The Intermittent Volunteer’s Weblog

Befriending People in Dallas Who Are Homeless

“Give Me a Shot of Anything” April 6, 2015

Monday, April 6, 2015

“Give Me a Shot of Anything:  House Calls to the Homeless”

I find these video clips to be riveting.  What do you think?

Night Time House Calls

http://www.givemeashotofanything.com/#!videos/vstc6=night-time-house-calls

Trailer

http://www.givemeashotofanything.com/#!videos/vstc6=extended-teaser

The Film Maker

http://www.givemeashotofanything.com/#!videos/vstc6=newfilmmakers

The Website

http://www.givemeashotofanything.com/#!

Boston Health Care for the Homeless

http://www.bhchp.org

 

Why Some Bostonians Refuse Shelter In The Dead Of Winter, And How They Survive October 29, 2014

From the Boston Globe:  listen to the story here…

http://commonhealth.wbur.org/2014/02/homeless-cold-winter-shelter

Why Some Bostonians Refuse Shelter In The Dead Of Winter, And How They Survive

A van crawls through the streets of downtown Boston, pausing at the intricate iron entrance to a city landmark or a doorway carved in stone. By day, these openings are passages to power and wealth. At night, they are coveted shelters from wind, sleet or snow. People inside the van know this. Their carefully trained eyes scan the shadows of every building, stairway or bench, watching for hints of life.

On Winter Street, at the end of a brick alley, there’s a flicker of movement. The van pulls over and a figure in a light coat emerges.

“Is that you James?” asks a man with a reassuring, deep voice who has stepped out of the van. “You going in tonight?”

Nelson Bennett knows James. He sees this young man often as Bennett circles downtown Boston in Pine Street Inn’s outreach van. It’s packed with blankets, hats, gloves, underwear, socks and sandwiches. Large insulated containers keep hot water handy for instant soup, oatmeal and hot chocolate.

“It always helps, especially in these conditions, to get some warm liquid into your body,” Bennett says.

Bennett and his crew are also out every night trying to persuade people who plan to sleep on the street to spend the night in a shelter instead.

Now, with the temperature at 15 degrees and dropping, Bennett wants to know, will James come in?

No, James says. His girlfriend was assaulted at one of the shelters and won’t go back, so he’s staying out with her. James stands next to a pile of ripped boxes from which he’s pulling pieces to build their bed. It will be three layers of cardboard pushed up against a glass office front with a short wall around the sides.

“I kind of go a little overboard,” James says, laughing. “I don’t want any of the rodents and whatnot getting in.”

James explains he collects new pieces of cardboard every night and throws them away in the morning.

“Once you get in this situation, it’s like impossible” to get a job and get back into housing, James explains. “I have my own issues up here,” he adds, tapping his head. “I’ve had a lot happen, but I don’t want to deal with it so…”
“Where do you guys stay during the day?” asks Lyndia Downie, the president and executive director at Pine Street Inn who is listening to James’ story. “Have you applied for housing?

Yes, James says, pinching his hands to stave off frostbite, but he’s discouraged.

“If you don’t have kids or you don’t have a disability, they make it seem like you can never get housing. I can’t even explain to you how hopeless I feel sometimes,” James says. “My dream is to be able to come home from work again, just fall back on the couch and mind my own business, and I feel like it’s never going to happen.”

Downie takes some more information from James that she will give to Pine Street’s daytime street team. Bennett brings James some underwear, hot chocolate and two blankets. They are the only bedding James has.

“Thank you, thank you very much,” James says as the crew moves on.

At this hour, around midnight, the streets are empty except for a few garbage trucks, taxis and Pine Street’s van.

‘Justice To The Body’

Outside Macy’s in Downtown Crossing, Bennett approaches bundles of people in each doorway. Cindy peaks out from under a cloth sheet, a Mylar and one wool blanket. She and her husband Carl are among three couples who claim the store’s sheltered entrances every night, in snow, sleet and bitter winds.

“Because we’re married,” Cindy says. “We stay together. We sleep together. There needs to be shelters where married people can get on their feet as well.”

Cindy says she sleeps with one eye open. A few nights ago someone took one of the couple’s blankets.

“But we manage,” Cindy says. “Body heat, love, big word, [and] strength.”

