DECEMBER 2005 | NUMBER
51
CONTENTS
*
Member-Get-A-Member Campaign prizes announced
* Available jobs in HCH
*
Avoid alcohol while taking Avinza or Kadian
* Highlights from Audio
Conference on Substance Abuse & Families
* Third National Training
Conference Preparing People for Change: Knowledge & Choice
* Project
H.O.M.E. Focus of NBC Nightly News Report
* SOAR: An initiative to increase
access to SSA disability benefits for people who are homeless
* Homeless,
Mentally Ill & Addicted: The Need for Abuse & Trauma Services
*
Coalition for the Homeless publishes Resource Guide
* Cultural
Competency: A practical guide for mental health service providers
*
Applications Invited for Robert Wood Johnson Executive Nurse Fellows
Program
* Flu Alert!
* Schizophrenia Research
* Factline: Tracking
Health in Underserved Communities
* Awards for excellence in affordable
housing
* California's Safety-Net Clinics: A Primer
QUESTIONS FROM OUR READERS
* Cognitive impairment in
chronically homeless people . . .
* Need for public restrooms . .
.
UPCOMING EVENTS OF INTEREST TO MEMBERS
*
December 21: National Homeless Persons' Memorial Day
* January 26 - 27:
National Alliance to End Homelessness Conference on Ending Family
Homelessness
* March 7 - 10: TB Case Management & Contact
Investigation
* March 16 - 18: The Road Home: National Conference on
Returning Veterans' & Their Families' Behavioral Health
* June 8 - 10:
2006 National Health Care for the Homeless Conference
* * *
MEMBER-GET-A-MEMBER CAMPAIGN PRIZES
ANNOUNCED!
Don't forget that we're in the middle of our 2006
Member-Get-A-Member Campaign and you've got another month to compete for
fabulous prizes! It's easy to participate:
> Contact friends and
colleagues about Network membership, tell them what you have gained from your
affiliation with this peer-support organization, invite them to join. Dues are
$35.
> For membership brochures, write Pat Petty, Network
administrative assistant, at network@nhchc.org or use
the online membership form at http://www.nhchc.org/network_join.html.
>
Mail the application and dues to HCH Clinicians' Network MGM
Campaign, P O Box 60427, Nashville, TN 37206-0427. Include your name on
the application so we know that you recruited the new member.
Why join now? Typically, those who join before December 31,
2005, are members through June 2006. Those who join through the
Member-Get-A-Member Campaign receive an extended memberships until June
2007. That's like getting a free year's membership in the Network!
What's in it for you? The good feeling that you'll get
knowing that you've made our numbers stronger, plus recognition at the 2006
National Health Care for the Homeless Conference. Those who recruit at least
one member during the Campaign will get a ribbon to wear at the conference
that recognizes Campaign participation. Those who recruit the most members will
receive these terrific prizes:
> First prize: $50 gift certificate to Caprial's Bistro in Portland, OR
>
Second prize $25 gift certificate to Caprial's
Bistro in Portland, OR
> Third prize: Autographed copy of
Caprial's Bistro-Style Cuisine
cookbook
Caprial's Bistro offers expertly prepared ethnically influenced
seasonal Northwest cuisine. You'll be able to use your gift certificate while in
Portland for the 2006 National Health Care for the Homeless Conference and the
11th Annual Network Membership Meeting. Caprial and John are in the second
season of their popular show, Cooking for Family and
Friends, that airs on Public Television (to see if Caprial and John's
Kitchen is being broadcast by your local Public Television station, visit http://www.caprialandjohnskitchen.com/tvshow/broadcast.html.)
Details: The Campaign runs until December 31, 2005. You'll
get credit for new and renewing members. Members of the Network Steering
Committee are eligible to participate. To verify that the person you recruited
joined, call or write Pat at 615 226-2292 or network@nhchc.org. Prize winners will be notified no later than
January 31, 2006.
Questions? Write Brenda Proffitt
at bproffitt@nhchc.org. Good luck!
* * *
AVAILABLE JOBS IN HCH
Please recall that the
National Health Care for the Homeless Council website includes a page of postings of available
jobs in HCH at www.nhchc.org/jobposting.html.
Several Council Organizational Members have current openings, including the
Executive Director's position at Albuquerque HCH. Your assistance in identifying
candidates for this and the other jobs listed on the site would be most
appreciated. On our site, you will also see how to post job openings or resumes
of persons seeking work in HCH. I hope you will find this feature of our
website helpful and utilize it freely.
