Alternatives Conference In Anaheim Today

Hanging at the Hyatt in sunny SoCal today, participating in the annual Alternatives Conference  being held at the Hyatt Regency here in Anaheim, California this week. 

We're just a stones throw from Disneyland and the whole event has a Disneyesque feel to it, from the Dancing Lions at last evening's kickoff dinner to the number of amazing choices we all have for things to do while here at the conference!  Everywhere I look there are people with smiles on their faces and folks are revved up into overdrive to make this conference an outstanding time for everyone involved.

I'll definitely have pics posted soon, and have some general conference flicks of our time in Tacoma (was that like just a week ago???) as well, just as soon as I can return home to the new house and figure out where all my cables, connectors and table legs for my desk are! 

Some very interesting sessions happening here today that I definitely don't want to miss, either, including information on the Fidelity Assessment Common Ingredients Tool and Journaling for Empowerment, Self-Advocacy and Social Justice, both of which happen at the first session of workshops!

There are 20 pages of workshops to choose from in the guidebook, and half the battle is figuring out which one you want to attend the most, since so many pique the interest and have potent potential for immediate use once we all return to our day jobs!

Anyway, I'm thrilled to be here, hugely thankful to the amazing folks at SAMHSA for assisting with the funding for this extraordinary event and getting so many of us here to participate, and am looking forward to networking and learning a passel of things I can apply to my daily life and to those I work for on a daily basis. 

More coming soon!

Kids "Out Of Control" - We've Been VINDICATED

To all the teachers, neighbors, family members, friends and strangers who made and make our hyperactive arses miserable, I can now say "get off our backs and start figuring out how to best live with our different ways!" 

And here's a novel suggestion - use at least some of us who are hyperactive to help you figure out some established best practices.  Not only are we the best suited to determine our own destiny, we also enjoy almost instant credibility with each other simply because we've experienced the same things and have had to find solutions to problems only we experience.

This is not to say that non-adhd persons aren't up to the task of assisting us, they most certainly are.  But I'm hoping that we will learn from the current trend in substance abuse, mental illness and homelessness that consumer-providers in recovery are powerful allies in the effort to help folks still mired in any of these areas to overcome them and turn their lives into healthy, happy existences that benefit everyone involved. 

We're extra-ordinary, we're here, we will run circles around most of you, and we will no longer be punished into silenced or force-controlled by those who don't know how to deal with our very special gift of hyperactivity.   

That's right, it's a gift and when it's harnessed and used to our (and ultimately, your) advantage, we are unstoppable and incredibly productive.  The trick here is to now learn the best methods for harnessing the amazing potential of ADHD gifted persons.

I would add here that there is also a tremendous sense of relief in knowing that I've been given a powerful extra in my genetic makeup and as a result, I've simply been read wrong by those charged with doing the reading, rather than being a "bad" or "uncontrollable," "non-compliant," kinda guy.  I suspect my mother and father, if they were still alive, would also argue that they too feel a sense of relief and vindication in that they didn't fail in parenting but rather, no one else actually knew what they were really having to cope with in dealing with a child experiencing hyperactivity.  

From this day forward, let there be no more shame, guilt or self-loathing.  We can look at ourselves in the mirror and know that, for whatever the reason, we are extremely fortunate to have a genetic improvement that provides us with prodigious creativity, energy and determination. 

Now if we can just keep our minds focused on the goals at hand, we'll be unstoppable!

(Check out the Lancet abstract here)

Hyperactive children may suffer from genetic disorder, says study

Report claims ADHD could be more of a neurodevelopmental condition than a behavioural problem

Ritalin is widely used to treat children diagnosed with ADHD. Photograph: Murdo Macleod 

 

Parents of hyperactive children should not be blamed for failing to bring up their offspring properly, according to scientists who today publish evidence that the condition is genetic.

Children with attention deficit hyperactivity disorder (ADHD) find it hard to concentrate and can be wild and uncontrollable both at home and at school. Controversy has raged around the drug most widely used to calm such children, Ritalin, which is of the amphetamine family. In the US, such drugs became popular among families who wanted their lively (non-ADHD) boys to do better in class, while in the UK they were tagged chemical coshes. Meanwhile, parents have often tacitly been blamed for lack of discipline or giving their children a sugar and additive-laden diet.

But today the furore around ADHD moves into a different space. Researchers, funded not by drug companies but by the Wellcome Trust and other bodies, are publishing the results of a study which for the first time identifies genetic changes in children diagnosed with ADHD.

And the particular DNA markers they found are in the same area of the brain as genetic variants linked to autism and schizophrenia. That means, say the authors of the paper in the Lancet, that ADHD would be better classified as a neurodevelopmental disorder than a behavioural problem.

"We hope that these findings will help overcome the stigma associated with ADHD," said Professor Anita Thapar from the MRC Centre in Neuropsychiatric Genetics and Genomics at Cardiff University, one of the authors.

"Too often, people dismiss ADHD as being down to bad parenting or poor diet. As a clinician, it was clear to me that this was unlikely to be the case. Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children."

One in 50 children is affected by ADHD, and while it used to be thought that they grow out of it, many continue to have problems in adult life.A genetic link has been suggested for some time, but not proven. Past investigations have shown that ADHD is more likely in a child who has a parent that suffers from the disorder, and that if one twin has ADHD, the other twin has a 75% chance of also having it.

But the study has found the first direct evidence by analysing DNA samples from 366 children diagnosed with ADHD, aged five to 17, and 1,047 children without the condition. They found the children with ADHD were more likely to have certain small segments of DNA either duplicated or missing than the other children.

Although this finding was limited to 16% of all the children with ADHD, they say it is highly likely the rest have other genetic variants that have not yet been identified.

The researchers point out that they have not found a single gene that is responsible for the condition, and environmental circumstances will also be part of the picture – although as yet they do not know what those are. "ADHD is a very complex disorder which will have a number of different causes. A number of different genetic factors will be involved along with other, non-genetic factors," said Dr Kate Langley, another of the authors.

The findings will not be used for diagnosing ADHD, they add, but they result in new treatments. The stimulant drugs most commonly used to control the symptoms have been around since the 1950s.ADHD support groups warmly welcomed the findings, which they said would make life easier for families.

"This is indeed extremely welcome news of clear evidence to confirm that attention-deficit/hyperactivity disorder (ADHD) is indeed a brain development disorder with closer links to autism than was previously thought," said Simon Hensby of Adders, an online information organisation.

"I hope this will be a welcome relief to the many families who have to face criticism and ridicule on a daily basis, when trying to explain the behaviour of their ADHD child. I hope also that many adults with ADHD will feel much better knowing that their condition wasn't something to do with their upbringing or diet.

"Extremely low self esteem is probably the biggest common factor in those diagnosed with ADHD, both children and adults. Now we can point to proof that it is a neurodevelopmental disorder. Let us hope that this leads to a better understanding and treatment for children and adult sufferers alike."

