New Conference Schedule

Pre-Conference Institutes

2016 Medical Respite Pre-Conference Institute

As the preeminent national voice on medical respite care, the Respite Care Providers’ Network (RCPN) Steering Committee has organized a full-day institute to examine current and emerging issues in the field of medical respite. The institute will be facilitated by a diverse collection of speakers representing different perspectives and expertise. Relationship development with funders, effective models of care coordination and care transition, and response to addiction and overdose are a few of the topics that will be highlighted. Additionally, there will be an in-depth discussion on how we as a community understand and promote medical respite care. Through panel presentations and interactive discussions, participants in this year’s institute will have the opportunity to engage in information sharing and networking with providers from across the country.

Presented by: Caitlin Synovec, MS, OTR/L, Occupational Therapist, Baltimore Health Care for the Homeless; Jessie Gaeta, MD, Chief Medical Officer, Boston Health Care for the Homeless Program; Rebecca S. Ramsay, BSN, MPH, Director-Population Health Partnerships, CareOregon; Brandon Clark, MBA, Chief Executive Officer, Circle the City; Donna Biederman, DrPH, MN, RN, Assistant Professor, Duke University School of Nursing; Honora Englander, MD, FACP, Associate Professor of Medicine, Medical Director, Community & Clinical Integration, Oregon Health & Science University; Henry Fader, JD, Attorney, Pepper Hamilton LLP; Jennifer Nelson-Seals, MSHRM, Executive Director, The Boulevard; Carrie Harnish, LMSW, Clinical Director Community Benefit, Trinity Health

Emerging from the Abyss: Programmatic and Professional Strategies to Help People Recover and Grow

Definition of the abyss:

Our clients and patients face tremendous challenges: homelessness, trauma, poverty, addiction, violence, disease, and many more. Too often, those experiencing (or have experienced) homelessness fall into an abyss of despair, suffering, and isolation. As long as this hopelessness persists the person will feel immobilized and helpless to change their situation much less heal and grow from their past trauma. The truth is there is hope for everyone. There is something in every human that allows us to recover and find the strength to walk out of the abyss and into a better more fulfilled life. Strong health outcomes suffer if the trauma is not a part of an integrated client centered approach to care. This pre-conference will examine the science and strategies necessary to partner with people on their journey out of the abyss. Post-traumatic growth and recovery is a combination of biological (medical), psychological, spiritual and social healing. Utilizing their experience and expertise in psychology and medical care presenters along with consumers and counselors will help participants conceptualize their role in the healing process and how to position services to maximize opportunities for growth. There is no darkness that hope cannot overcome.

Presented by: Matt Bennett, MBA, MA, Chief Innovations Officer, Coldspring Center; Siotha King-Thomas, Drug and Alcohol Certificate, Case Manager, Homeless Outreach Team, San Francisco Department of Public Health; Deborah Borne, MD, MSW, Medical Provider and Principal Investigator, San Francisco Department of Public Health

Primary Care Providers and Psychiatric Care: The Next Level

Integration of behavioral health and primary care is key to quality initiatives such as Patient-Centered Medical Home recognition. Furthermore, homeless healthcare providers are particularly challenged to provide primary care to patients with significant (and often severe and decompensated) mental health issues. Impacting the ability to improve health outcomes for clients beyond even the barrier of homelessness, psychiatric disorders can be barriers to care in and of themselves. We find that many primary care providers wish they had more mental health training in order to be more comfortable and skilled in their assessments and prescribing skills. This intermediate presentation targeted to the primary care team will address assessment, intervention, and treatment of mental and behavioral health issues, including psychiatric medication. This training will be particularly beneficial to programs with limited behavioral and mental health resources. The focus will be more on Bipolar Disorder, Schizophrenia, and other more complex presentations and medications. Presenters will also touch on chronic pain, trauma, substance use, and suicidal ideation. We hope after the PCI participants will feel more confident as a ‘bridge’ for patients, a bridge to a higher level of care, when the wait for that higher level of care is too long – because the only other place for patients who may be nearing crisis is the emergency room.

