Oakland Hotel Provides Medical for Unhoused Residents to Relieve Pressure on Hospitals

Published Jun 13, 2024, 4:17 PM

Across the country, EMERGENCY departments have seen their Homeless patient population DOUBLE over the last decade. 

In CALIFORNIA, about half of those patients go to the *E-R* multiple times each year. They often don’t need URGENT care, but they don’t have easy access to a *better option. 

KQED health correspondent Lesley McClurg talked with E-R docs in a few cities... and found a potential SOLUTION on tap in OAKLAND.

Across the country. Emergency departments have seen their homeless patient population double over the last decade. In California. About half of those patients go to the, er, multiple times each year. They often don't need urgent care but they don't have easy access to a better option. KQED Health Correspondent, Lesley mcclurg, talked with, er, docs in a few cities and found a potential solution on tap in Oakland.

Every room is full inside Scripps Mercy Hospital, several patients lay on gurneys waiting in the hallway of the, er,

many of them live on the streets or in shelters in San Diego. Hello, MS Katz. My name's Dr Norton. I'm going to be taking care of you today. Dr Valerie Norton, an e physician pulls up a stool next to Tamika Katz, a woman in her thirties, she's wearing gold colored hoop earrings and there are words tattooed and cursive on her arms. And where were you staying? The past three days? I was homeless earlier that morning, cuts

connected to a shelter. How long do you think you can stay at the shelter? I'm not sure. Ok. And what's your plan going forward? I have no, I have no place to go. Cuts says she's visited the, er, for various mental and physical health issues weekly for the past few years. She wrestles with addiction to alcohol and methamphetamines. She's what, er, docs call a frequent flyer. So in a given shift,

I'm dealing with multiple patients that are asking me for help with drug or alcohol detox or asking me for help with shelter or asking me for help with mental illness and we just have very limited resources to access for them. And Norton says the er, is not the right environment for people with mental illness. It's bright, loud, frantic. Some people who are experiencing homelessness use the er, for their primary care.

Sometimes they can't find a physician who is accepting new patients, they've allowed their insurance to expire, they don't have transportation to a clinic. There seems to be almost an insatiable appetite for emergency care and that's because it's super convenient. Right. We're always there, we're always open. It's like fast food.

This is true in many cities including San Francisco every year, about a quarter of the patients who seek care at the city's public hospital are patients who are unhoused. Dr Renee Shaw is an, er, doctor at SF General. If the only place that you can go is to an emergency department, then that's where they will seek care, whether that's for a medication refill or whether that's for your heart attack. But when the er, is packed, it lowers overall patient care, there are

limited resources in terms of the number of CT scanners or the number of X ray machines, we are finite human beings. And so the more crowded we are the less able we are to spread ourselves across that number of patients. People experiencing homelessness have long used the er but she says the 2019 California law has led to even more traffic. The policy requires hospitals to provide homeless people a meal, clothing and medical referrals. We are really out of crisis in a breaking point.

One way to solve this issue is to ensure people on the street receive ongoing medical care before they land in the er, that's one of the goals of Oak Days, a former hotel near the Oakland Coliseum that's been converted into permanent supportive housing.

60 residents live in simple rooms. Alameda County bought the hotel in the aftermath of the pandemic and now they lease it for a dollar a year. Hey, Brandon, I'm here to take your blood pressure. When patients arrive, they get a medical work up to find out what kind of care they need.

Residents can get help with everything from going to the toilet to daily insulin injections. Katherine Hayes is a co founder of Oak Days. We've really successfully housed many of those folks who had cycled previously like out of the hospital to the street, to a nursing home, maybe, you know, to jail back to a hospital back to the street back to a nursing home, combining housing with health care is not a new idea.

But what's unique is that Oak Days takes advantage of a benefit already covered by the state's public health insurance. If someone has complex medical issues, like daily dialysis, they qualify to have a nurse come to their house. But if you don't have a permanent home, it's impossible to access those benefits. Plus the state program is hard to enroll in. You really have to almost like speak a different language to be able to navigate all of the paperwork and bureaucracy that it involves. So Oak Day

provides housing and helps residents apply. And what we saw was an 80% reduction across the board in emergency room visits in inpatient hospital stays and in skilled nursing facility placements, which is an enormous cost savings. She says by her calculations, the facility has saved the state more than a half a million dollars in its first six months because it's a lot more expensive to cycle in and out of the hospital compared to providing ongoing home care.

Ok. I'll let the caregivers know. Ok. However, Oak Days faces a critical obstacle to scaling its model. The facility is full and there's a long waiting list for the state program that provides its funding.

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Vera Solito says she's thrilled she got in, she wheels herself to the door. She's paralyzed from the waist down in 2015, she slipped on a slick floor and injured her spinal cord. It was a really rough talk. She says a series of bad luck including a nasty divorce eventually landed her on the streets in the Tenderloin neighborhood in San Francisco.

Solito tried to stay in shelters, but she said she was often turned away as a falling risk as they were willing me out the door telling me they just, they're not a hospital. And I'm like, but the hospital tells me they're not a shelter. So, what the heck am I supposed to do? She slept upright during the day in her pushchair inside churches and tried to stay awake at night. There's no point in getting tent because if I get on the ground, that's a crisis, I can't get back up in a chair

after a year of sitting still all day and all night clio developed bed sores. Basically the pressure damaged her skin and tissue and then I got sepsis and it on my bottom side. So I got pretty sick. I ended up in the hospital and I stayed there for almost a month. The hospital connected her to Oak Days where she's been for the last year

and now she sees a doctor regularly and she sleeps in her own bed at night. It's like Disneyland. I mean, it's just, it's a huge difference. Just feeling safe when you close your eyes is a big, big deal. I never felt safe on the streets. Her eyes brim with tears. She picks up a ball of brightly colored yarn and starts crocheting a hat for another resident. She hopes she can stay at Oak Day's long term. I'm Leslie mcl, KQED News.

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