Neighborhood Context of Homelessness

    PubMed Central

    Pollio, David E.; North, Carol S.

    2013-01-01

    Objectives. We examined and compared the changing neighborhood characteristics of a group of homeless adults over time. Methods. We collected the addresses of previous housing and sleep locations from a longitudinal study of 400 homeless adults in the St. Louis, Missouri, region and compared census measures of housing and economic opportunities at different points along individual pathways from housing to homelessness and at 1- and 2-year follow-up interviews. Results. Sleep locations of homeless adults were much more concentrated in the urban core at baseline than were their previous housed and follow-up locations. These core areas had higher poverty, unemployment, and rent-to-income ratios and lower median incomes. Conclusions. The spatial concentration of homeless adults in areas with fewer opportunities and more economic and housing distress may present additional barriers to regaining stable housing and employment. A big-picture spatial and time-course viewpoint is critical for both policymakers and future homelessness researchers. PMID:23409889

  4. 76 FR 36955 - West Los Angeles VA Medical Center Veterans Programs Enhancement Act of 1998; Master Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-23

    ... homeless veterans, especially those coping with mental health problems such as PTSD. The WLA campus is a... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS West Los Angeles VA Medical Center Veterans Programs Enhancement Act of 1998; Master Plan...

  5. 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

    ... at the Chillicothe VA Medical Center in Chillicothe, Ohio. As consideration for the EUL, the lessee... placement for senior, disabled, homeless and/or at-risk Veterans and their families. FOR FURTHER INFORMATION... consideration under such a lease for the provision of medical care and services would result in a...

  6. Hearing the silent voices: narratives of health care and homelessness.

    PubMed

    Wise, Caitlin; Phillips, Kenneth

    2013-05-01

    Most homeless individuals lack adequate health care. With existing literature as a backdrop, this study sought to understand the experience of homeless persons in the health care system. Using a phenomenological approach, 11 homeless participants were interviewed and the transcripts from these interviews were analyzed for meaning. The health care experiences of the participants could be understood only when viewed within the context of homelessness. The four polar themes that emerged from the analysis--same/different, fair/unfair, freedom/barriers, and choice/no choice--highlighted the great divide between the health care experiences of those with a home and those without. Such understanding can help mental health nurses provide more appropriate care to this population. PMID:23663023

  7. Promoting positive parenting in the context of homelessness.

    PubMed

    Perlman, Staci; Cowan, Beryl; Gewirtz, Abigail; Haskett, Mary; Stokes, Lauren

    2012-07-01

    Recent national reports suggest that nearly 1,000,000 families with children experience homelessness and that this number is rising (National Center on Family Homelessness, 2009; U.S. Conference of Mayors, 2010; U.S. Department of Housing and Urban Development, 2011). Families experiencing homelessness are disproportionately more likely to have experienced economic, health, and social risk factors. These experiences can adversely influence the parent-child relationship. The purpose of this article is to (a) review the literature on the determinants and contextual issues of parenting in shelters; (b) describe specific programs that are focused on positive parenting in the context of homelessness; and (c) provide practice, research, and policy recommendations for supporting positive parenting among families living without homes.

  8. Differences in risk behaviors, care utilization, and comorbidities in homeless persons based on HIV status.

    PubMed

    Parker, R David; Dykema, Shana

    2014-01-01

    This cross-sectional pilot project measured differences by HIV status in chronic health conditions, primary care and emergency department use, and high-risk behaviors of homeless persons through self-report. Using selective random sampling, 244 individuals were recruited from a homeless shelter. The reported HIV prevalence was 6.56% (n = 16), with the odds of HIV higher in persons reporting crack cocaine use. HIV-infected persons were more likely to report a source of regular medical care and less likely to use the emergency department than uninfected persons. Validation of findings through exploration of HIV and health care access in homeless persons is needed to confirm that HIV-infected homeless persons are more likely to have primary care. Distinctions between primary care and specialty HIV care also need to be explored in this context. If findings are consistent, providers who care for the homeless could learn more effective ways to engage homeless patients.

  9. Teaching about vulnerable populations: nursing students' experience in a homeless center.

    PubMed

    Stanley, Mary Jo

    2013-10-01

    Cultural competence is not limited to ethnicity, religion, or race but is inclusive of vulnerable groups, such as the homeless. The complex health and social issues related to homelessness requires educational instruction that supports students' ability to address and care for the multidimensional elements that surround this group. Exposure to homeless populations provides nursing students with increased awareness of the issues related to health disparities, while promoting introspective reflection on one's values and beliefs. To increase student exposure to working with homeless clients, a service-learning project using a critical social theory (CST) lens was offered at a homeless center. The students' response that clients were "just like" them, coupled with ambiguity regarding the complex social-economic-political issues surrounding the homeless, may indicate a need for further education regarding cultural understanding, sensitivity, and vulnerability. This project demonstrates the need for learning experiences that support advocacy and social responsibility for vulnerable groups. PMID:24040771

  10. The Community College and the Homeless: A Model for the Nation. Job Training for the Homeless Demonstration Program Final Evaluation Report.

    ERIC Educational Resources Information Center

    Moehrlin, Cynthia D.

    Established in 1981, the Alternatives Program at Elgin Community College (ECC) has provided services for displaced homemakers, single parents, welfare recipients, and homeless women, laying the groundwork for the 1988 formation of the Fox Valley Consortium for Job Training and Placement of the Homeless. Using federal funding, the Consortium offers…

  11. Pastoral care and counseling with the "un-homeless homeless": understanding cultures of homelessness.

    PubMed

    Snodgrass, Jill

    2014-01-01

    This article presents a subset of findings from a larger study exploring the lived experiences of 16 former residents of a 90-day emergency family shelter program in Los Angeles County. Interpretative phenomenological analysis serves as a qualitative method for understanding the cultural uniqueness of the "un-homeless homeless." The findings offer implications for culturally competent pastoral care and counseling in the context of family homelessness and attend to both the process and content of caregiving.

  12. Childhood risk factors for homelessness among homeless adults.

    PubMed Central

    Koegel, P; Melamid, E; Burnam, m A

    1995-01-01

    OBJECTIVES. This effort used data from the Course of Homelessness study and comparative secondary data on the general population to identify negative childhood and family background experiences that may increase risk for adult homelessness. METHODS. Frequencies of negative childhood experiences were examined among a probability sample of 1563 homeless adults. Differences in risk for such experiences were calculated by sex, age cohort, and racial/ethnicity status. Where possible, rates of negative childhood experiences among the homeless were compared with the general population. RESULTS. Substantial numbers of this sample experienced multiple problems as children across several domains: poverty, residential instability, and family problems. Women and Whites disproportionately reported experiences suggestive of personal or family problems; non-Whites disproportionately reported experiences suggestive of personal or family problems; non-Whites disproportionately reported experiences suggestive of poverty. Homeless adults were at increased risk of childhood out-of-home placement, tenure in public housing, and homelessness, but not at greater risk for physical abuse. Women appeared to be at greater risk for sexual abuse. CONCLUSIONS. The problems that homeless individuals experience as adults have very clear analogs in their childhoods. Vulnerability to homelessness stems from factors unevenly distributed across age, sex, and race/ethnicity groups. PMID:7503338

  13. An Inside Look at Homeless Youths’ Social Networks: Perceptions of Substance Use Norms1

    PubMed Central

    Melander, Lisa A.; Tyler, Kimberly A.; Schmitz, Rachel M.

    2016-01-01

    Substance use among homeless young people is a pervasive problem, and there have been many efforts to understand more about the dynamics of this health compromising behavior. The current study examined perceived substance use norms within homeless youths’ social networks utilizing in-depth interviews. The sample included 19 homeless individuals aged 16 to 21. Four elements of substance use within networks emerged: substance use choices, drug use safety issues, encouragement and/or discouragement, and appropriate situations in which substance use is condoned. These findings provide unique insight into the norms associated with drug and alcohol use within homeless youths’ social networks. PMID:26989340

  14. 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....

  15. 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....

  16. 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....

  17. Predictors of Homelessness among Street Living Youth

    ERIC Educational Resources Information Center

    Slesnick, Natasha; Bartle-Haring, Suzanne; Dashora, Pushpanjali; Kang, Min Ju; Aukward, Erin

    2008-01-01

    While few studies have identified predictors of exiting homelessness among adults, even fewer studies have attempted to identify these predictors among homeless youth. The current study explored predictors of change in homelessness among 180 homeless youth between the ages of 14 and 22, recruited through an urban drop-in center. All youth were…

  18. 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…

  19. 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…

  20. Homelessness: Too Early To Tell What Kinds of Prevention Assistance Work Best. Report to the Congress.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    Although hundreds of state and local organizations provide homelessness prevention assistance, the Government Accounting Office (GAO) could not determine the effectiveness of this assistance because few assistance providers have the resources available to collect the client follow-up data needed for evaluation. Homelessness prevention programs,…

  1. Lost in the shuffle: culture of homeless adolescents.

    PubMed

    Oliveira, Joanne O'sullivan; Burke, Pamela J

    2009-01-01

    Estimates indicate that approximately 1.7 million youth are homeless in the United States. Many associated risk factors have been identified for adolescent homelessness, including family conflict, leaving foster care, running away or being thrown away, physical or sexual abuse, and coming out to parents as gay, lesbian, bisexual, transgender, or questioning one's sexual identity (GLBTQ). The purpose of this ethnographic study was to explore the culture of homelessness for adolescents. Nineteen homeless adolescents from a major urban area in the northeast U.S. were observed and interviewed over an 18-month period. The elements of the street culture of homeless adolescents were identified by study participants' stories. For many study participants, the decision to live on the streets was a logical and rational alternative to remaining in possibly dangerous and unstable home environments. It provided a means to their generating social capital. Nevertheless, it can be concluded that existing programs and policies relative to adolescents who are at risk for homelessness or already living on the streets should be re-examined and redesigned to meet the unique needs of vulnerable youth so they do not get lost in the shuffle.

  2. 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…

  3. 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…

  4. Access to Pre-K Education under the McKinney-Vento Homeless Assistance Act. Pre-K Policy Brief Series

    ERIC Educational Resources Information Center

    Boylan, Ellen; Splansky, Deborah

    2010-01-01

    The federal McKinney-Vento Homeless Assistance Act ("McKinney-Vento") provides federal funding to states to address the problems that homeless children and youth encounter in enrolling, attending, and succeeding in the nation's public schools. McKinney-Vento requires states to develop plans that ensure homeless children and youth the same access…

  5. Homelessness during pregnancy: a unique, time-dependent risk factor of birth outcomes.

    PubMed

    Cutts, Diana B; Coleman, Sharon; Black, Maureen M; Chilton, Mariana M; Cook, John T; de Cuba, Stephanie Ettinger; Heeren, Timothy C; Meyers, Alan; Sandel, Megan; Casey, Patrick H; Frank, Deborah A

    2015-06-01

    Evaluate homelessness during pregnancy as a unique, time-dependent risk factor for adverse birth outcomes. 9,995 mothers of children <48 months old surveyed at emergency departments and primary care clinics in five US cities. Mothers were classified as either homeless during pregnancy with the index child, homeless only after the index child's birth, or consistently housed. Outcomes included birth weight as a continuous variable, as well as categorical outcomes of low birth weight (LBW; <2,500 g) and preterm delivery (<37 weeks). Multiple logistic regression and adjusted linear regression analyses were performed, comparing prenatal and postnatal homelessness with the referent group of consistently housed mothers, controlling for maternal demographic characteristics, smoking, and child age at interview. Prenatal homelessness was associated with higher adjusted odds of LBW (AOR 1.43, 95 % CI 1.14, 1.80, p < 0.01) and preterm delivery (AOR 1.24, 95 % CI 0.98, 1.56, p = 0.08), and a 53 g lower adjusted mean birth weight (p = 0.08). Postnatal homelessness was not associated with these outcomes. Prenatal homelessness is an independent risk factor for LBW, rather than merely a marker of adverse maternal and social characteristics associated with homelessness. Targeted interventions to provide housing and health care to homeless women during pregnancy may result in improved birth outcomes.

  6. Changing homelessness services: revanchism, 'professionalisation' and resistance.

    PubMed

    Scullion, Lisa; Somerville, Peter; Brown, Philip; Morris, Gareth

    2015-07-01

    This paper argues that the increasing international salience of homelessness can be partially explained by reference to the revanchist thesis (involving processes of coerced exclusion and abjection), but the situation on the ground is more complex. It reports on interviews with 18 representatives of 11 homelessness service providers in one city in England. As Cloke et al. found, these providers tended to be either larger, more 'professional', 'insider' services or smaller, more 'amateur', 'outsider' services. However, this does not mean that the former were necessarily more revanchist and the latter less so. Rather, the actions of both types of organisation could, in some cases, be construed as both advancing and counteracting a revanchist project.

  7. Self-identified health concerns of two homeless groups.

    PubMed

    Kinzel, D

    1991-04-01

    A number of conclusions can be drawn from the themes derived from the interview data. First, even though the most basic physical needs, such as food, clothing, and shelter were being met, a recurring theme from the responses of the homeless was the need for interaction with a caring person. The feeling that no one cares, a lack of self-worth, and a sense of limited control over their lives may lead to depression, hopelessness, and finally illness. The extent and effectiveness of health-seeking behaviors among this group are limited because of decreased trust, decreased motivation for self-care, and isolation from social and health care systems. Second, if health needs are to be met, services must be provided in sites where they can be accessed by the homeless. For transients, health care services may be provided most effectively through the shelters. For the SRO residents, these services could be provided through a combination of clinics in hotel lobbies and visits to rooms. Third, developing trust with the homeless includes meeting their self-perceived basic needs. What may seem like nonnursing activities, such as fixing a meal, may be important in establishing rapport with SRO residents. If a nurse assists a homeless person to meet survival needs, that person may be more willing to deal with health issues. Fourth, the population is highly heterogeneous. Each subgroup has its own identity. Most SRO residents do not want to be identified with street people, even through a portion of them move between street life and SRO life. Health care professionals need to recognize these differences, accept the life-style of each subgroup, and respect each homeless person as a unique individual. Finally, caring is the primary element necessary in providing nursing services to the homeless. Awareness and understanding of the homeless way of life will increase nurses' effectiveness in working with this ever growing population. PMID:2048311

  8. Telephone Enrollment in the VA Healthcare System. Final rule.

    PubMed

    2016-09-12

    The Department of Veterans Affairs (VA) adopts as final, without change, an interim final rule amending its medical regulations. Specifically, this rule allows veterans to complete applications for health care enrollment by providing application information, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided to a VA employee over the phone. This action makes it easier for veterans to apply to enroll and speeds VA processing of applications. PMID:27632804

  9. Telephone Enrollment in the VA Healthcare System. Final rule.

    PubMed

    2016-09-12

    The Department of Veterans Affairs (VA) adopts as final, without change, an interim final rule amending its medical regulations. Specifically, this rule allows veterans to complete applications for health care enrollment by providing application information, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided to a VA employee over the phone. This action makes it easier for veterans to apply to enroll and speeds VA processing of applications.

  10. Writing and Retelling Multiple Ethnographic Tales of a Soup Kitchen for the Homeless.

    ERIC Educational Resources Information Center

    Miller, Dana L.; Creswell, John W.; Olander, Lisa

    An ethnographic study narrated three tales about a soup kitchen for the homeless and the near-homeless. To provide a cultural, ethnographic analysis, and share fieldwork experiences the study began with realist and confessional tales. These two tales emerged from the initial writing and presenting of the soup kitchen ethnography to qualitative…

  11. The McKinney-Vento Education for Homeless Children and Youth Program: Implications for Special Educators

    ERIC Educational Resources Information Center

    Losinski, Mickey; Katsiyannis, Antonis; Ryan, Joseph B.

    2013-01-01

    During the 2008-2009 academic school year, nearly a million (956,914) students were reported by school districts as being homeless, a 41% increase over just a 2-year period year. The purpose of this article is to provide a brief overview of national legislative efforts to address the education of children who are homeless, with a particular…

  12. Homelessness. Appropriate Controls Implemented for 1990 McKinney Amendments' PATH Program. Report to Congressional Committees.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

    The Projects for Assistance in Transition from Homelessness (PATH) program provides the states and territories with funds to serve homeless individuals who are seriously mentally ill or dually diagnosed with serious mental illness and substance abuse disorders. As part of the mandate of the authorizing legislation, the General Accounting Office…

  13. Educating Homeless Students in Urban Settings: An Introduction to the Issues.

    ERIC Educational Resources Information Center

    Stronge, James H.

    1993-01-01

    Introduces background issues regarding the education of homeless children in urban areas, focusing on problems of definition and identification and sociological factors related to homelessness. An overview is provided of the articles of the special issue. The challenges are how to meet the needs of an amorphous and troubled population. (SLD)

  14. Characterizing Stressors and Modifiable Health Risk Factors among Homeless Smokers: An Exploratory Pilot Study

    ERIC Educational Resources Information Center

    Kendzor, Darla E.; Reitzel, Lorraine R.; Businelle, Michael S.

    2015-01-01

    This pilot study was conducted to explore the associations between stressors related to homelessness and modifiable health risk factors (poor diet, insufficient physical activity, and overweight/obesity) and to provide direction for future research. Participants (N = 57) were homeless adults enrolled in a smoking cessation program. Analyses were…

  15. Conceptualizing Social Integration among Formerly Homeless Adults with Severe Mental Illness

    ERIC Educational Resources Information Center

    Tsai, Jack; Rosenheck, Robert A.

    2012-01-01

    The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well-studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors…

  16. The Education of Homeless Children and Youth: A Compendium of Research & Information.

    ERIC Educational Resources Information Center

    Stronge, James H., Comp.; Popp, Patricia, Comp.

    This publication provides current research and related literature on issues surrounding the education of homeless children and youth. It includes a variety of perspectives, reflecting the most recent trends in homelessness, determined by changes in policies, economics, and demographics. It also offers the latest research and scholarly opinions…

  17. Perchance to Sleep: Homeless Children without Shelter in New York City.

    ERIC Educational Resources Information Center

    Coalition for the Homeless, New York, NY.

    New York City's response to the demand for shelter has consistently been adequate. The city's homeless population is estimated at 35,000, including 11,000 members of homeless families, of whom almost 7,625 are children. The City's Human Resources Administration (HRA) has routinely failed to provide temporary emergency shelter for homeless…

  18. Homeless aging veterans in transition: a life-span perspective.

    PubMed

    Thompson, Carla J; Bridier, Nancy L

    2013-01-01

    The need for counseling and career/educational services for homeless veterans has captured political and economic venues for more than 25 years. Veterans are three times more likely to become homeless than the general population if veterans live in poverty or are minority veterans. This mixed methods study emphasized a life-span perspective approach for exploring factors influencing normative aging and life-quality of 39 homeless veterans in Alabama and Florida. Seven descriptive quantitative and qualitative research questions framed the investigation. Study participants completed a quantitative survey reflecting their preferences and needs with a subset of the sample (N = 12) also participating in individual qualitative interview sessions. Thirty-two service providers and stakeholders completed quantitative surveys. Empirical and qualitative data with appropriate triangulation procedures provided interpretive information relative to a life-span development perspective. Study findings provide evidence of the need for future research efforts to address strategies that focus on the health and economic challenges of veterans before they are threatened with the possibility of homelessness. Implications of the study findings provide important information associated with the premise that human development occurs throughout life with specific characteristics influencing the individual's passage. Implications for aging/homelessness research are grounded in late-life transitioning and human development intervention considerations. PMID:24286010

  19. Homeless Aging Veterans in Transition: A Life-Span Perspective

    PubMed Central

    Thompson, Carla J.; Bridier, Nancy L.

    2013-01-01

    The need for counseling and career/educational services for homeless veterans has captured political and economic venues for more than 25 years. Veterans are three times more likely to become homeless than the general population if veterans live in poverty or are minority veterans. This mixed methods study emphasized a life-span perspective approach for exploring factors influencing normative aging and life-quality of 39 homeless veterans in Alabama and Florida. Seven descriptive quantitative and qualitative research questions framed the investigation. Study participants completed a quantitative survey reflecting their preferences and needs with a subset of the sample (N = 12) also participating in individual qualitative interview sessions. Thirty-two service providers and stakeholders completed quantitative surveys. Empirical and qualitative data with appropriate triangulation procedures provided interpretive information relative to a life-span development perspective. Study findings provide evidence of the need for future research efforts to address strategies that focus on the health and economic challenges of veterans before they are threatened with the possibility of homelessness. Implications of the study findings provide important information associated with the premise that human development occurs throughout life with specific characteristics influencing the individual's passage. Implications for aging/homelessness research are grounded in late-life transitioning and human development intervention considerations. PMID:24286010

  20. Health care needs of the homeless of O'ahu.

    PubMed

    Withy, Kelley M; Amoa, Francine; Andaya, January M; Inada, Megan; Berry, Shaun P

    2008-08-01

    An interview study of 162 homeless individuals on O'ahu demonstrated that the homeless studied were 3 times more likely than the general population of O'ahu to rate their health as fair to poor, despite the fact that 77% of interviewees had medical insurance and 66% a regular health care provider Better self ratings of health were only associated with younger age and self report of having dental insurance when demographic variables were controlled for. Qualitatively the homeless population interviewed described 'good health' as avoiding illness and being able to make healthy lifestyle choices, finding emotional balance and caring for others. Commonly reported barriers to accessing care included financial factors such as being unable to purchase medications; environmental challenges such as clean drinking water and a safe place to stay; and general discomfort with the health care system. Clinical implications of this study indicate the need for providers caring for the homeless be alert to challenges particular to the homeless, such as barriers to following medical advice (high fiber/low salt diet, exercise, refrigerating medications, etc.). The surprising relationship between knowledge of having dental insurance and better self ratings of health deserves additional research, as does the lack of association between health ratings and having health insurance and a regular provider.

  1. Distal Stressors and Depression among Homeless Men.

    PubMed

    Coohey, Carol; Easton, Scott D

    2016-05-01

    Depression is a common problem among homeless men that may interfere with functional tasks, such as securing stable housing, obtaining employment, and accessing health services. Previous research on depression among homeless men has largely focused on current psychosocial resources, substance abuse, and past victimization. Guided by Ensel and Lin's life course stress process model, the authors examined whether distal stressors, including victimization and exposure to parent problems in childhood, contributed to men's depression above and beyond current (or proximal) stressors, such as substance abuse and health problems, and social resources. The sample consisted of 309 homeless men who had entered a federally funded emergency shelter. Using the Burns Depression Checklist, the authors found that one out of three men met the threshold for moderate to severe depression during the past week. The logistic regression showed that past exposure to parent problems was related to depression after accounting for current stressors and social resources (number of close adult relationships and whether their emotional support needs were met). Past victimization was not related to depression. To address men's depression, workers should concurrently provide services that meet men's basic needs (for example, housing) and address their relationship needs, including their need for emotional support. PMID:27263201

  2. Problem gambling and homelessness: results from an epidemiologic study.

    PubMed

    Nower, Lia; Eyrich-Garg, Karin M; Pollio, David E; North, Carol S

    2015-06-01

    The purpose of this study was to investigate the prevalence of gambling disorder and comorbid psychiatric disorders in a homeless population and identify features related to potential subtypes. At baseline, participants were administered a structured interview including socio-demographic sections of the National Comorbidity Study (NCS) interview; seven diagnostic sections of the Diagnostic Interview Schedule (DIS); the alcohol and drug abuse sections of the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM); and the Homeless Supplement to the DIS. At nine months post-baseline assessment, participants were administered additional NCS family history questions and the South Oaks Gambling Screen (SOGS). Participants were an epidemiologic sample of 275 predominately African-American homeless individuals, grouped as lifetime non-gamblers (n = 60), recreational gamblers (n = 152), and problem gamblers (n = 63), recruited on the street and through homeless shelters. Results indicate that lifetime rates of sub-clinical problem (46.2%) and disordered (12.0%) gambling were significantly higher than in the general population. Problem gamblers were more likely than non-problem gamblers to meet diagnostic criteria for antisocial personality disorder, post-traumatic stress disorder, bipolar disorder, and any psychiatric disorder, and more likely than non-gamblers to use illicit drugs or meet criteria for abuse/dependence for nicotine, alcohol, or any substance. This study provides evidence that problem gambling is a significant public health issue among the African-American homeless population. Homeless services should include assessment for problem gambling along with psychiatric disorders and referrals to resources and treatment programs. Future studies should explore the relationship of the onset and course of problem gambling and other psychiatric disorders with homelessness as well as racial differences in gambling patterns and problem severity

  3. Problem gambling and homelessness: results from an epidemiologic study.

    PubMed

    Nower, Lia; Eyrich-Garg, Karin M; Pollio, David E; North, Carol S

    2015-06-01

    The purpose of this study was to investigate the prevalence of gambling disorder and comorbid psychiatric disorders in a homeless population and identify features related to potential subtypes. At baseline, participants were administered a structured interview including socio-demographic sections of the National Comorbidity Study (NCS) interview; seven diagnostic sections of the Diagnostic Interview Schedule (DIS); the alcohol and drug abuse sections of the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM); and the Homeless Supplement to the DIS. At nine months post-baseline assessment, participants were administered additional NCS family history questions and the South Oaks Gambling Screen (SOGS). Participants were an epidemiologic sample of 275 predominately African-American homeless individuals, grouped as lifetime non-gamblers (n = 60), recreational gamblers (n = 152), and problem gamblers (n = 63), recruited on the street and through homeless shelters. Results indicate that lifetime rates of sub-clinical problem (46.2%) and disordered (12.0%) gambling were significantly higher than in the general population. Problem gamblers were more likely than non-problem gamblers to meet diagnostic criteria for antisocial personality disorder, post-traumatic stress disorder, bipolar disorder, and any psychiatric disorder, and more likely than non-gamblers to use illicit drugs or meet criteria for abuse/dependence for nicotine, alcohol, or any substance. This study provides evidence that problem gambling is a significant public health issue among the African-American homeless population. Homeless services should include assessment for problem gambling along with psychiatric disorders and referrals to resources and treatment programs. Future studies should explore the relationship of the onset and course of problem gambling and other psychiatric disorders with homelessness as well as racial differences in gambling patterns and problem severity

  4. Overdose Deaths Among Homeless Persons

    MedlinePlus

    ... of them involving opioids—are now the biggest killer among homeless people in the Boston area. Drug ... Cancer and heart disease were the next biggest killers (at around 16 percent each); HIV =accounted for ...