A van outreach worker comes back with the couple’s order, soup and sandwiches. Carl asks if they can also get a blanket.

Pine Street will hand out 60 to 70 blankets tonight, between two vans: one that circles downtown and another that runs through Back Bay into Brighton and Chestnut Hill. A handful of people refuse all offers of help.

“This guy won’t talk to us,” Bennett says walking up to one of two cocooned figures. He stands quietly for a minute, watching for any sign of life.

“We’ll make sure they’re OK, they’re breathing, the blankets are moving, and we’ll leave ‘em alone,” Bennett explains.

The van rolls down Summer Street to a brick facade with an arched opening. The door is four or five feet back, leaving a covered, nearly enclosed space that almost hides a man. Downie approaches.

“You don’t have to come in all night,” she says with quiet pleading. “You could just come in for a few hours and get out of the cold.”

“I don’t mind,” says the man named Stephen.

“I’m cool, or actually I’m pretty warm, I should say,” he laughs. “I like my privacy. That’s all.”

Stephen chooses solitude over the warmth of a crowded shelter, where men are packed tight on a lobby floor this particular night because all the beds are full. Stephen forces himself to get up and move on every morning around 4 a.m. He doesn’t want to get caught sleeping here, to risk losing this space.

“I just don’t want to be in the way, you know what I mean, to be an eyesore for everybody,” Stephen says.

The temperature has dropped to 13 degrees and there’s a biting wind.

A man carrying one sheet of cardboard approaches the van, asking for a coat. There aren’t any. He settles, gratefully, for chicken noodle soup. “Aw you guys are great, thanks,” says the man, also named James.

This James is a gambler, who says he’s just back from Foxwoods where he stayed in one of the big hotels and feasted on lobster and steak.

“I’m bankin’ three grand,” James whispers to Bennett. “I caught on to how to beat the casino at their own game, $400-500 a week, guaranteed. It’s a no-lose game. Where I’m headed now is paradise,” James says as he wanders off.

It’s these guys who Downie worries about the most, the ones who aren’t speaking rationally, aren’t dressed for the cold, who aren’t suicidal but show signs of mental illness.

“He lives in what I call no man’s land,” Downie says, “because if you’re a danger to yourself there’s a possibility of some kind of commitment or guardianship, but if you’re not, your options are pretty limited. In some ways the disease stops you from getting treatment so it’s an odd paradox for people.”

The van has 30 to 35 regular stops, places where the crew expects to find people sleeping outside. The stops change with construction, or as businesses crack down on overnight street occupants.

Street regulars, as some of the homeless folks call themselves, know where to find the van. Subhash is waiting as Bennett hops out on a corner near the Theater District.

“How you doing, boss? You going in tonight?” Bennett asks. And finally, Bennett gets the answer he’s been hoping for, a yes.

Subhash says he had a strategy he hoped would get him through the night.

“I was planning to just walk around,” Subhash explains. “Sleeping can get a little tough in the cold. So probably like 30 minute lie down, then you have to start walking again.”

Except Subhash is now losing feeling in his legs. Still, deciding to go in, where he’ll be on a floor, with someone’s feet in his face, is not the obvious choice for Subhash.

“If you’re homeless, sometimes you just want to lose the crowd,” Subhash says, “to feel a little more reassured about who I am and what not. But a lot of times it doesn’t really do justice to the body. You have to compromise one way or another.”

As the van nears Chinatown, it’s swarmed by almost a dozen men and women in their late teens or 20s.

“I need gloves and socks, for me and my girl,” one man calls out.

“Yeah,” says another, “we need gloves over here.”

The crew runs out of gloves and blankets and heads back to Pine Street Inn to restock.

“Normally we don’t get flooded like that where there’s all those people,” says Jill Fortuna, a full-time outreach counselor on the van. Fortuna says many of these young people aren’t regulars and may just be passing through Boston.

“It’s worrisome to see kids that young out there,” Downie says.

Back at Pine Street, Fortuna unlocks the door to a metal storage container and squints into the dark. Bennett points a flashlight at the labels on a stack of boxes.

“Psyched,” Downie yells after a few seconds. Bennett grins, “gloves, gloves, yes, yes.”

