UofL News caught up with Buchino to discuss her new joint appointment, and how her research is serving as a foundation for positive change.

UofL News: Why did you decide to take on the city鈥檚 new role of Homeless Services Director?听

Buchino: Homelessness has a tremendous public health impact, and it鈥檚 an issue that has a solution. Our community has a shortage of affordable housing, and COVID has only exacerbated housing instability. Since the city has prioritized funding housing initiatives with American Rescue Plan (ARP) funds, there is a real opportunity for creating systemic changes and making progress. I鈥檓 hopeful that by being in a leadership position, I can raise awareness of the root causes of houselessness while being part of enacting solutions.

UofL News: How does it feel to know your efforts have been recognized by city officials, and you鈥檒l provide leadership and guidance to solve difficult challenges?听听

Buchino: This is the dream, isn鈥檛 it? To see our research become a basis for positive change, and use our super powers for good. It鈥檚 truly humbling that I have been asked to serve the community in this way.

UofL News: Much of your research and community-engagement seems to have led you to this juncture. Explain a little about this journey.听听听

Buchino: As an occupational therapist, I worked in community-based practice settings to support individuals with chronic and persistent mental illness who were homeless or at risk of homelessness. When I transitioned to public health, it was because I witnessed how systemic gaps and barriers perpetuated poor health instead of supporting wellness, and my research has always been through that lens.

Two years ago, I led a team of UofL researchers in examining national best practices and our own system of care, providing recommendations for policy and system-level changes. After that report, Louisville Metro leadership, through the Homelessness Task Force, embraced our recommendations, and I have continued to be engaged in the city鈥檚 work since then.

UofL News: You have a clear passion to address houselessness. What fuels that passion?听听

Buchino: I am inspired by the people I have met throughout my career and volunteer positions. Housing is a right. Housing saves lives.

More often than not, a person becomes houseless听not听because of their own failure, but because systems fail them. Losing housing is traumatic, and yet we require people in crisis to navigate a complex and overwhelming system to find the resources they need, when our community should have provided those resources to prevent everyone from being unhoused. There鈥檚 no justice in that.

UofL News: Your time is now split between UofL and the city. How will your continued research and expertise as a faculty member inform changes you鈥檒l be able to implement in the community?听

Buchino: The (HSD) aims to make data-driven decisions about how we can be strategic in our approach to reduce the number of gaps and barriers that we see both inside Louisville Metro government and within the system of care.

Personally, my research has aimed to advance equity and elevate the voices of those with lived experiences. Often, we don鈥檛 ask people how we can help, and make assumptions that what we do as professionals will work for them. The unhoused population is creative, resilient and deserve to be included in the problem-solving process.

UofL News: What initiatives do you hope to lead as Homeless Services Director?

Buchino: I鈥檓 excited that the HSD is involved in the ARP projects that will both serve our unhoused neighbors and increase the affordable housing inventory. Beyond housing, the 2019 report provided seven recommendations toward systemic improvement, and Louisville Metro adopted those recommendations as a strategic plan. HSD brings the capacity to address those strategies, as well as to increase coordination and communication between providers, policy makers and the community.

UofL News:听Anything else you鈥檇 like to share?听听

Buchino: Addressing homelessness is a community issue, and not something that one department, one organization or even one sector can resolve. We need to create community-wide synergy around solutions. To learn more about root causes of homelessness and solutions, visit . 听

The study, , also projects the city may be able to gradually reopen by early June if even stronger containment measures 鈥� especially more extensive testing and consistent contact tracing and quarantine of all newly infected individuals 鈥� are implemented.

But the study also warns that if strong and effective social distancing measures are pulled back too quickly, as many as 900 more people in Louisville would die and about 2,000 more would be hospitalized by August.

Seyed Karimi, PhD, an assistant professor in the Department of Health Management and System Sciences at the UofL School of Public Health and Information Sciences, co-authored the report.