  5. Art Messaging as a Medium to Engage Homeless Young Adults Art Messaging as a Medium to Engage Homeless Youth

    PubMed Central

    Nyamathi, Adeline; Slagle, Alexandra; Thomas, Alexandra; Hudson, Angela; Khalilifard, Farinaz; Avila, Glenna; Orser, Julie; Cuchilla, Manuel

    2013-01-01

    Background Art has been shown to be an empowering and engaging entity with numerous benefits to vulnerable populations, including the homeless persons and young adults. Yet, 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. Objectives 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. Methods Qualitative methodology via focus group discussions was utilized to engage 24 homeless young adults enrolled from a drop-in site in Santa Monica. Results 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. Conclusions 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. PMID:21441664

  6. 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,…

  7. Homeless in God's Country: Coping Strategies and Felt Experiences of the Rural Homeless

    ERIC Educational Resources Information Center

    Hilton, Timothy; DeJong, Cornell

    2010-01-01

    This study examines coping behaviors and felt experiences of homeless adults in Michigan's Upper Peninsula. Data from in-depth interviews with 55 homeless adults reveal 5 general coping pattern groups: shelter users, campers, couch hoppers, mixed users, and circumstantial homeless. Homeless adults within each group experienced similar levels of…

  8. Hepatitis A/B vaccine completion among homeless adults with history of incarceration.

    PubMed

    Nyamathi, Adeline M; Marlow, Elizabeth; Branson, Catherine; Marfisee, Mary; Nandy, Karabi

    2012-03-01

    Hepatitis B virus (HBV) vaccination rates for incarcerated adults remain low despite their high risk for infection. This study determined predictors of vaccine completion in homeless adults (N= 297) who reported histories of incarceration and who participated in one of three nurse-led hepatitis programs of different intensity. Moreover time since release from incarceration was also considered. Just over half of the former prisoners completed the vaccine series. Older age (≥40), having a partner, and chronic homelessness were associated with vaccine completion. Recent research has documented the difficulty in providing vaccine services to younger homeless persons and homeless males at risk for HBV. Additional strategies are needed to achieve HBV vaccination completion rates greater than 50% for formerly incarcerated homeless men.

  9. A qualitative study of pregnancy intention and the use of contraception among homeless women with children.

    PubMed

    Kennedy, Sara; Grewal, Mandeep; Roberts, Elizabeth M; Steinauer, Jody; Dehlendorf, Christine

    2014-05-01

    We undertook a qualitative analysis informed by grounded theory to explore pregnancy intention and the barriers to contraceptive use as perceived by homeless women with children. Semi-structured interviews (n = 22) were performed in English and in Spanish. The dominant theme emerging from the interviews was a strong desire to avoid pregnancy while homeless. However, few women in our sample used contraception or accessed reproductive health care consistently. There were multiple barriers to using contraception and to accessing reproductive health care services that homeless women reported: (1) inability to prioritize health due to competing demands, (2) shelter-related obstacles and restrictive provider practices that impede access to reproductive health care services and the use of contraception, and (3) change in the power dynamics of sexual relationships while homeless, making women more vulnerable to sexual exploitation. Findings suggest a multifactorial approach is needed to help homeless women use contraception and access reproductive health services.

  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. Trajectories of women's homelessness in Canada's 3 northern territories

    PubMed Central

    Schmidt, Rose; Hrenchuk, Charlotte; Bopp, Judie; Poole, Nancy

    2015-01-01

    Background Repairing the Holes in the Net was a 2-year, multilevel action research project designed to inform the development of culturally appropriate and gender-specific services for northern women who are homeless or marginally housed and who face mental health and substance use concerns. The study was designed to learn about the barriers and supports experienced by homeless women in the North when accessing mental health care, shelter, housing and other services; and to inform the work of northern service providers and policy advocates in a position to implement adjustments in their praxis. Methods This article describes the trajectories of women's service access and their ideas for service improvement from 61 qualitative, semi-structured interviews conducted with homeless women in Whitehorse, Yukon (YT), Yellowknife, Northwest Territories (NT), and Iqualit, Nunavut (NU). Results Unresolved trauma, poverty and social exclusion, inability to find and maintain housing and ineffective services emerged as interconnected and multifaceted challenges related to women's service engagement. In the face of these challenges, women displayed significant resilience and resistance, and offered important ideas for service improvement. Conclusions The 4 interconnected systemic challenges identified in the research, coupled with specific ideas for change cited by the resilient homeless women interviewed, offer points of entry to improve service policy and delivery. Implementing trauma-informed approaches emerged as a key example of how access to, and quality of, services could be improved for homeless women in the North. PMID:26700413

  12. Innovative Efforts to Address Homelessness Among Veterans.

    PubMed

    O'Toole, Thomas P; Pape, Lisa

    2015-01-01

    Ending homelessness among veterans has been a goal of the Department of Veterans Affairs for some time, and it is now becoming a reality in many communities. Unprecedented strides have been made through the rapid implementation of evidence-based innovations, capacity building, and a comprehensive strategic focus on 4 goals: prevention, moving veterans into permanent housing, providing the population-tailored care and services needed to keep them housed, and providing the supports necessary to allow them to recover and be productive members of their communities. PMID:26946863

  13. 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…

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. Escaping Homelessness: Anticipated and Perceived Facilitators

    ERIC Educational Resources Information Center

    Patterson, Allisha; Tweed, Roger

    2009-01-01

    One study with two distinct sections was conducted to identify factors facilitating escape from homelessness. In Section 1, 58 homeless individuals rated possible facilitators of escape (factors they believed would help them become more independent and self-sufficient). In Section 2, 80 participants who had already exited homelessness rated the…

  20. Pushed Out: America's Homeless. Thanksgiving 1987.

    ERIC Educational Resources Information Center

    National Coalition for the Homeless, Washington, DC.

    By winter 1987, up to three million men, women, and children will be homeless; the number of homeless persons will continue to increase at a rate of 25 percent. This report surveys the changes in the homeless population in the following 23 cities over the past year: Albuquerque (New Mexico), Atlanta (Georgia), Boston (Massachusetts), Chicago…

  1. 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,…

  2. Negative Cultural Capital and Homeless Young People

    ERIC Educational Resources Information Center

    Barker, Justin David

    2013-01-01

    This article examines the ways in which homeless young people find a sense of self-worth and dignity within the conditions of youth homelessness. It notes that, while homeless young people seek a space where they do not feel marginalised and can attain a form of social status and cultural competence, they also engage in practices and acts of…

  3. 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…

  4. 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…

  5. Determining VA physician requirements through empirically based models.

    PubMed Central

    Lipscomb, J; Kilpatrick, K E; Lee, K L; Pieper, K S

    1995-01-01

    OBJECTIVE: As part of a project to estimate physician requirements for the Department of Veterans Affairs, the Institute of Medicine (IOM) developed and tested empirically based models of physician staffing, by specialty, that could be applied to each VA facility. DATA SOURCE/STUDY SETTING. These analyses used selected data on all patient encounters and all facilities in VA's management information systems for FY 1989. STUDY DESIGN. Production functions (PFs), with patient workload dependent on physicians, other providers, and nonpersonnel factors, were estimated for each of 14 patient care areas in a VA medical center. Inverse production functions (IPFs), with physician staffing levels dependent on workload and other factors, were estimated for each of 11 specialty groupings. These models provide complementary approaches to deriving VA physician requirements for patient care and medical education. DATA COLLECTION/EXTRACTION METHODS. All data were assembled by VA and put in analyzable SAS data sets containing FY 1989 workload and staffing variables used in the PFs and IPFs. All statistical analyses reported here were conducted by the IOM. PRINCIPAL FINDINGS. Existing VA data can be used to develop statistically strong, clinically plausible, empirically based models for calculating physician requirements, by specialty. These models can (1) compare current physician staffing in a given setting with systemwide norms and (2) yield estimates of future staffing requirements conditional on future workload. CONCLUSIONS. Empirically based models can play an important role in determining VA physician staffing requirements. VA should test, evaluate, and revise these models on an ongoing basis. PMID:7860320

  6. The impact of homelessness prevention programs on homelessness.

    PubMed

    Evans, William N; Sullivan, James X; Wallskog, Melanie

    2016-08-12

    Despite the prevalence of temporary financial assistance programs for those facing imminent homelessness, there is little evidence of their impact. Using data from Chicago from 2010 to 2012 (n = 4448), we demonstrate that the volatile nature of funding availability leads to good-as-random variation in the allocation of resources to individuals seeking assistance. To estimate impacts, we compare families that call when funds are available with those who call when they are not. We find that those calling when funding is available are 76% less likely to enter a homeless shelter. The per-person cost of averting homelessness through financial assistance is estimated as $10,300 and would be much less with better targeting of benefits to lower-income callers. The estimated benefits, not including many health benefits, exceed $20,000. PMID:27516600

  7. The impact of homelessness prevention programs on homelessness.

    PubMed

    Evans, William N; Sullivan, James X; Wallskog, Melanie

    2016-08-12

    Despite the prevalence of temporary financial assistance programs for those facing imminent homelessness, there is little evidence of their impact. Using data from Chicago from 2010 to 2012 (n = 4448), we demonstrate that the volatile nature of funding availability leads to good-as-random variation in the allocation of resources to individuals seeking assistance. To estimate impacts, we compare families that call when funds are available with those who call when they are not. We find that those calling when funding is available are 76% less likely to enter a homeless shelter. The per-person cost of averting homelessness through financial assistance is estimated as $10,300 and would be much less with better targeting of benefits to lower-income callers. The estimated benefits, not including many health benefits, exceed $20,000.

  8. 76 FR 5432 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the Charlie...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ..., develop, renovate, manage, maintain and operate the EUL development. As consideration for the lease, the...; provide preference and priority placement for homeless Veterans and Veterans at risk of homelessness; and... by the Under Secretary for Health for applying the consideration under such a lease for the...

  9. 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

    ... EUL development. As consideration for the lease, the lessees will be required to construct, renovate... placement for homeless Veterans and Veterans at risk of homelessness and their families; and provide a... by the Under Secretary for Health for applying the consideration under such a lease for the...

  10. 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

  11. 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. PMID:27163478

  12. The Social Networks of Homeless Youth Experiencing Intimate Partner Violence

    PubMed Central

    Petering, Robin; Rice, Eric; Rhoades, Harmony; Winetrobe, Hailey

    2015-01-01

    While there is a growing body of research on intimate partner violence (IPV) experienced by the housed youth population, a limited amount is known about IPV experienced by homeless youth. To our knowledge, no previous studies have examined how homeless youths’ experience of IPV is related to their social network, even though the social networks of homeless youth have been shown to be significant indicators of health and mental health. The purpose of this study is to understand the relationship between IPV, gender, and social networks among a sample of 386 homeless youth in Los Angeles, California. Results revealed that one fifth of the sample experienced IPV in the past year. Stratified regression models revealed that IPV was not significantly related to any measure of male social networks; however, females who experienced IPV had more male friends (β = 2.03, SE = 0.89, p < .05) than females who did not experience IPV. Female homeless youth who witnessed family violence during childhood had more male friends (β = 2.75, SE = 1.08, p < .05), but those who experienced sexual abuse during childhood had fewer male friends (β = −2.04, SE = 0.93, p < .05). Although there was no significant difference in the rate of IPV victimization across genders, the context of this abuse appears to be drastically different. The results suggest that females with more male friendships are at greater risk for exposure to IPV. To date, there are few effective youth-targeted IPV prevention programs and none have been shown to be effective with homeless youth. These results provide insight into future program development. PMID:24421071

  13. 24 CFR 91.305 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Persons who are homeless or at risk of homelessness. (1) The plan must describe, in a form prescribed by HUD, the nature and extent of homelessness, including rural homelessness, within the state. (i) The... youth), the number of persons experiencing homelessness on a given night, the number of persons...

  14. 24 CFR 91.305 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of the nature and extent of homelessness (including rural homelessness and chronically homeless... currently housed but threatened with homelessness. The plan also must contain a brief narrative description of the nature and extent of homelessness by racial and ethnic group, to the extent information...

  15. 24 CFR 91.205 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... homeless or at risk of homelessness. (1) The plan must describe, in a form prescribed by HUD, the nature and extent of unsheltered and sheltered homelessness, including rural homelessness, within the... youth), the number of persons experiencing homelessness on a given night, the number of persons...

  16. 24 CFR 91.305 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Persons who are homeless or at risk of homelessness. (1) The plan must describe, in a form prescribed by HUD, the nature and extent of homelessness, including rural homelessness, within the state. (i) The... youth), the number of persons experiencing homelessness on a given night, the number of persons...

  17. 24 CFR 91.305 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Persons who are homeless or at risk of homelessness. (1) The plan must describe, in a form prescribed by HUD, the nature and extent of homelessness, including rural homelessness, within the state. (i) The... youth), the number of persons experiencing homelessness on a given night, the number of persons...

  18. 24 CFR 91.205 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... homeless or at risk of homelessness. (1) The plan must describe, in a form prescribed by HUD, the nature and extent of unsheltered and sheltered homelessness, including rural homelessness, within the... youth), the number of persons experiencing homelessness on a given night, the number of persons...

  19. 24 CFR 91.205 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... homeless or at risk of homelessness. (1) The plan must describe, in a form prescribed by HUD, the nature and extent of unsheltered and sheltered homelessness, including rural homelessness, within the... youth), the number of persons experiencing homelessness on a given night, the number of persons...

  20. 24 CFR 91.305 - Housing and homeless needs assessment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... of the nature and extent of homelessness (including rural homelessness and chronically homeless... currently housed but threatened with homelessness. The plan also must contain a brief narrative description of the nature and extent of homelessness by racial and ethnic group, to the extent information...

  1. 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.

  2. Successful Transitions of Runaway/Homeless Youth from Shelter Care

    ERIC Educational Resources Information Center

    Nebbitt, Von E.; House, Laura E.; Thompson, Sanna J.; Pollio, David E.

    2007-01-01

    Previous research indicates that runaway and homeless youth often achieve positive outcomes after shelter stays however few studies have examined how these outcomes are achieved. This study employs qualitative methods to explicate this phenomenon. Twenty-five providers and 21 youth from four shelters participated in this study. Youth were…

  3. Homeless Students' Perceptions of School Counselors: Implications for Practice.

    ERIC Educational Resources Information Center

    Daniels, Judy; Pier, Patricia; D'Andrea, Michael

    Youngsters who live in shelters face numerous challenges in school. Some of their experiences are highlighted here, along with an examination of the perceptions that these youth have of school counselors. The paper provides an overview of the impact of homelessness on school-aged youngsters and their families and discusses the results of a…

  4. Summary of Head Start Provisions on Homelessness and Foster Care

    ERIC Educational Resources Information Center

    National Association for the Education of Homeless Children and Youth, 2008

    2008-01-01

    On Wednesday, December 12, President Bush signed the "Improving Head Start for School Readiness Act of 2007" into law. The legislation reauthorizes the Head Start Act and contains numerous provisions on homelessness and foster care. A summary of those provisions is provided in this paper.

  5. Small Is Beautiful: The Library Train for Homeless Children.

    ERIC Educational Resources Information Center

    Cheunwattana, Aree; Meksawat, Pimol

    This paper presents the story of an effort in Thailand to reach out to children in high-risk situations by providing them with a library on old train carriages. The Library Train Project was initiated in 1999 by the Railway Police Division within the Royal Police Office. It is aimed at offering education services to homeless children as a way of…

  6. Immigration and Schools: Supporting Success for Undocumented Unaccompanied Homeless Youth

    ERIC Educational Resources Information Center

    National Association for the Education of Homeless Children and Youth, 2010

    2010-01-01

    Attending school and securing lawful status in the United States are two keys to safety and security for undocumented unaccompanied homeless youth. This brief is designed to provide young people, immigration attorneys and advocates, McKinney-Vento liaisons and educators with basic information to help them access these keys. After describing some…

  7. A Substance Use Profile of Delinquent and Homeless Youths.

    ERIC Educational Resources Information Center

    Forst, Martin L.

    1994-01-01

    This study provides empirical data on the substance use behaviors of delinquent and homeless youths. Results indicate that these children use tobacco, alcohol, and illicit drugs at higher rates than adolescents in general. Drug education and prevention programs must be tailored to fit the needs of these at-risk populations. (RJM)

  8. Supporting the Literacy Development of Children Living in Homeless Shelters

    ERIC Educational Resources Information Center

    MacGillivray, Laurie; Ardell, Amy Lassiter; Curwen, Margaret Sauceda

    2010-01-01

    There are approximately 1.5 million children in the United States who go to sleep each night without a home of their own (National Center on Family Homelessness, 2009). In this article, we provide insights into how educators can create greater classroom support, particularly in literacy learning and development, for this population. Drawing from…

  9. General Welfare Assistance: Barriers to Mentally Disabled Homeless Adults.

    ERIC Educational Resources Information Center

    Robertson, Marjorie J.

    The present study describes specific conditions which are thought to interfere with application for general welfare assistance by homeless persons with mental disabilities. This report summarizes the observations and recommendations of direct-service providers who serve the target population in the Skid Row area of Los Angeles. In-depth structured…

  10. Materials on the Education of Homeless Children. Updated.

    ERIC Educational Resources Information Center

    Jackson, Shelley

    This document comprises resource materials on the education of homeless children. It is divided into three parts. Part 1, "Overview," collects publications of the Center for Law and Education, and articles and editorials from "Education Week" and "The New York Times." Part 2, "Relevant Statutes and Regulations," provides materials pertaining to…

  11. 76 FR 63357 - VA National Academic Affiliations Council; Notice of Establishment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... AFFAIRS VA National Academic Affiliations Council; Notice of Establishment As required by Section 9(a)(2... establishment of the Department of Veterans Affairs (VA) National Academic Affiliations Council. The Secretary... partnerships between VA and its academic affiliates. The Council will provide a forum for discussion and...

  12. 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.

  13. "They just asked me why I became homeless": "failure to ask" as a barrier to homeless women's ability to access services post-victimization.

    PubMed

    Huey, Laura; Broll, Ryan; Hryniewicz, Danielle; Fthenos, Georgios

    2014-01-01

    As "access brokers" to resources for their clients, homeless shelter workers are often in a position to aid victimized homeless women in securing medical and psychological services post-victimization. Given high rates of victimization within this population, we would expect that a routine part of a shelter's case management process would involve queries regarding victimization. Through in-depth qualitative interviews with 42 victimized homeless women in Chicago and Detroit, we sought to discover the extent to which such queries were pursued by staff at their current shelter. What we found is that women are seldom asked to provide a complete history that includes experiences of violent victimization and its effects. From these results, we make several recommendations aimed at improving homeless victims' access to services.

  14. Runaway and Homeless Youth Grants: Improvements Needed in the Grant Award Process. Report to Congressional Committees. GAO-10-335

    ERIC Educational Resources Information Center

    Brown, Kay E.

    2010-01-01

    The Department of Health and Human Services (HHS) awards grants to provide shelter and services to runaway and homeless youth through the Basic Center, Transitional Living and Street Outreach Programs. In response to a mandate for a review of the grant award process for these programs in the Reconnecting Homeless Youth Act of 2008 (Pub. L. No.…

  15. The Most Frequently Asked Questions on the Education Rights of Children and Youth in Homeless Situations. Revised

    ERIC Educational Resources Information Center

    National Association for the Education of Homeless Children and Youth, 2009

    2009-01-01

    This document provides answers to frequently asked questions on the McKinney-Vento Homeless Assistance Act and the education rights of children and youth in homeless situations. The answers are general responses based on federal statutes, regulations, and guidance; relevant case law; and best practices from across the country. While the National…

  16. An Examination of the McKinney-Vento Act and Its Influence on the Homeless Education Situation

    ERIC Educational Resources Information Center

    Miller, Peter Michael

    2011-01-01

    This article describes the central elements of the McKinney-Vento Homeless Assistance Act and, drawing from Spillane's distributed leadership perspective, examines the policy's impact on the homeless education situation. Although the initial passing and subsequent revisions to McKinney-Vento are depicted as providing numerous benefits for students…

  17. Mobile Phone and Social Media Use of Homeless Youth in Denver, Colorado.

    PubMed

    Harpin, Scott; Davis, Jillian; Low, Hana; Gilroy, Christine

    2016-01-01

    The purpose of this study was to investigate homeless youth mobile phone and social media use, to plan health promotion efforts. Nearly half (46.7%) of runaway/homeless youth in this sample (n = 181) owned a mobile phone and a majority of those devices were smart phones. Ownership did not vary significantly by shelter location, though regular use of Facebook was more prevalent among those in housing programs or camping, than those living on the streets. Over 90% of youth in the sample reported using Facebook. Such media use might facilitate parent, family, and health provider communications with homeless youth. PMID:27074405

  18. The Impact of a Service-Learning Project on Student Awareness of Homelessness, Civic Attitudes, and Stereotypes toward the Homeless

    ERIC Educational Resources Information Center

    Buch, Kim; Harden, Susan

    2011-01-01

    In 2008, the University of North Carolina at Charlotte (UNC Charlotte) joined in a community initiative with the Urban Ministry Center to provide shelter to the homeless during the winter months. A student organization was formed to sustain university support. The author created a service-learning project as part of a Citizenship and Service…

  19. Ensuring Full Participation in Extra-Curricular Activities for Students Experiencing Homelessness. Best Practices in Homeless Education

    ERIC Educational Resources Information Center

    National Center for Homeless Education at SERVE, 2010

    2010-01-01

    Extra-curricular school activities, such as sports, music, theater, debate, and clubs, are often a key to engaging children and youth in school. They can provide students with a sense of belonging, stability, pride, and responsibility and strengthen a student's applications for higher education admission and scholarships. Homelessness, however,…

  20. Social networks as the context for understanding employment services utilization among homeless youth.

    PubMed

    Barman-Adhikari, Anamika; Rice, Eric

    2014-08-01

    Little is known about the factors associated with use of employment services among homeless youth. Social network characteristics have been known to be influential in motivating people's decision to seek services. Traditional theoretical frameworks applied to studies of service use emphasize individual factors over social contexts and interactions. Using key social network, social capital, and social influence theories, this paper developed an integrated theoretical framework that capture the social network processes that act as barriers or facilitators of use of employment services by homeless youth, and understand empirically, the salience of each of these constructs in influencing the use of employment services among homeless youth. We used the "Event based-approach" strategy to recruit a sample of 136 homeless youth at one drop-in agency serving homeless youth in Los Angeles, California in 2008. The participants were queried regarding their individual and network characteristics. Data were entered into NetDraw 2.090 and the spring embedder routine was used to generate the network visualizations. Logistic regression was used to assess the influence of the network characteristics on use of employment services. The study findings suggest that social capital is more significant in understanding why homeless youth use employment services, relative to network structure and network influence. In particular, bonding and bridging social capital were found to have differential effects on use of employment services among this population. The results from this study provide specific directions for interventions aimed to increase use of employment services among homeless youth.

  1. Service provision and barriers to care for homeless people with mental health problems across 14 European capital cities

    PubMed Central

    2012-01-01

    Background Mental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to assess current service provision and identify barriers to care for homeless people with mental health problems in 14 European capital cities. Method Two methods of data collection were employed; (i) In two highly deprived areas in each of the 14 European capital cities, homeless-specific services providing mental health, social care or general health services were assessed. Data were obtained on service characteristics, staff and programmes provided. (ii) Semi-structured interviews were conducted in each area with experts in mental health care provision for homeless people in order to determine the barriers to care and ways to overcome them. Results Across the 14 capital cities, 111 homeless-specific services were assessed. Input from professionally qualified mental health staff was reported as low, as were levels of active outreach and case finding. Out-of-hours service provision appears inadequate and high levels of service exclusion criteria were evident. Prejudice in the services towards homeless people, a lack of co-ordination amongst services, and the difficulties homeless people face in obtaining health insurance were identified as major barriers to service provision. Conclusions While there is variability in service provision across European capital cities, the reported barriers to service accessibility are common. Homeless-specific services are more responsive to the initial needs of homeless people with mental health problems, while generic services tend to be more conducive to long term care. Further research is needed to determine the effectiveness of different service delivery models, including the most effective coordination of homeless specific and generic

  2. 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

  3. Disaster response and people experiencing homelessness: Addressing challenges of a population with limited resources.

    PubMed

    Wexler, Bryan; Smith, Mary-Elise

    2015-01-01

    In this article the authors provide an overview of some issues that inhibit disaster planning and response for people experiencing homelessness and discuss the planning process conducted for this population in Worcester, MA. People experiencing homelessness face numerous challenges in preparing for disasters both natural and human caused. Similarly, providers attempting to aid these individuals must recognize and overcome various factors that hamper efforts to provide assistance. People experiencing homelessness lack the general resources many in the United States take for granted, including food, shelter, communication methods, and transportation. The population also has an increased prevalence of medical and psychiatric conditions. These factors amplify the typical difficulties in preparedness, communication, sheltering, and training for disasters. With these principles in mind, the authors reviewed the literature for best practices, identified potential stakeholders, and developed an annex to help address organization and delivery of care to those experiencing homelessness during a disaster. PMID:26150363

  4. Homelessness: a problem for primary care?

    PubMed

    Riley, Anthony J; Harding, Geoffrey; Underwood, Martin R; Carter, Yvonne H

    2003-06-01

    Homelessness is a social problem that affects all facets of contemporary society. This paper discusses the concept of homelessness in terms of its historical context and the dominance of the pervasive 'victim blaming' ideologies, which, together with the worldwide economic changes that have contributed to a fiscal crisis of the state, and the resultant policies and circumstances, have led to an increase in the number of 'new homeless' people. This paper attempts to challenge the dominant political discourse on homelessness. The widespread healthcare problems and heterogeneity of homeless people have a particular impact on health services, with many homeless people inappropriately accessing local accident and emergency (A&E) departments because of barriers inhibiting adequate access to primary care. A number of primary care schemes have been successfully implemented to enable the homeless to have better access to appropriate care. However, there is no consistency in the level of services around the United Kingdom (UK), and innovations in service are not widespread and by their nature they are ad hoc. Despite the successes of such schemes, many homeless people still access health care inappropriately. Until homeless people are fully integrated into primary care the situation will not change. The question remains, how can appropriate access be established? A start can be made by building on some of the positive work that is already being done in primary care, but in reality general practitioners (GPs) will be 'swimming against the tide' unless a more integrated policy approach is adopted to tackle homelessness. PMID:12939894

  5. [Prevalence of psychiatric disorders among homeless adolescents].