Bennett rips open the box to reveal dozens of flat packages, wrapped by volunteers from Natixis, in red snowflake and green snowman paper.

Downie bursts into laughter. It’s Christmas all over again, here at 1 a.m. in the dead of a cold winter night. But could the box be mislabeled?

“Let’s hope there’s gloves in here,” Downie says.

She and Bennett rip open the packages with the fury of any 8 year old.

“Yep, bingo,” Bennett says.

Downie is relieved.

“We’ve been going through gloves like crazy cause it’s been so cold,” she says.

The restocked van heads toward North Station. It’s closed, but four teenagers huddle near the entrance. Fortuna recognizes them.

“They’re a bunch of young kids that just recently showed up,” she says. “They’ll make a big huge bed near Haymarket. There’s four or five of them who sleep there.”

One by one, the teenagers come to the passenger window of the van. Ben Williams, the driver, writes down their name, date of birth, the last four digits of the Social Security number and the ZIP code of their last residence, information for Pine Street’s client database. One young woman, Marie, asks for soup and blankets, but says she’d rather sleep outside than go in.

“I’ve been doing it for a few years. It doesn’t really bother me,” Marie says in a sing-song voice. “You just bundle up and all that jazz.”

Marie shrugs and walks away as a man named Michael steps forward, saying he can’t take it any more. “The temperature, the wind, there’s no public restrooms,” he explains.

Michael just got out of prison on a cocaine conviction.

“Come to find out,” Michael says, “the lady who tested my drugs said the drugs were real. Annie Dookhan, yeah. Now I come home and there’s no housing.”

Michael says he doesn’t like shelters because the rules seems to change depending on who’s in charge.

“I really think about going back to jail, cause it’s like I know what to expect,” he says. “I expect to be in a cell, with a bed, a toilet, two inmates, breakfast, lunch and dinner. It’s simple.”

As the van drops Michael at Pine Street, Downie imagines a night when there won’t be anyone sleeping on the streets and shelters won’t be crowded. She says it would take about 2,000 new rooms.

Research shows that the units would pay for themselves over time, Downie adds, “because the expensive emergency service numbers go down and that offsets any new housing dollars. So doing nothing for chronically homeless people costs more money than putting them in supportive housing.”

The Patrick administration seems to agree. It expects to release details of a multimillion-dollar social investment project this spring aimed at reducing the number people like Cindy, James, Subhash and Michael who spend nights on the street, even in the dead of winter.

What Happens To The Body Of A Person Who Sleeps Outside In Extreme Cold?

Dr. Jim O’Connell, with Boston Health Care for the Homeless Program, explains:

When a person gets cold, their body shuts down blood going to the skin to preserve warmth near the heart. When hands and feet don’t have enough blood they may develop frostbite.

With frostbite, hands, feet, ears and noses can swell and blister. The skin turns black and necrotic. In cases of severe frostbite, dead tissue will fall off or autoamputate. Some patients are left with a disfigured toe or finger, some lose the tip or whole digit.

In the last two weeks in Boston, a homeless man who sleeps on the street lost one leg below the knee as well as part of the other foot to frostbite. Another man will need to have one of his legs amputated below the knee.

O’Connell explains the body’s reaction to cold in depth here.

 

 

Bear Witness September 3, 2013

Tuesday, September 3, 2013

Bear Witness

          “Bear witness to injustices that result in poor health, and work to remove those injustices and build health equity.  This is what healers owe society.  And this is what our society desperately needs at this moment in time.”

                                     ~~  Jessie M Gaeta, M.D.,  Medical Director of Boston Health Care for the Homeless Program

                                                Commencement Address, Boston University School of Medicine Convocation, 2013

 

Cold Feet March 20, 2013

Sunday, March 17, 2013

 

Cold Feet

by Karen Shafer

 

Although it’s cold here on the New England lake where I’m staying with my family — in the thirties — the weather has not stopped my ten-year-old grandson, Louis, from organizing family rowing parties on the lake the past two days.  It goes without saying that he’s the ship’s captain, which is almost certainly a motivating factor for any ten-year-old.  He’s enthusiastic about being in charge and even got his mother to go out rowing this morning when it was 29 degrees!