John N. Lozier, MSSW | Executive
Director| National Health Care for the Homeless Council
phone: 615 226-2292
ext 24 | email: jlozier@nhchc.org | website: www.nhchc.org
* * *
AVOID ALCOHOL WHILE TAKING AVINZA
OR KADIAN
Dear Editor,
You'll see new warnings about patients
avoiding alcohol while taking Avinza or Kadian (long-acting morphine). This is
different than the usual concern about alcohol adding to the sedative effects of
opioids. Alcohol also increases morphine release from Avinza and Kadian
capsules, leading to a potentially fatal dose of morphine. This "dose-dumping"
phenomenon was first seen with Palladone (long-acting hydromorphone), leading to
its removal from the market last summer. So far, this interaction only seems to
be a concern with long-acting opioids in capsule form. Alcohol can interact with
the extended-release coating on the pellets inside the capsule, causing the
coating to break down and release too much drug at once. Warn patients not to
drink ANY alcohol while taking Avinza or Kadian. This includes drugs or products
such as Nyquil, mouthwashes, cough syrups, etc. You may want to pass along
answers Prescriber's Letter gave to my query about how much alcohol might effect
this morphine product---secondary to concerns about overdose and educating my
patients on the street. The folks at Prescriber's Letter (excellent publication
on meds ---not linked to pharmaceutical companies) have always been quite
helpful, and I imagine would be glad to give you references.
Susan Louisa
Montauk, MD| Professor of Clinical Family Medicine | University of
Cincinnati College of Medicine
email: montausl@fammed.uc.edu
Subject: Question regarding Avinza and Kadian
Dr.
Montauk, I wanted to thank you for your comments and quickly give you
information about your question regarding Avinza and Kadian. From what I
understand, the amount released is dependent on the amount of alcohol ingested.
The more alcohol, the larger the "dumped" dose. I don't think information is
available to tell us how much morphine would be released if someone ingested one
drink versus three, though. I have cc'd the writer of this article to make sure
I am giving you correct information. Kayla, would you mind verifying
this?
Melissa Blair | Assistant Editor | mblair@pletter.com
* * *
Yes, that is correct. It does appear to be
dose-related, but it's difficult to know how much alcohol would be considered
dangerous. Palladone is the only drug that has an in vivo study, but the
patients were given naltrexone to counteract alcohol's effects. Plus it would
also depend on how opioid-tolerant a person is. Although Avinza and Kadian only
have in vitro studies to suggest a similar pharmacokinetic interaction, the same
warning applies. However, the FDA says the risk is not as high with Avinza and
Kadian. Their response regarding the recent warning for Avinza: "The dose range
of the Avinza products falls into a significantly lower portion of the potency
range for opioids compared to the dose range for the Palladone products.
Therefore, dose-dumping due to an alcohol interaction with Avinza is less likely
to result in morbidity or mortality than dose-dumping that would occur with
Palladone. While the results of the ongoing in vivo studies of Avinza could
still result in a regulatory action depending upon the extent of the effect
found in those studies, in theory the concerns are not as clinically significant
as those that resulted in Palladone being removed from the market." I hope this
helps!
Kayla Dotson, Pharm D | Assistant Editor | Pharmacist's
Letter/Prescriber's Letter | Therapeutic Research Center | phone: 208 255-7080 |
email: kdotson@pletter.com
* * *
HIGHLIGHTS FROM AUDIO
CONFERENCE ON SUBSTANCE ABUSE & FAMILIES
The November 10 Leadership to End Homelessness Audio Conference Series
call focused on two programs in San Francisco and how they are responding to
substance abuse issues in homeless families in their programs. Nella Gonclaves
of Catholic Charities CYO and Beth Stokes of Hamilton Family Center described
their work with homeless families using harm reduction
strategies. Under this approach, parents who are abusing substances are
not restricted or expelled from shelter or permanent housing programs. Instead,
providers actively seek to maintain families in housing, minimize the effects of
substance abuse on parents, children and their communities and help promote
parents' efforts to recover from addiction. Both speakers acknowledged that
using a harm reduction approach with families is controversial. They noted,
however, that without this approach, many of the families with substance abuse
problems they are now serving would fall through the social service delivery
cracks endangering children and families. An audio file of the call will be
available shortly on the National Alliance to End
Homelessness website. For more information or to listen to past
conferences, visit www.endhomelessness.org/audio.