    PubMed

    Aichhorn, Wolfgang; Santeler, Stefan; Stelzig-Schöler, Renate; Kemmler, Georg; Steinmayr-Gensluckner, Maria; Hinterhuber, Hartmann

    2008-01-01

    Various studies show a high prevalence of mental disorders among homeless people. So far most of these studies deal solely with single men, mainly affected by homelessness. Few data exist for women, children, adolescents and whole families that are more and more affected by poverty and homelessness. This study, conducted in Innsbruck/Austria, determined the prevalence of psychiatric disorders among homeless adolescents. The adolescents were recruited in a counselling centre and homeless shelter specifically founded for homeless youth. Mental disorders were diagnosed with the Structured Clinical Interview for DSM-IV (SKID-I). 40 adolescents and young adults ranging from 14-23 years (mean 17.9 years) were included in the study. The results show that 58% of the homeless adolescents were exposed to continuous violence in their families and that violence was a major reason for them to leave home. The overall prevalence of diagnosed psychiatric disorders was 80% in the whole sample; the leading disorder was substance abuse/dependence (65%), followed by mood disorders (42.5%), anxiety disorders (17.5%) and eating disorders (17.5%). 57.5% of the adolescents had a history of self-harm and 25% reported at least one suicide attempt. Duration of homelessness had the greatest influence on the prevalence of mental disorders. Longer duration of homelessness was associated with a higher risk of psychiatric disorder or self-harm. These results demonstrate the urgent need for early psychosocial and psychiatric help for homeless adolescents. PMID:18826872

  6. An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

    PubMed

    Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

    2015-02-01

    Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study.

  7. The impact of current alcohol and drug use on outcomes among homeless veterans entering supported housing.

    PubMed

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

    2013-05-01

    Permanent supported housing has increasingly been identified as a central approach to helping homeless individuals with disabilities exit from homelessness. Given that one third or more of homeless individuals actively use substances, it is important to determine the extent to which individuals who report using alcohol and/or drugs at the time of housing benefit from such programs. The current study examines data from the evaluation of the United States Department of Housing and Urban Development-Veterans Affairs (HUD-VA) Supported Housing (HUD-VASH) program to determine differences in housing and clinical outcomes among participants with two different levels of active alcohol or drug use at time of housing entry. Whereas veterans with 1-15 days of active use and 15-30 days of active use had significantly more days homeless than abstainers, albeit with small effect sizes (.06 and .19, respectively), there were no significant differences in days housed or days in institutions. Interaction analysis suggests that the highest frequency substance users who spent time in residential treatment prior to housing had the poorest housing outcomes, while those who were not in residential treatment had outcomes comparable to abstainers. Although active substance users clearly benefit from supportive housing with small differences in outcomes from abstainers, high frequency substance users who were admitted to residential treatment before housing placement, may be an especially vulnerable population. PMID:23730966

  8. Youth Homelessness and Social Stigma

    ERIC Educational Resources Information Center

    Kidd, Sean A.

    2007-01-01

    Building upon previous exploratory qualitative research (Kidd S.A. (2003) "Child Adol. Social Work J." 20(4):235-261), this paper examines the mental health implications of social stigma as it is experienced by homeless youth. Surveys conducted with 208 youths on the streets and in agencies in New York City and Toronto revealed significant…

  9. Education Rights of Homeless Students.

    ERIC Educational Resources Information Center

    Education Law Center, Inc., Newark, NJ.

    This document is designed to help New Jersey parents, guardians, and caregivers understand the legal concepts and procedures involved in disputes over the enrollment of homeless students in local public schools. It also informs them of their legal rights. The requirements of the McKinney Act and of the state regulations concerning the education of…

  10. Homeless--And Doubled Up

    ERIC Educational Resources Information Center

    Dill, Vicky

    2015-01-01

    The bank foreclosed on your home because your parents divorced and don't have enough money to pay the mortgage. You're locked out of your house. Where will the family sleep? Most families turn to friends and relatives at times like these. That's why about 75 percent of the 1,258,182 homeless students in the United States live…

  11. HIV Infection and Homeless Adolescents.

    ERIC Educational Resources Information Center

    Athey, Jean L.

    1991-01-01

    A literature review reveals that homeless adolescents are at extremely high risk for acquiring HIV infection. Sexual and drug use behaviors that put these adolescents at risk are described. New models of social, health, and mental health services for these youth are outlined. (GLR)

  12. Universal screening for homelessness and risk for homelessness in the Veterans Health Administration.

    PubMed

    Montgomery, Ann Elizabeth; Fargo, Jamison D; Byrne, Thomas H; Kane, Vincent R; Culhane, Dennis P

    2013-12-01

    We examined data for all veterans who completed the Veterans Health Administration's national homelessness screening instrument between October 1, 2012, and January 10, 2013. Among veterans who were not engaged with the US Department of Veterans Affairs homeless system and presented for primary care services, the prevalence of recent housing instability or homelessness was 0.9% and homelessness risk was 1.2%. Future research will refine outreach strategies, targeting of prevention resources, and development of novel interventions. PMID:24148032

  13. Homeless Women's Personal Networks: Implications for Understanding Risk Behavior.

    PubMed

    Tucker, Joan S; Kennedy, David; Ryan, Gery; Wenzel, Suzanne L; Golinelli, Daniela; Zazzali, James

    2009-01-01

    The goal of this exploratory study was to examine the composition of homeless women's personal networks in order to better understand the social context of risk behavior in this vulnerable population. Twenty-eight homeless women residing in temporary shelters in Los Angeles County provided detailed information about their extended personal networks. Women named 25 people with whom they had contact during the past year, and then were asked a series of questions about each one of these named network members. Results indicate that the personal networks of homeless women are larger and more diverse than suggested by previous research. About one-third of women's relationships were with high-risk individuals (i.e., people perceived to drink heavily, use drugs, or engage in risky sex). However, most women also reported having relationships that could be characterized as both "low risk" (e.g., involving individuals perceived as not drinking heavily, using drugs, or engaging in risky sex) and "high quality" (e.g., long-term, emotionally close, or supportive), although these relationships tended to be rather tenuous. Our results suggest a need to assist homeless women in strengthening these existing low-risk/high-quality relationships, and extending the diversity of their networks, in order to increase women's exposure to positive role models and access to tangible support and other needed resources. PMID:20351796

  14. The Role of Recovery Housing: Prioritizing Choice in Homeless Services.

    PubMed

    Paquette, Kristen; Pannella Winn, Laura A

    2016-01-01

    Housing options for people exiting homelessness and seeking recovery from substance use disorders are limited. Policies tend to favor low-demand models such as housing first and permanent supportive housing that do not require abstinence, but offer immediate housing placement based on consumer choice and separate housing from clinical services. While these models have proven effective in promoting housing retention, especially among individuals with a primary diagnosis of mental illness, evidence to support positive outcomes related to people with a primary or co-occurring substance use disorder are mixed. Recovery housing models provide abstinence-focused environments and integrated peer support embedded within a recovery framework. Various models exist along a continuum from fully peer-run to clinically staffed residences. However, this continuum is typically separate from the homeless services system, and many barriers to integration persist. Recent national dialogues have begun to explore opportunities to integrate housing and substance use recovery approaches to meet the needs of people who need both types of support. This perspective paper argues that recovery housing is essential for supporting some homeless individuals and families. Within a comprehensive continuum based on choice, both recovery housing and low-demand models can support housing retention, reduce homelessness, promote recovery, and foster self-determination.

  15. The Role of Recovery Housing: Prioritizing Choice in Homeless Services.

    PubMed

    Paquette, Kristen; Pannella Winn, Laura A

    2016-01-01

    Housing options for people exiting homelessness and seeking recovery from substance use disorders are limited. Policies tend to favor low-demand models such as housing first and permanent supportive housing that do not require abstinence, but offer immediate housing placement based on consumer choice and separate housing from clinical services. While these models have proven effective in promoting housing retention, especially among individuals with a primary diagnosis of mental illness, evidence to support positive outcomes related to people with a primary or co-occurring substance use disorder are mixed. Recovery housing models provide abstinence-focused environments and integrated peer support embedded within a recovery framework. Various models exist along a continuum from fully peer-run to clinically staffed residences. However, this continuum is typically separate from the homeless services system, and many barriers to integration persist. Recent national dialogues have begun to explore opportunities to integrate housing and substance use recovery approaches to meet the needs of people who need both types of support. This perspective paper argues that recovery housing is essential for supporting some homeless individuals and families. Within a comprehensive continuum based on choice, both recovery housing and low-demand models can support housing retention, reduce homelessness, promote recovery, and foster self-determination. PMID:27064834

  16. Finding Homeless Youth. Patterns Based on Geographical Area and Number of Homeless Episodes

    ERIC Educational Resources Information Center

    Witkin, Andrea L.; Milburn, Norweeta G.; Rotheram-Borus, Mary Jane; Batterham, Philip; May, Susanne; Brooks, Ronald

    2005-01-01

    A census of homeless youth was conducted in locations across Los Angeles County, California. Building on previous research that has focused on homeless youth in cruise areas, the authors examined demographic and behavioral differences between homeless youth in cruise and noncruise areas. Youth in cruise areas were more likely than youth in…

  17. Unaccompanied Homeless Youth: Intersections of Homelessness, School Experiences and Educational Policy

    ERIC Educational Resources Information Center

    Aviles de Bradley, Ann M.

    2011-01-01

    School districts are faced with the challenge of how best to serve the needs of a growing homeless student population. As the numbers of homeless children and youth continue to rise, it is imperative for educators and others to understand the experiences of unaccompanied homeless youth. A qualitative research project was undertaken to obtain the…

  18. Homelessness Outcome Reporting Normative Framework: Systems-Level Evaluation of Progress in Ending Homelessness

    ERIC Educational Resources Information Center

    Austen, Tyrone; Pauly, Bernie

    2012-01-01

    Homelessness is a serious and growing issue. Evaluations of systemic-level changes are needed to determine progress in reducing or ending homelessness. The report card methodology is one means of systems-level assessment. Rather than solely establishing an enumeration, homelessness report cards can capture pertinent information about structural…

  19. 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

  20. 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

    ... Veterans and Homeless Veterans With Families' Reintegration Into Employment AGENCY: Veterans' Employment... training, and skills training) to expedite the reintegration of homeless Veterans into the labor...

  1. Head injury and mortality in the homeless.

    PubMed

    McMillan, Thomas M; Laurie, Marie; Oddy, Michael; Menzies, Mark; Stewart, Elaine; Wainman-Lefley, Jessica

    2015-01-15

    Risk factors for head injury are also risk factors for becoming homeless but there is little research on this vulnerable group, who can be neglected by health services that specialize in acquired brain injury. This study investigates the prevalence of admissions to hospital with a head injury in the homeless and associations with later mortality. It compares homeless people with and without a record of hospitalized head injury (HHI) and the Glasgow population. Data were obtained from a U.K. National Health Service strategy to enhance care of the homeless. This included development and production of local registers of homeless people. In Glasgow, the initiative took place over a seven-year period (2004-2010) and comprised 40 general practitioner (family practice) services in the locality of 55 homeless hostels. The register was linked to hospital admissions with head injury recorded in Scottish Medical Records and to the General Register of Scotland, which records deaths. A total of 1590 homeless people was registered in general practitioner (family doctor) returns. The prevalence of admission to hospital with head injury in the homeless over a 30-year period (13.5%) was 5.4 times higher than in the Glasgow population. In the homeless with HHI, 33.6% died in the seven-year census period, compared with 13.9% in the homeless with no hospitalized HI (NHHI). The standardized mortality ratio for HHI (4.51) was more than twice that for NHHI (2.08). The standardized mortality ratio for HHI aged 15-34 (17.54) was particularly high. These findings suggest that HHI is common in the homeless relative to the general population and is a risk factor for late mortality in the homeless population. PMID:25010750

  2. 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. PMID:25595171

  3. 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.

  4. [Street doctors warn of epidemic of uninsured homeless persons in the Netherlands].

    PubMed

    Slockers, Marcel T; van Laere, Igor R A L; Smit, Ronald B J

    2015-01-01

    Over the past few years, the Netherlands Street Doctors Group, a national network of doctors and nurses providing outreach primary care to homeless people in the Netherlands, has observed a growing number of homeless patients who do not have health insurance resulting in their access to healthcare services and medication being limited. In this article we raise the alarm about the epidemic of uninsured Dutch homeless. We explain and comment on the reasons why people are no longer insured and elaborate on the regulations and obligations related to homelessness and the characteristics of consumers and providers of social and medical services. We describe how difficult it is for homeless people to become re-insured as in order to follow a complex set of requirements commitment and patience are necessary. For most homeless patients, the re-insurance process requires the personal guidance and support of a motivated case manager. Consequently, we suggest that policy makers and service providers should have a better understanding of factors contributing to being uninsured and more compassion for those who are.

  5. An exploration of subjective wellbeing among people experiencing homelessness: a strengths-based approach.

    PubMed

    Thomas, Yvonne; Gray, Marion A; McGinty, Sue

    2012-01-01

    Negative perceptions of homelessness contribute to deficit models of practice, false notions of homogeneity, and marginalization. Wellbeing is a state of satisfaction with material, social, and human aspects of life and can be measured both objectively and subjectively. The study explored the meaning and experience of wellbeing in the everyday lives of 20 homeless participants through fieldwork and interviews. This study revealed that health contributed little to their overall perception of wellbeing. Keeping safe, being positive and feeling good, connecting with others, and the ability to participate in "normal" life were the key contributors of subjective wellbeing. The authors demonstrate that social exclusion experienced in homelessness has a negative effect on subjective wellbeing. Services that provide opportunities to experience social inclusion and develop community and cultural connections will improve the wellbeing of homeless persons. PMID:23078011

  6. Making the invisible visible: a Photovoice exploration of homeless women's health and lives in central Auckland.

    PubMed

    Bukowski, Kate; Buetow, Stephen

    2011-03-01

    Women and the concept of homelessness are weakly connected in the international discourses on health and housing. This PhotoVoice study gave a sample of homeless women in central Auckland a camera with which to photograph their lives in order to voice their felt health needs as advocates and agents for positive change. Interviews explored the meanings given to street lives captured in the photographs and reveal threats to the women's mental health and worsening addictions. Their tight-knit, resilient community, including dogs, was seen as 'family' who provide support and protection. The women perceived social services as helping them survive and support their health, but not ending their homelessness. Barriers to them getting and staying off the street included a shortage of affordable, secure housing, which has also tended to become overcrowded. They identified their own leaders who could link with state housing services to implement and evaluate new homelessness programmes, such as Housing First.

  7. Homeless drug users' awareness and risk perception of peer "Take Home Naloxone" use – a qualitative study

    PubMed Central

    Wright, Nat; Oldham, Nicola; Francis, Katharine; Jones, Lesley

    2006-01-01

    Background Peer use of take home naloxone has the potential to reduce drug related deaths. There appears to be a paucity of research amongst homeless drug users on the topic. This study explores the acceptability and potential risk of peer use of naloxone amongst homeless drug users. From the findings the most feasible model for future treatment provision is suggested. Methods In depth face-to-face interviews conducted in one primary care centre and two voluntary organisation centres providing services to homeless drug users in a large UK cosmopolitan city. Interviews recorded, transcribed and analysed thematically by framework techniques. Results Homeless people recognise signs of a heroin overdose and many are prepared to take responsibility to give naloxone, providing prior training and support is provided. Previous reports of the theoretical potential for abuse and malicious use may have been overplayed. Conclusion There is insufficient evidence to recommend providing "over the counter" take home naloxone" to UK homeless injecting drug users. However a programme of peer use of take home naloxone amongst homeless drug users could be feasible providing prior training is provided. Peer education within a health promotion framework will optimise success as current professionally led health promotion initiatives are failing to have a positive impact amongst homeless drug users. PMID:17014725

  8. Coping Styles and Alcohol Dependence among Homeless People

    PubMed Central

    Opalach, Cezary; Romaszko, Jerzy; Jaracz, Marcin; Kuchta, Robert; Borkowska, Alina; Buciński, Adam

    2016-01-01

    Background and Objectives The ways in which homeless individuals cope with stress may differ from those relied upon by the members of the general population and these differences may either be the result or the cause of their living conditions. The aim of the study was to determine the preferred coping style among the homeless and its relationship with alcohol dependence. Methods The study included 78 homeless individuals and involved the collection of demographic, sociological, psychological and medical data from each participant. Coping styles relied upon when dealing with stressful situations were assessed using a Polish adaptation of the Coping Inventory for Stressful Situations. Alcohol dependence was assessed using the Michigan Alcoholism Screening Test (MAST) and a quantitative analysis of alcohol consumption. Results Men accounted for 91.93% of the study population. Nearly 75% of the subjects met the alcohol dependence criterion. Significant relationships were observed between the individual's age, preferred coping style and alcohol consumption level. As an individual’s age increased, the use of emotion-oriented coping styles decreased, while an increase in alcohol consumption was associated with a more frequent use of emotion- and avoidance-oriented strategies. Conclusions The findings of this study, similarly to those of many other studies of homeless individuals but investigating other areas (e.g. epidemiology of tuberculosis and traumatic injuries), are an exaggerated representation of associations observed in the general population. The results describe a group of people living on the margins of the society, often suffering from extremely advanced alcoholism, with clear evident psychodegradation. The presence of specific ways of coping with stress related to excessive alcohol consumption in this group of individuals may interfere with active participation in support programmes provided for the homeless and may further exacerbate their problems. PMID

  9. Are childhood abuse and neglect related to age of first homelessness episode among currently homeless adults?

    PubMed

    Mar, Marissa Y; Linden, Isabelle A; Torchalla, Iris; Li, Kathy; Krausz, Michael

    2014-01-01

    This study investigates 500 homeless adults and the associations between childhood maltreatment types and the age of first reported homelessness episode. Those first experiencing homelessness in youth (age 24 years or younger; 46%) were compared with those first experiencing homelessness at a later age (older than age 24 years). In individual models, physical abuse, emotional abuse, and emotional neglect were associated with first experiencing homelessness during youth (p < .02 for all types of maltreatment). In the simultaneous model, only emotional abuse remained significantly associated (p = .002). In addition, increasing numbers of maltreatment were associated with becoming homeless during youth (p < .0001). These results highlight the unique associations between childhood maltreatment types and becoming homeless earlier in life and support the need for early interventions with at-risk families.

  10. Development of occupational therapy in a homeless shelter.

    PubMed

    Herzberg, G; Finlayson, M

    2001-01-01

    SUMMARY This paper describes a program which provides occupational therapy services to a population of homeless individuals residing in an emergency shelter in Ft. Lauderdale, Florida. Principles of community-built practice were combined with the use of the Canadian Model of Occupational Performance to provide the theoretical approach for the program. A needs assessment was done and the programming developed and implemented based on identified needs is described. Outcomes and recommendations for the future are discussed. PMID:23944266

  11. 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…

  12. Over the Edge: Homeless Families and the Welfare System.

    ERIC Educational Resources Information Center

    National Coalition for the Homeless, Washington, DC.

    Homelessness among families is quickly reaching crisis proportions across the country. Over 30 percent of America's three million homeless people are members of families, and families are the fastest growing segment of the homeless population. Perhaps more disturbing, homelessness represents only the most extreme manifestation of a more…

  13. Who Is Doing Well? A Typology of Newly Homeless Adolescents

    ERIC Educational Resources Information Center

    Milburn, Norweeta; Liang, Li-Jung; Lee, Sung-Jae; Rotheram-Borus, Mary Jane; Rosenthal, Doreen; Mallett, Shelley; Lightfoot, Marguerita; Lester, Patricia

    2009-01-01

    There is growing evidence to support developing new typologies for homeless adolescents. Current typologies focus on the risks associated with being homeless, with less consideration of the positive attributes of homeless adolescents. The authors examined both risk and protective factors in a sample of newly homeless adolescents. Using cluster…

  14. 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…

  15. 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…

  16. Increased 30-Day Emergency Department Revisits Among Homeless Patients with Mental Health Conditions

    PubMed Central

    Lam, Chun Nok; Arora, Sanjay; Menchine, Michael

    2016-01-01

    readmission, compared to non-homeless patients presenting with mental health conditions (25.2%, 2.6%) and NHNM (7.7%, 1.5%). Conclusion Homeless patients presenting with mental health conditions were more likely to return to the ED within 30 days and to be readmitted to the hospital. Interventions providing housing might improve their overall care management and have the potential to reduce ED revisits and hospital readmissions. PMID:27625726

  17. Increased 30-Day Emergency Department Revisits Among Homeless Patients with Mental Health Conditions

    PubMed Central

    Lam, Chun Nok; Arora, Sanjay; Menchine, Michael

    2016-01-01

    readmission, compared to non-homeless patients presenting with mental health conditions (25.2%, 2.6%) and NHNM (7.7%, 1.5%). Conclusion Homeless patients presenting with mental health conditions were more likely to return to the ED within 30 days and to be readmitted to the hospital. Interventions providing housing might improve their overall care management and have the potential to reduce ED revisits and hospital readmissions.

  18. Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless.

    PubMed

    Poremski, Daniel; Woodhall-Melnik, Julia; Lemieux, Ashley J; Stergiopoulos, Vicky

    2016-02-01

    Adults with mental illness who are homeless experience multiple barriers to employment, contributing to difficulties securing and maintaining housing. Housing First programs provide quick, low-barrier access to housing and support services for this population, but their success in improving employment outcomes has been limited. Supported employment interventions may augment Housing First programs and address barriers to employment for homeless adults with mental illness. The present paper presents data from qualitative interviews to shed light on the persisting barriers to employment among people formerly homeless. Once housed, barriers to employment persisted, including the following: (1) worries about disclosing sensitive information, (2) fluctuating motivation, (3) continued substance use, and (4) fears about re-experiencing homelessness-related trauma. Nevertheless, participants reported that their experiences of homelessness helped them develop interpersonal strength and resilience. Discussing barriers with an employment specialist helps participants develop strategies to overcome them, but employment specialists must be sensitive to specific homelessness-related experiences that may not be immediately evident. Supported housing was insufficient to help people return to employment. Supported employment may help people return to work by addressing persisting barriers.

  19. Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless.

    PubMed

    Poremski, Daniel; Woodhall-Melnik, Julia; Lemieux, Ashley J; Stergiopoulos, Vicky

    2016-02-01

    Adults with mental illness who are homeless experience multiple barriers to employment, contributing to difficulties securing and maintaining housing. Housing First programs provide quick, low-barrier access to housing and support services for this population, but their success in improving employment outcomes has been limited. Supported employment interventions may augment Housing First programs and address barriers to employment for homeless adults with mental illness. The present paper presents data from qualitative interviews to shed light on the persisting barriers to employment among people formerly homeless. Once housed, barriers to employment persisted, including the following: (1) worries about disclosing sensitive information, (2) fluctuating motivation, (3) continued substance use, and (4) fears about re-experiencing homelessness-related trauma. Nevertheless, participants reported that their experiences of homelessness helped them develop interpersonal strength and resilience. Discussing barriers with an employment specialist helps participants develop strategies to overcome them, but employment specialists must be sensitive to specific homelessness-related experiences that may not be immediately evident. Supported housing was insufficient to help people return to employment. Supported employment may help people return to work by addressing persisting barriers. PMID:26666250

  20. Assessing health conditions and medication use among the homeless community in Long Beach, California

    PubMed Central

    Chong, Mok Thoong; Yamaki, Jason; Harwood, Megan; d'Assalenaux, Richard; Rosenberg, Ettie; Aruoma, Okezie; Bishayee, Anupam

    2014-01-01

    Objective: Persons experiencing homelessness are a vulnerable population and are at increased risk for morbidity and all-cause mortality compared to the general population. This study sought to evaluate medication use, regular physician visits, and identify health conditions among the homeless population of Long Beach, California. Methods: Two “brown bag” medication review events were held at homeless shelters in the Long Beach area. Demographic information, medication use, and comorbid disease states were obtained through surveys. Findings: Three-fourths of the cohort (95 participants) consisted of males, and the average age of participants was 48 years. Psychiatric disorders and cardiovascular disease were the most common disease states reported at 32% and 46%, respectively and so were medications used in treating these chronic diseases. Medication adherence was found to be a significant problem in this population, where more than 30% of patients were nonadherent to medications for chronic diseases. Furthermore, foot problems, hearing and vision difficulties constitute the most commonly overlooked health problems within the homeless population. Conclusion: Based on this and other similar finding, we must accept that the homeless represent a vulnerable population, and that because of this fact, more programs should be focused at improving availability and access to health care among the homeless. Regarding the high number of reported health problems in the study, more studies are needed and more studies should incorporate screening for foot, hearing, and vision issues, both to increase awareness and to provide an opportunity for devising possible solutions to these highly preventable conditions. PMID:25114938

  1. Assessing trauma, substance abuse, and mental health in a sample of homeless men.

    PubMed

    Kim, Mimi M; Ford, Julian D; Howard, Daniel L; Bradford, Daniel W

    2010-02-01

    This study examined the impact of physical and sexual trauma on a sample of 239 homeless men. Study participants completed a self-administered survey that collected data on demographics, exposure to psychological trauma, physical health and mental health problems, and substance use or misuse. Binomial logistic regression analyses were used to examine the relative significance of demographic factors and the four types of trauma exposure associated with three outcomes: mental health, substance abuse, and physical health problems. The authors found that trauma history was significantly associated with more mental health problems but was not associated with substance abuse problems for homeless men. This study reinforces service providers' perceptions that because many homeless men experience the long-term, deleterious effects of not only current stressors, but also abuse and victimization that often begin in childhood, homeless men are a subpopulation in need of proactive prevention services that emphasize long-term continuity of care rather than sporadic crisis-based services. Study findings suggest that mentally ill, homeless men need proactive services that address the sequelae of abuse with care that is specialized and distinctly different from care for homeless adults with substance abuse or physical health care issues.

