Hiring and retaining appropriate staff is essential for programs serving those who have experienced chronic homelessness. This paper describes specific staffing challenges and strategies from the Collaborative Initiative to Help End Chronic Homelessness (CICH), an 11-site, multi-agency Federal program designed to serve people experiencing chronic homelessness who also have a disabling condition such as substance use or mental health problems. This paper addresses approaches to staffing including team structures, staff supervision, and training. Challenges identified include low pay, high rates of burnout and turnover, limited time for supervision, and multiple staff training needs. This paper also explores specific staffing strategies based on the experience of the CICH sites, and concludes with implications for practice, research, and policy, including recommendations for ongoing staff training, suggestions for future mixed-methods research, and a call for an enhanced focus on strengthening the homeless services workforce.
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http://dx.doi.org/10.1007/s11414-009-9201-3 | DOI Listing |
BMC Health Serv Res
December 2024
Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Background: After release from incarceration, individuals are rarely connected to primary care or to social services despite bearing a disproportionate burden of poor health (e.g., chronic illness) and structural determinants of health (e.
View Article and Find Full Text PDFCase Rep Infect Dis
December 2024
Department of Medicine, Temple University Hospital, Philadelphia, Pennsylvania, USA.
The city of Philadelphia has seen an increase in homelessness and substance use disorders, often associated with xylazine-contaminated opiates. Here, we report the first two cases of wound infection and bacteremia associated with the Gram-negative rod species. Both cases were associated with maggot colonization in chronic lower extremity wounds from fentanyl/xylazine injections.
View Article and Find Full Text PDFQual Health Res
December 2024
School of Nursing, University at Buffalo, State University of New York, Buffalo, NY, USA.
Although chronic health conditions and homelessness are prevalent problems in the United States and globally, little research has used the lens of burden of treatment theory to examine the experiences of people facing these challenges simultaneously. This study aimed to illuminate dimensions of treatment burden, which refers to the work of being a patient with chronic conditions, and patient capacity to manage this burden in a sample of people experiencing homelessness and chronic health problems in Buffalo, New York, United States. We completed in-depth interviews with men and women recruited from a homelessness services organization ( = 27) and applied core concepts from burden of treatment theory to our analysis to probe how participants navigated tasks related to treatment and self-care.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, Pennsylvania, USA.
People experiencing homelessness (PEH) face higher rates of traumatic brain injury (TBI), which is associated with greater unmet healthcare and social needs and increased difficulty transitioning out of homelessness. While efforts have emerged to address this TBI disparity via screening, staff training and case management, gaps exist in the delivery of evidence-based TBI rehabilitation to PEH. This case report describes the delivery of interdisciplinary TBI rehabilitation to a male patient experiencing homelessness within a US context.
View Article and Find Full Text PDFFront Public Health
November 2024
Research Group on Global Health and Human Development, University of the Balearic Islands, Palma, Spain.
[This corrects the article DOI: 10.3389/fpubh.2024.
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