Continuum Of Care

Prevention strategy work of Kings/Tulare Continuum of Care

Tulare County Supervisors have joined counterparts in Kings County in adopting a 10-year strategy to prevent homelessness.

Connecting the Dots is a plan developed by the Kings/Tulare Continuum of Care on Homeless.

The non-profit has representatives from faith-based groups, city governments — including Tulare, Visalia, Porterville and Hanford — and several organizations that assist the needy.

Over the last three years, KTCCH received $3.7 million in federal Housing and Urban Development grants to add 98 beds to homeless shelters in the two counties. It also paid to give 78 people access to extended housing in apartments.

"Connecting the Dots is intended to refocus current efforts and provide best practices for developing new programs," according to the 70-page report.

There is no requirement to develop such a plan, said Sarah Scott, president of KTCCH and director of community impact for the United Way of Tulare County. But doing so helps communities be more competitive for homeless assistance grants. Her group's plan includes successful strategies that have been done in other communities.

Locally, there are signs of improvement despite a high unemployment and a down economy.

Every January, Tulare and Kings counties join the nation in the Point in Time Count. Volunteers organized by KTCCH hit the streets to count homeless people in Visalia, Tulare, Porterville, Earlimart, Lindsay, Cutler-Orosi, Pixley, Woodlake, Armona, Avenal, Corcoran, Hanford, Lemoore and Stratford. They also helped direct homeless to help.

"These are folks that are living on the streets, under a bridge, in a car or in a shelter," Scott said.

The single-day count turned up 804 homeless in the cities, a 17 percent drop from last year's survey count of 966 homeless people and a more than 20 percent drop from the 1,012 counted in 2007.

Most of the homeless counted in January, 620, were in Tulare County cities. About one in five in the two counties were children and one in three were female.

Scott said that, as a rule of thumb, multiplying the number of homeless counted by three should give an approximate number of the total homeless in the two counties.

Scott credited the decline to the two counties receiving in 2009 about $2.8 million in grants from the American Recovery and Reinvestment Act's Homeless Prevention and Rapid Rehousing Program.

"It's basically a rental-assistance program, to prevent people from becoming homeless and rehousing individuals and families who are homeless," Scott said.

Nine Recommendations to Increase Continuity of Mental Health ...

Continuity of therapy is a vital component of quality care for people with serious mental illnesses and must be given more attention by consumers themselves, family members, advocates, providers, administrators, and researchers alike. At the moment, there is an important opportunity to develop a national consensus statement on the principles and practice standards that should form the basis of a continuum of therapy designed to provide realistic assurance that consumers can access vital medications when and where they are needed. Important strides have been made in identifying the specific factors which promote continuity of therapy – it is time to seize this important opportunity as yet another stepping stone to achieving the transformation of America’s mental health care system for the benefit of consumers and their families, our communities, and our Nation. A roundtable of mental health experts has developed a set of nine recommendations for enhancing continuity of medication therapy for persons with schizophrenia or serious mental illness, including schizophrenia. They are as follows:

Mental Healthcare Recommendation #1 -

Encourage collaborations between hospitals and community-based organizations. Use fiscal incentives to foster collaborations including the standardization of information and shared electronic health records.

Mental Healthcare Recommendation #2 -

Use a quality improvement approach to enhance continuity of therapy by benchmarking at the organizational level performance and outcomes standards regarding continuity of care.

Mental Healthcare Recommendation #3 -

Ensure all consumers have a level of care management for the transition from inpatient to community. Care management services should be reimbursable by all payers and the disincentives to providing it should be removed.

Mental Healthcare Recommendation #4 -

Hospitals and community providers should focus on the “Pull Model” of transition from inpatient to outpatient care. The Pull Model focuses on involving community-based providers in the transition planning process from the beginning. Provider organizations should focus on staff competency in engagement and strategies and motivational interviewing.

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Mental Healthcare Recommendation #5 -

Accreditation standards should be aligned to address and improve continuity of therapy in treating serious mental illness. This may include developing standards to ensure evidence of an active process of care management and transition between levels of care, a quality review of the success of transition plans, and measuring engagement.

The continuum of long-term care

Continuum of care, project for people with post-trauma head or spinal injuries : report for stage one 1994

Continuum of care

Continuum of care

Children and Their Families, The Continuum of Care