2016 Fall Regional Training Archived Materials
Thursday, September 22
| 7:30-8:30 a.m. | Registration/Check-in |
| 8:30-10 a.m. | • Housing Is Health Care? Prove it! Using Data to Address Social Determinants of Health • Possible Medicaid Expansion Changes in Kentucky: What’s Next Based on Lessons Learned in Indiana |
| 10-10:30 a.m. | Break |
| 10:30 a.m.–12 p.m. | • Harm Reduction Interventions in Supportive Housing • Do Ask, Do Tell! Collecting Data on Sexual Orientation and Gender Identity in Health Centers |
| 12-1 p.m. | Lunch (provided) |
| 1-2:30 p.m. | • The Impact of Syringe Exchange Programs • Consumer Engagement: Building Effective Organizational Structures |
| 2:30-3 p.m. | Break |
| 3-4:30 p.m. | • Cross-disciplinary Approaches to Drug Dependence and the Homeless • Consumer Engagement: Fostering Leadership Development |
| 5-6:30 p.m. | Networking Reception |
Friday, September 23
| 7:30-8:30 a.m. | Registration/Check-in |
| 8:30-10 a.m. | • Integrating Community Health Workers into Your HCH • Patient Satisfaction: A Conversation for Health Care for the Homeless Programs |
| 10-10:30 a.m. | Break |
| 10:30 a.m.–12 p.m. | • Delivering Clinical Preventive Health Services • Successes and Challenges of Managing a Medical Respite Program |
| 12-1 p.m. | Lunch (provided) |
| 1-2:30 p.m. | Listening Room/Focus Group: Substance Use and HCH |
| 2:30-3 p.m. | Break or End |
| 3-4:30 p.m. |
• Site Visits:
|
Workshop Descriptions
Thursday, September 22
8:30 – 10 a.m.
Housing Is Health Care? Prove it! Using Data to Address Social Determinants of Health
View slides from this presentation (PDF).
When we discuss social determinants of health, we sometimes use the terms “upstream” and “downstream”: upstream social factors like housing, education, and transportation flow down to impact people’s health. Unfortunately, most EMR systems are better at capturing data on the downstream effects than on the upstream causes. In this workshop, we’ll take an entertaining and conversational look at how social determinants of health impact people who are experiencing homelessness, and how we can use data to provide quality care and advocate for policy change. The panelists will begin by briefly sharing their personal approaches to collecting and using data on social determinants, but the majority of the workshop will focus on barriers that audience members face and opportunities to overcoming those barriers.
Speakers: Chuck Amos, MBA, Director of Performance Improvement, Health Care for the Homeless, Baltimore, MD; Chris Espersen, MSPH, Independent Contractor, Chris Espersen Consulting, Franklin Park, IL
Salon E
Possible Medicaid Expansion Changes in Kentucky: What’s Next Based on Lessons Learned in Indiana
View slides from this presentation (PDF). Additional materials: Medicaid Waiver Handout, Fact Sheet on Medicaid Expansion in Indiana, Fact Sheet on Medicaid Expansion in Kentucky.
Kentucky’s expansion of Medicaid in 2014 to many low-income adults previously ineligible for coverage enrolled over 450,000 people into Medicaid and cut its uninsured rate to 7.5% last year. Widely considered to be one of the most successful health care expansion programs in the country, the state is now proposing to change the Medicaid program in ways that may impact eligibility, coverage and benefits for poor and vulnerable populations. Indiana has a Medicaid program with components similar to the one Kentucky is proposing and has experience implementing strategies to overcome new barriers to care—especially for homeless populations—that may emerge. This workshop will provide an overview of the Kentucky Medicaid waiver proposal and identify how the program may change, lessons learned from an Indiana health center, and discussion about how enrollment activities in Kentucky may be impacted. Leadership from Indiana Health Centers will discuss the changes and challenges they have faced from administrative level and on the frontline with patient care. Conversation will also focus on how best to prepare for these changes, as well as continue to advocate for needed improvements that better enable access to comprehensive and affordable health care for health center patients.
Panelists: Elvin Plank, Chief Executive Officer, Indiana Health Centers, Indianapolis, IN; René Kougel, Chief Operating Officer, Indiana Health Centers, Indianapolis, IN; Dustin Pugel, Research and Policy Associate, Kentucky Center for Economic Policy, Berea, KY; Jackie Engle, Outreach & Enrollment Director, Family Health Centers, Inc., Louisville, KY
Moderator: Barbara DiPietro, PhD, Senior Director of Policy, National Health Care for the Homeless Council, Baltimore, MD.
