An Open Letter to WHAS Investigative Report Concerning EMS and Emergency Room Usage
Homelessness and Emergency Medical Services
In order to insure accurate news reporting regarding the “hundreds of ambulance runs” from Wayside Christian Mission’s Emergency Shelter, there are a number of discernable facts that are not so obvious and yet deserving of your consideration. It must be remembered that Wayside Christian Mission is the “final safety net” and “last chance” in caring for the area’s homeless population. We serve many clients who were turned away by other agencies and, as such, provide vitally needed services to those who are in the highest risk category.
Too, no citizen, homeless or otherwise, can be denied the right to emergency ambulatory care. Both logic and compassion dictate that the seeking of refuge in a homeless shelter does not necessitate a forfeiture of this basic right; furthermore, if Wayside Christian Mission attempted to restrict a client’s access to emergency ambulatory care, this would amount to nothing less than a scandalous violation of a citizen’s protected right. As such, it is unreasonable to assume that Wayside Christian Mission should be held liable if a resident chooses to access emergency medical treatment.
In truth, it is far more reasonable to believe there would be many more ambulance runs if those living in the security of these shelters returned to their abandoned buildings or highway overpasses. Adverse weather is also a determining factor, for during times of searing heat or bitter cold, Wayside Christian Mission’s Operation White Flag brings even more homeless men and women into their Emergency Shelter. These are typically the chronic homeless who shy away from the shelter except during the worst possible weather conditions; as expected, the chronically homeless are often the ones with the most pressing health issues. For the record, Wayside Christian Mission houses more homeless than any other local organization. With all this, it is even more reasonable to believe that, without Wayside Christian Mission and other like-minded organizations, there would be desperate overcrowding in the city’s morgue.
Additionally, recent trends such as the rise in outpatient treatment and the deinstitutionalizing of the mentally ill coupled with the inherent health issues common among the homeless have created greater, almost overwhelming challenges to shelter operators; however, both the homeless and society at large have benefited from the efforts of those who battle homelessness on a number of fronts. Rather than adding to the financial burden, the humanitarian efforts of Wayside Christian Mission and other area shelters have saved the public millions of dollars.
Homelessness and Trends in Outpatient Treatment
According to The Journal of the American Medical Association, the length of the average hospital stay has been substantially reduced in recent years. Owing to today’s skyrocketing health care costs, many illnesses that once prescribed long hospital stays are now being treated on an outpatient basis. This cost-cutter measure may work well in a number of cases; unfortunately, those who are homeless cannot expect to convalesce while living under a viaduct. Proper outpatient treatment requires sanitary living conditions, a healthy diet, and a measure of assistance. These vital requirements for recovery are not found on the streets. In truth, were it not for the services of homeless shelters, the burden of outpatient care would fall upon costly nursing homes or necessitate longer hospital stays; either way, the taxpayer would end up footing a rather exorbitant bill.
The University Hospital refers many of its patients to our Emergency Shelter on Jefferson Street as there are eighty medical beds reserved for convalescing residents. The utilization of Wayside Christian Mission’s eighty medical beds helps to ease the overcrowding of limited floor space while saving the hospital substantial sums of money and manpower.
Inherent Health Issues and Homelessness
Homeless shelters receive residents who are far more likely to be plagued with health-related issues. Poor hygiene, long term substance abuse, inadequate diets, and harsh living conditions ultimately result in a grave toll against the individual’s overall health. According to a study by Mary Ann Burg titled Health Problems of Sheltered Homeless Women and their Dependent Children, risks of illness and disease are the expected byproducts of life on the streets.
“Because of their adverse and transitory living arrangements, homeless people in general have a higher prevalence of illness resulting from exposure to the elements, violence, poor nutrition, parasites, and infectious disease than other impoverished persons.”
These health problems, often life-threatening, present an even greater challenge to the facilities that serve the homeless, yet, without the services provided by homeless shelters, hospitals and convalescent centers and, for that matter, taxpayers would be further burdened by the health issues inherent to homelessness.
Locally, Phoenix Health Care operates a medical clinic that assists in the treating of patients residing in area homeless shelters.
Homelessness and the Deinstitutionalizing of the Mentally Ill
With the introduction of new antipsychotic drugs in the 1950s, the trend of deinstitutionalizing mentally ill persons began. Many who had spent much of their lives under around-the-clock care were suddenly released from institutions onto the streets. It was believed by some mental health experts that the institutionalization of the mentally ill created more harm than good; it was further argued that these new drugs would allow the mentally ill to live among society—making their own choices and benefiting from their new found independence. As an added benefit, it was argued that the closing of these institutions would ultimately save taxpayer dollars. The deinstitutionalization of the mentally ill appeared to be a win-win situation; rather than being locked away, mentally ill people would gain by living among society while the steady drain on the public coffers would be substantially reduced.
