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Posts Tagged ‘barriers for the homeless’

Yesterday was the kickoff for Cover the Uninsured Week 2009.  Most of the patients at the Respite are uninsured.  In fact, if you receive our print newsletter, you would’ve already read a story about Walter, who became homeless as a result of his wife’s bills for breast cancer treatment.  (If you’d like to receive our print newsletter, email your address to respitesupport AT zoomtown DOT com).

The link between lack of health insurance and bankruptcy is clear: a 2001 Harvard study found medical bills to be a leading cause of personal bankruptcy.  And even those with health insurance may find  that their coverage isn’t sufficient to face major or chronic illness.  Student health plans, “mini med” plans, and limited liability coverage can offer lower premiums, but seldom afford the protection needed to weather catastrophic (or even serious) illness.

In November 2007, the Wall Street Journal reported on inflated medical bills received by Jim Dawson of Merced, CA.  After exceeding a $1.5 million lifetime maximum benefit on his health coverage, Dawson was slammed with $1.2 of grossly inflated medical charges.  Dawson’s charges were removed after the medical center received an inquiry from the Wall Street Journal, but few of my homeless clients are lucky enough to have a major media outlet report on their behalf!

It’s a problem from any angle: the same Wall Street Journal article noted that the hospital admitted its charges were necessarily inflated to account for the 2/3 of issued charges it would never collect.  And physicians’ skyrocketing malpractice insurance costs have forced some M.D.s to leave the medical world.  A New Hampshire emergency physician shares this perspective.

Many of the patients at the Respite have experienced the horrors of a lack of medical care.  When a medical concern arises, they typically wait until it becomes urgent to seek emergency care.  Even if they do seek medical attention early, homeless patients may be forced to wait until their illness or injury becomes an emergency so that they can qualify for free or subsidized services. 

Clearly, our healthcare system needs improvement.  I don’t want to discount the low-cost, free, and subsidized services provided so generously in the Greater Cincinnati region.  Low-cost medical and dental clinics and relief from hospital bills are services that homeless men and women rely on.  Still, there is much work to be done in improving healthcare for the homeless.  Cover the Uninsured Week is just one more great reason to mention it.

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A few weeks ago, a new client arrived at the Center for Respite Care with a horrific case of frostbite.  Freezing rain splashed off the sidewalk as he gingerly walked to our front door with only bandages on his feet.  The frostbite was a result of working as a parking garage attendant.  Today, he is healing, but still faces toe amputation. 

Personally, I’m not a fan of cold weather.  Our current weather makes me want to hide underneath the covers–or, at least, it used to.  One recent morning, I woke up and immediately decided I had left a window open.   I dug out my trusty thermometer: fifty-eight degrees!

I called my landlord, but ten days later, the whole building was fifty degrees.  The landlord came over, but it was too late to call for repairs.  We went without heat that night.

There is a big difference between having some heat and having no heat.  I piled three comforters on the bed, cranked up a tiny space heater, and shivered.

My heat was fixed the next day, but not everyone is so lucky.  In fact, every night in Cincinnati, hundreds of homeless men, women, and children are without heat and shelter.  Unlike me, they have little hope of reprieve until summer.  What little time and money they have go toward finding the next meal, tracking down loved ones, and waiting for benefits such as food stamps and rental assistance.  The unlucky ones develop pneumonia, frostbite, infections, and cancer.

If you’re snowed in today, appreciate your heat!  And consider helping your fellow citizens find shelter, heat, and medical care.  The economy is tight for everyone, and no group feels this more acutely than the homeless.

To make a donation to the Center for Respite Care visit our website.

Check back soon for Respite in the news.  (Hint: did you see Respite in the Enquirer last Sunday?)

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Reading other blogs about homelessness is a curious thing.  There are blogs by those who are or have been homeless, those who work or volunteer with a homeless clientele, and blogs about other topics that mention homelessness once in a while (typically when the author has an encounter with a homeless person).

The most frequently commented upon blog articles seem to be those about an individual’s first night of homelessness.  I admit, I frequently leave comments on these articles myself.

Why is it that we’re so sympathetic to the person who experiences their first day of homelessness, but callous toward the person who has been homeless for months or years?  It’s a matter of perspective.  The person spending a stray night in a homeless shelter could well be us, we think.  

What if we lost our jobs and had a concurrent major illness?  What if a loved one (or ones) passed away suddenly?  What if . . . whatever combination of tragedies it might take.  I think we’ve all had thoughts that it could be us.  For some it might take more tragedies than others, but the possibility is there.

In considering the chronically homeless person, we’re less sympathetic.  Why?  Because we believe we cannot sink to that level.  We would pull ourselves out or find help somehow.

We may be able to make the leap to understanding who someone (even ourselves) can become homeless, but we believe that if you’re homeless for more than a few weeks, well, you must just be lazy.  Or ignorant.  Or an addict.  Why don’t they just get jobs after all?  Or just apply for the loads of benefits we finance through our taxes?  Or get social security?

We fail to consider the psychological effects of life on the streets.  It takes many of our clients several days to warm up to staff at the Respite and our mission is to help them.  Imagine how difficult they find it to reconnect with family and friends.

And all those “free benefits”?  True, they’re out there.  But how long can you afford to wait?  It can take weeks to qualify for food stamps, months to gain tenant-based rental assistance, and years to be awarded social security disability.

