Dealing with the homeless.

With respect to health care, this is the time of year when we see more of our homeless and under privileged souls that usually wonder the streets while most of us sleep showing up on the door steps of emergency departments. Inner city health care facilities have larger numbers of these folks than do their community hospital brethren, but the people are the same. Some are older, some are younger, some are even couples. Some are new to living on the streets and with the housing market and economy being what it is I suspect the numbers homeless people will increase this year.

Several of these folks showing up in emergency departments will undoubtedly be malingering in some way shape or form. Some of them will be admitted to the hospital for brief periods of time because they complain of chest pain, abdominal pain, or perhaps they will present with mental illnesses of sorts. I find that when the temperature really starts to drop the ED waiting room seems to fill up.

Clearly acute care health organizations are not the answer to the homeless problem the country has. What ever medical resources that are consumed by these folks will never be reimbursed, and the dollar amounts will just be added to the mounting bad debt that many hospitals already carry. Many of these folks are looking for a warm place and something to eat. I can't say I wouldn't do the same thing if I were in there shoes.

While many health care organizations do not want to deal with the homeless due to the negative fiscal and social issues, what are health care facilities doing if anything to get ready for the winter homeless? Clearly most cities have not added additional resources for these people to tap into. How does your facility deal with this inevitable issue this time of year?