A Little Contrast Is Good For The Soul, Yo

One of the things I do for the Center For Social Innovation is work closely with two national consumer advisory networks, the PATH Consumer Provider Network and the Services in Supportive Housing Peer Specialist Network, to help facilitate and support the groups as they pursue a variety of issues and projects related to homelessness, poverty, housing and outreach.  The groups are near and dear to my heart, since I'm a consumer-provider as well, having successfully navigated my way out of poverty and now work to help others do the same. 

The term "consumer-provider," by the way, is just a fancy way of saying, "been there, done that, got the T-shirt," but those who work with peeps like us don't really know what to call us.  They've tried many names over the years, from client to patient to member to survivor to participant.  Someone ultimately decided on the term "consumer" for the time being, so for now we're all considered consumers, unless we also now work in the field, in which case we're now called consumer-providers. 

A lot of us don't really like this new term, even though it's supposed to be the least stigmatizing.  Unfortunately, whenever you put a label of any sort upon any individual, you single them out and separate them from the "all."  The less human sounding the name, the more likely - at least in my mind - it will be to stigmatize.  One has to think only about the term "illegal alien" to understand what I'm getting at here.  But in a practical sense, there has to be some way we can talk about those of us who've overcome the challenges and difficulties, whether self-induced or via terribly bad luck, of the streets.  I can't blame folks for trying to figure out the least offensive term for people like me, and since I don't have a better suggestion, I don't have a lot of room to criticize.  But as usual, I digress.

I greatly enjoy the work I do with the Path Consumer-Provider Network, as well as the brand new Services In Supportive Housing Peer-Specialist Network.  I think the potential these two groups have in their ability to help change the way services are rendered is significant and I firmly believe that their voices are able to cut across all cultural and socio-economic lines as they share their unique and varied lived experiences, as well as their considerable expertise.  It's really an honor to be involved with them in any capacity and it's always inspiring to spend time with them.  

In addition to these two groups, I'm also in the process now of assisting a community in Anchorage, Alaska create a local consumer advisory board.  I think many would be surprised to learn just how serious the problem of homelessness is in Anchorage, with the aboriginal population of Alaska suffering from homelessness more so than for any other population in the region.

Surprise surprise, eh?  Sigh.   

Forgive my brief tangent here, but back in the 90s, when I spent some time as a guest of the state of California for cultivating the evil weed (I wasn't smoking cannabis at that point in my life but instead was actually growing it for medicinal purposes for a couple of family members.  This is not to say I didn't use cannabis, I was a heavy pot smoker almost my entire life but at this particular period in my history, marijuana was not a substance I indulged in, for a number of reasons"),  I spent the majority of my downtime hanging out "in the car" with the "skins."  That's joint-speak for: "I spent most of my free time with the Native Americans housed in the unit." None of this is derogatory or meant as such, although I can see my politically correct friends and colleagues wincing.  Rather, it is how we all self-identified in the pen. Nuff said.

My time and experience with my skin-brothers was incredibly important in my spiritual growth and self-respect development.  Frankly, it brought me back to my spiritual center and helped me overcome my tremendous anger at my perception that a God of some sort had long ago abandoned me.

I'm forever indebted to my aboriginal brothers and The Ancients for the joy, peace and hope they restored to my heart.  If I can assist my Native brothers and/or sisters in any way, nothing is going to stop me from doing so. 

Suffice it to say, Cook Inlet's site visit is an important trip for me because the Native American population is so disproportionally impacted - as usual - by homelessness and substance use, both of which, as far as I'm concerned, are primary symptoms of living one's life in abject poverty.

Another project that also gets top priority from me, and one I've been working on for the past several months as well, is getting a voice to the big person's table to share the difficulties one faces when seeking help for a substance use addiction.

Last summer I participated in a panel effort for the National Institute on Drug Abuse (NIDA) that helped disaster responders better address the needs of methadone maintenance clients who are displaced as a result of a natural or man-made disaster.  This was a great opportunity to both help clients who are really working the program correctly, and to help staff and volunteers identify those scandalous individuals who may be trying to obtain methadone for nefarious purposes.

I guess you can liken it to the way of a proficient burglar gone good and then teaching people how to safeguard their homes from theft and police what to look for when they are investigating a burglary.  In any event, I believe my input was well received and beneficial to attendees present at the training.

Problems problems
We've been working on scheduling a site visit to the Anchorage agency for some time now.  Site visits are often carefully structured by those who're receiving the visit from the Grantor or Technical Assistance Center (TAC), since many folks view it like as an audit, even though it's not officially considered one.  Still, you can imagine how much anxiety you might feel if you put yourself in their shoes for a moment and thought about what it would be like to have folks you don't really know and who are essentially tasked with ensuring the money they're giving you is being spent efficiently and effectively.

So while this scheduling effort was occurring, the date to participate on the panel for NIDA's substance use policy review came in, and I of course locked the date and had our logistics folks begin making my travel arrangements.

A couple of days later while reviewing an email discussing the site visit to Cook Inlet, I was surprised to discover that the dates for that event were now firmed up and unfortunately, I'd need to be in Anchorage the day I was also to sit on the NIDA panel in Washington, DC.

