Posts by Steven Samra
Tent Cities: The Huntsville Solution
Published November 18, 2009 @ 07:55AM PT
While volunteering for the 3rd annual Huntsville Alabama Operation Stand Down, I did some street outreach to spread the word to veterans about the three day event. In the course of that outreach, I visited one of Huntsville's Tent Cities and was surprised to learn that the camp was run by a local agency, thanks to an agreement they had worked out with local police, who had also worked out an agreement with the Alabama Department of Transportation (ADOT).
The camp sits under viaduct on the north end of the city and in order to stay individuals must first register with a nearby homeless services provider. The agency requires ID and provides the funds in necessary to procure one. A tent, if one is available, is provided to the individual and that person is then directed to the camp. A police officer is assigned to patrol the camp and does so on a regular basis, checking with the residents to make sure the area remains relatively trouble free. Every Tuesday, additional local service providers pass through the camp, offering resources and referrals while also monitoring the conditions of the camp and the residents within.
Disabled and Soaring Out of Homelessness
Published November 10, 2009 @ 06:57AM PT
The population of homeless individuals in this country is chock full of people who are suffering from a serious health and/or mental health condition; HUD's 2008 Annual Homeless Assessment Report states that 43 percent of homeless adults suffer from some disability and more than two-fifths of sheltered homeless people have a disability.
While our society has attempted to assist folks suffering with disabilities via the Social Security Administration, the process of obtaining federal disability benefits (SSDI/SSI) is tedious, complex and often far beyond the scope of the typical layperson's ability to navigate and ensure proper and successful completion of the application procedure ("successful" meaning approval of benefits).
Nashville's Street Paper Thriving in Down Economy
Published August 19, 2009 @ 07:06AM PT
Two years ago, a small group of local Nashville residents came together to discuss new ways they could help people experiencing homelessness. Something more meaningful than distributing food or providing a bus pass or a referral to a local provider. Something that could empower homeless people while helping the Nashville community better understand the issue.
Nashville's first street paper, The Contributor, was borne from that meeting. For the past year and a half, while other small weekly papers have been closing their doors, this paper has been thriving while serving a mission greater than simply reporting the news.
The Contributor delivers diverse perspectives on homelessness while employing dozens of homeless individuals in the process has now been thriving here in Nashville for the past year and a half. Circulation is now around 4,000 monthly and increasing at a time when other newspapers are closing their doors and moving on. So many prospective vendors arrive at the weekly trainings it's hard to get them all set up for business in the time we originally allotted for this task.
The Contributor's premise is simple; the all volunteer staff donates their time to organize, assemble and distribute the newspapers to people experiencing homelessness. While this staff consists primarily of individuals who have never spent a homeless night, many work in some way with disadvantaged populations and they've done an admirable job of both relating to the folks on the street and providing critical moral, financial and physical support for the newspaper. While advertising would help defray at least some of the costs to publish the paper, The Contributor staff has not exploited this potential opportunity at this point, although there are plans in the future to increase ad sales.
Articles, photos, poetry, songs, puzzles and cartoons can be submitted by anyone, although if the writer has never experienced homelessness, the piece must be related in some way to homelessness. Those writers who've "rough slept" at some point during their lives or are currently on the street can write about anything, since one of the goals is to provide readers with diverse perspectives.
To sell the newspaper, an individual must be either homeless or formerly homeless and undergo a 30 minute training that lays down the do's and don'ts of behavior as a Contributor vendor. The new vendor is then issued an ID card and supplied with 15 free newspapers, which he/she can then sell for one dollar wherever they please, whenever they please. When a vendor needs additional papers, they can purchase them from the office for 25 cents apiece. The vendor can also earn free papers by referring a new vendor or by writing/contributing something that gets published in the paper.
If a vendor purchases a consecutive total of ten dollars worth of papers, they receive a black carry-bag emblazoned with The Contributor logo. This provides additional visibility and credibility for the vendor and the ten dollar goal ensures that expensive supplies aren't given to those who aren't serious about selling the paper. As a vendor's total newspaper purchases increases, he/she becomes eligible for additional items, including a newspaper vest, hat and shirt. Importantly, when a vendor sells 300 papers per month consistently (over three or four months), they are allowed to choose a "home territory." This allows the vendor to capitalize on the relationships and return customers they have cultivated as they work a particular area.
