CICERO PERSPECTIVE
What to consider
By Randy Shumway, 5-6 minutes, 1/25/2024
Editor’s note: This is part three of a five-part series addressing homelessness originally published in the Deseret News.
In my last two columns, I’ve attempted to highlight the root challenge for those experiencing chronic homelessness. Much of our public discourse focuses on shelter and affordable housing. Housing is certainly an important ingredient in the continuum of care and, for many, housing stability is the key to recovery. But for our most vulnerable population, the state of “homelessness” is both an unfortunate symptom and an aggravator of other, “co-occurring” maladies — all of which are problematic, but few of which are typically at the root of the issue.
The root problem is debilitating trauma, frequently accompanied by one or more of four equally challenging problems: mental health disabilities, substance use disorder, habituation and criminal activity. This being the case, society will not rescue, let alone help recuperate, these individuals by building more physical shelter alone — they need qualified human support that is accompanied with the medical care, services infrastructure and accountability that will enable meaningful, lasting improvement.
One of society’s greatest needs for increased investment is in graduating and effectively engaging more qualified behavioral health workers. The U.S. Bureau of Labor Statistics predicts a national deficit of 74,000 social workers each year for the next decade — a chilling figure, given the fact that low pay for case managers, coupled with high stress and less than optimal outcomes, results in extraordinarily high turnover. Furthermore, implementing the know-each-by-name model highlighted in yesterday’s article requires even more qualified behavioral health workers. Effective technology will certainly help track and scale services, but technology will never replace the importance of human engagement in a person’s recovery.
The State of Utah’s educational and government leaders are quickly responding to this urgent need. The University of Utah is currently designing the curriculum for a stackable credential model to be rolled out within the next few months in partnership with Salt Lake Community College. The idea is to replicate in behavioral health a similar approach to the many tiers of certifications used in physical health care such as licensed practical nurse, registered nurse, bachelor of science in nursing and nurse practitioner.
These licensed clinical behavioral health caregivers will originate from Utah’s applied technology colleges, community colleges, and universities, significantly increasing the number of desperately needed individuals prepared and certified to provide mental and behavioral support. Utah’s Commerce Department has rapidly responded with innovative ideas around licensure at each of these stages. Licensing will legitimize the training and increase access to reimbursements from Medicaid as well as potentially from private insurers, thus elevating compensation prospects for these worthy human rescuers.
But neither the University of Utah nor Utah’s Department of Commerce have been content to stop there. Knowing the need is overwhelming right now, the university will shortly begin to integrate clinical behavioral health training into its existing human services degrees as well as introducing fast-track retooling opportunities for nontraditional students. And Utah’s licensing agency is currently presenting to the Legislature smart approaches to qualify licensed clinical social workers more rapidly by significantly reducing required clinical hours without a decline in necessary preparation.
These are wonderful examples, and they will make a meaningful impact, but still, we need more. This type of creativity, collaboration and urgency in the public sector will be required by every service provider in order to pivot to new, more effective approaches that will best rescue those in greatest need.
For example, the state Legislature and municipal leaders can increasingly focus laws and investments on protecting those who have experienced, and who continue to experience, debilitating trauma and rapidly getting them the service-rich, recovery-focused care that builds human dignity. Criminal justice can embrace reforms that rely heavily on outcomes-oriented data to inform what requirements best work to propel recovery as well as the types of expungements that allow for lasting rehabilitation. And legacy providers can embrace evidence-based practices — even when it requires painful organizational changes, new techniques and increased accountability.
All of these reforms will require a significant increase in the number of qualified professionals offering the much-needed human engagement and services that drive lasting change, particularly for our most vulnerable populations that we too often refer too narrowly to as the “chronically homeless.”
Please go to www.utah-impact.org to engage with other Utahns committed to helping those experiencing homelessness.
Randy Shumway is the founder and chairman of the Cicero Group, the treasurer of the Utah Impact Partnership and the co-chair of the Utah Homeless Council.
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