In theory, mainstreaming the mentally ill appeared to be a favorable alternative to institutionalization; however, according to a study by Crystal Ribeiro titled Deinstitutionalization of the Mentally Ill, this new trend was not without flaw:
“Unfortunately, these programs were not completely well thought out or implemented…The programs thought to replace care given in institutions were not nearly adequate. These programs, attempts to place the mentally ill back in society to be helped by the community members, day programs, and medications were not fully implemented to the full extent needed to replace institutions. This process led to an overwhelming number of mentally ill loose in society, becoming criminals due to lack of treatment.”
While it cannot be rightfully argued that all mentally ill people should be herded back into institutions, statistical studies indicate that mental illness is among the leading causes of homelessness. Where day programs and medications fail, homeless shelters afford a vital safety net. In other words, homeless shelters are providing many essential services to the mentally ill that were once offered by those institutions that have since been closed. It may be furthered argued that America’s streets are somewhat safer because of the fundamental services homeless shelters provide to the mentally ill.
Breaking the Cycle of Homelessness
Wayside Christian Mission combats the ravages of homelessness on a number of fronts. Our Sober Living Program and similar programs offered by other area shelters and agencies can point to literally hundreds of men and women whose lives were once desperately out of control but are now living useful, productive lives. It is worth noting that sobriety programs have saved the public millions of dollars in lost revenue and in the mounting costs of expensive treatment programs funded by the government. Wayside Christian Mission provides more than cots and three hot meals a day—we are teaching life skills to those battling substance abuse, ignorance, and poverty. Ultimately, all of society benefits when a homeless person becomes a self-sustaining member of the community.
Granted, a number of ambulatory request calls placed by clients in our Emergency Homeless Shelter are frivolous. This is unfortunate and yet this is not always preventable; quite simply, mental illness will often impair a client’s better judgment. Too, the anxiety resulting from living in a homeless shelter can induce a sense of uneasiness and panic when a non-threatening illness occurs. Persons experiencing homelessness have limited health care options at their disposal with the Phoenix Health Care for the Homeless Clinic being the only alternative to emergency care they can generally access. Wayside Christian Mission did not create this problem nor does the Mission perpetuate this problem—the problem exists because more health care services do not exist.
In order to insure accurate news reporting regarding the “hundreds of ambulance runs” from Wayside Christian Mission’s Emergency Shelter, there are a number of discernable facts that are not so obvious and yet deserving of your consideration. It must be remembered that Wayside Christian Mission is the “final safety net” and “last chance” in caring for the area’s homeless population. We serve many clients who were turned away by other agencies and, as such, provide vitally needed services to those who are in the highest risk category.
Too, no citizen, homeless or otherwise, can be denied the right to emergency ambulatory care. Both logic and compassion dictate that the seeking of refuge in a homeless shelter does not necessitate a forfeiture of this basic right; furthermore, if Wayside Christian Mission attempted to restrict a client’s access to emergency ambulatory care, this would amount to nothing less than a scandalous violation of a citizen’s protected right. As such, it is unreasonable to assume that Wayside Christian Mission should be held liable if a resident chooses to access emergency medical treatment.
In truth, it is far more reasonable to believe there would be many more ambulance runs if those living in the security of these shelters returned to their abandoned buildings or highway overpasses. Adverse weather is also a determining factor, for during times of searing heat or bitter cold, Wayside Christian Mission’s Operation White Flag brings even more homeless men and women into their Emergency Shelter. These are typically the chronic homeless who shy away from the shelter except during the worst possible weather conditions; as expected, the chronically homeless are often the ones with the most pressing health issues. For the record, Wayside Christian Mission houses more homeless than any other local organization. With all this, it is even more reasonable to believe that, without Wayside Christian Mission and other like-minded organizations, there would be desperate overcrowding in the city’s morgue.
Additionally, recent trends such as the rise in outpatient treatment and the deinstitutionalizing of the mentally ill coupled with the inherent health issues common among the homeless have created greater, almost overwhelming challenges to shelter operators; however, both the homeless and society at large have benefited from the efforts of those who battle homelessness on a number of fronts. Rather than adding to the financial burden, the humanitarian efforts of Wayside Christian Mission and other area shelters have saved the public millions of dollars.