Sheena Crankson, who has been diagnosed with ADHD herself and whose 13-year-old son Jesse has the condition, said that people blamed her all the time. "So many parents will have been told it's them, for years, in spite of the fact that your child is struggling and their self-esteem is going down and down and your self-esteem is too," she said.

Crankson, who lives in New Maldon, Greater London, once took her son to an NHS sleep and behaviour clinic, even though, she said, "we should have been upstairs talking to the psychiatrist about ADHD". The nurse she saw "said I think most of it is your fault". Crankson added: "I felt worse by the time they'd finished than when I went in."

She is trying to get her son, who also has other problems, a diagnosis of autistic spectrum disorder because, she said, ADHD is not taken seriously enough.

A Taste Of Fall In The Northwest

Training in Seattle has been, as always, a real adventure.  Met a lot of great folks and made some wonderful connections, spent some quality time with Bill Hobson, the ED of Seattle's Downtown Emergency Service Center and am going to try working with a local service provider here in the Seattle area to establish a new website dealing with methadone maintenance.

As always, anytime I leave the West Coast, I'm sad to go, but I'm really excited to return to Nashville because I think I've gotten some info from DESC that will interest Clifton Harris and the gang over at the Key Alliance.

And while I'm thinking about Bill, One of the things he advocated in his presentation - and anyone who's read this blog for any length of time will know I've been advocating as well - related to the collaborative effort needed between homeless service agencies, the police and the local business community.  I still clearly recall the first meeting I attended in Nashville in my "official" capacity as an outreach specialist in our fair city; we had gathered at the Downtown Partnership's offices over on 4th street to debate an "anti-panhandling" initiative they were proposing as a result of what appeared to be an increased level of "aggressive" panhandling.  As we debated the proposal, members of the Nashville Homeless Power Project spent considerable energies lambasting the DTP for their attempt at correcting a problem the community had identitfied as something needing immediate attention - and one gentleman from NHPP went so far as to blame one of the general contractors in the room who was in the middle of a construction project downtown for the problems of those experiencing homelessness because the man was not "hiring the homeless" in the area.

Suffice it to say, a lot of feathers were ruffled, including my own, when after the meeting my own boss, BigWillyC, commented to me that one of the gentlemen who worked on the staff of the NHPP was incensed that I'd commented on the issue without first discussing my comments with him!

Now before many of my very dear friends at the NHPP come down on me like an elephant on a flea, let me be very clear here: I'm supportive of the NHPP, always have been and always will be.  Furthermore, the individual who I think made some serious managerial errors is no longer with the group and the organization has long since refocused their goals and is working overtime to help correct some of the problems that were created as a direct result of that management issue.  Jay Mazon is an amazing lady and folks like Cathie Buckner, Clemmie Greenlee, Howard Allen and John Zirker are absolute pioneers in the field of advocacy for people experiencing homelessness and I continue to learn from each of them on a daily basis.  I would battle to the end of my days for any one of those individuals and I think they know this and can count on it from me.  Any one of these co-founders of the group have done more to improve conditions for the population of homeless individuals on our city streets than most of the people I've worked with over the years, combined. 

My point here is that the actions at that meeting were really no way to build an alliance, cultivate a relationship, or attempt to work together with either the local business community or the police.  Now I realize that our reasons may differ but our goal is the same; end homelessness in the downtown Nashville area.  Who gives a crap what the motivations are?  I don't have to agree with someone's rationale., but it often helps to bring in as many players - many of whom, by the way, can bring substantial resources to the table - as possible to tackle the problems we're facing in our community.

Bill's recognition of the importance of cultivating these relationship is, I think, a very critical component in the war to end homelessness, especially when you consider that as a cause, we're not very well supported in our communities.  Ask folks to help hungry children, or disabled veterans, or abused women, and you can usually count on some pretty substantial turnout.  Ask them to assist in helping those experiencing homelessness on our city streets and while some will certainly step up to the task, it's not nearly as compelling a response.  Hence the desperate need for relationship building and collaborative partnerships.  As Howard Gentry famously said at one of our town hall commission meetings a couple of years ago, "Governement can't do it alone."

You ain't kidding, Howard.....

Tacoma II

Flying to Tacoma Washington this morning to participate in another SAMHSA/PATH training event for the good peeps in and around the Seattle-Tacoma area, Promoting Wellness, An Integrated Approach to Homeless Service Delivery.

I should make clear here however, that while we'll be in Tacoma, there will be folks from all over the place who are coming to participate and learn some new stuff, refresh their current knowledge and generally have a great time with like-minded folks.

I'm looking forward to another great time and we're going with a full crew as well; if memory serves me correctly, there will be 11 people who will be training in some capacity on everything from Motivational Interviewing with Outreach Guru Ken Kraybill to a perspective on Global Homelessness with Wayne Centrone and Jeff Olivet, two guys who have more knowledge about issues related to homelessness than just about everyone else I know - combined.  The good peeps from Seattle's DESC will also be there to talk about Housing First and their very successful efforts with it.

It's shaping up to be an incredible event and I'm so looking forward to cramming the cranium full of good stuff; I'll report back on the conference later this week.

"they feel the truth has finally been revealed."

Like I said back in March, when this story was happening and fresh in the minds of those of us who pay attention to stuff like this, I believed we owed the Green's a very humble apology for jumping to conclusions about the death of Cherokee Wolf. 

Not everyone agreed with me, but hey, this is America and we've got a right to our own opinions. 

What we don't have however, is a right to argue the facts: 

"According to the Medical Examiner's Office's final report, the infant died from complications with a birth defect involving his brain and heart."

Nuff said for me. 

My original apology stands and I hope the Greens are able to recover and move on from this tragic and horrid chapter in their lives.

Police Rule Out Foul Play In Baby's Death

12-Week-Old Diagnosed With Severe Head Injury

POSTED: 8:51 pm CDT September 15, 2010

UPDATED: 7:10 pm CDT September 16, 2010

Metro police investigators have ruled out foul play in the February death of 12-week-old Cherokeewolf William Diedrich.

According to the Medical Examiner's Office's final report, the infant died from complications with a birth defect involving his brain and heart.

Cherokeewolf was hospitalized in January after his foster parents found that he was not breathing, police said. He was diagnosed with a severe head injury, prompting police to investigate his death as a homicide.

The Greens, the boy's foster parents, told Channel 4 News they lost custody of their biological daughter and were not allowed to attend Cherokeewolf's funeral while police investigated.

This was despite a preliminary autopsy by then-Medical Examiner Bruce Levy, which said the child's death was likely natural.

However, after months of testing and analysis, the Medical Examiner's Office determined that bleeding in the child's brain was caused by the birth defect, as well as a condition known as hypertrophic cardiomyopathy, which is characterized by abnormal heart rhythm.

According to authorities, Cherokeewolf was born Nov. 9, 2009, to Kimberly Diedrich, who was homeless at the time. The Tennessee Department of Children's Services took custody of the baby and placed him in the care of foster parents Todd and Cheri Green.

On the night of Jan. 9, Todd Green called 911 to report the baby was not breathing. The child was hospitalized at Vanderbilt Children's Hospital and was soon placed on life support.

