We have a relationship with the downtown hospitals. They'll call us and we'll send someone out in the van to pick up clients and drive them home or to the shelter. They understand, for the most part, that we fill up, and with the exception of the brand new staff, understand that the shelter does not have any reserved beds even if a patient has given us as their address. We will work with the hospital to try and find that person a place to go, and if worst comes to worst, they'll let the client spend the rest of the night in their waiting room and we'll pick them up in the morning in time for coffee. It's not an ideal arrangement, but it works for the most part.
Unfortunately, because of the way the hospital is divided, our shelter actually falls in the catchment zone for one of the suburban hospitals...how, I don't know, but it does. This means, that when an ambulance picks up one of our clients from the shelter or surronding area, they generally wind up almost on the edge of the city, outside of our driving boundaries, and if the buses have stopped running for the night, with no way to get back downtown. This particular hospital has somewhat of a relationship with us, simply by default, but not in the same way as the others. And so, when that cab pulled up, I just knew it was going to be a person dump.
And so, an old lady wound up on my steps, in the winter, with no jacket, no way to get anywhere, and our shelter was full. Even though I'd turned away numerous people that night, I let her in, because really, what was I to do, the cab had driven away, and she wasn't one of our regulars who I knew could be "street smart". It turned out, she had a house, but didn't have keys and so had no way to get in. The hospital had given her a cab voucher to get to us, and assumed that we'd take care of the situation for them...how nice of them.
I was pissed off. SO, I did something I rarely do, I called up the hospital, and politely, gave them a piece of my mind...I think may have scared the poor girl in the ER, not something I'm proud of. See the thing is, I can totally empathize with them. This woman is a frequent flier, and there was nothing medically wrong with her. Brought in by ambulance, she presented without her jacket and keys. The hospital would have given her cab fare home, but despite repeated calls to her land lord, she had no way to get inside, and they were unable to reach anyone else for her to stay with. They then sent her to the homeless shelter, thinking we could give her a place and help her out in the morning. She also contributed to the situation by lying and saying she was a regular of ours when in truth, she was brand new and had no idea what she was getting herself into.
I explained to the hospital that we need them to PHONE first before sending us something. That maybe together we could work out a plan. I explained that we fill up quickly at night and so unless they call first there is no gaurantee that a person is going to get in. I talked to two different people, and I think I got my point across. What I really wanted to say though was "dumping people on the doorstep of a shelter is NOT okay". I really felt for this woman even though her lifestyle is likely what caused this situation in the first place. And despite being medically cleared, she really did not look healthy.
The thing is, hospitals are not homeless shelters. They aren't set up to house clients because they have no place else to go. The emergency room is not set up, nor should it have to be, to deal with people like this woman who present over and over and over and over and over. I'm not sure what the answer is though. Obviously we need some sort of a different system. Personally, I think perhaps a lock smith might be a good assest to our emergency system. I can't tell you how many people we house when they get locked out for the night. Makes me double check my spare set of house keys everytime.