Case management working with people living in poverty
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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

CASE MANAGEMENT: WORKING WITH PEOPLE LIVING IN POVERTY

Joseph Walsh

Nonprofit Learning Point

October 18, 2013


Learning objectives

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.


Assignment

ASSIGNMENT

Next week:

Bring a list of your favorite referral sources

Read the journal article

Due COB Tuesday, November 8th

Email to [email protected]

30% final grade


Today s agenda

TODAY’S AGENDA

Introductions

Overview of poverty, housing, and homelessness

Overview of case management

Best practices in case management


Next week s agenda

NEXT WEEK’S AGENDA

Ethical principles for case management practice

Client assessment and prioritizing client needs

Creating and implementing a service plan


Living in poverty

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


Affordable housing

AFFORDABLE HOUSING

What is it?

What factors are involved?

Resources:

HOME

www.phonehome.org

Virginia Supportive Housing

www.virginiasupportivehousing.org


Homelessness defined

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)


Mckinney vento reauthorization

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.


Homelessness nationally lifetime prevalence

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.


January 2012 point in time count survey

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.


The impact of homelessness on children

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.


The impact of homelessness on adults

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.


Why housing matters

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


Case management defined

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.


Case management activities

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


Diversity and cultural competency

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


Achieveing cultural competence

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


Stages of cultural understanding

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


Stages of cultural understanding cont

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


Strengths based case management

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.


Principles of sbcm

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]


Group activity

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?


Housing stability

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?


Best practices in case management

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


Best practices motivational interviewing

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.


Assumptions behind mi

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


The four intervention principles of mi

THE FOUR INTERVENTION PRINCIPLES OF MI

Express Empathy

Develop Discrepancy

Roll with Resistance

Support Self-Efficacy


Four categories of change talk in motivational interviewing

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


Next week

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


Some free online trainings

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


Some additional resources

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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