This of course was a real bummer, since as a matter of priorities I really had my heart set on the Alaska visit and frankly had more time invested in the effort than I did in the NIDA panel.

So I moped around for a few minutes, until I thought a bit about the choices I was being forced to make.  Just a decade ago, the kinds of things I was deciding between was whether to try and use my last few dollars to buy some food or put towards a motel room.  To buy a coat, or eat for a couple of days.  To buy tires for my beat up, broke down old Ford, or put gas in the tank and risk a blowout.  To pay the electric bill and go without propane for heat, or to sit in the dark while warm.   To find some more dope or buy my kids a Christmas gift (an I wish I could say I did the right thing, but the truth be known, I bought the dope instead to avoid having to suffer from dope sickness on Christmas).

But it didn't take me long to lose my funk over the scheduling conflict when I put a little historical perspective on things.

Bottom line here, I've got a lot of nerve lamenting the fact that I would have to give up one marvelous opportunity to pursue another fabulous opportunity, both of which would help others who need it the most, and often receive it the least.  Sometimes, a little contrast is definitely good for the soul, ya know?

Merry Christmas, everyone.  We're all lucky to be here today.

The Counters are coming! The Counters are coming!

Each year during the last week in January, "the counters" gather in cities and towns around the country. A makeshift army of volunteers and service providers descend on shelters, libraries and empty parking lots during the wee hours of the morning to count the citizens of their community who are enduring homelessness.

Most of these counters, having worked all day, are by now bleary-eyed and tired, bodies and mind grappling  with the odd request to be awake, alert and energized at a time when they're usually asleep in the comfort of a real bed.  Between yawns, they strike out into that cold dark night, searching for others who are themselves hoping to grab a few winks between the countless hassles, dangers and problems they encounter each night while living on the streets.

While the need for accurate data concerning the number of our community members who are forced to experience homelessness is important for many reasons, two major problems arise from this annual "point in time count, (PITC)." 

The count got it's start back in 2005 thanks to the U.S. Department of Housing and Urban Development's (HUD) effort to provide government and agency officials with an estimate of just how many people were experiencing homelessness on a given night.   Essentially, Congress got tired of throwing money every year at a situation they had no hard data on and tasked HUD with requiring those communities receiving McKinney-Vento Homeless Assistance Grant funds to conduct a point-in-time count at least every other year.

HUD requires these counts be performed sometime in the last seven (or ten, depending on which website you check) days of January.  One thing is certain however, 2011 will be a required count year, so everyone will be out and about on the streets this January.  The  numbers obtained in the count, they surmised, would help paint a better picture of the homeless situation across America, as well as bolstering the Homeless Management Information System (HMIS) data, which Congress had also asked HUD to have up and running nationally by 2004.

So there is a real need for the count, no doubt about it.  But the first problem arises with those who perform the count.  While in most areas teams are often headed by an outreach specialist or "skilled" volunteer, large numbers of well-meaning but inexperienced volunteer counters make up the bulk of many the teams. 

A significant portion of these volunteers have little idea what to look for, are only vaguely familiar with the areas they are tasked with "searching," and can't see beyond the edge of their flashlight beams anyway.  Many are also fearful of what they might encounter as they wander through places no one in their right minds would ever venture into at 3 o'clock in the morning.

It's usually colder than a well digger's arse on any night just about anywhere in the country in January, and many volunteers realize too late that they should have passed on this particular "exciting opportunity" at serving their community.   In the true spirit of volunteerism however, they make the best of it, zip through the "zone" they are supposed to cover, and miss just about everyone they haven't stepped directly on.

I remember one team several years ago who actually drove their area, never once getting out of the car because it was "too cold."  Although they patrolled an area often frequented by people experiencing homelessness, they turned in a zero on their count form.

The second problem is with the folks living on the street, many of whom know the count is coming and often do their best to remain undetected for a variety of reasons, not the least of which is that police officers have been known to magically materialize right on top of their sleeping spot just a night or two after the count.  Hmmm.

 Some don't want to be counted for personal reasons unfathomable to the rest of us. Some are intoxicated or engaging in criminal drug use behavior and don't want to be discovered. Some don't like being awakened by people they see as altruistic nose-pickers bent on saving the world one homeless individual at a time.  Still others are suffering from a mental illness and/or a co-occurring substance use disorder and are frightened half to death at the sudden intrusion into their space by a pair or team of shadowy figures rapidly approaching while wielding flashlights.

 

Understand here that my intent is not to malign the countless conscientious volunteers who brave the cold and the danger of the streets and do an excellent job with a very difficult job while receiving little or no training.   But In a study done in New York City and published in the American Journal of Public Health in August, 2008, Estimating Numbers of Unsheltered Homeless People Through Plant-Capture and Postcount Survey Methods, researchers placed "planted" people in local shelters and at areas on the street known by count coordinators to have heavy populations of homeless individuals.  The study concluded that in shelters, the "plants" were missed 29 percent of the time, while on the street it was much worse; between 39 and 41 percent of the "plants" were missed by counters.

That's a third of folks in shelters, and damned near half of those on the street who were missed in the official point in time count in New York City.  If this even remotely represents a national average for missing individuals during homeless point in time counts,  it's probably safe to assume that we're underestimating the actual population of people experiencing homelessness by around 35 percent.