This is a critical component of the overall aspect of the newspaper, since another goal is to provide the general public with face to face interaction with people experiencing homelessness. By engaging with those on the street, stereotypes diminish, constructive relationships are formed and public perception shifts towards a more positive understanding of people they know to be homeless.
Vendors are not employees of the newspaper. Rather, they are their own bosses running their own business. The Contributor simply supplies them the necessary materials needed to keep the business running. Anyone experiencing homelessness can sell the paper, and they can do so on their terms, at times convenient to them, anywhere they find themselves at any given moment in time. There is no dress code, although when vending individuals must display their Contributor badges, refrain from any other type of selling, respect the right of "first come first serve" and/or "home territories" with other vendors, and vend only when sober.
Violations of these simple rules can result in disciplinary actions, including suspension of newspaper sales and a termination of the sales relationship if the violations are severe or repeated.
Content and articles run the gamut, from stories written by local outreach workers to diatribes and screeds from those who have had difficulties with homeless individuals in the past. Photos, weekly columns and puzzles provide readers with a diverse perspective on homelessness, allow a genuine and immediate sense of gratification as they purchase the paper, and contribute to someone actually working to improve their lot in life rather than simply panhandling for money.
Local businesses, once wary and reluctant to allow Contributor vendors near their store fronts, soon realized that when vendors are present, panhandlers move on. As vendors made connections in the area, this brought return customers to businesses and now, most businesses are so pleased to have vendors near their store fronts they often provide coffee and snacks to those vendors they have established a relationship with.
Most importantly, for vendors there is a return of self respect, of accomplishment, of belonging once again to their community. Several vendors have been able to parlay their sales into housing and many use it to supplement their meager social security disability checks.
One of the homeless vendors who wrote about his transition from a Tent City to housing recently won a "Best Vendor Essay" award from the North American Street Newspaper Association and Tasha French, Executive Director for The Contributor, was just elected to serve on their board.
Starting a street newspaper from scratch may seem like an overwhelming task, but when compared to what individuals on the street must endure on a daily basis simply to obtain a little food and a safe place to lay their heads each night, it's barely worth mentioning. The rewards are great, the cost is minimal, and if you are interested a number of resources are available to assist you in getting the effort from the drawing board to the street. It's a great way to help and anyone can contribute.
Beyond the "Street Persona"
Published April 29, 2009 @ 05:09AM PT
I met "Ox" under a local freeway overpass. We were at a food service for the homeless held every Tuesday here in Nashville. He was a "big ol boy" as my Southern friends would say, and what attracted my attention immediately, besides his ox-like size and a scraggly mustache, was the fact that he was continually moving backward in the serving line as he repeatedly switched spots with women he felt were worse off than he and who were in line behind him. That evening he was wearing an obviously too-small shirt with "Who farted?" written across the front in huge- and I mean HUGE- red letters. He was embarrassed as hell about that shirt, but it was the only thing in the church donation box he could find that fit him.
I instantly liked him. That night we sat smoking and talking while listening to the gospel music that accompanies this particular meal, courtesy of the event's organizer and her well-known group of musicians and singers. By the end of the night, his gregarious personality had left such a mark on me I left the event considering him a close acquaintance, perhaps even a genuine friend.
Over the next few months, Ox and I spent a lot of time together. He did become a friend... and a damned good one at that. My wife felt the same way after spending just one day with him as he helped us move. He was just the most likable guy I think I've ever met. At that time, he was staying in one of those cheap, tiny two-man dome tents hidden in a small grove of trees and I swear, the first time I saw him enter it I thought we'd need to grease the sides with butter just to get him inside!
But in he went, and his big body immediately sucked up the space of that tent in a way I don't think I can describe here. I remember thinking he barely had enough room to get in, let alone live, dress, cook, read, sleep or exist with any level of tent-comfort at all. Frankly, he could have probably worn that tent as a moomoo and passed it off as some new avant garde fashion design, had he hung around the right crowd.
On one particular morning, I caught him snoozing and woke him up with a pouch of Bugler and a Ziploc bag of instant coffee. As I watched the sides and top of that little tent bulge, swell and bow while he dressed, I asked him if he was interested in some housing instead of another morning spent wrestling with himself in a pocket. He stuck his head out through the zipper, making me more certain than ever that the tent would have looked just fine on him, and explained to me why he wasn't in housing in the first place.
