Big changes

Also: Steward Heath CEO faces criticism from former supporters [Donate ❤️]( [View in Browser](  February 6, 2024 Hi CommonHealth reader, What a difference a year can make. At the end of 2022, I reported that [a record number of homeless families were showing up at Massachusetts emergency rooms](. These families went there not for medical care but for a roof over their heads. Often they waited until the wee hours of the morning for hospital staff to help them. The people I interviewed found the situation galling. But in hindsight, it could have been a lot worse. Usually, a hospital social worker would help the families access the Massachusetts family shelter system, where they got their own room and a variety of support services. Now, fast forward a year or so. Gov. Maura Healey's administration has [deemed that same family shelter system full]( partly due to [a spike]( in newly arrived immigrants. Folks are being placed on a [waitlist]( that’s roughly 700 families long. And dozens of homeless families have spent nights at Logan Airport, while others have slept in their cars. State officials have scrambled to setup overflow sites to shelter waitlisted families. In [one case]( the need was so urgent state officials overrode local opposition. Families I’ve spoken to consider themselves lucky when they get a spot in an overflow site, where there are hundreds of people sleeping in one space and using just a couple bathrooms. “There isn't really a safety net any longer. I mean if the safety net is: ‘You're approved [for shelter] and we'll call you — sometime,’ that's not a safety net,” Emily Herzig, a senior paralegal at the Northeast Justice Center, told me. As I’ve [documented]( the fraying of this safety net, it’s the children I can’t get out of my head. I recently met a young girl who is almost 3, nearly old enough for preschool, but she hasn’t yet learned to walk or talk. She’s never said so much as “mom” or “dad.” Her parents don’t know why — and they don’t know how to access medical care, having only recently arrived in the U.S. For the past month, [this family]( has been sleeping at Logan and in a crowded temporary shelter. Despite having traveled the length of Latin America, the dad told me they’ve never lived in such harsh conditions. I thought the delay in this child's development must be an outlier. But Aura Obando, the medical director for the family team at Boston Health Care for the Homeless Program, told me homeless children have a significantly higher risk of learning disabilities and other delays. Shelter staff have also noted an increase in recent years in the level of medical need in families entering the shelter system. “We definitely see it. It's not surprising to me, I guess, but it's heartbreaking,” said Obando. “That's why the argument is to really shorten that experience of homelessness, because a lot of it could be reversed.” I can’t help but wonder what the Massachusetts shelter system will look like a year from now. Will it return to being a national model? Or will financial and logistical realities dictate even more limits on services? Recently, the state reserved the right to limit the length of time a family can stay in the shelter system. They haven’t yet acted on that, but many homeless advocates say they are watching with some trepidation. Like them, and like you, I will be watching for changes. However, my colleagues will take the lead in reporting the twists and turns of this unfolding story because, at the end of this week, I will be making a career transition. I'm excited to share that I’ll be joining NPR’s Science Desk, where I’ll cover global health. It’s been a great pleasure to write this newsletter and hear from readers. As you know, you're in great hands with Priyanka. I will happily join you on the other side, as a dedicated reader of the CommonHealth newsletter. P.S.— One more thing: Valentine's Day is coming up. Please send Winston Flowers from WBUR! You'll show your loved one how much they mean to you while supporting the independent journalism you value. [Check out our elegant options and delivery area.]( And if you order by Friday, there's a 10% discount, plus you can check it off your to-do list. 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