Ben Rock for the National Health Care for the Homeless Council

2012 Health Care for the Homeless Orlando Regional Training

Alabama • Florida • Georgia • Kentucky • Mississippi North Carolina • South Carolina • Tennessee

Jointly sponsored by Vanderbilt University School of Medicine & the National Health Care for the Homeless Council

November 1-2, 2012 Sheraton Orlando Downtown 400 West Livingston Street Orlando, FL 32801

Training Schedule Thursday, November 1, 2012 7 a.m.

Registration Opens 7:30 - 9 a.m.

Light Breakfast 8:15 - 9:45 a.m. Plenary Session

Opening Remarks and Families Experiencing Homelessness Discussion Ballroom B 10 - 11:30 a.m. Optimizing Population Health for LGBT People in Patient Centered Medical Homes

Orange Understanding the Impact of Homelessness on Children: Trends and Supports Amelia

Chronic Pain Management: Providing Safe, Effective, Compassionate Care Magnolia A 11:45 - 12:30 p.m. Lunch 12:45 - 2:15 p.m. Housing Is Health Care: Systems Integration Orange

Models of Workforce Development Amelia

The Nuts and Bolts of Health Reform Magnolia A 2:30 - 4 p.m.

Behavioral Health and Primary Care Integration Orange

Forming and Maintaining a Consumer Advisory Board Amelia

Health and Homelessness among Veterans: Experiences of HCH Grantees Magnolia A 4:45 - 5:30 p.m. Health Care Center for the Homeless Tours Meet and depart from Sheraton Orlando Downtown Lobby 2

Training Schedule Friday, November 2, 2012 7 a.m.

Registration Opens 7:30 - 9 a.m.

Light Breakfast 8:15 - 9:45 a.m. Plenary Session

Opening Remarks and Families Experiencing Homelessness Discussion Ballroom B 10 - 11:30 a.m. Building a Patient-Centered Medical Home

with the Meaningful Use of Electronic Health Records

Orange They’re Catchy, Part 1: STD Prevention, Screening, and Treatment Amelia Trauma-Informed Care Magnolia A 11:45 - 12:30 p.m. Lunch 12:45 - 2:15 p.m. Exceptional Care for Exceptional Times: Medical Respite Care, Part 1 Orange

They’re Catchy, Part 2: Infectious Disease Prevention, Screening, and Treatment Amelia

Preventing and Responding to Workplace Violence Magnolia A 2:30 - 4 p.m.

Exceptional Care for Exceptional Times: Medical Respite Care, Part 2 Orange

HIV and Primary Care Integration Amelia

National Outreach Guidelines for Underserved Populations Magnolia A 3

Workshop Descriptions Behavioral Health and Primary Care Integration This session will define and explore various models of behavioral health and primary care integration used in the United States. In addition, the speakers will explain the advantages of this integration in a health care for the homeless site. The impact of cost, quality, and provider and patient satisfaction will be explored. The evolution of this model at the Heath Care Center for the Homeless in Orlando will be elaborated upon as a best practice.

Presenters: Pia Valvassori, ARNP, PhD, is a clinical researcher for the National HCH Council and is a clinical faculty member at the University of Central Florida. For 15 years, she has been a family nurse practitioner with the Health Care Center for the Homeless in Orlando. Valvassori has served on the Board of Directors for Shepherd’s Hope, Homeless Services Network of Central Florida, Florida Coalition for the Homeless, and the National HCH Council.

Dewey Wooden, LMHC, is the Behavioral Health Manager and a counselor at the Orange Blossom Family Health Center’s Health Care Center for the Homeless.

Building a Patient-Centered Medical Home with the Meaningful Use of Electronic Health Records Meaningful use of Electronic Health Records (EHRs) supports the patient-centered medical home (PCMH) through increased health care access, improved care delivery systems, and engagement in culturally competent outreach and education. Safety net organizations need support to adopt and integrate meaningful use of EHRs in their practices to assist in delivering evidence-based, patientcentered, culturally competent, efficient, and high-quality health care to the homeless and other medically underserved populations. This workshop will present resources and innovative best practice examples of integrating health information technology, including EHRs in the care delivery to the homeless population and other medically underserved communities. This workshop will address the key elements for PCMH transformation and the core requirements for meaningful use (MU) of health information technology to support the homeless population’s complex medical and psychosocial needs.

