Homelessness

homelessness assitance act

lack of a FIXED, REGULAR, ADEQUATE nighttime residence, and living in a shelter or place not designed for human habitation 

homelessness assistance act expanded in 2009 expanded to include homeless emergency assistance rapid transition housing, what does this say

being at imminent risk of housing loss within the next 2 weeks and fleeing domestic violence with inadequate resources to obtain permanent housing

homelessness definition

lack of a fixed, regular, adequate nighttime residence, and living in a shelter or place not designed for human habitation or being at imminent risk of housing loss within the next 2 weeks and fleeing domestic violence with inadequate resources to obtain permanent housing

where do you live? are you living in a shelter? are you concerned about your safety? do you have inadequate resources to obtain permanent housing?

what are you going to ask a homeless person to clarify that they are homelessness

sidewalks, cars, campgrounds, transportation stations or even simple huts 

some homeless people live…

expanded definition of homelessness by housing and urban development

1. lack of FIXED, REGULAR, ADEQUATE nighttime residence, includes those who have been in an institution for less than 90 days who qualified for homelessness under this definition prior to institutionalization

2. those who will imminently lose their primary nighttime residence

3. unaccompanied youth under 25 years of age, or families with children and youth who are defined as experiencing homelessness under different federal definitions

4. those who are fleeing or attempting to flee domestic violence, date violence, sexual assault, stalking or other life-threatening conditions that relate to violence against an individual or family member

Housing and Urban Development

what is the most authoritative definition of homelessness?

step 1 defining chronic homelessness (HUD) 

must have qualifying disability, defined as 

• condition is expected to be long-continuing or indefinite 

• condition substantially impedes ability to live independently 

• condition could be improved by provision of more suitable housing and is physical, mental or emotional impairment including alcohol abuse, drug abuse PTSD and head injuries 

must be verified in writing by licensed professional

step 2 defining chronic homelessness 

duration of homelessness

• 12 continuous months in shelter/street/place not meant for habitation 

• if not currently in above location must have been in an institutional care facility for <90 days but was in above location for 12 consecutive months prior to institutionalization 

• at least on 4 separate occasions in the past 3 years 

length of time experiencing homelessness, and whether or not he has a disability

What kind of questions do we need to ask to clarify whether this patient’s experience of homelessness is chronic or not?

homelessness management information system

what is the system that providers document homelessness

doubled up

individuals are unable to maintain their housing and stay with friends/family 

point-in-time counts (PIT counts)

unduplicated one-night estimates of both sheltered and unsheltered populations of individuals experiencing homelessness

Continuum of Cares, during last week in January of each year

The one-night counts are conducted by ___ ___ ____ nationwide and occur _______________________

physical or sexual abuse

92% of females experiencing homelessness have a history of __________

urban

most homelessness is ___

lack of affordable housing

what is the major driver of homelessness?

rural 

this area of homelessness is difficult because there is a lack of transportation 

TBI + PTSD, compensation, difficulty finding jobs, social support, increased risk

why are veterans homelessness?

sicker

those experiencing homelessness are ____ when they do present to the hospital

5x more likely to be re-admitted 

unsheltered patients are ___________________ to the hospital within 30 days of discharge compared to someone housed and equally as poor

47 years

homelessness life expectancy

addiction-related illness

what is the most common cause of death of homeless people

skin and foot conditions 

what conditions are most frequently sited in homeless people?

cold related injuries as they face the elements of climate and many nights outside

skin related injuries?

infrequent opportunities to remove to change socks and shoes, combined with reliance on shared shower facilities

why are these skin and food conditions frequent?

fungal infections 

shared shower facilities place homeless people at high risk for ___ ___ involving the feet

respiratory infections and COPD, TB, viral infections, pneumonia, influenza

in addition to skin and foot injuries, homeless individuals are also susceptible to? 

dental disorders, STI, cognitive and functional impairment, cardiometabolic disorders, cancers

other infections that may be seen in homeless indiviuals

TBI

what brain injury is more common in those experiencing homelessness than in the general population?

recognize the existence of those experiencing homelessness and ask questions, document in the social history 

how can we respond to homelessness?

severe mental illness, substance abuse, chronic health conditions, skin infections, arthropod infestations, respiratory infections and more

what are health factors that affect homelessness?

social issues, addiction, economic status, language barriers, literacy, lack of knowledge of available help, particularly for those experiencing rural homelessness, isolation, shortage of services

barriers

identify, ask questions, trust your instinct, be kind and creative with asking about social history 

solutions

housed beds

taking a history on a person experiencing unsheltered homelessness uses what acronym?

homlessness history, outreach engagement, utilization, salary/income, eat, drink, bathroom, encampment, daily routine, substance abuse

what does housedbeds stand for?