Homeless situation....

I've been lurking around this thread for days and debated if I wanted to actually participate.

I previously (until last year), for 6 years, was a data analyst supporting an inpatient and outpatient multi-disciplinary care (physicians, nurses, dieticians, social workers, psychiatrists, and health promoters) program for the un & underserved population. In plain English this means poor, un or under-insured, chronically ill patients - the large majority homeless or housing insecure. I have analyzed the data and I have shadowed the clinicians on home visits and spent days in the clinics in order to understand the operations in order to best determine how to build out health information systems to capture meaningful data to drive better patient care and outcomes. I have perspective from the back end of this as well as seeing first hand how these people live and hear about what they are going through.

One of the biggest issues faced in attempting to gain control of their chronic conditions was housing insecurity and homelessness. The majority of the chronically ill were diabetics and they had no refrigerator to store their insulin in and generally speaking in regards to other medications that they'd get at the hospital and put in their backpacks (that we would provide for them), they never lasted because on the streets and in shelters, your backpacks and belongings are constantly stolen or thrown away if you step away from them for too long and you have no house, car,or reliable people surrounding you to look after it for you.

What happens when people who are chronically ill begin to start feeling really bad because they don't have their prescription medications? They start using illegal substances or drinking again. Then after a couple weeks of not having their prescriptions, some serious health event happens and they are taken back to the ER for uncompensated care.

In reality, these people need inpatient rehab and/or mental health residence to go get sorted out and detox, etc. That's the first step. The next step is some place to go when they are finished with treatment (for those who won't be staying permanently in the psych hospital). If they have no place to go, this cycle repeats itself until the patient dies most of the time.

Only after the inpatient care and rehab (for those with substance abuse and mental health issues) can you begin to think about work farms and other such things. You can't send an addict or mentally ill person to a work farm (or any other work program) until they are sober and have the tools to function in society. It's also unreasonable to expect that these same sub-population would be able to flourish at any rate we would deem a success in one of those tiered programs where they work up to being given permanent housing while simultaneously having to deal with addiction or severe mental health (or both) in an outpatient/non-residential setting. You have to address the underlying issues first.

I've seen it first hand. I've studied the data. I know what works and what doesn't with this particular group of the homeless - and I recognize that my post does not address all the various types of homeless characteristics.

My next point I'll make in a separate post as this one is already quite long.