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- Creators: Lucio, Joanna
- Creators: School of Politics and Global Studies
Description
Social impact bonds (SIBs) are a multi-year contract between social service providers, the government, and private investors. The three parties agree on a specific outcome for a societal issue. Investors provide capital required for the service provider to operate the project. The service provider then delivers the service to the target population. The success of the project is evaluated by outside party. If the target outcome is met, the government repays the investors at a premium. Nonprofit service providers can only serve a small community as they lack the funding to scale their programs and their reliance on government funding and philanthropy leads to a lot of time focused on raising money in the short-term and inhibits them from evolving their programs and projects for long-term strategic success. Government budgets decline but social problems persist. These contracts share risk between the government and the investors and allow governments to test out programs and alleviate taxpayer burdens from unsuccessful social service programs. Arizona has a severe homelessness problem. Nightly, 6000 people are homeless in Maricopa County. In a given year, over 32,000 individuals were homeless, composed of single adults, families, children, and veterans. Homelessness is not only a debilitating and difficult experience for those who experience it, but also has considerable economic costs on society. Homeless individuals use a number of government programs beyond emergency shelters, and these can cost taxpayers billions of dollars per year. Rapid rehousing was a successful intervention model that the state has been heavily investing in the last few years. This thesis aimed to survey the Arizona climate and determine what barriers were present for enacting an SIB for homelessness. The findings showed that although there are many competent stakeholder groups, lack of interest and overall knowledge of SIBs prevented groups from taking responsibility as the anchor for such a project. Additionally, the government and nonprofits had good partnerships, but lacked relationships with the business community and investors that could propel an SIB. Finally, although rapid rehousing can be used as a successful intervention model, there are not enough years of proven success to justify the spending on an SIB. Additionally, data collection for homelessness programming needs to be standardized between all relevant partners. The framework for an SIB exists in Arizona, but needs a few more years of development before it can be considered.
ContributorsAhmed, Fabeeha (Author) / Desouza, Kevin (Thesis director) / Lucio, Joanna (Committee member) / School of Politics and Global Studies (Contributor) / Department of Economics (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Homelessness is one of the most visible and tragic problems facing Phoenix today. As Tucson cut its homelessness count nearly in half over the past six years, Phoenix only saw a reduction of 25%. The question remains: what is the best solution for Phoenix to reduce and eventually eliminate homelessness? This paper examined costs and benefits as well as examples in other cities and states of Housing First solutions' effectiveness at reducing the number of people suffering from homelessness. It was found that Housing First solutions, namely Permanent Supportive Housing and Rapid Re-Housing, would be highly effective in combating the homelessness experienced by those in the Phoenix area.
ContributorsGhali, Zakary Hawkes (Author) / Lewis, Paul (Thesis director) / Kilman, Margaret (Committee member) / School of International Letters and Cultures (Contributor) / School of Politics and Global Studies (Contributor, Contributor) / School of Public Affairs (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and enhance the patient experience of care (Triple Aim). Interprofessional collaboration among diverse disciplines is evident on the Phoenix Biomedical Campus, integrating a wide variety of institutions and multiple health profession programs; and at the Student Health Outreach for Wellness (SHOW) free clinic, -- a successful tri-university, student-led, faculty mentored, and community-based model of interprofessional learning and care -- based in downtown Phoenix. This project conducted a comparative analysis of interprofessional components of 6 different clinical models in order to provide recommendations for best practice implementation. These models were chosen based on availability of research on interprofessionalism with their clinics. As a result, three recommendations were offered to the SHOW clinic for consideration in their efforts to improve both patient and educational outcomes. Each recommendation was intentionally formulated for its capacity to increase: interprofessionalism and collaboration between multiple disciplines pertaining to healthcare, among healthcare professionals to promote positive patient and educational outcomes. These recommendations include implementing an interprofessional education (IPE) course as a core component in an academic program's curriculum, offering faculty and professional development opportunities for faculty and mentors immersed in the interprofessional clinics, and utilization of simulation centers. Further studies will be needed to evaluate the impact these specific interventions, if adopted, on patient and educational outcomes.
