Monday, June 9, 2014

A Snapshot from the Frontline: Where Boston's Homeless Find Health Care

by Nomad

Providing health care to homeless citizens is a job that gets far too little attention compared with, say, celebrity news. One film takes a closer look at the people who have dedicated themselves to that task.

Director  Jeff Schwartz hadn't anticipated that his short film would turn into a full-length documentary.. or a life-changing experience.
"With a small crew and unprecedented access to homeless men and women on the streets.. I was introduced to people I would have normally passed by. "
The result was a film that hat NPR has called "extremely powerful" and "fascinating."
"Give me a Shot of Anything: House Calls to the Homeless" deals with lives of homeless and the doctors and care-givers who provide them with health care. 
Schwartz gave his assessment:
"These are people that care. They see the humanity of the homeless and make sure they are granted basic rights like food, shelter and quality health care."
On a larger scale this film documents one city's response to America's health care needs, the Boston Healthcare for the Homeless Program

Here's the trailer.

McInnis House
Dr. O'Connell, a graduate of Cambridge University Theology Masters program and Harvard Medical School, has brought together an impressive team under the roof of The Barbara McInnis House. The program offers cost ­effective, short ­term medical and recuperative services to homeless men and women.

Opened in 1985 and located at Jean Yawkey Place in Boston, McInnis House has grown into a 104­-bed program and provides round the clock nursing care, including dental services. Moreover, it has now expanded- to fit the need- to become a network of clinics, a 77,000-square-foot medical complex that includes a pharmacy.

Patients who come usually do not require hospitalization but are too sick for life on the streets. This film documents one city's response to America's health care needs, the Boston Healthcare for the Homeless Program. 
It is also nationally recognized as a model for other cities in the US and in Canada.

Republican Safety-Net Lie
Governors who have rejected Medicaid expansion and who suggest that emergency care is an appropriate "safety-net" for the poor and homeless, might ought to listen to Dr. O'Connell. He says:
I think everyone who works with homeless people finds that it is complicated medicine. One of the first discoveries you make is that people have chronic illnesses that have been neglected for a long time—hernias have been ignored for many years, hypertension has been out of control and unknown for many years, diabetes not yet diagnosed or treated.
By the time a person reaches the emergency care stage- if they actually survive that point- the  situation is a health crisis and much more difficult and expensive to treat.
O'Connell also told an interviewer, the unique circumstances make the homeless much more difficult to treat:
When caring for someone with no home, no place to go, and nowhere to store medications, the obstacles to treatment can be overwhelming. You are galvanized to take action to reduce those obstacles and change social policy for people who are so vulnerable. But failed policy is, in fact, failure in so many sectors of our society—education, corrections, health care, and social services. Inadequacies in each of these areas have allowed homeless people to fall through the cracks. Fixing the problem is a big job, and one doctor is just one small voice.
(I recommend readers to check out the interview with O'Connell. His views, coming from the front-line, are worth your time.)

Good News.. or Number Juggling?
There's some good news to report on the war on homelessness.
According to the survey by the U.S. Department of Housing and Urban Development- reported by USAToday last year, the number of homeless veterans and chronically homeless significantly declined in the last six years. Says HUD secretary Shaun Donovan
"We've seen that in one of the most difficult economic periods in this country, we've made remarkable progress to reduce homelessness, particularly among veterans and the chronically homeless."
Donovan attributes the drop to more than just an improving economy. The Obama administration, he notes, as focused its efforts with more housing vouchers and a program called Rapid Re-Housing, which helps with rent and utility costs. Diverted funds and expanded grants to urban areas have also played an important role in lowering the number. 

Not everybody is convinced by these claims, For example, Maria Foscarinis. She is executive director of the National Law Center on Homelessness and Poverty. The organization fights for homeless people’s rights at the national and local level. 
Foscarinis thinks the data cited by HUD is misleading and that other studies suggest a very different story. Assessing homelessness is notoriously difficult because it is often so difficult to actually tally the numbers.
But there are other numbers that need to be looked at before celebrations begin.
She says other data show that the number of homeless is actually on the rise. She points to a U.S. Department of Education report that found a record number of homeless children enrolled in public schools during the 2011-12 school year.
That study released in October found 1.1 million homeless children. The study counts children in families that live doubled up with other families or friends in one place. The HUD survey only counts people in shelters or on the street.
Foscarinis says agencies that provide services to the homeless are seeing more people looking for help and fewer resources to meet the need.
As the medical director of McInnis House, Dr. Monica Bharel points out:
"How we take care of the most vulnerable members of our society really shows what values we, as a society, have chosen"