Interagency Council Research Articles

Progress in Federal Coordination to Advance Meteorological Services

Abstract In 2020, the federal government completed the first major restructuring of its interagency coordination for meteorological services in over 50 years. The Interagency Council for Advancing Meteorological Services (ICAMS) now provides White House–level coordination of federal resources to advance the full suite of meteorological services now and into the future. Of particular relevance to the external community is ICAMS’ objective to strengthen and expand partnerships with nongovernment sectors. This article outlines ICAMS intellectual foundations, progress, and near-term plans, including efforts to develop a long-term strategy, as means to foster community engagement. ICAMS will continue to provide coordination across federal agencies and opportunities for input from, and engagement with, nongovernmental entities. The development of a long-term strategy is a process that ICAMS is embarking on in earnest, and sustained external community engagement is key to sound development and effective implementation.

Professional Preparation, Growth, and Recognition in the Service Coordination Workforce

A survey was distributed to Part C early intervention (EI) service coordination (SC) stakeholders in one state in order to gain a deeper understanding of service coordinator knowledge, skills, and motivators for professional growth and recognition. Survey participants (N = 107), including dedicated service coordinators, program managers, social emotional consultants, parent liaisons, local interagency council coordinators, and developmental pediatric consultants, identified knowledge and skills required for the role of service coordinators. Key motivators for professional growth within the SC role were also identified, including monetary, award/acknowledgment, and varied levels of responsibility. Data collected were analyzed, reviewed with Part C administrators, system point of entry leadership, and shared with EI stakeholders. Findings are being used to guide systems planning and decision-making to ensure service coordinators have opportunities for professional growth and are well prepared with the knowledge, skills, and supports necessary to partner with families and other professionals in EI. Information gained may also inform other state Part C programs and professional development entities as they (1) create and assess systems to support SC personnel; (2) build service coordinators' capacity to implement evidence-informed practices; (3) recognize service coordinators' critical role and expertise; and (4) foster the retention of well-trained, well-supported service coordinators.

Analysis of Sustainable Development Goals in the regions of Georgia

Georgia was one of the first countries to join the UN Resolution on Sustainable Development Goals and to start achieving those goals at the national level. The inter-agency council was set up for implementation and monitoring, and a relevant plan was set up to ensure the phased implementation of the 17 Sustainable Development Goals, both at national and local levels. Since the goals of sustainable development are universal and inclusive, this is why it is important to involve local governments in their implementation. In achieving the goals of sustainable development, it is important to analyze the role and function of municipalities and how actively they are involved in the implementation of the national plan. The article examines the involvement of local governments in the implementation of the National Plan for Sustainable Development Goals. Key words: Regions of Georgia, Sustainable Development, Local Development, Decentralization.

Community Partnerships: Training Case Managers Working with Individuals Experiencing Chronic Homelessness

Background: Homelessness is a chronic problem across the United States, with approximately 25% of homeless people located in California. In 2012, the United States Interagency Council to end Homelessness developed guidelines to implement Housing First initiatives and training for case managers. Launched in February 2017, Sacramento’s Flexible Supportive Rehousing Program, a permanent Housing First initiative, was adapted from Los Angeles County’s Housing for Health. Methods: A comprehensive training academy for case managers working with individuals experiencing chronic homelessness was developed, implemented, and evaluated. Goals were to improve case managers’ ability to keep clients in housing, and to improve health outcomes as indicated by the Social Determinants of Health. Results: Knowledge, skills, and attitudes (KSA) objectives were provided for each training module. Case managers demonstrated knowledge and skills acquisition by presenting case studies following a provided rubric. Attitude changes were assessed using an adaptation of a validated tool. Evaluation of progress toward longer-term goals is ongoing.

Caring for Older Adults Experiencing Homelessness in the Inpatient Psychiatry Setting: Challenges and Recommendations

