Fibromyalgia Temporary Housing Program - Coursework Example

Fibromyalgia Temporary Housing Program The Fibromyalgia Housing Project Introduction Fibromyalgia is a debilitating disorder that affects an estimated 10 million Americans ages 18 and older (National Institute of Health 2007). The disorder is characterized by widespread muscles pain, increased pain sensitivity, sleep stage abnormalities, morning stiffness, headaches, painful menstrual periods, tingling or numbing in the hands or feet, and problems with memory and thinking. Patients experienced many tender spots on the body that cause pain when pressed. Pain can range from a mild ache on some days to sharp, debilitating pain and extreme fatigue on others. The causes of Fibromyalgia are not clear, but it is clear that it is a disorder with a number of possible causes. It seems sufferers have all experienced stressful or traumatic events, such as car accidents, repetitive injuries, illness, and certain diseases that can accompany the discomfort. These may include rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitus (spinal arthritis) (National Institute of Health 2007). Scientists believe there maybe a genetic factor involved in the disorder and women who have a family member with the disorder are more likely to have it themselves. Researchers once believed the debilitating pain reported by Fibromyalgia sufferers was the result of the accompanying depression they experience, however, recent brain scan research has shown an increase in blood flow to the areas of the brain that detect pain intensity (Anderson 2008). Common limitations of patients suffering from Fibromyalgia include exertion and mobility limitations (pushing, pulling, lifting, etc.), extremely reduced energy and stamina levels, cognitive deficits, and the need for a restricted environment due to sensitivities to cold, light, noise and changes in air pressure (Contreras 2003). Fibromyalgia can be very difficult to diagnose and presently there are no specific tests that can be used to determine a clear diagnosis. For this reason, some patients may require several doctor visits and tests to be performed prior to receiving a correct diagnosis. The American College of Rheumatology currently presents the standards for diagnosing Fibromyalgia after other factors have been ruled out. This diagnostic standard includes checking for a certain number (11-18) of tender points on the patients body. Because the complaints and symptoms of Fibromyalgia can be vague and vary between patients, physicians tend to put patients through repeated evaluations prior to diagnosis (Elrod 1997). This extensive diagnostic process leaves many chronically ill and debilitated patients unable to work and sometimes pursuing a diagnosis and treatment for years. In addition, the condition currently has no effective treatment. Treatment is currently based on relieving symptoms, such as the sleep disorder and the pain with sleeping medications, antidepressants, and pain killers. Two medications have recently been approved by the Food and Drug Administration for treatment of Fibromyalgia. These are Lyrica and Cymbalta (Fibromyalgia Network 2009). Studies suggest some symptom relief, but consistent relief for most patients is still unavailable and the current strategy for treatment is attempting different drug cocktails and/or alternative treatments (National Institute of Health 2008). Due to the time period and difficulty in obtaining an accurate diagnosis and the lack of adequate treatment options, many sufferers are struggling with a low capacity to function and find it difficult to maintain a consistent work schedule due to their symptoms. This creates a financial crisis for most sufferers, especially for those without family support or alternative methods to generate income in order to maintain housing. According to the Social Security Disability Determination criteria, a person needs 6 months to a year of consistent debilitating symptoms in order to be eligible for benefits (Social Security Administration 2008). With a back log of 1.5 million disability cases waiting for administrative review, this leaves some patients with no expendable resources or family in dire financial straits (Social Security Administration 2008). The length of time to apply and obtain benefits for a Fibromyalgia sufferer can be years. For many of these patients, the inability to maintain housing becomes a very real problem. Currently, there are no alternatives besides homeless shelters for these patients, which many turn to while waiting for benefits during the disability process. The need for a social program to provide housing for these patients is imperative to assist them in their healing process. It is documented that stress can make symptoms worse, even leading to other diseases that can exacerbate the sufferers problems, leading to more prolonged periods of disability (National Institute of Health 2008). This creates more strain on the Social Security Disability system if sufferers experience this stress and they are unable to rest and pursue adequate treatment options. The need for temporary housing for Fibromyalgia patients during their diagnostic and treatment procedures is essential to their recovery process and would greatly enhance their ability to pursue healing and return to normal or semi-normal functional capacity, thereby allowing many patients to stay off the Social Security Disability roles. 