  2. School-Community Partnerships and the Homeless.

    ERIC Educational Resources Information Center

    Gonzalez, Maria Luisa

    1991-01-01

    Aided by the First Presbyterian Church, the Dallas Jewish Coalition for the Homeless, numerous business and service groups, individual volunteers, and shelters, City Park School in innercity Dallas has become an exemplary program for homeless students. School and community partnerships can form an extended family for needy students. A sidebar…

  3. Perceptions about Homeless Elders and Community Responsibility

    ERIC Educational Resources Information Center

    Kane, Michael N.; Green, Diane; Jacobs, Robin

    2013-01-01

    Human service students were surveyed ("N" = 207) to determine their perceptions about homeless elders and communal responsibility for their well-being. Using a backward regression analysis, a final model ("F" = 15.617, "df" = 7, "p" < 0.001) for Perceptions about Homeless Persons and Community…

  4. Spirituality and Mental Health among Homeless Mothers

    ERIC Educational Resources Information Center

    Hodge, David R.; Moser, Stephanie E.; Shafer, Michael S.

    2012-01-01

    Mothers are one of the fastest growing segments of the homeless population in the United States. Although mental health problems often contribute to homelessness, little is known about the factors that affect mothers' mental health. To help identify protective factors, this longitudinal study examined the relationship between spirituality and…

  5. Intervention Strategies with the Homeless Population

    ERIC Educational Resources Information Center

    Dykeman, Bruce F.

    2011-01-01

    A literature review describing psychological and sociological factors of homelessness. Methods of estimating the frequency of homelessness are described, along with recent point-in-time and period-of-time estimates. Models of service delivery are reviewed. A biopsychosocial model of intervention is proposed that describes stages of intervention…

  6. Predictors of Transience among Homeless Emerging Adults

    ERIC Educational Resources Information Center

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

    2014-01-01

    This study identified predictors of transience among homeless emerging adults in three cities. A total of 601 homeless emerging adults from Los Angeles, Austin, and Denver were recruited using purposive sampling. Ordinary least squares regression results revealed that significant predictors of greater transience include White ethnicity, high…

  7. 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…

  8. Preliminary Findings on Rural Homelessness in Ohio.

    ERIC Educational Resources Information Center

    First, Richard J.; And Others

    This report is designed to present preliminary findings from the first comprehensive study of rural homelessness in the United States. The study was conducted during the first 6 months of 1990, and data were collected from interviews with 921 homeless adults in 21 randomly selected rural counties in Ohio. The sample counties represent 26% of the…

  9. The Disadvantage of Homelessness in Children's Schooling.

    ERIC Educational Resources Information Center

    Shaver, Debra M.; Dornbusch, Sanford M.

    This paper presents findings of a study that investigated the extent to which homeless children in the United States receive the "free and appropriate education" to which they are entitled. Data were collected through several surveys conducted in two San Francisco Bay Area counties: (1) surveys of parents in homeless shelters with 313 school-age…

  10. Changing homelessness services: revanchism, ‘professionalisation’ and resistance

    PubMed Central

    Scullion, Lisa; Somerville, Peter; Brown, Philip; Morris, Gareth

    2015-01-01

    This paper argues that the increasing international salience of homelessness can be partially explained by reference to the revanchist thesis (involving processes of coerced exclusion and abjection), but the situation on the ground is more complex. It reports on interviews with 18 representatives of 11 homelessness service providers in one city in England. As Cloke et al. found, these providers tended to be either larger, more ‘professional’, ‘insider’ services or smaller, more ‘amateur’, ‘outsider’ services. However, this does not mean that the former were necessarily more revanchist and the latter less so. Rather, the actions of both types of organisation could, in some cases, be construed as both advancing and counteracting a revanchist project. PMID:25442718

  11. Capacity for Survival: Exploring Strengths of Homeless Street Youth

    PubMed Central

    Bender, Kimberly; Thompson, Sanna J.; McManus, Holly; Lantry, Janet; Flynn, Patrick M.

    2009-01-01

    The majority of research on homeless youth has focused on the multitude of problems faced by this vulnerable population. The current study, while acknowledging the hazards of life on the streets, seeks to explore the personal strengths and informal resources street youth rely on to navigate their environments. Qualitative data from seven focus groups conducted with street youth ages 18–24 were analyzed using content analysis. These data, rich with interactions among youth participants, highlight three important themes: developing “street smarts,” existence of personal strengths, and informal resources relied upon by youth to survive. Results provide valuable insights into the strengths of homeless youth that can be useful to providers in assessing street youths’ service needs and increasing the likelihood of long-term positive outcomes. PMID:19915687

  12. Health disparities in the Native Hawaiian homeless.

    PubMed

    Yamane, David P; Oeser, Steffen G; Omori, Jill

    2010-06-01

    While it is well accepted that Native Hawaiians have poor health statistics compared to other ethnic groups in Hawaii, it is not well documented if these disparities persist when comparing Native Hawaiian homeless individuals to the general homeless population. This paper examines the Native Hawaiian homeless population living in three shelters on the island of Oahu, to determine if there are significant differences in the frequency of diseases between the Native Hawaiian and non-Native Hawaiian homeless. A retrospective data collection was performed using records from the Hawaii Homeless Outreach and Medical Education (H.O.M.E.) project. Data from 1182 patients was collected as of 12/05/09. Information collected included patient demographics, frequency of self reported diseases, family history of diseases, risk factors, prevalence of chronic diseases, and most common complaints. The data from Native Hawaiians and non-Native Hawaiians were examined for differences and a 1-tail Fisher exact analysis was done to confirm significance. The data reveals that the Native Hawaiian homeless population is afflicted more frequently with asthma and hypertension compared to other ethnic groups. While diabetes constituted more visits to the clinics for Native Hawaiians compared to the non-Native Hawaiians, there was no significant difference in patient reported prevalence of diabetes. The Native Hawaiian homeless also had increased rates of risky behaviors demonstrated by higher past use of marijuana and methamphetamines. Interestingly, there was a lower use of alcohol in the Native Hawaiian homeless and no significant difference between Native Hawaiians and non-native Hawaiians in current use of illicit drugs, which may represent a hopeful change in behaviors. These troubling statistics show that some of the health disparities seen in the general Native Hawaiian population persist despite the global impoverished state of all homeless. Hopefully, these results will aid

  13. A scoping study: children, policy and cultural shifts in homelessness services in South Australia: are children still falling through the gaps?

    PubMed

    Parry, Yvonne Karen; Grant, Julian; Burke, Lynette

    2016-09-01

    Homeless families are the fastest growing segment of the homelessness population. Homelessness services are often the first to know when children are at risk of disengagement with health, welfare and education services. Changes to Australian policy to explicitly attend to the needs of children are attempts to address the complexity of, and provide better outcomes for, homeless children. There are mounting levels of evidence describing some of the needs of children who are homeless. Using the scoping study methodological framework, this review of academic and grey literature identified the extent to which service providers provide for the needs of homeless children. The literature search was conducted from September 2012 to April 2013 using ProQuest, Science Direct, Sage and OVID databases. Therefore, the objectives of this scoping study were to: (i) identify the specific needs of children in homelessness; (ii) describe recent changes in policy relating to care for children in homelessness services; (iii) explore the evidence on how service providers can enact care for children in homelessness services; (iv) identify the types of practice changes that are needed to optimise outcomes for children; and (v) identify the gaps in service delivery. This article describes the Australian policy changes and explores the potential impact of subsequent sector reforms on the internal practices in front-line homelessness services, in order to overcome structural and systemic barriers, and promote opportunities for children in homeless families. This scoping study literature review contributes to the understanding of the impact of policy change on front-line staff and suggests possible practice changes and future research options. PMID:26607690

  14. Impact of chronically street homeless tenants in congregate supportive housing.

    PubMed

    Levitt, A J; Jost, J J; Mergl, K A; Hannigan, A; Degenova, J; Chung, S Y

    2012-07-01

    New initiatives to house chronically street homeless (CSH) adults have led to increasing proportions of this population living in congregate supportive housing, but little is known about the impact of this shift on supportive housing programs. The present multisite, mixed-methods study examined service utilization and lease compliance among 52 chronically street homeless and 46 long-term shelter stayer (LTSS) adults during their first 12 months in congregate supportive housing. Quantitative analysis of administrative data revealed that CSH tenants used significantly more service resources than LTSS tenants, including more advocacy, escorting, and psychiatric treatment and more assistance with financial, housing, and mental and physical health issues. The 2 groups did not differ significantly on measures of lease compliance. Qualitative focus groups with CSH tenants, service provider staff, and property management staff all indicated that existing supportive housing services are suitable for this population, although some adjustments, additional resources, or both, may be indicated.

  15. Impact of chronically street homeless tenants in congregate supportive housing.

    PubMed

    Levitt, A J; Jost, J J; Mergl, K A; Hannigan, A; Degenova, J; Chung, S Y

    2012-07-01

    New initiatives to house chronically street homeless (CSH) adults have led to increasing proportions of this population living in congregate supportive housing, but little is known about the impact of this shift on supportive housing programs. The present multisite, mixed-methods study examined service utilization and lease compliance among 52 chronically street homeless and 46 long-term shelter stayer (LTSS) adults during their first 12 months in congregate supportive housing. Quantitative analysis of administrative data revealed that CSH tenants used significantly more service resources than LTSS tenants, including more advocacy, escorting, and psychiatric treatment and more assistance with financial, housing, and mental and physical health issues. The 2 groups did not differ significantly on measures of lease compliance. Qualitative focus groups with CSH tenants, service provider staff, and property management staff all indicated that existing supportive housing services are suitable for this population, although some adjustments, additional resources, or both, may be indicated. PMID:22880979

  16. Family Histories and Multiple Transitions Among Homeless Young Adults: Pathways to Homelessness

    PubMed Central

    Tyler, Kimberly A.; Schmitz, Rachel M.

    2013-01-01

    This study explored the early family histories of homeless young adults, the types and number of transitions they experienced, and their pathways to the street. Intensive qualitative interviews were audio taped and transcribed with 40 homeless young adults 19 to 21 years of age in the Midwest. Findings show that family backgrounds were generally characterized by substance use, child maltreatment, and witnessing violence, all of which provide social context for understanding why so many of these young people opted to leave home in search of an alternative living situation. The current findings also reveal that while some young adults ran away from home as adolescents, others were “pushed out” (i.e., told to leave), or removed by state agencies. Current study findings illustrate that young adults’ trajectories are marked by multiple living arrangements such as home, foster care, detention facility, and drug rehabilitation. Overall, study results show that young adults’ family histories place them on trajectories for early independence marked by multiple transitions and numerous living situations, culminating in a lack of a permanent residence to call home. PMID:24151346

  17. Advanced Battery Manufacturing (VA)

    SciTech Connect

    Stratton, Jeremy

    2012-09-30

    LiFeBATT has concentrated its recent testing and evaluation on the safety of its batteries. There appears to be a good margin of safety with respect to overheating of the cells and the cases being utilized for the batteries are specifically designed to dissipate any heat built up during charging. This aspect of LiFeBATT’s products will be even more fully investigated, and assuming ongoing positive results, it will become a major component of marketing efforts for the batteries. LiFeBATT has continued to receive prismatic 20 Amp hour cells from Taiwan. Further testing continues to indicate significant advantages over the previously available 15 Ah cells. Battery packs are being assembled with battery management systems in the Danville facility. Comprehensive tests are underway at Sandia National Laboratory to provide further documentation of the advantages of these 20 Ah cells. The company is pursuing its work with Hybrid Vehicles of Danville to critically evaluate the 20 Ah cells in a hybrid, armored vehicle being developed for military and security applications. Results have been even more encouraging than they were initially. LiFeBATT is expanding its work with several OEM customers to build a worldwide distribution network. These customers include a major automotive consulting group in the U.K., an Australian maker of luxury off-road campers, and a number of makers of E-bikes and scooters. LiFeBATT continues to explore the possibility of working with nations that are woefully short of infrastructure. Negotiations are underway with Siemens to jointly develop a system for using photovoltaic generation and battery storage to supply electricity to communities that are not currently served adequately. The IDA has continued to monitor the progress of LiFeBATT’s work to ensure that all funds are being expended wisely and that matching funds will be generated as promised. The company has also remained current on all obligations for repayment of an IDA loan and lease

  18. 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. PMID:23744291

  19. 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.

  20. Interventions to Improve Access to Primary Care for People Who Are Homeless: A Systematic Review

    PubMed Central

    2016-01-01

    Background People who are homeless encounter barriers to primary care despite having greater needs for health care, on average, than people who are not homeless. We evaluated the effectiveness of interventions to improve access to primary care for people who are homeless. Methods We performed a systematic review to identify studies in English published between January 1, 1995, and July 8, 2015, comparing interventions to improve access to a primary care provider with usual care among people who are homeless. The outcome of interest was access to a primary care provider. The risk of bias in the studies was evaluated, and the quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. Results From a total of 4,047 citations, we identified five eligible studies (one randomized controlled trial and four observational studies). With the exception of the randomized trial, the risk of bias was considered high in the remaining studies. In the randomized trial, people who were homeless, without serious mental illness, and who received either an outreach intervention plus clinic orientation or clinic orientation alone, had improved access to a primary care provider compared with those receiving usual care. An observational study that compared integration of primary care and other services for people who are homeless with usual care did not observe any difference in access to a primary care provider between the two groups. A small observational study showed improvement among participants with a primary care provider after receiving an intervention consisting of housing and supportive services compared with the period before the intervention. The quality of the evidence was considered moderate for both the outreach plus clinic orientation and clinic orientation alone, and low to very low for the other interventions. Despite limitations, the literature identified reports of

  1. Use of VA and Medicare Services By Dually Eligible Veterans with Psychiatric Problems

    PubMed Central

    Carey, Kathleen; Montez-Rath, Maria E; Rosen, Amy K; Christiansen, Cindy L; Loveland, Susan; Ettner, Susan L

    2008-01-01

    Objective To examine how service accessibility measured by geographic distance affects service sector choices for veterans who are dually eligible for veterans affairs (VA) and Medicare services and who are diagnosed with mental health and/or substance abuse (MH/SA) disorders. Data Sources Primary VA data sources were the Patient Treatment (acute care), Extended Care (long-term care), and Outpatient Clinic files. VA cost data were obtained from (1) inpatient and outpatient cost files developed by the VA Health Economics and Resource Center and (2) outpatient VA Decision Support System files. Medicare data sources were the denominator, Medicare Provider Analysis Review (MEDPAR), Provider-of-Service, Outpatient Standard Analytic and Physician/Supplier Standard Analytic files. Additional sources included the Area Resource File and Census Bureau data. Study Design We identified dually eligible veterans who had either an inpatient or outpatient MH/SA diagnosis in the VA system during fiscal year (FY)'99. We then estimated one- and two-part regression models to explain the effects of geographic distance on both VA and Medicare total and MH/SA costs. Principal Findings Results provide evidence for substitution between the VA and Medicare, demonstrating that poorer geographic access to VA inpatient and outpatient clinics decreased VA expenditures but increased Medicare expenditures, while poorer access to Medicare-certified general and psychiatric hospitals decreased Medicare expenditures but increased VA expenditures. Conclusions As geographic distance to VA medical facility increases, Medicare plays an increasingly important role in providing mental health services to veterans. PMID:18355256

  2. Part I, Patient perspective: activating patients to engage their providers in the use of evidence-based medicine: a qualitative evaluation of the VA Project to Implement Diuretics (VAPID)

    PubMed Central

    2010-01-01

    Background This qualitative evaluation follows a randomized-control trial of a patient activation intervention in which hypertensive patients received a letter in the mail asking them to discuss thiazide diuretics with their provider. Results of the parent study indicated that the intervention was effective at facilitating discussions between patients and providers and enhancing thiazide prescribing rates. In the research presented here, our objective was to interview patients to determine their receptivity to patient activation, a potential leverage point for implementing interventions. Methods Semi-structured phone interviews were conducted with 54 patients, purposefully sampled from a randomized controlled trial of a patient activation intervention. All subjects had a history of hypertension and received primary care from one of twelve Veterans Affairs primary care clinics. All interviews were transcribed verbatim and reviewed by the interviewer. Interviews were independently coded by three qualitative researchers until consensus was attained, and relevant themes and responses were identified, grouped, and compared. NVivo 8.0 was used for data management and analysis. Results Data from this qualitative study revealed that most participants held favorable opinions toward the patient activation intervention used in the clinical trial. Most (82%) stated they had a positive reaction. Patients emphasized they liked the intervention because it was straightforward and encouraged them to initiate discussions with their provider. Also, by being active participants in their healthcare, patients felt more invested. Of the few patients offering negative feedback (11%), their main concern was discomfort with possibly challenging their providers' healthcare practices. Another outcome of interest was the patients' perceptions of why they were or were not prescribed a thiazide diuretic, for which several clinically relevant reasons were provided. Conclusion Patients

  3. The educational opportunities in a departmental program of health care for the homeless.

    PubMed

    Romero, L; Heffron, W A; Kaufman, A

    1990-01-01

    Persons who live on the streets and are homeless present many challenges to providers of health care. This paper describes a 14-year ongoing project in the Department of Family, Community, and Emergency Medicine at the University of New Mexico School of Medicine. This small clinic started in an inner-city rescue mission and subsequently has progressed to a much larger health care project for the homeless. Experience in this setting demonstrates that such a site can provide service to the homeless, while at the same time providing educational experiences for medical students and residents and an opportunity for academic research. This project can be duplicated in any academic medical center to provide both service and education.

  4. Police use of handcuffs in the homeless population leads to long-term negative attitudes within this group.

    PubMed

    Krameddine, Yasmeen I; Silverstone, Peter H

    2016-01-01

    The police interact with homeless individuals frequently. However, there has been relatively little research on the attitudes of homeless individuals towards the police, and how police interactions may impact these. This is important since the attitudes of homeless individuals can impact how often they report crimes, and how well they support police when they are investigating crimes in this population. We interviewed 213 homeless individuals in a single city, representing approximately 10% of the total homeless population. They were interviewed at either homeless shelters, or events held specifically for the homeless population. Of these individuals, 75% were male, and 47% had interacted with a police officer within the past month. Self-reports suggested that 60% had a drug and/or alcohol issue and 78% had a mental illness. We found a highly statistically significant difference between the group that had been handcuffed and/or arrested compared to those that had not. This was across multiple domains and included how the individual regarded the police in terms of their empathy and communication skills, and how much they trusted the police. These changes were long-term, and if a homeless individual had been arrested or handcuffed (and verbal reporting suggested that being handcuffed was the by far the most important factor) then these negative attitudes lasted at least 2 years. The primary conclusion from this study is that when police handcuff a homeless individual, this can lead to long-term negative views about the police across several domains that appear to be long lasting, and were linked to feelings of not being respected by the police. It is therefore proposed that police officers should be made aware of the potential long-term negative consequences of this single action, and that police forces should consider providing specific training to minimize any unnecessary overuse of handcuffs.

  5. Sex Trade Behavior Among Heterosexually Active Homeless Men

    PubMed Central

    Tucker, Joan S.; Wenzel, Suzanne L.; Kennedy, David P.; Golinelli, Daniela; Ewing, Brett

    2013-01-01

    Sex trade behavior is fairly common among homeless adults and may contribute to higher rates of HIV/AIDS in this population. This study provides a detailed examination of the sex trade-related attitudes and behaviors of homeless men by: (1) determining the prevalence of sex trade-related behaviors, including sex with female sex workers (FSWs); (2) identifying risk factors for having sex with FSWs; and (3) comparing men's relationships with FSWs and non-FSWs in terms of relationship qualities and HIV-related risk behaviors, such as condom use. Structured interviews were conducted with a probability sample of 305 heterosexually active homeless men recruited from meal lines in Los Angeles. Recent sex with a FSW was reported by 26% of men, and more likely among those who were older, used crack cocaine, had more sex partners, believed that sometimes men just need to have sex no matter what, and were embedded in networks that were denser and where risky sex was more normative. Compared to non-FSW partners, men with FSW partners felt less emotionally close to them, were more likely to believe the partner had never been tested for HIV, and were more likely to have sex with them under the influence of drugs or alcohol; however, they were not more likely to talk about using condoms or to use condoms with FSWs. Whether the relationship was considered “serious” was a stronger correlate of condom use than whether the partner was a FSW. Implications of these findings for HIV prevention efforts among homeless adults are discussed. PMID:23720137

  6. PSINET: Assisting HIV Prevention Amongst Homeless Youth by Planning Ahead

    PubMed Central

    Yadav, A.; Marcolino, L. S.; Rice, E.; Petering, R.; Winetrobe, H.; Rhoades, H.; Tambe, M.; Carmichael, H.

    2015-01-01

    Homeless youth are prone to Human Immunodeficiency Virus (HIV) due to their engagement in high risk behavior such as unprotected sex, sex under influence of drugs, etc. Many non-profit agencies conduct interventions to educate and train a select group of homeless youth about HIV prevention and treatment practices and rely on word-of-mouth spread of information through their social network. Previous work in strategic selection of intervention participants does not handle uncertainties in the social network’s structure and evolving network state, potentially causing significant shortcomings in spread of information. Thus, we developed PSINET, a decision support system to aid the agencies in this task. PSINET includes the following key novelties: (i) it handles uncertainties in network structure and evolving network state; (ii) it addresses these uncertainties by using POMDPs in influence maximization; and (iii) it provides algorithmic advances to allow high quality approximate solutions for such POMDPs. Simulations show that PSINET achieves ~60% more information spread over the current state-of-the-art. PSINET was developed in collaboration with My Friend’s Place (a drop-in agency serving homeless youth in Los Angeles) and is currently being reviewed by their officials. PMID:27642227

  7. Dental care for the homeless over Christmas 1990.

    PubMed

    Daly, B

    1991-11-23

    Each year since 1970, the charity CRISIS has provided a place of warmth and shelter for the homeless of London (guests) over the Christmas period. In 1990 they converted a large factory warehouse off the Old Kent Road and set it up to cook meals, provide beds, games, televisions, hairdressing, chiropody, medical and dental care--and information on housing, as well as general advice. Washing and cleaning facilities were provided in Portakabins parked in the yard outside the warehouse. Guests were provided with a complete change of clothing, which were altered to fit if necessary.

  8. Correlates of depressed mood among young stimulant-using homeless gay and bisexual men.

    PubMed

    Nyamathi, Adeline; Branson, Catherine; Idemundia, Faith; Reback, Cathy; Shoptaw, Steven; Marfisee, Mary; Keenan, Colleen; Khalilifard, Farinaz; Liu, Yihang; Yadav, Kartik

    2012-10-01

    Homeless gay and bisexual (G/B) men are at risk for suicide attempts and have high risk of depressed mood, defined as elevated level of depressive symptoms. This study describes baseline socio-demographic, cognitive, psychosocial, and health- and drug-related correlates of depressed mood in 267 stimulant-using homeless G/B young men who entered a study designed to reduce drug use. G/B men without social support were 11 times more likely to experience depressed mood than their counterparts who had support; those who reported severe body pain were almost six times more likely to report depressed mood than those without pain. Other factors that increased risk of depressed mood included being homeless in the last four months, injecting drugs, reporting poor or fair health status, and high levels of internalized homophobia. This study is one of the first studies to draw a link between pain experienced and depressed mood in homeless young G/B men. Understanding the correlates of depressed mood among homeless G/B young men can help service providers design more targeted treatment plans and provide more appropriate referrals to ancillary care services.

  9. Correlates of depressed mood among young stimulant-using homeless gay and bisexual men.

    PubMed

    Nyamathi, Adeline; Branson, Catherine; Idemundia, Faith; Reback, Cathy; Shoptaw, Steven; Marfisee, Mary; Keenan, Colleen; Khalilifard, Farinaz; Liu, Yihang; Yadav, Kartik

    2012-10-01

    Homeless gay and bisexual (G/B) men are at risk for suicide attempts and have high risk of depressed mood, defined as elevated level of depressive symptoms. This study describes baseline socio-demographic, cognitive, psychosocial, and health- and drug-related correlates of depressed mood in 267 stimulant-using homeless G/B young men who entered a study designed to reduce drug use. G/B men without social support were 11 times more likely to experience depressed mood than their counterparts who had support; those who reported severe body pain were almost six times more likely to report depressed mood than those without pain. Other factors that increased risk of depressed mood included being homeless in the last four months, injecting drugs, reporting poor or fair health status, and high levels of internalized homophobia. This study is one of the first studies to draw a link between pain experienced and depressed mood in homeless young G/B men. Understanding the correlates of depressed mood among homeless G/B young men can help service providers design more targeted treatment plans and provide more appropriate referrals to ancillary care services. PMID:23017039

  10. A support intervention to promote health and coping among homeless youths.

    PubMed

    Stewart, Miriam; Reutter, Linda; Letourneau, Nicole; Makwarimba, Edward

    2009-06-01

    Homeless youths are often vulnerable to limited support resources and loneliness. Peers are a potent source of social support. A support intervention for homeless youths was designed to optimize peer influence and was pilot tested. The intervention was based on an initial assessment of support needs and intervention preferences from the perspective of 36 homeless youths and 27 service providers. Based on the results, a 20-week pilot intervention program was designed, consisting of 4 support groups, optional one-on-one support, group recreational activities, and meals. Support was provided by professional and peer mentors, including formerly homeless youths. A total of 56 homeless youths aged 16 to 24 took part. Participants completed pre-, mid-, and post-test quantitative measures and qualitative interviews. In spite of challenges due primarily to attrition, the youths reported enhanced health behaviours, improved mental well-being, decreased loneliness, expanded social network, increased coping skills, enhanced self-efficacy, and diminished use of drugs and alcohol. Further research could focus on replication at other sites with a larger sample.

  11. Perspectives on housing among homeless emerging adults.

    PubMed

    Ryan, Tiffany N; Thompson, Sanna J

    2013-02-01

    Homeless emerging adults need the safety and stability of housing programs if they are to avoid the elements and victimization of the streets, however, barriers to obtaining housing are numerous. This study identified factors associated with perspectives of housing services among 29 homeless emerging adults (ages 18-23 years) through one-on-one interviews. Data were gathered and analyzed using grounded theory methodology for qualitative information. Major themes of peer support and positive personal and programmatic interactions in the context of emerging adult development were noted as important factors in housing service utilization. These major themes should be taken into consideration for current housing programs, due to homeless emerging adults' oscillation between their desire for formal support and personal independence. Greater emphasis on services that do not require long term commitments and are more flexible in addressing specific barriers to housing for homeless emerging adults may increase use.

