as an illustration http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2001/11/04/MN165298.DTL
SQUALOR IN THE STREETS Public health Toll One man's medical costs show how city is burdened by bills Patrick Hoge, Chronicle Staff Writer Sunday, November 4, 2001 Printable Version Email This Article STREET SQUALOR A chronic homeless problem. Solutions neither easy nor cheap. Homeless addicts largely ignored. One man's medical bills. A neverending cycle for the mentally ill. Mark Shotley's medical costs in the past three years were more than $200,000, but he never got the bill. Taxpayers covered the costs because Shotley, a Minnesotan by birth, had moved to San Francisco and become one of its chronically homeless residents. The city finally totaled costs of medical treatment for street indigents in fiscal 2000. The bill was conservatively put at $41 million to treat 2,579 homeless people, including Shotley. The Chronicle first met Shotley at the Fifth and Market streets bus shelter where he camped, day and night last spring, in the electric wheelchair he got through San Francisco General Hospital. He was incontinent, alcoholic and paraplegic. Shotley sat there for hours, teeth clenched against the discomfort of being trapped atop his own excrement, against the knowledge of leg ulcers that were so large they exposed his bones. The Chronicle notified city officials of his condition, but was told there was no place that could take him. Shotley regularly commuted via Muni bus to San Francisco General for treatment. Often he could be found in the lobby, sitting asleep while his wheelchair was recharged via a wall plug. The $200,000 in medical costs The Chronicle extrapolated from his medical records didn't include surgical procedures, which ultimately included amputation of his legs, medications or days spent in intensive care, so the actual cost was much greater. Shotley said he has a history of depression. He has been a homeless alcoholic since age 15, according to his older brother, Spencer. Shotley's siblings told The Chronicle he is welcome home, but Shotley said he doesn't like Minnesota winters and doesn't want to be a burden on his family. Shotley told The Chronicle he had been in residential addiction treatment programs in Minnesota, Oklahoma and Texas. While in Texas, Shotley said, he was jailed for public intoxication "three times a week" for eight years, and was once imprisoned for robbery. In 1998, Shotley wandered to San Francisco and was picked up by police three times in three months, for being drunk, defrauding an innkeeper and stealing merchandise. The district attorney never pursued charges. Then he fell 25 feet into BART's Powell and Market entrance while drunk, fracturing his spine and paralyzing himself from the waist down. Doctors at San Francisco General Hospital put rods in his spine and sent him to live at the city's Laguna Honda Hospital. There, Shotley was verbally abusive and threw food trays and urine bags, and after 3 1/2 months he was evicted, hospital records show. The city was able to place Shotley in a nursing home. In November 2000, after 16 months, Shotley argued with a nurse, departed and is not welcome back, according to hospital records. Shotley returned to General Hospital seven more times, sometimes with a wheelchair full of fecal matter and maggots in his wounds. He also went to the emergency rooms at Saint Francis Hospital and Oakland's Highland Hospital at least five times. Between hospital stays, Shotley failed to attend clinic appointments for wound care. He was embarrassed to ride on a Muni bus with a wheelchair full of feces, he said. Once, a bus driver stopped and demanded that the person causing the foul odor get off. Shotley remained silent, and eventually the vehicle proceeded. There are "hundreds and hundreds" of patients like Shotley in the city, says Dr. Robert Okin of San Francisco General. The cost of treating them is rarely totaled, though, because the government doesn't require it. In recent years, the city has only run the cost once, and the total was presumed to be an undercount because it only included patients who gave no address. Page A - 18 >Damn, and that's the post. > >Layeth the smacketh down. > >> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| Message: http://www.houseoffusion.com/lists.cfm/link=i:5:193663 Archives: http://www.houseoffusion.com/cf_lists/threads.cfm/5 Subscription: http://www.houseoffusion.com/lists.cfm/link=s:5 Unsubscribe: http://www.houseoffusion.com/cf_lists/unsubscribe.cfm?user=89.70.5 Donations & Support: http://www.houseoffusion.com/tiny.cfm/54
