We thought it might be nice to share something different on our news blog today. From time to time, graduate students contact us to write a research paper about Anka or one of our programs for a class. We are always happy to help and this particular student sent us her research paper after it was completed. We were so impressed we decided to share it on our news blog. Enjoy!
CASA VERDE – A COMMUNITY-BASED PROGRAM FOR HOMELESS VETERANS
By: Mary Banks, Counseling Psychology Graduate Student, Holy Names University
This paper focuses on the community-based organization (CBO), Anka Behavioral Health, Inc. and their community-based program, Casa Verde, a transitional housing program for veterans experiencing homelessness as well as mental health and substance misuse challenges. I chose to focus on Casa Verde since I have a strong desire to help in efforts towards relieving the invisible wound of mental illness that is a catalyst for self-medication and can result in homelessness and other destructive behaviors to individuals’ mental, emotional and physical well-being. My desire towards assisting veterans developed after studying the effects of combat, learning about the challenges with civilian-life readjustments, and hearing a very personal account by an undergraduate colleague whose brother committed suicide without her family’s awareness of warning signs. My other reason for selecting Casa Verde was because of my personal conviction that no one should suffer from mental anguish, emotional instability or experience any other social deprivation as a result of “mental health injustice.” For me, mental health injustice is suffering and being bound by unhealthy cognitive experiences which can deprive a person of self-sufficiency, of social connections, of economic opportunities, of physical well-being and of opportunities towards self-actualization – the realization of personal and potential growth, self-fulfillment and peek experiences.
My interest with Casa Verde is in learning how this community-based program addresses the invisible wounds of mental illness as well as homelessness and drug misuse as part of its efforts in assisting veterans towards successful re-integration in their communities.
SUMMARY OF COMMUNITY-BASED ORGANIZATION
History and Mission
Anka Behavioral Health, Incorporated (Anka), which initially began in 1973 as a small organization serving developmentally delayed children, has since developed into a premiere behavioral healthcare corporation comprised of a multitude of Northern and Southern California sites (also one site in the State of Michigan). Casa Verde is one of the Corporation’s many community-based programs with its mirrored-mission “to eliminate the impact of behavioral health problems for all people.”
The character values undergirding Casa Verde’s mission, programs and services are evident from its philosophy which is “to treat the whole person by fully integrating care of both mind and body, always using clinically-proven, psycho-social models designed to promote health and wellness while containing costs.” Hence, its character values are caring, dependable, and professional.
Anka’s value of caring is exhibited through integrated care and person-centered planning; through its promotion of recovery and resiliency within a positive environment; and through its transitional residential services for veterans.
Casa Verde’s value of dependability is evident in its ability to provide transitional housing services for homeless veterans who utilize wrap-around referral services provided in partnership with the U.S. Department of Veterans Affairs (VA) in addressing co-occurring issues such as mental illness and substance misuse; in its ability to provide services that are grounded in modern/evidence-based practices; and in its ability to reduce veteran homelessness with the assistance of the VA’s “Homeless Providers Grant and Per Diem Program.”
The value of professionalism is exhibited by Casa Verde in its participation of providing award-winning programs and services under the leadership of Anka. Also, the value of professionalism is competently exercised throughout the corporation’s nearly 1000 employees, including Anka’s Casa Verde’s Program Administrator who manages its Veterans Transitional Housing Program in Antioch, California.
Casa Verde’s Program Administrator and other Anka employees are offered cutting-edge training in the continuance of their professional growth towards effectively administering the Anka’s programs and services. In fact, all employees partake in the company’s
E-Learning program that encompasses such training as evidence-based practices, cultural competency, legal and ethical standards, case management, community treatment and habilitation, person-centered planning, clinical supervision, effective communication, crisis response, and many other topics.
Programs and Services
Casa Verde manages outreach services, and transitional living and permanent housing programs as well as providing case management services to its resident veterans. Casa Verde’s outreach services are a connecting catalyst for homeless veterans towards transitional and ultimately into permanent residence; and into necessary rehabilitative services. While veterans utilize these programs, Casa Verde consistently works to improve veterans’ overall well-being and self-sufficiency. With case management services, Casa Verde, in partnership with the VA, refers veterans to the VA’s rehabilitation services for any mental health and/or substance abuse challenges they encounter. All Casa Verde’s administered programs and services work synergistically towards veterans receiving the mental health and case management services they need to successfully re-reintegrate in their communities.
Funding and Targeted Populations
Overall, Anka has multiple funding opportunities from which it draws from in order to fund not only its corporate operations but also its many programs and services carried out by its CBO sites throughout California as well as a site in Michigan. There are funding opportunities through public contributions or donations such as with vehicles, through campaigns such as crowdfunding, through fundraising events such as direct giving at events; and through planned giving such as with gifts of legacy from trusts, stocks and bonds, estates, retirements or life insurances. All these sources of funding are vital to Anka’s work and have direct impact on the populations served through its multiple CBO sites. Casa Verde benefits from these sources of funding. Such is the case when “Anka was awarded a $6,400 grant through the Home Depot Foundation’s Community Impact Grants Program.” The grant resulted in the purchase of materials for needed renovations of Casa Verde’s transitional residential property. On July 25, 2014, exterior property improvements were completed by Home Depot’s associate volunteer force. In all, Home Depot provided over $15,000 worth of labor and materials to renovate and upgrade Anka’s Casa Verde’s Victorian-style site.