 

As a family, we’ve rowed across the lake twice this weekend and staked our claim, like settlers, on the shore of an island or promontory, which my grandson has dubbed ‘New Louis.’  (Please don’t tell the people in the waterside mansions up the hill from where we landed that new settlers have arrived:  they no doubt think they own the land.)  Today when he, his eight-year-old sister, Anna, his father and I made ‘the crossing’, it was 37 degrees and also quite windy — and we were rowing into the cold wind and against the waves.  At times, it seemed seemed to me that we were either going backwards or sitting still in the middle of the lake, paddling our hardest, and I thought, “Hmm, making this crossing yesterday was really fun, but this is starting to feel a little like actual work.”

 

Eventually, though, we gained the coast of New Louis and clambered ashore — or rather, they leaped, and I crawled.  While the other three first scrambled up a pine tree that had been blown over and uprooted to a 45-degree angle by a recent storm, then went off hiking, I sat on a wall, regretting the fact that I’d left my winter boots in Boston.  My feet in tennis shoes and cotton socks had gotten damp from water in the bottom of the boat, and how cold they now felt became the full focus of my attention, delighted though I was with the outing and with our newly conquered territory.

 

I soon figured out that, though the temperature was in the mid-thirties, if I took off my damp socks and shoes and sat barefoot with my feet under a pile of dry leaves and grass, my feet were warmer and I was more comfortable than I was sitting in wet shoes.  I hung my damp socks on a branch to ‘dry’ and piled more dry pine needles over the ‘nest’ into which I’d pushed my feet.  Chastising myself for being a wimp and a whiner did nothing to erase the fact that nothing seemed more important to me than how cold my feet felt.  And I had only been out in the wind and damp for about forty-five minutes… an hour max.

 

As I sat on the wall pondering what a softie I’ve become in middle age, I began to think of our homeless brothers and sisters, out on the street in similar weather and that which is much more severe.  I remembered how, in times past when I’ve been around homeless people in the winter, there’s nothing they’ve seemed to need more — and nothing which is more often lacking — than clean dry socks and shoes, and I recalled how charities serving the homeless population often emphasize this.  Being in New England, I thought of sock drives sponsored by the Boston Red Sox.  I vowed that the next time I show up at a service provider which helps homeless people, I’ll do so with at least a pack if not an armload of white athletic socks…  and I wistfully and pitifully imagined borrowing one of those pairs of socks for myself at that moment, just until we got back to the house.

 

My family came back from their hike, and we rowed back across the lake… with the wind this time, and in a quarter of the time, thank goodness.  I did more reflecting as we paddled;  the rhythm of the oars moving through the water was conducive to it.  I thought about how comfort-dependent I am, especially as I get older — and, indeed, what comfortable lives most of us middle-class Americans live.  How pampered we are, and how miserable it must be to be homeless, living on the street, and know that you are facing hours, days of cold, wet feet.  How does one cope with that?

 

We reached the small sandy beach in front of the house where we are staying, pulled the rowboat onto shore, traversed the yard and entered the lovely, warm, dry house.  I rushed straight to my slippers and greeted them with a sense of appreciation and affection I’d forgotten I could feel for shoes.

 

KS

 

Common Cathedral February 13, 2013

Wednesday, February 13, 2012

 

Common Cathedral

 

I’ve just been invited by my daughter, her family, and a wonderful friend who is a nurse serving the homeless community in Boston to attend services at Common Cathedral one Sunday in the next few weeks.  Can’t wait!

 

http://ecclesia-ministries.org/common_cathedral.html

 

Coercion or Cooperation? January 10, 2012

Monday, January 9, 2012

Coercion or Cooperation?

Pine Street Inn in Boston, Massachusetts, New England’s largest resource for homeless men and women, sends Outreach vans onto the city’s streets 365 nights per year — in the cold, snow and rain — offering homeless men and women help in the form of warm blankets, hot meals, clean clothes and transportation to shelter.  The journal below allows us to follow a van on one night’s journey and details some of the experiences of the shelter’s outreach volunteers.