Presenters: Anna Gard, FNP-BC, is a family nurse practitioner and Health Disparities Consultant with the Association of Clinicians for the Underserved. Gard provides technical assistance to special populations on quality improvement performance, patient-centered medical home, chronic care management, and meaningful use of health information technology. Andrea Brooks, BS, is the HIV Prevention Services Administrator responsible for overseeing the Department of HIV Prevention Services (DHPS) at Camillus Health Concern in Miami. The department operates Project SafeStreet, which is funded by the Center for Disease Control & Prevention (CDC). Project SafeStreet provides HIV/AIDS prevention and community outreach through general HIV education and services to Camillus clients.

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Workshop Descriptions Chronic Pain Management: Providing Safe, Effective, Compassionate Care Chronic pain is in literature and news and on our minds. We’ve gone from under-treating pain to an epidemic of opioid addiction, overdose, and deaths – and pain is still often not adequately treated. Homelessness increases the risk of chronic pain, exacerbates suffering, and makes pain management more complicated. This workshop will provide a framework and tools for the evaluation and management of chronic pain as well as recommendations for practice adaptations for patients experiencing homelessness.

Presenter: Barbara Wismer, MD, MPH, has practiced medicine in a homeless health care setting at Tom Waddell Health Center in San Francisco for 15 years and was medical director for 11 years during that time. Dr. Wismer is board certified in internal and preventive medicine, and her areas of interest are chronic pain, traumatic brain injury/ cognitive impairment, and quality improvement.

Exceptional Care for Exceptional Times: Medical Respite Care, Part 1 In this two-part training participants will receive an overview of the core fundamentals and key elements of medical respite care as well as the history and context for the development of respite programs around the nation. Participants will learn how to develop admission criteria for shelter-based and stand alone respite programs and why admission, readmission criteria and treatment agreements are useful tools in managing the respite milieu and in maintaining safety. The audience will learn about the resources provided by the Respite Care Provider’s Network (RCPN). Attendees will learn how to incorporate RCPN tools into the assessment of the feasibility of developing a medical respite program and in program design.

Presenters: For the past 15 years, Sarah Ciambrone, MS, has been Director of Respite Services for Boston Health Care for the Homeless Program at McInnis House, a 104-bed stand alone program that provides medical respite care to homeless men and women. She is responsible for the administrative oversight, leadership, and development of this nationally recognized model program providing short-term respite care for medically ill homeless adults with a staff of over 150 persons. She is an active member of the National Health Care for the Homeless Council and was a founding member and previously chaired the NHCHC Respite Care Providers’ Network. Melinda Thomas, PA-C, has been with Boston Health Care for the Homeless Program since 1998, initially working at Betty Snead House, an 18-bed medical respite unit for homeless women. She is currently on the Family Team, caring for homeless families in shelters and in motels. Thomas completed her training as a physician assistant at Allegheny University in Philadelphia, where she became interested in the health care issues facing homeless persons.

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Workshop Descriptions Exceptional Care for Exceptional Times: Medical Respite Care, Part 2 In the second part of the presentation, several case studies will be used to illustrate how respite care is continually challenged to exceed the usual admission criteria to meet the community needs of vulnerable patients who cannot be cared for elsewhere. The studies will illustrate the gaps in health care delivery and how respite programs are, and need to be, creative, innovative and flexible. Case studies can powerfully help to advocate for the importance of respite to hospital partners in making the case for respite. Real referrals of cases will be given to participants in small groups who will determine if a patient can be admitted, develop an admission plan and treatment plan for each patient, identify program components to meet the exceptional patient needs. Actual patient outcomes will then be revealed and compared to those developed during the discussion.