Ox had a hard time holding a job. In fact, Ox had a hard time holding just about anything besides a cigarette, coca cola and triple whopper with cheese. It wasn't because he was lazy; rather, he was what most folks would consider "slow." Ox was developmentally challenged and struggled most of his life to do the things you and I take for granted. He used to say that when he went to school, he "rode the short bus."
He also suffered from bad eyesight, chronic seizures and a host of other health issues. As a result, Ox had a difficult time maintaining long-term employment and completing most things that required sustained effort, including school (he'd been to college twice; a testament to his determination and he was proud to put this accomplishment in face of detractors who said he'd never even be able to finish high school). That he didn't graduate always bothered him and he told me often that if I was able to help him return to housing, he'd one day finish his college degree.
As we worked together over the summer to try and find housing, I had the opportunity to speak several times with his parents and they were able to tell me more about Ox than I've probably ever known about anyone else I've worked with previously on the street.
Hey Mister, Can Ya Spare a Bus Pass?
Published April 21, 2009 @ 06:33PM PT
What do tobacco and bus passes have in common?
On the street, I am almost always asked for one of these two things (but more often both). To many, these items may seem insignificant.
Although tobacco may not the most appropriate item to give away, it opens doors for "engagement" with folks on the street than any other approach I've ever tried. My pragmatism here outweighs the health concerns I have about tobacco. If I do not get an opportunity to build a relationship with someone on the street, tobacco addiction falls to the bottom rung on their ladder of potential risks to their health.
Opening the lines of communication is important. But if you ask me, the bus pass is the more important resource I'm providing. It means a whole lot more than simply a pass to ride the bus.
Consider "Johnny's" situation. He approached me several weeks ago and the right side of his face was grotesquely swollen and discolored. Johnny complained of a vicious toothache and it was obvious that he was suffering from a wicked abscess (a fairly common condition for folks on the street). Most of the folks on the street don't seek out a dentist until the pain is so bad they can't avoid it. But even then, locating a doctor, making an appointment, and showing up for treatment is a huge pain in the arse when you're living on the streets or in shelter. And, as I've mentioned previously, if you happen to be homeless here in the Buckle of the Bible Belt, you can almost certainly forget about pain prescriptions.
But, as I pointed out vigorously to Johnny, abscesses are nothing to screw around with. They can be extremely dangerous and even fatal if left untreated. Of course, Johnny was not only scared to go to the dentist (like at least half of the population), he was also in so much pain he was unable to walk the distance it would take to get to one anyway. Although I was on foot myself this particular day, I did have a pocket full of passes. I gave him two all-day tickets and ordered him to head to the local emergency room and ask for some antibiotics before he keeled over in front of us. Just about any qualified dentist was going to make sure the infection was under control before they worked on or pulled the tooth anyway, and any self-respecting ER doc would know that instantly. My statement was closer to the truth than either of us imagined; the doctor at the ER told Johnny that if he would have waited just a few hours more, he almost certainly would have wound up in their ICU unit, if he wasn't dead instead.
They gave him an IM shot of some big-gun antibiotic, a small handful of samples and a script that equaled out a 10-day regimen of antibiotic treatment. Johnny sold the second bus pass I gave him for $4, saving someone almost a dollar on an all-day pass in the process, and was then able to panhandle the remaining $4 for the $8 bottle of medicine. Johnny continues to thank me today for demanding he go to the ER, but the truth is, the bus pass was the instrument that got him there, and frankly, it may have also saved his life.
One of the reasons the passes are so valuable is that in Nashville, the services designated for the homeless are scattered all over the city and and getting them often requires long walks. This makes accessing more than one per day difficult in its own right. It gets worse when the person must access a service on the west side of town while the lunchtime meal service is on the east side of town. It becomes even more problematic if the sleeping spot is in yet another part of town. If the individual is hoping to stay at the Mission or the local Salvation Army Men's Lodge for the evening, they will need to make certain they are able to be at the door by 4pm. This pretty much rules out afternoon appointments anywhere besides the south side of town, since there is little hope that you will be able to traverse the distance quickly enough after the appointment to make it to the agency in time to get a bed. And by the way, if it's the Mission they're hoping for, they will probably need to get there considerably earlier than 4pm, since folks start lining up shortly after lunch on many days.