Imagine just for a moment that you are one of the homeless women or men described in the article.  As you read, ask yourself whether you would respond better to the approach used by Pine Street — one of respect and trust building — or to the methods used by many other cities, which often includes this choice:  “Do you want to go to a shelter or go to jail?”  KS

 

 

One Night’s Journey

December 2011

Have you ever wondered what happens to Boston’s homeless men and women on cold winter nights?



Every night, Pine Street Inn’s Outreach vans head out, loaded with warm blankets, hot meals and clean clothes, offering rides to shelter. Through the cold and snow, the Outreach teams crisscross the city from 9:00 p.m. to 5:00 a.m., serving people in need.

Here are just a few of the situations that Outreach counselors Nelson, Vincent and Maggie encounter during one night on the vans.

10:05 p.m., Financial District

Outreach counselors find two homeless women in their 60s, Susan and Annie, huddled together in an alley. Susan was assaulted the previous night, and Annie is determined to stay by her side “to protect her.” Maggie offers the women hot soup and a sandwich. She listens as they tell their story, but senses that it will take time to build their trust before they will accept a ride to the shelter. Reluctantly, the Outreach team moves on, but they will check on Susan and Annie again tomorrow.

1:30 a.m., Washington Crossing

Outside a coffee shop, the Outreach team finds Donald, whom they have encouraged to go to shelter before. Tonight, he accepts a ride to Pine Street. On the way, Donald tells the counselors that he has been sick. By the time the van arrives at Pine Street, Vincent has arranged for Donald to see a doctor the next morning.

3:45 a.m., Boston Common

It’s cold and raining when Nelson spots a light coming from under a bridge. There, Nelson finds James, who is trying to stay dry. Nelson has known James for three months and is slowly trying to build his trust and convince him to spend the night at Pine Street. James has not been ready in the past, but tonight when Nelson asks if he’d like a ride to the shelter, James says “yes.”

A warm bed and a hot meal were his first steps on the road to a better life. Today – with the help of Pine Street – James has a full-time job and is living in his own apartment.

5:00 a.m., Pine Street Inn

The outreach vans return to Pine Street and the counselors meet to talk about the individuals they spoke with the night before and prepare for the next night’s journey.

Video link: “Human Dignity is Paramount:

http://www.pinestreetinn.org/about_history.php

http://www.pinestreetinn.org/



 

Medicine That Matters October 13, 2011

Thursday, October 13, 2011

 

Medicine That Matters

by Karen Shafer

“The Boston Health Care for the Homeless Program’s mission is to provide or assure access to the highest quality health care for all homeless men, women and children in the greater Boston area.”

The lobby of Boston Health Care for the Homeless Program at Jean Yawkey Place, with Deshawn Parris, Security Officer, and Shirley Berard, Administrative Assistant

Jean Yawkey Place 

In the summer of 2011, while touring the Boston Health Care for the Homeless Program, I stepped off the third-floor elevator into Barbara McInnis House, looked around, and began to cry, (and I’m pretty sure it was what Oprah refers to as “the ugly cry”.)  Those accompanying me — my daughter, two of my grandchildren, and our tour guide, Manager of Volunteer Services Carrie Eldridge-Dickson — at first looked at me in surprise.  After all, we were viewing a beautiful, pristine environment decorated in pastels — a state-of-the-art facility which provides “medical respite care”, short-term medical and recuperative services, for homeless men and women in Boston, Massachusetts.  I felt as if I’d stepped into an ideal world.

 

My companions’ surprise turned quickly to understanding.  They shared the comprehension that my tears were in part joyful at what has been accomplished there, but that they also conveyed frustration at how few of our homeless brothers and sisters will ever experience the level of loving and dignified care expressed in the atmosphere surrounding us at that moment.

 

The 104-bed Barbara McInnis House is a medical respite care facility spread throughout three floors of Jean Yawkey Place, Boston Health Care for the Homeless Program’s central facility which opened in May of 2008.  The building also houses a primary care walk-in clinic with ten exam rooms and four meeting rooms for mental health care, a dental clinic with five operatories, a pharmacy, office space for “street” and “family” outreach teams, and the organization’s administrative offices.

 

Barbara McInnis House provides 24-hour care for homeless men and women who are too sick for life on the streets or in shelters but not sick enough to occupy acute care rooms in area hospitals.  It has a dining room that serves patients three nutritious meals a day, and a large common area and outdoor patio — all under one roof.

