Hospitals and the homeless

One of my great frustrations over the years has been the practice of Madison hospitals to discharge patients to homeless shelters. It’s something we’ve had to deal from time to time, especially when those discharges take place outside of the shelter’s hours of operation. Patients are given cab fare and it becomes the cabby’s responsibility to help them to the doors of the shelter. When, as is so often the case, the shelter isn’t open, Grace staff and volunteers are left with the responsibility of helping the discharged patient until the shelter opens. Sometimes, patients are brought in wheelchairs; occasionally they might have oxygen tanks or catheters. More than once, I have called the hospital in question and expressed my frustration verbally. It’s not just that we aren’t in a position to deal with the situation; it’s that the hospital staff can’t be bothered to find out or know what the shelter hours are before discharging someone to the street; and also don’t seem to care that the patient may not be physically able to negotiate homelessness.

Fortunately, in recent years, I haven’t encountered many such incidents but I attribute that more to chance than to the reduction of the practice. It may also be that with the opening last fall of The Beacon, Madison’s new day resource center, the hospitals have sent discharged patients there rather than to the men’s drop-in shelter at Grace.

Whatever the case, in recent weeks, I have spoken with several men and cab drivers, who arrived at Grace outside of shelter hours. On at least one occasion, I invited a man in to sit in our reception area to wait until the shelter opened. On another occasion, on a warm, sunny day, I simply told him when the shelter would open and where else he might go to wait (the Beacon, the Central Library). I was on my way to an appointment; it was after our offices had closed, and there was nothing more I could do.

A recent piece on Huffington Post explores the phenomenon; hospitals’ usual  denials that they discharge patients to the streets, and the growth of recuperative care facilities for homeless people. Such facilities have proven to be cheaper and more effective than the alternatives:

A survey among 98 homeless people who had been hospitalized in New Haven found that 67 percent stayed in a homeless shelter the first night after being discharged from the hospital, while 11 percent slept on the street.

Both crowded, chaotic shelters and the street are obviously inappropriate places for medical recovery, which can have serious consequences for the patient, including a return to the hospital. Being homeless can increase the odds of re-hospitalization within 30 days almost four-fold.

Madison homeless advocates and agencies have been working for a number of years to develop respite care facilities here. Recently, it was announced that Healing House, a proposed facility for homeless families and created by Madison Area Urban Ministries, received a $500000 grant from CUNA/Mutual to help with the  renovation and operation of its facility. Grace Church provided significant financial support to the early efforts to create such a facility. Healing House will serve families experiencing homelessness with a family member who is receiving medical treatment or recovering after hospitalization. It will fill an important gap in homeless services, but the population served by Grace’s Drop-In Shelter will continue to lack a similar facility. Here’s hoping that such a facility will soon be operational for them as well.

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