There is an exclusive source of additional funding utilized by Casa Verde to also address veteran homelessness as well as their mental health disorders and/or drug misuse. The VA’s Homeless Providers Grant and Per Diem (GPD) Program is this additional funding. The VA’s Homeless Providers GDP is a homeless grant program in which recipients of the grant must renew their request for funding either annually (based on funding) or up to 24 months only with programs that have supportive housing or service centers (offering services such as case management, education, crisis intervention, counseling, services targeted towards specialized populations including homeless women Veterans, etc.). Since Casa Verde’s program and services address veterans’ (men and women) homelessness as well as any behavioral and emotional trauma, and other challenges, it is eligible for these funds and receives monetary support from the VA’s Homeless Providers GDP Program. Thus, veterans are able to live in Casa Verde’s housing for up to two years as staff help veterans to re-integrate back into society.
Casa Verde focuses on the population of homeless veterans who are in need of critical social services such as housing, psychotherapy and rehabilitation from substance misuse. Currently, Casa Verde’s demographic population consists of women and men, predominantly over the age of forty. However, there is a diversity of residential veterans from the older Vietnam and Korean Wars to men and women who have served in more recent deployments of Iran, Iraq and Afghanistan. Casa Verde’s maximum population capacity is twelve veterans at its transitional residential site, with women and men in separate, designated living spaces.
Staffing and Service Setting
Currently, Casa Verde’s Program Administrator solely oversees case management services of its veterans due to the allowed number of occupants for the site. Also, its Program Administrator meets weekly with the VA’s case management liaison in establishing case notes and to discuss case updates of its resident veterans. Casa Verde’s Program Administrator works collaboratively with veterans to create goals within their treatment plans for establishing stable income for themselves, for accessing earned benefits, for addressing any mental, substance misuse and/or medical issues, and for eventual transition to permanent housing. In all, staffing services for the veterans it serves are in-line with Anka’s view of its staff “as an invaluable resource to be utilized when designing, implementing, and operating all programs… [and that] its staff embodies a commitment to excellence, entrepreneurial solutions, creativity and customer service.” These attributes produce quality outcomes towards re-integration of veterans in their communities.
Casa Verde’s is the only veterans transitional housing program facility that is part of Anka’s many other Northern California Regional, community-based sites with its location in Antioch, CA. Some services and programs are administered on site at Casa Verde’s residential location while others are administered at other more appropriate locations such as VA hospitals, clinics or offices. To the extent that veterans receive services and programs at site Casa Verde, they reside in a Victorian-style, home-like facility where the promotion of recovery, resiliency and self-sufficiency is extended to residence. Casa Verde adheres to a “clean and sober” policy, meaning residence are not allowed to engage in drinking or drug misuse at the site nor appear on its premises in any state of intoxication or under the influence of illegal or unauthorized drug substances. This drug-free and sober policy is maintained by residence agreeing to random drug and alcohol tests.
One particular public policy that Casa Verde adheres to is The VA Homeless Providers Grant and Per Diem Program. This public policy was authorized by Congress in 1992 under Public Law 102-590, H.R.5400: Homeless Veterans Comprehensive Service Programs Act of 1992. In essence, the Act authorizes the Department of Veterans Affairs to assist public or non-profit private entities with partial funding for the creation of facilities, for supportive housing or centers of services; or for transportation purchases in order to engage in outreach and transportation services. The Act also grants the VA power to provide financial funding to public and non-profit private entities, and state and local governments for creating programs that assist the homeless veteran population. The law also allows the VA to partially fund operating expenses for these facilities through per diem payments or capital grants for organizations that are eligible.
COMMUNITY MENTAL HEALTH APPROACH
Community Mental Health Development and Evidence-Based Practices
Community mental health developments are those approaches that are created and employed to address mental health issues. As a community-based site, Casa Verde’s mental health developments as well as its modern/evidence-based practices underlay its mission, values, programs and services. Under its transitional residential services, the customer recovery model is utilized to empower residents to co-develop individualized service plans in helping them manage their mental health symptoms and increase life skills. The integrated model of care addresses mental health and substance abuse problems within the same program and within a single, revisable treatment plan.
In general, wellness and recovery reaches beyond physical well-being. In fact, it encompasses well-being experienced mentally, emotionally; and, for many, spiritually. Wellness leads to recovery and, thus, an increase in an improved quality of life.
