Last month, for the first time in my 10-year career as a doctor in Boston providing health care to people experiencing homelessness, I faced having to send a baby and her mother back to the street, where they had spent their past few nights.
I grew up in and went to medical school in the South. I’ve often thought of going back to be closer to family and friends, but one of the things that keeps me in Massachusetts is the compassion built into policies here. For example, almost everyone in Massachusetts has health insurance, so even all of the homeless patients I see can get the care they deserve. That level of compassion is absent in policy environments elsewhere.
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For patients like the mom and infant I saw last month, that compassion has meant that — up until very recently — I could get them into shelter immediately. Since 1983, Massachusetts has been a “right-to-shelter” state for families. As a former secretary of Health and Human Services said about providing shelter to homeless families, “we ought to be able to do that in the richest country on the face of the Earth.”
But a few months ago, that changed when Governor Maura Healey declared that Massachusetts would cap the number of families in shelters, creating a wait list for additional families in crisis.
After hours on the phone with partner agencies, we were able to make a safe plan for the family I saw. But other families have not been so lucky. Our team has encountered families sleeping in the airport, in emergency departments, and, like the mom and baby I saw in clinic, on the street.
Now, on top of all of the suffering the cap has caused, the Massachusetts House voted to place time limits on families living in shelters, limiting families to 9- to 12-month stays. Whether this plan moves forward now depends on the state Senate.
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Time limits on family shelter stays will not solve the problem of family homelessness.
All the families I see in shelters are working to get out. But housing in Massachusetts is among the most expensive in the country. Furthermore, the average wait time for a housing voucher nationally is 30 months; in Massachusetts, it’s nearly 4 years. Given those numbers, and the ongoing barriers to creating more housing, providing only nine months of shelter in many cases is grossly inadequate.
Some have blamed the current strain on the shelter system on newly arriving migrants. While it’s true that these families account for some of the people utilizing the shelter system now, about half of shelter occupants are long-time Massachusetts residents. Furthermore, our moral obligation to keep children off the streets should not hinge on how long a family has been in the state. Some of the migrants I have spoken with report that they were put on a bus at the border without knowing where they were headed, which some have called a political stunt. But the state’s response to political stunts should not be to retreat from its own values.
There is strong evidence that immigrants, including undocumented immigrants, contribute more to the economy than they take. In a state that is losing population, with significant workforce implications, figuring out how to embrace hundreds of new families is advantageous.
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Just two years ago, I received a letter saying that the state had billions of extra dollars and would be writing me a rebate check as a Massachusetts taxpayer. While the fiscal picture has changed somewhat, I still believe that we can find a solution to the current situation in a state as well-resourced and historically compassionate as ours.
I urge the state Senate to vote down time limits on shelter stays. Instead, I urge them to increase funding for programs like RAFT and rent control measures that keep people in housing before they become homeless; and HomeBASE the Massachusetts Rental Voucher Program that help them get out of shelters. But none of these programs is enough on its own. Massachusetts must continue to support families in crisis and be more creative in its approaches to ending family homelessness.
Dr. Avik Chatterjee is a family team physician at the Boston Health Care for the Homeless Program and an assistant professor at Boston University Chobanian and Avedisian School of Medicine.