Presented by: Marianne Savarese, RN, BSN, Program Coordinator, COO, City of Manchester Health Care for the Homeless Program; Susan Marie, PMHNP, PhD, Medical Director for Behavioral Health, Old Town Clinic, Central City Concern; Lynda Bascelli, MD, Chief Medical Officer, Project HOPE

A Seat at the Table: Influencing State HealthCare Delivery System Reforms & Aligning Internal HCH Operations

HCH providers always understood health in a broad context, and have evolved a model of care designed to recognize how social determinants of health are critical factors to achieving better outcomes and greater stability. As states are implementing changes to the larger health care environment and increasingly acknowledging factors such as housing, there are now new opportunities to achieve two goals: to leverage our knowledge and experience to help state systems understand what’s needed to truly reform health care, and to align internal HCH operations with state-wide goals (including quality of care outcomes measures). While relationships have always been important to maintain with state Medicaid, MCO plans, hospitals, the public health and criminal justice communities, grant makers and housing providers, new financing methods and other factors are now changing traditional dynamics and offering new opportunities to bolster the health, housing and social services framework. This is happening in a variety of states, regardless of the state’s decision on Medicaid expansion. This PCI will feature presentations from HCH leaders in this work, state partners, and national experts who will share lessons learned from these experiences, the common features of key initiatives that can be replicated across states, and strategies for leveraging a seat at the state policy table (and maximizing your role once there).

Moderated by: Barbara DiPietro, PhD, Senior Director of Policy, National Health Care for the Homeless Council

You Receive Federal Funding! Why Should We Support You? How would You Answer that Question?

Working Together for Quality must be an organization-wide commitment. If one aspect of the organization is not strong and unable to provide sufficient support, then all other areas are not as effective as they could be. This statement could not be truer than in the area of fund development as it relates to establishing your value and making your case for support! The process of fund development: the identification of prospective resources, sharing the organizational story to cultivate those prospects, exercising the stewardship necessary to obtain and sustain the receipt of additional resources are best accomplished when we are all working together. But, how does an agency identify and organize the tasks necessary to create a quality-driven, effective model for financial sustainability? What does that look like? As we are all too aware, the federal funding for 330h grantees does not fully fund our programmatic offerings. So, where do those additional financial resources come from to fill the funding gap? How do you identify those resources? Whose job is it to secure the additional resources? Is it the fund development manager, if you have one? The CEO? The Medical Director? The Case Manager? The Board? How do you determine and communicate your value? Are you providing quality and cost-effective services and how do you communicate that to your prospective patients, partners, and/or the community-at-large? This presentation will answer all these questions and more as we take participants through small and large group discussion, interactive exercises, skills-building processes, and modeling in order to build organizational capacity while establishing the fund development process as a quality measure.

Presented by: Donald Shepard, PhD, Professor, Brandeis University; Caitlin Feller, MPP, PCMH CCE, Principal, Community Health Solutions (CHS); Maureen Neal, CFRE, COO, Advancement, The Daily Planet

Your Oral Health Program: Strategies for Success

This one day intermediate level training is designed specifically for Community Health Center (CHC) executive directors, operations managers, and chief financial officers who want to learn how to sustain, build or begin financially successful oral health programs. Experienced CHC leaders and technical advisors will share the results of how they created and sustained their successful dental programs. Throughout the day, presentation formats will include lecture, small group discussions, and report-outs to the entire group. Breakout sessions will provide multiple opportunities for participant interaction, sharing of promising practices, and anecdotes of both successful and less successful efforts to provide sustainable oral health services to the homeless.

• Laying the Groundwork: Learn HRSA goals relative to FQHCs and dental programs and how to work within them painlessly, creating the right leadership approach, assessing the environment of care and recognizing its critical impact on program design, learn capital equipment requirements for starting or expanding a dental program
• Staffing for Success: Learn staffing requirements to maximize productivity of the oral health program Rewarding success (incentives/bonus)
• Scheduling for Success: Learn strategic scheduling for dentistry and dental hygiene services, and how to create a strategic template Elements of the scheduling policy Scheduling busters
• Fees/Sliding Fee Discount Scale and a HRSA PIN
• Developing Billing Excellence: Learn the unique nature of oral health billing and accounts receivables
• Learn from experienced CHC managers their experience in recruiting and/or contracting with oral health professionals
• Dental Program Performance Key data to track dental performance: What the data reveals, how we use data to improve dental performance, developing ownership and accountability within dental
• Quality of Care Issues Defining quality in dental: Assuring quality of care, how the patient defines quality of care State Medicaid programs, FQHCs and the community standard of care – reducing the risk of penalties and take-backs.

