Client-Identified needs and agency-provided services at a harm reduction community based organization in the District of Columbia
Research
Milken Institute School of Public Health at the George Washington University, 950 New Hampshire Ave, Suite 300, Washington 20052, DC, USA
Harm Reduction Journal 2015, 12:17Â
doi:10.1186/s12954-015-0051-4
Published: 3 June 2015
Abstract (provisional)
Background Harm reduction case management relies on client-identified goals to drive
the provision of care in order to “meet clients where they are atâ€. This research
measured the level of agreement between client-identified needs and agency-provided
services at a community based organization (CBO) in Washington DC by examining: (1)
the services clients most often identified, (2) the services most often given to clients
by the CBO, and (3) the level of alignment between client-identified needs and services
provided. Methods Case file reviews were completed for 151 clients who received case
management services at the CBO between January 2010 and February 2011. Client-identified
needs and agency-provided services were extracted from case files and divided into
9 matching need and service categories: pharmaceutical assistance (e.g., prescription
renewal), medical or dental care, housing, mental health services, substance use services,
support services (e.g., support group meetings), legal assistance, and employment/job
training. Client-identified needs and services provided were analyzed using McNemar’s
Chi-square to assess for significant differences in discordant pairs. Results Clients
were mostly Black (90.7 %), heterosexual (63.6 %), HIV positive (93.4 %), and over
40 years old at the time of intake (76.2 %). On average, clients identified 2.44 needs
and received 3.29 services. The most common client-identified needs were housing (63.7
%), support services (34.3 %), and medical/dental care (29.5 %). The most common agency-provided
services were housing (58.2 %), support services (51.4 %), and medical/dental care
(45.2 %). In 6 of the 9 service categories, there were statistically significant (p
lt; .01) differences between those who received services not asked for and those
who did not receive asked for services in the categories of pharmaceutical assistance,
medical/dental care, substance abuse services, support services, legal assistance,
and food access. In each of these matched service categories, the percentage of clients
who received services not asked for was significantly higher than those who did no.
Conclusion This research shows that, while there is general alignment between the
services that clients most often want and the services most often provided, there
are still instances where services are requested but are not being provided.