Translation;whatever the final count number turns out to be, take a third of that number and add it in for a more realistic representation of the actual number of persons on the street that night.

Let me be clear here.  The volunteers are not at fault or somehow doing a bad job. Rather, the concern lies with the way in which we perform the count, and therefore, I'm suggesting a minor change in the way point in time counts are conducted.

To me, counting at night is just a bad idea overall, regardless of what time one may start the effort. Darkness conceals much and the world is a very different place at night, especially late at night.  Therefore, if we were to simply move the time the count starts forward to ensure the start  coincides with daybreak in each area, I believe we will see a significant increase in the accuracy of the count.

Several additional benefits may also become immediately apparent. 

Volunteers would almost certainly be more refreshed, alert and energetic with at least a partial night's sleep under their belts.  They may also be more apt to enter dangerous or unsavory areas when they can see their surroundings clearly.  The expanding daylight should also assist them in identifying sleepers more effectively, especially if folks are beginning to stir.

Additionally, they will not be rudely interrupting an individual's sleep and may find responses to their questions more palatable.  This alone would make the count a better overall experience while promoting engagement and interaction with those experiencing homelessness.

This interaction may help substantially in dispelling stigma and myths associated with homelessness.  Volunteers may also be more inclined to thoroughly explore their zone, since daylight usually brings at least a slight increase in temperature and a definite increase in the safety factor for everyone involved.

True, duplication of counted individuals, perhaps the biggest reason cited when explaining why the count is done at 3am, may increase slightly.   

However, it's unlikely that it will be so significant as to severely skew the count, especially if counters are able to provide physical descriptions of the counted, a real possibility now, since there would be enough light to actually see the person being interviewed.  

And frankly, if the New York City study is any indication, we're missing about 40 percent of the folks outside anyway, so getting an occasional double-count on someone is hardly going to make a difference.  

Furthermore, as HMIS data becomes more accurate, matching count tallies with this data will provide a better reflection of the true number of people actually on the streets and make the issue of duplicity a moot one.

As for increasing the accuracy of the shelter counts, I'll leave that to the good people who are on the inside, since they know their world better than I.  It does seem fairly obvious to me  however, that if they were to simply station counters by the doors as people exit in the morning or arrive in the afternoon, they'd most likely increase their accuracy.  I can see missing one or two, but you'd have to take a nap to miss 29 percent of  people passing directly in front of you.

(From the  US Interagency Council On Homelessness)

PLANNING FOR THE 2011 POINT-IN-TIME (PIT) COUNT

Continuums of Care (CoCs) across the country undertake community-wide efforts to collect information on the number and characteristics of individuals and families experiencing homelessness.  The U.S. Department of Housing and Urban Development (HUD) requires CoCs to complete this point-in-time (PIT) count at least every two years during the last ten days of January.  2011 is a required year, and planning for conducting the count is underway. Why is the PIT Count Important? Collecting good data on the number, characteristics, and service needs of individuals, families, and unaccompanied children experiencing homelessness is a critical component of local homeless planning and program development. Accurate data helps communities to: Understand changes in trends among homeless populations; Adjust the types of programs and services available according to need and use resources as efficiently as possible; Justify requests for additional resources and/or programming modifications; Comply with reporting requirements from HUD, other funders, and local stakeholders; Raise public awareness about the issue of homelessness; and Measure community progress towards preventing and ending homelessness. Nationally, the PIT count process will be used as the primary data source for federal agencies to understand homelessness trends and track progress against the goals and objectives contained in Opening Doors, the Federal Strategic Plan to End Homelessness.  Additionally, the Congressionally-mandated Annual Homeless Assessment Report (AHAR) is prepared using PIT and Homeless Management Information System (HMIS) data. It is critically important that homeless service providers, whether HUD-funded or not, participate in planning for and conducting the PIT count.  In particular, CoCs should be sure to reach out to providers serving homeless veterans and unaccompanied children to ensure the accurate and appropriate collection of PIT data for these two subpopulations. 2011 Point-in-Time Count In 2011, all CoCs are required to complete a PIT count of homeless people for a single night during the last 10 days in January.  Conducting the PIT count outside the last 10 days of January 2011 requires the CoC to submit a waiver to HUD.  Waiver requests should and  be submitted via email to Michael Roanhouse, Office of Special Needs Assistance Programs (SNAPS) at michael.roanhouse@hud.gov and must include the proposed date of the count and the rationale for selecting a date outside the last 10 days of January. The PIT data reported to HUD must include only persons who meet HUD’s homeless definition (e.g., literally homeless).  While some communities may choose to capture data on precariously housed persons (i.e., those staying with friends, couch surfing, etc.) for local planning purposes, this data must not be reported to HUD.  In 2011, data from PIT counts will be the definitive national count of homeless veterans.  For more information on what data CoCs should collect and how local Veterans Affairs (VA) and CoC staff can collaborate see Guidance for Counting Veterans As part of the 2011 subpopulation data collection, HUD is requiring CoCs to collect information on unaccompanied homeless children who are under 18 years of age (previously called unaccompanied youth).  For more information on this terminology change and suggestions about how CoCs and homeless youth providers can work together on the PIT count see Guidance for Counting Unaccompanied Homeless Children. In October 2010, HUD notified CoCs that they should collect information on chronically homeless families as part of the 2011 PIT count.  See HUD’s October 22, 2010 listserv message to review this guidance. CoCs can review further guidance for the 2011 PIT count, including details on how to report homelessness prevention participants, in 2011 Point-in-Time Count: Guidance and Reminders for Data Collection and Reporting.  2011 Annual Housing Inventory Count HUD has made important changes to collecting and reporting 2011 Housing Inventory Counts, including bed type updates and data check recommendations prior to submission.  For details CoCs should review Instructions for Completing the 2011 Housing Inventory. Resources Questions about PIT or HIC? All PIT and HIC questions should be submitted to the Virtual Help Desk on HUD’s Homelessness Resource Exchange (www.hudhre.info).  To submit a question: 1. Select HDX for the Program/System under “Your Details.” 2. Under “Question Details,” select PIT or HIC for the topic and PIT or HIC for the subtopic, whichever is applicable. PIT Posters HUD will ship posters for the National Street and Shelter Point-in-Time Count to each CoC on December 17, 2010.  The posters are being printed in two sizes and will also be available for download from the HRE (www.hudhre.info) no later than December 17th.

