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CASE MANAGEMENT: WORKING WITH PEOPLE LIVING IN POVERTY

CASE MANAGEMENT: WORKING WITH PEOPLE LIVING IN POVERTY. Joseph Walsh Nonprofit Learning Point October 18, 2013. LEARNING OBJECTIVES. After completion of this course, students will: Have a general understanding of homelessness and housing instability.

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CASE MANAGEMENT: WORKING WITH PEOPLE LIVING IN POVERTY

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  1. CASE MANAGEMENT: WORKING WITH PEOPLE LIVING IN POVERTY Joseph Walsh Nonprofit Learning Point October 18, 2013

  2. LEARNING OBJECTIVES After completion of this course, students will: Have a general understanding of homelessness and housing instability. Effectively apply the strengths perspective to case management with clients. Develop an understanding of ethical standards as they apply to case management. Effectively assess and prioritize clients needs and use that information to create a service plan.

  3. ASSIGNMENT Next week: Bring a list of your favorite referral sources Read the journal article Due COB Tuesday, November 8th Email to jwalsh@vcu.edu 30% final grade

  4. TODAY’S AGENDA Introductions Overview of poverty, housing, and homelessness Overview of case management Best practices in case management

  5. NEXT WEEK’S AGENDA Ethical principles for case management practice Client assessment and prioritizing client needs Creating and implementing a service plan

  6. LIVING IN POVERTY What challenges do your clients (who live in poverty) face? What resources are there? For a description … Census poverty thresholds by year: https://www.census.gov/hhes/www/poverty/data/threshld/index.html

  7. AFFORDABLE HOUSING What is it? What factors are involved? Resources: HOME www.phonehome.org Virginia Supportive Housing www.virginiasupportivehousing.org

  8. HOMELESSNESS DEFINED An individual who is homeless lacks a fixed, regular, and adequate nighttime residence and includes those who are living in a shelter or a place not fit for human habitation (for example, a bench, the sidewalk, or under a bridge). ~HUD (Dept. of Housing and Urban Development)

  9. MCKINNEY-VENTO REAUTHORIZATION The HEARTH Act adds to this definition ... Imminent risk includes situations where a person must leave his or her current housing within the next 14 days with no other place to go and no resources or support networks to obtain housing. Instability includes families with children and unaccompanied youth who: 1) are defined as homeless under other federal programs, 2) have lived for a long period without living independently in permanent housing, 3) have moved frequently, and 4) will continue to experience instability because of disability, history of domestic violence or abuse, or multiple barriers to employment.

  10. HOMELESSNESS NATIONALLY: LIFETIME PREVALENCE In 2001, the prevalence of: Lifetime precarious housing was 12.9%, Lifetime literal homelessness was 6.2% Literal homelessness was 1.9% (over five years) Tompsett, C.J., Toro, P.A., Guzicki, M., Manrique, M., & Zatakia, J. (2006). Homelessness in the United States: Assessing changes in prevalence and public opinion, 1993-2001. American Journal of Community Psychology, 37(1/2), 47-61.

  11. JANUARY 2012POINT-IN-TIME COUNT & SURVEY http://www.homewardva.org/sftp-homeward/January%202012%20general%20snapshot%20FINAL%20030912%20MEA.pdf What surprises you about this? How many of your clients share these characteristics? Ackermann, M. (2012). January 2012 snapshot of individuals and families experiencing homelessness in the Richmond region. Richmond, VA: Homeward. Retrieved from www.homewardva.org.

  12. THE IMPACT OF HOMELESSNESS ON CHILDREN Increases likelihood of becoming homeless as an adult (Burt, 2001). The National Child Traumatic Stress Network reports that children who are homeless are: Sick at twice the rate of other children. Go hungry twice as often as other children. Are twice as likely to repeat a grade. Suffer increased exposure to traumatic experiences such as assault, domestic violence, and separation.

  13. THE IMPACT OF HOMELESSNESS ON ADULTS The National Health Care for the Homeless Council reports that adults who are homeless may suffer from: Health problems (TB, AIDS, malnutrition, dental problems, physical disabilities) Exposure (frostbite, parasites, infections) Addictions Mental health problems Violence Unstable housing may make it difficult to manage such problems.

  14. WHY HOUSING MATTERS Housing stability leads to an increased quality of life on all measures Homelessness results in an inefficient use of community resources It is a human right

  15. CASE MANAGEMENT DEFINED Case management is an approach to social service delivery that attempts to ensure that clients with multiple, complex problems and disabilities receive services they need in a timely, appropriate fashion.