ContributorsMousa, Mohammad (Co-author) / Mousa, Bakir (Co-author) / Johnson, Ross (Co-author) / Harrell, Liz (Thesis director) / Saewert, Karen (Committee member) / Harrington Bioengineering Program (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
ContributorsWilson, Ethan Sinead (Author) / Jehn, Megan (Thesis director) / Harrell, Susan (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
This thesis examines Care Not Cash, a welfare reform measure that replaced traditional cash General Assistance program payments for homeless persons in San Francisco with in-kind social services. Unlike most welfare reform measures, proponents framed Care Not Cash as a progressive policy, aimed at expanding social services and government care for this vulnerable population. Drawing on primary and secondary documents, as well as interviews with homelessness policy experts, this thesis examines the historical and political success of Care Not Cash, and explores the potential need for implementation of a similar program in Phoenix, Arizona.
ContributorsMcCutcheon, Zachary Ryan (Author) / Lucio, Joanna (Thesis director) / Williams, David (Committee member) / Bretts-Jamison, Jake (Committee member) / School of Public Affairs (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
With homelessness existing in the complex web of poverty that persists in the living environments that stretch across this nation, it has become incredibly important to understand the intricacies that navigate and perpetuate this in our society. With homelessness being an individual experience of struggle and survival, the current dialogue does not reflect such. The current dialogue communicates homelessness as a shared hardship, a result of similar decisions. Such dialogue has shown to be malevolent and accusatory, as it makes no room to portray the individual experience, and the actual cause and perpetuation of such a living situation. Attached to the concept of homelessness are specific stereotypes, generalizations, and negative assumptions, which go into creating the grounds for biases and stigma that revolve around the image of homelessness. To gauge the current dialogue that exists around homelessness and how this dialogue is internalized, one-on-one interviews were conducted. These interviews produced narratives that were pieced together to present a more inclusive, understanding, and holistic dialogue around the concept and human experience of homelessness, and poverty altogether. These narratives reveal the flaws and social injustices that are posed by the current dialogue, and further provide the necessary pieces to improve such conversations. In transforming the current dialogue, the human experience of homelessness can be greater understood and, therefore, redefine the vitality of a shared humanity.
ContributorsKiermayr, Hannah Theresa (Author) / Sandoval, Mathew (Thesis director) / Cruz-Torres, Maria (Committee member) / School of Politics and Global Studies (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Law enforcement officers are frequently tasked with addressing and responding to public safety and community concerns related to issues of homelessness. While interactions between law enforcement and individuals experiencing homelessness occur frequently, issues of homelessness also span public health, policy, and housing spheres. Because of this, several communities in the United States also lean on outreach workers to address issues of homelessness. Recent research has described both law enforcement officers and outreach workers as street-level bureaucrats. Both groups grapple with unique shift demands, lack of supervision, burnout, and issues such as turnover, all while leveraging their personal knowledge and connections to make decisions on a case-by- case basis.In two studies, this dissertation explores the role of the police and outreach workers in responses to issues of homelessness. This is important to address because there is evidence that these two groups have a high degree of contact with individuals experience homelessness and have similar decision-making processes. Yet, they are largely siloed from one another making it difficult to generate policies related to issues of homelessness that are informed by both groups. In study one, responses to close- and open-ended responses (N = 1,163) drawn from a survey distributed to law enforcement personnel are analyzed, merged, and interpreted. The second study of this dissertation is an ethnography of outreach workers in Maricopa County, Arizona. The collective findings from these two studies underscore a remarkable similarity between outreach worker and law enforcement decision making, as well as a growing need to strengthen the relationships between these two groups to support longer-term solutions. Co-created training guides and events can be constructed to enhance the relationship between these two groups and to support mutually beneficial outcomes.
Portions of this research were supported by a Law and Science Dissertation Grant, via the National Science Foundation, award SES-2016661 to Arizona State University. This project was also supported by Arizona State University’s Graduate College and Graduate Student and Professional Association’s Graduate Research Program Award. The findings and conclusions are those of the author and do not reflect the position of the National Science Foundation or Arizona State University.
ContributorsBrown, Katharine L (Author) / Telep, Cody W (Thesis advisor) / Lucio, Joanna (Committee member) / Young, Jacob Tn (Committee member) / Arizona State University (Publisher)
Created2023