  12. Homeless Women, Street Smarts, and Their Survival.

    ERIC Educational Resources Information Center

    Pearce, Carole

    2001-01-01

    A qualitative study of four homeless women depicted their self-perceptions, instability of relationships, decision-making processes, and resourcefulness. Their informal learning included situational and intentional learning applied to survival. (SK)

  13. Identifying relevant components to include in a parenting intervention for homeless families in transitional housing: Using parent input to inform adaptation efforts.

    PubMed

    Holtrop, Kendal; Chaviano, Casey L; Scott, Jenna C; McNeil Smith, Shardé

    2015-11-01

    Homeless families in transitional housing face a number of distinct challenges, yet there is little research seeking to guide prevention and intervention work with homeless parents. Informed by the tenets of community-based participatory research, the purpose of this study was to identify relevant components to include in a parenting intervention for this population. Data were gathered from 40 homeless parents through semistructured individual interviews and were analyzed using qualitative content analysis. The resulting 15 categories suggest several topics, approach considerations, and activities that can inform parenting intervention work with homeless families in transitional housing. Study findings are discussed within the context of intervention fidelity versus adaptation, and implications for practice, research, and policy are suggested. This study provides important insights for informing parenting intervention adaptation and implementation efforts with homeless families in transitional housing. (PsycINFO Database Record

  14. Experiences of Being Homeless or at Risk of Being Homeless among Canadian Youths

    ERIC Educational Resources Information Center

    Miller, Pamela; Donahue, Peter; Este, Dave; Hofer, Marvin

    2004-01-01

    A qualitative study was undertaken with four groups -- immigrants, youths, Aboriginal people, and landlords -- in order to explore, compare, and contrast diversity issues among the homeless population and those at risk of homelessness in a larger Canadian city (Calgary, Alberta) with a smaller city (Lethbridge, Alberta), to better understand their…

  15. Educational Rights of Homeless Youth: Exploring Racial Dimensions of Homeless Educational Policy

    ERIC Educational Resources Information Center

    Aviles de Bradley, Ann Marie

    2009-01-01

    Research that addresses educational rights of unaccompanied homeless youth in grades 9-12 is limited. The McKinney-Vento Act was created to address the many needs of homeless individuals, including children and youth's right to an education. McKinney-Vento was created over twenty-years ago, and this research sought to examine the implementation of…

  16. From Homelessness to Community: Psychological Integration of Women Who Have Experienced Homelessness

    ERIC Educational Resources Information Center

    Nemiroff, Rebecca; Aubry, Tim; Klodawsky, Fran

    2011-01-01

    This longitudinal study examined psychological integration of women who were homeless at the study's outset. Participants (N = 101) were recruited at homeless shelters and participated in 2 in-person interviews, approximately 2 years apart. A predictive model identifying factors associated with having a psychological sense of community within…

  17. Homelessness Comes to School: How Homeless Children and Youths Can Succeed

    ERIC Educational Resources Information Center

    Murphy, Joseph F.; Tobin, Kerri J.

    2011-01-01

    Homelessness is a complex and layered phenomenon, but schools can be effective in reducing its educational consequences. Schools currently are not doing enough. The next step is to consider the services that are needed for students as they arrive on the school campus. Taking care of homeless children in school systems involves seven provisos:…

  18. Enhancing mental health services for homeless persons: state proposals under the MHSH Block Grant Program.

    PubMed Central

    Salem, D A; Levine, I S

    1989-01-01

    The Mental Health Services for the Homeless Block Grant Program has made available more than $57 million to the States in fiscal years 1987-89 to encourage States to develop and strengthen community services for homeless mentally ill persons. Funds were provided for five basic services, which include outreach, case management, mental health treatment, residential support services, and training for service providers. State applications for funds reflected considerable diversity among the services proposed. The manner in which States proposed to use the funds is described, including methods used to identify high need areas and distribute funds and plans for delivering services. PMID:2543021

  19. RN-to-MSN students' attitudes toward women experiencing homelessness: A focus group study.

    PubMed

    Chung-Park, Min; Hatton, Diane; Robinson, Linda; Kleffel, Dorothy

    2006-08-01

    When health professionals, including RNs, have negative attitudes toward women experiencing homelessness, they create barriers to services. It is incumbent on nursing faculty to develop curricula that address homelessness and associated stereotypes, as well as to prepare students to provide safe and appropriate care to the homeless population. The aim of this qualitative study was to examine the attitudes of RN-to-MSN students toward mothers living with their children in a transitional shelter. A convenience sample of 10 students enrolled in a community health nursing course at a university in southern California participated in the study. Two focus groups were conducted: one before and one after a 15-week clinical experience. Data analysis revealed that during the clinical experience, students discovered that they, or perhaps an individual like them, could become homeless. Their attitudes and views changed to include a bigger picture of homelessness, described by public health nursing researchers as "moving upstream." This article suggests strategies for integrating clinical experiences with socioeconomically vulnerable individuals into undergraduate nursing curricula.

  20. Homeless people's right to health: reflections on the problems and components.

    PubMed

    Paiva, Irismar Karla Sarmento de; Lira, Cindy Damaris Gomes; Justino, Jéssica Micaele Rebouças; Miranda, Moêmia Gomes de Oliveira; Saraiva, Ana Karinne de Moura

    2016-08-01

    In the present context of neoliberalism, it can be seen that employment and family links are becoming more fragile, contributing to the phenomenon of social exclusion, and making people who are homeless - the Homeless - more visible. This population, situated on the margin of the healthcare network, challenges the universality, equity and integrated quality of Brazil's Unified Health System - the SUS, and has been the subject of focalizing policies. The debate on this theme is the subject of this study, which is an integrative review of Brazilian publications in the literature databases of Lilacs (Latin America and the Caribbean Health Sciences Database) and the BDENF (Base de Dados de Enfermagem - Nursing Database), to provide a survey of the literature on characterization of the Homeless as a group, their needs and the policies that have been developed to serve them. The study reveals that discussion on the homeless has been timid in production of knowledge, principally in relation to comprehension of the social determinants of the health-disease process of this group. The social policies addressing this population are, mostly, compensatory and existentialist, so that they do not allow for materialization of the right to health as a possible outcome. In this context, it becomes necessary to build social policies that are coherent with the social needs of the homeless. PMID:27557032

  1. Homeless, mentally ill and addicted: the need for abuse and trauma services.

    PubMed

    Christensen, Richard C; Hodgkins, Candace C; Garces, Lorrie K; Estlund, Kathleen L; Miller, M David; Touchton, Reginald

    2005-11-01

    This paper examines an empirical investigation of the lifetime prevalence of trauma (defined as sexual and/or physical abuse) in a cohort of adults enrolled in a federally funded initiative that provides treatment for homeless persons suffering the effects of comorbid substance use and serious mental illness, and considers the impact of this information on clinical programming. Data collected from homeless individuals with co-occurring disorders admitted to the Seeking Treatment and Recovery (STAR) Program during a one year period (n=78) were analyzed for a history of trauma events. Of those individuals evaluated, 79.5% (62/78) acknowledged a history of either physical and/or sexual abuse at some time in their lifetimes. Of this population, 100% of the homeless women (27/27) with co-occurring disorders had experienced a life-altering traumatic event while 68.6% (35/51) of the homeless men also reported trauma histories. We describe the trauma-based interventions made in the STAR Program that have the potential for replication in other initiatives committed to serving homeless individuals with co-occurring disorders. PMID:16311487

  2. Perceptions, Attitudes, and Experience Regarding mHealth Among Homeless Persons in New York City Shelters.

    PubMed

    Asgary, Ramin; Sckell, Blanca; Alcabes, Analena; Naderi, Ramesh; Adongo, Philip; Ogedegbe, Gbenga

    2015-01-01

    Mobile health may be an effective means of providing access and education to the millions of homeless Americans. We conducted semi-structured interviews with 50 homeless people from different shelters in New York City to evaluate their perceptions, attitudes, and experiences regarding mobile health. Participants' average age was 51.66 (SD = 11.34) years; duration of homelessness was 2.0 (SD = 3.10) years. The majority had a mobile phone with the ability to receive and send text messages. Most participants attempted to maintain the same phone number over time. The homeless were welcoming and supportive of text messaging regarding health care issues, including appointment reminders, health education, or management of diseases considering their barriers and mobility, and believed it would help them access necessary health care. Overwhelmingly they preferred text reminders that were short, positively framed, and directive in nature compared to lengthy or motivational texts. The majority believed that free cell phone plans would improve their engagement with, help them navigate, and ultimately improve their access to care. These positive attitudes and experience could be effectively used to improve health care for the homeless. Policies to improve access to mobile health and adapted text messaging strategies regarding the health care needs of this mobile population should be considered.

  3. Perceptions, Attitudes, and Experience Regarding mHealth Among Homeless People in New York City Shelters

    PubMed Central

    Asgary, Ramin; Sckell, Blanca; Alcabes, Analena; Naderi, Ramesh; Adongo, Philip; Ogedegbe, Gbenga

    2015-01-01

    Mobile health may be an effective means of providing access and education to the millions of homeless Americans. We conducted semi-structured interviews with 50 homeless people from different shelters in New York City to evaluate their perceptions, attitudes and experiences regarding mobile health. Participants’ average age was 51.66 (SD±11.34) years; duration of homelessness was 2.0 (SD±3.10) years. The majority had a mobile phone with the ability to receive and send text messages. Most participants attempted to maintain the same phone number over time. The homeless were welcoming and supportive of text messaging regarding healthcare issues including appointment reminders, health education, or management of diseases considering their barriers and mobility, and believed it would help them access necessary healthcare. Overwhelmingly they preferred text reminders that were short, positively framed, and directive in nature compared to lengthy or motivational texts. The majority believed that free cell phone plans would improve their engagement with, help them navigate, and ultimately improve their access to care. These positive attitudes and experience could be effectively used to improve the homeless healthcare. Policies to improve access to mobile health and adapted text messaging strategies regarding healthcare needs of this mobile population should be considered. PMID:26313765

  4. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review

    PubMed Central

    2011-01-01

    provide important new evidence regarding interventions to improve health, housing status, and access to healthcare for homeless populations. The additional studies included in this current review provide further support for earlier evidence which found that coordinated treatment programs for homeless persons with concurrent mental illness and substance misuse issues usually result in better health and access to healthcare than usual care. This review also provides a synthesis of existing evidence regarding interventions that specifically support homeless populations with HIV. PMID:21831318

  5. 78 FR 42455 - Medications Prescribed by Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... physician to a veteran as a specific therapy in the treatment of any illness or injury suffered by a veteran....009, Veterans Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.011, Veterans Dental Care... Administrative practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug...

  6. An Ecological Systems Comparison Between Homeless Sexual Minority Youths and Homeless Heterosexual Youths.

    PubMed

    Gattis, Maurice N

    2013-01-01

    This study examined risk and protective outcomes by comparing homeless sexual minority youths to heterosexual homeless youths regarding family, peer behaviors, school, mental health (suicide risk and depression), stigma, discrimination, substance use, and sexual risk behaviors. Structured interviews (N = 147) were conducted with individuals ages 16-24 at three drop-in programs serving homeless youths in Toronto. Bivariate analyses indicated statistically significant differences between homeless sexual minorities (n=66) and their heterosexual counterparts (n=81) regarding all variables: family, peer behaviors, stigma, discrimination, mental health, substance use and sexual risk behaviors with the exception of school belonging. Specifically, homeless sexual minority youths fared more poorly (e.g. lower satisfaction with family communication, experienced more stigma, used more drugs and alcohol) than their heterosexual counterparts. Improving family communication may be a worthwhile intervention if the youths are still in contact with their families. Future research should focus on victimization in the context of multiple systems.

  7. Homeless, Mentally Ill Youth Benefit from Housing Program

    MedlinePlus

    ... Housing Matters and the National Alliance to End Homelessness (NAEH) in the United States. Nan Roman, NAEH's ... Housing First is a proven method for ending homelessness," Roman added, "and has been shown to increase ...

  8. Social Policy and Social Science Research on Homelessness.

    ERIC Educational Resources Information Center

    Blasi, Gary L.

    1990-01-01

    Reviews prior research on homelessness and describes what remains to be done. Calls for greater attention to the socioeconomic causes of homelessness, its image in the media, and public attitudes toward the problem. (DM)

  9. Homeless in Dhaka: Violence, Sexual Harassment, and Drug-abuse

    PubMed Central

    Uddin, Md. Jasim; Ashraf, Ali; Rashid, Mashida

    2009-01-01

    Bangladesh has experienced one of the highest urban population growth rates (around 7% per year) over the past three decades. Dhaka, the capital city, attracts approximately 320,000 migrants from rural areas every year. The city is unable to provide shelter, food, education, healthcare, and employment for its rapidly-expanding population. An estimated 3.4 million people live in the overcrowded slums of Dhaka, and many more live in public spaces lacking the most basic shelter. While a small but growing body of research describes the lives of people who live in urban informal settlements or slums, very little research describes the population with no housing at all. Anecdotally, the homeless population in Dhaka is known to face extortion, erratic unemployment, exposure to violence, and sexual harassment and to engage in high-risk behaviours. However, this has not been systematically documented. This cross-sectional, descriptive study was conducted to better understand the challenges in the lives of the homeless population in 11 areas of Dhaka during a 13-month period from June 2007 to June 2008. A modified cluster-sampling method was used for selecting 32 clusters of 14 female and male respondents, for a sample of 896. In addition to sociodemographic details, this paper focuses specifically on violence, drug-abuse, and sexual harassment. The findings showed that physical assaults among the homeless, particularly among women, were a regular phenomenon. Eighty-three percent of female respondents (n=372) were assaulted by their husbands, station masters, and male police officers. They were subjected to lewd gestures, unwelcome advances, and rape. Male respondents reported being physically assaulted while trying to collect food, fighting over space, or while stealing, by police officers, miscreants, or other homeless people. Sixty-nine percent of the male respondents (n=309) used locally-available drugs, such as marijuana and heroin, and two-thirds of injecting drug

  10. Homeless in Dhaka: violence, sexual harassment, and drug-abuse.

    PubMed

    Koehlmoos, Tracey Pérez; Uddin, Md Jasim; Ashraf, Ali; Rashid, Mashida

    2009-08-01

    Bangladesh has experienced one of the highest urban population growth rates (around 7% per year) over the past three decades. Dhaka, the capital city, attracts approximately 320,000 migrants from rural areas every year. The city is unable to provide shelter, food, education, healthcare, and employment for its rapidly-expanding population. An estimated 3.4 million people live in the overcrowded slums of Dhaka, and many more live in public spaces lacking the most basic shelter. While a small but growing body of research describes the lives of people who live in urban informal settlements or slums, very little research describes the population with no housing at all. Anecdotally, the homeless population in Dhaka is known to face extortion, erratic unemployment, exposure to violence, and sexual harassment and to engage in high-risk behaviours. However, this has not been systematically documented. This cross-sectional, descriptive study was conducted to better understand the challenges in the lives of the homeless population in 11 areas of Dhaka during a 13-month period from June 2007 to June 2008. A modified cluster-sampling method was used for selecting 32 clusters of 14 female and male respondents, for a sample of 896. In addition to sociodemographic details, this paper focuses specifically on violence, drug-abuse, and sexual harassment. The findings showed that physical assaults among the homeless, particularly among women, were a regular phenomenon. Eighty-three percent of female respondents (n=372) were assaulted by their husbands, station masters, and male police officers. They were subjected to lewd gestures, unwelcome advances, and rape. Male respondents reported being physically assaulted while trying to collect food, fighting over space, or while stealing, by police officers, miscreants, or other homeless people. Sixty-nine percent of the male respondents (n=309) used locally-available drugs, such as marijuana and heroin, and two-thirds of injecting drug

  11. The Impact of VA and Navy Hospital Collaboration on Medical School Education

    ERIC Educational Resources Information Center

    Atre-Vaidya, Nutan; Ross, Arthur, III; Sandu, Ioana C.; Hassan, Tariq

    2009-01-01

    Objective: The U.S. Department of Veterans Affairs (VA) is the largest single provider of medical education in the United States and is often the preferred training site for medical students and residents. However, changing priorities of patients and the marketplace are forcing medical schools and the VA to consider new ways of practicing medicine…

  12. 78 FR 56271 - FY 2014-2020 Draft VA Strategic Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ... AFFAIRS FY 2014-2020 Draft VA Strategic Plan AGENCY: Department of Veterans Affairs. ACTION: Notice of... availability of the FY 2014-2020 Draft VA Strategic Plan (Strategic Plan) for public review and comment, as...). The Strategic Plan provides the Department's long-term direction and places a stronger emphasis...

  13. Military and VA General Dentistry Training: A National Resource.

    ERIC Educational Resources Information Center

    Atchison, Kathryn A.; Bachand, William; Buchanan, C. Richard; Lefever, Karen H.; Lin, Sylvia; Engelhardt, Rita

    2002-01-01

    Compared the program characteristics of the postgraduate general dentistry (PGD) training programs sponsored by the military and the Veterans Health Administration (VA). Gathered information on program infrastructure and emphasis, resident preparation prior to entering the program, and patients served and types of services provided. Programs…

  14. 32 CFR 105.10 - SARC and SAPR VA procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... to accept reports of sexual assault along with the SAPR VA and healthcare personnel. (6) Report directly to the installation commander in accordance with 32 CFR part 103, to include providing regular... criminal investigative personnel on the SAPR policy and program and the roles and responsibilities of...

  15. Geropsychology Training in a VA Nursing Home Setting

    ERIC Educational Resources Information Center

    Karel, Michele J.; Moye, Jennifer

    2005-01-01

    There is a growing need for professional psychology training in nursing home settings, and nursing homes provide a rich environment for teaching geropsychology competencies. We describe the nursing home training component of our Department of Veterans Affairs (VA) Predoctoral Internship and Geropsychology Postdoctoral Fellowship programs. Our…

  16. Housing Stability among Homeless Individuals with Serious Mental Illness Participating in Housing First Programs

    ERIC Educational Resources Information Center

    Pearson, Carol; Montgomery, Ann Elizabeth; Locke, Gretchen

    2009-01-01

    This article presents findings from an exploratory study of three programs using the Housing First approach to provide permanent supportive housing for single, homeless adults with serious mental illness and often co-occurring substance-related disorders. This approach provides direct, or nearly direct, access to housing that is intended to be…

  17. Characterizing Stressors and Modifiable Health Risk Factors Among Homeless Smokers: An Exploratory Pilot Study.

    PubMed

    Kendzor, Darla E; Reitzel, Lorraine R; Businelle, Michael S

    2015-10-01

    This pilot study was conducted to explore the associations between stressors related to homelessness and modifiable health risk factors (poor diet, insufficient physical activity, and overweight/obesity) and to provide direction for future research. Participants (N = 57) were homeless adults enrolled in a smoking cessation program. Analyses were conducted to characterize the sample as well as the relations between relevant stressors (discrimination, chronic stress, and fear and mistrust) and health risk factors. Inadequate daily consumption of fruits, vegetables, and fiber was common. High-fat diet and insufficient physical activity were also prevalent, and the majority of participants were overweight/obese. Participants commonly endorsed discrimination, fear of victimization, mistrust of others, and several other stressors. Greater endorsement of stressors was associated with a high-fat diet. Results suggest that lifestyle interventions and policy changes may be warranted in homeless shelters to attenuate the potential effects of stressors on high-fat dietary consumption among smokers.

  18. Correlates of self-reported incarceration among homeless gay and bisexual stimulant-using young adults.

    PubMed

    Nyamathi, Adeline; Reback, Cathy J; Salem, Benissa E; Zhang, Sheldon; Shoptaw, Steven; Branson, Catherine M; Leake, Barbara

    2015-06-01

    Gay and bisexual (G/B) homeless adults face multiple challenges in life which may place them at high risk for incarceration. Yet, little is known about this understudied population in terms of risk for incarceration. Baseline data collected from a longitudinal study between October 2009 and March 2012 in Hollywood, California, explored correlates of self-reported incarceration among G/B homeless stimulant-using adults (N = 353). Findings revealed older age, less education, having children, as well as a history of injection drug use and being born in the United States were positively associated with incarceration. Moreover, having poor social support and having received hepatitis information were also correlated with a history of incarceration. Our findings help us gain a greater awareness of homeless G/B adults who may be at greater risk for incarceration, which may be used by health care providers to design targeted interventions for this underserved population. PMID:24733231

  19. Correlates of Risky Alcohol and Methamphetamine Use among Currently Homeless Male Parolees

    PubMed Central

    Salem, Benissa E.; Nyamathi, Adeline; Keenan, Colleen; Zhang, Sheldon; Marlow, Elizabeth; Khalilifard, Farinaz; Yadav, Kartik; Faucette, Mark; Leake, Barbara; Marfisee, Mary

    2013-01-01

    Homeless men on parole are a hard-to-reach population with significant community reintegration challenges. This cross-sectional study describes socio-demographic, cognitive, psychosocial and drug-related correlates of alcohol and methamphetamine use in 157 homeless male parolees (age range 18–60) enrolled in a substance abuse treatment center in Los Angeles. Logistic regression results revealed that being African American and older were negatively related to methamphetamine use, while being older and more hostile were related to riskier alcohol abuse. Findings from this study provide a greater understanding of correlates of methamphetamine and alcohol- two of the most detrimental forms of substances abused among currently homeless parolees. PMID:24325770

  20. Parental Incarceration as a Risk Factor for Children in Homeless Families

    PubMed Central

    Casey, Erin C.; Shlafer, Rebecca J.; Masten, Ann S.

    2015-01-01

    The current study aimed to describe the prevalence of children of incarcerated parents (COIP) in a sample of homeless/highly mobile children, examine the relationship between parental incarceration and other risk factors, and investigate the effect of parental incarceration on child academic and mental health outcomes. The authors compared COIP (n = 45) to children whose parents were never incarcerated (n = 93) within a sample of 138, 4- to 7-year-old ethnically diverse children residing in emergency homeless shelters. Children's caregivers provided information about children's history of parental incarceration and other family experiences. Children's teachers reported academic and mental health outcomes in the subsequent school year. Compared to children with no history of parental incarceration, COIP experienced more negative life events. Regression models revealed that a history of parental incarceration was a significant predictor of teacher-reported internalizing problems. These results have implications for the identification and treatment of the highest risk homeless/highly mobile children. PMID:26478648

  1. Community characteristics and violence against homeless women in Los Angeles County.

    PubMed

    Heslin, Kevin C; Robinson, Paul Langham; Baker, Richard S; Gelberg, Lillian

    2007-02-01

    Research on violence against homeless women has focused mainly on individual rather than community-level risk factors. Using an ecological conceptual framework, we estimated the independent association of community characteristics with sexual and physical assault in a probability sample of 974 homeless women. Participants were interviewed at 66 assistance programs in Los Angeles County, California in 1997. Individual responses were linked to community-level data from land use files and the U.S. Census by the facility ZIP codes. Multivariate logistic regression analysis showed that women using service providers in closer proximity to Skid Row had higher odds of physical assault (OR=1.48; 95% CI=1.03, 2.14). A number of individual characteristics were also associated with violent victimization. To reduce violence against homeless women, ensuring the safety of locations for shelters and other assistance programs should be a planning priority for local housing authorities. PMID:17337808

  2. 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,…

  3. The Multi-Dimensional Lives of Children Who Are Homeless

    ERIC Educational Resources Information Center

    Grineski, Steve

    2014-01-01

    It is widely reported that children who are homeless are victimized by overwhelming challenges like poverty and ill-advised policy decisions, such as underfunding the McKinney-Vento Homeless Assistance Act. This act is the only federal legislation devoted to this marginalized group. Children who are homeless, however, should not be characterized…

  4. Crossing the Threshhold: Successful Learning Provision for Homeless People.

    ERIC Educational Resources Information Center

    Cameron, Helen; McKaig, Wendy; Taylor, Sue

    This guide tells the story of a successful collaboration between The City Literary Institute and homelessness agencies to create an arts-based learning program for homeless people in central London. It identifies guidelines and good practice to stimulate similar work in other locations with problems of homelessness and rough sleeping. The guide is…

  5. On the Edge of Homelessness: Rural Poverty and Housing Insecurity.

    ERIC Educational Resources Information Center

    Fitchen, Janet M.

    1992-01-01

    Uses long-term field research, interviews, questionnaires, and public records in upstate New York to link the risk of rural homelessness to poverty trends. Recommends broadened definition of rural homelessness to include those at risk. Suggests homeless programs apply themselves to rural situations. (TES)

  6. Falling through the Gaps: Homeless Children and Youth. Fact Sheet

    ERIC Educational Resources Information Center

    Lovell, Phillip; DeBaun, Bill

    2012-01-01

    In each state, between 41 percent and 91 percent of the homeless students identified by the U.S. Department of Education (ED) are not considered homeless by the U.S. Department of Housing and Urban Development (HUD). Nationwide, as many as 715,238 homeless students fall into a bureaucratic gap between HUD and ED. This is because ED, HUD, and other…

  7. Homelessness in the Elementary School Classroom: Social and Emotional Consequences

    ERIC Educational Resources Information Center

    Chow, Kirby A.; Mistry, Rashmita S.; Melchor, Vanessa L.

    2015-01-01

    This study examined elementary school teachers' experiences working with homeless students. Specifically, we focused on the psychosocial impacts of homelessness on students and their teachers. Qualitative, semi-structured interviews were conducted with 28 teachers who worked at designated public schools for family homeless shelters. A prominent…

  8. Homeless High School Students in America: Who Counts?

    ERIC Educational Resources Information Center

    Cumming, John M.; Gloeckner, Gene W.

