Shelter Health: Essentials of Care for eople iving in Shelter >en >raybill, MSW Deff Elivet, MA ational Health Care for the Homeless Council www.nhchc.org Shelter Health: Essentials of Care for eople iving in Shelter The ational Health are for the Homeless ouncil The ational Health Care for the Homeless Council began as an element of the -proect HCH demonstration program of the Robert Wood ohnson Foundation and the ew Memorial Trust. We are now over rganiational Members and over 00 individuals who provide care for homeless people throughout the country. ur rganiational members include grantees and subcontractors in the federal Health Care for the Homeless funding stream, members of the Respite Care roviders etwork, and others. Homeless and formerly homeless people who formally advise local HCH proects comprise the ational Consumer Advisory oard and participate in the governance of the ational Council. 4tatement of 5rinciples We recognie and believe that: ! homelessness is unacceptable ! every person has the right to adequate food, housing, clothing and health care ! all people have the right to participate in the decisions affecting their lives ! contemporary homelessness is the product of conscious social and economic policy decisions that have retreated from a commitment to insuring basic life necessities for all people ! the struggle to end homelessness and alleviate its consequences takes many forms including efforts to insure adequate housing, health care, and access to meaningful work. 7ission 4tatement The mission of the ational Council is to help bring about reform of the health care system to best serve the needs of people who are homeless, to work in alliance with others whose broader purpose is to eliminate homelessness, and to provide support to Council members. Consistent with our Mission Statement, we: ! Advocate for universal health care and for the improvement of current systems intended to serve people who are poor and homeless ! Research critical issues ! Train and organie health care providers, service agencies, and homeless people themselves to improve care ! ublish newsletters, monographs, action alerts, policy statements, training videos and books ! Collaborate with a broad range of public and private entities interested in the problems of health care and homelessness. ational Health Care for the Homeless Council 2 www.nhchc.org Shelter Health: Essentials of Care for eople iving in Shelter cnowledgments This proect was developed with the support of the Health Resources and Services Administration. The views expressed in this document do not necessarily reflect the views of HRSA. The development of the proect was guided by the Shelter Health Advisory Committee, consisting of Edward onin, Sharon rammer, ohn ilvar, Amy rassette, inda livet, Alina ere-Stable, aren Rotondo, Marion Scott, and Allan Ainsworth. Also indispensable to this proect have been Heather arr, eth Miller raybill, Sharon Morrison, Hannah ouldin livet, at ost, and Marcia Stone. As always, ohn oier has provided great vision and support. This guide draws extensively on Marsha McMurray-Avila’s book Organiing Health Care for Homeless People, en raybill’s Outreach to People periencing Homelessness, and The Health Care of Homeless Persons: A anual of Communicale iseases and Common Prolems in Shelters on the Streets, im ’Connell, editor. The Health Care of Homeless Persons was published by the oston Health Care for the Homeless rogram and generously shared with the ational Council for this and other purposes. Homeless Health Care <os Angeles and the Seattle-ing County Health Care for the Homeless etwork have also done pioneering work in the area of training shelter providers, and we have utilied and adapted their materials for this uide. Additionally, we have drawn from the work of many other organiations for this uide, and we have tried diligently to give proper attribution. We are deeply appreciative of all the work that has given us a foundation for this publication. Drawing on the wisdom of many, we have attempted to create a document that will be useful to many. lease feel free to duplicate and adapt these materials for your own training and operational purposes attribution as to source will be appreciated. Reproduction or sale of these materials for profit is prohibited. Thanks to you all, en raybill and eff livet May 200 ational Health Care for the Homeless Council 3 www.nhchc.org Shelter Health: Essentials of Care for eople iving in Shelter Table of ontents >. Why This Buide? Why %ow? D The Tool its A uide for Shelter roviders Ways to Use This uide 0 The Causes and Conditions of Homelessness Homelessness and Health Care: Fundamental ssues 3 Understanding the Connections etween oor Health And Homelessness