The Health-Care Cost of Homelessness
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The Health-Care Cost of Homelessness


[Sirens] I’ve know this guy for five and a half years, he was housed. When they fall out of housing, they become instantly vulnerable on the streets. I honestly feel that each individual in the top fourteen should be housed and will be housed. That’s my goal. I work with Hollywood’s “Top Fourteen.” It’s fourteen individuals that have been in the city of Hollywood, most of them decades, and they are high utilizers of emergency systems and hospitals. These are individuals that every social service agency in the city of Hollywood have tried to outreach and place in housing for the last ten-fifteen years. They call it service resistant. It’s three and we are on our way to Hollywood to meet up with Douglas. What up, Douglas? How are you? What we are doing early in the morning is we are focusing particularly on people that are too sick to access services on their own, but not really sick enough to be compelled to treatment, and to actually talk to them in an environment that is less overwhelming than the middle of the day. I did get your phone messages…Are you ok? Yeah I’m alright, I’m alright. I was just. Why does your face look puffed up? Is it puffed up? A little bit, yeah. Have you thought about going back to the hospital? Well I would, if I need to. I’m not opposed to it, you know. You know before when he wanted to go to the hospital, he had a really bad MERSA infection. MERSA seems to be a really common problem for a lot of people living outside right now. One of our “Top Fourteen” died in this alleyway here. That was kind of rough, you know. You work on a person for a year or two, and you slowly watch them die on the streets. Build a relationship with them and then just watching them pass away on the streets, it hurts. It really does. There’s a lot of outreach teams out here that give out sandwiches, give out clothing. I’m trying to get you off the streets. I’ll let somebody else give ’em a sandwich. It’s this guy. This guy here. Terrance! What’s up? You can’t be out here forever, Terrance. That’s for sure. We know that. And I know you don’t like it out here. That is deep. But what you can get – You don’t have to die. It’s been five years. Are you crying? Don’t cry. Don’t cry. Don’t you cry. Ready? I,2,3. Yeah, we need a paramedic. He was housed. He was housed with his case manager in the housing, he lost his housing. If we was any other agency, he would have went back on the streets and probably died on the streets. You guys know which hospital he is going to? Are you family or? His caseworker. People think it’s just homelessness, but it’s are a lot of people out here who are really sick. And it’s hard enough to try and navigate the county system, they don’t pick the medication. Medical appointments is almost impossible to make if they don’t have a case manager taking them to their appointments. So it’s a mess. We have seen patients come in who are here in our E.R. every other day who are hospitalized for weeks and months, and countless times, and half are explicitly homeless, and maybe half of the remaining we suspect are homeless, but they’re not really talking to us about their housing situation. They have a range of social issues like homelessness or substance use and then they have this piece where their social fabric has just fallen apart for them. So their family members are no longer in contact with them. Maybe their neighbors are no longer there and so they don’t really have anybody to turn to to help them out. What ends up happening when we get somebody successfully connected to somebody like Anthony is we can then call Anthony when they are
in the E.R. and we can problem solve together. Having somebody be like ‘I am in charge of
helping this patient, no matter what, no matter where, call me’ is the best thing that has ever happened. Once you get to the Top Fourteen list, you never come off that list. I’m almost like a family member. Still I have Eddy Carter that needs to go
to the doctor. Eddy is 65. He knows he is on the Top Fourteen. He knows he’s been homeless, probably the longest person in Hollywood. He refused housing, came back to the streets,
double amputee. That’s top fourteen. This is his. This is where he plugs into his wheelchair
at, at night. We told police here that he needed to go to
the hospital, so we set it up for him to go to the hospital. He knew he was supposed to meet us right here this morning to see if he still wanted to go to pick him up. He’s not here, so he’s hiding from us right