    2012-01-01

    After interviewing homeless high school students, the research team in a Colorado school district discovered that many students had not revealed their true living conditions (homelessness) to anyone in the school district. This research team developed an anonymous survey written around the homeless categories identified in the McKinney-Vento…

  9. Exploring the Lived Experiences of Homeless Families with Young Children

    ERIC Educational Resources Information Center

    Hinton, Stephanie; Cassel, Darlinda

    2013-01-01

    This study researched the experiences of homeless families with young children between the ages of four and eight. Many families experience homelessness every year; therefore, it is important for early childhood educators to have an understanding of how homelessness affects families with young children so that educators can effectively serve the…

  10. From substance use to homelessness or vice versa?

    PubMed

    McVicar, Duncan; Moschion, Julie; van Ours, Jan C

    2015-07-01

    Homelessness is associated with substance use, but whether substance use precedes or follows homelessness is unclear. We investigate the nature of the relationship between homelessness and substance use using data from the unique Australian panel dataset Journeys Home collected in 4 surveys over the period from October 2011 to May 2013. Our data refer to 1325 individuals who were homeless or at risk of becoming homeless. We investigate dynamics in homelessness and substance use over the survey period. We find that the two are closely related: homeless individuals are more likely to be substance users and substance users are more likely to be homeless. These relationships, however, are predominantly driven by observed and unobserved individual characteristics which cause individuals to be both more likely to be homeless and to be substance users. Once we take these personal characteristics into account it seems that homelessness does not affect substance use, although we cannot rule out that alcohol use increases the probability that an individual becomes homeless. These overall relationships also hide some interesting heterogeneity by 'type' of homelessness.

  11. Educating Homeless Children and Adolescents: Evaluating Policy and Practice.

    ERIC Educational Resources Information Center

    Stronge, James H., Ed.

    One of the more enigmatic issues of contemporary homelessness is that of schooling. This collection highlights issues related to the provision of an education to homeless children and youths. Background information is offered, with an analysis of educational policy relating to homeless children. Practical strategies and a review of successful…

  12. 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)

  13. The Cycle of Family Homelessness: A Social Policy Reader.

    ERIC Educational Resources Information Center

    Institute for Children and Poverty, New York, NY.

    Research on homeless children and families carried out by the Institute for Children and Poverty over the last 6 years is compiled in this document. The contents range from programmatic solutions and policy recommendations to simple "snapshots" of homeless families. Much of the research is based on the experiences of Homes for the Homeless, which…

  14. Homeless Children in America: Challenges for the 1990s.

    ERIC Educational Resources Information Center

    Rafferty, Yvonne

    The 1980s brought an unprecedented rise in the number of homeless families with children. That there may be as many as three million homeless persons in the United States, with families representing one-third of this population, indicates that homelessness is a social problem of catastrophic proportions. This paper finds that while Federal…

  15. Reliability and validity of the addiction severity index among homeless substance misusers.

    PubMed

    Joyner, L M; Wright, J D; Devine, J A

    1996-05-01

    Retrospective self-reports of behavior are widely used in alcohol and drug research. However, assessments of the reliability and validity of such data among certain populations are nonexistent. This study examines the ability of the Addiction Severity Index (ASI), a widely used clinical and research instrument, to provide valid and reliable data within a homeless population of drug misusers. The results support the usefulness of the ASI in producing quality data among homeless substance misusers seeking treatment. Qualitative data gathered from field interviewers are used to highlight strategies for enhancing the quality of ASI data in the future.

  16. The Boston Health Care for the Homeless Program: A Public Health Framework

    PubMed Central

    Oppenheimer, Sarah C.; Judge, Christine M.; Taube, Robert L.; Blanchfield, Bonnie B.; Swain, Stacy E.; Koh, Howard K.

    2010-01-01

    During the past 25 years, the Boston Health Care for the Homeless Program has evolved into a service model embodying the core functions and essential services of public health. Each year the program provides integrated medical, behavioral, and oral health care, as well as preventive services, to more than 11 000 homeless people. Services are delivered in clinics located in 2 teaching hospitals, 80 shelters and soup kitchens, and an innovative 104-bed medical respite unit. We explain the program's principles of care, describe the public health framework that undergirds the program, and offer lessons for the elimination of health disparities suffered by this vulnerable population. PMID:20558804

  17. KaVA ESTEMA project

    NASA Astrophysics Data System (ADS)

    Oyadomari, Miyako; Imai, Hiroshi; Cho, Se-Hyung; Asaki, Yoshiharu; Choi, Yoon-Kyong; Kim, Jaeheon; Yun, Youngjoo; Matsumoto, Naoko; Min, Cheul-Hong; Oyama, Tomoaki; Yoon, Sung-Chul; Yoon, Dong-Hwan; Kim, Dong-Jin; Dodson, Richard; Rioja, Maria; Burns, Ross; Orosz, Gabor; Nakagawa, Akiharu; Chibueze O, James; Nakashima, Jun-ichi; Sobolev, Andrey

    2016-07-01

    The ESTEMA (Expanded Study on Stellar Masers) project is one of three Large Programs of the KaVA (the combined array of the Korean VLBI Network and Japanese VLBI Exploration of Radio Astrometry), and conducted in 2015-2016. It aims to publish a database of the largest sample of VLBI images of circumstellar water (H2O) and silicon-monoxide (SiO) maser sources towards circumstellar envelopes (CSEs) of 80 evolved stars in late AGB to early post-AGB phase. Here we present the specifications of the ESTEMA observations and the planned scientific goals in order to share the basic information of the ESTEMA with astronomical community and encourage future collaborations with the ESTEMA and future follow-up observations for the targeted stars.

  18. 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.

  19. 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

  20. VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs. Final rule.

    PubMed

    2013-08-20

    The Department of Veterans Affairs (VA) is amending its VA Health Professional Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP). These regulations comply with and implement sections 302 and 603 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (the 2010 Act). Section 302 of the 2010 Act established the VIOMPSP, which authorizes VA to provide financial assistance to certain students seeking a degree in visual impairment or orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA and the United States. Section 603 of the 2010 Act reauthorized and modified HPSP, a program that provides scholarships for education or training in certain health care occupations.

  1. VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs. Final rule.

    PubMed

    2013-08-20

    The Department of Veterans Affairs (VA) is amending its VA Health Professional Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP). These regulations comply with and implement sections 302 and 603 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (the 2010 Act). Section 302 of the 2010 Act established the VIOMPSP, which authorizes VA to provide financial assistance to certain students seeking a degree in visual impairment or orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA and the United States. Section 603 of the 2010 Act reauthorized and modified HPSP, a program that provides scholarships for education or training in certain health care occupations. PMID:23977714

  2. Up the Down Staircase: A Look at Family Homelessness in New Jersey. A Report of Homes for the Homeless.

    ERIC Educational Resources Information Center

    Institute for Children and Poverty, New York, NY.

    In response to the increasing numbers of homeless families, Homes for the Homeless surveyed families in emergency shelters in Newark (New Jersey) to gain some insights into the characteristics and circumstances of urban homeless families. Newark was chosen because it is a large urban center with a high concentration of welfare recipients that is…

  3. 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 surfing"…

  4. 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 surfing" or…

  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. The VA-Medical School Partnership: The Medical School Perspective.

    ERIC Educational Resources Information Center

    Petersdorf, Robert G.

    1987-01-01

    Issues in the relationship between the Veterans' Administration (VA) and medical schools are discussed, including VA faculty recruitment and retention, ambulatory care in VA teaching hospitals, governance and growth of research within VA medical centers, and effects of cost containment and competition on teaching and training in VA hospitals. (MSE)

  7. 48 CFR 801.690 - VA's COCP.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA's COCP. 801.690 Section 801.690 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL DEPARTMENT OF... Responsibilities 801.690 VA's COCP....

  8. Expanded Access to Non-VA Care Through the Veterans Choice Program. Interim final rule.

    PubMed

    2015-12-01

    The Department of Veterans Affairs (VA) revises its medical regulations that implement section 101 of the Veterans Access, Choice, and Accountability Act of 2014 (hereafter referred to as "the Choice Act"), which requires VA to establish a program to furnish hospital care and medical services through eligible non-VA health care providers to eligible veterans who either cannot be seen within the wait-time goals of the Veterans Health Administration (VHA) or who qualify based on their place of residence (hereafter referred to as the "Veterans Choice Program" or the "Program"). These regulatory revisions are required by the most recent amendments to the Choice Act made by the Construction Authorization and Choice Improvement Act of 2014, and by the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. The Construction Authorization and Choice Improvement Act of 2014 amended the Choice Act to define additional criteria that VA may use to determine that a veteran's travel to a VA medical facility is an "unusual or excessive burden," and the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 amended the Choice Act to cover all veterans enrolled in the VA health care system, remove the 60-day limit on an episode of care, modify the wait-time and 40-mile distance eligibility criteria, and expand provider eligibility based on criteria as determined by VA. This interim final rule revises VA regulations consistent with the changes made to the Choice Act as described above.

  9. Partnering with a Homeless Shelter to Provide Authentic Community Involvement

    ERIC Educational Resources Information Center

    Ross, Edna; Cox, Fannie M.

    2013-01-01

    Hotel Louisville is owned and operated by Wayside Christian Mission and is staffed by screened and vetted Wayside resident clients. This unique situation, along with the University of Louisville (UofL) partnership, positions both as national exemplars for authentic community involvement with higher education. The purpose of this article is to…

  10. 7 CFR 272.9 - Approval of homeless meal providers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... State or local governmental agency identified by the State food stamp agency, shall approve... are effectively carried out. The State food stamp agency, or another appropriate State or local....9 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION...

  11. Medical care collection or recovery--VA. Notice.

    PubMed

    1998-10-13

    In a companion document published in the "Proposed Rules" section of this issue of the Federal Register, we proposed to amend VA's medical regulations concerning collection or recovery by VA for medical care or services provided or furnished to a veteran: (i) For a non-service connected disability for which the veteran is entitled to care (or the payment of expenses of care) under a health-plan contract; (ii) For a non-service connected disability incurred incident to the veteran's employment and covered under a worker's compensation law or plan that provides reimbursement or indemnification for such care and services; or (iii) For a non-service connected disability incurred as a result of a motor vehicle accident in a State that requires automobile accident reparations insurance. The proposed rule includes methodology for establishing charges for VA medical care or services. Using this methodology, information for calculating proposed charge amounts at individual VA facilities for inpatient facility charges, skilled nursing facility/sub-acute inpatient facility charges, outpatient facility charges, and physician charges is set forth below. If this methodology were adopted subsequently as a final rule, the applicable data in this document, designed for the period August 1998 through September 1999, would be used for the period from the effective date of the final rule through September 1999. Accordingly, interested parties may wish to retain this document for future reference.

  12. Death, drugs, and disaster: mortality among New Orleans' homeless.

    PubMed

    Rayburn, Rachel L; Pals, Heili; Wright, James D

    2012-01-01

    Tracking homeless individuals over time has proved to be extremely difficult; thus, only limited longitudinal data on the homeless exist. We analyze longitudinal data originally collected from the New Orleans Homeless Substance Abusers Program in 1991-1993, supplemented with mortality data for the same sample by year 2010. We use social bonding theory to examine the effect of conventional social ties on mortality among a sample of substance abusing homeless people. This is of special concern when researching the older homeless persons. We find that social bonding theory does not help to understand mortality among this population. However, alcohol abuse, as compared to crack cocaine, does increase the likelihood of early mortality.

  13. The parallel universe of homeless and HIV-positive youth.

    PubMed

    Ebner, Deborah L; Laviage, Marcia M

    2003-01-01

    The HIV/AIDS crisis among teens in this country is alarming, but the rates are even more staggering when these youth are homeless. They tend to live in a world typically considered by those trying to care for them-family, friends, and healthcare providers-as unreachable and hopeless. This article seeks to present "their world" to health professionals in attempts to depict it not as inaccessible, but as a sensitive one that takes great care and support in order for contact to be successful. Their words and those of individuals who have tried to make this connection are used to facilitate the presentation.

  14. The hunger-obesity paradox: obesity in the homeless.

    PubMed

    Koh, Katherine A; Hoy, Jessica S; O'Connell, James J; Montgomery, Paul

    2012-12-01

    Despite stereotypes of the homeless population as underweight, the literature lacks a rigorous analysis of weight status in homeless adults. The purpose of this study is to present the body mass index (BMI) distribution in a large adult homeless population and to compare this distribution to the non-homeless population in the United States. Demographic, BMI, and socioeconomic variables from patients seen in 2007-2008 were collected from the Boston Health Care for the Homeless Program (BHCHP). This population was compared to non-homeless adults from the National Health and Nutrition Examination Survey (NHANES). Among 5,632 homeless adults, the mean BMI was 28.4 kg/m(2) and the prevalence of obesity was 32.3 %. Only 1.6 % of homeless adults were underweight. Compared to mean BMI in NHANES (28.6 kg/m(2)), the difference was not significant in unadjusted analysis (p = 0.14). Adjusted analyses predicting BMI or likelihood of obesity also showed that the homeless had a weight distribution not statistically different from the general population. Although underweight has been traditionally associated with homelessness, this study suggests that obesity may be the new malnutrition of the homeless in the United States.

  15. Youth Homelessness: Prevalence and Associations with Weight in Three Regions.

    PubMed

    Cutuli, J J; Steinway, Caren; Perlman, Staci; Herbers, Janette E; Eyrich-Garg, Karin M; Willard, Joe

    2015-11-01

    This study investigated the utility of the Youth Risk Behavior Survey (YRBS) to document associations between homeless status and weight while estimating the prevalence of youth homelessness in three regions. A school-based survey, the YRBS includes youths who have been difficult to involve in past research. Analysis of 2011 YRBS data produced population-weighted estimates of youth homelessness prevalence separately for Connecticut, Delaware, and Philadelphia. Public high school students anonymously reported their housing status, height, and weight on the YRBS. Height and weight were converted to body mass index (BMI) percentile-for-age scores. Homelessness was associated with higher BMI percentile scores for youths compared with nonhomeless peers. Associations between BMI percentile and different forms of homelessness (homeless with family, unaccompanied homeless without family) were explored at each site. Estimates of one-month homelessness prevalence ranged from 3.9 percent to 5.9 percent at each site. Homelessness, especially family homelessness, is associated with risk for higher BMI. The YRBS is an informative tool for estimating the prevalence of youth homelessness, expanding on what is known through other, more commonly used methods.

  16. Youth Homelessness: Prevalence and Associations with Weight in Three Regions.

    PubMed

    Cutuli, J J; Steinway, Caren; Perlman, Staci; Herbers, Janette E; Eyrich-Garg, Karin M; Willard, Joe

    2015-11-01

    This study investigated the utility of the Youth Risk Behavior Survey (YRBS) to document associations between homeless status and weight while estimating the prevalence of youth homelessness in three regions. A school-based survey, the YRBS includes youths who have been difficult to involve in past research. Analysis of 2011 YRBS data produced population-weighted estimates of youth homelessness prevalence separately for Connecticut, Delaware, and Philadelphia. Public high school students anonymously reported their housing status, height, and weight on the YRBS. Height and weight were converted to body mass index (BMI) percentile-for-age scores. Homelessness was associated with higher BMI percentile scores for youths compared with nonhomeless peers. Associations between BMI percentile and different forms of homelessness (homeless with family, unaccompanied homeless without family) were explored at each site. Estimates of one-month homelessness prevalence ranged from 3.9 percent to 5.9 percent at each site. Homelessness, especially family homelessness, is associated with risk for higher BMI. The YRBS is an informative tool for estimating the prevalence of youth homelessness, expanding on what is known through other, more commonly used methods. PMID:26638508

  17. Substance dependency among homeless American Indians.

    PubMed

    Lobo, Susan; Vaughan, Margaret Mortensen

    2003-01-01

    Extensive qualitative research in the San Francisco Bay Area in California and in Tucson, Arizona, indicates strong associations between substance abuse and homelessness among American Indians. This article takes a comparative approach to describe and analyze precipitating factors and survival patterns of those who are both homeless and who suffer from substance dependency. Possible precipitating factors presented through case studies consider the complex interaction of childhood fostering or adoption into non-Native families, different types of involuntary institutionalization during youth, and the personal impact of accident, trauma and loss. Coping strategies and keys to survival are examined, including the role of the extended family and close friendships, American Indian and mainstream organizations that offer formal and informal services, the existence of anchor or key households, the helping relationships and sobriety groups among homeless individuals, spirituality, and cultural resiliency.

  18. Psychosocial Predictors of Rule Following in Hostels for Women Experiencing Homelessness

    ERIC Educational Resources Information Center

    White, Katherine; Wood, Maria

    2011-01-01

    This study examined the psychosocial factors impacting upon the rule-following behaviour of residents of a hostel providing crisis accommodation to women who are homeless. After their arrival, residents of a women's hostel (N=83) completed questionnaires assessing the theory of planned behaviour constructs of attitude, subjective norm, perceived…

  19. Youth with Disabilities Who Are Runaways and/or Homeless: Responding to the Need.

    ERIC Educational Resources Information Center

    Fesko, Sheila Lynch; Graham, Steven; Temelini, David

    This document reports on two studies by the Bridges to Inclusion project concerning issues surrounding runaway and/or homeless youth with disabilities. The first study surveyed emergency adolescent shelter providers funded by the Family and Youth Service Bureau. Findings addressed types of disabilities frequently identified or suspected in…

  20. Trials, Tribulations, and Occasional Jubilations while Conducting Research with Homeless Children, Youth, and Families

    ERIC Educational Resources Information Center

    Toro, Paul A.

    2006-01-01

    A personal account of a program of research on homelessness and poverty spanning the past 20 years is provided, with a focus on the many methodological, practical, and ethical difficulties encountered. Interesting discoveries and enjoyable aspects of the research process are also presented. Several role conflicts that arose for the researcher in…

  1. A Dimensional Model of Psychopathology among Homeless Adolescents: Suicidality, Internalizing, and Externalizing Disorders

    ERIC Educational Resources Information Center

    Yoder, Kevin A.; Longley, Susan L.; Whitbeck, Les B.; Hoyt, Dan R.

    2008-01-01

    The present study examined associations among dimensions of suicidality and psychopathology in a sample of 428 homeless adolescents (56.3% female). Confirmatory factor analysis results provided support for a three-factor model in which suicidality (measured with lifetime suicidal ideation and suicide attempts), internalizing disorders (assessed…

  2. Helping Homeless Individuals with Co-Occurring Disorders: The Four Components

    ERIC Educational Resources Information Center

    Sun, An-Pyng

    2012-01-01

    Homeless individuals with co-occurring disorders (CODs) of severe mental illness and substance use disorder are one of the most vulnerable populations. This article provides practitioners with a framework and strategies for helping this client population. Four components emerged from a literature review: (1) ensuring an effective transition for…

  3. Experiences Associated with Intervening with Homeless, Substance-Abusing Mothers: The Importance of Success

    ERIC Educational Resources Information Center

    Slesnick, Natasha; Glassman, Michael; Katafiasz, Heather; Collins, Jennifer C.

    2012-01-01

    This article documents the experiences of providing housing and supportive services, or ecologically based treatment, to shelter-recruited, substance-abusing homeless women with young children in their care. Among clients, observed experiences related to housing, substance abuse, and health and mental health care are discussed. Among therapists,…

  4. 76 FR 62434 - Federal Property Suitable as Facilities To Assist the Homeless

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-07

    ... for use to assist the homeless. FOR FURTHER INFORMATION CONTACT: Juanita Perry, Department of Housing...), providers should contact the appropriate landholding agencies at the following addresses: COE: Mr. Scott... suitable/available in the 10.22.2010 FR Washington Fox Island Naval Lab 630 3rd Ave. Fox Island WA...

  5. Homelessness and the mentally ill offender.

    PubMed

    Richman, B J; Convit, A; Martell, D

    1992-05-01

    This paper presents the results of a retrospective analysis of the discharge summaries of 69 mentally ill offenders. The subjects were patients in a New York State Psychiatric Hospital for a two-year period between January 1988 and December 1989 who were referred by the courts under New York State Criminal Procedure Law (CPL). The subjects were further compared as to homelessness at the time of the instant offense to study the association of this variable and criminal behavior among the mentally ill. Statistical analyses demonstrated significant relationships between variables of homelessness, prior offense history, and substance abuse.

  6. KENO V.a Primer: A Primer for Criticality Calculations with SCALE/KENO V.a Using CSPAN for Input

    SciTech Connect

    Busch, R.D.

    2003-01-17

    The SCALE (Standardized Computer Analyses for Licensing Evaluation) computer software system developed at Oak Ridge National Laboratory (ORNL) is widely used and accepted around the world for criticality safety analyses. The well-known KENO V.a three-dimensional Monte Carlo criticality computer code is the primary criticality safety analysis tool in SCALE. The KENO V.a primer is designed to help a new user understand and use the SCALE/KENO V.a Monte Carlo code for nuclear criticality safety analyses. It assumes that the user has a college education in a technical field. There is no assumption of familiarity with Monte Carlo codes in general or with SCALE/KENO V.a in particular. The primer is designed to teach by example, with each example illustrating two or three features of SCALE/KENO V.a that are useful in criticality analyses. The primer is based on SCALE 4.4a, which includes the Criticality Safety Processor for Analysis (CSPAN) input processor for Windows personal computers (PCs). A second edition of the primer, which uses the new KENO Visual Editor, is currently under development at ORNL and is planned for publication in late 2003. Each example in this first edition of the primer uses CSPAN to provide the framework for data input. Starting with a Quickstart section, the primer gives an overview of the basic requirements for SCALE/KENO V.a input and allows the user to quickly run a simple criticality problem with SCALE/KENO V.a. The sections that follow Quickstart include a list of basic objectives at the beginning that identifies the goal of the section and the individual SCALE/KENO V.a features which are covered in detail in the example problems in that section. Upon completion of the primer, a new user should be comfortable using CSPAN to set up criticality problems in SCALE/KENO V.a.

  7. HIV risk, seropositivity and predictors of infection among homeless and non-homeless women sex workers in Miami, Florida, USA.

    PubMed

    Surratt, H L; Inciardi, J A

    2004-07-01

    Although homelessness has frequently been associated with substance abuse, and has been established as a predictor of HIV risk among substance abusers, little is known about the impact of homelessness on HIV risk among female sex workers. This analysis investigated the contribution of homelessness to sexual risk taking among a sample of 485 female sex workers recruited into an HIV prevention programme in Miami, Florida, 41.6% of whom considered themselves to be currently homeless. Findings indicated that in comparison to non-homeless sex workers, significantly more homeless sex workers were daily users of alcohol and crack, and their past month sex work reflected significantly more frequent vaginal and oral sex acts, higher levels of unprotected vaginal sex and more numerous sexual activities while 'high' on drugs. At the same time, a significantly greater proportion of homeless sex workers encountered customers that refused to use condoms than did the non-homeless sex workers. There were no significant differences in HIV seropositivity between the homeless and non-homeless women (22.5 and 24.9%, respectively), primarily because the majority of the women in the study cycled in and out of homelessness. PMID:15223529

  8. Oversight Hearing on Jobs and Education for the Homeless. Joint Hearing before the Committee on Education and Labor and the Select Committee on Aging. House of Representatives, One Hundredth Congress, First Session (Los Angeles, California, March 20, 1987).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    This document provides witnesses' testimonies and prepared statements from the Congressional hearing held in Los Angeles, California to examine the problems of the homeless and to suggest ways to alleviate some of the problems of the homeless. Opening statements are included by Representatives Augustus Hawkins, Edward Roybal, and Matthew Martinez.…

  9. Homeless but Connected: The Role of Heterogeneous Social Network Ties and Social Networking Technology in the Mental Health Outcomes of Street-Living Youth

    PubMed Central

    Rice, Eric; Ray, Diana; Kurzban, Seth

    2013-01-01

    Although social integration tends to have positive effects on the mental health of housed adolescents, the role of homeless adolescents’ social networks is more ambiguous. Social network data were collected from 136 homeless adolescents in Hollywood, California to examine how network ties are associated with symptoms of anxiety and depression. Face-to-face relationships with street-based peers were a risk factor for both anxiety and depression, while contacting home-based friends through social networking technology was found to be protective for depression. Community-based and public agencies serving homeless adolescents should consider facilitating the maintenance of these protective relationships by providing internet access. PMID:22075769

  10. Homeless but connected: the role of heterogeneous social network ties and social networking technology in the mental health outcomes of street-living adolescents.

    PubMed

    Rice, Eric; Kurzban, Seth; Ray, Diana

    2012-12-01

    Although social integration tends to have positive effects on the mental health of housed adolescents, the role of homeless adolescents' social networks is more ambiguous. Social network data were collected from 136 homeless adolescents in Hollywood, California to examine how network ties are associated with symptoms of anxiety and depression. Face-to-face relationships with street-based peers were a risk factor for both anxiety and depression, while contacting home-based friends through social networking technology was found to be protective for depression. Community-based and public agencies serving homeless adolescents should consider facilitating the maintenance of these protective relationships by providing internet access.

  11. Sexual health: the role of sexual health services among homeless young women living in Toronto, Canada.

    PubMed

    Oliver, Vanessa; Cheff, Rebecca

    2012-05-01

    Recent statistics indicate limited condom use, high STI (sexually transmitted infection) rates, and a general lack of knowledge about reproductive and sexual health among homeless youth. This research focuses on the experiences of homeless female and transgendered youth, providing an insider's perspective on shaping sexual health interventions. This qualitative research is based on life history interviews and participant observation with eight homeless young women who reflect the diversity of the homeless population in Toronto, Ontario, Canada. Their particularized sexual experiences and health-seeking behaviors illustrate the range of issues faced by this community, speaking to the efficacy of current health promotion strategies. Too often faced with judgmental health and social service providers who they perceive to undermine their agency and empowerment, these women highlight the challenges they face when seeking sexual and reproductive health services and information. In addition to speaking to the struggles and frustrations they face in regard to their sexual health and the services with which they choose to interact, the women provide suggestions for improved care. From these, the authors include key recommendations for the provision of culturally competent, sex-positive, and nonjudgmental health services with the hope that health practitioners and promoters can learn from these experiences, both positive and negative, when caring for and supporting young women living in exceptional circumstances.