Human Rights, Shelter, and Health Care Thinking of Hosting a Homeless Shelter 3I >>. What You eed to now GH ringing Health are into the helter The Tool its 2 The Facts on Common Health Conditions 2 The Facts of ice 4 ntake, Showers, and Clean Sheets: Heading ff nfestations n Homeless Shelters 4 The Top 4: Asthma, Diabetes, Cardiovascular Disease, and SeiQures 4 About Asthma 4 About Diabetes 0 About Cardiovascular Disease 3 What To Do f Someone is Having a Seiure Health romotion Health romotion in Shelters Homeless Family Facility utrition uidelines Why Dental Care Matters to Homeless eople 2 Environmental Health and afety The Tool its Hand Washing uidelines for Environmental Safety in Shelter uidelines for the Control of Communicable Disease in Shelter Standard recautions in Shelters Sample Shelter olicies 2 Environmental Health is ot Dust About Control of Disease 0 Safety Manual ational Health Care for the Homeless Council 4 www.nhchc.org Shelter Health: Essentials of Care for eople iving in Shelter For the Women of atrina and ther Disasters Making Shelters Safe for Transgender Evacuees A Word About Animals and Environmental Health 0 ental llness and ubstance Use Disorders The Tool its Effective Approaches What Works Suggestions for Relating to a erson Experiencing Mental llness 00 Suggestions for Relating to a erson Experiencing ntoxication 0 Understanding Addiction 02 rinciples of Effective Drug Addiction Treatment 03 Suicide 0 Suicide Myths and Facts 0 Signs of Depression and ossible Suicide Risk 0 ..A..D. .A..S. 0 lossary of Common Mental Health Terms 0 lossary of Selected Terms Related to Substance Use Disorders, Treatment, and Recovery 4 Ta9ing -are: -oping with Brief and Qoss RGR The Tool its 22 When the Hurricane Hits 23 Care for the Caregiver 2 Common Causes of Stress in Homeless Services 2 Signs and Symptoms of Secondary Traumatic Stress 2 Self-Assessment Tool: Self-Care 2 Finding Resiliency and Renewal in ur Work 30 Caring for Your Self, Your Soul, Your Sanity 32 Mindfulness and Self-Care for Shelter roviders 33 Helping thers Cope with rief and oss 3 Reactions to oss 3 eys to Understanding and Accepting the rief rocess 3 Some Suggestions to Help rieving eople 3 Recovering From the Aftermath of a Disaster 3 ommunication and onnection The Tool its 42 Common Human eeds: The asis for utreach 43 Seven Human eeds 44 Frameworks of Engagement 4 urpose and rinciples of utreach 4 Where utreach Happens 4 ational Health Care for the Homeless Council www.nhchc.org Shelter Health: Essentials of Care for eople iving in Shelter Services rovided Through utreach and Case Management 0 ood Communication ARS: pen uestions 2 ARS: Affirmations 3 ARS: Reflective istening 4 ARS: Summaries Creating a istening Environment ustaining ommunity Dialogue and Response The Tool its Working Effectively in the Community Checklist for Making Successful Referrals 0 Everyone Hates Meetings Meetings Stink 2 Ten Tips for Effective Meetings 4 uiding rinciples and Shelter Standards Disaster lanning 2 When Disaster Strikes, Health Care for the Homeless Takes to the Streets >>>. UF, ow What? ext teps RDO ext Steps Tips for Trainers 2 essons earned >X. 7ore Resources ROY ist of rganiations ist of Acronyms Further Reading ational Health Care for the Homeless Council www.nhchc.org Shelter Health: Essentials of Care for eople iving in Shelter Why This uide Why !owd ational Health Care for the Homeless Council www.nhchc.org Shelter Health: Essentials of Care for eople iving in Shelter The Tool its At the beginning of each section of this uide, readers will find lists that outline the contents of the Tool its that can be found in electronic form on the CD that accompanies this uide. While some of the tools and handouts are found both in the uide and in the Tool its, most of the items listed below are only found in the Tool its. They are to be used to supplement the material in the Yuide and to provide shelter providers with day-to- day tools for use in the shelters. Tool it : eneral nformation A- “Why Are eople Homeless” A fact sheet from the ational Coalition for the Homeless A-2 “Homeless Children: America’s ew utcasts” from the ational Center on Family Homelessness A-3 “nternally Displaced ersons” A-4 “Right to Health” A-P “Right to Housing” ational Health Care for the Homeless Council www.nhchc.org Shelter Health: Essentials of Care for eople iving in Shelter uide for helter roviders The ational Health Care for the Homeless Council provides publications and trainings on providing effective health care for homeless persons. n late 200 and early 200, we have chosen to focus our efforts on shelters that have been created to house persons displaced by the recent hurricanes, and on pre-existing shelters that have absorbed other