SOURCE: National
Alliance to End Homelessness | Online Newsletter | November 16, 2005
* * *
PREPARING PEOPLE FOR CHANGE: KNOWLEDGE &
CHOICE
We are forwarding a short description of the National Resource & Training Center on Homelessness &
Mental Illness recent conference, Preparing People
for Change: Knowledge & Choice. For PowerPoint presentations and
other materials from the conference, visit the website nrchmi.samhsa.gov. For a write-up about the
conference from the newsletter of the Interagency Council on
Homelessness, go to www.ich.gov. Over
800 providers, consumers and public officials attended more than 75 workshops
and sessions, each presented by national experts and organized around the
homelessness-related topics of services, housing, and cross-cutting
issues.
Speakers at this year's conference included Charles G. Curie,
Administrator of the Substance Abuse & Mental Health
Services Administration (SAMHSA), who presented the
2005 Exemplary Program Awards to 12 programs from across the country that
serve individuals and families who are homeless. The programs were selected
based on several criteria, including use of evidence-based practices and
consumer involvement. The final plenary session included a panel of consumers
presenting their own personal paths to recovery, emphasizing a major theme of
the conference. A special evening session was devoted to a conversation about
the recent hurricanes in the Gulf Coast. The discussion centered around what
impact the hurricanes had on the service delivery system in the home communities
of attendees, what innovative responses had been developed, what lessons had
been learned, and how best to move forward.
SOURCE: National Resource &
Training Center on Homelessness & Mental Illness
* *
*
PROJECT HOME FOCUS OF NBC NIGHTLY NEWS REPORT
On November 15, NBC
cameras turned their focus on Sister Mary Scullion and
Project H.O.M.E., the Philadelphia-based organization she founded in
order to assist homeless individuals and helping the city drastically reduce its
homelessness numbers by half. For more on the story, see www.msnbc.msn.com/id/10055262.
SOURCE: National Alliance to End Homelessness | Online
Newsletter | November 21, 2005
* * *
SOAR: AN
INITIATIVE TO INCREASE ASSESS TO SSA DISABILITY BENEFITS
SSI/SSDI Outreach, Access and Recovery (SOAR) is a new
technical assistance and training initiative helping increase access to SSA
disability benefits for people who are experiencing homelessness. Through
SSI/SSDI outreach and assistance, initial approval rates can soar to 60 -
95 percent of applicants without appeals. The SOAR initiative will increase the
number of homeless people in your State who receive SSI and SSDI by:
>
Encouraging collaboration among key stakeholders
> Facilitating
strategic planning to improve access to SSI/SSDI at the State and community
levels
> Offering a Train-the-Trainer program, to build the capacity
of your state to train front-line staff to assist homeless people with SSA
disability applications
> Providing follow-up observation and feedback
on the State's first Stepping Stones to Recovery training
>
Delivering on-going support and technical assistance from SOAR TA
Team
> Tracking outcomes to ensure long-term support and dissemination
of promising practices
> Training manual: Stepping Stones To
Recovery: A Case Manager's Manual for Assisting Adults who are Homeless, with
Social Security Disability and Supplemental Security Income
Applications
For more information, go to www.pathprogram.samhsa.gov/SOAR where you can learn
about SOAR and training opportunities, access tools and resources, and download
the training manual, Stepping Stones
ToRecovery. SOAR is sponsored by
the U.S. Department of Health & Human Services'
Substance Abuse & Mental Health Services Administration, Center for Mental
Health Services.
* * *
HOMELESS, MENTALLY ILL
& ADDICTED: THE NEED FOR ABUSE & TRAUMA SERVICES
"Homeless, Mentally Ill and Addicted: The Need for Abuse and
Trauma Services" examines an empirical investigation of the lifetime
prevalence of trauma (defined as sexual and/or physical abuse) in a cohort of
adults enrolled in a federally funded initiative that provides treatment for
homeless persons suffering the effects of comorbid substance use and serious
mental illness, and considers the impact of this information on clinical
programming. The study was conducted by Richard C.
Christensen, MD, MA, from the University of Florida College of Medicine.
Data collected from homeless individuals with co-occurring disorders admitted to
the Seeking Treatment and Recovery (STAR) Program during a one-year period
(n=78) were analyzed for a history of trauma events. Of those individuals
evaluated, 79.5 percent acknowledged a history of either physical and/or sexual
abuse at some time in their lifetimes. Of this population, 100 percent of the
homeless women (n=27) with co-occurring disorders had experienced a
life-altering traumatic event while 68.6 percent of the homeless men also
reported trauma histories. The paper, which appeared in the Journal of Health Care for the Poor and Underserved,
describes the trauma-based interventions made in the STAR Program that have the
potential for replication in other initiatives committed to serving homeless
individuals with co-occurring disorders. A copy of the article is attached see Christensen/JHCPU.doc.
