OXFORD UNIVERSITY Provision of Health Care to People

OXFORD UNIVERSITY Provision of Health Care to People Experiencing Homelessness Wayne A. Centrone, NMD, MPH HCH Clinicians’ Network Steering Committee Meeting – April 2008 Albuquerque, New Mexico

Report Outline • Introduction to Program • Curriculum Design – Online Program (Moodle) – Intensive Training – Assignments • Facilitation and Instruction • Impressions and Ideas – Transferability for U. S. HCH Market • Questions and Answers

Introduction to Program • Developed through professional committee and peer review • Designed for “Transdisciplinary” professionals • Based at Rewley House in Davidson College • Not a “paint by numbers” curriculum or program

Curriculum Design • Socratic Method – Modules of Instruction • Online (Module 1) – Mentoring – Tutoring • Oxford Lecturers • Guest Tutors • Intensive Trainings – Module Lectures (Modules 2 - 5) – Topic Lectures w/in Modules – Tutor and Small Group Driven

Module Instruction • Module 1 – Provision of HC to PEH • Module 2 – Homelessness: Exclusion Health and Society • Module 3 – Health Care Needs of PEH • Module 4 – Organizing HC Provision for PEH • Module 5 – Working w/ HP who have Complex & Multiple Needs • Module 6 – Intensive at European HHC Conference

Modules and Topics • Module 1 (online instruction) – What is homelessness? – What are the challenges of PEH? – What models exist to deliver HC services to PEH? – Challenges associated with the delivery of HC services to PEH? – Provider development and burnout prevention

Modules and Topics • Module 2 (Intensive w/ assignment) – Homelessness exclusion from society and the concept of social capital – Homelessness as exclusion from Health & HC – The ethics of resource utilization: Are people experiencing homelessness deserving or undeserving? – International aspects of homeless legislation – Emotional Retreat: How do we cope as professionals in our work w/ PEH

Modules and Topics • Module 3 (Intensive w/ assignment) – Population vs. personalization: tailored HC and promotion to disadvantaged groups – Special Populations: Veterans, women, families, older homeless, youth and GLBT – Presentations: Individual assignments – HC needs of the hard to reach groups w/ housing needs: refugees, asylum seekers, BME, gypsies and travelers – Stigmatization and homelessness

Modules and Topics • Module 4 (Intensive w/ assignment) – Health inequalities: How do we define them? How do they apply to PEH? – Ill health in the homeless population of Boston: A case study in organizational management – Looking at applying risk management and case management to care of PEH – Personality attachment disorder: Delivering a service to PEH – Case Discussion

Modules and Topics • Module 5 (Intensive w/ assignment) – Mental health problems in homeless populations: delivering effective TX – Competency/capability/autonomy: Balancing respect with safety – The role of psychological approaches – Delivering service for people with complex needs – Unique care considerations

Modules and Topics • Module 6 (Intensive w/ poster presentation) – Multidisciplinary approaches – Skills advancement – Professional collaboration – Mentoring and career enhancement – European model of HC delivery to PEH

Facilitation and Instruction • English Design • Broad Influence – – – Faculty Guest Tutors Clinicians Academics U. S. Presence – Dr. Jim O’Connell • Collegial – Experts in their fields • Evidence Based – E. g. GLBTQ Presentation

Oxford: A Living History

Impressions and Ideas • Fantastic and. . . – Well organized – readings, writings and reviews – Thoughtfully developed and structured (Dr. Angela Jones, et al) – Transdisciplinary – maybe need for “break out” sessions • Great Program Outline and Framework – – Good mix b/w “online” and “intensives” Lends instruction for “mentoring” Has “international” bridging capacity Foundational framework for bigger programs – Board Certification? • Bring Program to U. S. Audience – Partnership w/ Oxford – Involve U. S. training/academic institution's – Convene U. S. tutor/instructor cohort