Friday, August 19, 2011

Toy Soldier


Author(s):

 Roger Wade pays homage to the dedication, compassion, and persistence of outreach workers and counselors who work at the nation’s emergency shelters. He offers a vignette dramatizing the dangers they face on a daily basis and describes how they provide life-changing services to men and women experiencing homelessness.
The following story is my conjecture of what could have happened, given a myriad of possible dangers that counselors in an outreach program may confront. I have heard of injuries sustained by these men, not necessarily from the persons they are trying to help, but through related accidental scenarios. To relate them in a statistical format, the reader would most likely find it impressively factual, but nonetheless statistical. I therefore ask the reader’s forgiveness for the following dramatization in my attempt to portray the dedication these men have in fulfilling their humanitarian duties. In a broader sense, I am sure something very similar to what you are about to read has happened more than once in this county. In Insurance Circles, I think it’s called “The Law of Averages.”
Very few people in society know what an Emergency Shelter counselor really does. I’ve never read about it in the newspaper. If they did know, people would quickly forget it. There’s also a segment of a community’s makeup that is aware of the tragic hypocrisy of rampant homelessness in this country and, therefore, are interested enough to read about it. In return, they live the example of their forbearers’ American character, freely devoting time, energies, and money for the homeless men and women’s plights in the context of confusing present day American societal values.

An outreach counselor’s job of rendering early morning aid to a poor solitary homeless man who had “bunked out” under his bridge of choice the previous evening, isn’t always as simple as bungling the guy, with his few meager belongings into a van.
As an illustration, permit me to relate the events of a particular day of July 23, 2009. The counselors found a half-asleep older man straggled under a bridge amongst discarded food packaging, empty beer and pop cans, a half empty liquor bottle and assorted dirty shirts and underwear. The man was startled by the sudden hello from one of the counselors, and grabbed for a knife under his mattress, struggling to rise up from his stupor to cut his imagined attackers. The man was tall and probably powerful in his earlier years, but now could only waver off balance towards his enemies from a flashback from another time.
Before the two well-trained counselors could out maneuver and disarm their confused assailant, he waved his knife in a roundhouse lurch, slashing one of the counselor’s right arm. He was quickly disarmed by his compatriot’s quick response without hesitation on either side of them. Through strong and calm reassurances, Ken and Burke directed another homeless man toward their van for a chance at a better life, starting with the shelter they both worked for. The slashed arm was wrapped by an old shirt found in their van. The doctor would have to come later.
In the myriad of sayings that have been expounded upon over the millennia, such as “a job is a job” there are sometimes such metaphoric understatements that it becomes ludicrous to have the temerity to ever say it. Being an outreach counselor, at the particular emergency shelter I’m referring to, mostly aptly illustrates that fact.
The two counselors I write about are Ken and Burke, counselors in every sense of the word. When they’re not resituating the homeless, they conduct open-air meetings with the men and women who live in the shelter on a daily basis. As spokesmen, they focus their constituents on job placements, medical agencies that can help them, food and clothing vouchers, not to mention haircuts and a decent pair of shoes.
When a shelter resident reaches a certain point of stability, some of them being alcoholic or drug habitual users, and others mentally ill, these counselors, along with the aid of other staff members place them in a transitional mode of living. This may be a motel unit, or a modest apartment or efficiency, sometimes for quite a few months, until their recipients exert a societal adherence through keeping appointments with the agencies that can help them, along with their own conscious and deliberate avoidances of habits that have been injurious to them during their homeless years.
Like everything else on paper, including this one, it sounds good and feasible and progressive, until you arrive at the pitfalls. For example, a counselor who thought his client was going to “make it” gets a phone call one morning from the hotel manager. The client has been arrested for she doesn’t know what and his motel room has been totally trashed. Then, the counselor’s job of a different sort begins, a discouraging duty for him or her to clean up the motel room, putting it back in order.
Then there’s the going to court for some of their clients, trying to defend them in front of a judge by assuring the courts that if their man is given probation, they will redouble their efforts in making sure he keeps his medical, psychiatric appointments, drug counseling sessions, even if they have to drive him there themselves.
The pitfalls in a homeless man’s life, due to his forced lifestyle, are many – and correspond in like manner to a counselor’s job. Nonetheless, what each has accomplished for others, each in his own way, cannot be properly described in the English language. So, the two counselors I’ve told this story about, Ken and Burke, go on. They go forward, regardless of the injuries to their minds and bodies. And, like the poem Little Boy Blue, by Eugene Field, these two gentlemen – once boys of blue, their dusty little toy dogs and rusty toy soldiers – didn’t have to wait that long, they’ve been with them all along.
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HRC Resource
2011

