Posts Tagged ‘Guest Blog’
It’s an election year, and here in Philadelphia, we’re feeling the usual election-year buzz.
This year, Pennsylvanians will elect a governor and a U.S. senator – so people across the city are organizing, registering, mobilizing and educating potential voters and candidates on the state’s critical issues.
This year, one of the most active groups mobilizing voters is a coalition called Vote For Homes!, a group comprised of people experiencing homelessness, formerly homeless persons, low-income individuals and families, along with allies and advocates.
For the past dozen election cycles (or so), Vote For Homes! has worked to mobilize and educate citizens during the about the issues that impact our communities, with particular emphasis on the needs of low-income and homeless people and families: housing, jobs, and support services. Drawing on a range of experience and expertise, Vote For Homes! proposes constructive policies and engages in dialogue with candidates. We lead non-partisan voter registration campaigns, reaching out especially to folks in shelters, programs and struggling neighborhoods where people often feel alienated from the political system. Project H.O.M.E. is proud to be one of the leaders in the Vote For Homes! campaign.
We do this because we recognize that it isn’t enough to provide quality services to persons and families in need – we must also address the structures, systems, and policies that aggravate situations of poverty and homelessness. We do this because we believe that all citizens must act responsibly through the political process to try to better our community.
And – most importantly – we do it because it works.
During the 2008 mayoral election, we reached out to all the candidates with a platform to address critical issues about homelessness and poverty in the city. We packed a local church for one of the most well-attended and energetic candidate forums of the entire campaign. We hosted hundreds at a Get Out a Vote rally and both major candidates appeared to speak to our constituents.
The eventual winner, Mayor Michael Nutter, quickly reached out to us for input in formulating policies on homelessness. A few months into his administration the Mayor announced significant new initiatives which have resulted in over 2,000 new housing opportunities created for homeless persons and families thus far. He has also worked hard in the midst of major economic crisis to minimize cuts to programs serving the most vulnerable citizens.
This shows what can happen when we take our democratic rights and responsibilities seriously – it shows what can happen when we claim our power as individuals and as a community working together.
But we also need to realize that success only happens when we work together.
In the past several years, we’ve registered well over 10,000 homeless and low-income voters. We’ve mobilized thousands of people to get to the polls. And we’re doing it again this year.
We believe it is vital for service providers to take the next step and turn your commitments, experience, and knowledge of the issues into nonpartisan electoral action.
Whether the races are for local, state, or federal offices, educate yourselves about what is at stake in this election. Find out about the issues and the candidates. Talk with friends and colleagues. Encourage folks to get out and vote – and do so yourself!
The opportunity is at hand. Together, we can make a difference – just as we have in the past.
For out more about Vote For Homes! and how you can get involved!
Our group was made of roughly 20 people from our state at the conference, and about 8 of us went on hill visits on Wednesday. I was very glad to have had a chance to experience hill visits in April, and knew a little bit what to expect. It did feel as though everyone else on these visits was a seasoned veteran, but at least I had some experience to draw on! We had such excellent packets prepared for us by the NAEH staff — everything we needed to be able to carry out the visit was in there.
We spoke primarily about fully funding McKinney, about Section 8 vouchers, and about the fact that we see growing demand for services and shrinking resources at the local level.
We had a nice mixture of people, including someone from local government (City Office of Housing), someone who works with a large local funder of services and housing for homeless families, a woman who runs survival services in a rural part of the state, and the ED of a private social service organization and day labor agency (which does not accept public funds but sees the urgent need for federal funding and policies that help end homelessness), as well as someone from the major homelessness advocacy group in the County (me). Good range of people to offer their take on these issues to the staffers.
I came prepared to invite both Senators and their staff to specific events in our state during the August recess, and I plan to write a thank you note to each of them that repeats that invitation. I surprised myself by doing something I hadn’t planned to do, namely inviting Senator Murray during the Wednesday morning coffee to attend our backpack-stuffing day for Project Cool for Back-to-School. I did not want to put her on the spot, but it seemed like a nice opportunity to let her know that we appreciated her work on behalf of children who are homeless.