Another reason they're so valuable is that, well, they're valuable. It costs $4.80 for a regular all day pass. That may not seem like much to many of us, but it may just provide someone with some food who has walked to an appointment with a prospective employer and missed the lunch meal in the process. If they're also unlucky enough after their interview to be so far away from the mission or the SA they can't get back in time for a bed slot, that lowly bus pass may turn out to provide them with a cash resource for the only food they've had the entire day, since you've got to be "in" the mission or SA in order to access the evening meal.
I've seen bus passes traded for coats, backpacks, sandwiches, tobacco, booze, and shoes. I've watched people let others hold bus passes as collateral while they use the holder's pushcart to haul cans to the local recycler. I've even seen bus passes used as currency to pay back folks when the individual had no hard cash but did have a couple of passes.
Passes have always been fairly expensive here, but prices increased - and routes were eliminated - this summer, making the transportation situation even more difficult for the poor and the homeless. Unfortunately, because of the scattered services, lack of transportation, coupled with a dearth of outreach, makes providing services to the homeless more difficult than it has to be.
However, it wouldn't be hard to fix this problem. The Metropolitan Transit Authority (MTA) currently has discount plans available for seniors and the disabled. Why not provide similar discounts on a sliding scale, based on income? Better yet, MTA could provide an ID (these are already issued for those who are able to use the discounted passes) that allowed a set number of free rides during normal business hours, thereby ensuring that individuals could make critical appointments to agencies, doctors and employment interviews. There are ways to overcome the obstacles facing those who are trying to help themselves. We need to do all we can to ensure individuals get the hand up they so desperately need and providing transportation to important services seems like a relatively easy way to both get, and keep, their ball own rolling.
Tangled in the Safety Net
Published April 03, 2009 @ 10:18AM PT
"Norton" has been staying with the author since being discharged from a hospital in January. It was the only way he could continue receiving the 22 pills he takes each day that keep him alive. The following is the complicated, frustrating story of a man stuck in the social safety net. It's just one example of the battles homeless people face each day trying to survive. Photo by Steven Samra.
Last November I ran into a client I hadn't seen for several months. Nothing unusual about that, since many folks in the homeless community sometimes up and disappear for a period of time, then pop back up later as if they'd been there all along.
I found "Norton" living in the front section of Nashville's largest Tent City during one of my regular visits to the camp. This particular area of this camp was at the time known for hard partying and occasionally rough behavior; the camp's controversial order to close on June 1, 2009 arose as a result of a stabbing that occurred in this area over Labor Day Weekend, 2008. Things have calmed considerably since last summer, but the reputation continues to impact the camp negatively.
I had gone into Tent City early on this morning to visit and bring supplies to some of the residents. As I began my walk into the camp, I stopped in at of the more notorious sites in the camp. A ratty couch, several chairs, an old hospital toilet seat chair and a rickety table surrounded a fire pit, and several people, including Norton, were milling about, in various stages of intoxication. Norton himself was three sheets to the wind and mumbling incoherently, lying in the dirt with a Colt 40 tucked under his arm.
I pulled up an old lawn chair, grabbed a spot by the fire and began passing out some breakfast burritos and Bugler tobacco to the folks around the fire. I tried to speak with Norton, but he was barely conscious as I attempted to cajole him into eating one of the burritos. I could tell he had been abusing himself hard for some time; he appeared gaunt, badly "sucked up" and paler than a piece of chalk.
"Louise," one of the women at the camp, sat Norton up and tried to get him to take a couple of bites of his burrito. Initially reluctant, he complied when another gentleman at the fire began strongly "encouraging" him to take a bite or he would be cut off from the beer.
As the rest of us chatted, Norton ate about a quarter of the burrito then promptly threw it up into his lap.
"He's in bad shape, Steve," one of the guys at the fire whispered to me. "Can you take him to the hospital?"
"How long's he been vomiting?" I asked.
"About a week, now," he responded.
We got Norton up off the ground, slung his arms around our necks, and dragged him to my car.
Homeless and Heading to the Hospital
Published March 26, 2009 @ 09:52PM PT
Around the country, if you're homeless, you're probably also wandering the streets without any type of healthcare coverage, unless you're one of the lucky few who receive Social Security Disability (SSDI) or Supplemental Security Insurance (SSI) ("lucky," is a matter of perspective here, but at least they have a small income and government sponsored healthcare).
Insurance is one of those things that, for many of the poor and homeless, we know exist but we've rarely been fortunate enough to actually have for any length of time in our lives.