  12. A case study of a Canadian homelessness intervention programme for elderly people.

    PubMed

    Ploeg, Jenny; Hayward, Lynda; Woodward, Christel; Johnston, Riley

    2008-12-01

    The aims of this study were to describe: (1) how the Homelessness Intervention Programme addressed the needs of elderly people who were homeless or at risk of homelessness; and (2) the factors that influenced the ability of the programme to address client needs. The programme was offered by a multi-service non-profit agency serving low-income families and individuals in an urban neighbourhood in Ontario, Canada. Using a case study approach, we conducted 10 individual interviews and three focus groups with programme clients, programme providers, other service providers and programme funders. Programme providers completed intake forms, monthly follow-up forms and exit/housing change forms for each of the 129 clients served by the programme over a 28-month period. Approximately equal proportions of clients were between 54 years old and 65 years old (47%) and over 65 years (53%). There were equal proportions of women and men. In addition to being homeless or marginally housed, clients lived with multiple and complex issues including chronic illness, mental illness and substance abuse. Through the facilitation of continuity of care, the programme was able to meet the needs of this vulnerable group of elderly people. Three types of continuity of care were facilitated: relational, informational and management continuity. The study confirmed the value of a continuous caring relationship with an identified provider and the delivery of a seamless service through coordination, integration and information sharing between different providers. Study findings also highlighted the broader systemic factors that acted as barriers to the programme and its ability to meet the needs of elderly people. These factors included limited housing options available; limited income supports; and lack of coordinated, accessible community health and support services. The central findings stress the importance of continuity of care as a guiding concept for intervention programmes for homeless and

  13. Mobile phone technology: a new paradigm for the prevention, treatment, and research of the non-sheltered "street" homeless?

    PubMed

    Eyrich-Garg, Karin M

    2010-05-01

    Individuals experiencing homelessness have disproportionately high rates of health problems. Those who perceive themselves as having greater access to their social support networks have better physical and mental health outcomes as well as lower rates of victimization. Mobile phones offer a connection to others without the physical constraints of landlines and, therefore, may make communication (e.g., access to one's social support networks) more feasible for homeless individuals. This, in turn, could lead toward better health outcomes. This exploratory study examined mobile phone possession and use among a sample of 100 homeless men and women who do not use the shelter system in Philadelphia, PA. Interviews were comprised of the Homeless Supplement to the Diagnostic Interview Schedule, a technology module created for this investigation, and the substance use and psychiatric sections of the Addiction Severity Index. Almost half (44%) of the sample had a mobile phone. In the past 30 days, 100% of those with mobile phones placed or received a call, over half (61%) sent or received a text message, and one fifth (20%) accessed the Internet via their mobile phone. Participants possessed and used mobile phones to increase their sense of safety, responsibility (employment, stable housing, personal business, and sobriety or "clean time"), and social connectedness. Mobile phones could potentially be used by public health/health care providers to disseminate information to the street homeless, to enhance communication between the street homeless and providers, and to increase access for the street homeless to prevention, intervention, and aftercare services. Finally, this technology could also be used by researchers to collect data with this transient population.

  14. Mobile phone technology: a new paradigm for the prevention, treatment, and research of the non-sheltered "street" homeless?

    PubMed

    Eyrich-Garg, Karin M

    2010-05-01

    Individuals experiencing homelessness have disproportionately high rates of health problems. Those who perceive themselves as having greater access to their social support networks have better physical and mental health outcomes as well as lower rates of victimization. Mobile phones offer a connection to others without the physical constraints of landlines and, therefore, may make communication (e.g., access to one's social support networks) more feasible for homeless individuals. This, in turn, could lead toward better health outcomes. This exploratory study examined mobile phone possession and use among a sample of 100 homeless men and women who do not use the shelter system in Philadelphia, PA. Interviews were comprised of the Homeless Supplement to the Diagnostic Interview Schedule, a technology module created for this investigation, and the substance use and psychiatric sections of the Addiction Severity Index. Almost half (44%) of the sample had a mobile phone. In the past 30 days, 100% of those with mobile phones placed or received a call, over half (61%) sent or received a text message, and one fifth (20%) accessed the Internet via their mobile phone. Participants possessed and used mobile phones to increase their sense of safety, responsibility (employment, stable housing, personal business, and sobriety or "clean time"), and social connectedness. Mobile phones could potentially be used by public health/health care providers to disseminate information to the street homeless, to enhance communication between the street homeless and providers, and to increase access for the street homeless to prevention, intervention, and aftercare services. Finally, this technology could also be used by researchers to collect data with this transient population. PMID:20397058

  15. 77 FR 44653 - Continuum of Care Homeless Assistance Grant Application-Technical Submission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-30

    ... URBAN DEVELOPMENT Continuum of Care Homeless Assistance Grant Application-- Technical Submission AGENCY... the original Continuum of Care Homeless Assistance Grant Application. DATES: Comments Due Date: August... lists the following information: Title of Proposal: Continuum of Care Homeless Assistance...

  16. 76 FR 81959 - Notice of Proposed Information Collection: Comment Request; Homelessness Prevention Study Site...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... URBAN DEVELOPMENT Notice of Proposed Information Collection: Comment Request; Homelessness Prevention... following information: Title of Proposal: Homelessness Prevention Study Site Visits. OMB Control Number, if... requirements associated with HUD's Homelessness Prevention Study Site Visits. This information...

  17. 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

    ... URBAN DEVELOPMENT Notice of Submission of Proposed Information Collection to OMB Homelessness Prevention... site visits that are part of HUD's Homelessness Prevention Study. The proposed information collection... collection for the Homelessness Prevention study that was already approved under emergency review...

  18. Delivery of gender-sensitive comprehensive primary care to women veterans: implications for VA Patient Aligned Care Teams.

    PubMed

    Yano, Elizabeth M; Haskell, Sally; Hayes, Patricia

    2014-07-01

    The Veterans Health Administration (VA) has undertaken a major initiative to transform primary care delivery through implementation of Patient Aligned Care Teams (PACTs). Based on the patient-centered medical home concept, PACTs aim to improve access, continuity, coordination, and comprehensiveness using team-based care that is patient driven and patient centered. However, how PACT principles should be applied to meet the needs of special populations, including women veterans, is not entirely clear. While historical differences in military participation meant women veterans were rarely seen in VA healthcare settings, they now represent the fastest growing segment of new VA users. They also have complex healthcare needs, adding gender-specific services and other needs to the spectrum of services that the VA must deliver. These trends are changing the VA landscape, introducing challenges to how VA care is organized, how VA providers need to be trained, and how VA considers implementation of new initiatives, such as PACT. We briefly describe the evolution of VA primary care delivery for women veterans, review VA policy for delivering gender-sensitive comprehensive primary care for women, and discuss the challenges that women veterans' needs pose in the context of PACT implementation. We conclude with recommendations for addressing some of these challenges moving forward.

  19. The power of the drug, nature of support, and their impact on homeless youth.

    PubMed

    Hudson, Angela L; Nyamathi, Adeline; Slagle, Alexandra; Greengold, Barbara; Griffin, Deborah Koniak; Khalilifard, Farinaz; Gedzoff, Danny; Reid, Courtney

    2009-10-01

    The purpose of this study was to explore homeless youths' perspectives on the power of drugs in their lives, the preferred type of drugs used, barriers to treatment, and strategies to prevent drug initiation and abuse. This was a descriptive, qualitative study using focus groups with a purposeful sample of 24 drug-using homeless youth. The results provided insight into the lives of drug-using homeless youth. The most commonly used drugs were marijuana and alcohol. Reported reasons for drug use were parental drug use, low self-esteem, and harsh living conditions on the streets. Barriers to treatment were pleasurable enjoyment of the drug, physical dependence, and non-empathetic mental health providers. Strategies to prevent initiation and abuse of drugs were creative activities, such as art, sports, and music, and disdain for parental/family drug use and abuse. Comparative research is needed on specific personal factors that cause initiation and deterrence of drugs use/abuse among homeless youth.

  20. Cell phone use among homeless youth: potential for new health interventions and research.

    PubMed

    Rice, Eric; Lee, Alex; Taitt, Sean

    2011-12-01

    Cell phone use has become nearly ubiquitous among adolescents in the United States. Despite the potential for cell phones to facilitate intervention, research, and care for homeless youth, no data exists to date on cell phone use among this population. In 2009, a survey of cell phone use was conducted among a non-probability sample of 169 homeless youth in Los Angeles, CA. Levels of ownership and use, instrumental uses (connecting to case workers, employers) and patterns of connecting to various network types were assessed (family, home-based peers, street-based peers). Differences in socio-demographic characteristics and cell phone ownership were assessed via t test and chi-square statistics. Sixty-two percent of homeless youth own a cell phone; 40% have a working phone. Seventeen percent used their phone to call a case manager, 36% to call either a potential or current employer. Fifty-one percent of youth connected with home-based peers on the phone and 41% connected to parents. Cell phones present new opportunities for intervention research, connecting homeless youth to family and home-based peers who can be sources of social support in times of need. Moreover, cell phones provide researchers and providers with new avenues to maintain connections with these highly transient youth.

  1. The Power of the Drug, Nature of Support, and their Impact on Homeless Youth

    PubMed Central

    Hudson, Angela L.; Nyamathi, Adeline; Slagle, Alexandra; Greengold, Barbara; Griffin, Deborah Koniak; Khalilifard, Farinaz; Gedzoff, Danny; Reid, Courtney

    2010-01-01

    The purpose of this study was to explore homeless youths’ perspectives on the power of drugs in their lives, the preferred type of drugs used, barriers to treatment, and strategies to prevent drug initiation and abuse. This was a descriptive, qualitative study using focus groups with a purposeful sample of 24 homeless drug-using youth. The results provided insight into the lives of drug-using homeless youth. Most commonly-used drugs were marijuana and alcohol. Reported reasons for drug use were parental drug use, low self-esteem, and harsh living conditions on the streets. Barriers to treatment were pleasurable enjoyment of the drug, physical dependence, and non-empathetic mental health providers. Strategies to prevent initiation and abuse of drugs were creative activities, such as art, sports, and music, and disdain for parental/family drug use and abuse. Comparative research is needed on specific personal factors that cause initiation and deterrence of drugs use/abuse among homeless youth. PMID:20155605

  2. 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

  3. Homeless People’s Perceptions of Welcomeness and Unwelcomeness in Healthcare Encounters

    PubMed Central

    Wen, Chuck K.; Hudak, Pamela L.

    2007-01-01

    Background Homeless people face many barriers to obtaining health care, and their attitudes toward seeking health care services may be shaped in part by previous encounters with health care providers. Objective To examine how homeless persons experienced “welcomeness” and “unwelcomeness” in past encounters with health care providers and to characterize their perceptions of these interactions. Design Qualitative content analysis of 17 in-depth interviews. Participants Seventeen homeless men and women, aged 29–62 years, residing at 5 shelters in Toronto, Canada. Approach Interpretive content analysis was performed using iterative stages of inductive coding. Interview transcripts were analyzed using Buber’s philosophical conceptualization of ways of relating as “I–It” (the way persons relate to objects) and “I–You” (the way persons relate to dynamic beings). Results Most participants perceived their experiences of unwelcomeness as acts of discrimination. Homelessness and low social class were most commonly cited as the perceived basis for discriminatory treatment. Many participants reported intense emotional responses to unwelcoming experiences, which negatively influenced their desire to seek health care in the future. Participants’ descriptions of unwelcoming health care encounters were consistent with “I–It” ways of relating in that they felt dehumanized, not listened to, or disempowered. Welcoming experiences were consistent with “I–You” ways of relating, in that patients felt valued as a person, truly listened to, or empowered. Conclusions Homeless people’s perceptions of welcomeness and unwelcomeness are an important aspect of their encounters with health care providers. Buber’s “I–It” and “I–You” concepts are potentially useful aids to health care providers who wish to understand how welcoming and unwelcoming interactions are fostered. PMID:17415619

  4. Residential treatment for dually diagnosed homeless veterans: a comparison of program types.

    PubMed

    Kasprow, W J; Rosenheck, R; Frisman, L; DiLella, D

    1999-01-01

    This study compared two types of residential programs that treat dually diagnosed homeless veterans. Programs specializing in the treatment of substance abuse disorders (SA) and those programs addressing both psychiatric disorders and substance abuse problems within the same setting (DDX) were compared on (1) program characteristics, (2) clients' perceived environment, and (3) outcomes of treatment. The study was based on surveys and discharge reports from residential treatment facilities that were under contract to the Department of Veterans Affairs Health Care for Homeless Veterans program, a national outreach and case management program operating at 71 sites across the nation. Program characteristics surveys were completed by program administrators, perceived environment surveys were completed by veterans in treatment, and discharge reports were completed by VA case managers. DDX programs were characterized by lower expectations for functioning, more acceptance of problem behavior, and more accommodation for choice and privacy, relative to SA programs after adjusting for baseline differences. Dually diagnosed veterans in DDX programs perceived these programs as less controlling than SA programs, but also as having lower involvement and less practical and personal problem orientations. At discharge, a lower percentage of veterans from DDX than SA programs left without staff consultation. A higher percentage of veterans from DDX than SA programs were discharged to community housing rather than to further institutional treatment. Program effects were not different for psychotic and non-psychotic veterans. Although differences were modest, integration of substance abuse and psychiatric treatment may promote a faster return to community living for dually diagnosed homeless veterans. Such integration did not differentially benefit dually diagnosed veterans whose psychiatric problems included a psychotic disorder. PMID:10189513

  5. Coping and Suicidality among Homeless Youth

    ERIC Educational Resources Information Center

    Kidd, Sean A.; Carroll, Michelle R.

    2007-01-01

    This study examined the impact of coping strategies employed by homeless youth upon suicidal ideation, suicide attempts on the streets, and feeling trapped/helpless. Coping strategies examined in the analysis included problem-focused and avoidant coping, along with several coping strategies identified in previous exploratory qualitative studies.…

  6. Foreclosed: Two Million Homeless Students and Counting

    ERIC Educational Resources Information Center

    McKibben, Sarah

    2009-01-01

    This article reports that according to First Focus, a bipartisan advocacy organization for children and families, a predicted two million children will lose their homes over the next two years because of the foreclosure crisis. From an economy deep in recession, an entirely new population of homeless students has emerged. And with job losses at…

  7. Survival Strategies of Older Homeless Men.

    ERIC Educational Resources Information Center

    Cohen, Carl I.; And Others

    1988-01-01

    Examined how 281 homeless men aged 50 and older living on skid row were able to procure basic necessities such as money, food, shelter, and health care. Found men had and used informal supports to survive. Inability to fulfill needs was primarily associated with physical health, depression, lack of contacts with institutions and agencies, and…

  8. Gender Differences in Victimized Homeless Adolescents

    ERIC Educational Resources Information Center

    Johnson, Regina Jones; Rew, Lynn; Kouzekanani, Kamiar

    2006-01-01

    Most of what we know about sexual abuse comes from efforts to examine female children victimized by men. Although some researchers have identified similarities between male and female victims of sexual abuse, few studies have examined gender-specific factors associated with sexual health practices among homeless adolescents. The aim of this study…

  9. 77 FR 20849 - Homeless Veterans' Reintegration Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ... Veterans' Reintegration Program AGENCY: Veterans' Employment and Training Service (VETS), Department of...: Section 2021 of Title 38 of the United States Code (U.S.C.) reauthorizes the Homeless Veterans Reintegration Program (HVRP) through fiscal year (FY) 2012 and indicates: ``the Secretary of Labor shall...

  10. The New Vagabonds? Homelessness Outside the Megalopolis.

    ERIC Educational Resources Information Center

    Huff, Dan; Johnson, David

    This paper reports results of a survey of 47 homeless adults, interviewed in Ada County, Idaho. Most respondents were male, white, currently single, with no religious preference. The mean number of years of formal education was 11.6. Seventeen percent of the sample were American Indians. Ninety-three percent were unemployed. Twenty-five percent of…

  11. Education and Homeless Youth: Policy Implementations

    ERIC Educational Resources Information Center

    Center for Higher Education Policy Analysis, University of Southern California, 2007

    2007-01-01

    "The Navigator" is a free newsletter published by the Center for Higher Education Policy Analysis (CHEPA) focusing on directions and trends in higher education policy. The theme of this issue is: "Education and Homeless Youth: Policy Implementations." The lead article, authored by CHEPA director William G. Tierney, describes CHEPA's study of the…

  12. Deinstitutionalisation does not increase imprisonment or homelessness.

    PubMed

    Salisbury, Tatiana Taylor; Thornicroft, Graham

    2016-05-01

    Closing long-stay psychiatric beds remains contentious. The review by Winkler et al in this issue examines 23 studies of deinstitutionalisation for the outcomes of people discharged from psychiatric hospitals after an admission of 1 year or longer. The majority of these studies identified no cases of homelessness, incarceration or suicide after discharge from hospital. PMID:27143004

  13. Resilience and Suicidality among Homeless Youth

    ERIC Educational Resources Information Center

    Cleverley, Kristin; Kidd, Sean A.

    2011-01-01

    Homeless and street-involved youth are considered an extremely high risk group, with many studies highlighting trajectories characterized by abusive, neglectful, and unstable family histories, victimization and criminal involvement while on the streets, high rates of physical and mental illness, and extremely high rates of mortality. While there…

  14. Homeless: How Residential Instability Complicates Students' Lives

    ERIC Educational Resources Information Center

    Hallett, Ronald E.

    2010-01-01

    In this article, the author examines the challenges of highly mobile students and what educators can do to retain and support them. The findings and recommendations presented here are based on two complementary research projects conducted with homeless students transitioning from high school to college. The author focuses on the residential…

  15. Effects of social support and conflict on parenting among homeless mothers.

    PubMed

    Marra, Jaime V; McCarthy, Elissa; Lin, Hsiu-Ju; Ford, Julian; Rodis, Eleni; Frisman, Linda K

    2009-07-01

    Research has shown that having a supportive social network is generally beneficial for individuals, particularly those who are homeless or at risk of homelessness. However, conflict within these networks may diminish the positive effects of social support on well-being, and these effects may be felt acutely within a vulnerable population with multiple needs. This study examined the impact of conflict and social support on parenting behaviors in a sample of mothers who are homeless and were involved in a study of case management interventions of varying intensity. We found that women who reported high emotional and instrumental social support self-reported greater improvements in parenting consistency over time than those who reported lower levels of support. However, three-way interactions showed that conflict in support networks was a risk factor for harsh parenting practices among participants who reported lower levels of instrumental social support. Results suggest that social support may enhance homeless mothers' ability to provide consistent parenting, but that these benefits may be undermined if conflict occurs in combination with limited levels of instrumental social support.

  16. Predictors of substance abuse treatment participation among homeless adults.

    PubMed

    Ibabe, Izaskun; Stein, Judith A; Nyamathi, Adeline; Bentler, Peter M

    2014-03-01

    The current study focuses on the relationships among a trauma history, a substance use history, chronic homelessness, and the mediating role of recent emotional distress in predicting drug treatment participation among adult homeless people. We explored the predictors of participation in substance abuse treatment because enrolling and retaining clients in substance abuse treatment programs is always a challenge particularly among homeless people. Participants were 853 homeless adults from Los Angeles, California. Using structural equation models, findings indicated that trauma history, substance use history and chronicity of homelessness were associated, and were significant predictors of greater recent emotional distress. The most notable result was that recent emotional distress predicted less participation in current substance abuse treatment (both formal and self-help) whereas a substance use history alone predicted significantly more participation in treatment. Implications concerning treatment engagement and difficulties in obtaining appropriate dual-diagnosis services for homeless mentally distressed individuals are discussed. PMID:24238716

  17. Voices From the Street: Exploring the Realities of Family Homelessness

    PubMed Central

    Gültekin, Laura; Brush, Barbara L.; Baiardi, Janet M.; Kirk, Keri; VanMaldeghem, Kelley

    2015-01-01

    Homelessness threatens the health and well-being of thousands of families in the United States, yet little is known about their specific needs and how current services address them. To fill this knowledge gap, we explored the experiences of homelessness families in Detroit, Michigan. We targeted homeless mothers and their caseworkers for study to see if the perceptions of needs and services were in alignment. Using focus groups and content analysis, we identified four overarching themes that illustrate homeless mothers' experience with homelessness. We then analyzed data from caseworkers to look specifically for similarities and differences in their perceptions. Key findings included reports of family histories of violence, poverty, social isolation, and a lack of informal support as contributing to homelessness. The differing perspectives of mothers and their caseworkers regarding how best to move forward highlight how current programs and services may not be meeting the needs of this growing and vulnerable cohort. PMID:25186947

  18. 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

  19. 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

    ..., Virginia. As consideration, the selected lessee will be required to finance, design, develop, construct... provide preference and priority placement for homeless and at-risk Veterans, and provide on-site... plan proposed by the Under Secretary for Health for applying the consideration under such a lease...

  20. 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

    ... Center (Uptown Division) in Augusta, Georgia. As consideration, the selected lessee will be required to... required to provide preference and priority placement for Veterans at risk for homelessness, and provide on... business plan proposed by the Under Secretary for Health for applying the consideration under such a...

  1. 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.

  2. 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

  3. 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

  4. How Effective Homelessness Prevention Impacts the Length of Shelter Spells

    PubMed Central

    Goodman, Sarena; Messeri, Peter; O’Flaherty, Brendan

    2014-01-01

    Homelessness prevention programs intervene with households apparently in imminent danger of becoming homeless, and try to keep them housed. If they are at least partially successful, how do they change the average shelter spell of households actually becoming homeless? We use data from 2003 to 2008 for Homebase, a New York City homelessness prevention program that studies have found to be effective in reducing shelter entries. Homebase made no difference in average shelter spells at the community level. This result, like many results about shelter spell length, is not easy to reconcile with the idea that shelter spell length is a reflection of the seriousness of underlying problems. PMID:24610995

  5. The VA Maryland Health Care System's telemental health program.

    PubMed

    Koch, Edward F

    2012-05-01

    The VA Maryland Health Care System introduced videoconferencing technology to provide psychiatry, evidenced-based psychotherapy, case management, and patient education at rural clinics where it was difficult to recruit providers. Telemental health services enable rural clinics to offer additional services, such as case management and patient education. Services have been expanded to urban outpatient clinics where a limited number of mental health clinic hours are available. This technology expands the availability of mental health providers and services, allowing patients to receive services from providers located at distant medical centers.

  6. Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non-VA Hospitals?

    ERIC Educational Resources Information Center

    Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.

    2009-01-01

    Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

  7. Development of fragility functions to estimate homelessness after an earthquake

    NASA Astrophysics Data System (ADS)

    Brink, Susan A.; Daniell, James; Khazai, Bijan; Wenzel, Friedemann

    2014-05-01

    Immediately after an earthquake, many stakeholders need to make decisions about their response. These decisions often need to be made in a data poor environment as accurate information on the impact can take months or even years to be collected and publicized. Social fragility functions have been developed and applied to provide an estimate of the impact in terms of building damage, deaths and injuries in near real time. These rough estimates can help governments and response agencies determine what aid may be required which can improve their emergency response and facilitate planning for longer term response. Due to building damage, lifeline outages, fear of aftershocks, or other causes, people may become displaced or homeless after an earthquake. Especially in cold and dangerous locations, the rapid provision of safe emergency shelter can be a lifesaving necessity. However, immediately after an event there is little information available about the number of homeless, their locations and whether they require public shelter to aid the response agencies in decision making. In this research, we analyze homelessness after historic earthquakes using the CATDAT Damaging Earthquakes Database. CATDAT includes information on the hazard as well as the physical and social impact of over 7200 damaging earthquakes from 1900-2013 (Daniell et al. 2011). We explore the relationship of both earthquake characteristics and area characteristics with homelessness after the earthquake. We consider modelled variables such as population density, HDI, year, measures of ground motion intensity developed in Daniell (2014) over the time period from 1900-2013 as well as temperature. Using a base methodology based on that used for PAGER fatality fragility curves developed by Jaiswal and Wald (2010), but using regression through time using the socioeconomic parameters developed in Daniell et al. (2012) for "socioeconomic fragility functions", we develop a set of fragility curves that can be

  8. 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. PMID:23512110

  9. Examining women's agency in managing intimate partner violence and the related risk of homelessness: The role of harm minimisation.

    PubMed

    Meyer, Silke

    2016-01-01

    Intimate partner violence (IPV) has a detrimental impact on women and children's emotional, physical and social well-being and has been identified as one of the most common contributors to women's experiences of housing instabilities and homelessness. Women affected by IPV often experience a great level of uncertainty around housing solutions when trying to leave an abusive partner. This study explores women's responses to IPV and the related risk of homelessness through women's narratives (n = 22) in Queensland, Australia. Of particular interest are women's decisions and actions to minimise the impact of IPV as well as homelessness on their and their children's safety and well-being. Findings reveal that women's agency in relation to harm minimisation can take various forms, including the decision to stay with, leave or return to an abusive partner. The data offer insights into women's strategic attempts to manage IPV and the related risk of homeless while trying to minimise the harm associated with one and the other. Implications for understanding women's agency in managing IPV and the related risk of homelessness and providing adequate support mechanisms to improve women and children's social, emotional and physical well-being are discussed.

  10. U.S. Minority Homeless Youth's Access to and Use of Mobile Phones: Implications for mHealth Intervention Design.

    PubMed

    Jennings, Larissa; Lee, Nicole; Shore, Deborah; Strohminger, Nancy; Allison, Burgundi; Conserve, Donaldson F; Cheskin, Lawrence J

    2016-07-01

    Few interventions for homeless youth have leveraged the potential of mHealth technologies, in part because of the limited data on phone behaviors, perceptions, and intervention preferences among youth experiencing homelessness. We conducted 9 focus groups (n = 52 homeless youth) and 41 individual structured interviews also with homeless youth in underserved communities in Baltimore and Washington, DC, to ascertain how youth perceived their mobile phone, acquired and maintained mobile services over time, and thought mHealth programs for this population should be designed. We also measured phone use, functionality, source, duration of ownership, and reasons for changing phones or numbers. Results showed that mobile coverage was high, as most youth self-purchased phones or received gift payments from others. Maintaining mobile connectivity was often challenging because of financial constraints and interpersonal conflict. Youth valued phones to access social support but used several tactics to avoid perceived negative consequences of phone ownership, such as harassment, theft, or relational disputes. Youth most preferred mHealth content relating to sexual, reproductive, and mental health provided that mobile communication was confidential, empowering, and integrated with other digital media. Integrating hidden phones, financial support, and safety management may improve homeless youth's access to and engagement with mHealth strategies over time. PMID:27232544

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

    PubMed Central

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

    2014-01-01

    Objectives: 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. Methods: 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. Results: 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. Conclusion: 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. PMID:25320613

  12. Agreement Between HEDIS Performance Assessments in the VA and Medicare Advantage: Is Quality in the Eye of the Beholder?

