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About Street roots. (Portland, OR) 1998-current | View Entire Issue (May 20, 2016)
News Page 8 Street Roots • May 20-26, 2016 Street Roots • May 20-26, 2016 ■ ■ News 1 Page 9 Ü ■ Ili □I d lilll ¡Ijjji 1811 ■ 1» Jjjj 1 y i II WR ill k JB B ■B y II ■iS« Jjjj lililí BIB^ bmibb W ft i ■ ll i 'You can't be well i f you're sleeping on a sidewalk or in a crowded shelter,' says John Lozier, leader o f the National Health Care for the Homeless Council III ì I jbhhb 111 » 1 111 IB j ìiìiiiìib m gjjg Art Rios fought the system; now he fights within it BY AM ANDA WALDROUPE homeless and housing policy has not softened. “I’m still radical in those meetings,” he said. In recognition of the transformative changes in his life rt Rios has long been a visible member of and community service, Rios will be awarded the council's downtown Portland’s homeless population Ellen Dailey Award on June 1 during the council’s national anti an outspoken advocate for people conference in Portland. experiencing homelessness. Dailey lived in the Boston area and spent pari of her life In 2908. he was one of the leaders of the homeless. She suffered from numerous health problems Homeless Liberation Front, a group of homeless and was passed from doctor to doctor. Her experiences people who camped, in protest, outside of City Hall caused Dailey to become an outspoken activist for better for weeks, asking then-Mayor Tom Potter and the health care for homeless people, and she helped found the City Council to suspend the city’s sit-lie and council's National Consume! Adxisnry Board. She was camping ordinances until homeless people could known for haring a formidable, charismatic presence and is find housing. He is part of Right 2 Dream Too’s considered instrumental in helping to create programs that leadership. During the 2012 Grand Floral Parade, ensured homeless people could have continuity of care and he sat down in the middle of the parade route, timely health care. holding a sign that said, “Housing Now, Homes Rios met her twice at the council’s annual conferences. have Hearts." “She was raz/,” lie said, “She told you how it was. But Art Rios is chairman of Central Previously, he said, his activism had been she also gave you the tools to fight your own demons and antagonistic toward the city, the Police Bureau and H h i Coi/fcm s Health Services Advisory CounnL told you. ‘You can get through this. You can gel through the bureaucratic forces that affect homeless your homelessness.’ She was a very inspirational woman.” Rios, who spent 25 years of his life homeless and has Now. he is working within the system. Rios. 45, serves on numerous boards and committees, including on A overcome drug and alcohol addictions, shares Dailey’s belief that the best way for policymakers and elected officials to learn about Home for Everyone’s coordinating board and Central City Concern's homelessness - and craft better programs and public policy is to board of directors and its Health Services Advisory Council, which he listen to homeless people. chairs. He is also a member of the National Healthcare for the “We have the chance to educate people about homelessness and Homeless Council's National Consumer Advisory Board. health care ... and teach people about drug addiction and mental He says his point of view and desire to see radical change in illness,” Rios said. “We deal with it on a daily basis.” STAI I W K I II R BY AMANDA WALDROUPE John Lozier: It was an important initiative. The approach evolved from interest in the Robert Wood Johnson foundation. They /T " 1 h e fact that safe, stable and affordable established some demonstration programs that I housing is an essential factor for a sought to establish something very simple - JL person’s good health is increasingly which was probably a radical idea at the time - acknowledged among housing and health care that homeless people can be effectively engaged providers, policymakers and advocates. in primary care services. There were 19 original It is a conviction John Lozier has held for projects, and we served decades. tens of thousands of Lozier is the founder and executive people. director of the National Health Care for We’ve understood from the Homeless Council, a national the beginning that nonprofit and membership organization housing is the core that provides comprehensive health care problem. Housing is to homeless people at primary care health care. You can’t be clinics the council either established or well if you’re sleeping on partners with. On May 31, the council a sidewalk or in a will hold its annual national conference crowded shelter. One of in Portland. the main things that has The council was founded in 1986 and happened is that we have since then, its network has grown to refined those include more than 10,000 doctors, understandings. When we nurses, social workers and advocates. "O ur economy treats think about violence, we The council provides support, training think about trauma and housing and health and mentoring to more than 200 public trauma-informed care. health centers and hundreds of care as commodi? And we think about organizations throughout the country ties, as things to he cultural humility, an that receive grant funding from the bought or sold fo r increasingly important federal government’s Health Care for the pro fit, not as the approach to health care Homeless program. fundamental human for the homeless. Encouraging people experiencing rig h t that we homelessness to become actively A.W.: I t seems largely involved in their health care is one of the understand they are. accepted that homelessness council’s most important accomplish They are necessary is a public health problem ments. The council was one of the first for our s u rv iv a l." organizations to have a consumer JOHN LOZIER - not a public safety one, fo r example. B u t it took a advisory council; membership is entirely long time, even, fo r public made up of homeless people who have officials a n d the public to received care at a clinic supported by the understand how much harm - physical, m ental council. In its trainings and work with clinicians, a n d otherwise - can be caused from being unable to council staff emphasize case management and get a fu ll night o f sleep. close relationships between providers that ensure effective referrals and continuous care. J.L.: Right Sleep science is another place It also helps homeless