Presenters: For the past 15 years, Sarah Ciambrone, MS, has been Director of Respite Services for Boston Health Care for the Homeless Program at McInnis House, a 104-bed stand alone program that provides medical respite care to homeless men and women. She is responsible for the administrative oversight, leadership, and development of this nationally recognized model program providing short-term respite care for medically ill homeless adults with a staff of over 150 persons. She is an active member of the National Health Care for the Homeless Council and was a founding member and previously chaired the NHCHC Respite Care Providers’ Network. Melinda Thomas, PA-C, has been with Boston Health Care for the Homeless Program since 1998, initially working at Betty Snead House, an 18-bed medical respite unit for homeless women. She is currently on the Family Team, caring for homeless families in shelters and in motels. Thomas completed her training as a physician assistant at Allegheny University in Philadelphia, where she became interested in the health care issues facing homeless persons.

Forming & Maintaining a Consumer Advisory Board This workshop focuses on how a consumer advisory board (CAB) can enhance consumer involvement in governance as well as advocate on behalf of consumers of the HCH project and in the community. Different models for CABs will be discussed, including real-life challenges and achievements. Consumers involved in governance at several projects in the region will share their unique experiences developing and maintaining CABs at their local projects.

Presenters: Dan Rabbitt, MSW, is responsible for representing the interests of the National HCH Council in Washington, DC, working with the National HCH Council’s Policy Committee and management structure to advance the annual Advocacy Agenda and mobilizing National HCH Council member organizations, other advocates and service providers, and homeless people for the amelioration of poverty and homelessness. Valarie Dowell is the program advocate for the Cincinnati Health Care for the Homeless Network, serving as the staff liaison to the Consumer Advisory Board. Derek Winbush is the chair of the Boston Health Care for the Homeless Consumer Advisory Board.

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Workshop Descriptions Health and Homelessness among Veterans: Experiences of HCH Grantees In 2011, 22,486 veterans were served by HCH grantees (Uniform Data System, 2011). Veterans are consistently over-represented in the homeless population, and these numbers are anticipated to increase with the return of service members from the current conflict. To develop a better understanding of the demographics, health statuses, service utilization, and unmet needs of veterans who are served by HCH grantees and the collaborations between HCH grantees and Veterans Administration Medical Centers (VAMCs), the National Health Care for the Homeless Council has been conducting a mixed-methods study. Key expert interviews and focus groups were conducted with clinicians, administrators, and veteran consumers of HCH grantees in the spring of 2012. The second phase of data collection involved a national needs assessment survey, which was launched in September 2012. This workshop will present the preliminary findings from the key expert interviews and focus groups. To supplement these research findings, two case studies will be presented to exemplify the lack of health care options for some veterans due to dishonorable discharge (DD) and how HCH grantees can integrate care to promote quality health care and advocate for stable income (SSI/SSDI) and permanent housing.

Presenters: Brooks Ann McKinney, MSW, is the Director of Medical Respite and Safety Net Provider Relations at Mission Hospital in Asheville, North Carolina. McKinney is the former chair of the Respite Care Providers’ Network Steering Committee. Sarah Knopf, MA-R, is a Research Assistant with the National HCH Council. Knopf conducts research in the HCH field with a particular emphasis on veterans experiencing homelessness.

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Workshop Descriptions HIV and Primary Care Integration With the advent of antiretroviral treatments and advances in biomedical treatments for HIV infection and prevention, care for people living with HIV/AIDS radically changed. Initially psycho-socially focused, HIV treatment became largely medicalized, such that HIV is often considered a chronic illness. Yet, unlike many other chronic illnesses, even if effectively contained, the effects of long term HIV infection continue to complicate treatment for those infected. Further, many disadvantaged and marginalized individuals, especially those with mental illness, substance use, or homelessness, are first diagnosed with AIDS. As care for PLWHA moves from targeted to mainstream settings, primary care providers will be challenged to adapt their practices. This workshop will explore the impact of policy changes and the clinical and structural adaptations required of primary care practices to meet the standards of high quality, comprehensive, culturally competent HIV care.