Detectives met Wednesday with Associate Medical Examiner Dr. Adele Lewis, who has been investigating the cause of Cherokee wolf's death, to review the results of the autopsy. As a result of that meeting, police have classified the baby's death as natural.

"We are required by Tennessee law to report all suspected instances of child abuse. We maintain that our actions in this case, to report suspected child abuse, were appropriate and legally required based on the clinical findings," Vanderbilt said in a statement Thursday.

The Greens have since regained custody of their daughter, Rebekah. They moved to Florida after Earl Green lost his job at Opryland Hotel due to the May flood. They said they feel the truth has finally been revealed.

"We needed it to be very clear that William was loved and taken care of and we would have never harmed him," said Cheri Green.

Reporter Dennis Ferrier contributed to this story.

Previous Stories:

• February 4, 2010: Foster Baby Had Signs Of Brain Bleeding
• February 3, 2010: Homeless Foster Child Taken Off Life Support

“I don’t like her at all.”

My friend and colleague Wendy Grace Evans has written a piece running currently in the Homelessness Resource Center that knocked the socks off me and sent me into a well of emotions so deep I didn't want to linger there very long. 

I warn you before you read this, if you've ever experienced mental illness and/or substance abuse and have had to deal with uncaring, arrogant, mean, disinterested or just plain nasty care providers while in the throes of an event, this piece may take you back there and it's not a pleasant place to revisit.

But it's an insightful journey that exposes how we feel when we're being "worked on" by people who are supposed to be both professionals and concerned with our overall well-being.....

Memory, States of Mind, and Compassion

Author:

Evans, Wendy Grace

 

Description: This is the first person account of one woman’s two-hour journey through memory, states of mind, compassion, and a shift in perspective. HRC writer Wendy Grace Evans talks candidly about participating in a simulation for medical students. The simulation was designed to teach the techniques of Motivational Interviewing, de-escalation, and physical safety. Wendy learns more about her own experiences with co-occurring disorders and recovery than she anticipated.

Content:
On Wednesday night I receive a phone call from the Executive Director of a homeless shelter. He asks me if I can pitch in for a simulation training for medical students as an actress. Of course I can. The training is focused on creating realistic opportunities for medical students to interact with people who are living with mental illness, homelessness, and substance use. The students have received training in Motivational Interviewing techniques, de-escalation, and safety skills.

I am asked to play the role of “Francine.” I am given an overview of her immediate situation. She is 42 years old and is tweaking on methamphetamine. Tweaking is the most aggressive stage of meth addiction and refers to a person who has not slept in 3-15 days as a result of taking methamphetamine. My character, Francine, also has a history of trauma and a broken arm. She has been staying at an emergency shelter for three days. She has the perception that she has been hired by the police to seek out alleged crimes in the desert.

She is willing to seek help. Willingness is a critical component. It can be difficult to tap into when the illness part of the brain has overwhelmed a human being who has a much larger story as a whole person. I know this from experience. It is often a kind and compassionate medical provider who can help someone feel she is safe, and compel her to share her story and begin to activate positive changes.

While I have not experienced meth addiction or homelessness, I have experienced various states of mania and depression, delusional thinking, substance use, and trauma. I have a long history of interacting with medical professionals in various states of mind. I am a woman in recovery from co-occurring disorders and this seems like a unique opportunity to be of service to medical professionals.

Recovery from substance use has a very clear line. I am either sober or I am not. But recovery from mental illness proves to be more challenging. It is possible, even when medicated, to slip in and out of recovery. While various states of mania can be highly productive and creative, there is a fine line between functioning at high speeds and spilling over into frenetic chaos that feels like my brain is on fire.

I also have the unusual perspective of understanding both the spirit and techniques of Motivational Interviewing (MI) and de-escalation skills. I have life and work experience with mental illness, substance use, recovery, and therapeutic interventions such as MI.

Prior to the simulation, I conduct some research on meth use and watch 20 YouTube videos of people tweaking. This way, I can better understand how to accurately portray mannerisms and speech patterns.

I approach this assignment with two goals in mind. I am providing an accurate portrayal of mental illness and addiction. I will also be able to respond appropriately based on how the medical students are using the techniques they have been trained in. If the students approach my character with empathy, open-ended questions, and support, I am easier to talk to and more honest about what is really going on. If the students do not use the techniques, I have been instructed to exhibit very challenging behavior.

There are three actors, six medical students, a Crisis Intervention Police Sergeant, a psychiatrist trained in outreach, the executive director of a shelter, and a physician who has developed the curriculum for this new pilot program.

The medical students each have opportunities to interact with Francine for 15-minute segments. A debriefing with trainers follows each segment, a freeze period, and then the students rotate. We do this for one hour and fifteen minutes. It is exhausting and a remarkable opportunity for insight, reflection and new ideas.

I am reminded of how difficult it is to be in a medical office and feel that the doctor does not see who I am as a whole person. I have spent much time in troubled states of mind, convincing medical professionals that I really don’t belong there or that I am incredibly smart, if they could just understand. The experience of feeling judged sparks outrage. The lack of understanding and invalidation can shift me into a place of broken weeping within seconds, if I am not well.

It is remarkable to be in a position of health and awareness and to observe the medical students’ responses to my character’s behavior. It is powerful to experience empathy for medical professionals who at times appear to be frightened by my character’s behavior.

The medical student observes that Francine is picking at her skin. As Francine, I request lotion. The medical student is unwilling to provide lotion despite several requests, after which my character becomes increasingly agitated. It seems to be a simple request, one that is easily managed. Eventually my character slams the chair, shouts, and scrapes her wrists back and forth on the edge of the chalkboard. The medical student states she will leave if Francine does not calm down. At this point Francine transitions to a place of willingness and fear, begging the provider not to leave.

I am struck by the value of this opportunity that offers a space for providers to interact with someone who knows all too well the signatures of experiencing states of mind marked by both mental illness and substance use. This is an opening for human beings to interact with human beings, and an opportunity to practice compassion, empathy, and non-judgment.

I say practice because it seems this is difficult. At one point in the simulation, one of the medical students is uncomfortable and stops the session. As Francine, I tell the medical student that I think she is nice, hoping to elicit some previously unavailable compassion. The student responds in kind and then stops the session. She tells her instructors, “I don’t like her at all.” I am struck by the vehemence in her voice, the fear, and what ultimately I perceive as judgment towards Francine.

The medical student has very little information about Francine beyond the frightened woman who presents aspects of who she is. It is this place that is ultimately dangerous for both patients and medical providers.

Everyone, regardless of her diagnoses, is not a walking dysfunction, but rather a whole person with a whole life story that sometimes runs off course.

The Battle Is Over and I Am The Victor

I mentioned last month that I had purchased a home.  What you didn't know was that when I was just one day from the official close date on that first home, the title company discovered the seller had a $118,000 IRS tax lien on the property. 

Not sure what the guy was thinking, but what I do know is that the seller's agent had known about that tax lien since last February when he was first approached about listing the house by the seller.