What happened really surprised me — two other constituents who were at the morning coffee came up to say that they wanted to help, too — one was a school nurse in two districts in our County with high numbers of children who are homeless, and one was a psychotherapist in private practice with children and adolescents. They were both visiting with their children and husbands (who were at different conventions in town), and both immediately gave me their contact information. The nurse told me that she struggles when a child comes to her with a stomach ache, and she knows she has to ask when the child last ate something, knowing that in some cases it may be two days ago. Her school sends children home with backpacks filled with food for the weekend, but she wants to do more. And, Sen. Murray’s education staffer was standing right there, so they got to hear that it’s not only the people who came for the NAEH conference who care a lot about this issue. Sarah Bolton was very gracious, and asked me to follow up with her about the invitation to the Senator.
Thank you to the NAEH conference folks for helping to offset the costs of registration for me. It made a big difference for our small organization to be able to afford to send me to my first NAEH conference.
Every year, Capitol Hill Day offers a time for advocates of ending homelessness to sit down with their Senators and Representatives and discuss pressing and pertinent issues regarding homelessness. In doing so, it also provides another great opportunity – a chance for these passionate advocates to come together and have their voices heard. This year, those voices were heard as loudly as ever before – advocates from 40 states and Guam held over 215 meetings with Congressional offices, and the results are still pouring in! With every additional meeting, the value and effectiveness of Hill Day 2010 increase that much more. We’ll do a follow-up blog post in a few weeks once we have finalized all of the results. In its decades-long existence, Hill Day’s track record of spreading knowledge, creating awareness, and igniting political movement clearly demonstrates just how powerful a tool it has been.
This year, Hill Day became even stronger.
Take the story of our advocates from Maine as an example. Six years ago, before our current group was involved, the Maine Congressional Delegation was largely unaware and unconcerned with homelessness issues. However, in the years since the Maine advocates have been active in Hill Day events, several Members of Congress from the state, including both Senators, have become champions of the issue. Thanks to our State Captains and Hill Day Participants, stories like this one are becoming more common across the nation with each passing year. Given the similar stories from other states and the great numbers from this year, Hill Day 2010 is proving to be an historically successful year.
At a personal level, my experiences as a first time organizer of Capitol Hill Day were both memorable and educational. To see weeks of coordination and planning with State Captains come together was special, as was the chance to see so many hours of work translating into influence on federal policymaking. Moreover, getting to meet, in person, the men and women whom I had been e-mailing and calling incessantly (we called it “gentle nudging”) in the lead-up to the conference was wonderful. It is not often that I get to meet people so passionate about a cause as unselfish as ending homelessness. Thanks in large part to the efforts of these advocates, Capitol Hill Day 2010 was a great success.
At a workshop that Ron organized for the National Coalition on Homeless Veterans, I had the honor of presenting data that show that African Americans are overrepresented among the homeless veteran population. As illustrated in the Alliance’s most recent report on homelessness among veterans, while African American veterans make up 10 – 11 percent of the veteran population, they make up 45 percent of the homeless veteran population.
As I was pulling together my slides for this presentation, I was struck by following from the HUD’s fifth Annual Homeless Assessment Report:
“When compared to their counterparts nationwide, homeless people are much more likely to be adult males, African Americans, non-elderly, alone, veterans and disabled.”
For more than two decades the homeless veteran’s population has been a scar on the face of America. The Heroes Today, Homeless Tomorrow Report (1991), set the stage, or tone at the national public policy level for dialogue. Yet little inside, or outside the national debate has focused on why African American veterans are continually disproportionately represented. Early Congressional Black Caucus Veterans Braintrust issues forums convened in 1992, and in 1993, in which deceased VA Secretary Jesse Brown (1992) testified, revealed that of the estimated 250,000 single male veterans who were homeless nationally, 40% were Black, or African American. The currently available literature does not reveal, nor does it provide meaningful explanations on this phenomenon. However, striking and overlapping seminal reports of the post Vietnam era Forgotten Warrior Project (1976), Legacies of Vietnam Study (1981), and National Vietnam Veterans Readjustment Study (1984) all link black military enlistments with the quest for jobs, training, education and economic advantage. Thus, suggesting that today’s overwhelmingly male and disproportionately black homeless veteran’s population are worse off than before the Vietnam Conflict. There is a clear commitment according to new VA Secretary Eric Shinseki & Four Star U.S. Army General (Ret.) to end homelessness among veterans. Yet numerous professionals, practitioners, and advocates argue you can’t solve the homeless veterans problem unless you better understand why African American veterans are continually overrepresented among the homeless population factually! Despite, the overall reduction in homelessness from 195,000 homeless veterans six years ago.
