The Safe Harbor homeless shelter was opened in 2011 by the Pinellas County Sheriff's Office to reduce the high costs and jail crowding caused by arrests of homeless people for minor, nonviolent crimes. But the shelter has created a burden on the countywide emergency medical services system. Safe Harbor is one of the highest users of EMS, in part because the shelter has no medical staff and uses EMS as the primary health care provider for its residents. The sheriff, county officials and medical providers should seek alternatives for Safe Harbor that would relieve both EMS and local hospitals of the burden of providing expensive transport and treatment for even minor health issues.
Former Pinellas Sheriff Jim Coats and his deputy, current Sheriff Bob Gualtieri, initially envisioned Safe Harbor as a stripped-down emergency shelter for homeless adults and inmates who had nowhere to go when they got out of jail. Set up to house 250, shelter residents received three meals a day and a mat on the floor for sleeping. Some limited services soon were added, including visiting caseworkers and drug counselors. But there was no provision for medical care, even though the shelter serves a population known to have acute medical needs. A shelter resident who claimed to have some medical training was asked to leave after she was discovered trying to treat some residents.
More than three years later, the shelter relies on weekly visits by Pinellas County's mobile medical unit and on EMS. Safe Harbor, located on 49th Street near Largo, is the third-highest user of EMS in the county, with 545 EMS calls last year. Many of those calls are dispatched to nearby Largo Fire Station 40 — so many that Largo is seeking extra money from the county. The 911 calls are made by both residents and staff, and they involve complaints ranging from very minor to serious, but more than 90 percent of the patients are taken to a hospital for treatment. Few of the homeless patients have the ability to pay either the ambulance service or the hospital.
A more efficient system that reduces reliance on EMS, emergency rooms and the taxpayers surely can be devised. Placing a doctor, nurse practitioner or nurse at Safe Harbor likely would reduce the number of 911 calls and the cost of residents' care. Should the Florida Department of Health in Pinellas play some regular role in providing health services for these county residents? Could the medical staff at the jail, which is nearby, be utilized at the shelter? The EMS system is for emergencies, not routine health care. Safe Harbor needs a different plan.