Community Health Sciences (CHS) 187A – “Introduction to Interventions for At-Risk Populations” Caseworker Training for UCLA Mobile Clinic & APA Health CARE Spring 2011 Course Description: This service-learning course is designed for students to learn about health and social needs/services from primarily a public health perspective, drawing on other related academic and professional disciplines. The course uses a community-based service learning strategy to enhance and deepen knowledge of concepts covered in class. In the service portion of the course, students will function as case workers and committee members for the UCLA Mobile Clinic and/or UCLA APA Health CARE. Student Learning Goals: Students will learn about health and social service needs of the medically indigent, about the organizations and public programs that currently provide services to this population, the history of homelessness/poverty and immigration in Los Angeles, public health theories that are often used to address health disparities, and client advocacy (public benefits advocacy, issues affecting skid row homeless, low/no-cost health services in Los Angeles, etc.). To function as caseworkers, students will learn how to take a social history, about health and safety issues, and will identify organizations in Los Angeles County that provide services to the homeless/low income immigrant community. Additionally, students will learn about the importance of advocacy for policies that benefit underserved populations. Lastly, students will be assigned to a committee of the Mobile Clinic (much like a department in a non-profit organization), and will be accountable for a particular committee project for the quarter. Project Descriptions: Mobile Clinic Project at UCLA (www.mcp.ucla.edu) The UCLA Mobile Clinic is a student-run, street-based program that provides health and social services to the homeless and medically indigent in the Hollywood/West Hollywood area. UCLA has partnered with GWHFC (the Greater West Hollywood Food Coalition) to provide basic health and social services to the clients this nonprofit organization already serves. This inter-disciplinary project engages undergraduates in service as caseworkers who serve a medically indigent population, medical students that oversee health services delivery, law students spearheading a legal services component with the UCLA Law School and Public Counsel (a probono law organization), and public health students who oversee the administrative, evaluation, extra-mural grantwriting, referral and follow-up aspects of the project. Additional Mobile Clinic locations include Samoshel (a homeless shelter for adults), Step Up on Second (a mental health drop-in Center), and OPCC (a drop-in shelter for youth and adults). The latter three sites are located in Santa Monica. APA Health CARE at UCLA (www.apahealthcare.org) APA Health CARE (Asian Pacific American Health Collaboration, Access, Resource & Education) is a student-run program that provides health screening and social services to medically indigent Asian and/or Latino immigrants in Los Angeles. The UCLA School of Public Health’s AANCART-Los Angeles project has teamed up with Public Health, Medical (APAMSA) and undergraduate students (pre-med APAMSA) to host health fairs that provide health screenings (hepatitis B, cholesterol, diabetes, hypertension, and/or colorectal cancer), health education, and patient navigation. APA Health CARE has partnered with a number of Asian community clinics, Asian nurses organizations and social service organizations to provide health screening tests. This inter-disciplinary project engages undergraduates in service as navigators and health educators who work with culturally and linguistically isolated Asian immigrants, medical students who perform medical history and fingerstick tests for cholesterol/diabetes testing, AANCART interns who oversee the colorectal cancer education and testing, volunteer nurses who perform phlebotomy for Hepatitis B screening, and public health students who oversee the administrative, referral and follow-up aspects of the project. Enrollment: Undergraduates by instructor consent ONLY. Professional and graduate students welcome.

