JOIN US IN KANSAS CITY | MAY 16-18, 2012 

Dr. Bookhardt-Murray

"A little drop of kindness goes a long way. That little drop can make a big difference in somebody's life, especially the more in need of it they are. I just try to look each person in the eye and connect with something. Be patient. Be understanding. Be compassionate and don't judge people."    

Dr. Jeannine Bookhardt-Murray, Chief Medical Officer, Harlem United, connected with Dr. Darlene Jenkins, Research Director, National Health Care for the Homeless Council, to discuss Dr. Bookhardt-Murray's career, how she became involved with HCH services, the work of Harlem United and the Upper Room AIDS Ministry and her strategies for self-care. FULL INTERVIEW 

John Lozier, MSSW

"Get all homeless people on Medicaid." That was goal #1 of our Medicaid Reform Committee in 2001. We've been at this a long time, and finally that goal is within sight.
 
In 2014, the Affordable Care Act (ACA) will extend Medicaid to most people under 133% of poverty. That will include most of our homeless neighbors. This is a momentous victory worth defending, but it is a fragile and incomplete accomplishment. FULL LETTER  

CHRONIC PAIN GUIDELINES 

The HCH Clinicians' Network developed clinical guidelines, Adapting Your Practice: Recommendations for the Care of Homeless Adults with Chronic Non-Malignant Pain, that have been accepted to the National Guidelines Clearinghouse of the U.S. Department of Health and Human Services and are now posted to their website.  

CALL FOR HEALING HANDS TOPICS

The Network Communications Committee seeks topic suggestions for upcoming issues of Healing Hands, the Network's clinical newsletter, which reflects issues of concern to direct service providers and program administrators who serve people experiencing homelessness. Email topic ideas to Victoria Raschke by March 30th. 

OPIOID DEPENDENCE
An Introduction to Extended-Release Injectable Naltrexone for the Treatment of People with Opioid Dependence, from the Substance Abuse and Mental Health Services Administration, provides an overview of extended-release injectable naltrexone (Vivitrol), a treatment for people with opioid dependence. It also discusses how this treatment differs from other medication-assisted treatments, safety concerns, and patients most likely to benefit from this treatment. 

CLINICAL DECISION SUPPORT  

The Primary Care Development Corporation recently released Translating Evidence into Practice: A How-To Manual for Implementing Clinical Decision Support, which provides step-by-step guidance for medical directors and senior leaders at primary care organizations to implement quality improvement initiatives, with a special focus on using electronic health records to advance chronic disease management. The manual was developed following a two year project with Open Door Family Medical Centers (Open Door), a federally qualified health center (FQHC) with four practice sites in Westchester County, NY, serving over 40,000 underserved patients.

MENTAL HEALTH CARE FOR UNDERSERVED POPULATIONS  

Connecting with Care (CWC) is a collaborative project between Boston Public Schools and community service agencies to provide school-based mental health services to students and their families living in high-crime, urban neighborhoods. Data suggest that the program has enhanced access to cost-effective mental health treatment that has improved children's mental and behavioral health. View more profiles of innovations related to mental health care and vulnerable populations on the Health Care Innovations Exchange website.

CHILDREN AND TRAUMA
The Campaign to End Child Homelessness presents a free training series on trauma and trauma-informed care: Children and Trauma: Understanding Impact and Strengthening Resilience. Special focus will be given to kids and families experiencing homelessness and how organizations can provide trauma-informed services to these populations. Register for the first webinar, Understanding the Impact of Trauma on Children, scheduled for March 14, 2012.   

CO-OCCURRING DISORDERS TRAINING
Focus on Integrated Treatment (FIT) is a cost-effective, interactive online training program that helps you develop the skills needed to successfully deliver an integrated treatment plan for clients with co-occurring substance use and mental health disorders. Learn more about the courses and register for FIT.