"Disgruntled" doesn't begin to describe my attitude towards the scumbag who tried to pull one over on somebody and the agent who should have done a little better due diligence before putting his reputation on the line.

As you can imagine, it put me into one hell of a bind with my current residence, not to mention wreaking havoc with the carefully orchestrated plan to move during a lull in my business travel.  But things happen for a reason I suppose, and it turns out that I actually found a better place with a little more square footage and double the land.  Additionally, the old seller and realtor paid me back all my costs incurred and covered my new home warranty as well as the second appraisal and home inspection.

I was able to close today on the new place so I'm still able to vacate my current residence on time, and while it is a little more hectic to actually move thanks to the tight schedule I'm under this month, all in all I wound up with a better home, in a better area, for a better price.

Woot - Home Sweet Home Indeed!

It may seem a little strange to see a post about buying a new home in a blog about homelessness, until you realize that this home purchase culminates the journey I've been on since I became "of adult status" 35 years ago and struck out on my own to make my mark on the world.   Suffice it to say, I did little marking of the world but the world sure left it's mark on me over the years.  Oh to know then what I know today..

Let this be an example for those of you who think that the person you saw yesterday living under a bridge and smoking crack cocaine will never amount to anything, because people CAN change and miracles DO come true....

Hallelujah!  It's a  beautiful thannngggg....

Cop Suspended 3 Days For Making "Derogatory" Comments About "The Homeless"

Channel 5had a story that threw me right into overdrive this morning.  I had just awakened and bleary-eyed, had turned on the TV news to catch up on the haps around town.  The first story out of the gate was the one below, and all I could think of as I listened was, "I can't believe it, they actually finally caught and punished someone for stigmatizing people experiencing homelessness!"

I have a ton of respect for the majority of police officers on the force here, and it was a slow and grudging buildup of said respect after some of the horrendous treatment I've received at the hands of "law officers" who did more harm to me psychologically and physically than any amount of drug abuse ever did.  I have a close friendship with one of the finest Metro PD officers on the force and I have had a great working relationship with many others as well.

But I've also heard numerous reports about how people on the street have been victimized, abused, hassled, mistreated, unfairly harassed, and targeted by officers with a vendetta or, as the folks on the street like to say,  "a hard-on" for them. 

I recognize the difficulty of the job we ask our police to do for us.  It's a dangerous and often vicious world out there beyond the safety of the sunshine and the homestead, and we ask the police to go where most of us would never dare.  They take on things we normally RUN from so they deserve our respect if for nothing else than the fact that they do the work none of us wants to have to deal with.

But part of being a cop is understanding that you work in a diverse community and as such, cultural sensitivity is a must.  Furthermore, an officer must protect him/herself from the creep of cynicism towards their community members as a result of constantly immersing oneself in the worst that the community has to offer.

I realize this is a difficult balance and at times a damned tough wire to walk.

I gotcha.

But an officer is expected to maintain a higher standard of ethics, morals and behavior than the rest of us, simply because they represent the ideal of these things when they put on that uniform.  We as a community can accept the fact that they are human and everyone makes mistakes or has a bad day now and then.

We gotcha.

But there is really no excuse for maligning anyone, or adding to the stigma of a particular group of people who are trying to exist in our community.

Police are here to "protect and serve" all of us, not just those they may deem somehow worthy of protecting.   It's the "I may not like what you have to say but I'll defend to the death your right to say it" ideal.  When that starts to fade and/or is replaced by some preconceived, stereotypical notion about the type of person, neighborhood or community an officer may be dealing with, it's time to begin looking for a new career. 

A final concern I have with this event is the short length of time the officer in question has been on the force.  It's awful early in the life-cycle of cynicism to already have so many stereotypes embedded in one's thinking process.  I have some doubts about whether a three-day suspension will correct this; perhaps it would have been smarter to require the officer to take some training in cultural sensitivity and diversity, anger management, sociology and effective communication skills.

 Might not hurt to sit through a couple of showings of Crash as well....




Posted: Sep 14, 2010 10:49 PM CDT  Tuesday, September 14, 2010 11:49 PM EST

Video Gallery

Metro Officer Suspended For Inappropriate Comments 3:40

by Nicole Ferguson
NASHVILLE, Tenn. - A Metro police officer has been suspended after an internal investigation concluded he made inappropriate comments to drivers last spring.

Several of those drivers said the comments were either racially charged or took a hit at the homeless. Metro found they were simply "inappropriate."

Sabine Noelus filed a complaint against Officer Richard Coleman following her March car accident along I-40.

Noelus was rear-ended by an out-of-town driver near the Jefferson Street exit on March 23. While strapped in the ambulance gurney, Noelus says said she overheard Coleman tell the driver and his passenger that they "must feel awkward they're the only Caucasian people among all these African Americans," referring to Noelus and witnesses.

"They (police) need to learn how to treat people with respect and just do their job," said Noelus.

Following the complaint, Metro began to interview witnesses from the scene and the two other men involved in the accident, who Officer Coleman drove to Smith's Towing on Jefferson Street following the accident.

The men, who were from out-of-town, told investigators that Coleman made comments during the ride that were "rude," "demeaning," and "awkward.

One man said Coleman asked how they felt riding in his back seat, going onto say ""Well, lots of bums come in there and puke and (expletive) and you know, (expletive) all over the place, and they've got nasty diseases."

Another said once they arrived at Smith's Towing, Coleman said "There are a lot of black people here, this is the ghetto, you are the only two white boys that are going to be here, watch your (expletive)."

Coleman told his superiors a different story, denying he used any racial undertones or called anyone a bum, but admitting to inappropriate behavior.

In the report file, Coleman said he did ask the men how they felt in his back seat, explaining it was lined in plastic because it's "easier to clean when he has homeless sitting back there".

Coleman said he never referred to being in a black neighborhood, but warned the out of towners they "needed to make sure they locked up their valuables."

Metro concluded Noelus and the drivers, who were all interviewed separately after the accident, had similar accounts of conversations with Coleman but the language differed in their stories, and those stories could have easily been exaggerated.

Their report concludes Coleman did not make any racially charged comments on the scene of the accident.

They also interviewed Coleman's African-American colleagues who work with him in the primarily minority West precinct. Those officers said they'd never heard Coleman make any racially charged comments while conducting his work.

Coleman was offered a five-day suspension by his superiors for the Category C offense of unbecoming conduct. He counter-offered a three-day suspension, which was accepted on Monday. It will come out of his vacation time.

"If I'm saying something, and most of the stuff that the other drivers are saying, if they correlate with each other, how come that's all he's getting?" asked Noelus. "I'm not trying to get him terminated but at the same time I think there's something else that should be done."

Noelus and her attorney are also disputing the validity of Coleman's accident report, saying the sketches and narratives don't seem to correlate. Metro concluded the report was filled in correctly.

Coleman has been with the Metro Police Department for two years and has earned honorable recognition for his service. This is his first suspension.
Email: nferguson@newschannel5.com

"Clearly, however, many families are still being sucked into the swirling financial drain that leads to homelessness"

Gee, ya think?  I've watched with resignation the economic numbers that matter to those of us on the front lines in the war against homelessness and although they're not as bad as most of mainstream media wants you to think, they aren't anything to jump up and cheer about, either. 