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Mandatory Meeting Times and Location: Class: Fridays from 1:00-3:50pm in CHS 23-105 Faculty: Mike Prelip, DPA, MPH Phone: 310-825-4506 Email: [email protected] Teaching Assistant: Christopher Biely Email: [email protected] Office Hours: After class or by appt. Committee Meetings: Last 20 minutes of class (3:30 – 3:50pm) is mandatory meeting time to update other committees on your projects; please schedule additional out-of-class meetings as-needed with your committee and chair. Serving Food: ASSIGNED for Mobile Clinic students on a designated night (every other week) from 68pm (during weeks you do not casework). Clinics (only when signed up): You will need to be available for at least one of these timeslots each week. Each student should expect to serve as caseworker/navigator 3-4 times during the academic quarter: A. Mobile Clinic - Wednesday evenings 5-9pm on the corner of Sycamore and Romaine. Carpools meet promptly at the Mattel Children’s Center turnaround at 4:15pm on Clinic nights. This street-based site serves primarily a homeless adult population. B. Samoshel – Saturday mornings (every other week) from 9am at 505 W. Olympic Blvd. in Santa Monica. This site is a homeless shelter that caters to the adult population. C. Step Up on Second Healthy Living Group – Friday evenings 5:30-9:30pm for Healthy Living workshops. The location is 1328 Second St. in Santa Monica. This is a drop-in mental health organization for the homeless D. Step Up on Second Clinic – Saturday mornings E. OPCC (Ocean Park Community Center) – Saturday mornings F. APA Health CARE (APAHC) – student-run health screening services for medically indigent Asian immigrants. Health Fair type events occur monthly in Asian ethnic enclaves (Koreatown, Thaitown, Chinatown, San Gabriel, etc.) throughout Los Angeles County; collaboration with the Asian Pacific Liver Center at St. Vincent’s Medical Center to provide Hepatitis B screening (usually on weekends). Definition of Service Learning: Service learning combines service to the community with student learning in a way that improves both the student and the community. According to the National and Community Service Trust Act of 1993 (Corporation for National Service, Learn and Serve): Service Learning:  Is a method whereby students learn and develop through active participation in thoughtfully organized service that is conducted in and meets the needs of communities  Helps foster civic responsibility  Is integrated into and enhances the academic curriculum of the students, or the education components of the community service program in which the participants are enrolled  Provides structured time for students or participants to reflect on the service experience

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Service-Learning Requirements: The second component of the course takes place in the field, where students are required to complete a minimum of 5 hours of service learning per week outside of class (50 hours for the quarter). The hours can be completed by working at the clinics (4 hours per week for Mobile Clinic; 2 hours at Step Up, OPCC or Samoshel; variable hours at APA Health CARE or Asian Pacific Liver Center screenings), distributing food to our clients if not working at clinic that week (2-2½ hours), networking with other organizations that can offer services to our clients (variable hours), and by working on an assigned group project or committee (variable hours). Driving/transportation time is NOT included as part of field work requirements. Students are required to sign up for a committee and expected to take initiative and play an active role. Each student will be assessed by coordinator and committee evaluations based on projects completed during the quarter. List-Serve: You will need to sign up to be on the appropriate list serve(s) by Monday of week 2. This ensures you get updated information, meeting minutes, and an opportunity to sign-up for clinic nights and other events. For MOBILE CLINIC, SAMOSHEL, STEP UP ON 2ND, and OPCC, please send a message from your email account to: [email protected] (do not type in anything on the subject line or in the message section). You should receive a confirmation that you are on the list serve shortly. For APA HEALTH CARE, send a message from your email account to: [email protected]. To send emails to everyone on the respective list serve, use [email protected] or [email protected]. Required Reading: Required readings correspond to the lecture topic of the week. This should be done before class and you are expected to summarize the reading in your weekly journals. The articles are available online (links are provided in this syllabus). Please note that as a registered student, you are eligible to view the full articles online (or at the UCLA library that houses the journals) free of charge. You may be prompted to enter your BOL and password. Links are provided below, as well as the title, authors, and citation for the article. If you are unable to access the article by clicking on the hyperlink, please use Google Scholar (scholar.google.com) or National Library of Medicine/Pubmed (pubmed.com) and enter the article’s title or authors in the query. You should be directed to the online article. If you continue to have problems, you may go to a UCLA library and view the article there. Academic Dishonesty Campus policies for academic dishonesty described in the UCLA catalogue will be used as the standard for work performed in this course. Grading Information: Grades are assigned using the University guidelines for straight scale [A+ (98-100), A(9397), A- (90-92), B+(88-89), B (83-87), etc.]. Grading criteria include class attendance and participation, caseworker/service learning, weekly journals, final group project/presentation (your particular project for your committee), pop quizzes and an in-class final examination. Your grade will be based on the following: A. Attendance and participation in class (10 points): You will receive one point for each class, dependent upon your level of participation. There are no make-up points allowable for attendance/participation. You will not receive credit if you arrive late or leave early. In general, the first 1½ hour of class is to cover topics delineated in class schedule. The next ½ hour – 45 minutes is for committee updates, any committee presentations, and the last ½ hour is for mandatory in-class committee meetings with the coordinators. B. Service Learning (10 points): You will be required to complete 50 hours of service learning (average of 5 hours per week), as described. Hours can be fulfilled by going to clinic, conducting site visits, completing work assigned by your committee, participating in health fairs, and entering/uploading patient files into the Mobile Clinic or APAHC database. 3