WEBINAR ON COMORBID CONDITIONS
The National Council for Community Behavioral Healthcare webinar, Preparing for New Treatment Expectations: Addressing Comorbid Mental and Physical Conditions, recorded on January 11, highlights key findings from the Robert Wood Johnson Foundation Synthesis Report, Mental Disorders and Medical Comorbidity, on caring for comorbid conditions. The webinar also included discussion of the TEAMcare Model and the "key ingredients" for successful clinical models that address multiple chronic conditions.

INSULIN PEN USAGE
As part of the CDC Expert Video Commentary Series on Medscape, CDC's Dr. Melissa Schaefer talks about the infection risks associated with sharing insulin pens. In the brief video, "Don't Do It: Sharing Insulin Pens Jeopardizes Patients," she reviews key points on the safe use of insulin pens. Protection from infections, including bloodborne pathogens, is a basic expectation anywhere that healthcare is provided. Read the recent CDC Clinical Reminder on Insulin Pen Usage.

SCREENING FOR TRAUMA
The Primary Care Post-Traumatic Stress Disorder (PC-PTSD) is a four-item screen that was designed for use in primary care and other medical settings and is currently used to screen for PTSD in veterans at the VA. The screen includes an introductory sentence to cue respondents to traumatic events. The authors suggest that in most circumstances the results of the PC-PTSD should be considered "positive" if a patient answers "yes" to any 3 items.
 
The Family Health History Questionnaire, used in the Adverse Childhood Events (ACE) study, provides a history of childhood maltreatment and household dysfunction that is highly correlated with adult psychological and physical well-being. Patients may not connect their own traumatic experiences to their current health conditions, so providers can help make the connection by utilizing these questionnaires in their practices.   

JANUARY HCH RESEARCH UPDATE 

In its quarterly HCH Research Update, the Council summarizes recent publications on health care and homelessness. January's issue, compiled from PubMed database, includes articles from approximately October to December 2011. Summaries are categorized into themes that vary by quarter. FULL UPDATE

RESEARCH SYMPOSIUM AT THE NATIONAL HCH CONFERENCE   

The Council will host its third research symposium at the 2012 National HCH Conference & Policy Symposium. This all-day Pre-Conference Institute, "Improving Chronic Pain Management for Individuals who are Homeless through Research and Evidence-Based Practices," will include a presentation on the most current scientific literature on chronic pain management and homelessness as well as a panel of clinicians providing promising practices for this area of care. To learn more, visit the conference agenda.    

PRACTICE-BASED RESEARCH NETWORK 

The Council's HCH Practice-Based Research Network (PBRN) focuses on research in clinical settings that explores issues affecting the primary health care needs of those experiencing homelessness. To learn more about joining the PBRN and receive invitations to participate in studies, please contact Darlene Jenkins, DrPH, the Council's Director of Evaluation and Research. Our newest PBRN member is:

• Dr. Paul Gregerson | John Wesley Community Health Institute | Los Angeles, CA

If you are interested in conducting research with the HCH PBRN, please complete the Research Proposal Form.

CONTRACEPTIVE SERVICES FOR WOMEN EXPERIENCING HOMELESSNESS: FIRST HCH PBRN JOURNAL ARTICLE   

Results from the first study conducted with our HCH Practice-Based Research Network were recently published in Women & Health journal by Barry Saver, MD, MPH, Linda Weinreb, MD, Lillian Gelberg, MD, MSPH, and Suzanne Zerger, PhD. The investigators surveyed HCH providers regarding the availability of contraceptive services at their projects and barriers to providing those services. The survey revealed that a majority of the participants provided some form of contraception (i.e. condoms, oral, injectable) but that very few provided the most effective forms of contraception (i.e. intrauterine devices, implants). ACCESS THE ABSTRACT 

CALL FOR CURRENT RESEARCH PROJECTS

Have you, your clinic, or organization been actively engaged in a research project relevant to the HCH Community? The Council would like to feature active research among our members and HCH grantees in future issues of Council News. The newsletter would highlight research relevant to individuals experiencing homelessness. There will also be a potential opportunity to share your work via a Council-sponsored webinar. If you are currently involved in a research project that you would like highlighted, please contact Patrina Twilley with additional information.   

