Federal embeds take on homelessness

The ideas and innovators shaping health care

Jun 13, 2023 View in browser   By Erin Schumaker, Ben Leonard and Shawn Zeller POLICY PUZZLE Olivet's got a big goal to meet on reducing homelessness. | Timothy Devine Photography Treating homelessness like the "public health crisis that it is" will help meet President Joe Biden's goal of reducing the number of people without a permanent place to live by 25 percent by 2025. So says Jeff Olivet, executive director of the U.S. Interagency Council on Homelessness. The Biden administration's All INside initiative, which Olivet is helping to lead, is now underway. Federal employees will go to California and five cities — Chicago, Dallas, Los Angeles, Phoenix and Seattle — to help accelerate local strategies. Erin caught up with Olivet to learn more. This interview has been edited for length and clarity. What were the selection criteria for these cities? Why Phoenix? It’s looking at a combination of political will, capacity of the system to deploy new approaches and the acuity of the problem. There were a number of factors, including the number of people living in unsheltered settings, but also very specific opportunities for advancing existing local efforts and bringing on new solutions. Phoenix and Maricopa County have seen a pretty significant increase in overall homelessness, but in particular, homelessness for people who are staying outside in tents and on the street. There’s a real crisis there of a very large encampment called “The Zone.” Is All INside modeled on previous efforts to end homelessness? There was a Bush-era initiative called the Collaborative Initiative to Help End Chronic Homelessness in the mid-2000s. That targeted 11 cities. There was an Obama-era program called Strong Cities, Strong Communities that really is the template for this program. We drew heavily on that model of embedding federal staff, providing technical assistance and support in navigating federal funding streams, peer-to-peer learning. Is there a bipartisan appetite for solving homelessness?  There are precedents for how to do good bipartisan solutions to homelessness. I’ll give you one very concrete one. Over the last 12 or so years, we’ve seen Democratic and Republican leaders on the Hill get behind efforts to end veteran homelessness. As a result, we’ve reduced veteran homelessness 55 percent in the last decade. What’s your timeline for getting the federal embeds on the ground? They will be onboarded a week and a half from now and then embedded in the cities very shortly after that, by the end of June.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     WELCOME TO FUTURE PULSE The Paragon Carousel, Hull, Mass. | Shawn Zeller This is where we explore the ideas and innovators shaping health care. It sounded like the last word on drinking earlier this year when the World Health Organization said any imbibing of alcohol isn’t safe for your health. It wasn’t. A new study out of Massachusetts General Hospital again makes the case that moderate drinking has heart benefits – because it reduces stress signaling in the brain. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, your host Ben talks with Katherine Ellen Foley about her report on what Food and Drug Administration traditional approval of the Alzheimer's drug Leqembi could mean for patients. Listen to today’s Pulse Check podcast TECH MAZE Would you take the smart pill? | Don Heupel/AP Photo Patients are bullish on emerging ways to deliver care like hospital-at-home and genetics testing. But they’re skeptical of some more advanced technology, like smart pills, which can gather information from inside a patient’s body and have already been used in colonoscopies. That’s what 6,000-plus patients in six countries told surveyors from consulting firm Ernst and Young. No go: 43 percent of respondents said they would be comfortable the smart pills, according to the survey of patients from the U.S., England, Germany, Canada, Ireland and Australia. That’s a far cry from the comfort level for hospital-at-home care (60 percent) and genetic testing (68 percent). Even so: Aloha McBride, EY global health leader, told Ben that the skepticism about tech like smart pills is partly due to a lack of awareness. Patients in countries with more digitally advanced health systems were more likely to buy in, she said. The survey found growing comfort among patients with sharing their electronic health information but also some skepticism about telehealth. Nearly three-quarters of patients said they preferred in-person visits to virtual ones. “It’s an area of opportunity,” McBride said. ART OF MEDICINE A study found it's harder for young people to get treatment for opioid use disorder than adults. | AP Just a fraction of teenagers getting opioid addiction treatment in residential facilities have access to the medication buprenorphine, new research says. Using a "secret shopper" method, Oregon Health & Science University researchers called those facilities, posing as the aunt or uncle of a hypothetical 16-year-old who had recently overdosed on fentanyl and survived. Just one in four facilities that provided adolescent treatment offered buprenorphine, according to a research letter published in the Journal of the American Medical Association on Tuesday. By comparison, nearly two-thirds of adult treatment facilities offer the medication, which helps patients wean off fentanyl. While several addiction medications are FDA-approved for adult use, buprenorphine is the only one for those 16 and older with opioid use disorder. Why it matters: "It’s underused in facilities taking care of kids," Todd Korthuis, study coauthor and head of addiction medicine at the OHSU School of Medicine said in a statement. "It’s hard to imagine getting adolescents with opioid use disorder off fentanyl without buprenorphine." Big picture: There were 2.2 million adolescents ages 12 to 17 with substance use disorder in 2021, according to Substance Abuse and Mental Health Services Administration data.   GET READY FOR GLOBAL TECH DAY: Join POLITICO Live as we launch our first Global Tech Day alongside London Tech Week on Thursday, June 15. Register now for continuing updates and to be a part of this momentous and program-packed day! From the blockchain, to AI, and autonomous vehicles, technology is changing how power is exercised around the world, so who will write the rules? REGISTER HERE.     THINK FAST Docs should be wary of ChatGPT, the AMA has decided. | Leon Neal/Getty Images The American Medical Association will have something to say about artificial intelligence, but not quite yet. The professional society for doctors decided at its annual meeting in Chicago this week that it would “develop principles and recommendations on the benefits and unforeseen consequences of relying on AI-generated medical advice” and work with government to prevent AI from causing harm. In the meantime, the group said doctors should be wary. While AI holds great promise in diagnosing and treating patients and reducing physicians’ administrative burdens, existing tools like OpenAI’s ChatGPT “have known issues and are not error free," the group said.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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