Presented by: Colleen Anderson, DDS, Dentist, Boston Health Care for the Homeless; Mark Doherty, DMD, Executive Director, DentaQuest Institute; Dori Bingham, Program Manager, DentaQuest Institute, Safety Net Solutions; Andrea Dickhaut, RDH, BSDH, MHA, Practice Administrator, DentaQuest Oral Health Center; Bob Russell, DDS, MPH, Public Health Dental Director, Iowa Department of Public Health; Danielle Apostolon, Technical Assistance Project Manager, Safety Net Solutions; Daniel Brody, DMD, Dentist, Valley Health Systems; Mark Koday, DDS, Chief Dental Officer, Yakima Valley Farm Workers Clinic[bg_faq_end]

Learning Labs

Comprehensive Opioid Safety Initiatives and Programming

Drug poisoning or overdose is the number one cause of death among homeless individuals in some communities. A robust and high quality opioid safety and overdose prevention initiative involves many strategies implemented or enhanced in different ways. Some communities and organizations have implemented overdose education and naloxone distribution (OEND) programs for people who may witness an overdose and/or people at risk for overdose. OEND programs educate people to prevent, recognize and respond to an overdose and offer them naloxone, the antidote to an opioid overdose. Medical providers play a role in opioid safety in the way they prescribe opioid pain reliever medications and prescription medicines that are frequently combined with opioids to enhance effects (e.g. benzodiazepines, certain anti-psychotics, etc.). Prescribers can also provide buprenorphine for people with an opioid use disorder. The need for naloxone prescribing and/or distributing is expanding, yet organizations struggle to address hurdles, wasting precious funding and time resources. Similarly, medication assisted treatment (MAT) services are insufficient for people with substance use disorders and experiencing homelessness. This workshop will provide practical support for navigating the interdisciplinary steps in establishing a comprehensive opioid safety initiative, including OEND, integrating overdose risk assessments into regular clinical and non-clinical practice, and the interdisciplinary components of office-based opioid treatment with buprenorphine. We will provide template documents, models implemented across the country, and case studies. We will brainstorm solutions for common hurdles and, in small groups, we will develop organization- or geographic- specific implementation support documents. Attendees should have a working knowledge of the role of MAT in preventing opioid overdoses and enhanced opioid safety, generally. Similarly, conceptual knowledge of overdose education and naloxone access initiatives is expected. The format is lecture, group discussion, small group activities and hands-on practice.

Presented by: Maya Doe-Simkins, MPH, Manager, Training & Technical Assistance, Heartland Health Outreach; Elizabeth Salisbury-Afshar, MD, MPH, Medical Director, Heartland Health Outreach; Haven Wheelock, BS, IDU Health Services Program Coordinator, Outside In.

Connecting Quality Management to Passion, Change, and Advocacy

This Learning Lab is a roller coaster ride through the theory and implementation of Quality Management. The ride begins with a plunge into quality theory, exploring how the roots of quality science can open up a new paradigm for HCH providers. This shift of thinking challenges us to see quality and homelessness within a broader community perspective and can help us shift from an organization-centric perspective to one that can help end homelessness. After considering this quality paradigm shift, we’ll focus on practical approaches that engage participants in activities to demonstrate the power of quality. This section will not only give participants confidence in their own ability to do quality work, but also a powerful Quality Improvement Tool (Model for Improvement) that they can use within their own programs. The Model for Improvement is proven to be a highly effective and robust framework that supports collaborative, strategic, systematic, accelerated change, and can be facilitated by novice evaluators, administrators, and leaders. This tool provides methodologies of setting clear aims, establishing reasonable measures, and selecting feasible improvement projects. The Learning Lab finishes by examining quality improvement in relation to the science of organizational change. At its core, quality is about identifying changes that can positively impact an identified problem. To test and implement changes, leaders must guide people through a process to change behavior and thinking. An organization’s ability to implement change allows it to realized better outcomes for patients and clients. Change is difficult and leadership is critical to the success of any quality initiative. A well-positioned quality program can change organizations, communities, and the quality of services patients receive.