Salon F-G
10:30 a.m. – 12 p.m.
Harm Reduction Interventions in Supportive Housing
View slides from this presentation (PDF).
Moving to a Harm Reduction model is essential to provide the most appropriate services to highly vulnerable populations in supportive and transitional housing. While Harm Reduction is a critical philosophy and practice in the health care world, navigating Harm Reduction in the housing arena can be challenging. With this shift towards Harm Reduction, housing providers have to address legal concerns, community stigma, and historical philosophies of care. Despite these challenges, Health Centers and housing providers can support each other in adopting this approach and creating effective care plans for mutual consumers. Join us as we discuss what Harm Reduction looks like in supportive housing and hear how Family Health Centers, Inc. has been able to blend Harm Reduction into their health, housing, and supportive service practices.
Speakers: Lauryn Berner, MSW, MPH, Project Manager, National Health Care for the Homeless Council, Nashville, TN; Nolan Nelson, MSSW, Health Care for the Homeless Supervisor, Family Health Centers, Inc., Louisville, KY
Salon E
Do Ask, Do Tell! Collecting Data on Sexual Orientation and Gender Identity in Health Centers
View slides from this presentation (PDF).
Lesbian, gay, bisexual, and transgender (LGBT) people face many health disparities and stigma in health care. Despite this, LGBT people remain largely invisible to their providers. Collecting sexual orientation and gender identity (SO/GI) data of new and returning patients is critical for health centers and other health care organizations to provide a welcoming, inclusive environment of care; and to provide high-quality care to all patients. HRSA recently added SO/GI data as a required element for the Uniform Data System (UDS) for CY 2016.
This presentation will teach participants about the barriers to care that many LGBT people face, describe the inequity in health outcomes for LGBT people, and detail both how and why to collect SO/GI data in electronic health records. At the end of the session, participants will have the tools to begin implementing data collection in their own electronic health records.
Speakers: Harvey Makadon, MD, FACP, Director of Education and Training Programs, The Fenway Institute, Fenway Health, Boston, MA and Chris Grasso, Associate Director of Informatics & Data Services, Fenway Health, Boston, MA.
Salon F-G
1 – 2:30 p.m.
The Impact of Syringe Exchange Programs
View slides from this presentation (PDF).
This presentation will describe for attendees the process the Louisville Metro Department of Public Health and Wellness went through to establish a syringe exchange program in Louisville. Included in the lecture will be a discussion of federal, state, and local regulations to consider when planning and implementing a syringe exchange program, community partnerships necessary for successful syringe exchange programs, and sources of funding for syringe exchange programs. There will be ample time for questions after the lecture portion of the presentation.
Speakers: Matthew La Rocco, CADC, Harm Reduction & Community Outreach Specialist, Louisville Metro Department of Public Health & Wellness, Louisville Metro Syringe Exchange Program, Louisville, KY
Salon E
Consumer Engagement: Building Effective Organizational Structures
View slides from this presentation (PDF).
After interviewing Consumer Leaders, Consumer Support Staff and HCH Executive Leaders, the National HCH Council developed a quick guide to highlight the value of consumer engagement and address the processes, benefits, and challenges of this work for Consumer Advisory Boards and Board of Directors. The guide includes strategies to create organizational structures for successful consumer engagement in governance and maximize these experiences, for both consumers and for sites. This workshop includes an overview of the guide and a discussion about the structures and supports needed to ensure consumers have more opportunities to shape health center governance.
Speakers: Katherine Cavanaugh, MSW, Consumer Advocate, National Health Care for the Homeless Council, Baltimore, MD; Valarie Dowell, BA, NCAB Co-Chair, Cincinnati Health Network, Cincinnati, OH
Salon F-G
3 – 4:30 p.m.
Cross-disciplinary Approaches to Drug Dependence and the Homeless
View slides from this presentation (PDF).
This interactive session will consist of cross-disciplinary analysis and planning for serving the needs of drug-dependent persons who experience homelessness. The session will be built around small group discussions about the range of needs and spectrum of approaches and strategies. Groups will be intentionally formed to include different members of clinical intervention teams, including consumers, and will consider ways in which varying state policies impact service provision. Individual groups will have opportunities to report to the larger group, as a way to cultivate cooperative learning and a team approach to addressing complex clinical and community problems.