"results of these bouts of excessive drinking show up in ERs"

I've never been much of a fan of alcohol, and about the only time I really drank with any regularity was when I was a teen and couldn't find any weed.  I hated the buzz - dull, slow and stupid, and a far cry from the mind altering, crystal-clear highs of the era from cannabis that used to be available, Sativas rolling in from the equatorial regions; Santa Marta gold, Panama Red, Michoacan.  Those weeds were....cerebral, uplifting, clear, not that heavy, wheelchair weed that Indicas are so famous for.  Not glorifying drugs here, just recalling information from the past, and hey, I've never been one to candy coat anything, so forgive me for bringing some Wikileaks reality to our sanitized, "suitable for mass consumption" forum here.  I could no more smoke weed today than fly to the moon, but I know that it was this love affair with the wild exotic places that weed used to be grown in that added to the fascination and interest I had for the stuff back then. 

Anyway, the booze phase ended pretty quickly for me, since hurling long pleas to the porcelain God, peeing in the dog bowl in front of the family, waking up ramming my car into the back of a parked truck, and vicious, day-long headaches (all things I did drunk) just didn't appeal to me at all. 

Turns out from the research I woulda been smarter to never start, and it may be why I'm a bit of a moron at times now.  I shudder to think of my fate had I continued drinking, like so many of my friends did.  

So that's my message for today.  Kiddies, just say "NO" to the boozio...


Scientists try to assess the impact of binge drinking on the brains of teens

By Laura Hambleton
Special to The Washington Post
Monday, December 6, 2010; 1:27 PM

Emergency room nurse Sheila DeRiso stood at the front of the high school auditorium and looked out on her audience of 50 teenagers and parents. From a black nylon bag she pulled out a long, plastic tube, then a stomach pump, a speculum, a catheter and an adult diaper. The group tittered. All these items are used in the ER every day to treat binge-drinking teens, she told them.

Then she yanked out a white body bag and unfolded it: "And this is if you don't make it."

The audience was dead silent.

Binge drinking, or consuming many drinks fairly quickly, has been a hallmark of college life. But students in high school and even middle school are also engaging in it, according to DeRiso, local police officials and experts. In one 2005 study of 5,300 middle school students, about 8 percent of seventh-graders and 17 percent of eighth-graders said they had tried binge drinking during that year.

The results of these bouts of excessive drinking show up in ERs across the region. Most weekend nights - and especially around holidays - young people arrive at the ER injured in car crashes, sick with alcohol blood poisoning, unconscious or barely conscious after binge drinking or engaging in the newest trend of blackout drinking, or drinking to the point of intentionally passing out.

"I am a nurse," DeRiso told her audience at Magruder High School in Rockville. "Alcohol affects your thinking, your coordination and judgment. Alcohol affects your brain."

Exactly how it affects the fast-developing and still malleable brains of young people is a hot scientific question. At a time when binge drinking is an entrenched part of life for many young people, scientists and epidemiologists are looking beyond the bodily injury that DeRiso sees in the ER at Montgomery General Hospital in Olney to the cognitive damage and physical and chemical changes that heavy drinking can cause in the adolescent brain.
Teens consuming alcohol

First, consider these statistics:

l Nationwide, people ages 12 to 20 drink 11 percent of all alcohol imbibed in the United States each year - and more than 90 percent of that is consumed in the form of binge drinks, according to a 2008 report by the Centers for Disease Control and Prevention.

l Nearly half of Maryland high school seniors say they have tried binge drinking, according to a study published in 2008 by the Maryland State Department of Education. A 2009 report that looked at students in all high school grades found that one in five said he or she had "had five or more drinks in a row within a couple hours on at least one day" in the preceding month.

l In Virginia, 76 percent of high school seniors and 64 percent of 10th-graders reported using alcohol in the previous 30 days, according to an annual youth study published in 2006.

l In 2005, 1,825 college students ages 18 to 24 died from alcohol-related unintentional injuries, including car crashes, or about five every day, one every five hours, according to the National Institute on Alcohol Abuse and Alcoholism.

l Although binge drinking is often defined as men downing at least five drinks or women four within two hours, a 2006 study of more than 10,000 first-semester freshmen at 14 colleges found that about 20 percent of men had had 10 or more drinks at one sitting and 10 percent of women had downed eight or more at least once during the previous two weeks.

