A recent viral video shed light on the horrific treatment of a female hospital patient in Baltimore who was put out on the street during a cold winter's night in only a thin robe and socks.
This scenario has become all too familiar, especially for those of us serving individuals experiencing homelessness. A patient unable to care for herself or himself is "dumped" in the street or at a homeless shelter, which not only puts the patient's health at risk but also creates a difficult situation for both the patient and those of us working in the city's network of emergency housing providers — shelters.
According to the Department of Housing and Urban Development, people living in shelters are more than twice as likely to have a disability compared with the general population. On any given night in 2017, 20 percent of the homeless population had serious mental illness, 16 percent had conditions related to chronic substance abuse, and more than 10,000 had HIV/AIDS. More and more, individuals experiencing homelessness are not only dealing with the much-talked-about opioid crisis gripping many of our communities, but homeless individuals are increasingly suffering from chronic diseases such as HIV/AIDS, heart disease, cancer, diabetes, spinal conditions, and a host of behavioral-health-related issues.
Routinely, hospitals are taking patients to emergency shelters when they need more extensive care. As a partner with the City of Philadelphia's Office of Homeless Services (OHS), SELF operates a mix of emergency housing (shelters), transitional housing, and safe havens. Every day, we serve approximately 500 homeless individuals, providing housing-related services including case management and assistance with securing permanent housing, educational and skills building coaching, and food services.
However, despite the array of assistance we provide, our shelters do not have regular health-care staff to care for those with chronic or other serious health-care conditions.
Only a week ago, an area hospital dumped a patient at one of our eight homeless shelters. The individual was physically weak and clearly incapable of taking care of himself and therefore shelter-inappropriate. When we told the driver we could not admit the patient, the driver left before we could contact the hospital or make a more appropriate placement.
If we had the staff to care for ill or chronically ill homeless participants, we would without hesitation. The problem is that we don't. Moreover, with current stagnant funding levels and decreasing political will facing the issue, I don't see this changing anytime in the near future. This is not just a Philadelphia problem or a Baltimore problem. It is a national problem. Hiring trained staff to deal with the medically fragile is one viable solution.
Another option is to enforce the policy that requires hospitals seeking placement for recently discharged patients to contact OHS to refer and gain clearance for placement in city-funded shelters. To circumvent this policy, hospitals will wait until city offices are closed to dump a patient on shelters. Because of the current OHS policy toward low barrier placement, many accept participants for which neither its facilities nor team members are adequately trained to assist.
It is our hope that programs that provide specialized services for medically fragile homeless individuals be given more consideration. Those in decision-making seats in government must work collaboratively with providers to strengthen partnerships with hospitals through policy, practice, and legislation if necessary, to ensure that homeless individuals are afforded every humane opportunity to recover fully from homelessness. Adequate health care and permanent housing are the first sound steps in this process.