But I am also not so naive as to believe we were going to experience some sort of miraculous Obama turnaround after a decade's worth of often imbecilic policies left this country teetering on the brink of the worst depression we've ever experienced.  I had higher hopes for his administration, given that it came to power controlling all branches of our illustrious government.  Unfortunately, Dems just don't have the "go for the throat" mentality that is sometimes needed in the political arena of today. 

I know there are increasing numbers who seem to be forgetting why we're experiencing- and who really sank us into - this morass, but  I've got a little more of my long-term memory left than the average American, who, as I recall from Grad School, stores about the last 18 months of socio-political recollections inside their cranial cavity (can't say the same about my short-term memory, which has been at least moderately damaged by years of cannabis/drug use).   

To be fair, it wasn't just the Bush administration that led us down this road-apple strewn path.  We've been following a colicky horse for several decades now; quite probably longer.  This is a two-party failure kiddies, and we're simply reaping the crop of crab-apples we've been sowing on both sides of the aisle since I've known the difference between our ( the middle class) truths and political "truths" (the start of which began in 1972 with Watergate and the subsequent chicanery of Tricky Dick Nixon).

I was checking out Dana Milbank's column this morning and I'm usually not aligned much with what he has to say, but today I think he really hit the nail on the head when he argued that "the Obama administration is pretty much out of options. Any major new effort would be blocked by Republicans, who have few alternatives of their own."

If I were a player in one of the two big parties; either the Republican or Republican-light, I'd be very concerned about the impact of a third-party candidate rising faster than a mobile home in a Fujita-5 tornado in the coming months.....

Number of Families in Shelters Rises

Katherine Taylor for The New York Times

Nick Griffith with his daughter, Ava, and son, Ethan, at Crossroads Rhode Island, a shelter in Providence where the family has lived since last month.

By MICHAEL LUO

Published: September 11, 2010

PROVIDENCE, R.I. — For a few hours at the mall here this month, Nick Griffith, his wife, Lacey Lennon, and their two young children got to feel like a regular family again.

Enlarge This Image

Katherine Taylor for The New York Times

Lacey Lennon, at a shelter with her son, Ethan Griffith, applying for housing programs.

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Katherine Taylor for The New York Times

Ava Griffith, 3, has had a setback since moving with her family into a homeless shelter. 

Never mind that they were just killing time away from the homeless shelter where they are staying, or that they had to take two city buses to get to the shopping center because they pawned one car earlier this year and had another repossessed, or that the debit card Ms. Lennon inserted into the A.T.M. was courtesy of the state’s welfare program.

They ate lunch at the food court, browsed for clothes and just strolled, blending in with everyone else out on a scorching hot summer day. “It’s exactly why we come here,” Ms. Lennon said. “It reminds us of our old life.”

For millions who have lost jobs or faced eviction in the economic downturn, homelessness is perhaps the darkest fear of all. In the end, though, for all the devastation wrought by the recession, a vast majority of people who have faced the possibility have somehow managed to avoid it.

Nevertheless, from 2007 through 2009, the number of families in homeless shelters — households with at least one adult and one minor child — leapt to 170,000 from 131,000, according to the Department of Housing and Urban Development.

With long-term unemployment ballooning, those numbers could easily climb this year. Late in 2009, however, states began distributing $1.5 billion that has been made available over three years by the federal government as part of the stimulus package for the Homeless Prevention and Rapid Re-Housing Program, which provides financial assistance to keep people in their homes or get them back in one quickly if they lose them.

More than 550,000 people have received aid, including more than 1,800 in Rhode Island, with just over a quarter of the money for the program spent so far nationally, state and federal officials said.

Even so, it remains to be seen whether the program is keeping pace with the continuing economic hardship.

On Aug. 9, Mr. Griffith, 40, Ms. Lennon, 26, and their two children, Ava, 3, and Ethan, 16 months, staggered into Crossroads Rhode Island, a shelter that functions as a kind of processing and triage center for homeless families, after a three-day bus journey from Florida.

“It hit me when we got off the bus and walked up and saw the Crossroads building,” Ms. Lennon said. “We had all our stuff. We were tired. We’d already had enough, and it was just starting.”

The number of families who have sought help this year at Crossroads has already surpassed the total for all of 2009. Through July, 324 families had come needing shelter, compared with 278 all of last year.

National data on current shelter populations are not yet available, but checks with other major family shelters across the country found similar increases.

The Y.W.C.A. Family Center in Columbus, Ohio, one of the largest family shelters in the state, has seen an occupancy increase of more than 20 percent over the last three months compared with the same period last year. The UMOM New Day Center in Phoenix, the largest family shelter in Arizona, has had a more than 30 percent increase in families calling for shelter over the last few months.

Without national data, it is impossible to say for certain whether these are anomalies. Clearly, however, many families are still being sucked into the swirling financial drain that leads to homelessness.

The Griffith family moved from Rhode Island to Florida two years ago after Mr. Griffith, who was working as a waiter at an Applebee’s restaurant, asked to be transferred to one opening in Spring Hill, an hour north of Tampa, where he figured the cost of living would be lower.

He did well at first, earning as much as $25 an hour, including tips. He also got a job as a line cook at another restaurant, where he made $12 an hour.
The family eventually moved into a three-bedroom condominium and lived the typical suburban life, with a sport-utility vehicle and a minivan to cart around their growing family.

In January, however, the restaurant where Mr. Griffith was cooking closed. Then his hours began drying up at Applebee’s. The couple had savings, but squandered some of it figuring he would quickly find another job. When he did not, they were evicted from their condo.

They lived with Ms. Lennon’s mother at first in her one-bedroom house in Port Richey, Fla., but she made it clear after two months that the arrangement was no longer feasible. The family moved to an R.V. park, paying $186 a week plus utilities. By late July, however, they had mostly run out of options.

They called some 100 shelters in Florida and found that most were full; others would not allow them to stay together.

They considered returning to Rhode Island. An Applebee’s in Smithfield agreed to hire Mr. Griffith. They found Crossroads on the Internet and were assured of a spot. Using some emergency money they had left and $150 lent by relatives, they bought bus tickets to Providence.

Now, the family is crammed into a single room at Crossroads’ 15-room family shelter, which used to be a funeral home. All four sleep on a pair of single beds pushed together. There is a crib for Ethan, but with all the turmoil, he can now fall asleep only when next to his parents. A lone framed photograph of the couple, dressed up for a night out, sits atop a shelf.
The living conditions are only part of the adjustment; there is also the shelter’s long list of rules. No one can be in the living quarters from 10 a.m. to 4:30 p.m. The news is even off-limits as television programming in the common area. Residents were recently barred from congregating around the bench outside.

Infractions bring write-ups; three write-ups bring expulsion.

The changes have taken a toll on the family in small and large ways. Ethan has taken to screaming for no reason. Ava had been on the verge of being potty-trained, but is now back to diapers. Their nap schedules and diets are a mess. Their parents are squabbling more and have started smoking again.