 

The cellar-to-roof renovation of this former city morgue and forensic research facility now addresses the unique medical needs of the city’s homeless men and women.  It was made possible through the combined generosity of private, foundation and corporate donors.  BHCHP raised $42,000,000 in the organization’s only capital campaign in its 26-year history.

 

Model of Care

Jean Yawkey Place sets the stage for the model of ‘integrated care’ practiced at BHCHP.  The organization’s web site, www.BHCHP.org, describes the complex challenge of tackling health care among the vulnerable homeless population.

“Many homeless patients struggle with at least one substance abuse problem, at least one chronic physical condition and a psychiatric illness. Each condition is often preventable and manageable… on its own. But, in combination and left untreated, such health problems become compounded and all too often fatal. Medicine, in general, and homeless medicine, in particular, have long grappled with addressing these interconnected aspects of a patient’s healthcare in a coordinated way. In the traditional care model, behavioral health care and medical care operate independently.

The integrated care model at BHCHP unites physicians, physician assistants, nurse practitioners, nurses, case managers and behavioral health professionals in a close collaboration. They follow patients together and separately in a variety of settings: on the street, at Barbara McInnis House, in outpatient clinics and, as needed, in shelter or housing.

A patient can move from street to clinic to hospital to respite care to shelter to housing, having easy and regular contact with at least one member of the medical team so that serious medical and behavioral diagnoses receive integrated attention.”

No homeless person is refused treatment at BHCHP.  The professional staff provides medical treatment to homeless men, women and children at eighty locations across the city — in adult and family shelters; in two hospital-based clinics; in emergency, transitional and permanent-supportive housing; and through home visits to formerly long-term homeless patients who are now housed through the Housing First initiatives in Boston.  They also provide care on the street, in alleyways and under bridges to those “rough sleepers” who avoid shelters.

 

BHCHP’s Beginnings

How does such an impressive result come to be?  An article from the American Journal of Public Health entitled “The Boston Health Care for the Homeless Program: A Public Health Framework” talks about its beginnings.  (O’Connell, Oppenheimer, Judge, Taube, Blanchfield, Swain, Koh: August, 2010)

 

In 1984, a community coalition consisting of eighty people representing shelters, homeless service providers, community health centers, nursing and medical schools, state and city governments, homeless persons, and advocacy groups was convened by Boston mayor Raymond Flynn and Massachusetts governor Michael Dukakis.  An extensive community needs assessment to identify gaps in existing health care services was then conducted.

 

Initial funding for the program came through a pilot grant of $300,000 annually for four years from the Robert Wood Johnson Foundation and Pew Charitable Trusts, subsequently matched by an additional $250,000 annually from the state of Massachusetts.

 

City wide cooperation and ‘buy in’ strikes me right away as a predictor of the program’s probable success, and, in particular, the inclusion of homeless people and their advocates in the planning.  All too often, critical issues of how service is to be conceived and delivered to the homeless community is decided by committees comprised of those who have never experienced homelessness, without ‘grass roots’ input.  Such a comprehensive network early on hopefully precludes the ‘fiefdom’ approach of non profit organizations that can occur in cities, resulting in duplication of services and competition for funding.

 

The Mission of BHCHP

“To provide or assure access to the highest quality health care for all homeless men, women and children in the greater Boston area.”

When the program began offering clinical services in 1985 with a staff of seven, these things stand out in terms of its mission:

“The coalition insisted that health care be embraced as a matter of social justice rather than charity, and they defined the program’s mission to ensure that the highest-quality health care would be available to all homeless men, women, and children in Boston.” (O’Connell, et al)

It also viewed  itself as a viable professional career for health professionals rather than as a volunteer opportunity and hoped to ensure thereby continuity of top-tier, accessible health care for homeless men, women and children.  This seems a radically positive, innovative notion, and would seem to insure that, by having physicians and other health care providers as salaried employees of BHCHP, not only would availability of health care be assured, but vital relationships of trust could be built between provider and patient, leading to ‘continuity of care.’

 

What is meant by ‘continuity of care’?

1.  Continuity of care from street and shelter to hospital requires an enduring and trusting relationship between the doctor or clinician and patient.

