New Study Shows Homelessness is Bad for our Health Care System

A recent study shows that people experiencing homelessness are amongst the most frequent users of emergency rooms in Baltimore. HCH Policy Director, Barbara DiPietro and colleagues (Dana Kindermann and Stephen Schenkel) recently conducted a research study to understand the demographics of the most frequent users of emergency departments.

By following the Top 20 most frequent emergency room users in the city, they found that homelessness was the single greatest commonality. The research also found the majority of these users were insured, a finding that runs contrary to popular opinion about homeless users of emergency departments. The sad fact is that our clients are often uninsured until they become so sick, they qualify for Medicaid because they become disabled. It is also a lesson to learn about health insurance and emergency department use—this study as well as many others show that everyone uses the emergency room, not just the uninsured. As we move ahead to implement the Affordable Care Act (hopefully!), it will take more than simply health insurance expansion to reduce ER use. We have to be mindful that meeting basic needs—like housing—is also part of the equation.

We have long known that homelessness is bad for your health – this study makes that case that homeless is also bad for our health care system.

Click here to read the full article – “Ill, Itinerant, and Insured: The Top 20 Users of Emergency Departments in Baltimore City.”

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There’s No Such Thing as a Lost Cause

Today on WYPR, 88.1 FM, Kevin Lindamood shared the story of Ernest, a former client of Health Care for the Homeless.

Click here to listen

The following is a transcript of the story:

“At 325 pounds, Ernest was a mountain of a man.  On good days he came to our clinic for a cup of coffee.   

On bad days he’d hallucinate and scream.  It took two of us to calm him, hanging our weight from his shoulders.

We’d learn that Ernest suffered from schizophrenia and shot heroin between his fingers. In and out of jail and the hospital, failure after failure, staff began to whisper that maybe Ernest was beyond our help.  Surely, he would die on the streets.

But one day, something happened to Ernest that happens to us all:  he got old.  And he qualified for Senior Housing.  And this time he got accepted, moved into an apartment, and set up his very own coffee maker.  Once housed – somehow, someway, something clicked.

Stabilized through treatment, Ernest stopped self-medicating with heroin. His doctor controlled his hypertension.  He got a job.  He’d walk 20 miles a week around Lake Montebello.  Once, Ernest had a belt cinched so tightly around his waist you could see the folds of fabric of the pants that no longer fit.

When Ernest died suddenly of a heart attack in 2006, he weighed just 200 pounds.  He had lived in his own home for eight straight years.

From Ernest we learned this: there’s simply no such thing as a lost cause.

Since his death, a host of “Housing First” projects – with high-level bipartisan support – lend legitimacy to Ernest’s anecdote. When given housing right away along with intensive services, 85% of folks like Ernest stay off the streets.  What’s more, their health improves and they show up far less often in costly emergency rooms.

Housing and Urban Development Secretary Shaun Donovan wasn’t joking when he told satirist Jon Stewart and his Daily Show audience last month that supportive housing is the solution to homelessness. Perhaps most comedic is the dark irony that our nation’s housing budget remains 40% of what it was in 1979.  We must reinvest in this national priority.

I’m Kevin Lindamood, President & CEO of Health Care for the Homeless for WYPR, 88.1 – your NPR news station. “

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An Important Legislative Victory for Homeless Youth

Something truly important happened yesterday in the Maryland General Assembly, bringing our State a step closer to improving access to care for vulnerable youth experiencing homelessness. In the final days of Maryland’s 430th Legislative Session, a bill to remove legal barriers currently preventing vulnerable youth from accessing basic medical and dental care passed the House of Delegates by a vote of 135 to 0. Before crossing over to the House, Senate Bill 72 already had passed the Senate by another unanimous vote of 47 to 0.

For more than 20 years, Health Care for the Homeless has provided health-related services to homeless children and families – often on an outreach basis. In 2011, we opened The CareFirst BlueCross BlueShield Pediatric & Adolescent Clinic. Under current law, however, licensed practitioners at HCH cannot provide routine medical care (e.g., treat the flu, a sprained ankle, asthma, or other acute & chronic health conditions) or dental care (e.g., provide a routine cleaning or fill a cavity) without parental consent. Unfortunately, HCH often is unable to obtain such consent for many homeless youth living alone with no regular contact with family members. In some situations, youth have no knowledge of their parents’ whereabouts; in others, youth are afraid to re-establish contact with abusive families.

Senate Bill 72 would fix this problem – allowing us to provide needed medical and dental care to homeless youth living in extremely unstable situations. It would also extend liability protection related to the inability to obtain parental consent for those licensed health care practitioners who often are responsible for providing care to homeless youth.