The older adult population is rapidly growing in the United States and across the globe. The Institute of Medicine estimates that the number of older adults with mental health or substance use disorders will reach 10.1 million to 14.4 million people by 2030. A particularly vulnerable subgroup within this aging population is the subset experiencing homelessness. According to a 2017 report by the U.S. Department of Housing and Urban Development, homeless adults >50 years old increased from 22.9% to 33.8% between 2007-2017. Moreover, the number of people >62 years old living in shelters or transitional housing increased during the same time period to 76,000, a growth of 69%. This challenge is likely to worsen in the next decade as adults >65 years old experiencing homelessness is expected to triple between 2017-2030. Amongst the general population of adults experiencing homelessness, there is a higher prevalence of mental health and substance use disorders compared to the general population. Mental health care of older homeless adults can be negatively affected by systemic issues associated with homelessness. Such factors include victimization while being homeless, involvement in the criminal justice system, medication nonadherence, and complex case management issues. Homeless individuals, especially women, with mental illnesses experience higher levels of victimization compared to their housed counterparts. A systematic review found that the on-year prevalence of criminal victimization among adults with major mental disorders was up 35% for violent victimization and 28% for nonviolent victimization. Additionally, the lifetime victimization rate ranged between 74% and 87%. Data also show that 63% to 90% of homeless individuals with severe mental illness have been arrested at least once, 28% to 80% have been convicted of a crime, and 48% to 67% have been incarcerated. These issues may affect rapport building by the treatment team and disposition planning. Furthermore, not attending an outpatient mental health appointment after a psychiatric hospitalization is associated with an increased risk for rehospitalization. A 2007 study determined that patients who attended a follow-up appointment had a 1 in 10 chance of being rehospitalized, whereas patients who did not attend (or were not offered) an appointment had a 1 in 4 chance of rehospitalization. At San Francisco General Hospital, a chart review during a 4-week period between February and April 2020 revealed that 83% of unhoused patients did not show up for their outpatient mental health appointment following discharge from a psychiatric unit. Proposed solutions to help older adults who first experience homelessness late in life include developing more affordable housing, boosting rental assistance (Housing Choice Vouchers), increasing wages, Supplemental Security Income, Social Security Disability Insurance, and state supplemental income. Another proposal is Permanent Supportive Housing (PSH), a program that provides housing paired with supportive services such as case-management, individual and group therapy, and peer support. Veteran-specific PSH has been used to reduce homelessness in chronically homeless veterans (United States Interagency Council on Homelessness, 2018). PSH is also less restrictive and less expensive than nursing home placement of chronically homeless individuals. The At Home/Chez Soi randomized controlled trial from Canada, showed that rent supplements and mental health support services improved housing stability for homeless adults with mental illness.

Restructuring of U.S. Federal Coordination to Advance Meteorological Services

Abstract For the first time in over 50 years, the United States has, at the direction of Congress, restructured the way in which federal departments and agencies coordinate to advance meteorological services. The new framework, known as the Interagency Council for Advancing Meteorological Services (ICAMS), encompasses activities spanning local weather to global climate using an Earth system approach. Compared to the previous structure, ICAMS provides a simplified, streamlined framework for coordination across all stakeholders in implementing policies and practices associated with the broad set of services needed by the United States now and into the future. ICAMS also provides improved pathways for research and services integration, as well as mechanisms to more effectively engage the broader community, including academia, industry, nonprofit organizations, and particularly the next generation of educators, researchers, and operational practitioners.

A Community Academic Partnership Approach to Addressing Health Needs of the Local Refugees: Participants’ Perspectives and Recommendations for Developing New Partnerships

Community-academic partnerships have demonstrated how collaboration can provide academic healthcare workers and non-medical community providers such as educators and social services with a comprehensive view of issues affecting refugee populations. The ICIH (Interagency Council on Immigrant Health) is a physician-community partnership consisting of healthcare professionals, non-medical educators, social workers, early childhood services and other community agencies. It was formed to address the well-being of a local immigrant population, strengthen bonds between the community and healthcare system, and educate and empower pediatricians to provide culturally aware services. The collaboration has been very successful as demonstrated by the production of multiple collaborative products in a very short time period with minimal funding. This article explores the experiences of community and physician members in order to share insights and recommendations for others working in small cities who wish to start such a collaborative. We collected data from 17 of 30 ICIH members through focus groups, interviews, and a survey and conducted a qualitative analysis using transcripts from these sessions. From our analysis, the following themes emerged: 1) increased awareness of challenges faced by refugee families, 2) making connections and collaborating with a diverse group of agencies, 3) improvement of care for the population using knowledge learned through the ICIH, 4) expanding perspectives through the sharing of information between agencies, 5) the importance of education for providers and community members about the refugee population, and 6) relational support gained through interaction with other service providers struggling to overcome similar obstacles. Results support the ideals of a productive community-academic partnership. With this information, we present recommendations for others working to establish similar community-academic collaboration efforts.

