All collected coins will go directly to enhancing the city's Housing and Homeless Services Program. Source: City of Las Vegas homeless services, 2011

Other community resources have a religious basis. For instance, built in 1977 by former members of the Nation of Islam using a grant from boxing champion Mike Tyson, Masjid as-Sabur has established a number of social projects including feeding the homeless, providing free health clinics as well as regular schools for poor and needy families; moreover, in collaboration with a Los Angeles-based philanthropic organization, Masjid as-Sabur has also undertaken a number of other social service projects in recent years (Abdullah, 2009). Other representative religious-based community resources and others that receive federal funding are set forth in Table 5 below.

Table 5

Neighborhood Services Department Resources for the Homeless

Organization

Services Provided

Catholic Charities #2

Purchase food products for feeding the homeless.

Catholic Charities #1

Provide transportation, clothing, Sheriff and Health cards for homeless to gain employment.

Catholic Charities #2 -- St. Vincent Help

Provide case management and permanent affordable housing for homeless clients.

Family Promise

Provide emergency shelter for homeless at various churches.

Shade Tree -- Substance Abuse Additions Recovery

Provide substance abuse counseling to residents of the emergency shelter program.

Salvation Army -- Vocational Training Services

Provide job training and job readiness services to homeless clients.

Source: City of Las Vegas Neighborhood Services Department, 2011

6.

Diagnosis - discuss aspects of the health concern of this community that is NOT being addressed despite the efforts of the partners involved.

The City of Las Vegas concedes that there are thousands of homeless on the streets of the city on any given day, but the long-term goal for reducing homelessness only includes 900 people. Clearly, developing affordable housing represents one of the most important issues facing the homeless population in Las Vegas today. In the meantime, the other common problems that afflict the homeless, including mental health and substance abuse issues remain underserved.

7.

Outcomes Identification -- describe ultimate outcomes or goals for improvement related to the health concerns of this community.

Clearly, gambling is not going to go away any time soon in Las Vegas and the concomitant gambling addictions and substance abuse issues that afflict the city's homeless must be addressed using 12-step programs such as Gamblers' Anonymous, Alcoholics Anonymous and Narcotics Anonymous. In addition, city statutes that prohibit feeding homeless people in parks and other public places should be repealed.

8.

Planning

a.

Recommend nursing actions to improve the health concern. To truly address the vast array of healthcare problems that characterize the homeless population, nurses must "hit the bricks" and visit the homeless where they congregate.

b.

Explain how nurses might work with the community and the population of interest to improve the health concern -- select primary and secondary prevention activities only.

c.

Discuss potential public and private partnerships that could be formed to implement the recommendations. Given the large number of religious-based private organizations that are already providing an array of services to the homeless, partnerships with Catholic Charities, the Salvation Army and agencies such as Shade Tree could provide a synergistic outcome.

d.

Discuss overall objective(s) for implementing these activities. Time is of the essence in implementing community-based partnerships for the homeless in Las Vegas. The homeless population continues to grow in spite of concerted efforts on the part of city officials to address the problem. Therefore, the overall objective for implementing partnerships would include combining appropriate mental health and other healthcare services at the earliest opportunity.

e.

Create a timeline for expected outcomes. A timeline of expected, but ambitious, outcomes is set forth in Table 6 below.

Table 6

Timeline of Activities/Tasks and Expected Outcomes

ACTIVITIES/TASKS / EXPECTED OUTCOMES

TIME (MONTHS) (2012)

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

1

Establish partnership with community-based resources.

X

X

X

X

X

X

2

Begin delivery of healthcare services

X

X

X

X

X

3

Identify opportunities to provide permanent affordable housing.

X

X

X

X

X

4

Lobby city officials to eliminate statutes against feeding homeless in city parks.

X

X

X

X

5

City's homeless population is reduced by 10%

X

6

Substance abuse problems among homeless are reduced by 25%

Include in the explanation the tools needed to use this evaluation.
It is axiomatic that in order to improve something, it must first be measured. Therefore, the City of Las Vegas's homeless census would be consulted to determine whether the initiatives set forth in Table 6 above concerning providing permanent affordable housing have been effective. The other initiatives would be more difficult to assess, but surveys of organizations providing mental health and substance abuse services could be used to establish benchmarks and assess the effectiveness of the community-based partnerships described above.

10.

Conclusion -- reflect on your perspective of the community's health and the national, state, and local efforts toward a healthier population has changed as a result of the study of this community.

Beyond the glitter that is Las Vegas lays a significant problem that the vast majority of tourists to the Entertainment Capital of the World never see. Despite the efforts on the part of city, state and federal organizations to address the problem of homelessness in Las Vegas, the numbers keep growing at an alarming rate. Indeed, as many as 20% of the homeless in Las Vegas are people who have full-time employment. Moreover, the healthcare problems that are associated with homelessness can create a downward spiral for those caught in this vicious cycle. These trends should serve as a call to action for healthcare providers and others who are involved in the provision of services to this population.