"I'd guess that at least a third of the patients who arrive [in the ER] between midnight and 5 a.m. are intoxicated," said Mary Pat McKay, a George Washington University professor of emergency medicine and public health who works in the ER at GWU Hospital. Many of the patients are university students, she said. "Holiday weekends and weekends after midterms tend to be the worst."
An adolescent brain

What are the consequences of so much drinking when your brain is still developing?

According to scientists, a young brain is incredibly dynamic, creating a multitude of connections among neurons, or brain cells, as a child is exposed to new things every day and learns new skills. Around 12 years old, the brain begins to refine those connections, in a "use-it-or-lose-it" process scientists think involves a kind of pruning, where only the most vital and exercised connections remain.

"There's a lot of chatter going on in the brain with all those connections," said Duke University professor of psychiatry and behavioral sciences Scott Swartzwelder, an author of the 2006 study of binge drinking among college freshmen. "Some of them are unnecessary. I liken it to a marble sculpture: When you chip away the extraneous connections, you reveal what the image really is. The remaining connections become more efficient. You begin to think through things without getting distracted. You begin to think more clearly."

Enter alcohol - large quantities of alcohol - which is a powerful drug that passes quickly into the bloodstream through the stomach and small intestine and makes its way to every organ of the body, including the brain.

"It is a very potent depressant that goes everywhere and affects every system," said Marc Schuckit, a professor of psychiatry at the University of California at San Diego and editor of the Journal of Studies on Alcohol and Drugs. "It affects every neurochemical system in the brain."

For instance, scientists believe alcohol can trigger an increase in dopamine, a chemical associated with pleasure and reward. They believe alcohol disrupts the workings of the frontal lobe, important in coordinating brain functions and modulating reasoning, intelligence and impulses. And since the first drink was consumed centuries ago, people have written about alcohol's ability to interrupt memory and learning, Swartzwelder said.

"Those three systems - learning, reward and the frontal lobe - are areas alcohol can powerfully affect," especially in a brain that is still a work in progress, said Swartzwelder, who has been studying this process in adolescent rats.
The memory deficit

Swartzwelder specifically studies the hippocampus, the part of the brain dedicated to forming memories and learning skills. Because the human hippocampus is similar in structure to a rat's, Swartzwelder has studied rats roughly the comparable age of adolescents and found that large quantities of alcohol can stop the hippocampus from functioning properly.

In humans that is called blackout drinking; in rats Swartzwelder calls it a profound memory deficit. It works like this: A teen drinks heavily but continues to function and doesn't lose consciousness. But the next day he or she cannot remember a thing that happened. The hippocampus stopped encoding new memories during that blackout time, according to Swartzwelder.

Swartzwelder gives his rats a dose of alcohol, and then "we teach them to go through the maze. And then see how they do.''

Not very well, apparently, which probably has implications for humans. If a student studies math problems all day and then drinks to the point of blacking out that night, chances are he will have to relearn all those problems once the alcohol has left his system, Swartzwelder said.

"People joke about blackouts, but they represent a serious neurological insult," he said. "If you took a blow to the head hard enough to disrupt memory, you'd be really worried."

Swartzwelder has looked for a biological explanation for the alcohol-fueled impairment of the hippocampus. He has extracted that part of a rat's brain and given it enough oxygen, glucose and other fluids to mimic ordinary life. He then adds alcohol and measures the electric currents in those brain cells. "Cells start to quiet down and the circuits stop responding," he said.

Swartzwelder cannot say whether alcohol-fueled deficiencies in learning and memory will persist, but another study he's done is suggestive. He compared adult rats that had been given alcohol during adolescence with adult rats that had never been given it. When both were then exposed to alcohol, the first group was more resistant to alcohol's sleepiness effect - an effect that naturally can limit alcohol consumption - and they also showed more impaired learning and memory skills.

This suggests, he said, that "you are changing the wiring of the brain with repeated alcohol exposure during adolescence."

Michael Taffe, an associate professor at the Scripps Research Institute in La Jolla, Calif., has also looked at the structure of brains exposed to alcohol and found a slowing in the growth of brain cells that transmit signals.

Taffe analyzed two groups of monkeys, one given an alcohol-Tang mixture to drink and one just plain Tang. He then tested how well each group could learn, remember and repeat a pattern on a touch-screen computer test. The group fed the alcohol could follow the pattern for five seconds before falling off in accuracy; the non-alcohol group lasted 20 seconds. Taffe then looked at the brains of these monkeys and found that the heavy drinkers had made fewer new neurons.

"We think there is a connection between the hippocampus and different kinds of memory tasks," Taffe said. "We think there is likely neurobiological damage, and what we saw is plausibly related to behavioral changes."
Dings in white matter

Eight years ago, Susan Tapert, a professor of psychiatry at the University of California at San Diego, started following a group of 28 people who were then 12 to 14 years old. Half had already engaged in binge drinking and half had not. For her study, Tapert each year took MRI scans of the brains of both groups and had the two groups take various cognitive and skill tests.