Mr. Griffith found that he could work only limited hours at his new job because of the bus schedule. The family did qualify last week for transitional housing, but that usually takes a month to finalize. They are still pursuing rapid rehousing assistance.

Others at the shelter with no job prospects face a steeper climb meeting the requirements.

Every few days, new families arrive. A few hours after the Griffiths got back from the mall, a young woman pushing a stroller with a toddler rang the shelter doorbell, quietly weeping.

Approximately $28.4 million has been spent through June 2010 on homelessness prevention for 57,220 people at risk of homelessness and $12.5 million has been spent to rapidly re-house 35,135 people experiencing homelessness.

HPRP continues making a significant difference for some experiencing homelessness but with some sort of verifiable weekly or monthly sustainable income....

Quarterly Leadership Council HPRP Report: April - June 2010

Report | 7 Sep 2010 Files: PDF | 227 KB | 2 pages This report illustrates how 13 cities across the nation are implementing the Homelessness Prevention and Rapid Re-Housing Program (HPRP). Data from the following cities are included in this quarterly report: Chicago, IL; Columbus and Franklin County, OH; Denver, CO; Los Angeles, CA; Miami-Dade, FL; Minneapolis and Hennepin County, MN; New Orleans, LA; New York, NY; Philadelphia, PA; Portland, OR; San Francisco, CA; Seattle and King County, WA; Washington, DC. Overall Program Spending As of June 30, 2010, Leadership Council cities have spent $28.7 million of $124.9 million in allocated prevention funding and $12.5 million of $81.6 million in allocated rapid re-housing funding. While communities continue to spend their rapid re-housing allocations more slowly than their prevention allocations, the pace of quarterly rapid re-housing spending has increased each quarter. Program Progress - Persons Served and Money Spent Approximately $28.4 million has been spent through June 2010 on homelessness prevention for 57,220 people at risk of homelessness and $12.5 million has been spent to rapidly re-house 35,135 people experiencing homelessness. Both Washington, DC and Miami, FL have spent almost 75 percent of their prevention allocations. Minneapolis and Los Angeles are unique among the cities in having served more persons with rapid re-housing resources than with prevention resources. Elements of Financial Assistance and Housing Relocation Prevention and rapid re-housing services provided through HPRP fall into two broad categories: financial assistance services or housing relocation and stabilization services. Individuals and families receive a combination of financial assistance and housing relocation assistance, depending on program design and need. Rental assistance and security and utility deposits are the most common forms of financial assistance. Case management and housing search and placement are the most common forms of housing relocation assistance. Motel vouchers and credit repair services are the services least provided. Note: The use of non-HPRP funds for financial assistance in New York accounts for the seemingly low rate of financial assistance provision. Outcomes – Exit to Permanent Housing Over 92,000 people have been served by rapid re-housing and prevention programs in the Leadership Council cities. Of the 24,352 that have exited from prevention programs, at least 18,033 (74 percent) have been discharged to permanent housing. Of the 28,164 who have exited from rapid re-housing programs, at least 27,172 (97 percent) have been discharged to permanent housing.

Thanks Springfield - You were Wonderful!

Got to visit Springfield, Illinois this week, winding up a PATH Technical Assistance training event with state PATH providers here in the Capitol City of the Prairie State.


As is usually the case when I work with folks who are part of the effort to serve the homeless, addicted and the mentally ill, I couldn't ask for a better bunch of peeps to hang with.  It's that "Servant's Heart" that shines through on everyone involved, the Radical Loving Care that folks in this line of work almost have to have in order for them to continue doing what they're doing, day in, day out, for years.

This kind of work weeds out quickly those who do it for any other reason, believe it.

I presented on the subject of Disclosure in the workplace, a topic that needs far more exposure than its been getting, especially when an agency is using consumer providers in their workplace.  This is a rapidly growing trend as more and more agencies are realizing what a tremendous benefit it is to use us in all areas of their business. We bring a lot of positive attributes, experience and knowledge to the table, which does make us a valuable asset to any agency.  Not saying we're without our challenges as well, but with the proper education and training for both the consumer and the agency, great things can usually be accomplished.

This particular training team was smaller than the typical ream I'm normally traveling with, but my colleague and friend Rachael Kenney is always wonderful to train and present with.  She constantly strives for perfection in her work and isn't afraid of constructive criticism when it comes her way.  In fact, she embraces it and usually takes it to the next level, which is a great way to model appropriate response to genuine CC.

The sessions went off without a hitch, which was better than my ability to get us to the site that morning (we walked six blocks in the opposite direction before figuring out I'd looked at the map upside down and gotten my directions backwards).  I don't envy Rachael's presentation material, either; anytime one has to discuss how to collect and apply data - on anything - makes for a 'brutal" presentation requirement!

But she pulled it off fabulously and I think folks at the conference were able to take some very usable info with them that can be applied immediately in their day to day work environment.

Many thanks to Tahtia and her crew for putting together such a well-oiled machine and having it go off without a hitch one!  It was an incredible learning opportunity for all involved and I'm thrilled I could play some small part in the overall effort!

6th Annual Hike for the Homeless October 16th

Okay everyone, time to limber up, get out those hiking boots, grab your Camelbak and get on down to Safe Haven for their 6th annual hike for those experiencing homelessness!  If you've participated before I know you'll be there; if you haven't, you don't know what you're missing so mark that calendar and bust out the boots, Gator and walking staff!  Safe Haven's got it goin on October 6th!

6th Annual Hike for the Homeless October 16th
Click Here to Register Online! 

Hike for the Homeless Video

Click here to watch the Hike for the Homeless video!

You May Be Done With Your Old Life, But....

The old life doesn't let you go just because you say you're done with it.

I was on the phone this morning, talking to my lovely significant other, Mz Dorothy.  Dorth, as her friends call her, is of course the amazing and beautiful lady who showed up in my life at exactly the right time for me and offered her support, strength and assistance to me in spite of my many shortcomings. 

I've told the story before but its been so long that maybe I need to tell it again (swirling mist and dream sequence begins as I take you all back in time and down the path to 1998ish)....

We were hanging out in Long Beach, California.  She'd flown my broke, drug addicted arse into LAX to meet up with her as she participated in a hair show at the Long Beach Convention Center.  Dorothy was a competition stylist and cosmetology trainer in her old life and as the Executive Director of Western and Eastern Hills Beauty Academies in Cincinnati Ohio, she also oversaw daily operations at both schools.  Definitely someone beyond the caliber of most of the folks I'd been dealing with over the previous decade or two.

Dorth was/is an amazing woman and she'd come into my life about a year and a half earlier through, of all things, an internet forum/chat group that helped with employment-related questions.

Yes kiddies, internet dating does sometimes have happy endings!

We'd cultivated a relationship over that period and she'd been out West to see me several times prior to our Long Beach adventure.  I'd always been honest with Dorothy about my...lifestyle, but she chose to see the positive instead of the negative.  Why I'll never know but I'm more grateful about that than perhaps anything else and trust me, there's a whole LOT to be grateful about in my life with her.