2. Problem Statement The Social Security System in the United States is currently under strain due to the increasing number of retirees and those on disability. Fibromyalgia is a disorder that is difficult to diagnose and even more difficult to treat. However, it is thought to be a disorder that is caused by trauma and stress, in addition to many other factors, including possible genetic factors. Until research illuminates the causes and adequate treatments, the best course for sufferers to maintain functional capacity is to reduce their stress levels, maintain adequate and restorative sleep, and work on managing symptoms through lifestyle changes, which include stress reduction. With the lengthy diagnostic and treatment protocols, Fibromyalgia sufferers currently are put into financial dire straits and many times maintaining adequate housing in a financial impossibility for them. This forces them to apply for Social Security Disability benefits, putting further strain on the system. It is estimated that as many as 10 million Americans may be suffering from Fibromyalgia. These consist mostly of women between the ages of 25-45, but many men and small children also suffer. Many of these women are single parents, and their illness can create a homeless population that is greater than just the sufferer. Children may end up living in cars with their sick mother who has no resources or family. Currently there is no social program that would cover housing costs for this demographic due to their lack of diagnosis, lack of proof of the disorder, and years spent pursuing treatment. Welfare programs such as Social Security Insurance and Food Stamps can provide some assistance, but it is inadequate to cover housing costs. Low income housing programs and handicapped housing programs require proof of disability in order to provide assistance. Fibromyalgia is a difficult disorder to prove, with all symptoms being reported by the sufferer and no adequate diagnostic test. This leaves a large portion of the population without the safety net needed in order to prevent possible permanent disability. 3. Proposal It is proposed to develop a social temporary housing program that addresses the needs of Fibromyalgia patients in the beginning of their disease process that allows them to stay off disability roles and maintain at least part time work status while they pursue treatment options, with the main goal of a return to full time work status and the ability to obtain and maintain housing. This temporary housing program would allow a sufferer housing for them and their dependents for a period of 6 months to a two years, which is the time required by the Social Security Administration to determine disability status and allows for an additional year while the patient is in the process of obtaining benefits. During this time period, patients would be supplied with low or no cost housing, with rent amounts to be determined by their monthly income. Patients would be encouraged to attempt to maintain a part time work schedule and they would be assisted in obtaining other social services, such as child care assistance, medical assistance, and food assistance if deemed necessary. If a sufferer is unable to maintain a part time work schedule due to the severity of their symptoms, this would need to be verified by a vocational expert and rent reductions would be considered upon that determination. The patient would be re-evaluated every 6 months and the determination would be made if they could maintain a part time schedule at that time. If not, then the patient would need to apply for Social Security Disability and possibly be moved to low-income handicapped housing if and when benefits are obtained. 4. Analysis The ultimate goal of this program would be to allow the space and time for the healing process to take place and prevent the need for patients to pursue Social Security Disability benefits. With possibly 10 million sufferer of Fibromyalgia in the United States, it is estimated that at least 10 % of that population do not have the familial support or financial resources to maintain housing for 6 months to a year (National Institute of Health 2007). Without the ability to work, these patients could become added to the homeless population and rely on shelters. The stress of homelessness not only affects their ability to recover from the illness, it extends to their ability to support any dependents they may have. This puts strain on other social programs for individuals and families in need. However, with a temporary housing program that supports a patients medical and daily needs, the patient may be able to continue working part time, with the main goal of enough physical recovery to maintain full time work with accommodations if necessary. In studies of long term sufferers, it is known that Fibromyalgia symptoms are more intense in the beginning of the disease or disorder process (Elrod 1997). By intercepting these patients in the beginning of their illness and providing a social safety net of housing while they pursue their healing options, this program would alleviate a significant portion of these patients having to apply for Social Security Disability benefits and keep them at least partially employed while they learn to adequately manage their symptoms. Currently, there is no such safety net for these sufferers and the stress of homelessness for them and their dependents will only serve to make them more symptomatic, leading to possible permanent disability status. The strain of the Social Security system is evident with such a large population struggling with this disorder. The ability to alleviate a huge stressor from the life of these patients would allow them to begin their recovery process with a chance at a higher success rate. With stress and trauma being major causes of Fibromyalgia, the stress and trauma of battling homelessness can only lead to a more lengthy disease process. The consequence of this is a longer period of disability, with the potential for permanent disability. This program would provide a gain to the taxpayer and the workers who currently fund the Social Security system. By funding temporary housing for patient recovery, patients may not need to apply for benefits, thereby saving strain on the system. In addition, the creation of a housing program for sufferers would help to alleviate the homeless problem in many cities and take pressure off of charity missions and shelters that provide services. Possible drawbacks to the program would include people who are able to work enough to maintain housing, yet report no symptom relief in order to maintain their status in the program. However, this would be addressed by certain policy conditions that follow. 