Most of the time, it doesn't matter, but when it's needed, it's usually needed very badly.
"Mike" was salvaging aluminum gutters from a home that had recently burned, trying to earn a few bucks to get him by. Mike is a roofer by trade but was recently laid off due to a lack of work; a common occurrence in today's economic environment.
Mike lost his balance pulling on the gutters and fell over and he belly-flopped the 28 feet, bouncing off lower roof in the process, and by the time he hit the ground, he'd broke both his arms and crushed two lumbar disks (L1, L2) in his back.
Mike spent 13 days in the hospital and underwent two surgeries (he's scheduled for a third in a few days... and there will be additional surgeries after that, he's been told). The first surgery occurred on one of his broken arms shortly after he arrived. Approximately six days later he was told that he would need a place to go soonbecause when they completed the second surgery they would be discharging him, since he had no insurance. A social worker had visited Mike the second day he was in the hospital and filed for food stamps for him. No discussion of housing, respite care or other arrangements occurred during that visit, and that was the last Mike saw of the social worker during his stay.
As he lay broken and battered in his hospital bed, the staff told Mike he had two choices after they completed the second surgery; he could go to the local Mission or they could discharge him to the only respite care provider for the homeless available here in Nashville. Mike was absolutely adamant that he wasn't going to go to the Mission because he had "no way to protect myself with two broken arms. I'd be a sitting duck." The respite site, while providing an outstanding service to many homeless individuals in Nashville, was also out of the question, since Mike would have to lay on a mat on the floor for the duration of his stay; a difficult proposition for a man with a broken back and two broken arms (because this agency deals with intoxicated individuals on a routine basis, they use floor mats rather than beds in order to protect individuals from falling out of bed while sleeping).
So Mike was about to undergo his second surgery and upon its completion was also facing the daunting prospect of having nowhere to go, no money to purchase any prescriptions, no transportation to take him anywhere, and no answers from the hospital, or anyone else, for that matter, about who might be able to assist him in his time of dire need.
Mike had the second surgery 11 days into his stay and was discharged two days later. By this time, he was able to connect with local outreach staff, who ultimately delivered him to the local "Tent City." Mike is recovering there today, courtesy of several concerned members of the camp who took him in and are helping him with everything from dressing in the morning to preparing meals to staying warm, dry and comfortable during the still chilly evenings here in Middle Tennessee.
Mike's story is a common one among the homeless. Most of us know that health care options for the uninsured are lean; for the homeless, it brings a whole new meaning to FUBAR and the problems usually start as soon as the person tells the hospital intake staff they are both homeless and have no insurance.
It's no secret that only the critically essential services will be done to stabilize an individual who fits this description and those of us without insurance know we'll be getting the "bare bones" model of health care treatment; just enough to make sure we are able to walk, roll or be pushed out the door as soon as legally possible. But most of us without insurance usually at least have a home to go to, and someone who cares enough about us to ensure we won't have to walk to that home when we're discharged, either.
For the majority of folks on the street however, there will be no such luxuries.
Mike's own situation was grim but he was at least taken to the ER via an ambulance. For a large number of homeless individuals facing discharge here in Nashville (and you can almost certainly insert the name of your favorite city in place of Nashville, I doubt seriously it would be much different), the options for leaving and rehabilitation are sparse. Contacting an outreach worker to lend a hand is a possibility, but the ratio of outreach workers to homeless individuals in Nashville is currently about 2,200:1 and just reaching one at any point in a given day is often a herculean task. If it's before 8am or after 5pm, our sick or injured individual might as well try to bribe the hospital security officer, (although with what I haven't a clue), in order to sit in the lobby because they've got a long wait.
And that wait may just stretch into a few days if the one or two outreach workers available for this kind of "general" street outreach are busy - and they almost always are. Although Nashville's recent shift to utilizing the Vulnerability Index as a tool for triaging and prioritizing outreach to the most vulnerable of the homeless population was an important advancement in outreach, its implementation has severely curtailed the outreach available to those individuals who are simply "homeless" but without life-threatening illnesses or health conditions.