But I digress, as usual.  It was in Long Beach that she caught me  injecting heroin in the bathroom.  I'd awakened about 3am in withdrawals and hustled into the bathroom to "get well."

I sat down on the throne, got out my equipment and began mixing the drug in the spoon.  I flicked the lighter and began cooking the batch for injection.  Meanwhile, Dorth had awakened and when the lighter flared up, she saw the flame flickering through the curtains on the french doors leading into the bathroom.

Just about the time I was in the actual act of injecting the drug, she swung the door open and asked what the hell I was doing.

She of course told me to get out and I began packing my bag. Over the next thirty minutes or so, I don't know what went through her mind that ultimately led her to ask me to stay, but I have to say that her decision at that moment was probably the biggest single thing in my recovery that kept me from returning to the streets.

I've been working since that point to leave my past behind me, which brings me to the point - or points - I'm trying to make.

You can choose to leave your past but that doesn't mean that your past has also chosen to leave you.  

There are dozens, hundreds, perhaps thousands of threads that tie you to who you were.  Some of them are thick and very noticeable, like a felony conviction, a child, credit status - good or bad (and in the case of drug abusers, usually bad) - relationships and family issues. 

Some are thin and translucent, like a thread from a spiderweb, and only comes into view when you trigger its connection somehow.  It's hard to provide an example here because these are the kinds of threads we create at a personal level; issues with family, old friends and acquaintances, things we've done "under the influence" that embarrass or shame us beyond words, things that only we know about but most likely have forgotten until they materialize, often at the most inopportune times, and remind us that escaping the past is just not gonna happen.

 
This is why I think our parents work so hard to provide their children with a life better than the one they had, no matter how good that life may have been for them.  It's why it's so damned important for all of us to inculcate at an early age the idea of personal responsibility, treating others the way you'd like to be treated, and paying attention to the fact that what you do today will mark you as the kind of person you are twenty years from now.

 To bad they don't teach these things in schools and instead leave them up to "the family."  Unfortunately, sometimes it's the family that causes the problems in the first place.

Maybe if we had courses in school - beginning with pre-school (it's never too early to begin learning and understanding the things that will affect how the rest of the world views and treats you) - that taught us all the importance of honesty, morals, ethics and acting righteously at every opportunity we'd be better off, both individually and collectively.

For now however, the best we can do is to lead by example.  Those of us who've made it through the mire and overcome - at least in part - the problems of our past are so desperately needed as beacons of hope as we are inspirations of overcoming the difficulties and challenges of "the past."

Indeed, it's a tough job but who better to do it than those of us who've faced the dragons and overcome?

"You can't turn on the light without creating shadows behind you."

"Eventually, Latinos and homeless white people are not going to be the only victims."

I've placed this here not so much to highlight the "White Supremacist" problems of the Volunteer State, although Lord knows, we've got our fair share of them, what with Tennessee being the birthplace of the Klan and all. 

Rather, I placed this story here because once again it illustrates how little larger society actually cares about violence perpetrated against those experiencing homelessness.   Oh sure, the truly macabre get publicized, as was the case with Tara Cole here in Nashville, but it usually takes a fairly persistent advocacy effort the get the matter noticed.  Frankly, had the Nashville Homeless Power Project not gotten involved, Tara's murder may very well have received the same treatment in the local media as did "Wellmaker and the 'unidentified woman,'" both of whom, according to the story"buried" in local newspapers, were homeless.  

Homelessness kills in a lot of different ways, no doubt about it.  But you would think and hope that when someone is brutally murdered by a psychotic racist, the death(s) would warrant more than a passing mention about an 'unidentified woman" on the last page of a major city paper.

Rest in Peace, Jane Doe and for the rest of you, it behooves us all to remember the final sentence of the piece below:

"Instead of inverting the reality, at some point they're going to have to face up to it -- especially because, eventually, Latinos and homeless white people are not going to be the only victims."

September 04, 2010 01:00 PM

Maybe Arizonans should worry about their white-supremacist problem

By David Neiwert

It's more than a little ironic, isn't it, that Arizonans will work themselves into a frenzy -- to the point of passing a police-state ordinance like SB1070 -- because of a single case like the murder of border rancher named Robert Krentz, even though the crime is being widely blamed on Mexican drug cartel activity, which is actually a distinct issue largely separate from "illegal immigration". (Indeed, it's not even clear that in fact Krentz's murder came at the hands of Mexicans.)

And yet when a white supremacist drives up next to a mixed-race couple and opens fire with a shotgun because of their races, as happened last October, the case is greeted with a yawn. As was the man's arrest this week:

A man suspected of killing a 39-year-old woman in Phoenix in October was arrested in Livingston, Tenn., on Wednesday, a Livingston Police Department spokesman said Thursday morning.

Aaron Schmidt

Schmidt is suspected of opening fire on the woman and her friend last October in what Phoenix police believe could have been a racially motivated crime.

Aaron Schmidt, 28 waived his extradition rights Thursday and can be picked up by the Phoenix Police Department, said Greg Etheredge, chief of the Livingston Police Department. Authorities believe Schmidt has been in Livingston since June.

The woman and a friend, Jeffrey Wellmaker, 48, were walking in Palma Park, on 12th Street and Dunlap Avenue about 1:30 a.m. Oct. 3 when a heavily tattooed, bald White man confronted them.
Wellmaker, who is Black, said the tattooed man yelled, "What are you doing with that White woman," according to Phoenix police at the time of the shooting.

The friends didn't respond and kept walking.

The tattooed man followed the pair for a couple blocks, police had said. By the time the couple reached Fourth Street and Puget Avenue, Wellmaker saw a white four-door newer model sedan with tinted windows drive past them.

In the passenger seat was the tattooed man. That's when Wellmaker said the passenger pulled out a shotgun and shot two blasts at the couple, according to police. One struck the woman and the second blast missed them.

The story was largely buried in the Phoenix newspapers -- perhaps because Wellmaker and the unidentified woman who was killed were homeless, instead of middle-class ranchers.

It's the same way that the case of Shawna Forde and her gang of killer Minutemen has been downplayed by the Arizona media, not to mention the national media, particularly Fox News.
 
It's the same way that report of camo-bedecked vigilantes firing on Latino border crossers received zero attention in any media beyond a handful of blogs:

Sheriff Antonio Estrada said that according to his department’s incident report, five undocumented migrants had crossed into the United States and were walking through a canyon around 5 a.m. on Friday when two unidentified males wearing camouflage clothing shot at them with a high-powered rifle.

“The victims claimed no demands were made. They were just walking and fired upon,” said Estrada, who added that the group had not been robbed. Estrada said that when the group ran, one of the men, Manuel Esquer Gomez, 45, from Nogales, Sonora sustained a gunshot wound to the left forearm.

As the group continued, the men stumbled upon skeletal remains of what they thought were two people.

