The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #58168

Lorraine Donner, RN, MSN, Committees of Human Development and Mental Health Research, University of Chicago, 611 Brooking Court, Lake Villa, IL 60046, Rachel B. Seymour, MS, School of Public Health, University of Illinois at Chicago, 850 West Jackson Boulevard, Suite 400 (MC 275), Chicago, IL 60607, Kendon J. Conrad, PhD, Midwest Center for Health Services and Policy Research, Hines VA Hospital, 151 H, Hines, IL 60141, Pat Lynch, BA, Independent Positive Living Under Supervision (I-PLUS) Agency, 109 South Genesee Street, Waukegan, IL 60085, 847-662-1145, ipluslc@yahoo.com, and George Lutz, PhD, North Chicago VA Medical Center, 3001 N. Green Bay Road, North Chicago, IL 60064.

This study examines a money management intervention, Coordinated Representative Payeeship (CO-RP). CO-RP increases financial stability of persons with mental illness at risk for homelessness by coordinating: 1) community-based money management and 2) psychiatric clinical services.

As part of a randomized clinical trial, this study blends qualitative and quantitative methods to describe CO-RP’s implementation process for the experimental group (n=80 of the total 160 subjects). Using documentation reviews and interviews with money managers, the CO-RP process was detailed for a 6-month period. Focus groups allowed consumers (n=8) and VA clinicians (n=15) to discuss their experiences with CO-RP.

Results show clinicians easily identify consumers needing money management, but barriers impede implementation. Almost 50% of experimental subjects receive Social Security benefits, but only half of those are actively enrolled in money management. Approximately 40% have Veteran’s benefits, but only 13% of them receive money management. Similarly, about 40% work, but only 13% of them utilize money management. Bureaucratic requirements delay CO-RP’s implementation. Plus, consumers and clinicians have concerns about personal rights issues that contribute to ambivalence about CO-RP.

Procedures and administrative supports need to facilitate the process for referring and engaging consumers in CO-RP, especially considering: 1) the need for timely intervention when consumers are ambivalent and very mobile, 2) that conventional referral paradigms need to be modified to ongoing, collaborative approaches with maintenance of working relationships and communication across agencies, and 3) it can be difficult to keep track of the steps in this complex process.

Learning Objectives:

• Participants will be able to describe implementation issues associated with providing money management services coordinated with psychiatric clinical care (CO-RP) for persons with mental illness who are at risk for homelessness.
• Participants will be able to describe some of the potential barriers to the implementation of money management services designed for persons with mental illness. 3. Participants will be able to discuss some recommendations for overcoming CO-RP implementation barriers and for translating this innovation into practice.

Keywords: Homelessness, Mental Illness

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.