In the words of Secretary Shinseki veterans’ lead the nation in homelessness, depression, substance abuse, suicides, and they rank up there in joblessness, as well. Approximately one half of homeless veterans are African America. While current estimates are that 131,000 veterans live on the streets of this the wealthiest and most powerful Nation in the world. More importantly, President Obama and the VA are committed to ending homelessness among veterans over the next five years.
1)One of the most obvious lessons learned is that there is a common perception among minority veterans that they are not being provided equal services by the VA system as reported by the Advisory Committee on Minority Veterans Report in 2008.
2)The failure to redress, or adequately explain why significant differences exist in homeless rates between black and white veterans, has dire consequences for vulnerable black families and communities with fewer resources, or assets. For example, fatherlessness, family poverty, and community violence.
3)The rigorous pursue or examination of cause and effect relationships, or factors from an environmental perspective (not individual vulnerability) by VA and community based participatory research partners sensitive to the racial, ethnic, gender and class nuisances of vulnerable poor, black and/or communities with fewer resources, or assets is lacking.
4)Black veterans were still generally found to have higher nonemployment rates (nonemployment refers to individuals unable to find work, but still are searching for employment…) than white veterans, reflecting dominant national employment trends. (Greenberg & Rosenheck, 2007)
5)Blacks & Hispanics disproportionately suffer from serious labor market problems. This occurs despite gains in average educational attainment and increased representation in higher-paying occupations among these groups. Blacks and Hispanics are more likely than Whites or Asians to be unemployed. When employed, Black and Hispanics are much more likely than Whites or Asians to be working in lower-paying occupations. Some factors include, but are not limited to: their lower average levels of schooling; their tendency to be employed in occupations that are subject to higher rates of unemployment; their greater concentration in the central cities of our urban areas, where job opportunities may be relatively limited; and the likelihood that they experience discrimination in the workplace. (Labor Force Characteristics by Race and Ethnicity, 2007)
One conclusion is that no systemic review and/or meta-analysis of homeless veteran’s scientific journal literature and no reports focusing on the disproportionate nature of African American homeless veterans have been published since Heroes Today, Homeless Tomorrow, 1991. Which either directly, or indirectly focus on black homeless veterans’ urban prevalence and incidence, or severity currently exist. For example, geographical distribution, risk factors, protective factors, utilization rates of homeless services, health status, mental health illnesses, substance abuse, employment considerations, poverty, housing, race and culture data. Also there are no cross-cutting studies from the VA healthcare system disciplines of psychiatry, psychology, social work, nursing, readjustment counseling, vocational rehabilitation, etc. The objective of such a review, analysis and/or comparisons would be (1) determine in which urban areas veterans status, race, ethnicity and homelessness predominate; (b) describe why there is disproportionate homelessness in predominantly urban areas of the country; and (c) qualitatively synthesize the existing knowledge to determine the best approaches for future national homelessness reduction efforts aimed at enhancing VA health equity, community development, neighborhood revitalization and family stabilization.
It is a transforming time for our agency and the services we provide. After many years without the tools to really help families end homelessness, we are finally seeing the resources needed to end homelessness. (The Road Home in Salt Lake City -operating the largest homeless shelter in Utah as well as an extensive transitional and permanent housing program.)
The Road Home has recently partnered with the State of Utah, Salt Lake City and Salt Lake County to utilize federal stimulus dollars to rapidly re-house families.