Presenters: Doug Berman, MSJ, is the Senior Vice President for Policy at Harlem United, a direct service agency grounded in evidence-based, outcome-driven programs that directly affect policies that address the current state of homelessness and the HIV/AIDS epidemic. Before joining Harlem United, Berman served as Director of Policy and Government Relations for Care for the Homeless. L. Jeannine Bookhardt-Murray, MD, is the Chief Medical Officer of Harlem United Community AIDS Center, which provides housing, prevention, primary care, dental, substance use, and behavioral health services. Dr. Bookhardt-Murray has been working in the HIV/AIDS medical field since 1984. She is board certified in Internal Medicine and credentialed as an HIV Specialist through the American Academy of HIV Medicine. Dr. Bookhardt-Murray is also a medical consultant to the NYS Department of Health/AIDS Institute and concentrates on the development of clinical guidelines for primary care practitioners.

Housing Is Healthcare: Systems Integration One of the greatest cross-systems challenges is the integration of primary care, behavioral health care (substance abuse and mental health), and access to supportive housing for persons who are homeless.

This session will describe how federal SAMHSA-HRSA grants are a catalyst for systems integration in the southeastern region. The presenter will make the case for targeting people who are homeless with complex healthcare issues and developing partnerships with supportive housing providers.

Presenter: Mark A. Engelhardt, MS, MSW ACSW, has 35 years of experience in behavioral healthcare, including 14 years as a nonprofit treatment provider and executive, 11 years as a regional state administrator of substance abuse and mental health (SAMH), and 10 years as a faculty member with the University of South Florida’s Department of Mental Health, Law, and Policy. Engelhardt has provided training, technical assistance, and evaluation for various state agencies, county governments, cross-systems advocacy groups, and substance abuse and mental health providers throughout the State of Florida and the U.S.

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Workshop Descriptions Models of Workforce Development This workshop provides a practical model designed to maximize clinical and organizational outcomes while enhancing the overall health of your workforce. Working with homeless populations has many challenges that can dramatically decrease the health and productivity of staff. This workshop combines strategies to overcome these challenges while giving the participant concrete concepts to improve the performance of staff. Based on the most recent research in business, science, and performance management, this powerful approach provides strategies that can transform programs and organizations. Whether you are an aspiring or experienced leader, you’ll see your role and work in a whole new light.

Presenter: Matt Bennett, MBA, MA, has a Master’s degree in community psychology and executive development (nonprofit management) and a Master’s in business administration. Bennett specializes in the development of trauma informed care, quality improvement, and results-based leadership and clinical practices.

National Outreach Guidelines for Underserved Populations Outreach is a critical function of health centers serving underserved populations, increasing access to care for marginalized community members by bringing vital information and services to people where they live, work, and spend time. A strong outreach model offers the best opportunity for the most vulnerable populations to be connected to and engaged with true medical homes. In 2000, Health Outreach Partners (HOP) developed its Farmworker Outreach Program Guidelines based on 30 years of experience providing direct outreach services to migrant and seasonal farmworkers. In 2012, HOP collaborated with four national partner organizations and an advisory panel to update and expand on those guidelines, creating the current National Outreach Guidelines for Underserved Populations. In this session, presenters will describe the development of ten guidelines aimed at creating comprehensive community health models in local communities and will discuss specific strategies for implementing them. Participants will share effective outreach strategies from their own programs serving migrant and seasonal farmworkers and others.

Presenter: Liberty Day, MS, joined the Health Outreach Partners team in 2008. Her responsibilities as an HOP Senior Project Manager include providing program consultation, training, and information services to local communities and community-based organizations working to improve access to quality health care to vulnerable and underserved populations. Before joining HOP, Ruihley graduated from the University of Kentucky with a Master of Science in Education, Counseling Psychology.

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Workshop Descriptions The Nuts and Bolts of Health Reform: What’s Important and What You Need to Do The health reform law creates both opportunities and challenges for health centers. This workshop will provide an overview of the national goals that have been set, those components of the law that will most directly affect HCH operations and consumers, and the changes that should be implemented to make the most of funding opportunities and systems changes. The discussion will include actions you can take to better educate policy decision makers to ensure implementation will be responsive to the health needs of individuals experiencing homelessness, and strategies for integrating staff and consumer participation to those efforts.

Presenter: Barbara DiPietro, PhD, is the Director of Policy for the National Health Care for the Homeless Council.

DiPietro conducts policy analysis, oversees advocacy activities, and coordinates the Council’s policy priorities with national coalition partners and federal agencies.

