Ricky Bayse wanted to testify before the Oregon Senate Committee on Health Care Wednesday, March 22, but he never made it to the Capitol.
He spent the morning screaming in pain inside his tent at Wallace Marine Park 2.4 miles away. Eventually, the pain subsided to the point where his caretaker and former girlfriend April Wynkoop thought he might be able to make it.
She managed to load his paralyzed body into her car and drive down State Street. They managed to get as far as Cottage Street, roughly 1,000 feet from the Capitol.
Moving from the passenger seat to his wheelchair proved too much for him.
Sitting in the car, Bayse told Street Roots he just wanted to tell lawmakers (and any hospital representatives that happened to be in the room) that he is a human being with a name and a face and a story.
"They should be treating people as people, not numbers — not how much income they are for the hospital, not how much they can get out of people before they die," Bayse said.
Senate Bill 1076, the legislation before the committee, would require hospitals to find resources for patients experiencing unsheltered homelessness after they are released from care.
Even if Wynkoop had pushed Bayse's wheelchair those 1,000 feet to the Capitol and up the ramp and through the metal detector to reach Hearing Room B, his pain would have been for nothing.
'It will get out of committee’
Committee members took testimony on SB 1070 — already held over from their meeting two days earlier — an hour into Wednesday's session. And then, with time growing short, they listened to only two witnesses before extending the public hearing again to March 27.
(Visit www.streetroots.org for updates on the legislation.)
One of the witnesses was Jimmy Jones, the executive director of the Mid-Willamette Valley Community Action Agency in Salem. He told Street Roots after the hearing that wealthy and influential forces in the hospital industry are allied against the bill.
Nonetheless, he added, it still stands a chance.
"I think it will get out of committee," Jones said. "It’s likely to be amended. Most people are not eager to take on hospital systems, but if you look at the agencies and networks that have endorsed it, there’s some weight there."
'My pain level is beyond recognition'
Bayse's lower body has been paralyzed since an accident while he was working on a vehicle in September 2019.
"It basically fell on him and pulled him down a small incline and severed his spinal cord," Wynkoop said. "It folded him in half — backwards."
He has been in and out of hospitals ever since, she said. Mostly out.
"He doesn't want to go back to the hospitals because they kick him out," Wynkoop said. "They've labeled him a drug addict and judge him. He's a human being. No matter what, he's still a human being."
And he's a human being in constant pain.
"My pain level is beyond recognition,” Bayse said.
He also faces mental health challenges, which often makes his speech patterns disjointed and incoherent. He told Street Roots he wants to die. He says that a lot, Wynkoop said.
"He says he wants to die not because he really wants to be dead, but death would be better than this," she said.
Bayse was injured eight months after spending a year in jail on drunk driving charges. After he went through physical rehabilitation, Wynkoop took responsibility for him.
"I've been doing the best that I can," she said. "I'm homeless too because of all of this. I'm trying to pull myself out because it's cost me everything. I can't work right now because taking care of him is the most important thing."
Bayse lives in Wallace Marine Park in a tent near Joyce "Mama Joy" Ebright.
"He screams all the time," Ebright said. "I can hear him from where I live. I try to help wherever I can."
Someone needs to help, Wynkoop said. It should be hospitals, she added.
All hospitals see a broken 38-year-old drug addict, she said.
"There are so many factors, and all the hospitals are doing is taking him as who he is now and forgetting about the rest," she said. "They don't know what I know."
What they don't know is the man who lost his mother to a heroin overdose and who lost his mobility to an accident.
"He's not gotten the proper mental health treatment, no proper counseling to grieve through this process," Wynkoop said. "You're grieving a loss, the loss of a life — at least the life that you know that's gone. You go to sleep. You wake up, and you're paralyzed. And it's your fault. You didn't do the things you needed to do to keep this from happening."
What the bill does
The bill requires hospitals to have a plan for releasing people who don't have shelter waiting for them. Hospital staff would have to learn a person's housing status and create a plan specifically for that person.
It also:
- Requires people who are homeless to be released during the daytime between Oct. 1 to April 30.
- Prohibits hospital personnel from discriminating against people based on their housing status.
- Requires hospital personnel to communicate a person's post-hospitalization needs when transferring people from one facility to another.