C. Performance/Evaluation (12 points): 1. Your performance on-site as a caseworker/navigator, as evaluated by public health and medical coordinators, will constitute 6% of your grade. 2. Each student is required to sign up and actively participate in a committee of the mobile clinic. This group will be working on a project designed to complement the operational aspects of the mobile clinic. Topics will be identified and groups will be assigned during the first class meeting. Your performance on your committee’s group project, as evaluated by the coordinators, committee chair and your peers, will constitute 6% of your grade. D. Pop Quizzes (10 points): There will be two pop quizzes administered throughout the quarter, and can be given any time during mandatory class sessions (Fridays 1-3:50pm). Each quiz will be worth 5 points, and will ask general questions on topics covered in the reader, in class presentations and discussions, and about the mobile clinic or APA Health CARE. There is no make-up for missed quizzes. E. Mobile Clinic/APA Health CARE Database (10 points) Every week each caseworker will be assigned to enter 5-10 client files into the database and upload this information to the electronic/web-based database. You should plan on spending about one hour each week completing this requirement. These files must be completed and returned each week no later than Friday of the week following receipt of the files. These files will be checked off each week for completeness by the Database Chair and given a weekly score for completion. F. Journals (16 points): Journals are due at the beginning of each lecture, from the second to ninth class session (8 journals worth 2 points each). They should be 1-2 pages, single-spaced. Please drop off journals at front desk on your way into class. Late or emailed journals are not accepted. Each journal should have three parts: Part A – Discussion of your progress and your committee’s accomplishments over the past week; discuss upcoming projects/events. Part B – Brief summary of assigned reading (short paragraph highlighting key points). Part C – special topic (listed in the lecture schedule section of this syllabus) G. Health Reform Research (4 points): There is a tremendous amount of discussion and controversy surrounding Federal Health Reform, signed into law by President Obama in March 2010. By week 5 (4/29/2011), find two articles (popular press, peer-review journal, magazine, or online) on health reform. The articles should have been published within the past six months. One article should support health reform, while the second article opposes it. Please select articles with strong evidence to support the authors’ position rather than an opinion piece that has many unsubstantiated attacks against those for/against health reform. Bring a copy of the article to class week 5, and be prepared to summarize briefly each article for the class (if called upon). H. Final Committee Presentation (4 points) During the last session of class, you and your committee members will deliver a brief (5-7 minute) group presentation on the progress your committee has made since the beginning of the quarter. You are expected to assess your committee’s role in the functioning of the mobile clinic project (similar to a particular department’s role in the functioning of a non-profit organization), and to identify significant contributions, lessons learned, and areas of improvement for next quarter. I. Strategic Plan (4 points) Each committee will be responsible for creating a strategic plan that coincides with the goals/objectives of the larger project. The strategic plan should include goals and proposed activities for months 3, 6, 9 and 12. 4

J. Final Examination (20 points) During 10th week of class, you will be given a written final examination worth 20% of your final grade. This exam will take one hour and will be administered in-class (not an open book/note exam). CLASS SCHEDULE – CHS 187B In general, class will run as follows. PLEASE arrive on time (both at the beginning of class and at break) 1:00-2:30 Topic of the week 2:30-3:00 Announcements, Discussion, etc. 3:00-3:10 Break 3:10-3:50 Database charts (Clinic) and Mandatory committee meetings with chairs and coordinators LECTURE SCHEDULE – CHS 187A Class# Date Topic(s) 1 4/1 Introduction to course; Discuss syllabus and expectations of students; Enrollment issues Sign-ups for food distributions, carpools and hold first committee meeting General Relief Advocacy Program (GRAP) Training (Rebecca Raizman, JD; Public Counsel) Reading: GRAP Manual, emailed to Mobile Clinic and APA Health CARE Listserves 3/29/11. 2