Optimizing Population Health for LGBT People in Patient-Centered Medical Homes As health centers transition to patient-centered medical homes, a key factor of success will be the ability to implement programs to optimize population health. As lesbian, gay, bisexual, and transgender (LGBT) people are often invisible to health care providers, the key do doing this will be implementing systems to obtain and document information about sexual orientation and gender identity in clinical settings and developing programs to respond to the health needs of LGBT patients. While most LGBT health disparities mirror health issues seen in the general population such as smoking and issues with weight, others are unique. Examples include care of transgender individuals, management of complex behavioral health issues, and HIV prevention among MSM. Presenter: Harvey Makadon, MD, is Director of the National LGBT Health Education Center and Clinical Professor of Medicine at Harvard Medical School as well as a member of the Division of General Medicine at Beth Israel Deaconess Medical Center in Boston.

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Workshop Descriptions Preventing and Responding to Workplace Violence Workplace violence is part of working with traumatized populations. This workshop presents a trauma informed approach to understanding, preventing, and working with escalating clients and patients.

Participants will learn strategies for each phase in escalation with a goal to help prevent and minimize situations from becoming dangerous. Strategies will also be presented in how to de-escalate clients and patients who have become dangerous and keep everyone involved as safe as possible. Finally, this workshop will examine approaches to reconnect with clients after violence has occurred and find opportunities to reestablish trust and safety.

Presenter: Matt Bennett, MBA, MA, has a Master’s degree in community psychology and executive development (nonprofit management) and a Master’s in business administration. Bennett specializes in the development of trauma informed care, quality improvement, and results-based leadership and clinical practices.

They’re Catchy, Part 1: STD Prevention, Screening, and Treatment The CDC and US Preventive Service Task Force have recommendations for prevention, screening, and treatment for STDs and infectious diseases. Homeless health care clinicians often see clients with acute care needs that take priority over more general prevention needs. The National Health Care for the Homeless Council Clinicians’ Network has recently released a new document to address the unique needs of HCH consumers and programs. In part one of this series, participants will discuss the current prevention, screening, and treatment recommendations from the NHCHC Clinicians’ Network, CDC, and USPTF for common STDs: HIV, Syphilis, Gonorrhea, Chlamydia and Human Papilloma Virus (HPV). Participants will explore best practices for implementing prevention and treatment efforts in their program.

Presenters: Deborah Borne, MD, MSW, is a family physician with the San Francisco Department of Public Health, where she serves as Medical Coordinator for homeless community-based services in shelters, care-based organizations, street outreach, and behavioral health centers. Dr. Borne’s work in San Francisco includes oversight of medical integration into the city-funded behavioral health centers and HIV-prevention and treatment quality efforts in safety net health centers, while working closely with the Health Promotion and Prevention Department to implement CDC-funded prevention efforts. Nadine Chipon-Schoepp, DO, is Assistant Professor of Family Medicine at Nova Southeastern University College of Osteopathic Medicine. Dr. Chipon-Schoepp’s current work includes Project H.O.P.E, Nova University’s Homelessness in Osteopathic Pre-doctoral Education program. The program is a five-year predoctoral primary care training curriculum funded by the United States Health Resources and Services Administration.

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Workshop Descriptions They’re Catchy, Part 2: Infectious Disease Prevention, Screening, and Treatment The CDC and US Preventive Service Task Force have recommendations for prevention, screening, and treatment for STDs and infectious diseases. Health care for the homeless clinicians often see clients with acute care needs that take priority over more general prevention needs. The National HCH Council Clinicians’ Network has recently released a new document to address the unique needs of HCH consumers and programs. In part two of this series, participants will discuss the current prevention, screening, and treatment recommendations from the NHCHC Clinicians’ Network, CDC, and USPTF for common infectious diseases such as TB, hepatitis C & B, influenza, and MRSAs. Participants will explore best practices for implementing prevention and treatment efforts in their program. Current adult immunization schedules will also be reviewed.