Facilitators: Richard W. Wilson, DHSc, MPH, Professor and Chair, Health Promotion and Behavioral Sciences, University of Louisville, Louisville, KY and Susan Buchino, PhD, OTR/L, Senior Research Manager, Commonwealth Institute of Kentucky, University of Louisville, Louisville, KY
Salon E
Consumer Engagement: Fostering Leadership Development
View slides from this presentation (PDF).
Organizations committed to promoting social justice and challenging systemic oppression and exclusion of marginalized populations must start by confronting their own organizational processes and patterns to ensure they don’t inadvertently repeat similar patterns. If we believe that those without housing should not be deprived of democratic rights, we must encourage the democratic participation of HCH consumers throughout our organizations, and implement decision making processes that promote genuine leadership – moving beyond typical models of engagement. In this workshop, we will discuss the qualities and skills that contribute to effective leadership, as well as ways that our organizations can create and foster spaces that allow people to enhance qualities and develop skills of effective leaders – such as emotional intelligence communication, self-awareness, and critical thinking.
Speakers: Katherine Cavanaugh, MSW, Consumer Advocate, National Health Care for the Homeless Council, Baltimore, MD; Rodney Dawkins, Community Health Worker, Heartland Health Outreach, Chicago, IL.
Salon F-G
5 – 6:30 p.m.
Networking Reception
Join your colleagues and Council staff for networking and fun after workshops at our opening reception. This is a great opportunity to connect with peers from across the region and learn more about the National HCH Council. Hors d’oeuvres and non-alcoholic beverages will be provided, and a cash bar will be available.
The Networking Reception is funded in part by a grant from the Foundation for a Healthy Kentucky.
Bourbon Raw: 446th S. Fourth St., Louisville, KY
Friday, September 23
8:30 – 10 a.m.
Integrating Community Health Workers into your HCH
View slides from this presentation (PDF).
In the summer of 2015, the National HCH Council completed a three-year demonstration project funded by the Center for Medicare and Medicaid Innovation, which measured the impact of integrating Community Health Workers (CHW) into HCH clinical practice. The preliminary findings demonstrate an extraordinary benefit to employing a CHW, improving the experience of both HCH clinicians and their clients. In order to perpetuate this accomplishment, the National HCH Council developed a comprehensive course for HCH programs interested in integrating CHWs into their practice. This online course details the roles and responsibilities of CHWs, hiring and supervising CHWs, and integrating and supporting CHWs in HCH settings, in addition to other resources. In this workshop, the Project Coordinator and an Administrator from a participating site will provide participants with a comprehensive understanding of the benefits and challenges of integrating CHWs into HCH programs, as well as tangible strategies for overcoming barriers.
Speakers: Julia Dobbins, MSW, Project Coordinator, National Health Care for the Homeless Council, Nashville, TN; Susan Carson Moore, MPA, MPH, Director of Homeless & Public Housing Health Services, Charles Drew Health Center, Omaha, NE.
Salon E
Patient Satisfaction: A Conversation for Health Care for the Homeless Programs
View slides from this presentation (PDF). Additional materials: Patient Satisfaction Survey, Patient Satisfaction Survey Results I & II.
Although the federal health center program requires Health Care for the Homeless (HCH) grantees to address patient satisfaction, specific guidelines and standardized processes are nonexistent. Programs are left to create not only surveying and assessment tools but also the methods and procedures for gathering and utilizing data. Moreover, addressing patient satisfaction is affected by several factors, such as requirements of funders, availability of staff resources and capacity, and the unique composition of individual programs and their clientele. As such homeless programs may benefit from discussion on the implementation process described in the patient satisfaction quick guide recently published by the National Health Care for the Homeless Council.
This workshop is targeted to all experience levels. Presenters will explain practice recommendations from the quick guide and tackle potential roadblocks through facilitated discussion, creative problem-solving, and peer-support among workshop attendees. Come prepared to share past successes and current challenges!
Speakers: Juli Hishida, MS, Project Manager, National Health Care for the Homeless Council, Nashville, TN; Brian VanderHorst, Chief Operating Officer, Cincinnati Health Network, Cincinnati, OH.
Salon F-G
10:30 a.m. – 12 p.m.
Delivering Clinical Preventive Health Services
View slides from this presentation (PDF).
