by: Amanda Brooks & Lindsay Friedrich
Imagine having to wait to receive a bus ticket, wait to be seen at a clinic for hours, while getting treated like a second class citizen, and then receiving a prescription slip you don’t have the money or ability to fill. This is a glimpse of health care in Cleveland for homeless people. Wait and wait, then receive little or no help. There are so many homeless people who have had to battle in order to receive minimal health care.
A survey was recently conducted to find out what is lacking in the health care offered to homeless people in Cleveland. Results from the survey of 87 homeless people in Cleveland show that there are many unmet needs. Despite many respondents saying there is limited choice and location in health care for the homeless people of Cleveland, 65% of those surveyed were able to get to a clinic when they were in need.
The largest responses when asked how health care could better serve the homeless people of Cleveland were: help filling prescriptions, ability to get regular check-ups, better hours, bus tokens to allow ease of travel, and to treat the homeless people with respect. These are just a few stories from those on the front line of the battle for sufficient health care for the homeless people in Cleveland.
Lisa Smith lives in Cleveland and is frequently homeless. When asked about health care in Cleveland, she had a long history of negative experiences. However, she has found Care Alliance has always helped, treating her quickly. Smith said there were always doctors available, the staff was courteous, and her prescriptions were filled there.
Ms. Smith did not have such praise for St. Vincent Charity Hospital. She said she has waited there several times for several hours. “If you have insurance, you are a queen or king there,” she said, “but if you have no insurance they tell you to get a home remedy book, or they give you some home remedy.” Smith complained once about the lack of actual care, and the nurse said, “It’s out of our hands.” Yet, she still had Smith sign the ‘white homeless form’ which allows the clinic to receive money for the homeless population they ‘serve’. Her experience at St. Vincent Charity Hospital shows the poor treatment many homeless people receive from staff at these facilities.
One homeless man, 69-year old Willis, has had different experiences with different clinics. At Care Alliance he said he received the best care they were able to offer to him. He used to go to Murtis Taylor clinic, but since they closed, he said there is a big problem with lack of health care facilities in that area. “I don’t think the health care here provides enough for all the different problems people have,” Willis said. “They throw us all together and treat us all the same. It lacks a whole lot.” Willis does have a variety of health problems to deal with, including spinal cancer, diabetes, neropathy (numbness in legs due to the diabetes), Drusen (a rare eye disease), and arthritis. “I’m in pain twenty-four hours a day,” he said. Due to his long list of health problems, Willis requires medicine in order to alleviate some of his pain and suffering. His prescriptions are difficult for him to attain. His story is like that of 19.4% of the survey respondents who said the biggest health care need in Cleveland for the homeless people is prescription coverage.
Aside from dealing with his various health problems, he had a very bad experience at one clinic, though he would not reveal which one. He was accused of having narcotics in his system when he was admitted to the facility. He was aggressively interrogated. However, two days later, the staff informed him that someone made a mistake, switching his sample with another patient with a similar last name. No one ever apologized, and they continued to question him throughout his stay at the hospital. This is another example of how homeless people are treated with a lack of respect by many of the health care facilities in Cleveland.
Leslie Stanchik, 31 and currently homeless, lives on the streets of Cleveland. She is also dealing with the lack of health care in Cleveland for homeless people. She had a child four months ago. She was able to get prenatal care from University Hospitals. This was due to the fact that she made it into their database before the hospitals non-insured patient quota was reached. “They have to take a certain number of non-insured patients,” Ms. Stanchik said. However, she realized that she was lucky to get in since other clinics are farther away with strange hours, and overworked staff. She said that the hospital staff treated her very well, and did not treat her differently because of her lack of housing. Her friends on the streets warned her about other clinics and hospitals. Ms. Stanchik has never tried to receive treatment anywhere else because of the stories of hassles others have been through.
Regardless of her University Hospital experience, Ms. Stanchik did say she still has trouble with health care. She is unable to visit an eye doctor in order to receive much needed glasses. She is also unable to get in to see a dentist, which she said was a major concern for her. This is also a major concern for 38.9% of survey respondents, who stated that dental care was their major health need which has gone unmet. Stanchik stated that she really needs both of these services, but has not found a way to receive them. “Most eye doctors and dentists want money up front if you have no insurance, and I don’t have the insurance or the money,” said Stanchik. Most services are available at the Free Clinic, she has found that short hours and lack of available bus tickets has kept her from being able to utilize this facility. “I never know when they are open,” Ms. Stanchik said, “it depends on the day if they are open, accepting patients, the hours; you always have to wait, it isn’t worth it.”
Even though their hours are often strange, and the facility is located rather far for many of the homeless people in Cleveland, 48.1% of survey respondents said the clinic they visited most often is the Free Clinic.
One formerly homeless woman, Pat Swindell, 34, said that she found health care in Cleveland to be anything but helpful. She found health services in the area for pregnant women to be practically non-existent. Swindell was told by local facilities that there was no more room in Cleveland for her to be cared for. She was transported to a shelter in Akron in order to receive care for herself and her unborn child.
Swindell has two children, and it is difficult for her to get them in for check-ups due to the limited clinic hours and staff. She said there is still great need for improvement in the health care for homeless people. “Not all homeless people are there because of drugs or alcohol,” said Swindell, regarding how homeless people are treated as patients. Swindell said that more women’s clinics and health services are desperately needed.
Another void in her opinion is a lack of treatment facilities for those suffering from drug or alcohol addiction. Swindell said that to get help at Metro Hospital for an addiction problem, one needed to go through the outpatient program to qualify for the inpatient program. Swindell claims that anyone familiar with recovery programs knows this is opposite of the needs of the addicted individual. It is also difficult for homeless people to be able to make it to outpatient treatment consistently given their lack of transportation. This is a major health care issue since, according to a survey conducted at one shelter early in 2002, many homeless people have had to struggle with some addiction problem. According to the recent health care survey, 35% of the respondents stated that their greatest need was mental, alcohol, or drug treatment.
Overall, Cleveland lacks a reliable way to provide health care consistently to homeless people. The local hospitals are able to accept a certain number, no where near fulfilling the need. The clinics are either partially staffed, hard to get to, or offer insults with treatment. This all causes homeless people to be left without reliable health care. Many interviewed considered the health care shortages as an outrage, since Cleveland is a city with world renowned health care providers.
Published in the November 2002 Homeless Grapevine Cleveland Ohio Issue 57