Support Systems Can Hinder as Well as Help

Many of the residents who come to Renewal House have little or no health insurance. Fortunately, the state of Massachusetts has several plans to cover and care for folks that are homeless, living in shelter or below the poverty level. We also partner with Boston Healthcare for the Homeless Program (BHCHP). Each month, a nurse from BHCHP visits Renewal House to meet with residents and discuss any health concerns they may have. If a resident requires assistance in between visits, we can call the nurse for information and referrals.

Homeless and poor individuals face enormous struggles around healthcare. We have had residents run out of prescriptions needed for mental health and other medical issues – and have to wait weeks to resolve the issue. We have seen residents have their health insurance cancelled without warning and with no reason given. We have had residents who have been refused services because they are from out of state. We had one resident who struggled with substance abuse issues go to the hospital complaining of back pain and come home with a two-week prescription of Vicodin.

One resident who moved to Massachusetts from Puerto Rico had a young son with a broken collar bone. He was treated in Puerto Rico and provided with a brace, but he required follow-up care here. When his mom called to make an appointment, she was told the earliest appointment they could have was in four months. We were able to call Boston Healthcare for the Homeless and the boy was seen within two weeks. However, when she arrived for her appointment, she was greeted by the doctor and an investigation team from the Department of Children and Families (DCF). Concern for the boy, it turns out, resulted in the medical appointment becoming an investigation of whether she was a “fit” mother. Fortunately, we had sent her with a bilingual Renewal House advocate who was able to help her through the interview. Although I understand why they felt the need to investigate this particular situation, I also recognize the vulnerability of this mother who was trying to do the right thing for herself and her son, but found herself scrutinized from all angles.

Just yesterday, I attended a consultation with a Department of Children and Families social worker, who said something I found very interesting. She said that once a family is in the DCF system, it is actually harder for them to get out than it is to stay in. She explained that once you are DCF-involved, you are watched for the rest of your days. A parent must be vigilant in all they do from that day forward to prove and re-prove their fitness as a parent. The parents we work with who are DCF-involved live in constant fear of having their children taken from them. This omnipresent fear is not supportive to the families. They feel further oppressed, afraid and defeated.

All services available to domestic violence victims are potentially hurtful and manipulative instead of helpful. It is a tricky dynamic, because the experience of being abused causes victims and survivors to believe they are powerless and weak, and unable to stand up for themselves. That is our role as advocates/intermediaries, and yet even we occasionally find ourselves overwhelmed by the systems that are meant to be helpful, but in reality can be oppressive and inflexible.

One final thought: Did you know that domestic violence is considered a pre-existing condition in seven states, including Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota and Wyoming, as well as the District of Columbia? Fortunately, debates are occurring at the Federal level to prohibit this practice. But it is shocking and disgraceful that insurers can currently refuse to cover injuries sustained by those who suffer abuse in the home. It is also another case of the system further victimizing those who desperately need services.