鈥淲e know from our modeling that decreasing the current social distancing measures without increased efforts to test, isolate, and do contact tracing can move us to an unstable path with increased hospitalization and infection trends that could be catastrophic,鈥� said Karimi, who also is a health economist with LMPHW.

Study co-author Sarah Moyer, MD, director of LMPHW and the city鈥檚 chief health strategist, said the study projects that measures the city put in place in March averted a surge of COVID-19 patients that otherwise would have overwhelmed Louisville鈥檚 health care system. Going forward, only about 400 of Louisville鈥檚 3,600 hospital beds will be needed for COVID-19 patients if current social distancing measures remain in place.

鈥淭his model validates the measures we have put in place to control the spread of COVID-19 in Louisville thus far,鈥� Moyer said. 鈥淭he study also serves as affirmation of our state and local efforts to slowly release restrictions.鈥�

鈥淭he study is a good example of how academic research can inform real-life public health policy decisions to protect community health,鈥� said Craig Blakely, PhD, MPH, dean of the University of Louisville School of Public Health and Information Sciences.

Mayor Greg Fischer expressed his appreciation for the collaborative effort between UofL and the local health department, adding that the data underscores what city and health officials have been saying: 鈥淲hile we鈥檙e making progress in the fight against COVID-19, we still have a long way to go.

鈥淓ven as some restrictions are eased, we must stay focused and vigilant,鈥� he said. 鈥淭hat鈥檚 why I have extended the executive order continuing the state of emergency here until June 1. It鈥檚 important that we not get our guard down against this dastardly disease.鈥�

Researchers used the Susceptible-Exposed-Infectious-Recovered (SEIR) model, which measures the effect of public health policy interventions to contain an infection. They projected trends in the numbers of actively circulating COVID-19 infections, active hospitalizations, and deaths in the city from April 20 to August 20.

The authors considered two potential scenarios that estimated the current number of COVID-19 deaths in Louisville. The scenarios consider two different dates for the effectiveness of public and private social distancing policies in Jefferson County 鈥� March 31 and April 7, which they labeled as status quo scenarios.

Under each of the two scenarios, researchers considered four potential alternatives reflecting outcomes if social distancing and other containment strategies had been either weaker or stronger by 10% increments. They projected number of infections, hospitalizations, and deaths that Louisville would see under each of those social distancing scenarios.

Their projections show that if stronger containment methods had been used from the presumed intervention days of March 31 and April 7, transmission of the virus would have decreased significantly, such that the number of infections in June would have been in two digits. On the other hand, if weaker containment methods were used from the presumed intervention days, virus transmission would have increased remarkably, such that the number of infections and hospitalization would not soon have stabilized.

Other report authors include Natalie DuPre, ScD, MS, Bert Little, PhD, MA, W. Paul McKinney, MD, all of the SPHIS.

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The Mayor鈥檚 Office for Safe and Healthy Neighborhoods will manage the Trauma Resilient Community Initiative, funded by the U.S. Department of Health and Human Services鈥� Substance Abuse and Mental Health Services Administration (SAMHSA), in partnership with UofL鈥檚 Kent School of Social Work and Centerstone Kentucky.

鈥淲e鈥檙e thrilled to work on this project because it so closely parallels our mission to create a just and better world,鈥� Kent Dean David Jenkins said. 鈥淥ur role in the Trauma Resilient Community Initiative is evidence of our unwavering commitment to ensure that every community member has equitable access to services that work, services that help people recover and services that help communities heal.鈥�

The initiative will use a community-based approach to build a 鈥渢rauma-informed鈥� system of care and services to children and families exposed to violence. The effort is meant to increase the knowledge and skills of people who respond to, make referrals for and provide services to youth and families.

