PORTLAND, Ore. – La atención de la salud no termina cuando una persona sale del consultorio médico. Varios factores externos del esquema tradicional de atención, como la vivienda, juegan un papel primordial en la salud general de una persona. Michael Mellick, administrador de casos de vivienda en CareOregon, dice que cualquier persona que experimente una falta crónica de vivienda, seguramente experimenta también otros problemas.
“Puede asumirse que caerán en problemas de dependencia de substancias, y tratamos de ayudarles con eso. Y seguido aparecen problemas de salud mental. Hay problemas de antecedentes criminales que deben ser resueltos.”
Enfrentar las determinantes sociales como una vivienda adecuada es obligatorio para las Organizaciones Coordinadas de Atención (“Coordinated Care Organizations”), que manejan el Plan de Salud de Oregon (“Oregon Health Plan”) en las comunidades locales. En Portland, seis organizaciones de salud –incluyendo “CareOregon" y “Kaiser Permanente”, lanzaron en 2016 la iniciativa La Vivienda es Salud (“Housing is Health”). Los fondos de ésta han sostenido dos desarrollos para propietarios de bajos ingresos, y otro proyecto está programado para abrir sus puertas este verano.
“Housing is Health” es parte de la respuesta de CareOregon a los problemas de vivienda. Los administradores del caso como Mellick ayudan a los clientes no residenciales a buscar soluciones para sus necesidades específicas. Describe a un cliente que había vivido en las calles durante dos años con una enfermedad pulmonar crónica. Dice que el hombre es viejo y está en una posición vulnerable, y que la vivienda le está ayudando a extender su vida.
“Sigue involucrándose en conductas que no necesariamente son las más saludables para él, pero su utilización y el costo de su atención decrecieron drásticamente por el simple hecho de que ahora duerme en un lugar cálido y seguro.”
Mellick dice que una amenaza frecuente para los clientes es el sentimiento de aislamiento. Puede venir de una variedad de fuentes, como un trauma en una edad temprana, o los efectos del racismo o la pobreza. Agrega que tratar esto podría contribuir a una sociedad mejor.
“No estás nada más acabando en el individuo – estás viendo su relación individual con la comunidad. Alivio, recuperación, renovación. Esto va hasta el concepto de las relaciones y el lugar de una persona en la comunidad.”
Disclosure: CareOregon contributes to our fund for reporting on Health Issues, Senior Issues. If you would like to help support news in the public interest,
click here.
get more stories like this via email
A bill making its way through the Maryland General Assembly could protect renters from unjust evictions.
House Bill 709 would create what is known as a "good cause" law. It would enable but not require local governments in Maryland to put eviction laws in place in their communities to prevent landlords from evicting tenants without cause. People could still be evicted for disorderly conduct that disturbs other residents, a major breach of a lease or causing damage to the property.
Erica Puentes, legislative coordinator for the advocacy group Progressive Maryland, said the idea is to help keep Maryland families stable.
"Good cause laws require transparency and accountability from corporate landlords for why they're choosing to evict a tenant," Puentes explained. "'Good cause' would prevent people from being evicted unless the landlord provides a good reason."
A number of city leaders, including the mayors of Baltimore and Takoma Park, have expressed support for a good cause law in the past few years. But some developers and landlords have voiced opposition, saying it would make it more difficult to evict problem tenants.
Corporate landlords file more than 5,000 eviction cases a year without providing a reason, according to the Public Justice Center.
Puentes emphasized all eyes are on the Maryland Senate, where the bill stalled in committee during last year's session. She added the law would give power to local governments to make new tenant laws and policies.
"There is a lot of appetite and need in Maryland for 'good cause,'" Puentes stressed. "Ultimately the counties and municipalities should have the power, and under 'good cause' they would have the power, to enact this legislation, based on the needs of their constituents."
The Public Justice Center reported more than 5,000 Maryland families are made homeless from evictions each year.
get more stories like this via email
Economists warn affordable housing is harder to come by in North Dakota, putting more people at risk of not having a roof over their heads but some new funding proposals could take a big bite out of the issue.
Leading up to this legislative session, a task force had been studying the issue. Some recommendations now on the table include a bill to set aside $200 million for communities to get more affordable housing projects developed.
Chandler Esslinger, executive director of the Fargo Moorhead Coalition to End Homelessness and board chair of the North Dakota Coalition for Homeless People, said boosting access with the funds is a good start, as service providers convey urgency to state lawmakers.
"This is what we need to meet demand," Esslinger asserted. "If you don't want to see increasing homelessness in your community, this is the type of investment that's truly required."
Esslinger acknowledged so far, lawmakers appear receptive to the need for action. She and other advocates said the crisis requires bigger commitments, but the $200 million figure might be easier to pass. Some residents who testified about the issue said the efforts might be well-intentioned but they are unsure using taxpayer dollars would be effective.
The current plan calls for additional studies to review work being carried out, with $10 million to aid efforts directly dealing with homelessness.
Denise Dykeman of Minot, who volunteers at homeless shelters, said the public needs to realize how a personal financial crisis can quickly spiral into an unstable situation.
"If folks don't have a support structure, like a group of family (members) that they can go to, you can end up homeless very easily," Dykeman pointed out.
She added barriers like mental illness and domestic violence further complicate some people's attempts to find steady work and a home to live in.
The Community Action Partnership of North Dakota said boosting homeless grant funding would expand services focusing on immediate needs, like emergency shelter and rental assistance.
Disclosure: The Community Action Partnership of North Dakota contributes to our fund for reporting on Budget Policy and Priorities, Health Issues, Housing/Homelessness, and Hunger/Food/Nutrition. If you would like to help support news in the public interest,
click here.
get more stories like this via email
More than half of rural residents with substance use disorder have experienced homelessness in the past six months, according to a new study.
Those who care for people with drug and other addictions in Maine said many people entering "sober homes" have spent time in jail or a shelter, since there is a critical shortage of affordable housing statewide.
Ron Springel, executive director of the Maine Association of Recovery Residences, said research points to the critical need for more certified recovery homes.
"In the 16 counties in Maine, there are at least four or five that don't have any certified recovery houses, or maybe only have one or two, with maybe half a dozen beds," Springel outlined.
Springel pointed out the American Society of Addiction Medicine has recognized recovery housing as a vital part of the continuum of care for substance use disorder, although many municipalities have put up barriers to prevent such homes from operating.
Since Gov. Janet Mills took office in 2019, the number of treatment beds in Maine has increased by 50% but the need is still growing. Supporters said recovery homes provide the peer support and structure those experiencing addiction in rural areas require for long-term recovery.
Springel argued they should be covered by MaineCare or private insurance like any other hospital stay or residential treatment program.
"The average length of stay is about six months although some people can stay longer," Springel explained. "The longer they are living in a sober, safe, stable environment, the better they do when they leave, not just during the time that they're there."
Springel noted the recovery community in Maine has grown tremendously over the years, with dozens of community organizations banding together to serve those most in need, including rural areas. He added there are thousands of success stories, they just do not get as much attention.
get more stories like this via email