4/8 HIV/AIDS 101 (Armand Cachero; Asian Pacific AIDS Intervention Team) Reading: Mobile Clinic, read: HIV/AIDS and Homelessness, available at: http://www.nationalhomeless.org/publications/facts/HIV.pdf APA Health CARE, read: CDC Factsheet on HIV/AIDS in Asian immigrants, available online at: http://www.cdc.gov/hiv/resources/factsheets/PDF/API.pdf Journal Topic, Section A (same for each week): Provide a brief discussion of clinic or other activities you participated in this past week. What are some of the projects that you and your committee have been involved in this week? What will you be doing the upcoming week Journal Topic, Section B (same for each week): Briefly summarize the assigned readings Journal Topic, Section C: Briefly describe yourself and how you became interested in working with the medically underserved. Is there a stigma about those with HIV/AIDS in the population that you work with? What are some of the challenges you might expect to encounter in disease management?

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4/15 General Relief Advocacy at assigned DPSS Office (meet at Ackerman at 12:50, depart promptly at 1pm, meet your supervisor at designated site at 1:45; be prepared to stay until 6:00pm) Journal Topic, Section B: Please highlight the GRAP training manual that was emailed/assigned for week 1 reading. Journal Topic, Section C: *your journal can be emailed after your advocacy session. Please email (just this week) to Christopher at [email protected] by Monday at 5pm. For all other weeks, please bring a printed copy to class. What was the DPSS office like? Why was it so difficult for individuals to apply for and receive benefits to which they are entitled? Briefly discuss your experience as a General Relief Advocate. Reading: Please re-read last week’s handouts and the GRAP manual in preparation for GR Advocacy with Public Counsel. Familiarize yourselves with the slides on GR eligibility, regulations, etc. so that you can be an effective advocate for the clients you will serve at the DPSS offices this week.

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Lesbian/Gay/Bisexual/Transgender (LGBT) Health Issues (Kevin Riley, PhD, UCLA Labor Occupational Safety and Health Programs) Journal Topic, Section C: We will be doing General Relief Advocacy next week. Why is this necessary, and how do you think it will help the clients you serve? Reading: Lesbian, Gay, Bisexual, Transgender Health (Centers for Disease Control, 2011). Link: http://www.cdc.gov/lgbthealth/ (please click on and read all tabs under “LBGT health”)

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Domestic/Partner Violence (Pat Butler, Sojourn) Organize carpools for next week’s field trip Journal Topic, section C – Briefly discuss how different cultures (e.g. the homeless “culture,” GLBT, Asians, Latinos) might affect the ways in which domestic violence or sexual abuse is defined, tolerated (or not), and addressed. *Please complete additional section (attached), evaluating your committee activities, on a separate sheet of paper (to be turned into coordinators/chairs) Reading: Mobile Clinic: Partner violence among homeless young adults: measurement issues and associations. Boris NW, Heller SS, Sheperd T, Zeanah CH. J Adolesc Health. 2002 May;30(5):355-63. Link: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T80-45PRTB49&_user=4423&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000059605&_version=1&_urlVersion=0& _userid=4423&md5=1c4e9dcc364c971d6f403759f67338b1

APAHC: A 16-Year Examination of Domestic Violence Among Asians and Asian Americans in the Empirical Knowledge Base: A Content Analysis. Yick AG, Oomen-Early J. J Interpers Violence. 2008 Feb 7(epub ahead of print) Link: http://jiv.sagepub.com/cgi/rapidpdf/0886260507313973v1