鈥淟ouisville is a compassionate city, and compassion requires that we work to remove barriers and create opportunities so that every citizen has the ability to reach their full human potential,鈥� Fischer said. 鈥淭his initiative is another tool we can use to dismantle the very real barriers of violence, trauma and racial inequity.鈥�

The partners aim to provide trauma treatment to 400 children and their families in west and south Louisville, where data show that youth and families are disproportionately affected by trauma, violence and inequities. The initiative also involves training 200 clinicians in trauma interventions and 200 first responders, volunteers and community service providers in a special youth mental health first-aid model.

Another 40 service providers, public school officials and leaders will be trained in a trauma-resilient approach through the initiative, which will also share the trauma-care information with 50 community agencies serving youth and families and develop a leadership advisory board to increase awareness of trauma and its effects. The initiative includes evaluation of its consumer impact.

鈥淭o help people traumatized by violence, it鈥檚 so important to use an approach that fully takes into account their circumstances,鈥� said Jennifer Middleton, associate professor of social work. 鈥淭he Kent School of Social Work鈥檚 researchers are pleased to be partners in this federally funded effort to aid people in ways that are sensitive to their needs and based on proven methods 鈥� and to help train members of our community to continue that care.鈥�

Middleton, Crystal Collins-Camargo and Bibhuti Sar are the Kent faculty working on the implementation, while Shantel Crosby and Heather Storer are on the research and evaluation team. Kent students also will be involved in ways that include conducting community needs assessments and providing trauma-focused therapy interventions. The Kent group will be looking at specific measures of functioning and well-being for the children and families, Crosby said.

鈥淥ur city has made significant gains towards deepening our understanding and ability to make progress against complex challenges like violence and racial inequity. This opportunity allows us to elevate a system that does not just focus on the individual, but organizations, systems and community as part of the healing process,鈥� said Rashaad Abdur-Rahman, director of the Office for Safe and Healthy Neighborhoods.

鈥淎t Centerstone Kentucky, we are proud to partner with SAMHSA, the Mayor鈥檚 Office for Safe and Healthy Neighborhoods and the UofL Kent School of Social Work to provide evidence-based trauma-informed care, creating stronger neighborhoods across our community,鈥� said Anthony Zipple, president and CEO, Centerstone Kentucky.

Besides the local ones, initiative partners include the Center for Trauma Resilient Communities, University of Pittsburgh School of Medicine and the Treatment and Services Adaptation Center for Resilience.

Highlights from Monday’s press release are below.听

The free, public TEDxUofL 2017: Growth conference is organized by the Planning Student Organization, affiliated with UofL鈥檚 urban and public affairs department.

The 10 a.m. to 4 p.m. event at the Red Barn will feature discussions about community, creation and cultural competency through a series of 鈥淭ED-style鈥� brief talks; the format is modeled on conferences that began in 1984 with one that tied in technology, entertainment and design (TED).

鈥淲ith creative ideas and a strong sense of community, we can cultivate a world where all cultures are embraced,鈥� said graduate student Nia Holt, a TEDxUofL organizer. 鈥淲e plan to explore how cultural competency, creation and community could help us improve our understanding of those around us and our surroundings.鈥�

Although the event is free, session space is limited and participants must register by April 6 for each session (cultural competency, community and creation) they plan to attend .听

Scheduled speakers and sessions听are:听

• Cultural Competency (10-11:30 a.m.), with Aaron Rollins, UofL public administration; Tony Belak, International Center for Compassionate Organizations; Pradeep Deshpande, Six Sigma and Advanced Control; and Brandy Kelly Pryor, Center for Health Equity.
• Community (noon-1:30 p.m.), with John Hopkins, Center for Neighborhoods; Eric Blair, Kentucky Refugee Ministries; Jessica Pendergrass, Louisville Grows; and Lynn Rippy, YouthBuild.
• Creation (2-3:30 p.m.), with Mark Hogg, WaterStep; Josh Miller, IDEAS xLab; Nat Irvin, UofL business; and Ehren Reed, Louisville Visual Art.