This question has been top of discussion for the better part of the past decade. Hospitals across the state (and country for that matter) have struggled with the difficult challenge of finding appropriate shelter settings for homeless patients no-longer in need of acute medical care. The problem has been exacerbated by graphic media coverage of so-called “patient dumping” on LA’s Skid Row.  I think we all know that these pictures do not tell the whole story. Let’s be clear, hospitals in no-way condone the inappropriate discharge of homeless patients.  The complexities of homelessness are far reaching and beyond what a collective of the brightest minds politically, medically and socially have been able to ascertain.  It seems the obvious answer to homelessness is – yes, housing. However, is a one-size-fits-all approach to solving homelessness even possible and if so, how do we get there?  I like to think of housing as the perfect end-game goal with a lot of necessary stops along the way.

Let us not forget that LA’s famed Skid Row was built as part of an urban design plan voted in by the public and city officials back in the 70s. A collective decision was made then to centralize services, creating an area of containment with the aim of connecting individuals to necessary services and eventually housing.  More than 40 years later – some still support this plan while others fight to create a new urban plan that puts housing at the foundation and imposes an end to the short-term shelter model of the past. Leaving service providers scrambling to reinvent themselves and create new models for funding to provide the still necessary services for the growing number of homeless.

From the exposure I have personally been given and the many discussions that I have participated in with providers from across the spectrum, one thing is abundantly clear. If you have met one homeless individual you have done just that – met one homeless individual.  Root causing the circumstance behind ones’ homelessness is as unique as one can imagine. Ask any discharge planner, social worker or service provider and you will get agreement on at least that. Some case needs are easily met with housing while more chronic cases require extensive mental health, substance abuse and vigorous other treatments requiring compliance – a whole other discussion for a future post.

So much effort has been put into seeking a solution to this very complex social issue. It is important that we continue to work together for meaningful solutions and not attempt to scapegoat this issue with ridiculous finger-pointing and blame. Hospitals are no more the cause of homelessness than they are the cure.  We are however, willing participants in local collaboratives that seek a productive path toward the end game stated above. In the absence of a holistic solution to homelessness; rest assured that hospitals will continue to provide acute medical care, recuperative care, and a host of other already established services for the homeless members of the communities we serve.