people regain their where our knowledge base has increased really sense of humanity, Lozier said. dramatically in recent years - even more “It’s a great thing that desperately poor recently than the awareness about trauma. I people and their providers are able to work so think I would have to take issue with closely and so lovingly together,” he said. homelessness being a health issue. It’s Lozier will retire at the end of this year. He predominantly an economic issue. It has to do spoke with Street Roots about how providing with the lack of affordable and appropriate and health care to homeless people has evolved and available housing for people, which in turn drives what still needs to happen to help the country’s health problems. In 1987, the Institute of most vulnerable citizens, including creating Medicine of the National Academy of Sciences universal care. published a report called “Homelessness, Health and Human Needs.” Amanda Waldroupe: When you started the It found that there are three relationships organization, how radical o f a n idea was it to between homelessness and health. One is that create a program specifically designed to provide poor health causes homelessness, for two health care to homeless people? reasons. One reason is economic: Most personal S TA F F W R IT E R ■ and across the country on violence. Almost everyone on the streets had witnessed violence in the course of their homelessness. respect Those two together are what makes the difference. A.W.: H ow so? A.W.: B y involving homeless people so m uch - a sking fo r their perspective, their input, their opinions - is to genuinely treat them as h u m a n beings, som ething I th in k a lot o f people forget because o f their appearance, because they live outside. P H O T O S B Y STEVEN L. W E A V E R , C O U R T E S Y O F T H È N A T IO N A L H EALTH C AR E FOR T H E H O M E LE S S C O U N C IL Doctor’s counsel patien ts a t H ealth to Hope clinics, a nationw ide project o f the Health Care fo r the Homeless Council established to provide health care fo r people experiencing homelessness. bankruptcies are health care bankruptcies. The other has to do with symptoms of illnesses and people who get squeezed out of housing. Secondly, homelessness, in turn, causes more health issues, with exposure to diseases in shelters and vermin on the streets and violence on the streets. And the elements. The third is that homelessness complicates all the elements and all the things you need to do to treat people. Add those up, and it’s a major public health problem. A.W.: You talked about how o ur understanding o f the health issues faced by homeless people has been refined. W hat do you think caused that refinement o f understanding to take place? J.L.: Science is part of i t The science has evolved. That’s not unimportant. Brain chemistry, neurology, the understanding about the effects of trauma in particular has gotten much deeper in the last decade. For us, a more important part of it has been asking people who have experienced homelessness to help define the issues. Our focus oniviolence, for example, achieved a new clarity for us when the National Consumer Advisory Board put together a survey it does for people experiencing homelessness J.L.: That’s true. Yes. We have tried to involve our patients at every stage of our work, and that starts with outreach and really being sensitive to people’s situations in the exam room. Much •earlier in our career we talked about what’s now patient center, self-determination and goal setting. It goes on arid on to patient satisfaction surveys to consumer advisory boards, which operate on a consensus model, so that their voices carry every bit as much weight as everybody else’s. A.W.: I was reading the council’s most recent quarterly newsletter, I n Focus, about the importance a n d effectiveness o f case management. The reason good case m anagem ent is so'effective is that it creates a one-on-one relationship a n d treats homeless people with compassion a n d respect. J.L.: Absolutely. It’s not just compassion. It’s J.L.: Just feeling sorry for somebody - one way to express compassion - can be condescending, for lack of a better word. But feeling respect for somebody is an expression of justice. It’s an expression of understanding. It’s an expression of the quality of all human beings in the face of our mortality. It’s giving a fellow human being his or her due. We’re not about charity. We’re about justice. Ultimately, that bleeds over to our understanding of what health care reform still needs to be. It needs to be universal. At best, with the Affordable Care Act fully implemented, there’s still 27 million who are uninsured in this country. A lot of those will be homeless people who for one reason or another aren’t eligible or not enrolled. That goal we set for universal health care coverage and accessibility to quality care still remains elusive. A.W .: You’ve advocated fo r m any years that housing is a n essential p a r t o f health care, yet the fu n d in g fo r housing a n d health care are entirely distinct. How do yo u thin k health care programs, like hospitals or Medicaid, should use some o f their fu n d in g to ensure their patients live in affordable housing? J.L.: Not enough is happening yet, but we are beginning to see some glimmers of the understanding that housing is health care and that it is a wise health care investment to make sure that patients are adequately housed. Some managed care organizations are spending their money on housing, or a less profound but equally important intervention like respite care. New York state is beginning to spend some of its Medicaid dollars. The problem is that we have siloed social and health needs apart from each other in the major federal streams, HUD (Department of Housing and Urban Development) and HHS (Department of Health and Human Services) spend money on very different things, A lot of people have tried to put those together at the local level. We need to get out of the silos and understand that housing is health care, and that if we want a healthy population, make sure that it is adequately housed. A.W.: There are a t least two competing values fo r delivering good a n d effective health care. One is doing it ou t o f the k in d o f compassion y o u ’re talking about. B u t health reform has generated a lot o f conversations about creating health care programs that are “evidence based” or have See HEALTH, page 10