I Think I am Done with Being Homeless

 


Author(s):
Tags:
feature |  faith |  community |  shelter
Jayne Sorels, executive director of The Interfaith Services Sanctuary in Boise, Idaho reflects on the history of how this organization came together in a flash of goodwill to find shelter for people in need. She also shares their philosophy that is grounded in compassion, dignity, love, kindness, and harmony, beliefs they live in a day to day world where there is little permanent housing and a scarcity of employment.
Jayne Sorels, Executive Director Interfaith Sanctuary Housing Services, in Boise, Idaho recalls one of her favorite memories:

“I remember standing in the parking lot of the shelter. There was a man walking around who had stayed with us for several years, but had never engaged in services. He walked by me and said, ‘So I think I’m done.’
‘You think you are done with what?’
‘I think I am done with being homeless.’”
Jayne explains that it can take people a very long time to begin to trust service providers. Her agency’s approach is to meet people where they are. She has found that when people are ready, they can connect them to supportive services and case management. “Meeting people where they are at…I call that love,” says Jayne. Through this, they help to build trust and relationship for people who have been living on the margins and who have been chronically homeless for a very long time. As an interfaith organization, they come together on the common ground of shared beliefs of all faiths: love, compassion, kindness, and harmony. Jayne explains that they do not just talk about these beliefs, they live them.
Jayne shares another memory, from the early days when the Sanctuary was just a winter shelter. The Hare Krishnas were cooking food and had a sacred way of cooking food. During the cooking process, a group of men from the Mormon community came into the kitchen with cardboard boxes of food, careful to take off their shoes first at the door, followed by a Buddhist group, and the interfaith group who came to deliver the food.
Today, Interfaith Sanctuary Housing Services is a collaboration of people of faith and conscience working together to shelter and serve individuals experiencing homelessness. They provide overnight shelter for men, women, and children, as well as supportive services to promote self-sufficiency, well being, and movement towards permanent housing. Interfaith was a response to the closure of a community shelter for men, women, and children and is an example of a Herculean effort on the part of the Boise faith community.
In November of 2005, with no non-restrictive shelters for women, children, and men, the faith community came together along with people of goodwill and decided that it was their responsibility to take action. A meeting was set for the following day in which the group agreed they would not leave without a solution. The initial solution was to start a tent city the following Thursday, on land the community’s rabbi had given permission to use. Jayne had been asked to coordinate efforts for the tent city. She is a self-described organizer. “We had no money, no building, no staff,” said Jayne. However, there was not full support for this plan, and controversy resulted. The First United Church of Christ had offered their space as a temporary shelter for a two-week period until December 5th. Following that, a Catholic congregant offered a 3,000 square foot warehouse as a gift.
The project was given to Jayne, and was established as a non-profit in 2007. By their second winter season, they purchased their own building through Idaho Housing and Finance and the Catholic Diocese. It is a 10,200 square foot warehouse and today they have 126 beds, plus additional floor space. The program is behaviorally based. There is no physical violence allowed and no sobriety requirement.
Prior to this experience, Jayne had never worked in homeless services, although she had always been drawn to working with people who had lived on the margins. “In my first week at the sanctuary a resident said to me, ‘I have been in every shelter West of the Mississippi and this is so different…you actually care about us.’” She was shocked that other shelters did not. Interfaith has 95 volunteers a week, all of whom are trained to serve from a place of compassion, respect, and dignity. “It has been a journey for each of us in our way to learn about compassion, but we have all been transformed. There have been all these little things. I am known as Mama Jayne. People who come to the Sanctuary feel like sons and daughters, brothers and sisters.” Jayne just performed a marriage ceremony, and has also had to perform memorial services when people die. “It breaks my heart every time. I get very close to people,” says Jayne.
The biggest challenge that Interfaith Sanctuary faces today is the same as faced in other communities. There are more and more people experiencing homelessness. In Boise, most people who are homeless come from Boise. There are few people experiencing homelessness who are travelling through on their way to other places. A small percentage of people had everything together until losing everything in one catastrophe. Jobs and affordable permanent housing are scarce. “We are working with people who have multiple layers of issues including mental illness, substance use, trauma, physical disabilities, and chronic homelessness.”
Boise is now in year five of its Ten Year Plan to End Homelessness. Last year, the Continuum of Care was slated to implement Housing First, but there was no new money for housing. HUD VASH money was used for Housing First, but recently the group came to the realization that without new funding, new ideas, and community involvement, they are up against a wall. They are unable to move people out of the shelter and housing programs. Recently the Boise Housing Authority closed their five-year long waiting list. Like many communities, they are focusing on what they can do and digging deep to come up with new, creative solutions for moving forward towards permanent housing and ending homelessness.
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HRC Resource
2011

Step-by Step: A Comprehensive Approach to Case Management


What is case management? How do you choose the right approach for your organization? What supports do case managers need to provide quality case management services? This article offers the answers to these questions and more.
Case management is one of the primary services offered to individuals and families who face multiple challenges, including severe mental illness, addiction, and homelessness. Many organizations offer “case management” without clearly defining what this means, why they chose a particular approach, how it relates to existing case management models and outcomes, and how they prepare case managers to provide these services. The following are steps organizations can take to begin to design a comprehensive approach to case management.