Among the drinkers, Tapert began to find small abnormalities in their MRIs that looked like ding marks in their brain's white matter - on the fatty myelin coating of the axons, the connecting fiber between neurons. Axons allow messages to flow to and from neurons, and the insulated myelin coating speeds the transmission. So if the myelin is compromised, Tapert hypothesized, students wouldn't perform as well on cognitive and memory tests. That turned out to be the case.

"We're seeing reduced quality of white matter in adolescents who engage in heavy drinking," she said. "White matter is important for cognitive abilities. The more these axons are coated with myelin, the more efficiently information is relayed."

"Alcohol is linked consistently with poor performance on a range of tasks, including sequencing, verbal and spatial functions, and math tasks," she said. "Students have trouble with putting together a puzzle, building a bookcase, reading a map, also higher-order thinking and organizing, such as, 'I have all this homework. How am I going to organize it and get it done?' We can see a 10 percent reduction in cognitive ability and brain health on many of these measures."

Tapert thinks that this reduced brain power could be permanent but that more research needs to be done to fully understand what is going on. She and others are looking at whether "the abnormalities we have observed in binge drinkers abate with abstinence." So far, "we have seen that the white-matter abnormalities are not normalized after just six weeks," but that might change over time.

In the meantime, DeRiso and others say they expect ERs will continue to treat too many young people for alcohol poisoning, injuries or worse.

"You don't know how many kids I've seen who are never the same," said Montgomery County police officer William Morrison, who heads the department's alcohol initiative unit. "They never go back to school, they have brain damage, they stop breathing."

Students say the culture of binge drinking is not about to change. "The first weekend of freshman year, there is a huge amount of drinking," said Benjamin Palacios, a senior at Vassar College whose family lives in Chevy Chase. "At Halloween parties last year, 17 kids were sent to the hospital."

Young people think of drinking as "quite 'cool,' " he said. "And as long as it is, kids will take it as far as they can."

Hambleton is a freelance writer and editor, and a documentary filmmaker in Chevy Chase.

Supportive Services for Veteran Families (SSVF) Program: Finally, "Sumthin Comin" To Those Who Need It NOW?

One of the most gut wrenching, heartbreaking things I've had to deal with while working with veterans is telling a man or woman with a family that there were no resources available to assist them as their world collapsed around them and they hit the bricks.  

The rate of burn-out for those of us in street outreach and case management is high, and a large part of the responsibility of this is vicarious trauma; that is, suffering trauma from hearing, feeling and dealing with the trauma of our clients, consumers, customers, fellow human beings.  It takes its toll on the soul, the psyche and the spirit, chipping steadily away until one day you awaken with irreversible compassion fatigue and basically, you just can't take any more trauma.

The other very frustrating part of working with these folks is that you know, YOU KNOW, that with just a little assistance, the person in question would be able to weather the storm and land back on their feet.  Unfortunately, until very recently, thanks to programs like the HPRP, those new to homelessness or teetering on the brink really had "nuthin comin" in the way of resources or available help.

I'm hoping like hell this is going to change and if it is, it's going to be because of programs like the one described below.  From the list of available areas of assistance, I'm holding my breath and crossing my fingers that those holding the purse strings have finally figured out what those of us in the field have known for a long time now; help those folks before they are considered "chronically homeless" and once they get back on their feet, just get outta their way....

 Supportive Services for Veteran Families (SSVF) Program

Overview: Public Law 110-387 authorized VA to develop the new Supportive Services for Veteran Families (SSVF) Program. Under the SSVF Program, VA will award grants to private non-profit organizations and consumer cooperatives who will provide supportive services to very low-income Veteran families residing in or transitioning to permanent housing. The grantees will provide a range of supportive services designed to promote housing stability to eligible very low-income Veteran families.

Background: Estimates for Veteran homelessness have dropped substantially in the past five years from 313,000 in 2003 to 107,000 in 2009. However, despite the success of VA Homeless Programs and its community partners, to end Veteran homelessness, VA must continue to assist families transitioning from homelessness to permanent housing and prevent at-risk families from becoming homeless.

Eligible Veteran Families: To receive supportive services under this program, you must be:

1. A member of a Veteran family: A Veteran family is defined as a single person or a family in which the head of household or the spouse of the head of household is a Veteran.

2. Very low-income: Your household income does not exceed 50% of area median income (as adjusted).

3. “Occupying Permanent Housing:” You either (a) are residing in permanent housing; (b) are homeless and scheduled to become a resident of permanent housing within 90 days pending the location or development of housing suitable for permanent housing; or, (c) have exited permanent housing within the previous 90 days to seek other housing that is responsive to your needs and preferences.

Supportive Services: Through the SSVF Program, VA aims to improve very low-income Veteran families’ housing stability. Grantees (private non-profit organizations and consumer cooperatives) will provide outreach and case management services and will assist participants to obtain VA benefits and other public benefits, which may include: § Health care services § Daily living services § Personal financial planning services § Transportation services § Fiduciary and payee services § Legal services § Child care services

§ Housing counseling services § Temporary financial assistance, including time-limited payments to third parties for rent, utilities, moving expenses, security and utility deposits, transportation, child care and emergency supplies

 Application Process: Once funds are available, VA will publish a Notice of Fund Availability (NOFA) in the Federal Register. Once the NOFA is released, details about the application process will be posted to the SSVF website (http://www1.va.gov/homeless/ssvf.asp) and http://grants.gov.