As for employment, would you hire someone who admitted to being homeless?  How about someone who claimed to have stable housing, but was mysteriously never home when you called?  Would you hire someone with dirty fingernails or ragged clothing?  Maybe you would.  Then again, maybe you’d prefer to hire the clean-cut teenager who made the honor roll last quarter.

Are we really as impervious as we believe?  Or is the hard truth that homelessness, once it happens, can be nearly impossible to escape?  How many of these truths do we ignore because they are simply too frightening to accept?

The ultimate truth is surely more complex, but everytime I read comment-loaded articles about an individual’s first terrifying night as a homeless person, I wonder.

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Happy Blog Action Day!  Despite writing about homeless people and the medical needs of this population all the time, I sometimes forget to consult the panel of experts (often referred to as our clients) that hang out on the Respite porch every afternoon.  Today, everyone was playing cards.  They let me interrupt to ask this question about poverty: What does it mean to be poor? 

Being poor means .  .  .

. . .fear of the future.

. . .a certain state of mind.

. . .appreciating things more.

. . .being scared.

. . .being treated like a second class citizen.

. . .there’s nowhere to go but up.

. . .you work hard to change your life to make it better.

. . .being frightened.

. . .wondering where meals will come from the last week of the month.

. . .lack of knowledge, not having much self-esteem.

. . .lack of independence.

. . .being without and being depressed.  Every day of being homeless is depressing.

. . .insufficient funds.

. . .being lost in the world.

 

I bolded the answers that my “experts” liked best.  Those two responses elicited an immediate approval from everyone in the vicinity. 

Finally, do you notice now many answers revolve around fear?  For those experiencing homelessness, extreme poverty is more about fear than money.

Another tenet of Blog Action is discussing solutions to the issue.  This is a gargantuan task.  Money alone isn’t going to work – everyone at Respite told me that today.  Compassion would be a start, maybe a huge start.  There is so much animosity towards those who are poor in the United States.  We’re willing to travel extreme distances to help out abroad; what about those in our community who are in need?

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I was tag surfing today, checking out other blog articles on homelessness and found a great description of one woman’s first day at a homeless shelter.  It contains many of the details I’ve heard from Respite clients (about their stay at “traditional” emergency shelters, not a respite facility), along with the fear, worry, and unease inherent to the situation. 

As you can tell from the woman’s description, a typical shelter is no place for someone to try to recover after being hospitalized, having surgery, or being released from an emergency room.  There are showers and a place to sleep, but in the wee hours of the morning, each person must return to the streets.  For an injured person, this would surely contribute to repeat hospitalizations and ER visits.

Running a homeless shelter is definitely a balancing game.  If you provide more services, you serve fewer people.  If you try to serve everyone, you can’t provide as much help for each individual.  At the Center for Respite Care, we provide medical recovery and 24-hour shelter.  We have high success rates for our population, but we are limited to serving fourteen people at a time.  Luckily, there are other agencies in Cincinnati that create something of a safety net, but we do sometimes turn people away because we don’t have the resources to serve them.  On the upside, we’re the only agency in Cincinnati that providing this service and can hopefully expand our size in the future. 

If you’ve never heard of the Center for Respite Care (or other similar respite care provider for the homeless), I’d urge you to visit our website: www.homelessrespite.org.

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It seems that winter has struck early this year.  Not so much in terms of weather, but in the increased amount of homeless people needing shelter and medical care in these first few days of October.  I believe that most homeless shelters experience a similar, weather-related trend: in the summer, occupancy rates go down because it’s more comfortable to “sleep out.” 

In the winter, however, some people are forced to follow rules they might otherwise reject; stay sober or sleep in the snow?  I wish I could claim this was not the case, but it seems to be so.  On the upside, cold weather gives us a chance to reach and help more sick people.

Unusually enough, however, we have seen a recent, prolonged increase in referrals even though temperatures are hardly uncomfortable outside.  I wonder if this is a result of chance, or the economy (anyone else trying hard to ignore that?), or some other factor I haven’t considered.

What do you think?  Will the current economic conditions cause shelters nationwide to be flooded with fellow citizens in need?  Or is this trend a fluke?

Some industries applaud a waiting list of customers, but not us!  We’re happy to help and thrilled to be a part of breaking the cycle of homelessness for so many people each year, but it pains me to think there will be people in need whom we cannot help, perhaps in unpredented numbers.

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It’s Friday again – our song this week is Tracy Chapman’s “Talkin’ Bout a Revolution,” again from LaDonna.  Millie, our nurse manager, wanted to share “Trying to Find My Place in the World,” but we couldn’t track it down on YouTube.  If anyone knows the artist for that piece, leave us a comment and I’ll post the song next week.

Meanwhile, “Revolution” is a fair description of day-to-day life for many low-income and homeless men and women who spend many a long hour waiting in line to secure benefits.  As a result of the recent economic downturn, cash-strapped agencies try to help a growing number of people with dwindling resources.  This can result in longer wait times for those who need help the most. 

For Respite clients who break the cycle of homelessness, being housed really is a revolution.  And it takes a personal revolution to work through issues of mental illness, addiction, and abuse.  That’s why we’re so proud of clients like Mike!

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