Step One: Research your options

Organizations with a working knowledge of case management models and associated outcomes can make informed decisions about which model or models may work best for their agency and population. Consider the following common case management models with an eye for what you currently do or approaches you would like to incorporate:

Standard Community Care Models

Broker Case Management Model First formally articulated approach to case management. Focus on assessing needs, referring to services and coordinating and monitoring on-going treatment. Case manager coordinates services provided by a variety of agencies and professionals. Services are mainly office-based.
Clinical Case Management Model Emerged out of a need for case managers to provide some therapeutic services. Many functions are similar to the Broker Model, including engagement, assessment and planning, and community linking, but with the added component of therapeutic interventions such as psychotherapy, psychoeducation and crisis intervention. Work is mainly office-based. Case managers are clinicians.

Intensive Comprehensive Care Models

Assertive Community Treatment (ACT) Originally created by Stein and Test, the Program for Assertive Community Treatment (PACT) was designed as a community-based alternative to the hospital for those with severe mental illness. The ACT model is an intensive and comprehensive approach to case management. Approach is defined by smaller case loads (10:1); a multi-disciplinary team approach (usually at least two case managers, a nurse, and a psychiatrist); shared case loads; services delivered by the team in person’s natural environment vs. making referrals outside of the team; unlimited timeframe; 24 hour coverage. A range of services are provided (e.g., mental health, housing, daily living skills, socialization, employment, crisis intervention, substance abuse treatment).
Intensive Case Management Developed to meet the needs of high service users and defined by low staff to client ratio, outreach, services brought to the client, practical assistance in a variety of areas. The main distinction from the ACT model is that caseloads are not shared.
Critical Time Intervention (CTI) Specialized, time-limited intervention for the transition from institutional to community care for people experiencing homelessness and mental illness. Designed to bridge the gap between homeless specific services and community services. Phase-oriented approach to case management with a focus on building community support networks and facilitating a gradual transition to community-based service providers over a period of 9 months.

Rehabilitation-Oriented Community Care Models

Strengths Model Developed in response to concerns that other case management models focused mainly on limitations and impairments vs. strengths and capabilities. Focus on strengths vs. pathology, the helping relationship as essential, contact in the community, and a focus on growth, change and consumer choice. Case managers provide direct services.
Rehabilitation Model Emphasizes the importance of consumer-driven goals and assessing and building concrete skills to attain these goals.
Source: Mueser, Bond, Drake, & Resnick, 1998; Herman, Conover, Felix, Nakagawa, & Mills, 2007.
An organization may choose one model to adopt with fidelity or they may use a combination of strategies. It is important to include program staff in the process of selecting or adapting a case management model. One way a program can do this is by creating a multi-disciplinary workgroup consisting of a core group of staff representing all roles in the agency. Once an organization finalizes its approach to case management, all staff should receive a summary of the key components of the model.

Step Two: Make professional development a priority

A comprehensive approach to case management includes developing clear expectations about the core skills and competencies necessary to provide quality case management services. Using common performance standards allows for consistent expectations across an organization. Organizations may consider researching and identifying core competencies and practices on which to base their trainings, professional development strategies, and performance evaluations (see below).

The Community Support Skills Standards

The Community Support Skill Standards were developed in 1996 by the Human Services Research Institute in Cambridge, Massachusetts, and represent a national set of competencies for direct support professionals, including advocates, case managers, housing specialists, outreach workers, and vocational counselors. These Skill Standards have been approved by the National Alliance for Direct Support Professionals, and they inform the College of Direct Support, an Internet-based curriculum for direct support professionals.