Presented by: Brooke Bender, MPH, Quality & Evaluation Specialist, Coldspring Center for Social & Health Innovation; Matt Bennett, MBA, MA, Chief Innovations Officer, Coldspring Center for Social & Health Innovation; Bettina Harmon, MDiv, President & Chief Quality Officer, Coldspring Center for Social & Health Innovation.

Navigating the Housing Arena from Public to Supportive Housing

This presentation will focus on the intersection of key stakeholders in the health and housing arena and their role in supportive housing and continuity of care. We will begin with an in-depth look at different types of public housing and where supportive housing fits into the public housing arena. This discussion will then lead into a conversation around identifying local partners in the housing arena like regional HUD, Public Housing Authorities, Americorp VISTA programs, FQHCs, CBOs, faith based organizations and strategies for engagement of these stakeholders. We will explore the ways in which FQHCs capture the demographics of their patient population in particular counting homeless and public housing residents on the Uniform Data System Report. Discussion will focus around the unique infrastructure of FQHCs and how this diversity drives the methodology for counting patient demographics. Conversation will then continue around which local stakeholders to engage in this process of counting patients and the implications of this information on expanding services around supportive housing. This final topic will focus on considerations for FQHCs interested in supportive housing services: (financing operations and budgeting for supportive housing) and affordability of offering supportive housing (vouchers and exploring new models of care of reimbursement for services). Case studies highlighting different types of administrative and service options for supportive housing programs with a focus on the different types of funding support (mainstream funding, state funded, engaging health care community to support people by Medicaid funding channels) will be included. Participants will be able to identify where they fit in the supportive housing world, the stakeholders they need to engage in the discussion around supportive housing in their local community and best practices for their particular community.

Presented by: Kim Keaton, MPA, Senior Program Manager, Corporation for Supportive Housing; Alex Lehr, MPH, Program Director, Community Health Partners for Sustainability.

Understanding MI and Trauma from a Perspective for Consumer Providers and Advocates

Consumer providers and advocates offer a rich and incredible important role in serving the diverse needs of people experiencing homelessness. Through life experience and real-world challenge, consumer advocates are a deep and credible source to best support people in moving from the experience of homelessness to permanent housing stability and life transformation. Critical to their work is grounding in the evidence-based practices that have been shown most beneficial in working with people experiencing homelessness. This Pre-conference institute, requested by the National Consumer Advisory Board (NCAB) leadership, will provide an introduction to the philosophy, knowledge, and skills of two evidence based practices trauma informed care and Motivational Interviewing. The team of trainers from the Center for Social Innovations t3 training institute will tailor the learnings to the unique learning needs of consumer professionals and advocates. While we do not have a consumer presenter at this time, we will bring in the consumer perspective through video/audio recordings, active discussion with attendees, and case examples.

Presented by: Wayne Centrone, NMD, MPH, Senior Health Advisor, Center for Social Innovation; Ken Kraybill, MSW, Senior Associate and Director of t3 Training, Center for Social Innovation.

How to Develop and Implement Medical-Legal Partnership, Address Housing and Other Social Needs People Experiencing Homelessness

Description TBA

Presented by: Aisha Forte Brown, JD, Staff Attorney-Medical Legal Partnership, Legal Aid NC; Charita McCollers, MSW, LCSWA, Social Worker, Lincoln Community Health Center.

Special Session: HCH Pioneers Explore the Past and Address the Future of HCH

Health Care for the Homeless (HCH) began as a national demonstration program that started in 1985, was replicated in the 1987 McKinney Act, and now serves over 850,000 people experiencing homelessness each year through 270 federally funded health centers. Over three decades, the National HCH Council has gathered the interests of health care professionals, researchers, advocates and people without homes into a respected, coherent and principled movement that insists upon accessible, quality care and the human right to housing and health care.

In this interactive session, long-time leaders in HCH will explore the vision and values with which we started, the evolution of the model of care, our impact to date, and the future of HCH in a rapidly evolving health care environment.

Registration for this significant session, occurring on Friday morning during the Learning Labs period, is FREE for those who have been involved in homelessness for 20 years or more (automatically calculated with on-line registration), and $50 for all others. Participation is limited to the first 125 registrants.

Moderated by: John Lozier, MSSW, Executive Director, National Health Care for the Homeless Council

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