- Requires hospitals to have plans, updated annually, to coordinate services with local health care providers, behavioral health agencies, social services and nonprofits.
Oregon law already has existing rules for discharging people hospitalized for mental health treatment, but the law doesn't specifically apply to people experiencing homelessness hospitalized for other health conditions.
'We are not the answer’
Dr. John Turner, an emergency-room physician from Silverton, submitted written testimony saying hospitals simply cannot double as social agencies.
"We are not the answer," he wrote.
Health care in Oregon and across the country has been critically injured during the pandemic, Turner added.
"We have less staff and less resources to handle our even previously challenging jobs, and the job is harder than ever before,” Turner said. “Burnout, career change and retirements are higher than ever."
If the bill passes, he testified, it will make health care in Oregon worse.
"It will increase boarding, delay definitive medical treatment, and sadly, it will make the Legislature feel like you have done something to help and protect those that need it, when in fact, you will be harming many others," he said.
Dr. Lazeni Koulibali, a Salem physician, echoed his Silverton colleague in his written testimony.
"The bill in its current form does nothing to solve the homeless crisis," he said. "There are no solutions suggested. Instead, it will put undue burden on the hospitals and create more chaos in the emergency rooms."
Jill Summers, a licensed clinical social worker at Salem Hospital, said in her written testimony that she wasn't representing the hospital and can see both sides of the issue.
"At its core, SB 1076 would turn basic human decency into law," Summers wrote.
"Our unsheltered neighbors have many barriers to following up after a hospital visit, including not having a phone to make appointments, lack of transportation, no electricity for oxygen concentrators, and lack of clean, running water for wound care and handwashing, to name a few," she said.
Many of the requirements outlined in this bill are already standard procedure at her hospital, she added. She offers people food, clothing and rides, as well as shelter information.
"But I don’t always have on hand what my patients need," she said. "Sometimes insurance companies won't pay for medication refills. After 5 p.m. and on weekends, most doctors' offices and community services aren't open. Unhoused patients also sometimes act in ways that result in getting banned from shelters ... Should the ER then keep people like this indefinitely?"
Summers said smaller hospitals face overwhelming challenges.
"They must do more with fewer resources," she said. "Their nurses will be asked to become experts not only in medical care, but in social work."
'The way forward is together’
Jones told committee members March 22 that he read the written testimony in opposition to the bill before coming to the Capitol.
"I drew two observations from that," he said. "One is that, quite frankly, people didn't very closely read the bill — which is something that is probably quite common."
He also came away with a sense of empathy, he added. Clearly, Jones said, hospital personnel are overwhelmed and overworked.
"That is something that I identify with and feel very closely to myself," Jones said.
However, he said, the undeniable reality is that there is a link between health and housing status.
"We talk a lot about the social determinants of health, but there can absolutely be very little application of the social determinants of health if it doesn't apply to the people who are exiting from the emergency rooms across the state of Oregon," Jones said.
The Rev. Greg Bolt of Salem First Presbyterian Church was the only witness, other than Jones, who was able to testify in person March 22. His church began offering a warming shelter through the local ARCHES Project five years ago with a grant from the Salem Leadership Foundation.
The shelter took in 1,500 people this past winter.
"There are many nights when we are full to bursting with individuals simply looking for a place to be warm," Bolt said. "We understand, more than many, the complexity of finding shelter and administering help to our houseless neighbors who find themselves in these situations.
"We seek not to blame others, but to recognize the way forward is together. We are in full support of any movement that will facilitate conversation between social services and hospitals so we can ensure a warm hand-off in these instances where the lives of the most vulnerable in our unsheltered population are literally at stake."
'I'm not going to give up’
Wynkoop said it mystifies her why any health care providers would oppose the bill.
"These are professional people," she said. "These are people who took an oath to help."
If nothing else, Jones told lawmakers, he hopes the bill starts a conversation to create better practices when sending patients from the emergency room to the streets.
"I sort of empathize with the medical community when they say, 'We don't really understand our place in this,'" he said. "I think a lot of people across Oregon also don't understand their place in this."
Her place, Wynkoop said, is at her friend's side.
"I'm not going to give up," she said. "I can't. I can't give up and walk away until he gets out of that park or he dies. At that point, I'm going to become a real activist because this shouldn't be happening. He's falling through the cracks."
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