Step 3: Evaluating the Impact of Your Services

Organizations must evaluate the effectiveness of their case management approach and make adjustments as needed. Organizations may begin this process by considering the following strategies:
  1. Be clear what you want to learn.
  2. What outcomes are you expecting for staff and consumers (e.g., decreased hospitalizations, increased staff retention, maintained housing)? What do funders want to know? Are there specific aspects of your model that would you like to focus on?
  3. Gather information.
  4. Develop concrete strategies for collecting information about the questions you are trying to answer. Specific methods of data collection should be formally integrated into your service design. Quantitative data may be collected through methods such as surveys, record reviews, and analysis of existing program data. Qualitative information can be collected through focus groups and interviews with consumers and staff, observations, and case studies.
  5. Analyze data.
  6. Create a plan for collecting, consolidating, and reviewing information about service activities. Look for themes and patterns and refer back to original questions and anticipated outcomes.
  7. Use the data.
  8. Develop systems for providing feedback or reports based on what you find. Adjust service design and delivery where appropriate based on outcomes.

Conclusion

Providing quality case management requires organizations to prioritize effective service design and delivery. To do this, it is important to be proactive and strategic when choosing a case management model, make professional development a priority, and identify methods for documenting and evaluating your case management services. With a clearly articulated and well-evaluated case management model, organizations can better serve individuals and families and set the stage for future growth and development.

For Further Reading:

Herman, D., Conover, S., Felix, A., Nakagawa, A., & Mills, D. (2007). Critical time intervention: An empirically supported model for preventing homelessness in high risk groups. Journal of Primary Prevention, 28, 295-312.
Mueser, K.T., Bond, G.R., Drake, R.E., & Resnick, S.G. (1998). Models of community care for severe mental illness: A review of research on case management. Schizophrenia Bulletin, 24(1), 37-74.
National Alliance for Direct Support Professionals. (2008). The 15 NADSP Competency Areas. Minneapolis, MN: Author.
Nelson, G., Aubry, T., & Lafrance, A. (2007). A review of the literature on the effectiveness of housing and support, assertive community treatment, and intensive case management interventions for persons with mental illness who have been homeless. American Journal of Orthopsychiatry, 77(3), 350-361.
Rapp, C.A., & Goscha, R.J. (2006). The principles of effective case management of mental health services. In Davidson, L., Harding, C. & Spaniol, L. (Eds.), Recovery from Severe Mental Ilnesses: Research Evidence and Implications for Practice (pp. 24-51). Boston, MA: Center for Psychiatric Rehabilitation.
Rubin, A. (1992). Is case management effective for people with serious mental illness? A research review. Health & Social Work, 17(2), 138 – 150.
Taylor, M., Bradley, V., & Warren, R. Jr. (1996). The Community Support Skill Standards: Tools for Managing Change and Achieving Outcomes. Skill Standards for Direct Service Workers in the Human Services. Human Services Research Institute. Cambridge, MA.
Ziguras, S.J., & Stuart, G.W. (2000). A meta-analysis of the effectiveness of mental health case management over 20 years. Psychiatric Services, 51(11), 1410-1421.
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HRC Resource
2011

Sunday, August 7, 2011

You Think It's Tough Now? - High Treason 2011

Good evening Mr. and Mrs. America and all the eyes and ears who read or hear the story. Sorry Mr. Murrow but I had to get someones attention.

We the People of the United States of America are in deed in a state or peril as we speak. Ladies and Gentlemen make no mistake about it, we have had an act of Treason perpetrated on us by none other than Senator Mitch McConnell and his partner John Boener (hope I spelled that right) along with all thier acomplices and henchmen.

These criminals have committed High Treason by holding the American economy hostage, while all the time swearing that it was the fault of the President of the United States. Then Mr. McConnell admits they did it and would likely do it again as evidenced in this article, in his own words.

When a criminal has the effrontery to  commit the most heinous of  crimes, that causes the entire nations credit rating to be lowered , making other nations see us as weaker, raises interest rate for the people who can least afford so that the ultra rich who they refuse to tax get even more money from the sweat of the common man. Is there not one Law Enforcement Agency left in America that will do the right thing and arrest these criminals. They have publicly admitted their deeds and laugh at us daring us not to like it and threaten us with a repeat if we don't act they way they say. I will swear out the warrant if someone can tell me where.

This is not a manifesto or the ramblings of a crazy person, Im just a guy who wonders what happened to America. What have we done to ourselves to have arrived at this point?? Whatever my part was in it I am Sorry and I promise to work hard to fix it if given a chance. Thank You.

Stephen A. Karnes
American
Texan

Thursday, July 28, 2011

Welcome to T.H.O.R.N.

Hello and Welcome to The Texas Homeless OutReach Network. We are here to help you. If you need information and or referrals to local community agencies we would be glad to help. There are no fees for our services. Other agencies that you are referred to may have fee schedules but T.H.O.R.N. does not. We welcome you one and all.


T.H.O.R.N. was born out of necessity, people need access to services. We are not here to re-create the wheel. We will work with and for existing agencies in order to provide you with the most comprehensive network of services.




Please contact us at the present time via e-mail at : txornet@hotmail.com