The fact is, transportation away from the hospital is probably going to be by the most common method known to the homeless around the world, "pavement pounding." Please imagine for a moment the discouraging task facing someone who is sick and/or injured enough that they must go to the hospital in the first place, but then must leave the hospital on crutches, with a walker, or in a wheelchair, knowing all along that wherever they're going to end up, it's going to be a damned hard trip to make. Imagine too the utter despair that must accompany the realization that you've got no place to go once you've left the hospital property. Toss in a little rain, perhaps a few snowflakes, and the situation becomes downright desperate, indeed. Sadly, such homeless discharges are quite common, not just here in Nashville, but in cities across the country.
In Mike's case, he had a definite stroke of luck, but only insofar as it took him from the hospital to a campsite. If our homeless hospital dischargee is, like Mike, unfortunate enough to have to fill a prescription for damned near anything and isn't able to reach one of the outreach workers in this city, he/she has a quest ahead of them that would drive Indiana Jones to leave adventuring forever and drown himself in a bottomless bottle of cheap Scotch.
There are two primary methods of getting a script filled in Nashville; neither is very quick. Incidentally, if you're hoping to fill a pain pill, forget it. No one will fill Codeine or Hydrocodone (Vicodin, Lortab, etc), but if you've received a script for something stronger, it's in your best interest not to tell anyone anyway, since people have been robbed, assaulted and even killed for scripts of Oxycodone, morphine, Diluadid other potent analgesics. Most folks I work with know all too well the hassles involved in getting pain pill prescriptions filled and don't even bother asking for them anymore. Many simply attempt to scrounge up enough money to buy some alcohol and drink themselves into a pain-free zone. Not the most efficient way of handling the problem but certainly one of the very few viable options available to them.
The first method in obtaining a prescription involves walking (or rolling, or hopping, or crawling) to the local supermarket to get a printout of the medication and the price for the number of pills in the prescription. But not just any old supermarket will do; It has to come from a specific store, located near downtown Nashville, and getting to it from the "homeless" hospital means a 2 mile walk through one tough neighborhood. Once the necessary paperwork for the prescription has been procured from the store's pharmacy, the individual must strike out again, this time to a local agency, which is approximately six very large city blocks away. Once at the agency, if funds are available - and this is a very big "if" indeed - a check is cut to the store for the amount of the prescription.
The individual must then turn around and walk back to the store in order to pay for and pick up the prescription. Sounds relatively straightforward, until you discover that A. the agency only fills prescriptions on certain days and B., funds are limited, to say the least. To say the most they are usually nonexistent after about the 10th of each month. Furthermore, most people don't know they must stop into this particular store first, so they end up having to make the walk twice, rather than once, which under the best of circumstances is difficult when one is sick, hurting or both. If they happen to show up on a day when the agency isn't cutting checks for prescriptions, they get to do it all over again on another day.
The other method involves engaging a friendly pastor or church and praying, no pun intended, that they will be able to fill the script for you. This method typically involves considerably more walking, since the individual must be able to find a church both with the funds available and the willingness to provide the service; a rare combination for non-members of most churches.
To be sure, Nashville's faith-based community is a Godsend (again, no pun intended) to the homeless population, since they provide the majority of meals, clothing and supplies necessary for life on the streets, but most don't advertise the services they offer so for the typical homeless individual, he/she is usually stuck walking from one church to the next, pleading with a pastor, deacon or priest for help. Complaints of favoritism, forced prayer before services are rendered and other assorted "demands" by the churches are common among the homeless population but in defense of the faith-based agencies here, they see a lot of volume and hear a lot of stories. Their overarching mission is saving souls and to that end, they use the tools available to them; prescription services, food, clothing, lodging, etc., to get people into the door in order to hear the "more important" message of salvation.
Finally, there is also a donated prescription medicine plan available to some in the Nashville area but few homeless individuals are able to take advantage of it, primarily because they have no idea how.
One bright spot in Nashville is the recent acquisition and current expansion of neighborhood health clinics specifically established to assist the poor and homeless in the community. The homeless population is already reporting decreased wait times, better overall service, additional services such as expanded dental and vision, and a better chance at actually receiving meds directly from the agency itself, rather than obtaining a prescription. A few have even received pain medication!
Individuals who are homeless and suffering an illness or injury that requires medical attention often find themselves in an untenable situation, to be sure. When one couples their personal misery with the costs incurred by society (read that: anyone who pays the exorbitant premiums on their healthcare insurance, not to mention general taxpayers who must bear the brunt of uninsured emergency responses) as a result of whatever their affliction may be, one thing is crystal clear; dramatic change is needed, and it is needed yesterday.