Banking on burden reduction: how the global financial crisis shaped the political economy of banking regulation

The Economic Growth and Regulatory Paperwork Reduction Act (EGRPRA) of 1996 requires the Federal Financial Institutions Examination Council—an interagency council composed of US banking regulators—to conduct decennial retrospective reviews of existing banking regulations, with an emphasis on reducing regulatory burden. EGRPRA reviews provide a lens to study the political economy of banking regulation before and after the global financial crisis (GFC) of 2007–2009. Through comparative case studies of EGRPRA reviews in 2007 and 2017, this article documents how ex post impact assessment of banking regulation and stakeholder participation in banking regulatory processes have changed over the last 10 years. Using within-case process tracing and content analysis of an original dataset of government documents and public input, this article analyzes the extent to which changes in review processes, participation, and outcomes can be attributed to the policy shock of the GFC and/or shifting political, regulatory, and/or market contexts. The results suggest that government–market interactions have changed considerably since the GFC and that regulatory politics explain many of these changes. While retrospective review and stakeholder participation therein may enable more effective and legitimate regulations and rulemaking processes, much work remains to realize these potential benefits in banking regulation.

The Philippine Sex Workers Collective: Struggling to be heard, not saved

The Philippine Sex Workers Collective is an organisation of current and former sex workers who reject the criminalisation of sex work and the dominant portrayal of sex workers as victims. Based on my interviews with leaders of the Collective and fifty other sex workers in Metro Manila, I argue in this paper that a range of contextual constraints limits the ability of Filipino sex workers to effectively organise and lobby for their rights. For example, the Collective cannot legally register because of the criminalisation of sex work, and this impacts their ability to access funding and recruit members. The structural configuration of the Philippines’ Inter-Agency Council Against Trafficking incentivises civil society organisations to adhere to a unified position on sex work as violence against women. The stigma against sex work in a predominantly Catholic country is another constraint. Recently, President Rodrigo Duterte’s war on drugs has been weaponised by some members of the police to harass sex workers. Finally, I reflect on strategies the Collective could adopt to navigate the limited space they have for representation, such as crucial partnerships, outreach work, and legal remedies.

Dave Didn't Have To Die: On Health Care For Homeless Patients.

A writer watches a homeless man's health decline because of a lack of care.

Regional patient safety and quality leaders aim to reduce disparities in healthcare with collaborative approach

PurposeWashington Patient Safety Coalition (WPSC) brings individuals and healthcare organizations together to identify and work on patient safety priorities. It holds bi-annual strategic planning sessions to assess program effectiveness around current organizational goals and to develop new goals. The purpose of this paper is to describe how WPSC members came to identify health disparities as a priority, and what they did to integrate this into organizational strategy.Design/methodology/approachFor the 2015 strategic planning session, WPSC staff used 2012-2015 internal activities records to conduct a SWOT analysis. The author conducted stakeholder and member “Sensing Surveys” and framed action items on two underlying considerations: first, positioning of the members within the patient safety landscape, taking into account where the members are most “touching” the issue of disparity and are most appropriately positioned to act as change agents and, second, WPSC is not an established content expert in health disparities.FindingsThe author focused the efforts on assisting the Governor’s Interagency Council in promoting Culturally and Linguistically Appropriate Services standards. This Council helps to drive policy, but not necessarily operationalizing it. WPSC has ability to fulfill that role; the membership is comprised of organizational leaders, those positioned to operationalize the Council’s disparity interventions. The WPSC saw an opportunity to partner the efforts, bridging gaps between policy and operational action.Practical implicationsThis viewpoint shows the power of a small collaboration interested in broadening awareness of a complex issue.Originality/valueHealth disparities are complex and multifaceted. Within the Seattle area there were many organizations committed to working on this topic, each with their unique value add to the issue.

Intergovernmental Alignment, Program Effectiveness, and U.S. Homelessness Policy

In the U.S. intergovernmental system, state governments can voluntarily and strategically align with federal government strategies and objectives. This study examines the effect of intergovernmental alignment on federal homelessness program outcomes. In 2010, the U.S. Interagency Council on Homelessness started the first national-level comprehensive strategic plan on homelessness: Opening Doors. The Opening Doors plan highlights intergovernmental partnerships as effective tools to implement federal homeless programs to different levels of governments in order to achieve federal outcomes. Using a difference-in-differences methodology, we find that county governments that align their homelessness program with the federal and state government have better program outcomes than those that do not align intergovernmentally. Our findings help to expand our understanding of intergovernmental mechanisms as effective policy tools to achieve federal program outcomes at the local level in the absence of financial inducements or legal mandates.

