Nightmare Weekend

Cindy McCallum said the two nights she spent on the grass opposite the Santa Barbara Rescue Mission were the scariest she’s lived through. The 53-year-old disabled homeless woman doesn’t say much about the evening before her ordeal, when she wandered the streets and stayed, at least part of the time, in Cottage Hospital’s parking garage. On Friday, October 28, Casa Esperanza homeless shelter had sent her to Cottage’s emergency room to be treated for a possible stroke. A few hours later, ER staff discharged her with a bus token.

Some details of what happened to McCallum between that Friday evening and the following Monday are still unknown. What is known is that McCallum — who is cognitively impaired and partially paralyzed from the effects of a stroke — spent the weekend outside, predominantly alone, unable to get up off the ground without assistance, use the bathroom, or defend herself. Her nightmare ended when another homeless woman spotted her Monday morning and called 9-1-1. She was brought back to Casa Esperanza in a police squad car.

McCallum’s ordeal is an example of what can happen to uninsured homeless residents after a hospital stay when they are too sick for Casa Esperanza. McCallum plunged into a cavernous gap in services when she was brought to Santa Barbara Cottage Hospital after suffering two strokes. She’d left her sister’s home in San Luis Obispo County in June to attend her daughter’s graduation from college in Orange County. When she had the strokes on July 4, her daughter brought her to an acute care facility. McCallum doesn’t remember how she originally landed at Cottage.

Cottage Rehabilitation Hospital discharged McCallum to Casa Esperanza around October 24. But shelter staff didn’t realize she couldn’t dress or shower independently or that she was incontinent. Medical bed residents must be able to perform those tasks.

“Every morning I wake up wet, and then I start crying,” McCallum said. When shelter staff sent her to the ER via ambulance at around 4 p.m. on Friday, they called ahead to instruct hospital workers not to return her to their facility because of her high level of need. According to shelter sources, ER personnel called three hours later and asked if McCallum could be returned there anyway. Staff refused.

Around 7:30 p.m., McCallum was seen on the street near the hospital, requesting directions to the parking garage. The next known interaction occurred in the garage in the morning when McCallum recalled bumping into a nurse she knew from the Rehabilitation Hospital. The nurse reportedly invited McCallum back to the Rehab Hospital and gave her a sandwich. Sometime that morning, it seems that county Adult Protective Services (APS) was called to assist because an APS caseworker is noted as having called Casa Esperanza around 11 a.m., asking if McCallum had a bed there. Again, the answer was no.

Eddie Tyrell of the Santa Barbara Rescue Mission said that during his Saturday morning shift an APS caseworker arrived; she said she was leaving a homeless woman with slurred speech across the street. (The Mission doesn’t allow residents inside until late afternoon.) Tyrell asked the caseworker if the woman had been medically cleared, and the APS worker reportedly responded that she had.

“When we were ready to discharge [her], it appears there were no facilities to take her, and her family wasn’t willing to help. … She was discharged with a bus token, and it was thought she was going to the Rescue Mission.”

Tyrell said he didn’t know McCallum had paralysis or was cognitively impaired, and he admitted he didn’t check on her. Knowing now how disabled she was, he said he deeply regrets that. McCallum never crossed the street to seek shelter. It’s unclear if other people offered her help, or if McCallum refused it. Additionally, though McCallum requires a skilled nursing facility, no such facility in Santa Barbara admits the uninsured, and all of them require a physician to admit and supervise a resident’s care.

Cottage Hospital spokesperson Janet O’Neill said ER staff discharged McCallum to the Rescue Mission. She was offered a cab but declined because she does not like to accept special services. So she took a bus token and planned to walk to Casa Esperanza. She went to the parking garage instead because she had left her purse there weeks earlier when she was first admitted to the facility.

O’Neill defended how the hospital dealt with McCallum. “She received ER care, but she did not need to be admitted,” O’Neill explained. “When we were ready to discharge [her], it appears there were no facilities to take her, and her family wasn’t willing to help. … She was discharged with a bus token, and it was thought she was going to the Rescue Mission.”

This year, Cottage Hospital is giving Casa Esperanza $39 for every night one of its former patients spends at the shelter, up to $150,000. McCallum is back in a medical bed at Casa Esperanza, even though her needs are beyond what the shelter can provide. She spends the bulk of her day curled up in the women’s dorm and seems bewildered as to how she managed to end up in a homeless shelter. “What amazes me is how fast it all happened,” she said, recalling the day of her strokes. She remembers walking down the street with her daughter, looking for a place they could get pedicures. Apparently, they never found one.