Delivering preventive health services can be an increasingly difficult challenge when providing care to people experiencing homelessness, especially with shorter appointment times. In this session, you will learn about creative ways to integrate preventive health services and screenings into appointments, regardless of the chief complaint. Building on the 2011 Healing Hands edition Addressing Key Preventive Health Measures in Health Care for the Homeless Settings, this session will help clinicians prioritize preventive health measures during primary care visits.
Speakers: Greg Morris, PA-C, CEO, Ascending to Health Respite Care, Colorado Springs, CO
Salon E
Success and Challenges of Managing a Medical Respite Program
View slides from this presentation (PDF).
Communities nationwide recognize the value of medical respite care in health care delivery for people experiencing homelessness; however, funding and sustainability are stumbling blocks for many as they work to develop their medical respite programs. The National HCH Council has assembled a panel of diverse speakers representing different perspectives to share their experience and expertise in medical respite care. In this panel discussion, representatives from three medical respite programs will share successes and challenges in developing, funding, and sustaining their programs. The panelists will discuss potential funding streams for medical respite care while sharing insight into how they developed relationships with funders. Panelists will also highlight their program model including staffing, services, and partnerships. This workshop will include panel presentations, interactive discussions, and opportunities to ask questions and share stories. Participants will leave with increased knowledge to support medical respite program operations.
Panelists: Jason Emmerson, MDiv, MPPA, Executive Director, United Caring Services, Evansville, IN; Jennifer Nelson-Seals, MSHRM, Chief Executive Officer, The Boulevard, Chicago, IL; Janell Watson, PhD, MSW, LSW, Director/Social Worker, Health Recovery Program, Gennesaret Free Clinic, Indianapolis, IN
Moderator: Julia Dobbins, MSW, Project Coordinator, National Health Care for the Homeless Council, Nashville, TN
Salon F-G
1 – 2:30 p.m.
Listening Room Session: Substance Use Disorder and HCH
This interactive session will bring participants together for a facilitated discussion about models of substance use recovery programs for homelessness service providers. Session participants will discuss, through collaborative conversation, ways to better align substance use treatment and prevention programs with other behavioral health initiatives and housing programs, enhance the integration of recovery supports to address substance use disorders, and define opportunities for new and existing programs to sustain and develop support for patients with opioid use disorders. Through a Listening Session format, the moderators hope to engage homelessness service providers and stakeholders from diverse professional and experiential backgrounds in a discussion about the current state of substance use treatment, prevention and recovery at health centers. The session will include a discussion of the opportunities, challenges and concrete next steps for advancing integrated substance use recovery practices and principles further into homelessness service clinics and environments.
Facilitator: Caroline Gumpenberger, MPH, Director of Education, National Health Care for the Homeless Council, Nashville, TN
Salon E
3 -4:30 p.m.
Site Visits: Sign up for site visits will be available Friday morning, September 23, from 7:30 – 8:30 a.m. Spots are limited and sign-up is required. Both sites are in walking distance to the training location; transportation will not be provided.
HCH Clinic: Family Health Centers, Inc. – Phoenix Health Care for the Homeless
Family Health Center-Phoenix, Louisville’s only Health Care for the Homeless program, has been in operation since 1988. Its staff of over 50 serves 5,000 individuals through 30,000 visits each year. Phoenix provides medical care both in its downtown clinic and through outreach at seven shelter and on the streets. Within the clinic, patients can also access dental, psychiatric, mental health, case management, and peer support services. Phoenix operates a 15-bed respite program within an emergency shelter. Phoenix’s scattered-site Permanent Supportive Housing program has been in operation since 2008 and currently houses 140 individuals using a Housing First model. Phoenix also operates Louisville’s Coordinated Assessment program, which has conducted over 3,000 vulnerability assessments and placed 800 individuals in permanent housing since beginning in April 2014.
Medical Respite: Family Health Centers, Inc. – Phoenix Respite Services
Family Health Center- Phoenix provides respite services homeless individuals in Louisville, Kentucky. A Hospital Liaison and a Peer Support Specialist assist clients needing recuperative care in coordinating services with our clinic, medical providers, and homeless service providers. Fifteen respite beds are available at Wayside Christian Mission; these beds are available for up to an initial one month stay with the possibility of an extension as needed. A physician is on-site at Wayside several days each week to provide medical care. Clients may also request help with laundry and have meals brought to their rooms. Clients may be referred to a shelter bed or may move directly into transitional or permanent housing upon discharge.