now, so I gotta go try to find him. Should we go to Starbucks? Sure. He’s like a ghost. But you can’t miss him. You can’t miss him. How you doing, Snake? Hahah. You’re not going? No that ain’t against the law, Eddy. I got you the chair. No, I’ll feel good when I place you in housing. Me too. Either way it goes, he’s getting housed. Either way it goes, he doesn’t know that though. But either way its goes, I’m housing him. I honestly feel that each individual on the Top Fourteen should be housed and will be housed. It may take six months, it may take sixteen months. It may take two years. But each individual on the Top Fourteen will be housed. That’s my goal. Los Angels is the highest per capita homeless city in the United States. I do believe that ultimately it’s less expensive for our society to house the homeless. And so I think that continuing to grow our inventory of permanent supportive housing will help us certainly in the hospitals to have fewer expenses, both of real illness that occurs when people are exposed to the elements, people who are assaulted because they can’t protect themselves, as well as people who seek out the hospital as a way to get to shelter. You don’t begin with someone who is chronically homeless by, you know, saying here is your apartment, right, because you have to engage people. What’s great about Anthony and case managers like him is that they meet people where they are. They begin the engagement process. They make people recognize that there is another choice. That there is a possibility of housing, so when you combine that kind of active empathetic case management with real housing and a real exit from homelessness, you see amazing success. I’ve never seen a homeless person that I’ve
worked with just happily jump up, jump in a car say ‘let’s go get housing.’ It doesn’t happen that way. I met Willie Davis, he was in jail. I went court. I talked to his probation officer at court. I talked to the judge at court and they released him to my custody in the hopes of housing him. They probably didn’t do what I did with Willie Davis, Willie Davis most likely would have died on the streets. I’m hopeful for Willie because he has
his medication. At his house, he called me this morning. He spent the night in his apartment. Now I just need him to get on his medication and see his doctor and slow down on that meth. So how’s it been for you here my man? You got a thirty day supply of medication. So we have to go back to the Saban Clinic and get you a follow-up appointment. We gotta start doing that. Yeah, I need you to take it every day. Alright, see you later buddy. Take care. Love you baby. Alright. Have a good day. Have a good weekend. I wish it was a team where we could do this for like 40 people, 50 people and hopefully that this pilot program that we are doing, that it goes county-wide and they will be doing this in each spot in the county and help a lot of people that need the help. I gravitate to the people that are underserved more because my father left when I was six months old and I always wondered what happened to him. Hi. This, this is my son. I’m glad to see you man, I’ve been worried
about you so much. Huh? I’ve been worried about you so long. Especially since my wife died. I know. I know, I know, I know. I love you man. Be safe, promise? I got back-up boy, I got back-up. I got an army behind me. Be safe Anthony. Alright. I know there’s families out there that haven’t
seen their loved ones. Somebody needs to love them and take care of them until they find their way back to their families.

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14 thoughts on “The Health-Care Cost of Homelessness

  1. GOD BLESS You Anthony !!!   Thank You for your very worthy and difficult work  –  This is our calling from God   –  Mark Meeker

  2. Anthony Ruffin inspired me even more to have a career working with the homeless population. Anthony, God bless you brother.

  3. This is depressing.. it's that hard to find housing for these 14 severe cases? Why is it so hard? Is it literally a money issue? Do people who have the means to help really not care at all? What the hell?

  4. We need to be like Jesus. Jesus did not say: get out of here, you dont have enough money. Why then do we? Satan wants us to be miserable. That being invented money through people to make people to be miserable. The world needs to change all at one time to not interrupt the flow of God's good gifts that he gave to us without a price.

  5. when ppl give up they don't want help. they become antisocial. getting help would mean they want to function normally again. its easy to get housing, not easy to maintain a roof over your head. they don't want to work and have responsibilities and have a family. they want to die peacefully. i work in a nursing home and some ppl are on the DNR (do not resesitate) list by choice. they have requested that if they stop breathing, do not perform cpr. my needs and wants may not be someone else. just saying.

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