Additional Information: For further information about the SSVF Program, please email SSVF@va.gov, call 1-877-737–0111, or visit http://www1.va.gov/homeless/ssvf.asp.

Overview: Public Law 110-387 authorized VA to develop the new Supportive Services for Veteran Families (SSVF) Program. Under the SSVF Program, VA will award grants to private non-profit organizations and consumer cooperatives who will provide supportive services to very low-income Veteran families residing in or transitioning to permanent housing. The grantees will provide a range of supportive services designed to promote housing stability to eligible very low-income Veteran families.

Background: Estimates for Veteran homelessness have dropped substantially in the past five years from 313,000 in 2003 to 107,000 in 2009. However, despite the success of VA Homeless Programs and its community partners, to end Veteran homelessness, VA must continue to assist families transitioning from homelessness to permanent housing and prevent at-risk families from becoming homeless.

Eligible Veteran Families: To receive supportive services under this program, you must be:

1. A member of a Veteran family: A Veteran family is defined as a single person or a family in which the head of household or the spouse of the head of household is a Veteran. 

2. Very low-income: Your household income does not exceed 50% of area median income (as adjusted). 

3. “Occupying Permanent Housing:” You either (a) are residing in permanent housing; (b) are homeless and scheduled to become a resident of permanent housing within 90 days pending the location or development of housing suitable for permanent housing; or, (c) have exited permanent housing within the previous 90 days to seek other housing that is responsive to your needs and preferences.

Supportive Services: Through the SSVF Program, VA aims to improve very low-income Veteran families’ housing stability. Grantees (private non-profit organizations and consumer cooperatives) will provide outreach and case management services and will assist participants to obtain VA benefits and other public benefits, which may include: § Health care services § Daily living services § Personal financial planning services § Transportation services § Fiduciary and payee services § Legal services § Child care services

§ Housing counseling services § Temporary financial assistance, including time-limited payments to third parties for rent, utilities, moving expenses, security and utility deposits, transportation, child care and emergency supplies

Application Process: Once funds are available, VA will publish a Notice of Fund Availability (NOFA) in the Federal Register. Once the NOFA is released, details about the application process will be posted to the SSVF website (http://www1.va.gov/homeless/ssvf.asp) and http://grants.gov. 

Additional Information: For further information about the SSVF Program, please email SSVF@va.gov, call 1-877-737–0111, or visit http://www1.va.gov/homeless/ssvf.asp.

Hate Crimes and Violence against People Experiencing Homelessness

I have long advocated for violence against those experiencing homelessness to be considered a hate crime.  I was recently reading Richard Troxell's book Looking Up At The Bottom Line: the Struggle For the Living Wage and in the chapter concerning his efforts to stop some major stores from selling videos of the heinous "Bum Fights" he mentioned a series of incidents in Cleveland, Ohio where a group of moronic punks were going around sneaking up on unsuspecting folks who were sleeping on the streets and shocking them in the throat and groin with a stun gun.  I was so incensed, so pissed when I read that story that I could barely contain my anger.  It got me to thinking again about the issue of violence against those experiencing homelessness and I thought it relevant to share the info below from the National Coalition for the Homeless....


Hate Crimes and Violence against People Experiencing Homelessness
Published by the National Coalition for the Homeless, August 2010

History of Violence
Over the past eleven years (1999-2009), advocates and shelter workers around the country have received news reports of men, women and even children being harassed, kicked, set on fire, beaten to death, and decapitated. From 1999 through 2009, in forty-seven states, Puerto Rico and Washington, DC, there have been one thousand seventy-four acts of violence committed by housed individuals, resulting in two hundred ninety-one deaths of homeless people and seven hundred eighty-three victims of non-lethal violence.
In response to this barrage of information, the National Coalition for the Homeless (NCH), along with its Civil Rights Work Group/Grassroots Organizing Committee, a nationwide network of civil rights and homeless advocates, began compiling documentation of this epidemic. NCH has taken articles and news reports and compiled them into an annual report. The continual numbers of reports of hate crimes and violence against people experiencing homelessness has led NCH to publish its eleventh annual report, “Hate Crimes Against the Homeless: America’s Growing Tide of Violence.” This annual report, which also includes an eleven-year analysis of this widespread epidemic, is available on the NCH website at: www.nationalhomeless.org/publications.