The bill, introduced by Senator Delores Kelley (along with a companion bill in the House of Delegates introduced by Delegate Samuel “Sandy” Rosenberg), quickly garnered overwhelming bipartisan support – unanimously passing the Senate Finance Committee and the full Senate earlier this session. Thanks to the support of partners in the community and in the legislature, Senate Bill 72 “crossed over” and passed the Health and Government Operations Committee of the House of Delegates without a single dissenting vote.

Yesterday afternoon, April 5, the full House followed the Senate by unanimously passing the measure and sending it to Governor Martin O’Malley for signature.
This important success in the waning days of Session resulted from a broad team effort.

  • Lisa Stambolis, HCH’s Director of Pediatrics, testified at several hearings and (along with her team and their community partners) identified several youth who powerfully shared their stories about barriers to care.
  • Pam Kasemeyer and Robyn Elliott, who represent a diverse range of organizations in Annapolis, were invaluable in their advocacy, support and council.
  • Senator Kelley and Delegate Rosenberg introduced and championed the bill.
  • Delegate Dan Morhaim, always a strong supporter of HCH, masterfully shepherded the bill through the House – with the backing of Chairman Pete Hammen and other members of the Health and Government Operations Committee, including and especially Delegate Nicholaus Kipke.
  • All the various pieces and players were held together by HCH’s Policy Director, Barbara DiPietro and Community Relations Coordinator Adam Schneider.

When you have the opportunity, please congratulate these partners – and thank them for their hard work and support. And please join us in asking for Governor O’Malley’s signature on this important legislation for homeless youth.

 

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Mary Jean Herron named among Maryland’s Top 100 Women

Health Care for the Homeless (HCH) is proud to announce that The Daily Record named Chief Financial Officer Mary Jean Herron as one of Maryland’s Top 100 Women.

The Daily Record’s annual list of Maryland’s Top 100 Women recognizes outstanding achievement by women as demonstrated through professional accomplishments, community leadership, and mentoring.

Mary Jean has played a critical role in the work of HCH for many years – serving in leadership positions on our Board and joining the executive staff as CFO in 2007. Mary Jean was named one of Maryland’s Top 100 Women in 2009 and was a member of teams granted the “Innovator of the Year” award by the The Daily Record and “Smart CXO-Executive Management Team” award by Smart CEO Magazine in recognition of her leadership in HCH’s new clinic project.

For more information about Maryland’s Top 100 Women and a complete list of winners visit TheDailyRecord.com.

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From the CEO: Outraged in Baltimore?

For the better part of the past 48 hours, folks have been asking if we’re outraged.  The unspoken assumptions are 1. that we’ve been following the Austin, Texas “Homeless Hotspots” controversy (it’s been hard to avoid) and 2. that we find the enlistment of persons experiencing homelessness in a project to sell Wi-Fi access to participants attending a technology conference somehow morally reprehensible (um, not so fast).

Here are a few things we find morally reprehensible and outrageous:

  • The persistence of homelessness in the wealthiest nation in the history of history.
  • 50 million Americans lacking health insurance each year with an equal number underinsured and at risk of medical bankruptcy – both of which can lead to homelessness.
  • New federal data analyzed this week by the National Low Income Housing Coalition showing that a full-time worker must earn $18.25 per hour to afford the rent and utilities on a modest two-bedroom apartment – when the federal “minimum wage” is just $7.25 an hour.
  • The budget of the Department of Housing and Urban Development at 40% of what it was in 1979 – adjusting for inflation – and the credible rumors of continued cuts.

Contemporary homelessness emerged over the past 30 years following specific public policy decisions, and despite recent acknowledgement at the highest levels of the federal government that supportive housing is in fact the solution to homelessness (as we were delighted to hear HUD Secretary Shaun Donovan tell the Daily Show audience early this month) evidence mounts at overburdened shelters, soup kitchens, and health clinics that the problem is only getting worse.  That’s what’s outrageous.  More women.  More men. More children.  More entire intact families sleeping on park benches and under bridges because the shelters are full.  Late last year, a woman 8 ½ months pregnant, turned away from shelter, slept on the front porch of Health Care for the Homeless.  That’s what’s reprehensible.

Current events at an Austin technology conference aren’t in the same book let alone on the same page.

Now, we’ll grant that the very concept of people without homes serving as hotspots to provide Internet access from our phones, tablets, and laptops also strikes us – in the words of several early commentators – as a bit “dystopian.”  But isn’t the reality that millions of Americans live in overcrowded shelters and cardboard boxes with millions more lacking health insurance and employment far more “Brave New World-ish” than a handful of people selling mobile Internet access?  And while it’s definitely a phenomenon worth contemplating – leaping in a few days from tech blogs to mainstream television and radio and even across the pond to the BBC – it’s hardly the issue that should inspire outrage or divert our attention from the more important work of ending homelessness altogether.