Presenters: Deborah Borne, MD, MSW, is a family physician with the San Francisco Department of Public Health, where she serves as Medical Coordinator for homeless community-based services in shelters, care-based organizations, street outreach, and behavioral health centers. Dr. Borne’s work in San Francisco includes oversight of medical integration into the city-funded behavioral health centers and HIV-prevention and treatment quality efforts in safety net health centers, and working closely with the Health Promotion and Prevention Department to implement CDC-funded prevention efforts. Nadine Chipon-Schoepp, DO, is Assistant Professor of Family Medicine at Nova Southeastern University College of Osteopathic Medicine. Dr. Chipon-Schoepp’s current work includes Project H.O.P.E, Nova University’s Homelessness in Osteopathic Pre-doctoral Education program. The program is a five-year predoctoral primary care training curriculum funded by the United States Health Resources and Services Administration.

Trauma-Informed Care Recent research on the brain and trauma gives those working in the helping professions a new paradigm to conceptualize and work with clients. Understanding how trauma has an impact on brain development puts harmful behaviors and destructive thinking patterns into context and gives helpers a roadmap for building relationships and promoting healing and growth. This training presents the Trauma Informed Paradigm in a practical context, giving learners both a theoretical basis and the tools to apply it immediately to their work with clients. Through the application of this Trauma Informed Paradigm, direct care workers/ helpers can minimize re-traumatization while creating an environment for the traumatized individual to regain control of his or her life.

Presenter: Matt Bennett, MBA, MA, has a Master’s degree in community psychology and executive development (nonprofit management) and a Master’s in business administration. Bennett specializes in the development of trauma informed care, quality improvement, and results-based leadership and clinical practices.

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Workshop Descriptions Understanding the Impact of Homelessness on Children: Trends and Supports America’s Youngest Outcasts 2010 found that almost 84,000 children experienced homelessness in Florida in 2010. Traumatic experiences, such as homelessness, can have a significant impact on all aspects of a child’s health and development. Participants will learn about the characteristics of children and families experiencing homelessness and the impact of homelessness on children’s lives. This session will also examine how the McKinney-Vento Act protects the educational rights of homeless students and how providers can connect children and families experiencing homelessness to basic needs and educational services through the public school system.

Presenters: Beth Davalos, MSW, LCSW, is a Licensed Clinical Social Worker in the Central Florida area, working with children and families for over twenty years. Davalos has worked in a private practice and hospital settings and in public education with children struggling with trauma, abuse, mental illness, and homelessness. Corey Anne Beach, BS, is a Program Associate for the Campaign to End Child Homelessness at The National Center on Family Homelessness.

She supports the research, development, and design of all Campaign plans and reports and coordinates Campaign policy, public awareness, and training activities. Beach also manages the PEACH Initiative, a physical and emotional awareness program for young children experiencing homelessness.

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Site Tour Information Orange Blossom Health Care Center for the Homeless On Thursday, November 1, at 4:45 p.m., the staff of Orange Blossom Health Care Center for the Homeless will host two tours of their facility.

Transportation Information The first group will depart from the Sheraton Orlando Downtown lobby at 4:45 p.m. and travel by shuttle to Health Care Center for the Homeless. This group will return to the hotel at 5:10 p.m.

The second group will depart from the Sheraton Orlando Downtown lobby at 5 p.m. and travel by shuttle to Health Care Center for the Homeless. This group will return to the hotel at 5:25 p.m.

Tour Sign-Up There will be a sign-up sheet at registration on Thursday. Each tour will have a limit of 15 people.

Tour Information The Health Care Center for the Homeless was founded in 1993 by Dr. Rick Baxley and began as an evening medical clinic at a local homeless shelter in Orlando. Over the years, it has grown to address multiple areas in health care, centralized within its own clinic building, the Orange Blossom Family Health Center. HCCH is located just a few blocks west of downtown Orlando and currently serves the homeless populations of Orange, Osceola, and Seminole counties with the goal of returning our patients to lives of self-sufficiency.

HCCH also serves the housed but uninsured or underinsured residents of Orange County in an effort to prevent the financial devastation that can result from catastrophic health care costs. Its programs include primary medical care, oral health services, behavioral health and substance abuse counseling, an on-site pharmacy, vision services, a residential TB shelter, mobile health services, and an aggressive street outreach program - the HOPE Team.