UPCOMING SURVEY ON UNIVERSITY/HCH PROGRAM COLLABORATIONS 

The Council is conducting a survey to learn more about how HCH programs collaborate with universities/medical schools for student placements. We are most interested in learning about the barriers and facilitators to this type of relationship (successes and challenges), and how collaborations are established/maintained. The survey will also explore how HCH programs are engaged in research.

The survey will be sent through Survey Monkey during the week of March 12th to all HCH administrators. We would greatly appreciate your feedback and your responses will help guide the work of the Council.

HOMELESS PERSONS MEMORIAL DAY    

More than 150 cities in 40 states and the District of Columbia held events on or around December 21st to honor their fallen homeless neighbors.  View the archive of events shared with NCAB. 

CONSUMERS AT NATIONAL CONFERENCE  

NCAB is excited to welcome several consumers who will present at the national conference in Kansas City: Tony Pelletier and Kristin Leve, who will present "Building Bridges with Law Enforcement," Rodney Dawkins and Raymond Burkes who will present "Establishing and Maintaining a CAB," Joseph Benson, who will co-present "Making Your Vote Count!" and Amy Grassette, who will co-present "Strategic Sharing." We will also welcome at least 35 Consumer Travel Subsidy recipients. 

CONSUMER PARTICIPATION OUTREACH

NCAB has recruited 10 sites to conduct this year's Consumer Participation Outreach (CPO) Survey, focusing on best practices around outreach and enrollment of hard-to-reach homeless persons. This data will be used to inform recommendations for effectively enrolling homeless persons in Medicaid as it expands to cover almost all HCH consumers in 2014. Thank you to each site for agreeing to support consumers in this important effort.  

NASHVILLE TRAINING ON SUICIDE PREVENTION TOOL   

Join us for a live training event on March 15, 2012, at Nashville's Oasis Center. Dr. Kelly Posner, Director of the Center for Suicide Risk Assessment, Columbia University, will present on the C-SSRS Suicide Prevention tool, with a question and answer session following the free presentation. The C-SSRS has been demonstrated in extensive international use to greatly increase the ability to assess a person's risk of suicide so that interventions and treatments can be targeted most effectively. For more details about the training, visit the Tennessee Justice Center's website.  

FOCUS GROUPS: HOW WILL MEDICAID EXPANSION WORK BEST FOR HOMELESS POPULATIONS?  

The National HCH Council is partnering with the Kaiser Commission on Medicaid and the Uninsured to conduct two rounds of focus groups in four cities. The first group will involve front line workers (outreach workers, benefits coordinators, case workers/managers, etc.) to determine how to best identify and enroll consumers in Medicaid and then engage them in health services. The second group will include Chief Executive Officers, Chief Financial Officers, and other management staff to determine how Medicaid managed care financing and other administrative changes will impact community based providers and the clients they serve. The four cities selected are Baltimore, Maryland; Houston, Texas; Portland, Oregon; and Chicago, Illinois. A policy brief will synthesize the challenges and solutions identified from the groups, and be circulated widely at the national level.
 
These focus groups represent an opportunity to raise awareness at a higher policy level of the specific issues facing homeless populations, the investments needed in outreach, and the breadth of services needed to meet comprehensive needs. The expansion of Medicaid in 2014 to most Americans at or below 133% of the federal poverty level--a key provision of the Affordable Care Act--is clearly the most significant change impacting individuals experiencing homelessness (currently 65% of HCH patients are uninsured). The Council encourages all HCH grantees (and others serving homeless populations) to work with health reform implementation efforts in their states and meet with their Medicaid director to emphasize the changes needed in order to ensure homeless populations are able to access benefits and care.   

HELP HOMELESS KIDS NOW!    

The Homeless Children and Youth Act, HR32, is bi-partisan legislation that would make it easier for homeless children, youth, and families to receive homeless assistance, no matter where they happen to be living. Urge your U.S. Representative to co-sponsor the Homeless Children and Youth Act. LEARN MORE AND ACT NOW