Each year on the same night as @NYCDHS’s Homeless Outreach Population Estimate (HOPE) of people experiencing homelessness on streets and subways, we lead the Hospital Homeless Count to identify those not counted by the City: people experiencing homelessness in NYC hospitals. 1/

Following the release of @NYCDHS's 2020 HOPE results, last week we published our 2020 Hospital Homeless Count report, identifying 226 people experiencing unsheltered homelessness in 30 NYC hospital emergency rooms and waiting areas. 2/ https://healthandhousingconsortium.org/wp-content/uploads/2020/08/2020-Hospital-Homeless-Count-Report-Final.pdf

Of the 226 people experiencing homelessness the Consortium identified this year, 74% were counted in @NYCHealthSystem hospitals, which only accounted for 11 of the 30 participating hospitals. 3/

Nearly half were located in Bronx hospitals, followed by Manhattan, Brooklyn, and Queens. The high total for the Bronx is almost entirely due to the unprecedented 69 people found at Lincoln Hospital, which accounted for 31% of the citywide total. 4/

We attempted to get some additional information on those surveyed, though 62% of people identified were sleeping (the count was conducted from 12:30–2:30am), so our samples sizes are smaller for the following data.

60 individuals responded to a question on what brought them into the hospital that evening: 6/

69% reported not having a regular doctor outside the ED and 76% reported 10 or more visits to the ED in the past year, including 22% who reported visiting the hospital every day. 7/

We also wanted to know if these folks had ever had contact with a street outreach team to understand their connection to homeless services. Of those who responded (n=74), 41% indicated that they had contact with at least one of the outreach teams, 32% said they had not. 8/

34% of respondents said that safety concerns were a reason they were not currently staying in a shelter, with some mentioning previous assaults and belongings being stolen. 9/

The Consortium has led the Hospital Homeless Count alongside @NYCDHS's HOPE since 2014, hoping to shed light on what we consider the "hidden homeless" population missed by the City's estimate, which leads to under-resourcing of vital services and housing. 10/

Based on the information we have gathered over the past 7 years, and in light of the current COVID-19 pandemic, we have the following recommendations: 11/

#1: We must commit to ending homelessness in NYC. COVID-19 has underscored that housing is health and that homelessness poses unacceptable challenges to maintaining health. We should not acquiesce to living in a city where tens of thousands are in shelters or unsheltered. 12/

#2: Address the systemic racism that places Black and Latinx individuals at a greater risk for homelessness, with intentional policies to end racial disparities in both health care and housing. 13/

#3: Allocate funding and resources for homeless services and permanent housing based on the number of people within emergency departments in addition to those on the street/subway. 14/

#4: Provide homeless outreach teams with the staff and resources needed to engage homeless patients inside hospitals. @BronxWorks has been paving the way, with a Hospitals Coordinator and embedding housing coordinators in hospital EDs. This should be replicated citywide. 15/

#5: Expand medical respite services for people in hospital EDs and inpatient beds who cannot be discharged because they have no home and are too sick to go to traditional shelters or the street. 16/

People experiencing homelessness are resilient, resourceful, and seek out the best options available to them, as we all do. Many believe their best option is a hospital ED over the shelter system. It is our responsibility to provide a better, safer option: permanent housing. 17/

While this count was conducted before the coronavirus pandemic hit NYC, this crisis has shown that homelessness is not only a moral injustice but a public health emergency. Hospitals can and should be important partners in the effort to end homelessness. 18/

The Consortium’s Hospital Homeless Count provides a baseline of data to work from, but a large-scale commitment from the City and State is needed to end, rather than just continue to manage, homelessness. To learn more and get involved, visit: https://healthandhousingconsortium.org/hospital-homeless-count/ end/