  16. CASE MANAGEMENT ACTIVITIES Assessment of client needs, strengths, and limitations Planning for appropriate service acquisition Linkage with service providers from various systems Advocacy on behalf of clients with other service providers in order to ensure that those services are made available Monitoring of service quality across providers Evaluation of the overall process Documenting services delivered and progress

  17. DIVERSITY AND CULTURAL COMPETENCY What is it? What role does is play in case management? A self-assessment http://www11.georgetown.edu/research/gucchd/nccc/documents/Checklist.CSHN.doc.pdf

  18. ACHIEVEING CULTURAL COMPETENCE Self-Awareness Reflecting on the ways one’s own culture affects practice Understanding Cultural Differences Developing communication skills Openness to difference Interest in learning about those differences

  19. STAGES OF CULTURAL UNDERSTANDING Cultural destructiveness Cultural incapacity – Belief in the superiority of dominant groups Cultural blindness – Evasiveness Cultural precompetence – Respect for other cultures with minimal related actions

  20. Stages of Cultural Understanding (Cont.) Cultural competence – The social worker accepts and respect differences, expands cultural knowledge, and actively pursues engagement with non-dominant clients and co-workers Cultural proficiency - The social worker not only understand persons of different cultures, but uses that understanding as a basis for practice

  21. STRENGTHS BASED CASE MANAGEMENT Everything you do should be predicated in some way on helping to discover and embellish, explore and exploit clients‘strengths and resources in the service of assisting them to achieve their goals. The resaerch indicates that strengths-based case management: Contributes to a hopeful client attitude Enhances client-worker relationship Increases retention Saleebey, D. (2006). The Strengths Perspective in Social Work Practice (4th ed.). Boston: Pearson.

  22. PRINCIPLES OF SBCM Strengths, abilities, and assets should form the basis for the helping relationship Goal-setting is driven by the client The client-case manager relationship is primary The community is viewed as a resource Case management is an active, community-based activity Marty D, Rapp CA, Carlson L. The experts speak: The critical ingredients of strengths model case management. Psychiatric Rehabilitation Journal. 2001;24:214–221. [PubMed]

  23. GROUP ACTIVITY Identify strengths that you have seen in your clients and in their environments. How have you (could you) build on those strengths? How have (might) your clients react to an emphasis on their strengths? Think back on a time you may have overlooked a client strength. Why did this happen?

  24. HOUSING STABILITY What role does it play in the work you do with your clients? What role does housing stability play in the welfare of your clients?

  25. BEST PRACTICES IN CASE MANAGEMENT Strengths-based case management Harm reduction Not abstinence Reduces dangers and risks associated with risky/self destructive behaviors Increases retention and the likelihood of achieving goals Rapid rehousing Keys to Ending Family Homelessness http://www.endhomelessness.org/library/entry/keys-ending-family-homelessness

  26. BEST PRACTICES: MOTIVATIONAL INTERVIEWING Motivational Interviewing (MI) is a client-centered, yet directive, method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. Originally developed for use with substance abusing populations, it can be useful with any clients who are ambivalentabout making a change.

  27. ASSUMPTIONS BEHIND MI Change occurs naturally The likelihood that change will occur is strongly influenced by interpersonal interactions The case manager is a significant determinant of treatment dropout, retention, adherence and outcome People who believe they are likely to change do so What people say about change is important Statements that reflect motivation and commitment predict behavior change

  28. THE FOUR INTERVENTION PRINCIPLES OF MI Express Empathy Develop Discrepancy Roll with Resistance Support Self-Efficacy

  29. FOUR CATEGORIES OF “CHANGE TALK” IN MOTIVATIONAL INTERVIEWING Point out the disadvantages of the status quo Point out the advantages of change Convey optimism about change Evaluate and encourage the client’s “intention” to change when it arises

  30. NEXT WEEK Read the assigned article Bring your favorite resources to share We will discuss: Ethical principles regarding case management practice Client assessment and prioritizing client needs Creating and implementing a service plan

  31. SOME FREE ONLINE TRAININGS CSAP’s (Center for Substance Abuse Prevention) Prevention Pathways http://pathwayscourses.samhsa.gov/index.htm Mandated Reporter online training http://www.dss.virginia.gov/family/cps/index2.cgi

  32. SOME ADDITIONAL RESOURCES National Alliance to End Homelessness www.endhomelessness.org Homeward www.homewardva.org 30 Days, Minimum Wage (Netflix) SAMHSA (TIP 35 is about MI) www.samhsa.gov Million Dollar Murray http://www.gladwell.com/2006/2006_02_13_a_murray.html 211 http://www.211virginia.org

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