Access to Health and Homelessness Reduction

Initiative for Homelessness Reduction and Access to Health
Population chosen and reason for the choice. What data and/or public policy support your choice?
According to federal law, homeless individuals are those lacking an adequate, stable, and regular nighttime dwelling. Their primary nighttime abodes include: (a) Institutions offering temporary residence to those meant to be institutionalized; (b) Supervised private or public organization-run shelters offering temporary accommodation; or (c) Private or public places not typically utilized or meant for regular human sleeping accommodation. Individuals who run away from home due to domestic violence and those discharged from establishments and lacking a set residence to stay at within a week’s time are also considered homeless. Excluded individuals include those apprehended for felonies or housed in correctional facilities. Several federal bodies besides the Housing & Urban Development Department (HUD) interpret the law taking into account particular initiatives, reflected by initiative regulations (Elwell-Sutton et.al 2016).
Housing was recognized as a fundamental right by the UNO in the year 1991, with the US having effectively decreased its homelessness rate, on the whole, by twenty percent from 2005 to 2013. According to the HUD’s 2016 congressional Annual Homeless Assessment Report figures, in the year 2016, 549,928 individuals were homeless on one single night; thirty-two percent of these stayed the night in unsheltered areas. While America has achieved considerable headway in its effort to eliminate homelessness through its 2010 Opening Doors strategy, it continues to be an unmanageable public health issue (Zerger et.al 2008).
Moreover, homeless individuals depict elevated chronic physical and psychological illness rates, co-occurring health issues, and affordable accommodation and healthcare-related impediments. Further, homeless persons overuse emergency facilities, resulting in elevated treatment expenses (Elwell-Sutton et.al 2016).
Insofar as homeless persons have accessibility to requisite healthcare amenities, they have depended on facilities like clinics, hospitals, ERs, etc. catering to poor individuals. The destitute (whether homeless or not) encounter several healthcare access-related barriers. Impediments are greater in case of the homeless. Realization of homeless individuals’ unique healthcare requirements has prompted the institution of special health services targeted at them. When describing and delivering such services, providers need to consider homeless individuals’ heterogeneity and community structure. But irrespective of the abovementioned differences or regional service differences, the homeless are at greater risk of contracting particular ailments, struggle with accessing care, and prove more difficult to treat as compared to others, owing to their lack of residence. Likewise, irrespective of differences in financing levels, support and history, among other things, endeavors to offer physical and psychological healthcare to the homeless share a few common characteristics as well. They stemmed as a reaction to an emergency, and not as a component of a carefully planned strategy. Services were typically taken to the homeless, instead of waiting for the homeless to come seeking them. Furthermore, they depend, ever more, on public financing, as the issue is now unmanageable by private sector organizations (Lashley, 2007).
In spite of a certain degree of progress in the past many decades, enormous barriers continue to exist. Accelerating attempts at decreasing gaps in health and healthcare call for increased community commitment towards improving homeless persons’ health (Lashley, 2007).
What outcomes do you wish to achieve? Be specific and make sure they are measurable.
I intend to launch a project offering supportive housing service access and a mini mobile healthcare clinic for no less than half the homeless population of the nation in the succeeding 5 years (Elwell-Sutton et.al 2016).
To this end, housing must be subsidized for poor households, means to attain financial stability ought to be provided via employment support and disability income access, and permanent supportive accommodations must be offered to individuals suffering from complex health issues. Besides, future integrated service innovations must be promoted for the homeless (Freeman et.al 1987).
Sound evidence-based measures to prevent homelessness ought to be developed and supported, including transition, discharge, or release planning; protection order, safety planning, and legal support access in case of abuse victims; rigorous case management; family strengthening; landlord intervention; and intra- and inter-organizational approaches (Zerger et.al 2008).
Inter-agency coordination and organizational development must be fostered. Collaboration of institutions in the areas of housing, AIDS/HIV prevention/treatment, drug/alcohol abuse prevention/treatment, criminal justice, and psychiatry can help deliver integrated, holistic services for preventing homelessness (Freeman et.al 1987).
An examination of the way Health and Human Services Department (HHS) agencies synthesize, perform, or fund health service, epidemiological, or interventional studies on the subject of homelessness protection/risk factors and identification of preventive technique for saving high-risk individuals from personal and housing instability patterns potentially ending in homelessness may also help (Elwell-Sutton et.al 2016).
Testing of different strategies by societies and governments for developing an exhaustive, coordinated plan for preventing homelessness must be promoted (for instance, an infrastructure may be established to support prevention, enable flexible fund usage, and support the forging of systematic alliances between healthcare systems and providers).
A point to note is: I have attempted to explore diverse services introduces over several years, and not merely specialized or newly-developed ones. In my analysis, I have only noted separate initiatives and services, and no single service 'system’ at all (Lashley, 2007).
How/when will you measure outcomes that were met?
For ascertaining outcome accomplishment levels by the initiative, the parameters mentioned below will be considered: Percentage decrease in unsheltered individuals; Homeless persons with healthcare access; Growth in homeless persons’ self-sufficiency; and duration of homelessness. After completion of 5 years, a second information acquisition process will be performed for determining number of homeless individuals and healthcare access. Public ideas and perspectives with regard to impacts of the plan will be solicited (Lashley, 2007).