With the flexibility allowed by the funds, our Rapid Re-Housing program is designed to give families a jump start. Funding allows payments for utility debts, deposits and rental assistance as well as a strong case management component. We have seen that once in housing, families rarely need to return to emergency shelter ever again.
The Road Home recently assisted a young single mother who had been living in the family winter shelter facility. She was able to move out with the assistance of the Rapid Rehousing Program. She and her three children found a nice apartment in West Valley City. Soon after moving, the mother found a job at a grocery store. Recently, she was promoted to be a manager there and has increased her income enough to afford her rent. She no longer needs our assistance.
We have also used these funds in conjunction with other programs. Another single mom staying in our women’s shelter was approved to re-unite with her children but needed a home to bring them to. We were able to access a single family home, beautifully renovated by the Neighborhood Stabilization Program funds, for this family. We worked with the mom through the application process for a Shelter Plus Care voucher with our local Housing Authority. And we used Rapid Re-housing funds to assist her with an old housing debt so that she would qualify for the voucher. In addition, we partnered with LDS Church’s thrift store to help this family acquire beds and basic furniture as well as a two week supply of food.
“Our team has been working side by side with our families to move out of homelessness and into housing,” said Matthew Minkevitch, Executive Director for The Road Home. “During the first six months of the project (Oct 1, 2009-Mar 31, 2010), the Rapid Rehousing team assisted 232 households as they moved out of homelessness and into housing in the community.”
To learn more about programs and services provided by The Road Home, visit www.theroadhome.org.
We’re happy to share the latest addition to the homelessness blogosphere. Today’s guest post is by Dhakshike Wickrema at Shelter Partnership.
In an attempt to expand our role as a community resource on homelessness in LA County, Shelter Partnership just started a new blog! We hope that it will get the word out to those looking to learn more about homelessness policy and programs in LA County and City.
Our goal is to inform not only the general public, but also homeless service providers and public agency staff so that they can stay abreast of important policy decisions and programmatic changes that may affect their clients.
Thus far we have covered topics such as the Greater Los Angeles Homeless Count, LA County’s initiative to provide rental subsidies to 10,000 recipients of General Relief (Assistance) and a program that links homeless older adults to subsidized housing. The contributors to our blog will include Ruth Schwartz, our Executive Director, and the planning/technical assistance staff, Nicky Viola, Steve Renahan and Dhakshike Wickrema.
Established in 1985, Shelter Partnership is a nonprofit organization that is dedicated to alleviating, preventing and ending homelessness in Los Angeles County. We carry out our mission in several ways: providing policy and planning advice and technical assistance to community-based organizations and public agencies and conducting research and publishing analytical studies to inform public policy regarding homelessness. We also operate a warehouse where large-scale donations of merchandise are stored and redistributed to frontline homeless service providers such as short-term and permanent supportive housing projects.
We look forward to any feedback and suggestions on how to improve our blog!
This morning, we’re thrilled to host Perla Ni, former publisher of the the Stanford Social Innovation Review and founder of GreatNonprofits on our blog! She’s writes today about our partnership to promote awareness of great organizations benefiting the poor and homeless.
When Hurricane Katrina hit, I was the publisher of the Stanford Social Innovation Review, and we wanted to write a story about how nonprofits were helping the victims. Even though we had access to far more information than the ordinary donor or volunteer, we found it difficult to find out which nonprofits were doing a good job of helping those in need. We only started to get a clearer understanding of which nonprofits were actually rising to the challenge when our former managing editor, David Weir, flew out to Biloxi, Miss., and walked up and down the streets, asking people which nonprofits had been out there helping them. The locals told him about several excellent small, local nonprofits that provided supplies and help. One guy told him how he had broken his leg and had been living in his car until volunteers from a local nonprofit came and found him and took him to the doctor. The local nonprofit in that case was unknown to the larger world and received little public attention or funding. . It struck me, as I struggled professionally to find great nonprofits for our magazine to write about, that there needed to be an online Yelp, or Amazon Reviews-type site, where clients, volunteers, donors, and others with first-hand experience with a nonprofit can share their experiences. . Fast forward two years. An average of 56,000 people per month are now coming to GreatNonprofits.org (and GuideStar, where the reviews are mutually shared), to write reviews about nonprofits and to find nonprofits based on these reviews.