Homelessness and Trends in Outpatient Treatment
According to The Journal of the American Medical Association, the length of the average hospital stay has been substantially reduced in recent years. Owing to today’s skyrocketing health care costs, many illnesses that once prescribed long hospital stays are now being treated on an outpatient basis. This cost-cutter measure may work well in a number of cases; unfortunately, those who are homeless cannot expect to convalesce while living under a viaduct. Proper outpatient treatment requires sanitary living conditions, a healthy diet, and a measure of assistance. These vital requirements for recovery are not found on the streets. In truth, were it not for the services of homeless shelters, the burden of outpatient care would fall upon costly nursing homes or necessitate longer hospital stays; either way, the taxpayer would end up footing a rather exorbitant bill.
The University Hospital refers many of its patients to our Emergency Shelter on Jefferson Street as there are eighty medical beds reserved for convalescing residents. The utilization of Wayside Christian Mission’s eighty medical beds helps to ease the overcrowding of limited floor space while saving the hospital substantial sums of money and manpower.
Inherent Health Issues and Homelessness
Homeless shelters receive residents who are far more likely to be plagued with health-related issues. Poor hygiene, long term substance abuse, inadequate diets, and harsh living conditions ultimately result in a grave toll against the individual’s overall health. According to a study by Mary Ann Burg titled Health Problems of Sheltered Homeless Women and their Dependent Children, risks of illness and disease are the expected byproducts of life on the streets.
“Because of their adverse and transitory living arrangements, homeless people in general have a higher prevalence of illness resulting from exposure to the elements, violence, poor nutrition, parasites, and infectious disease than other impoverished persons.”
These health problems, often life-threatening, present an even greater challenge to the facilities that serve the homeless, yet, without the services provided by homeless shelters, hospitals and convalescent centers and, for that matter, taxpayers would be further burdened by the health issues inherent to homelessness.
Locally, Phoenix Health Care operates a medical clinic that assists in the treating of patients residing in area homeless shelters.
Homelessness and the Deinstitutionalizing of the Mentally Ill
With the introduction of new antipsychotic drugs in the 1950s, the trend of deinstitutionalizing mentally ill persons began. Many who had spent much of their lives under around-the-clock care were suddenly released from institutions onto the streets. It was believed by some mental health experts that the institutionalization of the mentally ill created more harm than good; it was further argued that these new drugs would allow the mentally ill to live among society—making their own choices and benefiting from their new found independence. As an added benefit, it was argued that the closing of these institutions would ultimately save taxpayer dollars. The deinstitutionalization of the mentally ill appeared to be a win-win situation; rather than being locked away, mentally ill people would gain by living among society while the steady drain on the public coffers would be substantially reduced.
In theory, mainstreaming the mentally ill appeared to be a favorable alternative to institutionalization; however, according to a study by Crystal Ribeiro titled Deinstitutionalization of the Mentally Ill, this new trend was not without flaw:
“Unfortunately, these programs were not completely well thought out or implemented…The programs thought to replace care given in institutions were not nearly adequate. These programs, attempts to place the mentally ill back in society to be helped by the community members, day programs, and medications were not fully implemented to the full extent needed to replace institutions. This process led to an overwhelming number of mentally ill loose in society, becoming criminals due to lack of treatment.”
While it cannot be rightfully argued that all mentally ill people should be herded back into institutions, statistical studies indicate that mental illness is among the leading causes of homelessness. Where day programs and medications fail, homeless shelters afford a vital safety net. In other words, homeless shelters are providing many essential services to the mentally ill that were once offered by those institutions that have since been closed. It may be furthered argued that America’s streets are somewhat safer because of the fundamental services homeless shelters provide to the mentally ill.
Breaking the Cycle of Homelessness
Wayside Christian Mission combats the ravages of homelessness on a number of fronts. Our Sober Living Program and similar programs offered by other area shelters and agencies can point to literally hundreds of men and women whose lives were once desperately out of control but are now living useful, productive lives. It is worth noting that sobriety programs have saved the public millions of dollars in lost revenue and in the mounting costs of expensive treatment programs funded by the government. Wayside Christian Mission provides more than cots and three hot meals a day—we are teaching life skills to those battling substance abuse, ignorance, and poverty. Ultimately, all of society benefits when a homeless person becomes a self-sustaining member of the community.
Granted, a number of ambulatory request calls placed by clients in our Emergency Homeless Shelter are frivolous. This is unfortunate and yet this is not always preventable; quite simply, mental illness will often impair a client’s better judgment. Too, the anxiety resulting from living in a homeless shelter can induce a sense of uneasiness and panic when a non-threatening illness occurs. Persons experiencing homelessness have limited health care options at their disposal with the Phoenix Health Care for the Homeless Clinic being the only alternative to emergency care they can generally access. Wayside Christian Mission did not create this problem nor does the Mission perpetuate this problem—the problem exists because more health care services do not exist.
posted by Tim Moseley at 9:23 AM
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