* * *
NEW YORK COALITION FOR THE HOMELESS PUBLISHES RESOURCE
GUIDE
The Coalition for the Homeless announces that the 2005 edition
of its Resource Guide is available. The Guide
contains over 500 pages of information about food, shelter and services for
homeless New Yorkers. Cost: $25. To purchase, send a check made payable to the
Coalition for the Homeless, to Resource Guide, 129 Fulton Street, New York, NY
10038. Please be sure to include your name, complete address and phone number.
You may also order the guide online at www.coalitionforthehomeless.org. For more
information, contact Joshua Klinski at 212 776-2002 or
jklinski@cfthomeless.org.
* * *
CULTURAL COMPETENCY: A
PRACTICAL GUIDE FOR MENTAL HEALTH SERVICE PROVIDERS
-by Delia Saldana, PhD,
Hogg Foundation for Mental Health
I thought I'd forward the attached
guidebook see Cultural Competency.pdf. I
haven't reviewed it thoroughly, but think it looks potentially very useful to
HCH providers.
John Gilvar | Austin-Travis County Community Health Centers |
HCH Project | City of Austin Community Care Services Department
phone: 512
972-4006| website: www.ci.austin.tx.us/communitycare
* * *
APPLICATIONS
INVITED FOR RWJ EXECUTIVE NURSE FELLOWS PROGRAM
Deadline: February 1,
2006
A program of the
Robert Wood Johnson Foundation, the Robert Wood Johnson Executive Nurse Fellows Program is an advanced leadership program for nurses in senior executive
roles in health services, public health, and nursing education who aspire to
help lead and shape the U.S. health care system. Each year the program selects a
cohort of approximately 20 qualified nurses in senior executive positions to
participate in the three-year fellowships. Major components of the program
include an advanced leadership curriculum, seminar and workshop sessions,
pursuit of an individual learning plan, completion of an individual project,
intensive coaching, and significant experience with a senior executive mentor.
While the program allows fellows to remain at their home institutions, program
activities (including group sessions, course work, and a mentor experience) will
take fellows away from their regular duties for four to six weeks per year.
Fellows must secure a commitment from their home institutions for release time
and continued compensation so that they are free to attend and participate in
all program activities. The fellowships provide $35,000 over three years.
Applicants must be U.S. citizens or have permanent residency status. See the
RWJF website for complete program information and application procedures:
www.rwjf.org/applications/program/cfp.jsp?ID=19263
* * *
FLU ALERT!
According to a report from Trust for America's Health, if a moderately severe
strain of a pandemic flu virus hit the United States, 70 million Americans might
be at risk of contracting the disease and 2.3 million could be hospitalized.
A Killer Flu? examines shortfalls in the amount of available
anti-viral medication and hospital capacity to respond to an epidemic, and
offers recommendations to boost U.S. preparedness.
SOURCE: The Foundation
Center | Health Funding Watch | November 16, 2005
* *
*
SCHIZOPHRENIA RESEARCH
For scientists and anyone else interested
in the latest information on schizophrenia, the Schizophrenia Research Forum offers analysis of
recent findings, a database of annotated research citations, and a way for
researchers to connect with others conducting similar studies. This site is
sponsored by NARSAD, the National Alliance for Research on Schizophrenia &
Depression.
SOURCE: The Foundation Center | Health Funding Watch |
November 16, 2005
* * *
FACTLINE: TRACKING HEALTH IN
UNDERSERVED COMMUNITIES
Factline is a project of the Journal of Health Care for the Poor and Underserved,
sponsored by the National Library of Medicine and Meharry Medical College.
Taking its structure from the federal government's Healthy
People 2010, Factline is designed for journalists, students, community
workers and policy makers to present solid facts from scholarly research on
health disparities in a brief and understandable format. Each fact presented
comes supplied with the reference from the literature where it is established;
each page on the site is enhanced with Google
and PubMed search mechanisms to allow the interested
reader to go further on the subject in either the popular or the scholarly
literature.
Virginia M. Brennan, PhD | Editor, J. of Health Care for the Poor
and Underserved
phone: 615 327-6819 or 800 669-1269 | email: vbrennan@mmc.edu
| website: www.factline.org
* * *
AWARDS FOR
EXCELLENCE IN AFFORDABLE HOUSING
The Enterprise Foundation has
released MetLife Foundation Awards for Excellence in
Affordable Housing. The publication features case studies of six best
practices in supportive housing and property and asset management who were
award-winning projects in 2005. The publication offers detailed information on
the award-winning programs including program design, services offered, physical
building features, funding sources, neighborhood impact, and contact
information. For more information and to read the publication visit www.enterprisefoundation.org/metlife.