As the sponsoring company BBH Labs points out, Homeless Hotspots was conceived as an extension of the “Street Newspaper” concept where homeless individuals produce and sell papers for a buck or two – bringing this model “into the digital age.”   Critics and supporters subsequently have debated this very point.  We’re drawn to the argument that people experiencing homelessness take a more active and empowering role in the creation of newspaper content, that such initiatives provide opportunities for community organizing and education, and that this may differentiate one activity from the other. But we’re not sure the models are all that different. As with so many endeavors, it would seem to hinge upon the implementation. Street newspapers can be operated in an exploitative or empowering manner.  Factory jobs and just about every other form of employment can be exploitative or empowering, too. The offering of a product or service (in this case a decent Internet connection) for money is what we do here in the Unites States, is it not?

An important thing accomplished by both street newspapers and Homeless Hotspots, as pointed out by blogger and activist Mark Horvath, is that each provides opportunities for meaningful human interaction between people in the general public who may not fully understand issues of homelessness and marginalized individuals who understand those issues all too well.  Also in both models, the exchange of money takes place between customer and vendor rather than between beggar and begged. (Although the former roles may generate greater levels of comfort among all involved, we shouldn’t forget that begging and the conditions necessitating it ought to make us uncomfortable.)

Baltimore launches its own street newspaper this month – primarily in non-digital hard copy for now.  The editors and writers of the street paper – most of whom are people with the past and current experience of homelessness – may wish to bring the Hotspot concept to Baltimore, but we’ll let them be the ones to make that decision.  I’m eager to learn their take on the issue and the controversy – though I’m sure the arguments in the group similarly will fall all over the map.  Which brings me to the penultimate point:  if one wants to evaluate the usefulness and degree of possible exploitation of an activity involving people experiencing homelessness – how about we start by asking people experiencing homelessness. Glad to see mainstream media finally getting around to direct interviews with Homeless Hotspots participants yesterday.  Knee-jerk assumptions that “we” must advocate for “those” who can’t – the bottom line of an outraged “action alert” that recently hit our inboxes – misses the reality that the most powerful advocacy comes from those with the most direct understanding of the problem.

Final point:  Homeless Hotspots is no substitute for health care, housing, and jobs – resources needed to end homelessness. Shelter isn’t the solution to homelessness.  But in the absence of sufficient housing resources, it’s a humane interim step.  A week-long conference gig isn’t the solution to joblessness. But in the absence of employment paying a decent living wage, who’s to begrudge anyone the opportunity to make a few honest bucks?  Anything truly solved at the end of the day?  Not particularly.  But neither are we convinced that there’s any real harm done.  And who knows?  Maybe by facilitating conversation and awareness, some good will come out of it, too.

We welcome anyone whose fire has been fueled by outrage over this “social experiment” to join us in our necessary work toward public policies capable of making homelessness increasingly rare and brief.  Ending homelessness will be our best collective social innovation.

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Make Your Voice Heard!

Homeless Persons’ Lobby Day in Annapolis is Thursday, March 1. Join hundreds of HCH clients, staff, community partners and legislative champions to advocate for policies and programs that reduce the incidence and burdens of homelessness. The day begins at 9:45am with a rally in Lawyers’ Mall, just outside the State House.

Afterwards, join us to meet with elected officials on key proposals (click here to see the bills we’re watching in this year’s legislative session and our testimony). And between 11:00am – 1:00pm, take part in free workshops addressing the barriers to making homelessness rare and brief at the Stanton Community Center.

For more information or to sign-up for the workshops– contact Adam Schneider at aschneider@hchmd.org or call 443-703-1398.

Important Links:

Our advocacy priorities and budget testimony – http://www.hchmd.org/marylandgeneralassembly.shtml

The bills we are following and our testimony – http://www.hchmd.org/Bill%20Chart%202012.shtml

Share it! – Let your friends and followers know about Lobby Day on Facebook and Twitter or click here for a flyer about the event.

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From the CEO: The Importance of Being Ernest

The following remarks were delivered during the Health Care for the Homeless Chocolate Affair on February 2, 2012.

Ernest was a mountain of a man.  At 325 pounds with sagging jowls and bloodshot eyes, he had the nervous energy of a bulldog.  On good days he came to Health Care for the Homeless asking for a cup of coffee. “Coffee! Gimme some coooffee . . .” he’d drone in his deep semi-southern drawl. “I want my coffee!”

On bad days – which occurred with greater frequency – he’d pace the waiting room and flail his arms in active hallucination that he was seeing blood dripping from the walls.  It took two of us to calm him by hanging all of our weight from his mountainous shoulders.