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Rape and Sexual Assault (LaShonda Blunt, Santa Monica/UCLA Rape Treatment Center) Mental Health/Illness (Nina Tayyib, PsyD, MPH, LA County Dept. of Mental Health) Journal Topic, Section C: Are mental health issues common in the community your project works with? What are some of the common conditions? Talk briefly about sexual assault/rape in the community you work with. Are there varying degrees of tolerance, different interpretations of what would constitute either? Reading: All: Mental Health: A Report of the Surgeon General (2011): http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec2.html Mobile Clinic: (1) Health of homeless women with recent experience of rape. SL Wenzel, BD Leake, and L Gelberg. Journal of General Internal Medicine (2000);15(4): 265-268 Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495443/pdf/jgi_04269.pdf (2) Mental Illness and the Homeless (2006). Link: http://www.nationalhomeless.org/publications/facts/Mental_Illness.pdf APA Health CARE: (1) Only 14, Bangladeshi Girl Was Charged with Adultery and Lashed to death. (CNN.com, March 29, 2011). Link: http://edition.cnn.com/2011/WORLD/asiapcf/03/29/bangladesh.lashing.death/index.html (2)East Mind, West Mind: Mental Health Problems Among Asian Americans Are Often Stigmatized and Untreated. But Doctors are Finding Ways to Help (Newsweek 2008). Link: http://www.newsweek.com/2008/08/11/east-mind-west-mind.html (3) Lin and Cheung. Mental Health Issues for Asian Americans. Psychiatr Serv 50:774-780, June 1999. Available online at: http://www.psychservices.psychiatryonline.org/cgi/reprint/50/6/774

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Field Trip to LAC/USC Medical Center or Comprehensive Health Center Outpatient Navigation at LAC/USC Medical Center ***Carpools meet at the Ackerman turnaround PROMPTLY at 12:50, depart at 1pm, meet at LAC/USC (maps will be provided) at 1:30-1:45pm Journal Topic, Section C: What do you envision LAC/USC Medical Center to look like? What are some of the challenges your clients may face when accessing services? (please bring your journal to the field trip) Read: (1) Familiarize yourself with LA County’s ORSA guidelines and application: Link: http://www.lacountyhelps.org/applications/English/DHS_ORSA_Eng_Nov06.pdf & application: http://www.lacountyhelps.org/applications/English/DHS_ORSA_Eng_Nov06.pdf

(2) Familiarize yourself with LA County’s ATP guidelines and application: http://www.lacountyhelps.org/applications/English/DHS_ATP_Eng_Nov06.pdf (3) Ability to Obtain Medical Care for the Uninsured: How Much Does it Vary Across Communities? PJ Cunningham and P Kemper: JAMA (1998);280(10):921-927 Link: http://jama.ama-assn.org/cgi/reprint/280/10/921 Class Debate on Health Reform: Be prepared to be assigned a “side” and argue for or against health reform with a team of classmates. Journal Topic, Section C: Briefly summarize the two articles you identified on Health Reform (week 5). What is the rationale for universal health care in the United States? What are some of the arguments of those who opposed health reform? Why is there such a difference in opinion about health care being a privilege vs. right? Public vs. private health? Insurance vs. government-run programs? Reading: 1) Institute of Medicine, 1993: Access to Health Care in America, pages 1-18 http://books.google.com/books?hl=en&lr=&id=juBLbxjbEXAC&oi=fnd&pg=PA1&ots=NnhIY 0Vc8r&sig=zwh0ZV58JJUw3m672BIQbYZLsec#v=onepage&q&f=false 2) Schoen et al. Health Affairs (2004):487-503. Primary Care and Health Systems Performance: Adults’ Experiences in Five Countries http://healthaff.highwire.org/cgi/reprint/hlthaff.w4.487v1.pdf

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Mobile Clinic: Field trip to PATH Mall (*you will need to leave at 12:00noon and arrive to PATH Mall by 1:00pm. Plan to depart around 3:00pm from PATH Mall) APA Health CARE: Field trip to Asian Pacific Health Care Venture (leave campus at 1:00pm and arrive around 1:45pm, meet with Nittaya Gibson, depart around 3:30pm) *email journal (just this week) to Christopher ([email protected]) before Friday’s class meeting Reading: Mobile Clinic: Read overview of PATH Mall: http://www.epath.org/services/pathmall.php APA Health CARE: Read overview of Asian Pacific Health Care Venture: http://www.aphcv.org/ Journal Topic, Section C: You are at the end of your term in working with the Mobile Clinic or APA Health CARE. Talk briefly about some of the experiences you have had (both positive and negative). What are the key aspects of the program that you have enjoyed? What are some areas of improvement (when identifying issues, also suggest realistic and achievable solutions)? Committee Presentations (5-7 minutes per committee) Course Evaluation, Final Exam Committee presentations and strategic plan due

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