    PubMed

    Trivedi, Amal N; Wilson, Ira B; Charlton, Mary E; Kizer, Kenneth W

    2016-01-01

    Medicare Advantage (MA) plans and the Veterans Affairs (VA) health care system assess quality of care using standardized Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. Little is known, however, about the relative accuracy of quality indicators for persons receiving care in more than one health care system. Among Veterans dually enrolled in an MA plan, we examined the agreement between MA and VA HEDIS assessments. Our study tested the hypothesis that private health plans underreport quality of care relative to a fully integrated delivery system utilizing a comprehensive electronic health record. Despite assessing the same individuals using identical measure specifications, reported VA performance was significantly better than reported MA performance for all 12 HEDIS measures. The VA's performance advantage ranged from 9.8% (glycosylated hemoglobin [HbA1c] < 7.0% in diabetes) to 54.7% (blood pressure < 140/90 mm Hg in diabetes). The overall agreement between VA and MA HEDIS assessments ranged from 38.5% to 62.6%. Performance rates derived from VA and MA aggregate data were 1.6% to 14.3% higher than those reported by VA alone. This analysis suggests that neither MA plans nor the VA fully capture quality of care information for dually enrolled persons. However, the VA's system-wide electronic health record may allow for more complete capture of quality information across multiple providers and settings. PMID:27033565

  13. Agreement Between HEDIS Performance Assessments in the VA and Medicare Advantage: Is Quality in the Eye of the Beholder?

    PubMed

    Trivedi, Amal N; Wilson, Ira B; Charlton, Mary E; Kizer, Kenneth W

    2016-01-01

    Medicare Advantage (MA) plans and the Veterans Affairs (VA) health care system assess quality of care using standardized Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. Little is known, however, about the relative accuracy of quality indicators for persons receiving care in more than one health care system. Among Veterans dually enrolled in an MA plan, we examined the agreement between MA and VA HEDIS assessments. Our study tested the hypothesis that private health plans underreport quality of care relative to a fully integrated delivery system utilizing a comprehensive electronic health record. Despite assessing the same individuals using identical measure specifications, reported VA performance was significantly better than reported MA performance for all 12 HEDIS measures. The VA's performance advantage ranged from 9.8% (glycosylated hemoglobin [HbA1c] < 7.0% in diabetes) to 54.7% (blood pressure < 140/90 mm Hg in diabetes). The overall agreement between VA and MA HEDIS assessments ranged from 38.5% to 62.6%. Performance rates derived from VA and MA aggregate data were 1.6% to 14.3% higher than those reported by VA alone. This analysis suggests that neither MA plans nor the VA fully capture quality of care information for dually enrolled persons. However, the VA's system-wide electronic health record may allow for more complete capture of quality information across multiple providers and settings.

  14. 38 CFR 17.56 - Payment for non-VA physician and other health care professional services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...' (CMS) participating physician fee schedule for the period in which the service is provided (see 42 CFR...-VA physician and other health care professional services. (a) Except for anesthesia services, and... schedule or if the services constitute anesthesia services, payment for such non-VA health...

  15. 75 FR 26160 - Drug and Drug-Related Supply Promotion by Pharmaceutical Company Sales Representatives at VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-11

    ... VA medical facilities, including but not limited to hospitals, CBOCs, nursing homes, and... Veterans Nursing Home Care and 64.011 Veterans Dental Care. Signing Authority The Secretary of Veterans... VA facilities, and provide sales representatives with a consistent standard of permissible...

  16. Merging the fields of mental health and social enterprise: lessons from abroad and cumulative findings from research with homeless youths.

    PubMed

    Ferguson, Kristin M

    2012-08-01

    Despite the growing integration of supported employment within the mental health system in the United States as well as the widespread use of social enterprises abroad, the fields of mental health and social enterprises remain largely separate in the USA. The mental health field currently lacks a response that strengthens homeless youths' existing human and social capital, provides them with marketable job skills and employment, and impacts their mental health. To address this gap, this paper establishes a case for using social enterprises with homeless youths, drawing on both global precedents and findings from a mixed-methods study of a social enterprise intervention with homeless youths. Recommendations are offered for how to integrate social enterprises with mental health treatment as well as how to evaluate their impact on mental health outcomes.

  17. Wellbeing for homeless people: a Salutogenic approach.

    PubMed

    Dunleavy, Andrew; Kennedy, Lynne Alexandra; Vaandrager, Lenneke

    2014-03-01

    Homelessness affects considerable numbers in the UK and is caused by poverty and social exclusion. Much of the literature on housing and health is disease centric, where the experience of homelessness is described as traumatic, disempowering and socially isolating. Based on the Salutogenic approach, which calls for a positive orientation on health, the aim of this study was to explore the subjective lived experiences of wellbeing in the situated context of homeless people's lives. Nine in-depth qualitative interviews with temporarily housed adults (>25 years) in a socio-economically deprived region of North-west England were held. Accounts of renewed self-confidence, perceived resourcefulness and continual personal participation are said to be supporting wellbeing. A strong belief, or sense of coherence, in internal and external general resistance resources was a critical enabling factor for those living in temporary accommodation. Wellbeing was consistently linked with both social and formal activities; keeping occupied and having a strong sense of purpose were essential to wellbeing. In utilizing a Salutogenic approach we demonstrate how the 'context and meaning' of health actions can improve the understanding about the kinds of factors influencing wellbeing.

  18. Correlates of Frailty Among Homeless Adults

    PubMed Central

    Salem, Benissa E.; Nyamathi, Adeline M.; Brecht, Mary-Lynn; Phillips, Linda R.; Mentes, Janet C.; Sarkisian, Catherine; Leake, Barbara

    2013-01-01

    Frailty, a relatively unexplored concept among vulnerable populations, may be a significant issue for homeless adults. This cross-sectional study assessed correlates of frailty among middle age and older homeless adults (N = 150, 40–73). A Pearson (r) bivariate correlation revealed a weak relationship between frailty and being female (r = .230, p < .01). Significant moderate negative correlations were found between frailty and resilience (r = −.395, p < .01), social support (r = −.377, p < .01), and nutrition (r = −.652, p < .01). Furthermore, Spearman’s rho (rs) bivariate correlations revealed a moderate positive relationship between frailty and health care utilization (rs = .444, p < .01). A stepwise backward linear regression analysis was conducted and in the final model, age, gender, health care utilization, nutrition, and resilience were significantly related to frailty. Over the next two decades, there is an anticipated increase in the number of homeless adults which will necessitate a greater understanding of the needs of this hard-to-reach population. PMID:23676627

  19. Understanding heterosexual condom use among homeless men.

    PubMed

    Tucker, Joan S; Wenzel, Suzanne L; Golinelli, Daniela; Kennedy, David P; Ewing, Brett; Wertheimer, Samuel

    2013-06-01

    This study uses an event-based approach to examine individual, relationship, and contextual correlates of heterosexual condom use among homeless men. Structured interviews were conducted with a predominantly African American sample of 305 men recruited from meal lines in the Skid Row area of Los Angeles. Men reported on their most recent heterosexual event involving vaginal or anal intercourse. Adjusting for demographic characteristics only, condom use was more likely when men had higher condom use self-efficacy, greater HIV knowledge, or talked to their partner about condoms prior to sex. Condom use was less likely when men held more negative attitudes towards condoms, the partner was considered to be a primary/serious partner, hard drug use preceded sex, or sex occurred in a public setting. Condom attitudes, self-efficacy, partner type, and communication were the strongest predictors of condom use in a multivariate model that included all of the above-mentioned factors. Associations of unprotected sex with hard drug use prior to sex and having sex in public settings could be accounted for by lower condom self-efficacy and/or less positive condom attitudes among men having sex under these conditions. Results suggest that it may be promising to adapt existing, evidence-based IMB interventions for delivery in non-traditional settings that are frequented by men experiencing homelessness to achieve HIV risk reduction and thus reduce a significant point of disparity for the largely African American population of homeless men. PMID:22392155

  20. Using electronic patient records in mental health care to capture housing and homelessness information of psychiatric consumers.

    PubMed

    Booth, Richard G

    2006-12-01

    Homelessness among people with psychiatric illness is at an all time high. Many explanations for this phenomenon exist, including the incidence of discharge from inpatient hospital directly into the streets or shelter system. With little known about this unseen social issue afflicting many mental health consumers, this manuscript provides recommendations for using electronic patient records (EPR) as a conduit to capture housing and homelessness related information. With the increased use of EPRs in the Canadian health care system, the research and clinical benefits of this technology have only recently begun to be realized in mental health care. PMID:17050339

  1. Identifying the Precipitants of Homeless Protest across 17 U.S. Cities, 1980 to 1990

    ERIC Educational Resources Information Center

    Snow, David A.; Soule, Sarah A.; Cress, Daniel M.

    2005-01-01

    During the 1980s, homeless people formed social movement organizations and mobilized collective action events in cities across the US. From the vantage point of social movement theories and scholarship on homelessness, it is surprising that homeless protest was so prevalent in the 1980s. Yet we find evidence of homeless protest events across no…

  2. Arizona Head Start for Homeless Children and Families Project. 1995-96 Evaluation Report.

    ERIC Educational Resources Information Center

    Mulholland, Lori

    Homeless families with children constitute the fastest growing segment of the United States homeless population. This study evaluated Year 2 of the Arizona Head Start for Homeless Children and Families Project, designed to meet educational and social needs of homeless children and families, and to assist Head Start agencies in developing effective…

  3. Factors Associated with Homelessness of Adolescents under Supervision of the Youth Protection System

    ERIC Educational Resources Information Center

    Robert, Marie; Pauze, R.; Fournier, L.

    2005-01-01

    There are two factors that limit our knowledge of the risk factors associated with homelessness among runaway adolescents, namely (1) the samples used are often composed of youth homeless service users and/or youths living on the streets (visible homelessness), whereas most adolescents in fact use ''private'' resources (hidden homelessness), and…

  4. 75 FR 29366 - ``Homeless Veterans' Reintegration Program (HVRP) National Technical Assistance Center...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-25

    ... of the Assistant Secretary for Veterans' Employment and Training ``Homeless Veterans' Reintegration... the Homeless Veterans' Reintegration Program (HVRP) to include the Homeless Female Veterans and... to expedite the reintegration of homeless Veterans into the labor force. In order to assist the...

  5. Homeless Education and Social Capital: An Examination of School and Community Leaders

    ERIC Educational Resources Information Center

    Miller, Peter M.

    2011-01-01

    Background/Context: This study contributes to the literature on the schooling of homeless and highly mobile students. Although previous work has detailed the demographics of homelessness, the effects of homelessness on academic progress, and particular legal issues in homeless education, this research focused on how individual and institutional…

  6. Homelessness among Lesbian, Gay, and Bisexual Youth: Implications for Subsequent Internalizing and Externalizing Symptoms

    ERIC Educational Resources Information Center

    Rosario, Margaret; Schrimshaw, Eric W.; Hunter, Joyce

    2012-01-01

    Although lesbian, gay, and bisexual (LGB) youth with a history of homelessness (running away or being evicted from their homes by parents) report more psychological symptoms than homeless heterosexual peers, it is unclear whether symptoms are due to homelessness, given the absence of a non-homeless comparison group. This study longitudinally…

  7. Multilevel Considerations of Family Homelessness and Schooling in the Recession Era

    ERIC Educational Resources Information Center

    Miller, Peter; Schreiber, James

    2012-01-01

    This mixed methods investigation of homeless education in a major urban region identified a number of significant developments and dilemmas amid the larger homeless crisis in the United States. We found that the wider community demographics of homelessness have shifted in recent years, resulting in a higher number of homeless families--many of…

  8. 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…

  9. Learning from Families Experiencing Homelessness--How School Leaders Can Make a Difference through Transformative Leadership

    ERIC Educational Resources Information Center

    Warke, Amy L.

    2012-01-01

    Homelessness is a growing phenomenon, especially among women and children (Hulchanski, 2009). This study was conducted because of the increase in families experiencing homelessness registering in my school. In none of the current studies about homelessness have the researchers spoken to the families and children experiencing homelessness. This…

  10. The Dynamics of Families Who Are Homeless: Implications for Early Childhood Educators

    ERIC Educational Resources Information Center

    Swick, Kevin J.

    2004-01-01

    Family homelessness has emerged as a serious global problem (Stronge, 2000). Over the past 25 years in the United States, the makeup of the homeless population has changed significantly. As De Angelis (1994) reports: The landscape of homelessness has changed since the early 1980s, when nearly all homeless people were men. Today,…

  11. Hawai'i State Plan for the Education of Homeless Children and Youth.

    ERIC Educational Resources Information Center

    Hawaii State Dept. of Education, Honolulu. Office of the Superintendent.

    In 1987, Congress passed the Stewart B. McKinney Homeless Assistance Act. One of its provisions was that each child of a homeless individual and each homeless youth have access to a free, appropriate public education. As required by the Act, the state prepared a plan for indirect and direct educational services to the homeless children of Hawaii.…

  12. 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

    ..., construct, manage, maintain and operate the EUL development. As consideration for the lease, the lessee will... will be set aside to provide transitional housing and supportive services for homeless and at-risk... business plan proposed by the Under Secretary for Health for applying the consideration under such a...

  13. 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

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... placement for homeless and/or at-risk Veterans and their families; and provide a supportive services program... by the Under Secretary for Health for applying the consideration under such a lease for the...

  14. 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

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... homeless and at-risk Veterans and their families; and provide a supportive services program. FOR FURTHER... for applying the consideration under such a lease for the provision of medical care and services...

  15. 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

    ... and operate the EUL development. As consideration for the lease, the lessee will be required to... placement for homeless and/or at-risk Veterans and their families; and provide a supportive services program... by the Under Secretary for Health for applying the consideration under such a lease for the...

  16. Semi-nonparametric VaR forecasts for hedge funds during the recent crisis

    NASA Astrophysics Data System (ADS)

    Del Brio, Esther B.; Mora-Valencia, Andrés; Perote, Javier

    2014-05-01

    The need to provide accurate value-at-risk (VaR) forecasting measures has triggered an important literature in econophysics. Although these accurate VaR models and methodologies are particularly demanded for hedge fund managers, there exist few articles specifically devoted to implement new techniques in hedge fund returns VaR forecasting. This article advances in these issues by comparing the performance of risk measures based on parametric distributions (the normal, Student’s t and skewed-t), semi-nonparametric (SNP) methodologies based on Gram-Charlier (GC) series and the extreme value theory (EVT) approach. Our results show that normal-, Student’s t- and Skewed t- based methodologies fail to forecast hedge fund VaR, whilst SNP and EVT approaches accurately success on it. We extend these results to the multivariate framework by providing an explicit formula for the GC copula and its density that encompasses the Gaussian copula and accounts for non-linear dependences. We show that the VaR obtained by the meta GC accurately captures portfolio risk and outperforms regulatory VaR estimates obtained through the meta Gaussian and Student’s t distributions.

  17. Homeless female U.S. veterans in a national supported housing program: comparison of individual characteristics and outcomes with male veterans.

    PubMed

    Tsai, Jack; Rosenheck, Robert A; Kane, Vincent

    2014-08-01

    As more women serve in the U.S. military, the proportion of females among homeless veterans is increasing. The current study compares the individual characteristics and 1-year outcomes of homeless female and male veterans in the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program nationally. Administrative data on 43,853 veterans (10.69% females; 89.31% males) referred to HUD-VASH were analyzed for gender differences at baseline and over a 1-year period. Homeless female veterans were younger, had shorter homeless and incarceration histories, and were less likely to have substance use disorders than men. However, despite being less likely to report combat exposure, female veterans were more likely to have posttraumatic stress disorder. Homeless female veterans were also much more likely to have dependent children with them and to plan to live with family members in supported housing. Once admitted to HUD-VASH, there were no gender differences in attrition or main housing outcomes. Case managers were faster to admit female veterans to the program, reported better working alliances, and provided more services related to employment and income than male veterans. These findings suggest homeless female veterans may have certain strengths, including being younger, less involved in the criminal justice system, and more adept at relating to professional and natural supports; but special attention to noncombat trauma and family-oriented services may be needed. PMID:24730678

  18. Pregnancy and Sexual Health among Homeless Young Injection Drug Users

    ERIC Educational Resources Information Center

    Hathazi, Dodi; Lankenau, Stephen E.; Sanders, Bill; Bloom, Jennifer Jackson

    2009-01-01

    Research on pregnancy and sexual health among homeless youth is limited. In this study, qualitative interviews were conducted with 41 homeless young injection drug users (IDUs) in Los Angeles with a history of pregnancy. The relationship between recent pregnancy outcomes, contraception practices, housing status, substance use, utilization of…

  19. Prevalence and Predictors of Sexual Risks Among Homeless Youth

    ERIC Educational Resources Information Center

    Halcon, Linda L.; Lifson, Alan R.

    2004-01-01

    This study examined prevalence of sexual risks among homeless adolescents and described factors associated with those risks. Community-based outreach methods were used successfully to access this difficult-to-reach population. The sample included 203 homeless youth aged 15-22 recruited from community sites. Questionnaire items addressed…

  20. Summer Literacy Intervention for Homeless Children Living in Transitional Housing

    ERIC Educational Resources Information Center

    Willard, Adrienne Lisa; Kulinna, Pamela Hodges

    2012-01-01

    This study reports the findings of a six-week summer literacy program conducted at a transitional housing facility for homeless families in the Southwestern region of the U.S. This study is grounded on the body of knowledge on students' literacy and homelessness. The intervention included one-on-one instruction by tutors. This study examined…

  1. Idealized Visions from Outside: Homeless Perspectives on School Change

    ERIC Educational Resources Information Center

    Magolis, David; Carr-Chellman, Alison A.

    2013-01-01

    This article presents findings from a qualitative exploration of homeless individuals' experiences and their perspectives on ideal designs of schools. The article is part of a larger research project titled "Unheard Voices," which explores marginalized individuals' (homeless, prisoners, working poor, and migrant workers)…

  2. The Impact of Homelessness on the Health of Families

    ERIC Educational Resources Information Center

    Morris, Rita I.; Strong, Linda

    2004-01-01

    Qualitative research using the symbolic interactionism framework and grounded theory methodology was employed to discover the perceived health problems and dangers that homeless families with children endure. Data were collected using semistructured interviews from 34 homeless volunteer participants with 87 children. An in-depth analysis of the…

  3. Bringing It Home: Understanding the Lives of Homeless Youth

    ERIC Educational Resources Information Center

    Tierney, William G.

    2015-01-01

    In this commentary, the author reflects on a special issue that explores how educational institutions serve homeless and highly mobile students as well as their families. The number of homeless youth continues to rise, leading the author to question why structural constraints have not been removed. In addition to reflecting on the articles, he…

  4. The State of Homeless Children in the United States

    ERIC Educational Resources Information Center

    Kabler, Brenda; Weinstein, Elana

    2009-01-01

    Across America, the numbers of homeless children and families are growing as a result of many factors including the recent economic crisis, home foreclosures, and natural disasters. Because of an increase in the number of homeless children throughout the United States, this population has unmet needs that can be targeted in school settings under…

  5. Deja Vu: Family Homelessness in New York City.

    ERIC Educational Resources Information Center

    Institute for Children and Poverty, New York, NY.

    This report describes family homelessness in New York City, which has risen sharply since 1980. Currently, the City's family shelter system is at capacity. Homeless children are typically raised by single mothers who receive no child support, are 27 years old, are unemployed and receiving welfare, and have had at least one public assistance…

  6. 77 FR 1971 - Supplemental Security Income and Homeless Individuals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-12

    ... ADMINISTRATION Supplemental Security Income and Homeless Individuals AGENCY: Social Security Administration..., including those individuals who are homeless. According to the United States Department of Housing and Urban... transitional housing program; the vast majority of these individuals (nearly 80 percent) spent time only in...

  7. Homelessness and the Fiscal Year 1993 Federal Budget.

    ERIC Educational Resources Information Center

    National Coalition for the Homeless, Washington, DC.

    This paper analyzes the Bush Administration's budget request for homelessness programs, and argues that it promised little to alleviate the suffering of homeless people. The paper asserts that the proposal is the weakest in years, with overall spending down by 7 percent when adjusted for inflation. Programs hardest hit are new funding to increase…

  8. Heart to Heart Art: Empowering Homeless Children and Youth

    ERIC Educational Resources Information Center

    Shepard, Jerri; Booth, Deborah

    2009-01-01

    This article describes Heart to Heart Art, an after-school program developed for homeless children and youth at the YWCA in Spokane, Washington. Pre-service teacher candidates from a local university create meaningful activities that engage homeless students in visual art, music, drama, cooking, and community service. Heart to Heart Art was…

  9. 76 FR 33788 - Homeless Veterans' Reintegration Into Employment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-09

    ...' Employment and Training Service Homeless Veterans' Reintegration Into Employment AGENCY: Veterans' Employment... Veterans Reintegration Program through fiscal year (FY) 2011 and indicates: ``The Secretary of Labor shall... training) to expedite the reintegration of homeless veterans into the labor force.'' HVRP grants...

  10. Visible Voices: Literacy Identity and the Invisible Homeless

    ERIC Educational Resources Information Center

    Juchniewicz, Melissa M.

    2012-01-01

    Despite calls for increased awareness of and sensitivity to diverse students and their in- and out-of-school literacies, the "invisible homeless"--those who often decline to self-identify--receive inadequate scholarly attention. They are often individuals who fear the stigma associated with homelessness as they navigate workplace, academic, and…

  11. The Characteristics and Needs of Families Experiencing Homelessness

    ERIC Educational Resources Information Center

    National Center on Family Homelessness (NJ1), 2011

    2011-01-01

    This fact sheet was developed to help you understand the scope, causes, and impact of homelessness on children and families. You are encouraged to use it as well as the publications cited in its footnotes as tools more about homelessness. (Contains 78 endnotes.)

  12. Homelessness, Violence Exposure, and School Participation among Urban Adolescent Mothers

    ERIC Educational Resources Information Center

    Kennedy, Angie C.

    2007-01-01

    Using a risk and resilience framework, this exploratory study examines the relationships between homelessness, exposure to multiple types of violence, and school participation within a survey sample of poor adolescent mothers living in an urban setting. Participants who were homeless either currently or historically were compared with participants…

  13. Perceptions of Resiliency and Coping: Homeless Young Adults Speak Out

    ERIC Educational Resources Information Center

    Thompson, Sanna J.; Ryan, Tiffany N.; Montgomery, Katherine L.; Lippman, Angie Del Prado; Bender, Kimberly; Ferguson, Kristin

    2016-01-01

    This study explored the perceptions of resilience and coping among homeless young adults, a focus that differs from previous research by considering the unconventional resilience and coping of this high-risk population. Semistructured qualitative interviews were conducted with 45 homeless young adults. Individual interviews were audio recorded,…

  14. The Relationship between Learning Disabilities and Homelessness in Adults

    ERIC Educational Resources Information Center

    Markos, Patricia A.; Strawser, Sherri

    2004-01-01

    This article describes the relationship between learning disabilities (LD) and homelessness. Research describing the connection between disabilities and homelessness has focused on individuals presenting with disabilities such as mental illness, physical disabilities, medical disabilities, or substance abuse. At this time, the presence of LD in…

  15. Answering the Call: Facilitating Responsive Services for Students Experiencing Homelessness

    ERIC Educational Resources Information Center

    Grothaus, Tim; Lorelle, Sonya; Anderson, Kie; Knight, Jasmine

    2011-01-01

    After a review of the literature elucidating the status quo for students experiencing homelessness, this article shares the results of a mixed methods study. With a phenomenological qualitative emphasis, the mixed methods study explored the perceptions of parents and children experiencing homelessness regarding their academic needs and the…

  16. Spaces of Trauma: Young People, Homelessness and Violence

    ERIC Educational Resources Information Center

    Jordan, Lucinda

    2012-01-01

    Little contemporary research has examined young people's experiences of violence and homelessness in detail within the Australian context. This article draws upon qualitative research with 33 homeless youth in Melbourne and seeks to enhance understanding of the impact of violence on young people. It argues that everyday experiences of violence…

  17. Predicting Overt and Covert Antisocial Behaviors: Parents, Peers, and Homelessness

    ERIC Educational Resources Information Center

    Tompsett, Carolyn J.; Toro, Paul A.

    2010-01-01

    Parental deviance, parental monitoring, and deviant peers were examined as predictors of overt and covert antisocial behaviors. Homeless (N=231) and housed (N=143) adolescents were assessed in adolescence and again in early adulthood. Homelessness predicted both types of antisocial behaviors, and effects persisted in young adulthood. Parental…

  18. Adult Education for the Homeless: A Program in Jeopardy.

    ERIC Educational Resources Information Center

    Office of Vocational and Adult Education (ED), Washington, DC. Div. of Adult Education and Literacy.

    During its 8-year history, the federal Adult Education for the Homeless Program (AEH) pioneered new methods of service to adults in need and benefited over 320,000 homeless adults and families. Despite an evaluation that documented program success, funding was rescinded from the 1995 federal budget and never reinstated. AEH programs developed the…

  19. Substance Use and Health and Safety among Homeless Youth

    ERIC Educational Resources Information Center

    Rhule-Louie, Dana M.; Bowen, Sarah; Baer, John S.; Peterson, Peggy L.

    2008-01-01

    This study examines how substance use is associated with the health and safety of homeless youth using cross-sectional, self-report data from 285 homeless adolescents. Path models were used to examine concurrent relationships between youth's substance use and multiple aspects of their health and safety, including measures of psychological…

  20. How You Can Help Students Who Are Homeless

    ERIC Educational Resources Information Center

    Curriculum Review, 2009

    2009-01-01

    Many schools are struggling with high numbers of homeless students. Some research has suggested that homeless students are often experiencing exhaustion, hunger, stress, abuse and insecurity, making socialization and learning more difficult for them than it is for their peers. This paper discusses three easy ways school professionals can help and…