Winter shelter relaxes criteria

After deaths of 4 homeless men, city says program can open at higher temperatures


After exposure to extreme cold contributed to the deaths of four homeless people this month, the city is raising the temperature threshold for the Code Blue emergency shelter program from 25 to 32 degrees.

The city's new health commissioner, Dr. Joshua Sharfstein, made the change yesterday and said that a review of information on hypothermia shows that "there was still quite a risk up to 32 degrees" and that about half the city's deaths from the cold in the past few years had occurred in temperatures over 25 degrees.

While the old Cold Blue standard set the threshold at 25 degrees and sustained 15-mph winds, the new policy drops any reference to wind and allows some leeway for going a bit over 32 degrees if there's also rain, Sharfstein said.

The temperature change is part of a broader effort to protect homeless people from the cold, said Sharfstein, who became health commissioner Dec. 13 during an extended cold snap.

The Code Blue program had been in effect for 18 successive nights since Dec. 5, said Laura Gillis, president of Baltimore Homeless Services Inc., the city's quasi-public nonprofit agency that runs local, state and federal homeless assistance programs. Gillis said the Code Blue shelter in East Baltimore was open for 28 days last winter.

Gillis called the policy change "wonderful," not only for preventing deaths in the cold but also for the chance to refer more homeless people to agencies that can help with drug treatment and health care. Gillis said that at any given time, about 3,000 people are homeless in Baltimore.

Since February 2001, Sharfstein said, exposure to the cold has contributed to the deaths of 28 homeless people in the city.

According to a study released this month by the National Health Care for the Homeless Council, homeless people are three to four times more likely to die prematurely than people who have proper housing. The report links the high death rate among homeless men and women to acute and chronic health problems.

After Michael Clash and Dennis Waller died in Baltimore on the night of Dec. 3 while sleeping under blankets in a downtown plaza, the city Health Department decided to review information on hypothermia and details of the city's response, Sharfstein said.

After the review began, exposure to severe cold contributed to the deaths of two more men, David Cano, who was homeless, on Dec. 14 and John Turner, who was living in a group home but did not have shelter when he died the week of Dec. 12.

Along with the temperature change, Sharfstein said the new policy calls on city health officials to pay more attention to information gathered from local emergency rooms, looking for signs of hypothermia that might help fine-tune the city's response.

"If you find out there's a park where people are freezing, let's get people out there" and find out if word on the Code Blue program is reaching everyone who might need it, he said.

New fliers on hypothermia warning signs have been printed and will be available at social service agencies and the city's 18 regular homeless shelters, which can accommodate about 1,200 people.

Otherwise, the Code Blue program, which went into effect in 2002, will not change.

As Cold Blue works now, Gillis said, the health commissioner checks weather information and sets the program in motion by 10 a.m., signaling the shelter crew of 13 to be prepared to open the Oliver Recreation Center at 1400 E. Federal St. by 5 p.m.

Between 5 p.m. and 9 p.m., a bus makes rounds of five spots around the city, picking up homeless people and bringing them to the shelter. There they get a blanket, a cot, a hot meal and, if necessary, medical attention and a visit with a counselor who might be able to refer them to drug treatment or mental health services. By 7 the next morning, they've had breakfast and are sent on their way.

"I was extremely impressed with the shelter when I visited last night," Sharfstein said.

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