Solving homelessness, one person at a time: It’s harder than you think

MANCHESTER, NH – The city’s winter warming station is scheduled to close next Friday. I understand it has been serving between 25-60 people daily, depending on the weather. One of those people, for a short time, was Lexi Ramirez.

I met Lexi in November of 2020. She had been part of the large homeless encampment outside the Hillsborough County Superior Courthouse North, and one of about 30 people who were moved by the state to respite beds at Granite Recovery House in Derry. That lasted a few weeks – even though Governor Sununu said at the time that Lexi and the others would have several months to get their lives back on track. Most of those who were moved from the encampment to Derry returned to Manchester within a week or two. Lexi was one of the few who were determined to take advantage of the opportunity.

I sometimes wonder where Lexi could be now if only that “fix” provided by the state had been a real fix, or the promise of stability, kept.

Instead, four years later Lexi remains homeless. She most recently was staying at the Families in Transition shelter but her “good” foot – the one that doesn’t have amputated toes – was so badly and chronically infected from the disease that claimed her left toes years ago, that she was hospitalized. Again – she has been in and out of the hospital for months. This time, the infection required surgery. She suffers from an autoimmune disease called pyoderma gangrenosum which causes gaping painful ulcerated sores that are easily infected – especially when you are living at a shelter.

I went to the Elliot Hospital to check in on her Saturday.

“Your hair!,” I didn’t mean to blurt it out when I first laid eyes on her, but it was gone. Her head was completely shaved – the Lexi I have known for the past four-plus years has always had a beautiful mane of curly brown hair.

“Lice,” she said. They had to shave it all off.”

In addition to the lice she said she was told she also had bed bugs “all over her back” when she arrived at the Elliot, so the things she brought in with her have to be discarded.

“I was so embarrassed,” she said.

The surgery, which she had earlier this week on both her feet, was a procedure called wound debridement – removal of infected skin. Although this wasn’t the first time Lexi has experienced this procedure, she was surprised when she learned that this time they didn’t just remove the skin around the infected sores on her right foot.

“They took all the skin from my foot. All of it,” she said, pulling back her hospital bed sheet to reveal her feet, which were both covered in thick layers of gauze.

“I can’t possibly do this by myself,” said Lexi, about cleaning and bandaging both her feet from a shelter. She’s anxious about what’s next. Her understanding is that she will be released from the hospital on Monday.

“You lose your bed at the shelter after three days. I didn’t get to call in time the other day because I was trying to change my bandages,” she told me. “I hope I can get my bed back.”

I asked her if there were a chance she could be released to a nursing home, until her skin starts to heal and she is less susceptible to re-infection.  That is what happened to her last year, when she had surgery in Nashua. She was released to Premier nursing home.  That was an ideal situation for her but her healthcare provider – United Healthcare –  stopped paying before she was fully healed.

“I did appeal their decision and got one more week, but then I couldn’t stay any longer,” and that’s when Lexi found her way back to Manchester and, eventually, to the Beech Street Shelter where they couldn’t provide a bed, but at least she was out of the cold.

“I really don’t know what I’m going to do. I really don’t,” said Lexi, dipping the edge of her grilled cheese sandwich into the cream of chicken soup brought into her hospital room while we caught up. “Most of the time I feel like no one cares.”

Lexi is one person and her story is, unfortunately, not that unique. But this one woman’s experiences might help someone who still doesn’t get it to understand how deep and complex the “homeless problem” in our city is. When the warming station closes Friday we will see more people who are seemingly unsolvable out and about. I hope recent initiatives announced by City Hall will make a difference.

I hope recent changes in federal funding for services to the needy and Medicare won’t slow down progress in our city.

There are a lot of details to Lexi’s story that I’m not going to get into here, although there are archived stories linked below that will fill in some of the gaps, for those interested. We have to get past the blame game. We’ve got to have human compassion. There were many times when I just tried to help. Sometimes Lexi just needed a ride, or an advocate, or a coat, or a hot meal. I haven’t always written an update because, frankly, in the past four years that I’ve kept in touch with Lexi, the saddest truth is there are no immediate or satisfying answers.

Yes, she experienced childhood trauma and eventually found a way to dull the pain that led her down a difficult path that led to homelessness. No, she is not using drugs now.  Yes, she has a case manager at FIT who is trying to help her. And yes, she has some family members in the area. But no, they are not in a position to provide what Lexi needs right now.

What Lexi needs right now:

• A place where she can convalesce for as long as it takes. Not a temporary shelter bed.
• Crocs for her feet – she can’t wear shoes, at all. Previously it was just her left foot, because without toes it’s hard to keep shoes on your feet. Now, it is both her bandaged feet that need time to heal.
• Her electric wheelchair, which her family was able to get for her from the Community Caregivers Loaner Closet in Derry. It was left behind at the Beech Street shelter a month ago when Lexi was taken to the hospital to have her infected foot cleaned (which got infected again and is why she’s back in the hospital now).  The good news was she got into a bed at FIT after that previous hospitalization, rather than returning to Beech Street where she had no bed; the less good news was that when a family member inquired about the wheelchair a few weeks ago they were told the power cord was missing. As far as Lexi knows the chair is still at the Beech Street shelter and she hasn’t heard anything about the cord, or if anyone can help her get a replacement cord.
• Help printing out her CashApp records, which DHHS needs before she can qualify for the Choices for Independence Program. I’d never heard of this program, but after looking it up, it sounds like a state-run program that pays for people who should be in a nursing home to stay at home. Which sounds good for other people, but when you are Lexi and you don’t have a home to go to, I’m not clear about how this is going to solve any of her problems.

RELATED STORIES

• Nov. 19, 2020: Off they go: 22 homeless people offered a warm bed at Granite Recovery House, and the state’s picking up the tab
• Dec. 12, 2020: ‘All we need is a chance’: Couple moved from courthouse tent facing uncertainty again, as state funds dry up
• Dec. 22, 2020: Couple losing state-funded respite housing on Dec. 31 feeling stress of possible return to homelessness
• Dec. 28, 2021: Lexi and Brandon, a year later: She’s still homeless, he’s in jail
• Oct. 8, 2023: 3 years after she was swept from the courthouse homeless encampment, Lexi still struggles for survival