Philadelphia Department of Public Health AIDS Activities Coordinating Office

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Philadelphia Department of Public HealthAIDS
Activities Coordinating Office
Perspectives on Homelessness and HIV Programs in
Philadelphia Derick B. Wilson, Program Analysis
Supervisor, Presenter August 30, 2006 Ryan White
All Titles Conference
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AACO Homeless Philosophy

• We do not fund a specific program for the
  homeless
• We integrate the needs for homeless persons in
  all services funded, especially CTR, CRCS, early
  intervention, primary care, and case management
• Each agency funded is asked to submit a plan,
  when applicable for outreach and retention in
  care for persons who are homeless
• We fund a range of services whose goal is to
  prevent homelessness among those with HIV

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Definition of Homeless

• Federal definition of homelessness is a
  documented case, which is usually inclusive of
  persons who are living in a shelter.
• For many reasons (safety, stigma, drug use,
  etc.), persons eschew going to shelters.
• For program response purposes our definition of
  homelessness is inclusive of those in shelters,
  living on the street, living temporarily on a
  friend/family members couch, or anyone else who
  is in unstable/chronic non-permanent living
  conditions.
• This definition allows us to provide emergency
  and intensive services to a wider array of
  persons

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Philadelphia HIV Homelessness

• The Office of HIV Planning conducts several needs
  assessment studies each year. Recently, the
  results of several needs assessment activities
  indicated a need to further explore issues around
  HIV and homelessness.
• Both the Ryan White Planning Councils Needs
  Assessment Committee and the Comprehensive
  Planning Committee have noted this need.
  Additionally, the Philadelphia HIV Prevention
  Community Planning Groups Planning Priorities
  Committee has been examining HIV prevention and
  homelessness (primarily testing) for the past
  several months.
• Consequently, the Collaborative Workgroup
  (established to explore prevention and care
  crossover and is comprised of members of both
  planning bodies) has determined this was a key
  issue for planning this year.

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Web Based Survey
3 persons responding were currently homeless.
All 3 were positive.
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Challenges for HIV Homeless

• Concern with the long waiting list for housing
• Have to hide medications in the street or in the
  shelter
• Concern that medications being stored in the
  street during extreme weather may affect their
  potency
• Cant bring food into the shelter. No place to
  store it
• Concern that some case managers do not know how
  to approach housing issues
• Need for more housing
• If Im homeless then it is added pressure on did
  I take my meds today or did I eat today?
• How do you walk the streets and be mindful of
  what time to take your meds?
• Concern for too much bureaucracy in getting
  access to housing services
• Concern that section 8 housing services put
  individual in a block known for drug sales
• Concern that shelters have become big business
• If someone is incarcerated on a felony, upon
  release, they do not have access to medical
  welfare

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Key Services Funded with Required Homeless
Specificity

• Case Management
• Direct Emergency Financial Assistance
• Housing Assistance
• Housing Counseling
• Group Housing/Intensive Case Management
• Counseling and testing

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Storefront Initiative

• Five storefronts were designated. Three were in
  Philadelphia County, one in Delaware County, and
  a fifth in Camden County, New Jersey.
• The storefront concept was to provide a full
  range of HIV/AIDS related medical and social
  services in high prevalence areas. The goal of
  this one-stop-shopping modality was to provide
  immediate access to service for those with
  intensive needs.
• Funded primarily through the Minority AIDS
  Initiative
• Initiative recently concluded

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Storefront Lessons Learned Underlying Ideology
of Priorities

• For most homeless HIV persons encountered, HIV
  is not their most pressing concern
• Concerns with imminent survival outweigh long
  term health concerns
• Their decision making around HIV prevention and
  care will be governed by this ideology

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Storefront Lessons Learned Non-Traditional
Access Points

• There is a need to have HIV services at street
  level in the community
• Due to privacy and priority concerns, those
  services are most effective when in the context
  of a broad range of services to high risk
  individuals at non-traditional access points
  (NTAP)
• AIDS only services to homeless persons can lead
  to fear of further alienation
• NTAPs include faith based organizations, social
  service offices, shelters, feeding programs, etc.

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Storefront Lessons Learned NTAP Criteria

• Trust of high risk community
• Immediate access to community, located in high
  risk area
• Have a grass roots approach and staff
• Primary focus is related to other co-morbidities
• Commitment to integrating HIV services within
  their context in an invisible way

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Storefront Lessons Learned Outreach

• Outreach is a continual process
• Linkage into care constitutes more than just
  making an initial appointment
• Outreach must continue past initial appointment
  to ensure follow up to at least 3 appointments

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Questions
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Contact Information

• Derick B. Wilson
• Program Analysis Supervisor
• AIDS Activities Coordinating Office
• 1101 Market St., 9th Fl.
• Philadelphia, PA 19107
• 215-685-5224
• 215-685-5293 (Fax)
• Derick.B.Wilson_at_phila.gov

Thank You!