What is your plan to address this health initiative? Be specific.
Petitioning for the launch of client-focused healthcare with service integration will be especially important for individuals encountering marginalization and isolation when it comes to receiving healthcare. The 1986 BHCHP (Boston Health Care for the Homeless Program) was the earliest HCH initiative where doctors and nurses personally visited the homeless, and food, blankets and clothes were distributed by night and by day to the needy (Kushel et.al 2006). Thus, an objective, consistent healthcare practitioner presence may promote trust and participation which proves crucial to ongoing primary care. Additionally, multidisciplinary teams may co-locate psychiatric, addictions, and medical services, synchronize vertical healthcare system element integration (including ER, outpatient clinic, hospital, etc.), and enable horizontal integration between the health sector and criminal justice, after-jail, housing, and social services (Elwell-Sutton et.al 2016).
A campaign will be introduced to ensure holistic local plans deal with the broad range of emergency, permanent, and transitional accommodation needs of homeless persons; this will include rental units targeted at families having an income of less than 30% of the locality’s median income. Homelessness cannot be succesfully tackled in the absence of adequate housing supply for catering to the requirements of destitute families, including families with disabled members (Zerger et.al 2008).
Elimination of homelessness and improving homeless individuals’ health access calls for comprehensively integrated health, income and housing stabilization measures, enabling the homeless to recover. For ending homelessness, local, state, and federal level bodies and lawmakers need to collaborative and finance evidence-based supportive accommodation stability and accommodation acquisition practices (Lashley, 2007).
Also, homelessness elimination calls for accommodation together with HHS-supported services. Treating and providing services to the homeless ought to be covered under departmental activities, as part of 5 initiatives targeted particularly at the homeless and as part of 12 mainstream or non-targeted services pre-designed to cater to homeless persons or households (Zerger et.al 2008). Mainstream initiatives ought to bear in mind individuals fulfilling a collection of entitlement criteria, typically set by states, individually, though normally utilized in case of the poor (Kushel et.al 2006). Quite frequently, homeless individuals might be entitled to services financed using these initiatives. As mainstream initiative resources are considerably greater as compared to those allocated for homeless-focused initiatives, HHS must actively improve mainstream service access for the homeless (Zerger et.al 2008).
How will you notify the public/concerned parties that there is a problem? For example, if you choose to write a letter to the editor or to your congressperson, what will you put in the letter?
Concerned entities, in this case, will be the public, the HHS, and the housing department. Different approaches may be needed to notify each of the above entities (Elwell-Sutton et.al 2016).
I will organize roadshow campaigns, public gatherings and seminars over a course of 3 months within a number of states for increasing public awareness of homelessness’s effects of healthcare access. Solutions to the homelessness issue in their respective localities will be solicited from the public (Lashley, 2007).
In addition, I will pen a formal open letter addressed to the HUD and HHS informing them of the most recent homelessness rate and homeless persons’ healthcare access rate. Accompanying it will be a proposal outlining potential solutions to the issue and a request to implement them (Zerger et.al 2008).

Will anyone assist you in developing or implementing your initiative? Be specific about their roles.
The following key roles will prove critical to program development and successful implementation (Elwell-Sutton et.al 2016):
Social media campaigner: The individual holding this position will be responsible for carrying out the program’s campaign on social media. The role is crucial as society today spends considerable time on their social media accounts, and an internet campaign will help reach a wider population (Zerger et.al 2008).
Researcher: The researcher will be tasked with collecting data on precise, current figures of homeless individuals and their healthcare access. This would assist in preparing the proposal for the departments and making the public aware of the actual situation (Lashley, 2007).
Lobbyist: The lobbyist will petition a number of individuals and humanitarian organizations for financial assistance to ensure successful campaign and initiative implementation (Elwell-Sutton et.al 2016).
Will you ask for input from any group of people? What specifics are involved in your plan?
Yes, input will be sought from several entities including the HUD, for facilitating implementation of the plan to offer affordable, permanent housing to homeless individuals (Zerger et.al 2008).
Further, the HHS will also be approached for input, and assistance in implementing mobile clinic services for the homeless, in order for improving their healthcare service access (Kushel et.al 2006).
Public campaigns require considerable funding and thus, humanitarian bodies will be one among the main entities targeted for financial support (Elwell-Sutton et.al 2016).
Incorporated into the proposal will be health-related and other challenges linked to homelessness, the adverse effects of homelessness on the nation’s economy, information to support the above claims, how to resolve the issue of homelessness, financial implications, proposed solution and recommendations (Zerger et.al 2008).
Successful implementation of this project will ensure a drop in homelessness rates in the nation by greater than half the present figure.
























References
Elwell-Sutton, T., Fok, J., Albanese, F., Mathie, H., & Holland, R. (2016). Factors associated with access to care and healthcare utilization in the homeless population of England. Journal of Public Health, 39(1), 26-33.
Freeman, H. E., Blendon, R. J., Aiken, L. H., Sudman, S., Mullinix, C. F., & Corey, C. R. (1987). Americans report on their access to health care. Health Affairs, 6(1), 6-18.
Kushel, M. B., Gupta, R., Gee, L., & Haas, J. S. (2006). Housing instability and food insecurity as barriers to health care among low-income Americans. Journal of general internal medicine, 21(1), 71-77.
Lashley, M. (2007). Nurses on a mission: a professional service learning experience with the inner-city homeless. Nursing Education Perspectives, 28(1), 24-26.
Robertson, M. J., & Cousineau, M. R. (1986). Health status and access to health services among the urban homeless. American Journal of Public Health, 76(5), 561-563.
Zerger, S., Strehlow, A. J., & Gundlapalli, A. V. (2008). Homeless young adults and behavioral health: An overview. American behavioral scientist, 51(6), 824-841.