"On behalf of Boston Health Care for the Homeless Program, I wanted to thank you for the kind notes of support and encouragement you sent us. They arrived today, and I have spent most of the day posting them on computers for our staff to read. Tomorrow I’ll put up the patient notes on the floors.
For HIPPA reasons, I am a little reluctant to send photos out of fear they may contain patient information, which would get me in a LOT of trouble. But I have attached a photo of one of the messages I posted at the entrance to our temporary COVID ward. I also thought I would tell you a little about us.
We’ve been around since 1985, giving homeless folks in the greater Boston area access to the highest quality healthcare. The important thing to note is that we don’t give access to the highest quality care “possible” or the highest quality care “that is practical”. It’s the highest quality care. Full stop. In a city like Boston, that means very high quality care!
The two things we are probably best known for are street medicine and respite medicine. Street medicine is exactly what the name says; Doctors and nurses and case managers and recovery coaches who hit the road, day after day, caring for the sick. Respite care requires a bit more explanation. Imagine you were so sick you needed to be admitted to a local hospital. Once you’d recovered enough, you’d be discharged and finish your recovery at home.
But by definition, homeless people don’t have homes to recover in. And if you have a broken leg, or TB, or cancer, or COVID, you do not want to be living in a shelter or under a bridge. So once you are discharged from the hospital, you come to a place like us and finish up your recover. And while we have you, we try to help you find a place to live, get benefits straightened out, etc.
Our patient population is complex, to say the least! 80% of our patients have a diagnosed mental health disorder. 60% of our patients have a diagnosed substance use disorder (overdose has been the #1 killer of homeless people in Boston for over a decade). Significant portions of our patients have diagnoses like hypertension, diabetes, HIV/HEP C, asthma, etc. More often than not, the patients have multiple diagnoses, so it’s a mental health disorder, PLUS HIV, PLUS diabetes. Our patients also tend to have significant trauma histories, PTSD, incarceration histories, sexual abuse, etc.
That’s why our clinical team was so worried as COVID started to hit. Our patients have significant health challenges and the fear was that a virus would run roughshod through such a population. Weeks before we saw our first case, the leadership was making their plans and marshalling the resources and just getting ready. So when we saw those first cases, we opened a field hospital to hold people while they waited their results. Then we opened a 1000 bed facility with Mass General Hospital (500 beds for us, 500 beds for them) to quarantine people who tested positive and see if them became sick. And finally, wee converted the entire third floor of our facility to treat people who became sick.
And it wasn’t just our doctors and nurses, though they were awesome! Our housekeeping staff was working all the time to keep the facilities disinfected. Our case managers were supporting patients and assisting with testing. Our food service teams were constantly working to make food to support patients and staff alike. And we had a team of 13 or so recent college grads, not that much older than you, who went above and beyond to move mountains. I know of many, many times when these folks would put in a full day of work, then put in a 12 hour shift at one of our care tents, then come back and put in another full day of work. I truly believe that one of the reasons Massachusetts has made it through this pandemic as well as it has is because we leadership that took things seriously from the beginning, and staff that worked their tails off to make the plan a reality.
One last thing, I have attached a link to a recent story about the work we did at that 1000 bed facility, also known as Boston Hope. The WBUR article does a good job of describing the kind of people your notes went to. I want you to know they appreciate the support from the bottom of their hearts!"
Boston Healthcare for the Homeless