When Hurricane Katrina hit, I was the publisher of the Stanford Social Innovation Review, and we wanted to write a story about how nonprofits were helping the victims. Even though we had access to far more information than the ordinary donor or volunteer, we found it difficult to find out which nonprofits were doing a good job of helping those in need.
We only started to get a clearer understanding of which nonprofits were actually rising to the challenge when our former managing editor, David Weir, flew out to Biloxi, Miss., and walked up and down the streets, asking people which nonprofits had been out there helping them. The locals told him about several excellent small, local nonprofits that provided supplies and help. One guy told him how he had broken his leg and had been living in his car until volunteers from a local nonprofit came and found him and took him to the doctor. The local nonprofit in that case was unknown to the larger world and received little public attention or funding. .
It struck me, as I struggled professionally to find great nonprofits for our magazine to write about, that there needed to be an online Yelp, or Amazon Reviews-type site, where clients, volunteers, donors, and others with first-hand experience with a nonprofit can share their experiences. .
Fast forward two years.
An average of 56,000 people per month are now coming to GreatNonprofits.org (and GuideStar, where the reviews are mutually shared), to write reviews about nonprofits and to find nonprofits based on these reviews.
But we don’t consider our job to be done. We know there are still thousands of nonprofits out there doing important work that no one has heard of, and it is our mission to find them and give them, and those involved with them, a voice.
Right now, during the holiday season, we’re focusing on nonprofits that provide food or shelter to those in need. Teaming up with the Alliance seemed like a natural thing to do- and we are lucky to have such a great partner for the 2009 Food and Shelter Awards.
The campaign will highlight nonprofits making a difference in this sector and give them exposure to potential donors.
Are you trying to get your stories of impact out to donors and supporters? Well here’s a free and easy opportunity. You can encourage your volunteers, clients, and donors, to write reviews about your nonprofit.
If your nonprofit has at least 10 positive reviews (four or five stars), you’ll get included on the Top Charities List promoted on GreatNonprofits as well as on GuideStar, the premier site for philanthropic research on the Web.
Plus this is a great opportunity to engage your stakeholders. Your clients, volunteers, donors, and board members who write a review about you are likely to become more ardent supporters. You’ll gain powerful, authentic stories of your impact that you can use in your internal and external communication. Your stories of impact will inspire your staff and inspire your supporters. Here some examples of nonprofits and how they’ve used their reviews:
- North Hills Community Outreach, which provides food to the needy, has seen more online donations after they gathered reviews.
- Project Homeless Connect has used their reviews to recruit more volunteers
- DC Central Kitchen shows its supporters and donors through its reviews that it is committed to transparency.
It’s quick and easy to encourage reviews. Send out an email, post it to your Facebook fan or group page, or tweet it out. You can get started at on our website.
Today, we have a great guest post from our friends in Minnesota. It discusses data, and the importance of that data in approaching homelessness effectively and responsibly. As a member of our own Homelessness Research Institute at the National Alliance to End Homelessness, the importance of good, solid data is something I’ve learned very, very well. Hope you get the message too.
Between October 1, 2007 and September 30, 2008, nearly 13,000 people stayed in the emergency shelter and transitional housing programs that participate in Minnesota’s Homeless Management Information System (HMIS), according to a recent report from Wilder Research. HMIS participating organizations have about 3,400 beds per night designated for people experiencing homelessness, about 57 percent of the state’s total capacity.
The report, Homeless Service Use in Minnesota: Emergency shelter and transitional housing, federal fiscal year 2008 provides numbers and characteristics of people who reside in HMIS-participating emergency and transition housing. It uses aggregated data submitted annually to the US Department of Housing and Urban Development (HUD) for its Annual Homeless Assessment Report (AHAR) to Congress.