Surveying Homeless and Unstably Housed Youth: Methodological Considerations When Estimating the Prevalence and Characteristics of the Population (Research Note)

The United States Interagency Council on Homelessness has called for ending youth homelessness by 2020, a goal that requires accurate data on the scope and characteristics of youth experiencing homelessness. This research note describes the methodology and results of a collaborative survey conducted by 30 community-based organizations to estimate and describe youth experiencing homeless. Data were collected from 558 youth. Approximately 23% of youth were homeless or unstably housed the night before the count; an additional 15% reported being homeless in the month before the count. Characteristics of youth experiencing homelessness are described, and comparisons are made between homeless and nonhomeless youth. Strengths and limitations of the methodology are discussed in light of their implications for sampling and data collection with vulnerable and difficult-to-access populations.

Service use before and after the provision of scatter-site Housing First for chronically homeless individuals with severe alcohol use disorders

Based on an increasing evidence base, the U.S. Federal Government has endorsed permanent supportive housing using a Housing First (HF) approach as the ‘‘clear solution’’ to chronic homelessness (U.S. Interagency Council on Homelessness, 2010, p. 18). Canada and Europe have also implemented large-scale HF projects (Busch-Geertsema, 2011; Goering et al., 2014). HF, which entails providing low-barrier access to permanent, affordable housing (i.e., housing is not contingent on abstinence or sobriety) along with support services, typically refers to either singleor scatter-site housing. Single-site entails placing chronically homeless individuals into apartments in the same building with services provided on-site (Collins, Malone, & Clifasefi, 2013). Scatter-site refers to placing homeless adults into apartments rented from private landlords throughout the community with services provided by mobile treatment teams (Tsemberis, Gulcur, & Nakae, 2004). Both models use support services based on a harmreduction philosophy (Collins et al., 2012; Tiderington, Stanhope, & Henwood, 2012) and are effective at increasing housing stability and ending homelessness (Collins et al., 2013; Tsemberis et al., 2004). Research on HF for chronically homeless individuals with alcohol problems has predominantly focused on a single-site model. This research has shown that placement into single-site HF is associated with reduced alcohol use, service use, and overall cost (Collins et al., 2012; Larimer et al., 2009). Research on scatter-site HF has predominantly focused on homeless individuals with serious mental illness and co-occurring substance use disorders. Although it is not clear whether scatter-site HF for this population results in an overall decrease in substance use (Padgett, Gulcur, & Tsemberis, 2006; Padgett, Stanhope, Henwood, & Stefancic, 2011), reduced service use and cost has been found for these dually diagnosed homeless adults (Culhane, 2008). This report contributes to the literature by examining the service use of homeless

Evaluating Nursing Collections With the ICIRN's Essential Nursing Resources List

This study examines libraries’ nursing collections using the Interagency Council on Information Resources in Nursing's Essential Nursing Resources’ (ENR) 26th edition. An inventory of the online collections of 235 libraries was assembled and compared to free, government, or National Library of Medicine resources and licensed resources from the ENR. The top five resources listed on library websites in descending order were MEDLINE, CINAHL, ERIC, PsycINFO, and Google Scholar. The availability of specialized resources varied, based on factors such as the level of nursing degree at each institution or the libraries’ National Network of Libraries of Medicine membership statuses.

An Evidence-based Guideline for Prehospital Analgesia in Trauma

Background. The management of acute traumatic pain is a crucial component of prehospital care and yet the assessment and administration of analgesia is highly variable, frequently suboptimal, and often determined by consensus-based regional protocols. Objective. To develop an evidence-based guideline (EBG) for the clinical management of acute traumatic pain in adults and children by advanced life support (ALS) providers in the prehospital setting. Methods. We recruited a multi-stakeholder panel with expertise in acute pain management, guideline development, health informatics, and emergency medical services (EMS) outcomes research. Representatives of the National Highway Traffic Safety Administration (sponsoring agency) and a major children's research center (investigative team) also contributed to the process. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to guide the process of question formulation, evidence retrieval, appraisal/synthesis, and formulation of recommendations. The process also adhered to the National Prehospital Evidence-Based Guideline (EBG) model process approved by the Federal Interagency Council for EMS and the National EMS Advisory Council. Results. Four strong and three weak recommendations emerged from the process; two of the strong recommendations were linked to high- and moderate-quality evidence, respectively. The panel recommended that all patients be considered candidates for analgesia, regardless of transport interval, and that opioid medications should be considered for patients in moderate to severe pain. The panel also recommended that all patients should be reassessed at frequent intervals using a standardized pain scale and that patients should be re-dosed if pain persists. The panel suggested the use of specific age-appropriate pain scales. Conclusion. GRADE methodology was used to develop an evidence-based guideline for prehospital analgesia in trauma. The panel issued four strong recommendations regarding patient assessment and narcotic medication dosing. Future research should define optimal approaches for implementation of the guideline as well as the impact of the protocol on safety and effectiveness metrics.