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FACHC Homeless Healthcare Meet and Greet On Thursday, November 1, at 5:30 p.m., the Florida Association of Community Health Centers will host a Homeless Healthcare Meet and Greet.

What: Join FACHC for a social hour and meet fellow Florida homeless healthcare peers

and Primary Care Association representatives Who: Florida federally qualified homeless health center staff When: Thursday, November 1, 2012, 5:30 - 6:30 p.m.

Where: Spectators Bar and Grill, Sheraton Orlando Downtown Wear your name tags!

For more information, contact Erin Sologaistoa at (850) 942-1822 ext. 208 or erin@fachc.org.

Homeless Healthcare Survey Please have your homeless healthcare staff complete FACHC’s Homeless Healthcare Survey, so we can learn more about how to better support your work in this area. The five-question survey can be found at www.cvent.com/d/7cqxoc’. The deadline is November 15.

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Accreditation Information

After participating in this CME activity, participants should be able to describe and discuss Conditions and adverse realities of homelessness which lead to chronic,

life-threatening conditions; Barriers to persons experiencing homelessness receiving adequate diagnosis and treatment

to chronic, life-threatening conditions; and Effects of current health care reform legislation upon health care providers of individuals

experiencing homelessness.

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vanderbilt University School of Medicine and the National Health Care for the Homeless Council. Vanderbilt University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Vanderbilt University School of Medicine designates this live activity for a maximum of 12.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. a. To obtain credit for your participation in this activity, complete the online attendance form that will be emailed to you after the training. b. You will receive email notification of online credit availability 1-2 weeks after data is submitted to Vanderbilt CME. c. You may access your record of participation at any time by visiting the Division of CME website at www.cme.vanderbilt.edu and following the instructions to obtain a transcript.

CMEs are typically applicable and transferrable for a variety of health professions, including nursing, social work, and alcohol and drug counseling. Please check with your credentialing body to verify.

It is the policy of Vanderbilt University School of Medicine and the National Health Care for the Homeless Council to require disclosure of financial relationships from individuals in a position to control the content of CME activity; to identify and resolve conflicts of interest related to those relationships; and to make disclosure information available to the audience prior to the CME activity. Presenters are required to disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentations.

All course directors, planners, and speakers indicated no financial relationships to disclose.

This activity received no commercial support.

This program is supported by grant number NCA U30CS09746 from the Health Resources and Services Administration, Bureau of Primary Health Care. All contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA. 16

Contribute to Health Care for the Homeless

Please consider a tax deductible contribution to the National Health Care for the Homeless Council to raise awareness of issues related to HCH programs in the United States. Our work includes advocacy on Capitol Hill and grassroots mobilization in support of policy proposals that will increase access to health care and help end homelessness.

Please see someone at the registration table about giving to the National HCH Council or make a secure online contribution at www.nhchc.org/donate.

Ask us if your organization is a member of the National HCH Council and find out about membership benefits and first year costs. Thank you to the following organizational members in Region IV: Alabama Kentucky Birmingham Health Care, Inc. Franklin Primary Health Center Montgomery Area Community Wellness Coalition Whatley Health Services, Inc. Florida C.L. Brumback Health Center Genesis Community Health, Inc. Broward Health: Health Care for the the Homeless Program House of Hope Sulzbacher Center Brevard Health Alliance Camilius Health Concern Health Care Center for the Homeless, Inc. Tampa Community Health Center, Inc. Georgia St. Joseph’s Mercy Care Services

Kentucky Mountain Health Alliance, Inc. Kentucky River Foothills Development Council, Inc. Bluegrass Farmworker Health Center Family Health Centers, Inc. Mountain Comprehensive Care Center Louisiana New Orleans Health Care for the Homeless Tulane Drop-In Health Services North Carolina Mission Hospital Tennessee Chattanooga-Hamilton County Health Department Cherokee Health Systems United Neighborhood Health Services

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Notes and Contacts

Notes and Contacts

For more resources and training opportunities, visit us at www.nhchc.org

National Health Care for the Homeless Council P.O. Box 60427 Nashville, TN 37206