While little is known about the attackers, Sheriff Antonio Estrada has stated that “[i]t’s perturbing to hear of people with high-powered rifles and camouflage. It raises some real red flags.” He also told KVOA that the shooters might have been U.S. citizens. “I hate to think that is what we’re looking at but we’re not going to dismiss any possibilities,” Estrada stated. “They may be individuals who may be hunting illegal border crossers. That’s really a big concern for us.”

Arizona has a white supremacist problem -- one that has been exacerbated by the nativist immigrant-bashing that has been part and parcel of the right-wing approach to the issue in Arizona. Instead of inverting the reality, at some point they're going to have to face up to it -- especially because, eventually, Latinos and homeless white people are not going to be the only victims.

new law provides another boost through a five-year, $11 billion expansion of the community health center system that treats many in the homeless population.

Over the past couple of years I've witnessed several changes in health care that have for the most part have been detrimental to folks on the streets in and around Nashville.  While there have been some good steps forward with the implementation of the Mobile Medical Unit, the new expansion at the Campus for Human Development, (which has been renamed as the Room in the Inn), increased access for veterans to the VA through outreach and United Neighborhood Health's takeover of the local neighborhood clinics, we are still struggling mightily with a lack of money, resources, respite care and ancillary services needed to help people recover from injuries and illnesses. 

A portion of President Obama's stimulus money, in the form of the Homeless Prevention Rapid Rehousing Program (HPRP) has also had a small but very significant impact on getting folks housed and keeping them there, which in turn helps greatly in reducing illness and injury. 

Unfortunately, so much more is needed that it barely seems like we've made a dent, even with the changes I've mentioned here.

Access to Medicaid is going to help, especially for those who suffer serious illnesses and disabilities yet must live on the streets because they've been wiped out by the cost of health care and the impact their illness has had upon them.  It will not be the panacea to the problem but it's definitely better than what we've got now....


For the homeless, federal changes promise better access to health care

By Mary Agnes Carey and Andrew Villegas
Kaiser Health News
Friday, August 20, 2010; A05


BALTIMORE -- Homeless and unemployed, Tianne Hill said she dreads getting mail at the city shelter on Guilford Avenue where she lives because it often includes medical bills she can't pay.

The 40-year-old former waitress and short-order cook owes about $6,000 for abdominal surgery. She's expecting another bill soon for emergency treatment of a seizure. And she has other conditions that require expensive care: asthma, arthritis, anxiety and depression.

Like many other homeless people, Hill is uninsured and ineligible for Medicaid, the state-federal program that covers millions of other poor Americans. But beginning in 2014, Medicaid greatly expands under the new health-care law to include adults without children, who generally have been excluded.

The Medicaid expansion also will enable agencies that serve the homeless to divert resources now spent on medical care to other services such as finding housing and jobs. The new law provides another boost through a five-year, $11 billion expansion of the community health center system that treats many in this population.
These benefits and President Obama's recently announced plan to prevent and end homelessness mark a watershed moment in federal efforts on this issue, advocates say. Among its goals, the plan calls for greater coordination among housing, medical care and behavioral health programs to help end chronic homelessness in five years and homelessness for families and children over the next decade.

In a June report to Congress, the U.S. Department of Housing and Urban Development found that 643,000 people were homeless on a given night in 2009 and that roughly 1.56 million people -- or one in every 200 Americans -- spent at least one night in a shelter last year.

But the new health law won't eliminate some daunting obstacles to improving health care. Locating and enrolling homeless people in Medicaid will be a challenge. Many also suffer from chronic, complex medical conditions, including mental illness and addiction. Low reimbursement rates for some services may lead to access problems. "Caring for this population is not so simple," said John Lozier, executive director of the National Health Care for the Homeless Council.

Hill had a job but no health insurance when she had emergency surgery for a hernia five years ago. After the operation, she had to leave her restaurant job because she could not stand on her feet for long periods.

The lack of income and foreclosure on a relative's house where she was staying helped cause Hill and her husband to become homeless. When they couldn't stay with friends or family members, they slept in abandoned houses. Both now live at the shelter, Hill on the fourth floor and her husband, Linia Jennings, 50, on the fifth.

A Maryland law that provides some preventive-care services to adults covers Hill's medications for depression and helped her get a pair of eyeglasses. But not having comprehensive health insurance means that Hill does not get all the medical care she needs.

"It is a worry when you see a bump or you have an ache or a pain or something just doesn't feel right," Hill said. "And you don't want to keep running to the emergency room because you're going to keep getting these bills."

Just a quarter of the 6,000 clients treated annually at Baltimore's Health Care for the Homeless are covered by Medicare, the federal program for seniors, or Medicaid. Sixty percent of the center's $12.5 million budget is from federal, state and local funds, and the rest is from corporations, foundations and individuals. The Baltimore program also gives grants to facilities in Frederick, Harford, Baltimore and Montgomery counties that provide medical care to the homeless.

"If we are actually able to bill Medicaid for those services, imagine what we can do with the private resources that we're raising," said Kevin Lindamood, vice president for external affairs at the center. It will be able to serve more patients, possibly open more locations and do more to help clients get housing, finish a high school degree or find a job, he said.

Many of the homeless now gain access to health care through emergency rooms or community health-care centers, but that could change as part of the Medicaid expansion.

"They don't have to come to us. They may go to another provider," said Todd Johnson, assistant director of the Frederick Community Action Agency, which provides medical care, housing and other services to low-income or homeless individuals and families.

Medicaid covers the disabled and many poor parents and children; some states have expanded their programs to also cover childless adults. Twenty-four states have some form of Medicaid-like health coverage for childless adults, but most of those programs have benefits more limited than Medicaid, according to the Kaiser Commission on Medicaid and the Uninsured. (Both the commission and Kaiser Health News are part of the Kaiser Family Foundation.) In addition, the District and Connecticut have already extended their Medicaid programs to cover childless adults, which include some homeless individuals.

When the new law kicks in, Medicaid will cover everyone who makes less than 133 percent of the poverty line -- now $14,404 for individuals. The average monthly enrollment for Medicaid is about 48 million, and the Medicaid expansion is expected to add 16 million.

In the District, many homeless people who do not qualify for Medicaid get medical care under a program that covers residents who earn up to 200 percent of the federal poverty level, about $21,600 for an individual.

Maryland has a health-care program for adults earning up to about $12,550 a year that provides some primary-care services, including coverage for prescriptions and mental health care, but does not cover specialty services or a hospital stay. There are other programs as well, such as Montgomery County's Montgomery Cares, which provides primary health-care services to 26,000 residents, including about 850 homeless individuals who receive medical services at community clinics.

Virginia has no statewide program for the homeless, said Craig Markva, spokesman for the Department of Medical Assistance Services. Care is available through 59 free clinics across the state as well as local health departments.

"We're it or the hospital," said Nancy Pallesen, executive director of the Arlington Free Clinic.

Carey and Villegas are reporters for KHN (http://www.kaiserhealthnews.org), an editorially independent news service and a program of the Kaiser Family Foundation, a nonpartisan health-care policy organization that is not affiliated with Kaiser Permanente.