Casa Verde integrates the evidence-based practice of wellness and recovery into its case management services. Thus, its case management services for veterans functions as a Wellness Recovery Action Plan (WRAP). Casa Verde, under its case management services, works collaboratively with veterans to create WRAP goals that align veterans to receive the mental health, substance abuse care, transitional or permanent housing; and entitlement benefits necessary for their successful re-integration into their communities. Under WRAP, Casa Verde encourages veterans on implementing concepts of recovery: hope, personal responsibility, self-advocacy, and support into their daily lives; and assists veterans to identify wellness resources through connection with VA benefits to help themselves improve their emotional state having been effected by mental health challenges, substance misuse and other life difficulties.
Intervention is another evidence-based practice employed by Casa Verde’s transitional housing program. Intervention is a method used to interject some form of diversion assistance from individuals engaging in harmful acts counter to their well-being. Several aspects from the Behavioral Day Treatment and Contingency Managed Housing and Work Therapy (Behavioral Treatment) intervention are also present in Casa Verde’s intervention practice with its clients. For example, it is geared towards adults who are homeless and have co-occurring substance use and mental disorders; it is based on therapeutic goals management; it helps participants to stop using substances; and it provides them with housing and work training. However, these similar aspects of Casa Verde’s intervention responses are accomplished through a public partnership with the U.S. Department of Veterans Affairs through their Homeless Providers Grant and Per Diem Program. Also, with Casa Verde’s interventions, if clients are struggling with drug or alcohol detoxification, Casa Verde will connect them with a VA licensed Clinical Social Worker (addiction specialist) who determines the manner of treatment needed. Casa Verde then connects the client with a drug and/or alcohol detoxification center to aid in the process of a safe detoxification process. Like the Behavioral Treatment Intervention, Casa Verde requires that transitional resident clients are practicing drug and alcohol abstinence for continued stay at its site. Thus, Casa Verde conducts monthly random drug and alcohol tests to ensure adherence to this expectation.
Casa Verde’s Program Administrator shared cultural aspects of Anka Behavioral Health, Inc. as well as that of its community-based site and that both endeavor to continue to make a difference in the lives of many in its surrounding communities.
The culture of Anka is such that Case Managers are usually the direct contact with clients and are supervised by Program Administrators in a normal case setting and under normal circumstances. Program Administrators report to and are managed by the Regional Director.
The culture of recruitment is such that management desires those candidates who possess case management experience and empathy as well as understanding about the population served by its community-based sites. Individuals with these skills and knowledge will have an overall understanding about the work of Casa Verde and what they will encounter as a CBO-site employee.
The culture of Casa Verde’s site environment is such that employees work to establish and build a relationship of trust with resident veterans who have arrived to the site from a state of homelessness, who have experienced many wrongs in their lives; and who have been through crises, currently in crises, and are attempting to gain stabilization.
The culture of treatment services is such that Casa Verde works with individuals to encourage them to develop their own individualized style of case management goals. Yet, since structure is a necessity, caseloads are established at initial contact with clients; and SOAP notes are utilized so that there are effective assessments, interventions, and recorded progress of clients. Casa Verde’s Program Administrator notices that supportive transportation services have enhanced staff rapport with clients, increased its understanding of clients and enhanced case management meetings with clients.
The culture of transition is such that once clients are established in the transitional housing program, meetings with clients are on a weekly basis and include visits at clients’ own environment. Since, interpersonal relationship adjustments are a normal process between current and new clients who are accepted at Casa Verde’s transitional housing, its Program Administrator on Fridays hosts site meetings which are open forums for allowing clients opportunities to discuss any interpersonal concerns. Casa Verde’s Program Administrator strongly believes in maintaining a life-enhancement structure and, thus, conducts inspirational services to keep clients motivated, encouraged and to be self-determined not to become complacent in their current plights. Casa Verde’s Program Administrator believes that setting goals and staying focused, with the proper support and encouragement, those goals can be accomplished.
It is vital that community-based organizations are structured properly with leadership in place, with well-funded and accesses to future resources; with competent staff, with a clearly established mission and vision which guide the endeavors of organizations; with employed evidence-based practices; with adherence to all required local, state and federally mandated public policies and other regulations as well as have community-based policies in place; and with empathy for and non-judgment of clients served. Of course, there are other essential components that can be included in community-based organizations’ structural templates. The point is that essential components, particular to an organization, must be present in order that the populations it endeavors to serve experience the needed social benefits and opportunities necessary to improve the qualities of life of the communities that surround the community-based organization.
About the Author:
Mary Banks currently attends Holy Names University as a graduate student of Counseling Psychology. Mary’s decision to devote her life to working with veterans stems from a desire to relieve psychological and emotional challenges that she views as a type of injustice to the wellbeing of those who have sacrificed so much. The Anka/Casa Verde research project provided Mary with a comprehensive experience and understanding about working with veterans which she intends to utilize in further understanding the challenges that many veterans continue to face. In the past Mary has volunteered as a Court-Appointed Special Advocate, advocating for the social needs of youth under the care of Alameda County’s foster care court system. She has also volunteered for OreMi, a non-profit organization that provides mentorship to youth of incarcerated parent(s).