2.  Multidisciplinary teams should deliver care.

3.  BHCHP should act as a catalyst within the mainstream health care system to ensure that the special needs of homeless persons are addressed.

4.  BHCHP should serve as the “glue” linking hospitals and health centers with the community of shelters and homeless service providers.

5.  BHCHP should strive to bridge medicine and public health.

6.  BHCHP should create and implement ‘respite care.’  [now existing as Barbara McInnis House]  (O’Connell, et al)

It is also significant that BHCHP is located near two teaching hospitals, Massachusetts General and Boston Medical Center.  BHCHP has walk-in clinics on the campuses of both facilities.  Colleges and universities are now educating healthcare providers in increased sensitivity to the particular needs of various ethnic and social groups.  This is especially important as the homeless population is one which requires special care in building trust and relationships, both because of possible health issues such as mental illness or addiction, and because attitudes toward homeless people in society as a whole tend at times to be negative, and opportunities for rejection abound.

 

Who Deserves Compassionate Care?

One only has to read the comments section of newspaper articles on homelessness — where homeless people are frequently referred to as ‘bums’ or in other derogatory language — to understand the negativity which can be directed at people living on the street.  This attitude in the public at large may be a more powerful determinant of the quality and scope of the health care offered to the homeless population than one thinks.  For example, some nonprofit organizations seeking to provide health care to those living in poverty may be hesitant to include homeless individuals within their scope — even when they believe they are deserving and needful of help — because they may feel that the ‘homeless’ label will impede funding efforts.

 

So, at the heart of the mission of any program offering health care to those living in poverty must be the consideration of this question:  Are people experiencing homelessness deserving of compassionate care?  Whether or not to include homeless healthcare in programs may in part be a matter of conscience, where non profit leaders either bend to public pressure and opinion, or stand firm in the moral commitment to treat all human beings as equally deserving of inclusion in a community of care.

 

The decision at the outset by the founders of Boston Health Care for the Homeless Program to emphatically declare that individuals who are homeless are entitled to and would be provided with top tier, continuous and compassionate health care, provided in an integrated model by on-staff medical and clinical professionals, and with the assumption of the inherent worthiness of each patient to receive such care, regardless of circumstance, represents a rare commitment, but one that seems to have been met there in an extraordinarily successful manner.

 

Toward the end of our tour of the Boston Health Care for the Homeless Program, my family and I were fortunate to have a chance meeting with Dr. James O’Connell, a founding physician of the program and currently its president.  When we told him how moved we were by the beauty of the facility and the range and depth of its proffered services, he said, “Remember, it hasn’t always been like this!  It took us a while to get here.”

 

The success of the program says a great deal about an inspired vision; about the wisdom of its founders and their careful planning; about a limitless amount of dedicated work and commitment; and also, not to be underestimated, about the political and moral will of a public which supports and undergirds the idea that those who at this moment live in society’s shadows are nonetheless deserving of its best.

 

BHCHP Overview

~~ BHCHP has operated in the black for all of its 26 years and has brought medicine that matters to tens of thousands of homeless men, women and children.

~~ BHCHP employs close to 300 doctors, dentists, physician assistants, registered nurses, nurse practitioners, psychologists, psychiatrists, mental health case workers, chefs, building and maintenance staff, substance abuse counselors, case managers and dental assistants.

~~ BHCHP delivers health care to over 11,000 patients each year.

~~ BHCHP manages the medical care throughout greater Boston’s adult and family shelter system, in two hospital based clinics and at over 80 sites throughout greater Boston.

~~ Over its 26 year history BHCHP has developed a care model that makes it a leader in urban medicine throughout the world…compassionate, professional care from a full-time staff…immeasurable savings in both dignity and dollars.

Boston Health Care for the Homeless Program: www.BHCHP.org

 

Special thanks to Boston Health Care for the Homeless Program, in particular Tom McCormack andVicki Ritterband for editing, and Carrie Eldridge-Dickson;  and to Nancy Johnson, Master’s of Science Candidate with a focus on Community Health, for access to journal articles and for thoughtful discussions of and insights into public health policy.


 

This article appears in the October, 2011 issue of Street Zine, which is available from licensed street vendors across Dallas.