SOURCE:
National Alliance to End Homelessness | Online Newsletter | November 28,
2005
* * *
CALIFORNIA'S SAFETY-NET CLINICS: A
PRIMER
-by Elizabeth C. Saviano, Esq, and Margie Powers, MSW, MPH | November
2005
Providing essential health care services to vulnerable
populations, regardless of patients' ability to pay, is an indispensable
component of any health system. In California, though there is no formal "safety
net" for the millions of under-insured and underserved, a network of clinics and
providers, both public and private, works closely with communities to offer a
spectrum of critical services. This report (see
attached SafetyNetClinicPrimer.pdf) focuses on the outpatient clinic
portion of California's safety net and clarifies how this complex network
operates. It identifies the various players and provides a framework for
understanding their similarities and differences, including their funding
streams and organizational structures. Beyond direct service providers, the
state's network also includes 14 clinic consortia, geographically linked clinic
coalitions that play a critical role in strengthening the safety net. These
consortia offer a high level of support and expertise in areas including
information technology, quality improvement, and public policy advocacy. With
safety-net providers facing a wide range of challenges-from budget cuts to a
growing number of uninsured patients-continued and increasing levels of
community support will become invaluable as they work to fulfill their
missions.
* * *
QUESTIONS FROM OUR
READERS
Cognitive impairment in chronically homeless people . .
.
This is a request from Dr. Virginia Luchetti, a psychologist and
director of the Contra Costa Homeless Encampment Outreach
Project (HOPE) which is part of the larger collaborative Project Coming Home (CA) Chronic Homeless Initiative site.
She is examining the extent of cognitive impairment in people who are
chronically homeless, and the likelihood of these individuals being approved for
SSA disability benefits. She is looking for other psychologists (or programs
that have access to a psychologist) who may be interested in collaborating on
this study with her. Please see the attached invitation from Dr. Luchetti for more
information and contact her directly at vluchetti@sbcglobal.net if you or someone you know
may be interested in participating in her study. Please note that this study is
not federally funded.
* * *
Need for public restrooms
. . .
We received a question from someone conducting research on the
need for public restrooms who asked if there are health issues associated with
homeless people having access to public facilities. We would like to develop a
brief, comprehensive statement on the need for public restrooms, and we are
seeking two - three persons to work with staff on this project. If you are
interested, contact Brenda at bproffitt@nhchc.org and please put Need for public restrooms task force in the Subject line
of your message.
* * *
UPCOMING EVENTS OF INTEREST TO
MEMBERS
December 21: National Homeless Persons' Memorial Day.
Co-sponsored by the National Coalition for the Homeless and the National Health
Care for the Homeless Council. Please visit these sites for more information:
www.nationalhomeless.org and www.nhchc.org
January 26
- 27: National Alliance to End Homelessness Conference on Ending Family
Homelessness | Oakland Marriot City Center | Oakland, CA | For agenda,
online registration and hotel information, go to www.naeh.org/FamConf2006.
March 7 - 10: TB Case Management & Contact
Investigation | San Francisco, CA | Francis J.
Curry National TB Center | For a complete course description and
application information, visit
www.nationaltbcenter.edu/training/tb_case_management_intensive.cfm | Application
deadline: January 6, 2006
March 16 - 18: The Road
Home: National Conference on Returning Veterans' & Their Families'
Behavioral Health | Washington Hilton |Washington, DC | Sponsored by
Substance Abuse and Mental Health Services Administration in partnership with
Therapeutic Communities of America | For information, contact Andrea Vincent at
1 866 277-4772 or visit www.samhsa.gov | See Save the Date.pdf, attached
June 8 - 10: 2006 National Health Care for the Homeless
Conference | Hilton Portland & Executive Tower | Portland, OR | For
information, visit www.bphc.hrsa.gov/hchirc
# #
#
This electronic newsletter was developed with support from the Health Resources & Services Administration. Its
contents are solely the responsibility of the authors and do not necessarily
represent the official views of HRSA/BPHC.
You are currently subscribed
to Network News, an e-newsletter for members of the
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Brenda J. Proffitt, MHA | Editor,
Network News | HCH Clinicians' Network
P O Box 25605 | Albuquerque, NM
87125-5605 | phone: 505 872-1151 | e-mail:
bproffitt@nhchc.org bproffitt@nhchc.org