Reynaldo

When Reynaldo was released from a 16 month jail sentence he was suffering from serious health conditions and homeless. He became one of the estimated 37,000 New Yorker’s using the city’s homeless shelter system. Reynaldo eventually found his way to SUS where he was set up with transitional housing and enrolled in the Wellness Works program to better his health. He is now pursuing his B.A. in Computer Science and living near his family in permanent housing and maintaining a full time job.

The Dignity of Risk: A Poem

What if you never got to make a mistake?

What if your money was always kept in an envelope where you couldn’t get it?

What if you were never given a chance to do well at something?

What if you were always treated like a child?

What if your only chance to be with people different from you was with your own family?

What if the job you did was not useful?

What if you never got to make a decision?

What if the only risky thing you could do was to act out?

What if you couldn’t go outside because the last time you did it rained?

What if you took the wrong bus once and now you aren’t allowed to take another one?

What if you got into trouble and were sent away, and couldn’t come back because they always remember your “trouble”?

What if you worked and you got 46 cents an hour?

What if you had to wear your winter coat when it rained because it was all you had?

What if you had no privacy?

What if you could do part of the grocery shopping, but weren’t allowed to do any because you weren’t able to do all the shopping?

What if you spent three hours of every day just waiting?

What if you grew old and never knew adulthood?

What if you never got a chance?

-Author Unknown

“My Biography” By Israel J. Carbuckle, SUS DD Consumer.

Editors Note: This piece was written by Israel Carbuckle, a SUS consumer who participates in the Hicks Day Habilitation program. This is his original content and has not been edited by SUS staff.

My name is Israel J. Carbuckle and I am 26 years old. I was born on October 3, 1984 in Lincoln Hospital in the Bronx. When I was 2 years old I was diagnosed with Cerebral Palsy even though it has been diagnosed that my disability is not developmental. I am the last of 6 children from a mom who couldn’t love her children more and a father who couldn’t love his children less. I don’t know, it seems like somewhere in 64 years being a father became boring and drugs became more fun. My mother and I were very close but like they say God gives and takes away. My mom passed away in the summer of 2001 when I was 16 years old. Since I was a child I was very athletic, I love being active, but when you lose someone close to you life seems to not be the same for you anymore, and that’s sort of the case with me.

All of my brothers are older than me, but I am the only one of my mother’s kids to be serious about school. My 2^nd to oldest brother who were born in the same month as me turned to the gang life a few years after my mother died. My mom was like the glue that held all of us together, and when she died it seemed like everything around me was falling apart and I couldn’t stop it. When you’re the youngest you’re the last to know everything, but when my mom passed away I was the 3^rd to know. On June 21^st 2005 I graduated from Sheepshead Bay High School after moving to Brooklyn in June of 2004 to start my life over again.

Since my mother passed away I developed a love for writing. I wrote my 1^st poem at 17 years old and it got published in Morris High School’s Senior School Newspaper in the summer of 2002. After a while writing poems seemed to be small beans to me so I decided to write books. When you’re a writer you need inspiration, something to write about. I basically wrote about what I saw since I’m not much of an emotional person. I started a series of book called the Models Inc series molded after one of my favorite Game Shows Deal Or No Deal. I began writing my 1^st book in the fall of 2008 and I am the midst of writing my 3^rd book. Most of my books are 40 pages long (4 chapters, 10 pages each), but my 3^rd book is going to be a little longer. My 3^rd book is going to be called “More Than Just A Model” about this briefcase model (Notice a pattern) who goes to this wrestling camp in hopes of becoming a wrestler. I am currently in the middle of composing ideas for the book. I have been accepted for the Spring 2011 semester at New York City College Of Technology and hopefully that will help me in my future hopes of becoming an accountant, and a writer. I am receiving a lot of help from my Supervisor and the staff at SUS’s Hicks Day Habilitation (Work Without Walls Program).

Serving Individuals Living With HIV/AIDS

New York City continues to be at the epicenter of the U.S. epidemic, with more than 100,000 New Yorkers reported with HIV/AIDS. While advances in medical care for people living with HIV/AIDS (PLWHA) have been significant, disparities exist in health care access and health outcomes for PLWHAs. Despite the advances in treatment and increased life expectancy for PLWHA, HIV treatment remains challenging.

In 1991, Services for the UnderServed (SUS) initiated its first programs for persons living with HIV/AIDS with a scattered-site supportive housing program. SUS has expanded its ability to serve people with AIDS with new housing programs and an outreach program that provides harm reduction and medical outreach to approximately 250 homeless individuals per year who are placed in commercial SRO hotels by the City of New York for emergency shelter. While an AIDS diagnosis is a qualification for receiving housing or the other support services, it is often not the primary challenge for our consumers. Their homelessness, substance usage, or mental illness becomes a greater challenge and factors into their overall wellness. As extensively noted in the literature including the AIDS Institute Statewide Coordinated Statement of Need and Comprehensive Plan (2006), housing stability is closely linked to positive health outcomes among people living with AIDS. SUS has a strong record in stabilizing individuals through our Supportive Housing program. In 2009, through our transitional and permanent housing programs, almost 750 individuals were provided housing with supportive services. Of the individuals and families in permanent housing, 82% have been successful in maintaining housing for at least one year and 68% have maintained housing for at least two years.

SUS is working to address some of the factors associated with poor adherence to medical care plan and antiretroviral medications through some new and innovative models of service based on emerging research about care treatment to better serve our consumers. The Care Coordination project, funded by (Ryan White) New York City Department of Health and Mental Hygiene via Public Health Solutions, addresses HIV/AIDS healthcare disparities by facilitating access to care and other services via medical case management, navigation, promotion of self-reliance and patient education. It aims to combine elements of the HIV Navigation Model and the Chronic Care Model to define and implement an HIV-specific Care Coordination model within the integrated continuum of care. SUS is one of the few providers in NYC utilizing this model specifically to work with homeless adults. In addition, SUS was one of four organizations to be awarded a contract to provide Transitional Care Coordination to further our outreach to these individuals. The program is scheduled to start in Spring 2011.

Wellness Works, funded by two grants from the US Substance Abuse and Mental Health Services Administration (SAMHSA), expands, strengthens, and fully integrates treatment for persons who are homeless and have multiple co-morbidities, including mental illness, substance abuse disorders, and health issues including HIV/AIDS through the introduction of several Evidence Based Best Practices (EBBPs) including Wellness Self Management, Integrated Dual Diagnosis Treatment and Motivational Interviewing. These  EBBPs encourage disabled people  to choose a path of recovery (as they define it) and gives them the skills, language, and tools to support their recovery.  This new approach to service delivery enables individuals to better integrate into the community, secure and maintain housing, and achieve long-term wellness.

Both initiatives, in combination with stable housing, will work towards supporting access to care and improved treatment adherence. Once barriers to treatment have been eliminated and the patient is receiving adequate care, it is expected that individuals will experience a decrease in viral load, an increase in CD4 counts, and advances in disease stage will be reduced with adherence to their prescribed ARV medication. By reducing the viral load in individuals and periodic assessment of HIV transmission risk with harm reduction counseling and partner notification where needed, HIV transmission may ultimately be reduced in the community.

Joyce

Joyce was a young single mother trying to put her son through college when she lost her two brothers and her mother. The strain and stress were too much for her and she eventually turned to drugs. SUS’s Single Room Occupancy (SRO) Team reached out to Joyce. She found the support she needed at SUS to get clean and find stable housing. She has been drug free for 10 years and is working on her education. She plans to become a counselor, and work with individuals who are living with HIV/AIDS.