A companion report presents detailed tables for each of Minnesota’s 13 HUD-related ‘Continuum of Care’(CoC) regions. (As we’ve discussed on this blog before, a CoC is the administrative unit in charge homeless programs.)
Minnesota has among the highest AHAR participation rates in the county. In addition to strengthening HUD’s report and providing useful information at the local level, high AHAR participation helps secure funding for homeless programs throughout the state.
Homeless Service Use in Minnesota is an important step toward informing policymakers, service providers, advocates, and others about the use of services designed to meet the needs of people experiencing homelessness in Minnesota. This report is planned to be released annually, with the quality of information improving as participation in HMIS grows.
In the fight against homelessness, there are a number of solutions and ideas. So far, we as a country have embraced homelessness management – and constructed a series of shelters and assistance programs that do benefit the lives of the homeless but does little else to lift them out of homelessness in a more effective and permanent way.
The Alliance supports a different approach – one based on permanent housing as a solution to homelessness.
In between the two is the concept of transitional housing – a temporary situation that can aid individuals and family who are suffering a short-term crisis. Here’s a story from Bonnie Baxley, Executive Director at Community Lodgings. Inc., a transitional housing program in Alexandria, Virginia.
All families who enter Community Lodgings’ Transitional Housing Program are homeless and most are referred to us by local temporary shelters. Each of our families has their own unique story usually revolving around themes that are all too familiar: addiction, domestic violence and a lack of education.
Recently, we welcomed a new family to our program. J.D., a single mother, and her 5-month old son exemplify the constant struggle that characterizes homelessness. Still, they continue to overcome seemingly incomprehensible problems through support from our caseworkers and their own enduring hope and perseverance.
A 31-year old single mother, J.D., was referred to Community Lodgings from a local homeless shelter. She entered our two-year program with a history of incarceration and substance abuse as well as a hearing disability.
But since her worst days, J.D. has paid her debt to society, maintained sobriety for over two years, and now seeks a new life for her family. She has two children – a 5-month old son that lives with her and a 14-year old daughter living with an aunt in another city.
The family continues to make progress one step at a time. J.D. is currently employed through a temporary staffing agency, working a minimum of 16-20 hours per week while she seeks full-time employment. With the help of Community Lodgings, J.D. enrolled in culinary courses to broaden and strengthen her skill set. She focuses on maintaining sobriety, completing her education and obtaining a GED, and securing full-time employment to provide basic necessities for her children. She is also being treated for bipolar disorder at a local health clinic.
J.D. is determined to make a success of her life.
As JD progresses, her caseworker reviews and offers guidance on how to reorganize her financial situation – her budget is based on total monthly income and projected spending. The goal, for both J.D. and for Community Lodgings, is for J.D. to reach independence.
J.D.’s family is one of 13 families currently enrolled in Community Lodgings’ Transitional Housing Program. It is through our program that she and other families strive to meet the ultimate goals of independence and self-sufficiency.
The two-year transitional program helps our families “open doors to independence” by providing an apartment and a support system cultivated by caseworkers, program directors, and community programs. Families sign a two-year commitment contract with Community Lodgings and promise to: stay drug and alcohol free; attend all workshops, meetings and activities as prescribed by our caseworker; and pay a monthly fee based on 30% of her income. Caseworkers provide guidance and opportunities to improve education, employment, finances, health, housing maintenance and emergency services. They also work closely with our Family Learning Center staff to organize parenting, anti-gang, family violence, financial literacy and substance abuse workshops and computer literacy and English classes for adults.
For more information about Community Lodgings, please visit their website.
Happy Monday, everyone!
We have a GREAT treat today! Maria Foscarinis, of the National Law Center on Homelessness and Poverty (NLCHP), sent us a piece on her organization’s stance on the health care debate and the homelessness.
No doubt you’ve heard a thing or two about the raging controversy over health care. All the national papers, including the New York Times, the Washington Post and USA Today are a-buzz with recent criticisms, potential changes, and the likelihood that the administration will concede to the hysteria of the general public.
