Housing & Services that Work for Homeless Older Adults
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Transcript of Housing & Services that Work for Homeless Older Adults
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Housing & Services that Work forHomeless Older Adults
DMH Housing InstituteJune 12, 2012
2029 Century Park East Suite 4393Los Angeles, CA 90067www.alaseniorliving.org
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Objectives
1) Review the challenges and experiences of housing homeless older adults in permanent supportive housing during the first year
2) Discuss partnership with LAC DMH Genesis
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Bonnie Brae Village Community
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Bonnie Brae Village Community
Onsite Supportive Services Intensive Case Management Crisis Intervention Counseling Recreational Programming & Activities
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Population (N = 45) At Entry• Average Age: 66 years old• Average Length of Homelessness: 7 years• Chronic Health Conditions (30% have ≥ 3)
Hypertension - Arthritis - Alcohol Abuse• Income Level and Source
$836/monthSSA and SSI VA pension (2)
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Population (N = 45)• Mental Health Diagnoses
Major Depressive D.O. w/ anxietySchizophrenia – paranoid typeBi-polarPTSD
• Health Insurance 28 Dual eligible (62%)11 Medi-Cal only (24%)2 VA benefits (4%)4 Insured after housed (9%)
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Staffing Pattern2.5 FTE and 1 MSW Intern
1.0 Clinical Specialist – LCSW1.0 Social Worker- MSW0.5 Service Coordinator
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Staffing
Recommended ExpertiseMental health training with a background in gerontology and a focus on serving the older adult populationCompetence with Medi-Cal and MedicareConversant in healthcare and medication issues
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Relevant Training Topics
Death and Dying Advanced directives and health care decisionsHospital / SNF DischargePublic GuardianHoarding
Systemic Challenge: In-patient substance abuse Tx for older adults
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Procedures Intake and assessment tools
- Psycho/Social - Problem Scale- MMSE - Falls
Assessment- Clock Draw
Client Management Software- AASC Online (Pangea Foundation)
Follow-up/ well checks Establish relationships with physicians Collect emergency contact information
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Recommended Infrastructure Transportation Physical Environment
- Home Secure Program Landline
- PERS/EARS (St. Barnabas) Relationship with emergency response
personnel Relationship with lead social workers at local
hospitals
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Challenges Unique to Older Adults • High Mortality• Need for Higher Level of Care• Managing Systems of Care (IHSS/Caregivers)General • Illegal Activity• Public Intoxication/Substance Abuse• Language and Cultural Challenges
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• Difficulty adjusting to the major life change- Mismatched coping skills
• Mixed response about services onsite- Stigma about mental illness and services
• Attitudes are not constant Gratitude Entitlement Dissatisfaction Acceptance
ChallengesEmotional Response to Housing
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Statistics for 2010 - 2011
Mortality: 4 deaths in 12 monthsHousing Retention Rate: 88% (98%)Service Engagement: 88% Evictions: 0
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In-Kind Service Partners Genesis- LAC DMH (MSW, RN, Psychiatrist) St. Barnabas Senior Services Silverlake Medical Center St. Vincent’s Medical Center Housing Works
- Housing Retention and Substance Abuse Work
USC Tingstad Older Adult Counseling Center- Geriatric Assessment Program (GAP)
Shelter Partnership- Household Goods Donations
- In-service Trainings for Staff
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Featured Partner: GENESIS- Operational Agreement with LAC-DMH
effective November 2011
- Schedule and Frequency
- Current Caseload
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Featured Partner: GENESIS
Partnership Goals
1)Improve tenants access to mental health services in a non-clinical setting2)Improve care coordination between onsite social workers and DMH clinicians
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Featured Partner: GENESIS
Benefits
•Access to a multidisciplinary team of professionals•Access to culturally and linguistically diverse staff•Field-based delivery model is flexible and convenient for older tenants
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Conclusions• Older adults represent a diverse population
with different needs and preferences• Service partners give tenants access to a
broader range of services both on and offsite