We’d later learn that Ernest suffered from schizophrenia, that he shot heroin into the veins between his fingers in an attempt to calm himself, and that he had a developmental disability and a grade-school education.  And day after day, in and out of jail, in and out of the hospital, in and out of Adult Protective Services placements, failed attempt after failed attempt, staff began to whisper – and Health Care for the Homeless doesn’t admit this very often – that maybe, just maybe, Ernest was beyond help.  Any day now, especially with winter coming, Ernest would die on the streets.  And all we could really do was to keep the man alive.

But then one day, something happened to Ernest – something that happens to all of us:  he got old.  And he qualified for Senior Housing.  And despite the evidence of all past attempts that we were doomed to failure, we helped him apply, and we helped him get accepted, and we helped him move into an apartment and set up his very own coffee maker.  And – once housed – somehow, someway, something clicked.

Ernest was stabilized on mental health medications.  He stopped self-medicating with heroin. His doctor got his hypertension under control.  And then really bizarre things started happening as Ernest channeled all of that nervous energy elsewhere: He got a job in his senior apartment complex.  He’d call our telephone operator to ask for advice on how he should cook his Thanksgiving turkey.  He started walking four miles a day – each and every day – around Lake Montebello.  The man quit smoking.  I’ll never forget the day Ernest walked into our clinic with a belt cinched so tightly around his waist that you could see the folds of fabric of the pants that no longer fit him.  (We helped him buy a new pair.)

When Ernest died suddenly of a heart attack several years ago, he had reached his target weight of 200 pounds.  He had lived in his own home for eight straight years.

We learned from Ernest two things:  Lesson #1: there’s no such thing as a lost cause. Never, never, never write anybody off.

Lesson #2 – housing is really the most fundamental form of health care.  Ernest died a reasonably healthy man living, in his latter years, a fulfilled life.  Imagine how much richer his life could have been if we were able to help him earlier.  Imagine if our public systems were actually designed to help the most vulnerable – people like Ernest.  For if our systems were designed to help people like Ernest, we could truly end homelessness for everyone.

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LAST CHANCE to get HCH Chocolate Affair tickets!

You could win the last two tickets for The HCH Chocolate Affair!http://www.chocolateaffair.org/

$50 enters you into a drawing for the last two tickets to the event. The drawing  10am Thursday, February 2, 2012 (the day of the event). Click here to enter.

You are encouraged to provide your phone number when entering the raffle as we will contact the winner directly (your personal information will not be shared or used for any other purpose).

The $50 entry fee is not tax deductible, though all proceeds support the health services we provide homeless families at Health Care for the Homeless. The contest is limited to Maryland residents.

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15 Days until The HCH Chocolate Affair

Today we are just 15 days from Baltimore’s “sweetest night in town” – The Health Care for the Homeless Chocolate Affair. Do you have your ticket – https://secure.qgiv.com/for/chocolateaffair/

On February 2, 2012, Baltimore’s best restaurants, caterers, and chocolatiers will share their gifts with you during an incredible hors d’oeuvre reception and dessert buffet. Savor a chocolate-inspired dinner prepared for you by Executive Chef Carlos Gomez of the Baltimore Waterfront Marriott.

Best of all, you can enjoy something sweeter than chocolate – the inspiring stories of personal transformation that couldn’t have happened without you. Meet the staff and hear about the incredible work they do to change our community for the better.

Don’t delay, because we expect to sell out – https://secure.qgiv.com/for/chocolateaffair/

For more details visit our webpage dedicated to The HCH Chocolate Affairhttp://www.chocolateaffair.org/

 

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Join Us Dec 21 for Homeless Persons’ Memorial Day

On Wednesday, December 21 – the first day of winter, the longest night of the year – we will remember the over 111 men and women who are known to have died in 2011 and who, in life, had lacked a regular place to stay. You are invited to a 5:30PM memorial service at the Baltimore Inner Harbor Amphitheater (between the two pavilions near the corner of Pratt and Calvert Streets).

If the grave consequences of life on the streets weren’t already apparent, the arrival of long winter nights sheds greater light on the growing problem of homelessness in our communities. Lower temperatures, higher housing and energy costs, and insufficient shelter resources contribute to the premature deaths of many of our neighbors.

Join HCH and our partners on December 21 as we remember our friends and neighbors who passed away this year without a secure place to live, and recommit to the important task of ending homelessness.

For additional information on Baltimore City’s commemoration of Homeless Persons’ Memorial Day or to report the names of individuals who have died homeless, please contact Adam Schneider at aschneider@hchmd.org.

Homeless Persons’ Memorial Day is recognized in communities across the country on the first day of winter. For more information on activities across the country and for tips on organizing an event in your community, visit the National Health Care for the Homeless Council – http://www.nhchc.org/memorialday.html – or the National Coalition for the Homeless – www.nationalhomeless.org.

You can also connect with others and get more news on Homeless Persons’ Memorial Day events at this Facebook page: http://www.facebook.com/#!/events/290458947659658/

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