In our little corner of the world, we wonder what the health care debate will mean for the homeless population. We wonder if reform – should reform pass – will make a tangible difference in their lives: will the chronically homeless get the medical attention they need? Will improved coverage curb the number of costly emergency-room visits? Will the poor and very poor be assured health care coverage under federal programs like Medicaid? And since the Post brought it up, what about the families?
Here at the Alliance, we know what we’d like to see. Check out senior policy analyst Peggy Bailey outline the Alliance’s goals for improving health care.
And a slightly different perspective from our friends at the NLCHP. Many thanks to Maria Foscarinis and Ashley Shuler at NLCHP for their invaluable help in getting this piece posted today.
I was lucky: I had good health insurance, access to top doctors, and friends and family with the wherewithal to help. I also had a good education that helped me navigate the health and insurance systems and also to remain employed.
I had a home to go to after each round of chemo and, three years later, after hospital treatment for a recurrence of the cancer.
“Scott” is not so fortunate. Twenty-seven years ago, at the age of 21, he lost his left leg after a car hit him. A month earlier, he had lost his job as a forklift operator, and with that, his health insurance. Unable to afford his own home, he was living with his mother. The money he recovered from the driver of the car that hit him barely covered hospital expenses and the lawyer’s fees.
Through his state’s department of rehabilitative services, Scott was able to get a prosthetic leg. Finding work was challenging. For a year he had a job—and health insurance—with an office supply company, but when the company went bankrupt, he was out of work again. He worked as a migrant laborer for a while—with no insurance. When a relationship ended and he moved out, he had no place to go. He’s been homeless on and off ever since.
His family is too poor to help. He is bright and personable, but lacks the education that might help him get a job. He is on multiple waiting lists for housing but, for now, has no place to live but the streets. He is searching for work, but with a disability and without a home, he has been unable to find one.
And now his other leg is showing signs of problems.
What would have happened to me had I been in his place when I was diagnosed?
I doubt I would be alive today. Without health insurance, I would probably not have gotten the early intervention that helped save my life, or access to top doctors, or the latest treatments. Without a home to live in, I doubt I would have survived the depressed immune system and consequent infections that followed my treatments. And if I were alive, I’d probably have had a much harder and longer time recovering physically and emotionally from the rigors not only of disease but of treatment.
The consequences of lack of access to health care are devastating. The average life expectancy of homeless people in the U.S. today is 30 years less than that of the rest of the population. Homeless people suffer disproportionately from both acute and chronic disease, such as diabetes, arthritis, and lost limbs. Disability benefits are extremely difficult to apply for and receive: Except for about a one-year period long ago, “Scott” has never received them, despite his obvious disability.
Health care reform is now on the table in Washington, D.C., and it’s long overdue. But to be meaningful, it must include people like Scott. Medicaid, the federal health care program for poor people, does not currently cover all low-income people; in fact, 70% of homeless people are currently uninsured. The program must be reformed and barriers to it eliminated to cover all homeless and poor people.
- It must include primary and preventive care for people like Scott, and not just because they need it desperately. Right now, emergency room care is the primary medical care available to homeless people – but this is the most expensive care, costing an estimated three to four times as much as preventive measures or a doctor’s visit, and the most burdensome for all involved.
- It must include reasonable access to disability benefits for those who are disabled. Currently, about 40 percent of homeless people suffer from mental or physical disabilities, or both. Yet only 11 percent receive federal disability benefits, due to barriers including address requirements, missing identification documents, or lack of funds to obtain birth certificates and other records required to apply.
- Perhaps most importantly, it must include access to housing. Without a home, virtually no treatment will be effective—for the person or for taxpayers. A 2004 study of nine cities compared the cost of providing supportive housing to homeless persons, including those suffering from mental illness and addiction, to the cost of allowing people to live on the street. In all nine cities, supportive housing was significantly less expensive, and the health care costs were much less expensive. Supportive housing reduces health costs by reducing expensive emergency department visits. For example, the study found that San Francisco hospital costs were over $2,000 per day, while supportive housing was under $50 per day.
We all need health care and we all need housing. It’s part of being human.
It’s time to recognize that these are also basic human rights.