What is a Hate Crime?
In 1968, the U.S. Congress defined a hate crime as a crime in which the defendant intentionally selects a victim, or in the case of a property crime, the property that is the object of the crime, because of their race, color or national origin (Title 18 U.S.C Section 245). The first federal law to combat hate crimes, 18 USC Section 245, passed in 1968; it mandated that the government must prove both that the crime occurred because of a victim’s membership in a designated group and because the victim was engaged in certain specified federally-protected activities -- such as serving on a jury, voting, or attending public school.1
Federal bias crime laws enacted subsequently have provided additional coverage. The Hate Crimes Statistics Act of 1990 (HCSA) authorized the Justice Department to collect data from law enforcement agencies about crimes that “manifest evidence of prejudice based upon race, religion, sexual orientation, or ethnicity.”2 The Hate Crimes Sentencing Enhancement Act, enacted as a section of the Violent Crime Control and Law Enforcement Act of 1994, defines hate crimes as “a crime in which the defendant intentionally selects a victim, or in the case of a property crime, the property that is the object of the crime, because of the actual or perceived race, color, national origin, ethnicity, gender, disability, or sexual orientation of any person.” This measure only applies to attacks and vandalism that occur in national parks and on federal property.3
3 Source: Anti-Defamation League, http://www.adl.org/legislative_action/hatecrimes_briefing.html

Who commits hate crimes and violence against the homeless?
Most hate crimes/violent acts are committed not by organized hate groups, but by individual citizens who harbor a strong resentment against a certain group of people. Some are “mission offenders,” who believe they are on a mission to cleanse the world of a particular evil. Others are “scapegoat offenders,” who violently act out their resentment toward the perceived growing economic power of a particular racial or ethnic group. Still others are “thrill seekers,” those who take advantage of a vulnerable and disadvantaged group in order to satisfy their own pleasures. Thrill seekers, primarily in their teens, are the most common perpetrators of violence against people who are homeless. Eighty per cent of hate crimes/violence against homeless persons in 2009 were committed by perpetrators under the age of thirty.

In 2009:
Total Number of Violent Acts in 2009: 117
Total Number of Non-Lethal Attacks: 74
Total Number of Lethal Attacks: 43

Breakdown of 2009 Non-Lethal Attacks:
Beatings: 67%
Rapes/Sexual Assaults: 13%
Setting Victim on Fire: 8%
Shootings: 6%
Police Harassment/Brutality: 6%

POSITIVE ACTIONS TAKEN AGAINST HATE CRIMES
With this growing problem becoming more apparent in communities around the country, some states, cities, and advocacy groups are proactively addressing the issue.

Alaska added homeless status to a 2008 law creating more protection for vulnerable populations

California passed a law in 2004 mandating police officer training on hate crimes against homeless persons, particularly those with disabilities.

Florida passed a law effective October 1, 2010 adding “homeless status” to hate crime legislation.

Maine passed a law in 2006 that allows judges to take into consideration a victim’s homeless status when considering sentencing for the offender.

In May of 2009, Maryland added homeless persons to the existing hate crime law.

In 2007, Puerto Rico passed legislation that acknowledged the abuse and insensible treatment of homeless people.

In 2010, Rhode Island added homelessness to its hate crime definition for reporting purposes.

Cleveland passed an ordinance in 2008, making repercussions for “intimidation” and harassment more severe if these crimes are perpetrated against an individual because of his/her homeless status.

Los Angeles passed a resolution requiring homelessness awareness to be taught at the high school level, trainings for police officers dealing with possible hate crimes against the homeless, and tracking of hate crimes committed against homeless individuals.

The Miami-Dade County Homeless Trust has created a curriculum/video about homelessness that is shown in schools throughout the county to give young people a greater understanding of homelessness.

Seattle amended the city’s malicious harassment statute to criminalize particular acts, including malicious and intentional injury or threats against a person, or destruction of or damage to the person’s property, because of the perception that the person is homeless

In August of 2009, Washington DC added homeless people to its hate crimes law.

A statewide public education project in Florida to educate people about homelessness was initiated in 2007 by the National Coalition for the Homeless in conjunction with AmeriCorps*VISTA Volunteers. This project has now expanded to Georgia, Maryland, Massachusetts, and South Carolina.

RECOMMENDATIONS FOR ACTION

Supporting bills, such as:
- H.R. 3419, a bill, introduced in the U.S. House of Representatives by Congresswoman Eddie Bernice Johnson (D-TX) and 13 co-sponsors, which seeks to amend the Hate Crimes Statistics Act to include crimes against the homeless.
- S. 1765, a companion bill introduced in the U.S. Senate by Senator Benjamin Cardin (D-MD) and 11 co-sponsors, which seeks to amend the Hate Crimes Statistics Act to include crimes against the homeless.
- H.R. 262, a bill (David Ray Ritcheson Hate Crimes Prevention Act), introduced in the U.S. House of Representatives by Congresswoman Sheila Jackson Lee (D-TX), which seeks to provide support to victims of hate crimes, including housing assistance for homeless individuals.

Supporting state legislative efforts to add homeless persons as a protected class to state hate crime statutes.

Initiating police trainings to help law enforcement officers better understand homelessness in general and how to prevent and manage hate crimes against homeless persons.

Engaging in our public education initiatives in schools to educate young people about homelessness and to humanize our homeless neighbors.

Advocating against city measures that criminalize homelessness and for more constructive approaches to homelessness.

Advocating for more affordable housing and permanent supportive housing to bring an end to homelessness for those homeless members of our communities.

RESOURCES
National Coalition for the Homeless. “Hate Crimes Against the Homeless: America’s Growing Tide of Violence.” 2010, available at www.nationalhomeless.org/publications