Ysabel Bertolucci, AHIP, 1949–2012

Ysabel Bertolucci, AHIP, 1949–2012

Supportive Housing Cuts Costs of Caring for the Chronically Homeless

IN THE LATE 1990S, SEATTLE LEADers recognized the city had a problem. Homeless people with severe alcoholism consumed a tremendous share of public dollars, cycling in and out of emergency departments and the criminal justice system. The city’s political, business, and hospital leaders joined forces with social service and substance abuse treatment agencies to adopt a new strategy not only to curb costs, but also to keep so many chronically homeless people from dying on the streets. One of their first calls was to the Downtown Emergency Service Center (DESC), a group that ran housing projects targeting mentally ill and other vulnerable homeless populations. The city’s leaders asked the DESC to take a “housing-first” approach by creating a new facility where chronically homeless people with severe alcohol abuse problems could find shelter without first having to stop drinking or enter treatment. Bill Hobson, executive director of the DESC, explained that most shelters or housing facilities make treatment or abstinence a condition of housing. But the population Seattle was targeting included individuals who had repeatedly failed treatment programs— some as many as 20 times, Hobson explained. “Let’s accept that these individuals can’t or won’t stop drinking, and they are hurting the greater society with their use of crisis services,” he explained. The DESC adopted a “harmreduction” strategy, which aimed to reduce the harmful effects of drinking on the individual and on society, Hobson explained. The organization identified homeless people who incurred the greatest public costs because of their alcohol use problems and offered them individual apartments in a new facility at 1811 Eastlake. The facility opened in 2005 with a 24-hour staff of social workers and other clinicians. Staff helped residents access social and medical services and worked with them to address behavioral issues that had caused them to lose previous housing. Most residents continued drinking despite discussions with staff about the harmful effects of doing so. “Harm reduction is about helping people prepare to change,” Hobson said. It was a radical experiment, with its share of critics. But it worked. The housing-first model used by the DESC at 1811 Eastlake has been emulated by communities across the country working to eliminate chronic homelessness among individuals with severe substance abuse problems, mental illness, or other chronic diseases. Between 2006 and 2010, the number of beds in such supportive housing programs in the United States increased from 176 830 to 236 798. The United States Interagency Council on Homelessness (USICH) also has embraced the housing-first approach to chronic homelessness as a pillar of its plan to end homelessness in the United States. “Chronically homeless individuals are extremely expensive for the taxpayer,” said Barbara Poppe, executive director of the USICH. “[Supportive housing] benefits the entire community because people are not languishing on the streets.”

Ending child homelessness in America.

Approximately 1.5 million children experience homelessness in America each year. The current economic recession and staggering numbers of housing foreclosures have caused the numbers of homeless families to increase dramatically. The impact of homelessness on families and children is devastating. Without a place to call home, children are severely challenged by unpredictability, dislocation, and chaos. Homelessness and exposure to traumatic stresses place them at high risk for poor mental health outcomes. Despite the pressing needs of these children, federal policy during the last decade has focused primarily on chronically homeless adult individuals-to the exclusion of the families. In 2010, however, the U.S. Interagency Council on Homelessness issued a comprehensive plan to eradicate homelessness for all people through interagency collaboration and aligning mainstream services. A key goal is to prevent and end homelessness for families, youth, and children within 10 years. This policy-focused article describes several tools that can be used to help achieve this goal, including: general principles of care for serving homeless families and children; BSAFE-a promising practice that helps families access community-based services and supports; and the Campaign to End Child Homelessness aimed at action on behalf of homeless families and children at the national, state, and local levels.

Interagency Council on Information Resources for Nursing

Abstract The 21st edition of the Interagency Council on Information Resources for Nursing's biennial list is presented as a resource for collection development and for use in locating nursing information. The list includes print, multimedia, and electronic sources to support nursing practice, education, administration, and research activities.The editors have made a concerted effort to include the most recent editions of titles in print and to evaluate electronic sources. Price, publisher, and supplier information can be obtained by consulting standard print sources such as Medical and Health Care Books and Serials in Print (New Providence, NJ, Bowker), Encyclopedia of Associations (Detroit, Gale Research), and individual websites.