5. Policy The mission of the Fibromyalgia Housing Project is to provide low cost housing for patients in the process of pursuing diagnosis and treatment for their disorder while maintaining working status or applying for disability benefits in order to prevent adding to the homeless population. The goal is to prevent a patients need to go on permanent disability roles by intercepting them in the beginning phases of the disease process and relieving stress, a major contributor to the disabling condition. The objective of the program is to reduce the strain on the Social Security system of the United States. With the lack of adequate diagnostic proof of Fibromyalgia and the reliance on the patients reported symptoms, there is the potential to have certain patients applying for the housing program that may not have the disorder. This unintended effect may be mitigated by the tracking of medical records and the requirement that a treatment plan be developed for each patient and that each patient follows that treatment plan. The fact that an individual who is not experiencing debilitating symptoms would pursue such an intensive medical process and not have the reported symptoms in order to obtain housing is slim. The people accepted into the housing program would be required to be in active pursuit of a treatment plan, and the tracking and reporting of symptoms in a journal would be required. These reports would be evaluated in the 6 month vocational expert work evaluation. The possibility of individuals applying for the temporary housing program and not having Fibromyalgia symptoms is minimal due to the extensive medical process they would be required to undergo. If at the end of the 1 year, if it is determined a patient is unable to pursue even part time work, then the Social Security Disability application process would be required. The patient will still qualify for an additional year of housing assistance through this program while waiting for disability approval. If the patient does not obtain benefits and housing by this time period, a re-evaluation of patient status will be performed and housing may be extended for up to another year. If the Social Security Administration determines that the patient is not disabled, the patient will be required to work as much as they are able and rent will be based upon a percentage of their income. This may be the full rent amount based on market values in the area. If the patient is still unable to produce an adequate income, the reapplication for Social Security Disability benefits will be required. If at any time the individual is capable of returning to full time work, their rent will be collected based upon market values for the apartment. The individual can elect to stay in the building or leave for a private housing option. Services would be provided by vocational evaluation experts, social service staff that assist patients in obtaining medical and other services, rehabilitation experts that may be able to provide employment options that will allow the patient to cope with their symptoms while maintaining a work schedule, and housing staff that would be responsible for maintenance and intake. 6. Financing Budget requirements will be based upon market values for low income housing in each market area. With a number of senior and low income housing projects already in place, the real estate housing budget for the Fibromyalgia House would be in alignment with this standard. In addition, funds will need to be available for staff. This would be based upon current job market values for vocational counselors and maintenance and housing staff. The Seattle Housing Authority is a municipally owned public housing project that currently provides 6,500 federally-subsidized housing units in the Seattle area and employees 650 people. The organization serves approximately 23,000 people and has an annual budget of $114 million (Cat Lep 2008). The budget for the Fibromyalgia House would be based on the number of people in need in a certain metropolitan area and the figures from the Seattle Housing Authority would be used to approximate a budget for the Fibromyalgia House, with adjustments made for the conditions in each real estate market. The Seattle Housing Authority maintains a similar program, where residents pay rent based upon their income. Some residents pay no rent if they have no income. The Housing Authority also maintains a managerial and maintenance staff and a social service staff. The addition of a vocational/rehabilitation counselor to the Fibromyalgia House would be an additional cost. Funding will be administered by the managerial staff of the Fibromyalgia House. Budgets will be developed on an annual basis and be based upon perceived need. Funds will be dispersed by management and they will be responsible for applying for Federal Housing grants. All funds dispersed through the program will require contract bids, if necessary, and documented accounting of how the funds were used in relation to the project. 6. Staffing Employees will be screened for education, experience, and availability. Vocational and rehabilitation experts will be required to have a working knowledge of Fibromyalgia and this will be determined by a short exam. Additional training may be provided if funds are available. Managerial staff will be evaluated based on their experience in administering government funded housing programs. Maintenance staff will be evaluated based on trade education and experience. All salaries will be based upon market values and budgetary constraints. 7. Evaluation Program success will be evaluated by the percentage of patients who are able to maintain part time or full time work while managing their symptoms. Evaluation will also be based on the number of people who are assisted in vocational rehabilitation in order to prevent application for disability benefits. Success will be based upon the program showing at least a 70% success rate of patients maintaining at least part time work within their two years at the housing project. 8. References Cat-Lep, Phong. August 2001. Increased costs force Seattle Housing Authority toward job cuts. Seattle Post Intelligencer. Accessed 1/15/2009. http://www.highbeam.com/doc/1G1-94168653.html. Contretas, Minneke. 2003. Fibromyalgia Handbook. Accessed 1/2009. http://www.hre.wvu.edu/evc.login.handbook/chapter 16. html Elrod, Joe M. (1997). Reversing Fibromyalgia . Utah: Woodland Publishing. Fibromyalgia Network. Accessed 1/15/2009. http://www.fmnetnews.com/ National Institute of Health. Accessed 1/2009. http://www.niams.nih.gov/Health _Info/Fibromyalgia/fibromyalgia-ff.asp. Social Security Administration, Disability Evaluation Under Social Security , SSA Publication No. 64-039, ICN 486600, January 1998. Read More