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Housing & Services that Work for Homeless Older Adults

Housing & Services that Work for Homeless Older Adults. DMH Housing Institute June 12, 2012. 2029 Century Park East Suite 4393 Los Angeles, CA 90067 www.alaseniorliving.org. Objectives. Review the challenges and experiences

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Housing & Services that Work for Homeless Older Adults

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  1. Housing & Services that Work forHomeless Older Adults DMH Housing Institute June 12, 2012 2029 Century Park East Suite 4393 Los Angeles, CA 90067 www.alaseniorliving.org

  2. Objectives • 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

  3. Bonnie Brae Village Community

  4. Bonnie Brae Village Community • Onsite Supportive Services • Intensive Case Management • Crisis Intervention • Counseling • Recreational Programming & Activities

  5. 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/month SSA and SSI VA pension (2)

  6. Population (N = 45) • Mental Health Diagnoses Major Depressive D.O. w/ anxiety Schizophrenia – paranoid type Bi-polar PTSD • Health Insurance 28 Dual eligible (62%) 11 Medi-Cal only (24%) 2 VA benefits (4%) 4 Insured after housed (9%)

  7. Staffing Pattern 2.5 FTE and 1 MSW Intern 1.0 Clinical Specialist – LCSW 1.0 Social Worker- MSW 0.5 Service Coordinator

  8. Staffing Recommended Expertise • Mental health training with a background in gerontology and a focus on serving the older adult population • Competence with Medi-Cal and Medicare • Conversant in healthcare and medication issues

  9. Relevant Training Topics • Death and Dying • Advanced directives and health care decisions • Hospital / SNF Discharge • Public Guardian • Hoarding Systemic Challenge: In-patient substance abuse Tx for older adults

  10. 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

  11. 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

  12. 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

  13. Challenges Emotional Response to Housing • 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

  14. Statistics for 2010 - 2011 Mortality: 4 deaths in 12 months Housing Retention Rate: 88% (98%) Service Engagement: 88% Evictions: 0

  15. 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

  16. Featured Partner: GENESIS • Operational Agreement with LAC-DMH effective November 2011 • Schedule and Frequency • Current Caseload

  17. Featured Partner: GENESIS • Partnership Goals • Improve tenants access to mental health services in a non-clinical setting • Improve care coordination between onsite social workers and DMH clinicians

  18. 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

  19. 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

  20. Thank You Debbie Woodward, LCSW Clinical Supervisor Deborah@alaseniorliving.org

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