Attack the Messenger and Forget the Care


By Brian Davis

             I have seen the Promised Land for healthcare delivered to homeless people and it is in Dayton.  I recently toured the Health Care for the Homeless Clinic of Montgomery County, administered by Good Samaritan Hospital of Dayton the The Other Place, a local non-profit day shelter.  It is an amazingly clean and healthy environment just outside of Downtown Dayton with doctors available, check ups, pediatric care, long-term care, and the most amazing feature- a dentist for homeless people.  There is not one place in all of Cleveland that a homeless person can go to get dental care, no matter how far they are willing to travel.  If a homeless individual needs dental care, they have the choice of getting it pulled or lettering the tooth die at which time it will fall out.

            The facility in Dayton has an outreach component to go into the community to find people in need of help.  The Other Place health clinic has a mental health case manager and drug treatment programs.  There is space for Alcoholics Anonymous meetings, and a kind and enthusiastic staff willing to help.  As I was visiting, a man entered the waiting area asking for help with a dental problem.  The staff told him “no problem, have a seat and the dentist will be with you in a minute.”  The same situation repeated in Cleveland would look a lot different.  After the staff calms their laughter when a homeless man enters one of the health clinics in Cleveland looking for dental care, local staff would sent Dr. Orin Scrivello from Little Shop of Horrors to remove the homeless man’s teeth.

            The Other Place Health Care Clinic is a model for Ohio and possibly the county.  It is a wonderful example of how agencies can collaborate to provide the best services for homeless people in the face of huge obstacles created by the health care industry in the United States.  In Cleveland, we have a poorly administered organization that has chosen a much different path away from serving homeless people.  The need for service in Cleveland is at least three times of that of Dayton.  It is almost worth busing homeless people down to Dayton just so that they can find decent health care coverage.

            The Grapevine has criticized the local health care for the health care needs of the community.  Examples include the ending of night time outreach services during the first month of winter, hanging signs in the clinics stating that homeless people will be responsible to pay for the services, expanding to serve people in public housing, and the recent closing out of spite of the two buildings in June of this year.

            Let it never be said that our criticism was aimed at the staff of Care Alliance.  For al the bad decisions made by the leadership of Care Alliance, they have hired some of the most qualified, professional individuals in Cleveland.  They have employed many of the most committed and compassionate staff.  From outreach staff who have gone above and beyond the call of duty and volunteer a great deal of their time to the nurses who put aside great personal adversity to assist homeless people.  Unfortunately, the leadership of Care Alliance had had no idea how to manage these individuals to best serve the population.  There was some program staff that needed more oversight and made bad decisions.  These was a rare caseworker or site supervisors who were incompetent and disrespectful, but by in large our complaints have focused on the decisions made by the agency.

            We have never heard answers to our complaints.  We have yet to heard from the leadership at Care Alliance to defend their program decisions.  It is much easier to attack the messenger than debate the issues.  They have followed the path of ad hominum attacks or taking pot shots at the newspaper or the agency that published the Grapevine.

While Care Alliance lobs attacks at the Grapevine, dentists are provided the bridgework in Dayton.  While homeless epileptics wander around the city looking for medicine, Care Alliance looks to get on the AIDS gravy train.  While homeless people are discharged from the hospital suicidal and needing constant care in Cleveland, Care Alliance battles government agencies over penalties and fines.

            After the experience of the last four months with Care Alliance forcing homeless people into the streets while the two buildings they own sit vacant or underused, I have no confidence that Care Alliance can convince funding organizations to trust them.  The State of Ohio found the organization did not live up their grant agreement and asked them to return $38,000 that was provided for building renovation.  If the other government entities that provided renovation funds follow the State of Ohio lead, Care Alliance could be responsible for returning nearly a half million dollars.

            It is time for the Care Alliance Board of Trustees to step forward and clean house or fold up the tents.  Once the organization loses the confidence of those who provide the funding the only choice is demonstrate to the community that the organization has changed its wayward behavior by bringing in new management and new management and new board leadership.  Currently, the Department of Housing and Urban Development, the Department of Health and Human Services, Cuyahoga County, and United way are all re-examining their financial ties to the organization.  What is it going to take before the Board of Trustee reacts?

            For community leaders, they need to convene a group to develop a strategy to create a clinic for homeless people like the one in Dayton.  The County, City and the medical community need to make this a priority.  It is great to be thinking of constructing a biotechnology center with University Hospital and the Cleveland Clinic, but that is not going to provide dental care to homeless people.  We have neglected the poor for too long in this community.  It is time to provide the same level of care to the poorest citizens as we provide to our Mayor and our County Commissioners.  Anything less is a violation of the Hippocratic Oath by the doctors, and a human rights violation by the richest nation on earth.

 Copyright NEOCH and the Homeless Grapevine, Issue #49 August-September -2001